A low-purine diet is often prescribed for people with gout and Lesch-Nyhan Syndrome (a rare genetic disorder
that occurs in 1 out of 100,000 people). People with diabetic nephropathy need to restrict
proteins, a regimen that includes, but is not limited to, the restrictions imposed by a
low-purine diet.
Completely avoid very-high-purine foods such as anchovies, broth, and dried legumes.
Eat very little high-purine foods such as some fish, poultry, or meat.
Eat modest amounts of moderately high-purine foods such as oatmeal, soy, and spinach.
Consult a healthcare professional before you make major changes to your diet. Avoiding
foods high in purines can lead to a very-low-protein diet if you don’t substitute
appropriately.
Best bets: Cereals, eggs, cheese, fruit, nuts, milk, and many vegetables
Why do people follow this diet?
In people who have gout, uric acid production in the body is increased while its
elimination is reduced. The excess uric acid builds up in the bloodstream, is deposited in the
small joints or soft tissues, and causes symptoms that resemble arthritis. Purines are
compounds that are mainly found in animal protein and are metabolized to uric acid in the
body. A high-purine diet, obesity, regular
alcohol consumption, and diuretic therapy can
all contribute to elevated uric acid levels in individuals with gout. Preliminary research
suggests that insulin resistance may also play a role in the development of gout. A low-purine
diet and medications—such as nonsteroidal
anti-inflammatory drugs, corticosteroids,
and allopurinol—are commonly used to
treat gout. An effective diet is important in avoiding or reducing complications and lessening
the expense of drug treatment. Restricting calorie intake and alcohol consumption, and losing
weight (if overweight), can also reduce uric acid levels. It is important to drink plenty of
fluids to increase uric acid excretion from the body. Alternative sources of protein should be
included in a low-purine diet.
What do I need to avoid?
To avoid purines ask about ingredients at restaurants and others’ homes, and read
food labels. The following list is not complete. Consult with a healthcare professional before
making any significant changes to your diet.
The following foods have very high purine levels, and should
be avoided completely:
National Institute of Arthritis and Musculoskeletal and Skin
Diseases
www.nih.gov/niams
Arthritis Foundation
www.arthritis.org
The Purine Metabolic Patients Association
www.pumpa.org
Bibliography
Dessein PH, Shipton EA, Stanwix AE, et al. Beneficial effects of
weight loss associated with moderate calorie/carbohydrate restriction, and increased
proportional intake of protein and unsaturated fat on serum urate and lipoprotein levels in
gout: a pilot study. Ann Rheum Dis. 2000;59:539–43.
Emmerson BT. The management of gout. N Engl J Med
1996;334:445–51.
The information presented in the Food Guide is for informational purposes
only and was created by a team of US–registered dietitians and food experts. Consult
your doctor, practitioner, and/or pharmacist for any health problem and before using any
supplements, making dietary changes, or before making any changes in prescribed medications.
Information expires June 2009.
