Gout is a type of arthritis caused by high levels of uric acid in the body. A buildup of uric acid causes sharp crystals to form in the joints. This often causes joint pain and inflammation.

In the past, patients were told to strictly limit their intake of dietary purines. Purine is found in all the body's cells as well as certain foods. It is eliminated from the body as uric acid. Thus, excess purines can cause increased uric acid.

Newer gout medications have reduced the need for severe purine restriction. Even so, limiting certain foods and drinks may ease the severity of gout attacks. Modifying your diet can also help if you have problems with certain gout medications.

About 60 percent of people who have a gout attack will have another within 12 months. So, it's important to start treatment with the first attack. The following are dietary guidelines that have been shown to affect the level of uric acid in the blood.

Maintain a healthy body weight and exercise regularly
Obesity alone can cause the body to make more uric acid. Healthy eating and exercise is important for slow and steady weight reduction. But avoid rapid weight loss, which can raise uric acid levels. Check with your doctor before you increase your activity level.

Eat a balanced diet
Look to include a healthy balance of protein, fat and whole-grain carbohydrates in daily meals and snacks.

• Protein should make up no more than 15 percent of your total calories. Low-fat dairy, tofu, eggs and small amounts of meat and chicken are fine. Some studies have shown that dairy products may cause your uric acid level to drop slightly.
• Fats should make up about 30 percent of your diet. Focus on essential fats, such as those found in flax oil and ground flaxseed, fish oil, nuts and olive oil. There are some studies that show these may also help with inflammation. Diet should be low in saturated fats like butter, fatty meats, cheese and fried and processed foods.
• Carbohydrates should comprise about 55 percent of your daily calories. Avoid low-carbohydrate diets, which raise uric acid levels. Go for wholesome carbs such as vegetables, fruits, a moderate amount of beans/legumes and whole grains.

Avoid or limit certain high-purine foods and beverages
Recent research suggests that not all purine-rich foods are linked to gout. Meat and certain types of seafood and shellfish do raise uric acid and pose the most concern. However, moderate intake of purine-rich vegetables (spinach, cauliflower, mushrooms and legumes) does not appear to raise the risk of gout.

To help prevent an attack, limit:

• Alcohol, especially beer, can raise uric acid levels. It should be avoided or limited to one drink three times a week.
• Sugary drinks, such as sodas and fruit drinks, have been linked to higher uric acid blood levels.
• Animal protein. Limit meat, fish and poultry to four to six ounces per day. Pay close attention to, and limit or avoid the following:
  • Organ meats - liver, kidneys, sweetbreads
  • Seafood - anchovies, sardines, mackerel, herring, fish roe, canned tuna fish, shrimp, lobster, scallops, mussels
  • Red meat - beef, pork and lamb
  • Meat extract - soup, broth, gravy

Drink plenty of fluids
Focus mainly on water and unsweetened drinks. Attacks can be triggered by dehydration. In addition, adequate fluid intake (eight to 10 cups a day) helps dilute uric acid. Check with your doctor if you are on a fluid restricted diet to see how much fluid you should have.

Finally, though more research is needed, a recent large study implied a link between high intake (1,000 to 1,500 mg) of vitamin C and reduced risk of gout. Researchers believe it may act by helping the kidneys clear uric acid from blood. Vitamin C may also help protect against inflammation.

Talk to your doctor before you take supplements with vitamin C. High doses can cause stomach upset and/or diarrhea.