The Purine Foods Blog. Purine foods usually refers to food and drinks that are rich in purines, also known as High Purine Foods, or Purine-Rich Foods. Gout sufferers are concerned about these foods because they are a source of uric acid. But be careful. Vegetable purines do not affect gout. Also, more purines are generated by our natural cell turnover than we eat – which is why vegetarians get gout. You should read How Purine Foods Affect Gout before you study the High Purine Foods Chart.
Foods high in uric acid and purines form the conclusion of the High Purine Foods study, which is described below. This concludes the study: Purine-Rich Foods, Dairy and Protein Intake, and the Risk of Gout in Men.
This article is aimed at Gout Dieters. Specifically, gout sufferers who are actively monitoring the effects of their diet changes on their uric acid levels. Otherwise, gout sufferers interested in food should start at GoutPal Plan for Gout Foodies.
Gout Dieters should seek high-protein, low-purine foods. But, they must recognize that vegetable purines do not raise uric acid. Because not all foods high in purines can be described as foods high in uric acid.
Individual high protein foods from animals should not be omitted from your diet simply because they are high in purines. Because Gout Dieters must consider total diet and all factors that affect uric acid levels. Especially purine-rich flesh from overweight bodies.
I used to think that foods high in uric acid were the most important aspect of managing gout diet.
I first published my list of foods high in uric acid on July 22nd 2007. It took a lot of research to bring the science of purines into one list, and it’s been copied by thousands of websites around the world. At the time, after 2+ years working on this site, I knew more about gout than most people. A fraction of what I know now.
I soon learned that purine control was not as important as many people suggested. You should never ignore purines from animal flesh. But there are other factors in diet that are more important. I’ve created a better Purine Rich Foods list that focuses on foods that really matter. You can still read my original high purine foods list below. However, it is best used as a historic reference for the way we used to believe diet can affect gout. We now know that vegetable purines have no effect on gout.
Gout diet can be complicated, but do not worry.
I am here to make it easy for you to choose food that helps your gout.
Note, it’s YOUR gout diet.
Most of what you read about gout diet does not apply to you.
Gout diet must be personal.
Gout affects everyone differently, and everyone has different tastes.
I urge you to start with what you like to eat.
I will help you find ways to eat your favorite foods that make your gout better.
Everyone seems to think that gout is a disease caused by food. It is not! Your diet can affect gout, but it is only part of the story.
In these gout diet guidelines, I explain all the different ways that food can affect gout – good and bad. These are good reference pages that reflect current scientific research. But if you do not know where to start, then the best place starts with yourself. If you go to the gout forum, tell me some facts about your gout, some ideas about your favorite foods, or some of your worries about what you can eat, I will help you find the right guidelines that suit your situation. That way, you can focus on what matters to you, and safely ignore food facts that are not relevant to your gout. All you need to do is ask about your gout diet in the gout forum.
What foods are high in purines, is a common question from gout sufferers. If you want a simple answer, you should see my list of Purine Rich Foods.
In this part of the gout diet research guidelines, I review the main study into gout and high purine foods. As it is a big study, I have broken it down to separate parts. This article reviews the methods part of the High Purine Foods study. That link summarizes the report and introduces the study: Purine-Rich Foods, Dairy and Protein Intake, and the Risk of Gout in Men.
What Foods Are High In Purines? Study Methods
What Foods Are High In Purines? Study Population
The study involved health professionals aged from 40 to 75 in 1986. 49,932 men provided complete dietary, medical history, and medication information. 2782 (5.6 percent) were excluded as they had gout at the beginning, leaving 47,150 participants.
What Foods Are High In Purines? Assessment of Diet
Diets were assessed by reference to intakes of a preprepared list of over 130 food and drink items, updated twice during the course of the study. Full details of these food and drink lists are in separate studies.10-12
What Foods Are High In Purines? Assessment of Covariates
In order to get the best view of the affect of purines on the incidence of gout, it is usual in this type of statistical study to collect data on other factors. This is done to test if the trends shown in the results of the study are due to purines, or some other, confounding, factor. For this study, the authors also collected data on weight, regular medications, and medical conditions.
Ascertainment of New Cases of Gout
Where men reported new cases of gout, they were sent an additional questionnaire to validate their diagnosis of gout against criteria published by the American College of Rheumatology. Gout is considered confirmed if 6 or more from the 11 characteristics are positive:13
Hyperuricemia: Uric acid from blood test results higher than 7mg/dL (0.42 mg/dL)
Asymmetric swelling within a joint
Complete termination of an attack
The report describes various other procedures used to be as certain as possible that the reported cases were indeed gout.
What Foods Are High In Purines? Statistical Analysis
There are explanations of statistical techniques used that are beyond the scope of this summary14-16. I will confine the summary to describing the types of food included in the survey.
Food items were combined into groups to compute average daily intakes. The food groups used were:
Beef, pork, or lamb; processed meat, including sausage, salami, and bologna; bacon; hot dogs; hamburgers; poultry, including chicken and turkey; chicken liver; and beef liver
Tuna; dark fish; other fish; and shrimp, lobster, or scallops
Vegetables high in purines
Peas, beans, lentils, spinach, mushrooms, oatmeal, and cauliflower
Low-fat dairy products, including skim or low-fat milk, sherbet, low-fat yogurt, and cottage or ricotta cheese; high-fat dairy products, including whole milk, cream, butter, sour cream, ice cream, cream cheese, and other cheeses
Each food group was categorized into quintiles – a statistical process where results are ranked in order of average daily intake, and then divided into 5 groups. Statistical adjustments were applied to take account of potentially confounding variables:
The percentages of energy derived from fat and specific types of protein
Age (as a continuous variable)
Alcohol use (in seven categories)
Body-mass index (the weight in kilograms divided by the square of the height in meters, in six categories)
Rimm EB, Giovannucci EL, Stampfer MJ, Colditz GA, Litin LB, Willett WC. Reproducibility and validity of an expanded self-administered semiquantitative food frequency questionnaire among male health professionals. Am J Epidemiol 1992;135:1114-1126
Willett WC, Sampson L, Stampfer MJ, et al. Reproducibility and validity of a semiquantitative food frequency questionnaire. Am J Epidemiol 1985;122:51-65
Feskanich D, Rimm EB, Giovannucci EL, et al. Reproducibility and validity of food intake measurements from a semiquantitative food frequency questionnaire. J Am Diet Assoc 1993;93:790-796
Wallace SL, Robinson H, Masi AT, Decker JL, McCarty DJ, Yu TF. Preliminary criteria for the classification of the acute arthritis of primary gout. Arthritis Rheum 1977;20:895-900
Hu FB, Stampfer MJ, Manson JE, et al. Dietary fat intake and the risk of coronary heart disease in women. N Engl J Med 1997;337:1491-1499
Hu FB, Stampfer MJ, Manson JE, et al. Dietary protein and risk of ischemic heart disease in women. Am J Clin Nutr 1999;70:221-227
Willett W. Nutritional epidemiology. 2nd ed. New York: Oxford University Press, 1998.
Purine rich foods are often said to be the bane of every gout sufferers life.
We are often advised to avoid them completely, or reduce our purine intake.
But do our advisers really understand what they are talking about?
Gout is the only disease for which purines are important, and hundreds of different purine tables have been published. But, none of them make sense in relation to gout.
We know how purines affect gout, so publishing tables of every food that contains even the slightest trace of purines is pointless. If not pointless for reasons of completeness, it is certainly pointless for planning a gout diet. In fact, for gout diet planning, it is vital to only focus on those purines that are going to make a difference.
Scientists have known for decades that there are different kinds of purines, and that each has a different action when taken as part of your diet. This involves complicated processes that can vary from person to person, so even the best analysis of relevant purine rich foods can only produce an estimate that should be confirmed with uric acid blood tests.
Zollner’s analysis of purine metabolism suggests that xanthine and hypoxanthine are the most effective purines for increasing uric acid. I refer to these as “Gout Purines” and I have restricted the purine rich foods table to those compounds.
Recent research from Japan describes the purine content of more foods. I will use that information to extend and improve the Purine Rich Food Table below. I have started to list these foods at Is Very Low Purine Gout Diet Possible. My review of purine food charts is coming soon. Please subscribe to my update service below to get email notification when I upgrade my purine food charts.
Values are for 100g. Divide by 100 and multiply by your portion size for your diet analysis.
Figures are averages of several tests – natural products will vary, and cooking methods can affect final results.
Though this is a list of purine rich foods, many foods are not high enough to worry about. You can ignore any foods that contribute less than 50mg Uric Acid per meal. If you are not sure, please describe the ingredients of your meal in the gout forum, then I can tell you if you should ignore the purine content, or try to reduce it. If you cannot access the gout forum, please use the form at the end of this page, or click the orange Gout Support button.
Never forget that animal purines also exist in the flesh of your body. Excess flesh means more uric acid
There are other dietary problems that are worse than purines for many gout sufferers. I’ve written more about this in other pages within these gout diet guidelines
If you are serious about measuring the impact of purine rich foods in your gout diet, you must verify expected values from the tables with actual effects from your own uric acid tests.
Back in the mists of time (OK – 2005), I began my quest for food high in uric acid.
Sages spoke of the Land Of Plentiful Purines where gouties were banished to live out their days in exquisite swollen torture.
Then, came wise men from the East proclaiming that all was not as it seemed in GoutWorld…
To put it another way.
When most medics practicing today were in med school, the dietary control of gout was very simple: no high purine foods; limited medium purine foods; and unlimited low purine foods.
Then research in the 1970s and 80s began to question the simplicity of this view:
purine sources differ in their absorption rates, a fact not taken into account in our food tables.
[…] In summary it can be concluded that dietary purines are absorbed to a variable extent, depending on the degree of hydrolysis to nucleosides and/or nucleotides, and that they are oxidized to uric acid in the gut and excreted as uric acid, which is bad for gout but without influence on purine metabolism.
A low purine diet is universally recommended as a way of reducing gout attacks. GoutPal has a few more tips and a note of caution to help you manage your diet.
Do not get bogged down with Numbers. The nutrition tables that you use for your low purine diet are only a guideline. Focus on what works best for you. Always consider the total nutrition value per serving. Many tables show values for nutritional density, and often rank foods that you are only likely to eat in small quantities very badly. A small quantity of a high purine food will not normally cause a problem in isolation, but you must consider your total purine intake.
Do not get bogged down with Purines. Just because uric acid is produced from the breakdown of purines does not mean that all foods with purines are bad. You can usually enjoy variety beyond a restrictive low purine diet. There is significant evidence to suggest that vegetables do not cause problems and that dairy products can actually help reduce uric acid levels.
Water is good for gout – drink as much as you can. Opinions vary on how much is enough, but it is important to be constant. Drink water before, with and after each meal. Keep a glass of water by the bed to drink when you wake during the night because of all the water you’ve been drinking! Your urine should be clear at all times – if it isn’t drink a large glass immediately. It might take a few days to get into the habit, but it is well worth the effort.
Milk or fruit juice make useful substitutes to relieve the boredom.
Gravy is bad for you – avoid it like the plague! Many gout sufferers can tolerate moderate amounts of meat and fish in their diets, but hit problems due to sauces. The meat and fish stocks that are used in many sauces and gravies are poison to the gout sufferer. (Sauces with lower amounts of purines, especially dairy-based sauces, should not be a problem as part of a well-balanced, vegetable rich meal.)
Watch your weight. There is evidence that being overweight is a major risk factor for gout. It is certainly much easier to cope with a gout attack when you don’t have extra pounds of body weight pressing on swollen joints. But remember – Do Not Starve – if your body has no food available it will breakdown it’s own tissues, which can lead to gout.
Balance your weight with exercise. Though not a diet tip as such, it is important to consider exercise at the same time as you consider diet. Light to moderate exercise is good for the gout sufferer. Vigorous exercise can actually cause gout attacks as the body consumes it’s own purine rich tissue to supply energy.
If you are following all this advice, but still cannot seem to manage your diet, then you should seriously consider keeping a food diary and seek the advice of a nutritionist who understands gout.
If you have any tips for a low purine diet or general tips for managing gout, please share them on the gout forum.
This page (first published 15th Jan 2006) is copied from the old style GoutPal website, as part of an ongoing upgrade. Most food, drink and lifestyle advice is now contained in the Gout Diet Section.