Dietary changes may help lower uric acid levels in 6weeks

Many people with gout or hyperuricemia, a condition characterized by excess uric acid in the blood, adopt strict eating habits, avoiding meat and seafood or drastically reducing their food intake. Yet these measures do not always bring uric acid levels under control.

Experts say the problem often lies in focusing exclusively on foods to avoid rather than choosing alternatives that support healthy uric acid metabolism and excretion, according to HK01.

A study by researchers at Qingdao University in China, published in the journal Nutrients, examined the effects of a structured dietary intervention on 90 men with gout.

Participants were divided into two groups. One followed conventional dietary advice, including limiting alcohol and seafood, while the other adopted a more targeted nutrition plan for 42 days. Neither group changed or increased their prescribed medication during the study.

After six weeks, the intervention group recorded an average reduction of 112.4 micromoles per liter in blood uric acid levels. The proportion of participants reaching their target rose from 11.1% to 71.1%, roughly twice that of the control group.

Participants in the intervention group also lost an average of 1.63 kilograms in body weight and 2.39 kilograms in body fat, while their waist circumference decreased by 2.61 centimeters. Average systolic blood pressure fell from 134.6 to 131 mmHg.

The dietary approach centers on three principles, supported by eight practical recommendations.

Three key dietary principles

Replace protein sources rather than eliminate protein

Instead of avoiding protein altogether, people with high uric acid should reduce red meat consumption and choose lower-purine alternatives such as eggs and milk.

Excessively restricting protein can contribute to muscle loss and nutritional deficiencies. The study's dietary plan recommended approximately 1.2 grams of protein per kilogram of ideal body weight daily.

Maintain an adequate carbohydrate intake

Extremely low-carbohydrate or ketogenic diets may temporarily increase uric acid levels because ketone bodies can compete with uric acid for excretion through the kidneys.

Rather than eliminating carbohydrates, patients are encouraged to consume appropriate portions of whole grains and other complex carbohydrates as part of a balanced diet.

Increase vegetable consumption and avoid alcohol

The intervention encouraged participants to increase daily vegetable intake from approximately 270 grams to nearly 500 grams.

Vegetables contain fiber and plant compounds, including polyphenols and flavonoids, that may support metabolic health and influence pathways involved in uric acid regulation.

Avoiding alcohol and sugar-sweetened beverages, particularly those containing large amounts of fructose, is another important part of the approach.

Eggs provide high-quality protein while containing very little purine, making them a suitable choice for people with gout. Photo by Bui Thuy

Eight recommendations for daily meals

Limit foods rich in purines

Organ meats such as pork liver and beef tripe, along with certain fish and concentrated meat broths, can contribute substantial amounts of purines, which the body breaks down into uric acid.

Red meat and some seafood, including oysters and crab, should be consumed in moderation. Lower-purine protein choices, such as eggs and dairy products, can help diversify the diet.

Aim for around 500 grams of vegetables a day

Include a variety of vegetables, particularly colorful varieties such as carrots and purple cabbage.

Vegetables containing moderate amounts of purines, including mushrooms, asparagus and spinach, generally do not need to be eliminated, as dietary purines from plant foods appear to carry less gout risk than those from certain animal products.

Stay adequately hydrated

Drinking sufficient water supports kidney function and uric acid excretion.

The dietary recommendations suggest around two to three liters of fluids daily, although individual requirements depend on body size, physical activity, climate and medical conditions. People with kidney or heart problems should follow their doctor's advice on fluid intake.

Include an egg in the daily diet

Eggs contain high-quality protein and very little purine, making them a useful alternative to high-purine animal foods.

For many people with gout, an egg a day can fit into a balanced eating plan, depending on their overall nutritional needs.

Choose whole fruits and limit excessive sugar intake

Fructose metabolism can increase uric acid production, particularly when consumed in large amounts through sweetened drinks.

Fruits such as strawberries, cherries, plums and citrus fruits can be included in a balanced diet. Whole fruits generally do not need to be strictly avoided because of their natural sugar content, though portion sizes should reflect individual health needs.

Include milk and other dairy products

Zhang Hanwen, a nutritionist at the 924th Hospital of the PLA Joint Logistics Support Force in China, said milk proteins, including casein and whey, may support uric acid excretion through the kidneys.

Low-fat milk and unsweetened dairy products are generally considered suitable options for people managing elevated uric acid.

The dietary recommendations suggest more than 300 milliliters of milk daily, provided the amount is appropriate for the individual's nutritional needs.

Include tofu and soy products in your diet

Zhou Xin, a clinical nutrition specialist at Beijing Jishuitan Hospital, said people with stable gout do not necessarily need to avoid tofu or soy milk.

Although soybeans contain purines, processing changes the purine content of different soy products. Moderate consumption of tofu is generally compatible with a gout-friendly diet.

Avoid alcohol and sugary drinks

Beer and other alcoholic beverages can raise uric acid levels and increase the risk of gout attacks.

Alcohol can interfere with the kidneys' ability to eliminate uric acid, while beer also contains purine compounds.

Sugar-sweetened soft drinks, especially those containing high-fructose corn syrup, may further contribute to elevated uric acid levels and should be limited or avoided.
Diet alone may not be enough
Although the six-week study suggests that targeted dietary changes can improve uric acid control, its findings came from a relatively small group of men with gout and should not be interpreted as a guarantee that everyone can reach a safe uric acid level within 42 days.

Dietary adjustments can support gout management, weight control and overall metabolic health, but they do not replace medical treatment.

People prescribed uric acid-lowering medication should continue following their doctor's instructions and should not reduce or stop treatment on their own.