Lifestyle Changes to Help With Gout

How to lose weight with gout

If you want to work on weight loss, aim for slow, steady progress — about 1 to 2 pounds a week. Very strict diets with fast weight loss can actually trigger a gout attack, which you want to avoid.

Try to cut back on high-energy foods like fats and added sugars. If you need more guidance, or if you follow a specific diet that makes changes harder, your doctor can refer you to a registered dietitian who can help you create a plan that fits your needs.

Eating a Low-Purine Diet

Purines are natural chemicals in your body that your cells use to make DNA and other important materials. Your body also gets purines from certain foods.

When your body breaks down purines, it produces uric acid. If you have gout, eating too many high-purine foods can raise your uric acid levels and may trigger flare-ups.

Some foods have more purines than others, so doctors usually recommend that you limit these high-purine foods:

• Organ meats, such as liver, kidney, and sweetbreads. These have very high purine levels.
• Red meat, including beef, lamb, and pork. Smaller portions are safest.
• Certain seafood, such as anchovies, sardines, and cod. Seafood has health benefits, so small amounts are fine.
• Shellfish, such as mussels and scallops, are high in purines. Shrimp, crab, lobster, and oysters have a moderate amount of purines.
• Foods high in sugar, especially products with high-fructose corn syrup. Your body produces purines when it breaks down this type of sugar. You’ll find high-fructose corn syrup in many packaged foods like cereals, baked goods, salad dressings, and canned soups. 

Here’s an example of what a day of gout-friendly eating might look like. This is just a guide — your doctor or a registered dietitian can adjust it to fit your tastes and nutritional needs.

Staying Hydrated

Staying well hydrated helps your body clear out uric acid, which is the substance that causes your joint pain. Good hydration also lowers your chance of kidney stones, which can happen when uric acid levels stay high.

What does the research show?

Research shows that water makes a real difference. In one study, people who drank at least 8 cups (a half gallon) of water a day had almost half as many gout attacks as people who drank only a glass or less.

And squeezing the fresh juice of a lemon into your water not only adds flavor, but may also significantly cut your level of uric acid. A recent study shows that benefit after drinking lemon water for six weeks.

Other liquid options

Water is best, but several other drinks are safe if you have gout:

• Low-fat milk. The proteins in dairy help your body get rid of uric acid through your urine.
• Coffee. If you enjoy your morning cup, you can keep it. People who drink coffee regularly have a lower risk of developing gout, although scientists are not as certain that coffee prevents future attacks once gout starts.
• Tea. One large study found that people who drank more than six cups of tea (either black or green) a day had a lower risk of gout, especially in those with kidney problems.

Reducing or Cutting Back on Alcohol

Beer is especially tough on your body if you have gout. It has a high purine content, which your body turns into uric acid. One study showed that alcoholic beer can raise uric acid levels by more than 6%, and even nonalcoholic beer raises it by about 4%.

Alcohol of any kind can increase your risk of a gout attack. When your body breaks down alcohol, it produces more uric acid and slows your ability to get rid of it through your kidneys.

“Alcohol has negative consequences for people with gout for several reasons,” Solomon explains. “First, alcohol can raise uric acid levels. Second, alcohol is a diuretic and dehydration can lead to gout attacks in many patients.” In fact, many patients report alcohol as a clear trigger, he says.

Alcohol can also interact with the medicines you use to control your symptoms. NSAIDs like ibuprofen or naproxen carry a higher risk of causing stomach bleeding and ulcers when you drink. Alcohol can also increase the risk of liver problems when you take medicines like acetaminophen, leflunomide, or methotrexate.

“Alcohol is generally considered risky in patients with gout,” Solomon says, “but some patients with gout may be able to tolerate small amounts.” The limit on any given day is about 12 ounces of beer (a regular-size can), 5 ounces of wine (a glass), or 1.5 ounces of spirits (a shot).

During a gout attack, it’s best to avoid alcohol entirely.

Exercising Regularly

“Exercise is generally good for the joints, bones, and muscles,” Solomon says. Research shows that regular low- to moderate-intensity exercise can help lower uric acid levels.

Exercise also helps you avoid excess weight and other health conditions that increase your risk of gout.

Solomon suggests cardiovascular exercise (also known as “cardio” or aerobic exercise) to support weight loss.

How to skip the injuries

To avoid joint injuries, which can make gout symptoms worse, choose moderate-intensity, low-impact exercises — like walking, swimming, or biking. These activities don't twist or put too much stress on your joints.

Aim for at least 150 minutes each week of moderate physical activity. At a moderate level, your heart beats faster and your breathing becomes deeper, but you are not completely exhausted.

It’s very important to stay well hydrated when you exercise, Solomon says. This helps prevent dehydration, which can trigger a gout flare-up.

Treating Your Other Medical Conditions

Obesity, diabetes, and kidney disease are all linked to gout, and each of them can make the condition worse, says Solomon.

Extra weight can also increase inflammation in the body, raise uric acid levels, and put extra pressure on your joints. When your kidneys don’t clear uric acid as well — something that happens in kidney disease and sometimes in diabetes — your uric acid level can rise.

Certain medicines, like diuretics, can cause dehydration, notes Solomon, and this can trigger a gout attack or make your symptoms worse. If you have any other medical conditions, such as heart disease, talk with your doctor about the best way to manage them.

Find support

The Gout Support Group of America is a patient-led nonprofit organization that provides support for people living with gout.

The Arthritis Foundation supports all patients with arthritis, including gout.

Keep in mind, any step you take helps. Even if you do not make every change, the changes you do make can still lower your uric acid and reduce your risk of gout flare-ups.