What foods should be avoided in patients with gout (hyperuricemia)?

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From the Guidelines

To manage gout effectively, it is essential to avoid foods high in purines, limit alcohol intake, and reduce consumption of high-fructose corn syrup products and sugary beverages, as recommended by the 2020 American College of Rheumatology guideline for the management of gout 1. When considering dietary changes for gout management, it is crucial to prioritize foods that can help lower uric acid levels naturally.

  • Limit or eliminate organ meats (liver, kidneys, sweetbreads), game meats, and certain seafood (anchovies, sardines, mussels, scallops, trout, tuna) to reduce purine intake.
  • Reduce alcohol consumption, especially beer, as it increases uric acid production and decreases excretion, as supported by the 2017 updated EULAR evidence-based recommendations for the management of gout 1.
  • Limit high-fructose corn syrup products and sugary beverages, as they can raise uric acid levels.
  • Stay well-hydrated with water to help flush uric acid from your system.
  • Consider increasing consumption of low-fat dairy products, cherries, which may help lower uric acid levels naturally, as suggested by the nutritional recommendations for gout: an update from clinical epidemiology 1.
  • Maintaining a healthy weight through gradual weight loss (if overweight) can also reduce gout attack frequency, as recommended by the 2020 American College of Rheumatology guideline for the management of gout 1. While medication like allopurinol or febuxostat may be prescribed by your doctor, dietary changes remain essential for long-term management, and it is essential to prioritize the most recent and highest quality study, which in this case is the 2020 American College of Rheumatology guideline for the management of gout 1.

From the Research

Foods to Avoid with Gout

There is no direct information in the provided studies about specific foods to avoid with gout. However, we can look at the general management and treatment of gout:

  • The studies focus on the comparison of allopurinol and febuxostat in treating gout and hyperuricemia, with febuxostat showing greater efficacy in some cases 2, 3, 4.
  • Gout management often involves dietary changes, but the provided studies do not specify which foods to avoid 5, 6.
  • It is known that certain foods can trigger gout attacks, but this information is not present in the given studies.

Treatment Comparison

  • Febuxostat was found to be more effective than allopurinol in achieving target serum urate levels in some studies 2, 3.
  • Allopurinol had worse persistence rates than febuxostat among patients with gout 4.
  • A study found allopurinol to be noninferior to febuxostat in controlling flares, with similar outcomes in participants with stage 3 chronic kidney disease 6.

Gout Management

  • Gout is a common form of inflammatory arthritis with an increasing prevalence in developed countries 5.
  • Guidelines recommend a therapeutic target of serum urate concentration (sUA) <6 mg/dL, or even lower (≤5 mg/dL) in patients with large deposits 2.
  • Lifelong urate-lowering therapy (ULT) with xanthine oxidase inhibitors (XOIs), such as allopurinol and febuxostat, is the cornerstone of gout treatment 4.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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