Gout Prevention

People at risk for chronic gout will want to take steps to prevent a painful attack. There are several lifestyle and dietary changes that can reduce the risk of a gout attack and joint degeneration associated with gout. When these changes are not enough to stop gout episodes from happening, a doctor may recommend allopurinol or another daily prescription medication.

This page describes gout prevention strategies and a gout prevention diet, including which foods to avoid.

Strategies for Preventing a Gout Attack

A combination of one or more of these strategies can help prevent uric acid build-up that leads to a gout attack. Doctors and patients are encouraged to talk about which prevention strategies may be the most effective and achievable.

Avoid or limit alcohol

Consuming alcohol inhibits the body’s ability to excrete uric acid, increasing the risk of hyperuricemia and a gout attack. Just one or two glasses of beer, wine, or hard liquor can increase the likelihood of a gout attack, and the risk increases with the number of drinks consumed.

Drink plenty of water

Increasing water intake will help keep the kidneys healthy and help them flush out uric acid from the body. The recommended daily intake of fluids varies depending on an individual’s age, weight, sex, and other factors.

Lose excess weight or maintain a healthy weight

Obtaining and maintaining a healthy weight through diet and exercise helps reduce the risk of gout.

Research evidence suggests that sudden, dramatic weight loss, such as after bariatric surgery, may increase the likelihood of a gout attack in the short term. In the long term, excess weight loss—sudden or gradual—is an effective way to reduce risk.

Treat sleep apnea

While more research is needed, some evidence suggests that treating sleep apnea may significantly affect the frequency of gout episodes.Treatment typically includes using a C-Pap machine or another treatment device designed to increase oxygen intake while sleeping. Increased oxygen intake may lower uric acid production and reduce the risk of a gout attack.

The primary goals of sleep apnea treatment include improving sleep quality and heart health.

Avoid foods that can trigger a gout flare-up

People who are prone to gout can prevent uric acid buildup in the bloodstream by avoiding certain foods, including seafood, red meats, organ meats, and sugary drinks and foods.

Avoid medications that trigger gout

Certain medications, such as diuretics, are associated with hyperuricemia. People who take these medications and have gout may ask their health care providers other medications or treatments approach might be appropriate.

Take prescription gout medication

A doctor may prescribe medication to reduce the amount of uric acid produced by the body. Urate lowering medication is typically recommended to people who:

• Experience more than two gout attacks per year
• Have a gout attack and also have a history of tophi or renal stones (from previous attacks)
• Have a gout attack and also have chronic kidney disease

Commonly prescribed medications include allopurinol and febuxostat. Additional or alternative medications may be prescribed depending on the patient’s circumstances.

Gout Diet

Consuming certain foods and drinks can raise uric acid levels in the blood and trigger a gout flare-up. Other food may help decrease the likelihood of a gout flare-up. Experts estimate that an appropriate gout prevention diet can reduce uric acid levels up to 15%.

Foods that may trigger a gout attack

Physicians recommend avoiding or limiting consumption of:

• Alcoholic beverages, especially beer
• Sugary foods and beverages, particularly those made with high fructose corn syrup, such as sodas
• Meat, particularly organ meat or “sweetmeats,” such as liver, and game meats
• Seafood, particularly scallops, anchovies, and herring

Alcohol increases the amount of uric acid in the blood and limits the body’s ability to process and eliminate uric acid.

Foods that may help prevent a gout attack

A gout prevention diet includes plenty of vegetables, fruits, and complex carbohydrates, including whole grains and beans. Such a diet may also include low-fat dairy products and cherries:

• Low-fat dairy products, such as skim milk and yogurt, may decrease the levels of uric acid in the blood and thereby decrease their risk of gout attacks. High-fat dairy products do not have the same protective effect.

• Cherries have long been thought to prevent gout flare-ups, and there is some scientific evidence to support this. Fresh or frozen tart cherries, 100% unsweetened tart cherry juice, or cherry extract may be beneficial. Avoid sweetened cherries, such as cherry pie filling.

Eating a healthy, plant-based diet and taking other preventative steps, such as drinking plenty of water, avoiding alcohol, and maintaining a healthy weight, can go a long way towards preventing gout, other types of arthritis, and heart disease.

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By A.Moiz