Gout is a medical condition caused by high uric acid levels & a
substance called "PURINES".  I would like to ask if you could put
together a list of foods that contain OR produce purines (or that are
VERY Bad for people with gout to eat) & rank them
in categories "VERY HIGH PURINES", "Medium purines", or "Not too bad".
 (or something along these lines)  Simple lists are available at a
number of sites but I was unable to compile a more comprehensive list.
 Thank you.

Although I do not have gout, I do need to watch my intake of foods
high in purines, since I have a history of kidney stones. This is one
of the best online lists I have seen:

"FOODS HIGHEST IN PURINES
anchovies
brains
kidney, beef
game meats (venison, etc.)
gravies
herring (including roe)
liver (calf or beef)
mackerel
meat extracts
mussels
sardines
scallops
yeast

FOODS  MODERATELY HIGH IN PURINES
asparagus
bacon
breads & cereals, whole grain
cauliflower
eel
fish (fresh & saltwater)
legumes (kidney beans, navy & lima beans, lentils, peas)
meat (beef, lamb, pork, veal)
meat soups & broths
mushrooms
oatmeal
peas, green
pork (including ham)
poultry (chicken, duck, turkey)
shellfish (crab, lobster, oysters)
spinach
tongue
tripe
wheat germ & bran

FOODS LOWEST IN PURINES
beverages (coffee, tea, sodas, cocoa)
butter
bread & cereal (except whole grain)
cheese
eggs
fats
fish roe (including caviar)
fruits & fruit juices
gelatin
milk (including butter, condensed, malted)
nuts (including peanut butter)
pasta (evaluate sauce ingredients separately)
sugars, syrups, sweets
vegetables (except those above)
vegetable & cream soups 
	(made with acceptable vegetables. but not with beef stock)"

Dalmatian Club of America: Purine-Yielding Foods
http://www.thedca.org/Purines.txt

Here are three more good lists:

The Analyst: Low Purine Diet
http://www.diagnose-me.com/treat/T422164.html

VitaCost: Low-Purine Diet
http://www.vitacost.com/science/hn/Diet/Low_Purine_Diet.htm

Marin Urology: Foods Rich in Purines
http://www.marinurology.com/articles/calculi/foods/purines.htm

You'll find some useful charts on these three sites:

Dial a Dietitian: Purine Content of Foods
http://www.dialadietitian.org/resources/handouts/goutdiet.html#purine

Camino Medical: Nutritional Care Guidelines for Gout
http://www.caminomedical.org/handouts/pdf/Gout.pdf

University of Oxford: Purines in Foods
http://www.jr2.ox.ac.uk/bandolier/booth/gout/purfood.html

For a more comprehensive list of the purine content of foods, you may
want to purchase a book entitled "Gout Hater's Cookbook: Recipes Lower
in Purines and Lower in Fat. (Reachment Publications; 2000). It
contains detailed charts of foods that are high, moderate, and low in
purines. Many tasty recipes that avoid high-purine foods are included.

Reachment Publications
http://www.gout-haters.com/page1.html

Google Web Search: "purine OR purines" + "food" + "high" +  "low"
://www.google.com/search?hl=en&ie=UTF-8&oe=UTF-8&q=%22purine+OR+purines%22+food+high+low

I hope this helps! If anything is unclear, please request
clarification; I'll gladly offer further assistance before you rate my
answer.

Best regards,
pinkfreud

---

Request for Answer Clarification by abiedj-ga on 29 Mar 2004 20:56 PST

I'm just curious about the "Beans" section & things I've read.  Is
Tofu / Soy bean products considered Moderately high or a Low Purine
food?  Although beans themselves are listed in the middle, I've read
some of the articles that suggest tofu / soy products is a good source
of protein for gout sufferers.

Finally as dancethecon-ga  suggested, is it true that everyones body
chemistry reacts differently to the purines in some foods than others
or is it really strictly based on the amount of purines that
particular food has....period?  Thanks again.

---

Clarification of Answer by pinkfreud-ga on 30 Mar 2004 11:53 PST

Tofu is sometimes mentioned as a suitable meat substitute for gout patients:

"one study of gout patients suggested that eating tofu, which is made
from soybeans and is a source of complete protein, may be a better
choice than meats."

University of California at Davis
http://www.ucdmc.ucdavis.edu/ucdhs/health/a-z/93Gout__/doc93preventlife.html

I believe this is the study of gout patients mentioned in the source above:

"The effect of Tofu (bean curd) ingestion on uric acid metabolism was
examined in 8 healthy and 10 gout subjects. Ingestion of Tofu
increased plasma concentration of uric acid, together with increases
in uric acid clearance and urinary excretion of uric acid. However,
the increase in plasma concentration of uric acid was fairy small.
Interestingly, no significant rise in the plasma, urinary and
clearance of uric acid was observed in gout patients with uric acid
clearance > 6.0 mL/min (lower normal limit). The results suggest that
tofu is a preferable source of protein, especially in gout patients
with uric acid clearance > 6.0 mL/min."

PubMed
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=9598181

However, other reference sources discourage the use of soy products altogether:

"You should avoid bean products including soya milk, tofu,
beansprouts, bean paste, etc. as they all have fairly high purine
content."

Nutrition: Topic - Gout
http://www.nutrition.com.sg/atd/atdgout.asp

Here's a page that contains a comprehensive nutritional breakdown of soybeans:

Internet Symposium on Food Allergens: Composition of Soybeans
http://www.food-allergens.de/symposium-vol1(2)/data/soy/soy-composition.htm

You'll note that the purine content of dried soybeans is 380 mg per
100 g. In view of this, moderation in consuming soy products is
advisable for gout patients. Although tofu does appear to be better
than meat, it's still rather high in purines, and shouldn't be eaten
in large quantities by persons with gout.

It's true to a certain extent that everyone's body chemistry reacts
differently to foods. But the similarities among us are greater than
the differences. Those of us who are on special diets tend to learn
over a period of years what we can and cannot eat; sometimes we learn
the hard way, after a painful episode. My own experience with purine
restriction has taught me that, in my case, it's best to err on the
side of caution. My personal opinion is that no food is so tasty as to
be worth the unpleasantness that can follow a major dietary
indiscretion.

Best wishes,
pinkfreud

Answered quickly & precisely with lots of references, thank you.

Dear pinkfreud,

Do you drink much tea? When I was in my mid-20s, I had a couple bouts
of kidney stones, including one that landed me in the hospital for 10
days. I was drinking lots of iced tea daily--I drank it unsweetened,
so no calorie worries--and my doctor determined that my high iced tea
intake was the cause of my kidney stones (which were calcium oxcilate,
if I recall correctly). I cut back on the tea dramatically, and never
had another stone.

Your body chemistry could be far different from mine, so tea might not
cause precipitates in your kidneys. But it's something to consider,
just in case.

Here's hoping neither of us experiences that pain again!

dtc?

Oops! I meant "calcium oxalate." Sorry about that.

As a sufferer, may I add my two cents worth.. The things to avoid are
broccoli, peas, as many spices and condiments as possible, chocolate,
strawberries, salad dressings. I`ve never had any problems with meat,
all types, gravies and breads, as suggested by Pinkfroyd, but that`s
not saying she is wrong. Different people are affected different ways.
But there is one very important aspect that should not be overlooked.
Gout indicates that the spleen and kidneys are not working properly in
excreting URIC ACID, and therefore it builds up and the body has to
store it somewhere. The most convenient place is in the main joint of
the big toes and causes excruciating pain. Ask any sufferer. Do not
ignore it as it can lead to Lymphocytic cancer given time. The best
current treatment is a daily pill of PROGOUT, by presc ription from
your G.P. Hope this helps.

As someone who suffers from both kidney stones and gout, I have some
comments. First, too much of anything is not good for you.  Kidney
stones can be caused just as easily by too much brocolli as it can by
too much red meat.
There are 2 types of people that have uric acid problems:
over-producers and under-excreters.  Your doctor can do tests to try
to figure out which one you are. There are medicines that you can take
(allopurinol), but there are some issues to consider such as the
possible side effect of liver damage and the fact that once one you
start allopurinol you must take it for the rest of your life.
Ofcourse everyone is different, but some things that have helped me
and seem to help many others is drinking lots of water and dark
colored fruits such as cranberries, cherries, etc in fruit or juice
form.

Has anyone heard of the cherry pills working instead of drinking
cherry / cranberry juice?  Any success stories there?