What is a low purine diet?

Low purine diet is an eating plan that limits foods that contain purine. Purines are a natural substance found in some foods. When your body digests purine, a waste product called uric acid is produced. A buildup of uric acid crystals in the joints can cause a type of arthritis known as gout.

Purines are found in many healthy foods. The purpose of a low-purine diet is not to completely avoid purines. Instead, the goals are to limit and monitor how much purine is in the food you eat, and to learn how your body responds when you eat different foods that contain purine.

A low purine eating plan involves making food choices to limit your intake of purine. Purine is a kind of uric acid. Too much uric acid in your blood can cause certain conditions, such as gout and kidney stones. Eating a low-purine diet can help control these conditions.

Who should follow a low purine diet?

Your family doctor may recommend that you follow a low-purine diet if you have gout  or another condition caused by high levels of uric acid (also called hyperuricemia). Following a low-purine diet may help reduce symptoms such as pain, redness and tenderness in your joints.

Our understanding of the role that eating habits play in conditions such as gout is becoming more clear as researchers learn more about these diseases. Keep in mind that dietary changes alone usually do not completely relieve gout symptoms.

Talk with your family doctor about the benefit of dietary changes. If your family doctor has prescribed medicine for your gout, keep taking it until your doctor tells you to stop.

How do I get started?

Start by learning which of the foods that you eat are high in purine. Try to avoid eating high-purine foods and limit the amount of moderate-purine foods you eat. See the chart below for some suggestions.

Avoid	Limit	Enjoy
Beer	Chicken, beef, pork and duck	At least 12 cups of fluid, such as water or fruit juice
Soft drinks that contain sugar	Crab, lobster, oysters and shrimp	Low-fat and fat-free dairy products, such as cheese and yogurt
Fatty food	Lunch meats, especially high-fat versions	Eggs (in moderation)
Organ meats, such as liver, from any animal source	Liquor	Peanut butter and nuts
Bacon, veal and venison		Rice, noodles, pasta and potatoes
Yeast		Fruits
Anchovies, sardines, herring, mussels, codfish, scallops, trout and haddock		Vegetables
Gravy		Wine (in moderation)
		Coffee (in moderation)

Different people’s bodies react differently to different foods. You will probably learn over time what foods do or do not affect you. If you discover that a food tends to cause your gout to flare up, avoid eating that food. Likewise, you can more freely enjoy foods that do not cause problems.

Losing weight can also help reduce symptoms of gout. However, it’s important not to lose weight too quickly. Fasting and rapid weight-loss diets can actually increase the amount of uric acid in your body. Also avoid low-carbohydrate diets that are high in protein and fat because foods that are high in protein and fat usually contain significant amounts of purine.

What are tips for following this plan?

Reading food labels

• Avoid foods with saturated or Trans fat.
• Check the ingredient list of grains-based foods, such as bread and cereal, to make sure that they contain whole grains.
• Check the ingredient list of sauces or soups to make sure they do not contain meat or fish.
• When choosing soft drinks, check the ingredient list to make sure they do not contain high-fructose corn syrup.

Shopping

• Buy plenty of fresh fruits and vegetables.
• Avoid buying canned or fresh fish.
• Buy dairy products labeled as low-fat or nonfat.
• Avoid buying premade or processed foods. These foods are often high in fat, salt (sodium), and added sugar.

Cooking

• Use olive oil instead of butter when cooking. Oils like olive oil, canola oil, and sunflower oil contain healthy fats.

Meal planning

• Learn which foods do or do not affect you. If you find out that a food tends to cause your gout symptoms to flare up, avoid eating that food. You can enjoy foods that do not cause problems. If you have any questions about a food item, talk with your dietitian or health care provider.
• Limit foods high in fat, especially saturated fat. Fat makes it harder for your body to get rid of uric acid.
• Choose foods that are lower in fat and are lean sources of protein.

General guidelines

• Limit alcohol intake to no more than 1 drink a day for nonpregnant women and 2 drinks a day for men. One drink equals 12 oz of beer, 5 oz of wine, or 1½ oz of hard liquor. Alcohol can affect the way your body gets rid of uric acid.
• Drink plenty of water to keep your urine clear or pale yellow. Fluids can help remove uric acid from your body.
• If directed by your health care provider, take a vitamin C supplement.
• Work with your health care provider and dietitian to develop a plan to achieve or maintain a healthy weight. Losing weight can help reduce uric acid in your blood.

What foods are recommended?

The items listed may not be a complete list. Talk with your dietitian about what dietary choices are best for you.

Foods low in purines

Foods low in purines do not need to be limited. These include:

• All fruits.
• All low-purine vegetables, pickles, and olives.
• Breads, pasta, rice, cornbread, and popcorn. Cake and other baked goods.
• All dairy foods.
• Eggs, nuts, and nut butters.
• Spices and condiments, such as salt, herbs, and vinegar.
• Plant oils, butter, and margarine.
• Water, sugar-free soft drinks, tea, coffee, and cocoa.
• Vegetable-based soups, broths, sauces, and gravies.

Foods moderate in purines

Foods moderate in purines should be limited to the amounts listed.

• ½ cup of asparagus, cauliflower, spinach, mushrooms, or green peas, each day.
• 2/3 cup uncooked oatmeal, each day.
• ¼ cup dry wheat bran or wheat germ, each day.
• 2–3 ounces of meat or poultry, each day.
• 4–6 ounces of shellfish, such as crab, lobster, oysters, or shrimp, each day.
• 1 cup cooked beans, peas, or lentils, each day.
• Soup, broths, or bouillon made from meat or fish. Limit these foods as much as possible.

What foods are not recommended?

The items listed may not be a complete list. Talk with your dietitian about what dietary choices are best for you.

Limit your intake of foods high in purines, including:

• Beer and other alcohol.
• Meat-based gravy or sauce.
• Canned or fresh fish, such as:
  • Anchovies, sardines, herring, and tuna.
  • Mussels and scallops.
  • Codfish, trout, and haddock.
• Bacon.
• Organ meats, such as:
  • Liver or kidney.
  • Tripe.
  • Sweetbreads (thymus gland or pancreas).
• Wild game or goose.
• Yeast or yeast extract supplements.
• Drinks sweetened with high-fructose corn syrup.

Summary

• Eating a low-purine diet can help control conditions caused by too much uric acid in the body, such as gout or kidney stones.
• Choose low-purine foods, limit alcohol, and limit foods high in fat.
• You will learn over time which foods do or do not affect you. If you find out that a food tends to cause your gout symptoms to flare up, avoid eating that food.