Purines are found in many foods, and at different levels. They are metabolized (broken down) into uric acid, a waste product that is usually excreted with urine. If there is too much uric acid in the blood, people can develop a condition called hyperuricemia. Hyperuricemia is the precursor to gout, which is a rheumatic disease where excess uric acid develops into small, needle-like crystals in the soft tissues and joints. Hyperuricemia can occur if the kidneys are not properly excreting uric acid, but can also arise from over-consumption of purine-rich foods. What Is the Link Between Purines and Gout? Studies examining the relationship between diet and gout show that people who consume a lot of certain types of meat or seafood are more likely to have this medical condition. Calvin Brown, MD, professor of medicine in the division of rheumatology at Northwestern University says that “one of the ways which the body will have too much uric acid is if it’s breaking down foods that are very rich in the precursors to uric acid.” “In the days of the Middle Ages and the Renaissance, the very wealthy kings and nobility had quite a taste for organ meats … and hence were quite commonly affected with gout," Dr. Brown explains. Due to changes in diet, “gout due to excess [food] is actually quite rare.” Gout Treatment: What Foods Are High in Purines? It is recommended that people diagnosed with gout follow a diet that does not include the following purine-rich foods:
Seafood: Although it is recommended that a healthy diet includes a lot of fish, people who have gout should be aware that some seafood can increase levels of uric acid in the blood, and may make gout worse.High purine content: Anchovies, codfish, haddock, herring, mackerel, mussels, sardines, scallops, troutMedium purine content: Crab, lobster, oysters, shrimp.Meat: Though no longer part of a common diet in the United States, organ meats, such as liver, sweetbreads, and brains, are most dangerous for those with gout.High purine content: Bacon, turkey, veal, venisonMedium purine content: Beef, chicken, duck, ham, porkVegetables: Studies do not show an association between high-purine vegetables and gout to the same degree as with animal-based purines, suggesting other factors than purine content also play a role. However, there are some beans that are particularly high in purines, so people with severe gout may want to avoid them.Purine-rich vegetables: Asparagus, dried beans (especially fava and garbanzo), mushrooms, peas, spinach
Gout Treatment: Alcohol and Purines “In this day and age the most common [route to gout] is certain alcoholic beverages," Brown says. Beer and liquor (but not wine) lead to increased blood uric acid levels. The strongest evidence for a connection is with beer, possibly because it contains the highest amounts of purines, which come from its malt content. “To avoid gout, avoid stout,” he adds. Gout Treatment: What Can a Low-Purine Diet Do? In healthy individuals, it has been shown that a purine-free diet can reduce the levels of uric acid in the blood, and in a study that put participants on either a low-purine diet, a medication often prescribed for those with gout, or a combination of both, the diet led to similar reductions in uric acid levels as the medication. Because of these factors, it is thought that a diet low in purines may help ease the symptoms and halt the development of gout. Organizations including the National Institute of Arthritis and Musculoskeletal and Skin Diseases recommend avoiding foods that have a high purine content, along with beer. It is important to note that using diet as a means to help control hyperuricemia and gout should only be done after consultation with a medical professional. Never discontinue any medications for gout without talking to your doctor first.
