From the Guidelines
A diet for gout patients should focus on limiting alcohol intake, purine intake, and high-fructose corn syrup, while maintaining good nutrition, as recommended by the 2020 American College of Rheumatology guideline for the management of gout 1. The key components of this dietary approach include:
- Limiting high-purine foods like organ meats, game meats, certain seafood, and alcoholic beverages, especially beer
- Emphasizing low-fat dairy products, complex carbohydrates, fruits, vegetables, and adequate water intake
- Moderate protein consumption, favoring plant proteins and low-fat animal sources
- Weight loss, if overweight, to reduce uric acid levels and gout attacks This approach is supported by the 2020 American College of Rheumatology guideline, which conditionally recommends limiting alcohol intake, purine intake, and high-fructose corn syrup for patients with gout, regardless of disease activity 1. Additionally, the 2017 EULAR evidence-based recommendations for the management of gout suggest that every person with gout should receive advice regarding lifestyle, including weight loss if appropriate, avoidance of alcohol and sugar-sweetened drinks, and encouragement of low-fat dairy products 1. It is also important to note that the 2018 nutritional recommendations for gout suggest that evidence-based research is needed to support nutritional recommendations, and that weight loss for overweight gout patients has low to moderate quality of evidence 1. Overall, the dietary approach for gout patients should prioritize limiting alcohol intake, purine intake, and high-fructose corn syrup, while maintaining good nutrition, and should be individualized based on the patient's specific needs and health status.
From the FDA Drug Label
A liberal fluid intake is recommended, as well as sufficient sodium bicarbonate (3 to 7. 5 g daily ), or potassium citrate (7.5 g daily) to maintain an alkaline urine A fluid intake sufficient to yield a daily urinary output of at least 2 liters and the maintenance of a neutral or, preferably, slightly alkaline urine are desirable
The recommended diet for gout patients includes:
- A liberal fluid intake to yield a daily urinary output of at least 2 liters
- Alkalization of the urine with sufficient sodium bicarbonate (3 to 7.5 g daily) or potassium citrate (7.5 g daily)
- Maintenance of a neutral or slightly alkaline urine 2 3
- No specific purine-producing foods restriction is mentioned in the labels, but it is recommended to restrict purine-producing foods somewhat after the serum urate level returns to normal limits and tophaceous deposits disappear 3
From the Research
Diet for Gout Patients
There is no direct information on diet for gout patients in the provided studies. However, the studies discuss various treatments and therapies for gout, including urate-lowering medications and lifestyle modifications.
Treatment Options
- Urate-lowering therapies aim to prevent gout flares, with an emphasis on treat-to-target strategy; the escalation of therapies until the target serum uric acid is reached 4.
- Initial treatments include allopurinol and febuxostat, with uricosuric agents, probenecid, sulfinpyrazone and benzbromarone, as adjuncts 4.
- Standard pharmacotherapies for gout flares include the options of colchicine, NSAIDs and oral or intramuscular corticosteroids, with IL-1 inhibitors newly established as an option for flare refractory to standard therapies 4.
Medication Comparison
- Febuxostat can play a major role in the treatment of hyperuricaemia and gout, with an advantage over allopurinol in patients with renal dysfunction 5.
- Allopurinol is an agent of first choice for urate lowering therapy, but screening for HLA*B58:01 mutation is recommended in Southeast Asian and Black populations to decrease the occurrence of allopurinol hypersensitivity syndrome 6.