How do dietary purines influence gout?

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    Last Updated: October 25, 2023

    A frequent piece of advice for gout is a purine-restricted diet, as purines from the diet are broken down into uric acid and high purine meals tend to increase uric acid levels.[1][2] Purine rich foods include meat (particularly organ meat), fish, and shellfish. Exactly how much purine restriction can lower uric acid levels may depend on baseline purine intake and degree of restriction and unfortunately there is limited well-conducted research on the topic. One study on people with hyperuricemia reported a 0.57 mg/dL drop in uric acid after 2 weeks on a low purine diet, however this study lacked a control group.[3]

    To make matters more complicated, there are several types of purines and some evidence indicates they are not all equal in their effects on uric acid levels.[4] Because the amount of each purine type varies between foods, this means two foods might differ in their effect on uric acid even when purine levels are the same. One study, for example, found that the increase in uric acid 2-hours after eating a meal with either haddock (+0.34 mg/dL) or soybeans (+0.32 mg/dL) was greater than after a meal with beef liver (+0.15 mg/dL), despite a similar purine content between the three meals.[1]

    Average purine content of food groups

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    Adapted from Wu et al. J Food Compost Anal. 2019 Dec[5]

    References

    1. ^D Brulé, G Sarwar, L SavoieChanges in serum and urinary uric acid levels in normal human subjects fed purine-rich foods containing different amounts of adenine and hypoxanthineJ Am Coll Nutr.(1992 Jun)
    2. ^Mariana O C Coelho, Alistair J Monteyne, Ishara D Kamalanathan, Vesna Najdanovic-Visak, Tim J A Finnigan, Francis B Stephens, Benjamin T WallShort-Communication: Ingestion of a Nucleotide-Rich Mixed Meal Increases Serum Uric Acid Concentrations but Does Not Affect Postprandial Blood Glucose or Serum Insulin Responses in Young AdultsNutrients.(2020 Apr 17)
    3. ^Fernando Cardona, Francisco J Tinahones, Eduardo Collantes, Eduardo Garcia-Fuentes, Alejandro Escudero, Federico SoriguerResponse to a urate-lowering diet according to polymorphisms in the apolipoprotein AI-CIII-AIV clusterJ Rheumatol.(2005 May)
    4. ^G Sarwar, D BruléAssessment of the uricogenic potential of processed foods based on the nature and quantity of dietary purinesProg Food Nutr Sci.(1991)
    5. ^