Diets that are high in purines and high in protein have long been suspected of causing an increased risk of gout -- a type of arthritis caused by high levels of uric acid in the body. Excessive uric acid can form crystals in the joints, causing pain and inflammation). Results from a study led by Dr. Hyon K. Choi, reported in the March 11, 2004 issue of The New England Journal of Medicine, offer an interesting twist.
About the Study
Choi's research team followed 47,150 men with no prior history of gout over a 12-year period. During that time, 730 men were diagnosed with gout. Study participants who consumed the highest amount of meat were 40 percent more likely to have gout than those who ate the least amount of meat. Study participants who ate the most seafood were 50 percent more likely to have gout.
In this specific study, though, not all purine-rich foods were associated with an increased risk of gout. There was no increased risk associated with a diet that included:
- peas
- beans
- mushrooms
- cauliflower
- spinach
These foods are considered high in purines. Choi's team also found that low-fat dairy products decrease the risk of gout, and overall protein intake had no effect. Ultimately, diets shown to be connected to gout are the same kinds of diet linked to cardiovascular disease.
Recommendations for Seafood Should Be Individualized
At this point, it may seem things are getting confusing. Isn't seafood typically recommended as part of a diet which is healthy for the heart? Yet research has revealed that there is a strong, undeniable link between seafood and gout. How does Choi reconcile what seems like conflicting information? He believes "recommendations for seafood should be individualized."
Sorting Out the Myths
More importantly, how does a person begin to sort the myths from the facts and decide what to buy at the grocery store? According to the University of Washington, Department of Orthopedics:
- Obesity can be linked to high uric acid levels in the blood. People who are overweight should consult with their doctor to decide on a reasonable weight-loss program. Fasting or severe dieting can actually raise uric acid levels and cause gout to worsen.
- Usually people can eat what they like within limits. People who have kidney stones due to uric acid may need to actually eliminate purine-rich foods from their diet because those foods can raise their uric acid level.
- Consuming coffee and tea is not a problem, but alcohol can raise uric acid levels and provoke an episode of gout. Drinking at least 10 to 12 eight-ounce glasses of non-alcoholic fluids every day is recommended, especially for people with kidney stones, to help flush the uric acid crystals from the body.
Foods That Are Higher in Purines
Johns Hopkins lists the following foods as being higher in purines:
- hearts
- herring
- mussels
- yeast
- smelt
- sardines
- sweetbreads
Foods Moderately High in Purines
- anchovies
- grouse
- mutton
- veal
- bacon
- liver
- salmon
- turkey
- kidneys
- partridge
- trout
- goose
- haddock
- pheasant
- scallops
Gout Medications
Mayo Clinic experts suggest that medications for gout have reduced the need for dietary restrictions, but some modifications can decrease the severity or frequency of gout attacks. Dietary modification may also be preferred by people who cannot tolerate gout medications.
Sources:
Purine-Rich Foods, Dairy and Protein Intake, and the Risk of Gout in Men, The New England Journal of Medicine Volume 350:1093-1103, March 11, 2004
Gout by Alan Matsumoto, M.D., Johns Hopkins Arthritis; Gout, University of Washington, Department of Orthopedics
