While maintaining a healthy diet and lifestyle is important for managing the complications of gout, there is limited evidence that changing your diet can lower uric acid levels in the blood. This is because the majority of uric acid is produced naturally by the body rather than from the diet, and so dietary changes alone are often insufficient to control this lifelong condition. Long-term urate-lowering therapies (ULT), such as allopurinol, are typically required to prevent recurrent attacks. Without treatment, gout can lead to complications, including disability. See our information on treatments for gout for more details.

If you have gout, maintaining a healthy, balanced diet is important for preventing complications that can associate with gout. Your diet should include a variety of foods from the main food groups:

• Fruits and Vegetables: aim for at least 5-a-day.
• Whole Grains: opt for wholemeal bread, cereals, and potatoes with their skins.
• Moderate Protein: combine both animal and plant-based proteins. Limit your intake of high-purine foods (see below) where possible.
• Dairy Products: Include 3 portions of low-fat dairy daily (e.g. skimmed milk, yogurt, or cheese). NB: there is some evidence that skimmed milk can lower your blood uric acid levels slightly.

Purines are natural substances found in your body and in many foods. When they break down, they form uric acid.

• High-Purine Foods (Limit your intake): Offal (e.g. liver, kidneys), oily fish (e.g. mackerel, sardines), shellfish, game meats, meat extracts (Marmite, Bovril), beer and other types of alcohol e.g. spirits. NB: Although not high in purines, sugar-sweetened, ultra-processed food and drinks (including processed fruit juices, fizzy drinks) increase uric acid and should be avoided.
• Moderate-Purine Foods (Eat in moderation): Red meats (beef, lamb), poultry, mushrooms, legumes (beans, lentils), whole grains, and some vegetables (asparagus, cauliflower, spinach). NB: Often a ‘moderate’ amount refers to a ‘portion size’. A portion size of animal protein such as meat/meat products is equivalent to 85g (raw weight) or the size of a palm.
• Low-Purine Foods (Safe to eat): Low fat dairy (milk, cheese, yogurt), eggs, pasta, rice, most fruits and vegetables. NB: If you have diabetes, you may be advised to avoid certain fruits or fruit juices due to higher sugar content. Always check with your health professional.

Maintaining a healthy weight is important. In people who are overweight or obese, reducing your weight can:

• Reduce uric acid levels in the blood.
• Decrease the frequency of gout attacks.
• Relieve stress on weight-bearing joints (e.g. knees and ankles).

Focus on gradual weight loss with a combination of healthy eating and regular physical activity. Avoid crash dieting where possible, as rapid weight loss can trigger gout attacks.

• Vitamin C: Some research shows that diets high in vitamin C may reduce uric acid levels. Citrus fruits (oranges, limes etc.), peppers, and green vegetables are excellent sources of vitamin C.
• Cherries: Some studies have shown that sour cherries, or their juice, may reduce uric acid levels and inflammation due to their flavonoid content.

Recently, the DASH (Dietary Approaches to Stop Hypertension) Diet has been found to lower blood urate levels (https://pmc.ncbi.nlm.nih.gov/articles/PMC8169522/). The DASH Diet involves eating vegetables, fruits, and whole grains including fat-free or low-fat dairy products, fish, poultry, beans, nuts, and essential fatty acids like olive oil. Limiting foods that are high in saturated fat, such as fatty meats, full-fat dairy products, and saturated fats such as coconut, palm kernel, and palm oils. Also limit the use of sugar-sweetened beverages and sweets. For more information about the DASH Diet visit: https://www.bhf.org.uk/informationsupport/heart-matters-magazine/nutrition/foods-that-lower-blood-pressure/dash-diet

Alcohol inhibits uric acid removal by the kidneys, and so all forms of alcohol can increase uric acids levels and bring on gout attacks. Additionally, some alcoholic drinks (e.g. beer) have high levels of purine in them, which can be broken down into uric acid. Binge drinking can trigger gout attacks in some people. Your intake of alcoholic drinks some remain within recommended limits and try to avoid drinks that worsen your gout attacks. Some research has also shown that non-alcoholic beer can still raise uric acid levels, as they also contain purines.

NB: Almost a quarter (24%) of adults in England and Scotland regularly drink at levels which increase their risk of ill health. The UK’s Chief Medical Officer recommends that, to keep the risk from alcohol low, adults should not drink more than 14 units of alcohol per week. One unit of alcohol equals half a pint of standard beer, lager or cider, half a glass of wine, or one measure of spirits. There is no ‘safe’ alcohol limit.  For more details on alcohol and health, visit:  https://www.gov.uk/government/publications/delivering-better-oral-health-an-evidence-based-toolkit-for-prevention/chapter-12-alcohol#:~:text=Alcohol%20and%20Health

Managing your gout requires a comprehensive approach:

• Understand that diet alone is not enough—long-term urate-lowering therapy is essential.
• Focus on maintaining a healthy, balanced diet.
• Incorporate regular physical activity (when not experiencing a gout attack) and maintain a healthy weight.