People who have trouble metabolizing purines, such as people diagnosed with hyperuricemia or gout, are advised to limit consumption of high-purine foods and drinks. Purines are found in the cells of all living things, including humans, animals, and plants, so there is no way to eliminate them from a diet.

Purines, a common chemical compound found in foods and drinks, are metabolized by the body and turned into uric acid. Uric acid is then filtered out of the bloodstream by the kidneys. If excess uric acid builds up in the bloodstream, it can lead to the formation of uric acid crystals in one or more joints, resulting in gout. Read All About Gout - Symptoms, Diagnosis, Treatment

Purines in the Body and Food

Purines are molecules made up of carbon and nitrogen atoms, and these molecules are found in cells’ DNA and RNA. In the human body, purines can be divided into two categories:

1. Endogenous purines

About 2/3 of purines in the body are endogenous.1 These purines are produced by the human body and found inside its cells. A body’s cells are in a constant state of death and renewal,2 and the endogenous purines from damaged, dying, or dead cells must be processed by the body.

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2. Exogenous purines

Purines that enter the body via food are called exogenous purines. These purines are metabolized by the body as part of the digestive process.

When endogenous and exogenous purines are processed in the body, they create a byproduct called uric acid. Normally, about 90% of uric acid is reabsorbed into the body, and the rest is excreted in the urine and feces.3

Purines and Hyperuricemia

If the amount of purines in the body is out of balance with the body’s ability to process them, too much uric acid can build up in the body’s bloodstream. This condition is called hyperuricemia.

In some people, hyperuricemia can cause kidney stones or lead to an inflammatory joint condition called gout. Many other people with hyperuricemia have no signs or symptoms—doctors call this condition asymptomatic hyperuricemia.

Read more: All About Gout - Symptoms, Diagnosis, Treatment

People with hyperuricemia (either symptomatic or asymptomatic) are advised to avoid eating foods that have high purine concentrations and encouraged to eat a whole foods, plant-based diet.

In This Article:

Avoid High-Purine Foods

While all plants and meats contain purines, certain foods contain higher concentrations. In addition, certain other foods may affect the body’s production and metabolism of purines.

Foods that should be avoided on a low-purine diet include4:

  • Sugary foods and beverages, particularly those made with high fructose corn syrup, such as sodas5
  • Seafood, particularly scallops, anchovies, and herring6
  • Meat, particularly organ meat or “sweetmeats,” such as liver, and game meats6
  • Alcoholic beverages, especially beer

In addition to raising uric acid levels, alcohol can inhibit the body’s ability to process and eliminate uric acid,7 so people with gout are advised to avoid alcohol or drink in moderation.

Limiting the consumption of these foods and drinks may help treat hyperuricemia and reduce the risk of gout flare-ups.

See Gout Prevention Diet

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Eat a Healthy Diet

Just about everyone can benefit from eating a whole-foods, plant-based diet that emphasizes vegetables, fruits, nuts, legumes, and whole grains.

Infographic displaying which foods to avoid, moderate, or enjoy to balance purines.
Balancing Your Purines
(larger view)

Special dietary considerations for gout

People who are diagnosed with hyperuricemia are encouraged to eat a healthy diet and consider the following:

  • Moderate consumption of vegetables known to be high in purines, such as peas, asparagus, and oatmeal, does not seem to raise uric acid levels in the blood.8 Researchers suggest this variation may be due to their high fiber content.7
  • Low fat or no-fat dairy products7,9 are low in purines and have an inverse relationship with hyperuricemia. (While a plant-based diet emphasizes vegetables, fruits, and whole grains, it may also include some animal products.)
  • Drinking plenty of water may aid in digestion and lower uric acid concentrations in the blood.
  • Coffee and tea will not elevate uric acid levels—in fact, coffee may help lower uric acid levels.7,10
  • Many people believe unsweetened tart cherries help prevent hyperuricemia and gout flares, and some research supports this idea.7,11-13
  • Limited research suggests dietary supplements of vitamin C and folate may help treat or prevent hyperuricemia.10

In addition to lowering uric acid levels and reducing the risk of gout, a whole-foods, plant-based diet may lower overall levels of inflammation and reduce the risk of developing other types of arthritis.14,15 Healthy food choices may also decrease symptoms related to existing, chronic arthritis conditions.16-19

Read more about An Anti-Inflammatory Diet for Arthritis

References

  • 1.Liu D, Yun Y, Yang D, et al. What Is the Biological Function of Uric Acid? An Antioxidant for Neural Protection or a Biomarker for Cell Death. Dis Markers. 2019;2019:4081962. Published 2019 Jan 10. doi:10.1155/2019/4081962
  • 2.Gilbert SF. Developmental Biology. 6th edition. Sunderland (MA): Sinauer Associates; 2000. The Cell Death Pathways. Available from: https://www.ncbi.nlm.nih.gov/books/NBK10103/
  • 3.El Ridi R, Tallima H. Physiological functions and pathogenic potential of uric acid: A review. J Adv Res. 2017;8(5):487-493. doi:10.1016/j.jare.2017.03.003
  • 4.Ramirez-Sandoval JC, Madero M. Treatment of Hyperuricemia in Chronic Kidney Disease. Contrib Nephrol. 2018;192:135-146. doi:10.1159/000484288
  • 5.Choi HK, Willett W, Curhan G. Fructose-rich beverages and risk of gout in women. JAMA. 2010;304(20):2270-8. doi: 10.1001/jama.2010.1638
  • 6.George C, Minter DA. Hyperuricemia. [Updated 2020 May 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459218/
  • 7.Kakutani-Hatayama M, Kadoya M, Okazaki H, et al. Nonpharmacological Management of Gout and Hyperuricemia: Hints for Better Lifestyle. Am J Lifestyle Med. 2015;11(4):321-329. Published 2015 Sep 2. doi: 10.1177/1559827615601973
  • 8.Parthasarathy P, Vivekanandan S. Urate crystal deposition, prevention and various diagnosis techniques of GOUT arthritis disease: a comprehensive review. Health Inf Sci Syst. 2018;6(1):19. Published 2018 Oct 8. doi: 10.1007/s13755-018-0058-9
  • 9.de Oliveira EP, Burini RC. High plasma uric acid concentration: causes and consequences. Diabetol Metab Syndr. 2012;4:12. Published 2012 Apr 4. doi:10.1186/1758-5996-4-12
  • 10.Paul BJ, Anoopkumar K, Krishnan V. Asymptomatic hyperuricemia: is it time to intervene?. Clin Rheumatol. 2017;36(12):2637-2644. doi:10.1007/s10067-017-3851-y
  • 11.Chen PE, Liu CY, Chien WH, Chien CW, Tung TH. Effectiveness of Cherries in Reducing Uric Acid and Gout: A Systematic Review. Evid Based Complement Alternat Med. 2019;2019:9896757. Published 2019 Dec 4. doi:10.1155/2019/9896757
  • 12.Collins MW, Saag KG, Singh JA. Is there a role for cherries in the management of gout?. Ther Adv Musculoskelet Dis. 2019;11:1759720X19847018. Published 2019 May 17. doi: 10.1177/1759720X19847018
  • 13.Zhang Y, Neogi T, Chen C, Chaisson C, Hunter DJ, Choi HK. Cherry consumption and decreased risk of recurrent gout attacks. Arthritis Rheum. 2012;64(12):4004–4011. doi:10.1002/art.34677
  • 14.Philippou E, Nikiphorou E. Are we really what we eat? Nutrition and its role in the onset of rheumatoid arthritis. Autoimmun Rev. 2018;17(11):1074-1077. doi:10.1016/j.autrev.2018.05.009
  • 15.Pattison DJ, Symmons DP, Young A. Does diet have a role in the aetiology of rheumatoid arthritis?. Proc Nutr Soc. 2004;63(1):137-143. doi:10.1079/pns2003319
  • 16.Vadell AKE, Bärebring L, Hulander E, Gjertsson I, Lindqvist HM, Winkvist A. Anti-inflammatory Diet In Rheumatoid Arthritis (ADIRA)-a randomized, controlled crossover trial indicating effects on disease activity. Am J Clin Nutr. 2020;111(6):1203-1213. doi:10.1093/ajcn/nqaa019
  • 17.Little EM, Grevich S, Huber JL, et al. Parental Perception of Dietary Intervention in Juvenile Idiopathic Arthritis. J Altern Complement Med. 2019;25(6):643-647. doi:10.1089/acm.2018.0407
  • 18.van Vugt RM, Rijken PJ, Rietveld AG, van Vugt AC, Dijkmans BA. Antioxidant intervention in rheumatoid arthritis: results of an open pilot study. Clin Rheumatol. 2008 Jun;27(6):771-5. Epub 2008 Feb 15. PMID: 18274814; doi:10.1007/s10067-008-0848-6
  • 19.Lassus A, Dahlgren AL, Halpern MJ, Santalahti J, Happonen HP. Effects of dietary supplementation with polyunsaturated ethyl ester lipids (Angiosan) in patients with psoriasis and psoriatic arthritis. J Int Med Res. 1990 Jan-Feb;18(1):68-73. PubMed PMID: 2139859. doi: 10.1177/030006059001800109
Further Reading: Gout Prevention Diet
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