Gout is a type of arthritis that causes sudden, severe joint pain, and it is caused by having too much uric acid in the blood (NHS). The NHS advice for preventing attacks includes eating a healthy diet, and notes that your doctor may give you a list of foods to include or limit. This article walks through what the research says about each part of the plate, and where a few dates fit at the end of the meal.
This article is general information, not medical advice. If you have gout, follow the food list and treatment your own doctor gives you.
What the 2020 gout guideline says about food
The American College of Rheumatology guideline conditionally recommends that people with gout limit alcohol, limit purine intake and limit high-fructose corn syrup, and that those who are overweight follow a weight-loss programme (FitzGerald et al., 2020). It rated the evidence for these as low or very low certainty. The panel looked at cherries, cherry extract and dairy protein too, and found the evidence too weak for any specific recommendation. The NHS gives similar advice: lose weight if you are overweight, but avoid crash diets.
Vitamin C is where sources differ. The NHS says to ask a GP about vitamin C supplements. The ACR guideline conditionally recommends against adding them, after two small trials of 29 and 40 patients showed clinically insignificant changes in uric acid. Ask your own doctor before buying any.
Protein on the plate
In a case-crossover study of 633 people with gout, the highest fifth of purine intake over a 2-day period carried 4.76 times the odds of a gout attack compared with the lowest fifth (Zhang et al., 2012). Split by source, the top fifth of animal purine had odds of 2.41 and the top fifth of plant purine 1.39. The authors concluded that cutting back on purine-rich foods, especially of animal origin, may help reduce attacks.
Their high-purine list was broad: meats, organ meats, meat extracts and gravies, seafood, beans, peas, lentils, oatmeal, spinach, asparagus, mushroom, yeast, beer and other alcoholic drinks. Legumes are on it. Even so, the same authors wrote that plant foods, especially nuts and legumes, should be the preferred protein sources for people with gout. A dhal or a bean dish in place of a second meat dish fits that advice.
Vegetables and other plant foods
Spinach and mushrooms are on that purine list too. In the full paper, Zhang and colleagues report that the short-term effect of plant purine on gout attacks was substantially smaller than that of animal purine. They also cite a large study in which habitual eating of purine-rich vegetables was not associated with the risk of developing gout. That leaves plenty of room for vegetables on the plate.
What to drink with the meal
A 12-year study of 46,393 men with no history of gout recorded 755 new cases (Choi and Curhan, 2008). Compared with less than one sugar-sweetened soft drink a month, two or more a day carried a relative risk of 1.85, while diet soft drinks were not linked with gout. Total fruit juice and fructose-rich fruits such as apples and oranges were also linked with a higher risk.
The NHS adds plenty of fluids to avoid dehydration, some alcohol-free days each week and no more than 14 units of alcohol a week. Water with the meal covers the fluids point and takes the place of a sugary drink.
The sweet finish, sized right
Dates are a fructose-rich fruit. USDA FoodData Central lists 32.0 g of fructose per 100 g of Medjool dates and 19.6 g per 100 g of Deglet Noor dates. No study cited here tested dates directly, so there is no evidence that dates cause gout attacks or prevent them.
Portion and timing are what you can control. The NHS 5 A Day page counts a 30 g portion of dried fruit, dates included, as one of your 5 A Day, and says it should be eaten at mealtimes, not as a snack between meals, to reduce the impact on teeth (NHS). So keep dates for the end of a meal, weigh out 30 g once to learn the size, and count them alongside any juice or other fruit that day.
Stocking a kitchen that runs on this
Buying dates, nuts and legumes wholesale only helps if the portions stay small, so split large bags into meal-sized amounts at home.
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References
- NHS. Gout. https://www.nhs.uk/conditions/gout/
- NHS. 5 A Day: what counts? https://www.nhs.uk/live-well/eat-well/5-a-day/5-a-day-what-counts/
- FitzGerald JD, et al. 2020 American College of Rheumatology Guideline for the Management of Gout. Arthritis Care Res (Hoboken). 2020;72(6):744-760. PMID 32391934
- Zhang Y, et al. Purine-rich foods intake and recurrent gout attacks. Ann Rheum Dis. 2012;71(9):1448-53. PMID 22648933
- Choi HK, Curhan G. Soft drinks, fructose consumption, and the risk of gout in men: prospective cohort study. BMJ. 2008;336(7639):309-12. PMID 18244959
- USDA FoodData Central (SR Legacy). Dates, medjool, FDC 168191. https://fdc.nal.usda.gov/food-details/168191/nutrients
- USDA FoodData Central (SR Legacy). Dates, deglet noor, FDC 171726. https://fdc.nal.usda.gov/food-details/171726/nutrients