ARTICLE
Raised uric acid is one of the few conditions where changing what you eat has a direct and measurable effect. Uric acid is produced when the body breaks down purines, and purines come partly from the body itself and partly from food. Reduce the dietary load and levels usually come down.
This guide sets out which foods raise uric acid, which are safer, and how Ayurveda approaches the problem. It is written by the physicians at AyurMana, a residential Ayurveda hospital in Trivandrum, Kerala.
How food affects uric acid levels
Around two thirds of the uric acid in the body is produced internally. The remaining third comes from food. That proportion is worth keeping in mind, because it explains both why diet matters and why diet alone does not always bring levels into range.
When uric acid rises beyond what the kidneys can clear, it can form crystals in the joints. That is what causes the sudden, severe pain of a gout attack, most often in the big toe, though the ankle, knee and wrist are also affected.
Hydration matters as much as food. Uric acid is cleared through the kidneys, and clearance is poorer when someone is dehydrated. Many people find that simply drinking more water makes a noticeable difference.
High purine foods to limit
Organ meats
Liver, kidney, brain and sweetbreads are the highest purine foods there are. If you have raised uric acid or a history of gout, these are worth avoiding rather than limiting.
Red meat
Mutton, beef and pork are all high in purines. Chicken is moderate rather than high, so it does not need to be avoided entirely, but frequency and portion matter.
Certain seafood
Sardines, anchovies, mackerel, prawns, crab and mussels are high. This is a difficult one in Kerala, where fish is a daily staple. Smaller fish and shellfish tend to be higher than larger fish, and the practical answer for most people is reduced frequency rather than complete removal.
Alcohol, particularly beer
Beer is high in purines and alcohol in general reduces the kidney’s ability to clear uric acid. For anyone with recurrent gout attacks, this is usually the single most useful change.
Sugary drinks and anything with high fructose corn syrup
Fructose increases uric acid production directly. Packaged juices and soft drinks are worth treating the same way as alcohol here.
Some pulses and vegetables, in quantity
Certain dals, peas, spinach, cauliflower and mushrooms contain moderate purines. Current evidence suggests plant purines raise uric acid far less than animal purines, so these do not usually need to be removed. They are worth moderating if levels stay high despite other changes.
Foods that are generally safe
- Most fruits. Cherries in particular have been studied for their effect on gout attacks, and citrus fruits are useful for their vitamin C content
- Most vegetables, including the moderate purine ones in ordinary quantities
- Whole grains: rice, wheat, oats, millets
- Low fat dairy, which appears to help clearance rather than hinder it
- Eggs, which are low in purines
- Nuts and seeds
- Coffee, which several studies associate with lower uric acid levels
Drinks, water and alcohol
Water is the single most useful thing on this list. Two and a half to three litres a day is a reasonable target for most adults, adjusted for climate, activity and any kidney condition you have been told about.
Coffee appears to be beneficial rather than harmful here. Alcohol is the opposite, and beer is the worst of it. Packaged juices are best treated as sugary drinks rather than as fruit.
A sample daily plan
On waking
Two glasses of warm water.
Breakfast
Idli, dosa, oats or ragi porridge. Avoid making organ meat or heavy non vegetarian preparations a breakfast habit.
Mid morning
Fruit. Cherries, apple, guava or orange.
Lunch
Rice with a vegetable preparation, dal in moderate quantity, curd and salad. If fish is part of the meal, keep the portion small and the frequency low.
Evening
Buttermilk, coconut water or tea. Continue drinking water through the afternoon.
Dinner
Lighter than lunch. Vegetable soup, roti with a vegetable, or a millet preparation.
Where Ayurveda fits alongside diet
In Ayurveda, raised uric acid and gout are usually understood in terms of Vata and accumulated Ama, the residue of incomplete digestion. Treatment is therefore directed at digestion and elimination as much as at the joint itself.
Basti, the administration of medicated preparations through the rectal route, is given particular importance in Vata related conditions and is often part of a plan here. External therapies may be used for the affected joint where there is pain and swelling. Internal preparations are selected individually after assessment.
None of this replaces monitoring. If you are under medical treatment for gout, or taking urate lowering medication, Ayurvedic care should be planned alongside it and your levels should continue to be checked.
Frequently asked questions
How quickly can diet bring uric acid down?
Most people see some change within four to six weeks of consistent change, particularly if alcohol and sugary drinks are reduced and water intake increases. How far levels fall depends on how much of the uric acid is dietary in your case.
Do I have to stop eating fish completely?
Usually not. Frequency and type matter more. Smaller oily fish such as sardines and anchovies are the highest, so reducing those while keeping occasional larger fish is a workable compromise for most people in Kerala.
Are dals and spinach really a problem?
Less than was once thought. Plant purines appear to raise uric acid considerably less than animal purines. Most people do not need to remove them, though moderating quantity is sensible if levels remain high.
Can I stop my medication if diet brings the level down?
Not without your doctor’s advice. Urate lowering medication is usually prescribed for a reason, and stopping it abruptly can trigger an attack. Diet works alongside it.
Does lemon water help?
There is some evidence that citrus and vitamin C support uric acid clearance. It is unlikely to be transformative on its own but it does no harm and it encourages water intake.
What should I do during an acute attack?
Rest the joint, keep fluids up, and see a physician. An acute gout attack is painful and is usually managed medically in the first instance. Ayurvedic care is generally more useful between attacks than during one.
Speak to our physicians
If raised uric acid keeps returning despite dietary changes, it is worth having the whole picture assessed rather than adjusting food alone. Our physicians at AyurMana in Trivandrum, Kerala can help. Get in touch to arrange a consultation.
