Managing Painful Conditions with a Low-Purine Diet

Painful conditions like gout and kidney stones affect millions of people around the world. Fortunately, both can be well-controlled simply by making a few modifications to your daily routine and following a low-purine diet.

Not only can limiting your intake of purines aid in the prevention of these serious conditions, but it can also boost your intake of important nutrients by prioritizing healthy whole foods like fruits and vegetables. Plus, it’s easy to follow and effective, making it simple to manage symptoms and prevent flare-ups.

Low purine diet - Dr. Axe

Here’s what you need to know about a low-purine diet, including how to follow it and how it can benefit your health.

What Are Purines?

So what is the official purine definition in biology? Purines are a type of organic compound found in a variety of different foods, but they can also be produced naturally by the body. Chemically speaking, purines and pyrimidines form the building blocks of DNA and play a key role in maintaining overall health.

However, purine bases are also broken down into uric acid, which can form crystals that accumulate in the joints and contribute to gout, a type of arthritis that causes severe pain and inflammation. For this reason, a low-purine diet for gout is often recommended to help prevent uric acid from building up in the blood.

A gout diet menu is also sometimes recommended for those with kidney stones caused by the build-up of uric acid.

What Is a Low-Purine Diet?

A low-purine diet involves reducing your intake of certain foods to decrease the purine metabolism pathways, which are responsible for converting purines into uric acid.

Healthy whole foods like fruits, veggies, nuts, seeds and legumes are all encouraged as part of the diet while ingredients like red meat, seafood, wild game and organ meats should be consumed only in moderation.

Foods high in fructose, which is a type of simple sugar, should also be limited. Fructose is broken down into purine, which can increase levels of uric acid in the body. Although fructose is found naturally in fruits, these foods are also high in fiber, vitamins and minerals that can offset any negative effects.

Conversely, soft drinks, fruit juice and processed foods all typically contain a concentrated amount of fructose and should be limited on a low-purine diet.

Low-purine diets are recommended for those with gout or certain types of kidney stones to prevent flare-ups and minimize symptoms. A low-purine diet for dogs is also sometimes recommended to prevent uric acid kidney stones from forming in certain breeds who may be more susceptible.

Benefits

1. Prevents Gout Flare-Ups

Gout is a type of arthritis that is characterized by swelling, pain and redness in the joints. Fortunately, making just a few minor modifications to your diet can help prevent flare-ups and reduce gout symptoms.

For instance, according to a 2012 study out of Boston, frequent consumption of purine-rich foods increased the risk of recurrent gout attacks by nearly fivefold among those with gout. Another study published in Asia Pacific Journal of Clinical Nutrition reported that regular intake of purine-rich foods like red meat, seafood and alcohol was tied to higher levels of uric acid in the blood.

2. Protects Against Kidney Stones

Certain types of kidney stones are caused by high levels of uric acid. Increased excretion of uric acid through the urine causes the urine to become more acidic, making it easier for uric acid stones to form and causing symptoms like lower back pain, nausea, vomiting, fever, chills and blood in the urine.

In one study out of Iran, increased consumption of purine-rich foods was linked to a higher risk of developing kidney stones. A 2013 review published by the Universidade Federal de São Paulo also noted that reducing consumption of animal protein could help decrease purine intake and uric acid excretion to prevent kidney stones.

3. Prioritizes Nutrient-Dense Foods

Nutritious ingredients like fruits, veggies, nuts, seeds and legumes are all encouraged as part of a low-purine diet plan. Meanwhile, other foods like red meat, processed meat and alcohol should all be limited on the diet.

Not only can help ensure that you’re getting the nutrients that you need to support better health, but it can also protect against nutritional deficiencies as well as symptoms like fatigue, hair loss, weakness and constipation.

Foods to Eat

A typical low-purine foods chart is very balanced and contains an array of healthy ingredients, including fruits, veggies, nuts, seeds and legumes.

Here are a few of the foods that can be enjoyed as part of a low-purine diet plan:

Fruits: apples, oranges, bananas, pears, peaches, melons, berries
Vegetables: broccoli, kale, potatoes, zucchini, carrots, garlic, onions, Brussels sprouts
Nuts: almonds, walnuts, macadamia nuts, pistachios, cashews
Seeds: chia seeds, flax seeds, hemp seeds, pumpkin seeds, sunflower seeds
Legumes: beans, peas, lentils, chickpeas, peanuts
Whole grains: oats, millet, quinoa, couscous, farro, buckwheat, barley
Dairy products: milk, yogurt, cheese, kefir, grass-fed butter
Eggs: egg yolks and whites
Herbs and spices: cinnamon, black pepper, turmeric, ginger, coriander, oregano, basil
Beverages: water, tea, coffee

Foods to Avoid

Processed meat, fish and organ meats are all examples of high-purine foods that should be limited on a low-purine diet. Here are some of the key purine-rich foods that you should consume in moderation:

Organ meats: kidneys, tripe, liver, sweetbread, tongue
Seafood: anchovies, trout, haddock, herring, sardines, tuna, mackerel
Red meat: beef, lamb, pork
Wild game: venison, duck, veal, elk
Processed meat: ham, hot dogs, salami, bologna, jerky
Refined carbohydrates: baked goods, cookies, crackers, white bread, pasta
Alcohol: beer, wine, liquor
Added sugar: high-fructose corn syrup, agave syrup, honey
Sugar-sweetened beverages: soda, fruit juice, sports drinks, sweet tea

Some other plant-based ingredients may also contain purines as well, including spinach, cauliflower, mushrooms and dried beans and peas. However, research generally shows that these high-purine vegetables don’t have the same impact on uric acid levels as animal-based products and can be included in moderation as part of a low-purine diet menu.

Tips for Following the Diet

Following a low-purine diet doesn’t have to be difficult. In fact, it simply involves enjoying a variety of nutrient-rich foods that are low in purines such as fruits, veggies, nuts and seeds while also limiting your consumption of organ meats, processed meat, wild game and certain types of seafood.

Reducing your intake of alcohol can also help decrease purine consumption and keep uric acid levels low. According to one study in Clinical Rheumatology, increased alcohol consumption was associated with a higher risk of gout. However, the type of alcohol may also make a difference. In fact, one study noted that intake of beer and spirits was tied to an increased risk of gout whereas moderate consumption of wine was not.

It’s also important to stay hydrated and drink plenty of water during the day, which can help promote the excretion of uric acid through the urine to prevent it from building up in the body. Be sure to always keep a glass of water on hand or try setting a timer with reminders to drink more water throughout the day.

There are plenty of low-purine recipes available online, which make it easy to find healthy meals to add to your routine. Here are a few simple recipes to help get you started:

Risks and Side Effects

Although the low-purine diet is often recommended to minimize gout attacks and reduce symptoms, other medications and treatment methods may also be necessary. For example, anti-inflammatory medications are often prescribed to relieve symptoms during a flare-up and other types medications are also sometimes used to decrease uric acid production in the body.

Additionally, keep in mind that a low-purine diet may not aid in the prevention of all types of kidney stones. In fact, if you have calcium oxalate, cystine or struvite kidney stones, other dietary modifications, lifestyle changes and treatment methods may be required.

Because many of the animal proteins high in purines are also rich in other important nutrients like zinc, iron and omega-3 fatty acids, it’s also crucial to ensure that you’re getting these vitamins and minerals from other sources in your diet.

Although you can enjoy nutrient-rich foods like beef and seafood in moderation as part of a low-purine diet, you should also consume a variety of other healthy foods like vegetables, beans, nuts and seeds to help fill in any gaps in your diet.

Conclusions

What are purines? Purines are an organic compound found in a variety of different foods such as red meat and seafood. Purine synthesis also occurs naturally in the body and is used as a building block for DNA.
Purines are broken down into uric acid, which can accumulate in the body and contribute to gout and uric acid stones.
So what is a good diet for gout and kidney stones? A low-purine diet is often recommended to manage these conditions and involves limiting animal proteins, alcohol and fructose.
Meanwhile, healthy whole foods like fruits, veggies, nuts, seeds and legumes are encouraged as part of the diet.
In addition to preventing recurrent gout attacks and certain types of kidney stones, the diet also prioritizes nutrient-rich foods and can help improve the overall quality of your diet.