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.
That was from Zöllner in 1985, who concludes:
Supplements of dietary purines produce dose-proportional increases in plasma uric acid concentrations, uric acid pool size and renal uric acid excretion. The magnitude of these increases depends on the type of purine compound administered, which may limit the value of food tables for human dietetics. Purine content of food must be related not only to weight but also to energy and to protein, particularly if new foodstuffs or a vegetarian diet are ingested.
It is worth noting at this point, that foods never contain uric acid. Many do contain purines, which are a source of uric acid, but as Zöllner points out, there are different type of purine, and they metabolize to uric acid at different rates. He also points out that we do not really need to digest purines for uric acid, as we can make our own by reprocessing dead cells.
A turning point in our understanding of food high in uric acid came about in 2004. Choi and colleagues compiled statistics from a 12 year study of over 40,000 men. Though this statistical review adds nothing to our knowledge of how different purines affect gout in different ways, it certainly changed the way gout experts view diet.
Their conclusions set the foundation for today’s more effective gout diet plans:
Higher levels of meat and seafood consumption are associated with an increased risk of gout, whereas a higher level of consumption of dairy products is associated with a decreased risk. Moderate intake of purine-rich vegetables or protein is not associated with an increased risk of gout.
Though not the total story, as they do not factor in risks such as obesity and excess iron, those words should be tattooed on the hearts of all gout nutritionists. My simple view of purine control is to balance small portions (up to 4 oz) of meat or fish with low-fat dairy products. Fill the plate with whatever vegetable foods you enjoy. Simple and effective.
Finally, though we can see that some form of purine control may help gout, it is absolutely pointless to attempt this if you do not monitor your uric acid numbers. There is no correlation between gout pain and purines. You might still experience gout pain when uric acid is lowering because old urate crystals can cause a gout reaction before they dissolve completely. Make sure that you know and understand your uric acid level.
Food High In Uric Acid References
- Author: Zöllner N . Title: Purine and pyrimidine metabolism. Published: Sep 1985.
- Authors: Hyon K. Choi, M.D., Dr.P.H., Karen Atkinson, M.D., M.P.H., Elizabeth W. Karlson, M.D., Walter Willett, M.D., Dr.P.H., and Gary Curhan, M.D., Sc.D. Title: Purine-Rich Foods, Dairy and Protein Intake, and the Risk of Gout in Men. Published: March 2004.
What do you think about this page?
Did this page help you? If yes, please consider a small donation. Your donations help keep GoutPal's gout support services free for everyone. Please click to donate:
If not, please tell me how I can improve it to help you more.
Please note that my Feedback Form does not yet work on the current version of this website. So please send your feedback: