There are unexpected foods and lifestyle habits that can aggravate gout. While it's well-known that alcohol and organ meats should be avoided when suffering from gout, it's less widely known that non-alcoholic beverages, fructose, and protein can also negatively impact gout.

Furthermore, weight management is crucial for gout, yet rapidly losing weight can actually be a factor that worsens gout.

Professor Kim Hyung-duk of the Nephrology Department at the Catholic University of Korea's Eunpyeong St. Mary's Hospital pointed out on the Korean Society of Nephrology's YouTube channel that the cause of gout is uric acid, which is produced when purines are metabolized. “Therefore, if foods contain high levels of purines, uric acid levels will inevitably rise no matter how good the medication or how well weight is managed,” he said.

The high-purine foods that gout patients should avoid are actually well-known.

“Among foods notoriously high in purines, alcohol is a prime example. It's widely known that beer, in particular, has a high purine content and should be avoided,” Professor Kim said. “Are other alcoholic beverages like wine or whiskey okay?’ Unfortunately, the answer is no.” Kim emphasized that gout patients should avoid all alcoholic beverages.

Why? “The alcohol itself in alcoholic beverages inhibits the excretion of uric acid through urine and promotes the synthesis of uric acid from purines within the body. Therefore, gout patients need to avoid all types of alcoholic beverages, not just beer,” Professor Kim explained. “Surprisingly, this includes carbonated beverages with very little alcohol, such as non-alcoholic beer.”

might non-alcoholic beer be problematic? “While non-alcoholic beer, often called ‘zero beer,’ has lower purine content than regular beer, it still contains significantly more purines than plain water or other beverages. Gout patients should steer clear of all alcoholic beverages,” Kim noted.

Carbonated drinks are also not good for gout patients. Professor Kim said, “Carbonated drinks also contain very high levels of purines and can elevate uric acid levels.”

It is also well-known that among seafood, anchovies, shrimp, dried fish, oily fish, and fish roe are particularly high in purines and are representative foods gout patients should avoid. Among meats, organ meats are especially rich in purines and require caution.

However, uric acid levels can unexpectedly rise from other foods. According to Professor Kim, one prime example is fructose. Consuming large amounts of fructose requires significant energy to break it down in the body. During this energy-depleting process, purines are produced. This leads to elevated uric acid levels in gout patients, making it necessary for them to avoid excessive fructose intake as well.

Another often overlooked factor is protein. Professor Kim said, “Recently, riding the fitness craze, many people are exercising intensely to build muscle and consuming protein in the form of supplements. When animal protein is consumed excessively, the resulting acidic substances from animal protein can overwhelm the body, inhibiting the excretion of uric acid through urine.”

Among lifestyle habits, excessive weight loss is also detrimental to gout. “Obesity can be a cause of gout and also a factor that makes gout management difficult. For those who are overweight or obese, weight reduction is important. However, it's crucial to remember that too rapid weight loss can actually increase uric acid levels and trigger an acute flare-up of gout,” Kim explained.

To prevent gout flare-ups, it is recommended to manage weight gradually, aiming for a loss of about 0.5 to 1 kg per week. There are also healthy lifestyle habits recommended for individuals with gout. Adequate hydration is one of them. “Dehydration inevitably reduces the excretion of uric acid through the glomeruli, which can be a factor in triggering gout or worsening gout symptoms,” he said.

Certain foods are also recommended for individuals with gout. Professor Kim Hyung-deok advised, “The most representative are berry-type foods rich in antioxidant effects. Additionally, consuming probiotics, such as yogurt, eggs, and dairy products like milk, as well as eating a variety of vegetables, is also beneficial. Whole-grain bread made with various grains can also be beneficial.”

Professor Kim further explained, "The diet needed for gout patients involves avoiding overeating and consuming appropriate calories to maintain a healthy weight. It should be balanced in carbohydrates, protein, and fat. Carbohydrate intake should be slightly reduced if possible, and fructose consumption should be minimized as much as possible. For fats, unsaturated fats are preferable. For proteins, it's essential to balance animal proteins with plant-based proteins to prevent excessive intake of animal protein. This balanced approach can effectively prevent gout through a healthy diet."