What foods should you avoid with gout?
NIAMS (NIH) advises avoiding red and organ meats, shellfish such as shrimp and lobster, sardines and anchovies and sugar-sweetened drinks, and drinking less alcohol, including nonalcoholic beer. Purines run highest in organ meats and some seafood: per 3.5 oz (100 g), chicken liver 312 mg, shrimp 273 mg and fresh sardines 210 mg, against 0 mg in milk and eggs.
Studies find diet explains only a small part of uric acid levels (see the studies below), so food changes work alongside treatment, not instead of it. If you take a urate-lowering drug or have kidney disease, ask your doctor which foods matter for you.
Purines in common foods
| Food | Purines per 3.5 oz (100 g) | Group |
|---|---|---|
| Dried anchovies | 1,109 mg | very high (over 300 mg) |
| Chicken liver | 312 mg | very high (over 300 mg) |
| Pork liver | 285 mg | high (200 to 300 mg) |
| Shrimp (oriental shrimp) | 273 mg | high (200 to 300 mg) |
| Beef liver | 220 mg | high (200 to 300 mg) |
| Bonito (skipjack tuna) | 211 mg | high (200 to 300 mg) |
| Fresh sardines | 210 mg | high (200 to 300 mg) |
| Oysters | 184 mg | moderate (100 to 200 mg) |
| Rainbow trout | 181 mg | moderate (100 to 200 mg) |
| Fresh tuna | 157 mg | moderate (100 to 200 mg) |
| Chicken breast | 141 mg | moderate (100 to 200 mg) |
| Salami | 120 mg | moderate (100 to 200 mg) |
| Pork tenderloin | 120 mg | moderate (100 to 200 mg) |
| Fresh salmon | 119 mg | moderate (100 to 200 mg) |
| Beef tenderloin | 98 mg | low (50 to 100 mg) |
| Broccoli | 70 mg | low (50 to 100 mg) |
| Bacon | 62 mg | low (50 to 100 mg) |
| Cauliflower | 57 mg | low (50 to 100 mg) |
| Spinach | 51 mg | low (50 to 100 mg) |
| Peanuts | 49 mg | very low (under 50 mg) |
| Tofu (firm) | 31 mg | very low (under 50 mg) |
| White rice | 26 mg | very low (under 50 mg) |
| Potatoes | 6 mg | very low (under 50 mg) |
| Cheese | 6 mg | very low (under 50 mg) |
| Yogurt | 5 mg | very low (under 50 mg) |
| Bananas | 3 mg | very low (under 50 mg) |
| Milk | 0 mg | very low (under 50 mg) |
| Eggs | 0 mg | very low (under 50 mg) |
Measured total purines, raw foods unless named, from Kaneko K et al. Total purine and purine base content of common foodstuffs. Biol Pharm Bull 2014;37(5):709-721. Groups are the five bands the study uses, per 3.5 oz (100 g).
What NIAMS (NIH) says
What to avoid
- Level E NIAMS (NIH):
Having an unhealthy diet and eating foods that are rich in purines (usually from animal sources), a substance that breaks down into urate.
NIAMS, Gout, accessed 2026-10-12 - Level E NIAMS (NIH):
Avoiding red meats and organ meats (liver, kidney, tongue, and sweetbreads) that are higher in purines and may increase the risk for other health conditions.
NIAMS, Gout: Diagnosis, Treatment, and Steps to Take, accessed 2026-10-12 - Level E NIAMS (NIH):
Avoiding certain seafood, such as shellfish (shrimp and lobster), sardines, and anchovies.
NIAMS, Gout: Diagnosis, Treatment, and Steps to Take, accessed 2026-10-12 - Level E NIAMS (NIH):
Avoiding sugar-sweetened drinks, such as soda.
NIAMS, Gout: Diagnosis, Treatment, and Steps to Take, accessed 2026-10-12
Amounts and limits
- Level E NIAMS (NIH):
Drinking fewer alcoholic beverages. This includes nonalcoholic beer.
NIAMS, Gout: Diagnosis, Treatment, and Steps to Take, accessed 2026-10-12
What to choose
- Level E NIAMS (NIH):
Eating plenty of vegetables, fruits, and whole grains.
NIAMS, Gout: Diagnosis, Treatment, and Steps to Take, accessed 2026-10-12 - Level E NIAMS (NIH):
Eating low-fat or fat-free dairy products, poultry, and oils.
NIAMS, Gout: Diagnosis, Treatment, and Steps to Take, accessed 2026-10-12
Text in quotation marks is word for word from the official source. Level E means the position of an expert body or a drug label. How we grade evidence.
What studies found
Evidence behind the advice
- Level B In an RCT in 90 gout patients, a 42-day low-purine, energy-restricted diet lowered serum uric acid by 112.4 µmol/L more than in the control group. Nutrients, 2026
- Level A A meta-analysis of 47 controlled feeding trials (N = 2763) found that sweets and desserts, like sugar-sweetened beverages, raised blood uric acid when their sugars replaced other carbohydrate at equal energy. J Nutr, 2021
The other side and the limits
- Level C In pooled cross-sectional data from 16760 US adults without gout or kidney disease, liquor was one of seven foods linked to higher serum urate, although diet as a whole explained 0.3% or less of urate variation. BMJ, 2018
- Level C Vegetables high in purines showed no link at all with blood urate, which is the number gout advice is built on. PLoS One, 2012
- Level B In a 28-day randomized trial of 50 people with gout, tart cherry concentrate at doses up to 2 tbsp (30 ml) twice daily did not lower serum urate or change gout flare frequency compared with placebo. Rheumatology (Oxford), 2020, Lack of effect of tart cherry concentrate dose on serum urate in people with gout
Levels: A is a meta-analysis of trials, B a randomized trial, C an observational study, D lab work or case reports, E an expert position. How we grade evidence.
In practice
The biggest numbers are in organ meats and some seafood. Chicken liver has about 312 mg of purines per 3.5 oz and shrimp about 273 mg, while milk and eggs have close to none. NIAMS also names drinks: soda and other sugar-sweetened drinks, and alcohol, nonalcoholic beer included.
Vegetables are a different story. Spinach and cauliflower land in the low band, and a study of 2,076 healthy adults below found purine-rich vegetables were not linked to blood urate. It measured urate, not gout attacks. NIAMS tells people with gout to eat plenty of vegetables, fruits and whole grains.
Keep expectations realistic. A large analysis of US adults without gout below found diet explained 0.3% or less of the variation in uric acid. In a trial in people with gout, a low-purine diet did lower uric acid, but food choices work alongside the treatment your doctor sets, not instead of it.
Evidence behind this note
- Level C In pooled cross-sectional data from 16760 US adults without gout or kidney disease, liquor was one of seven foods linked to higher serum urate, although diet as a whole explained 0.3% or less of urate variation. BMJ, 2018
- Level C Vegetables high in purines showed no link at all with blood urate, which is the number gout advice is built on. PLoS One, 2012
- Level A A meta-analysis of 47 controlled feeding trials (N = 2763) found that sweets and desserts, like sugar-sweetened beverages, raised blood uric acid when their sugars replaced other carbohydrate at equal energy. J Nutr, 2021
- Level B In an RCT in 90 gout patients, a 42-day low-purine, energy-restricted diet lowered serum uric acid by 112.4 µmol/L more than in the control group. Nutrients, 2026
Written from the positions and data on this page, reviewed by the Bioma editorial system. How we verify.
Keep exploring
- Is a food good or bad for gout? Food-by-food pages
- Anchovies: what the research says
- Shrimp: what the research says
- Chicken liver: what the research says
- Salmon: what the research says
- Tuna: what the research says
- Spinach: what the research says
- Cauliflower: what the research says
- Milk: what the research says
- Cherries: what the research says
Sources
- NIAMS, Gout, https://www.niams.nih.gov/health-topics/gout (accessed 2026-10-12)
- NIAMS, Gout: Diagnosis, Treatment, and Steps to Take, https://www.niams.nih.gov/health-topics/gout/diagnosis-treatment-and-steps-to-take (accessed 2026-10-12)
- Kaneko K et al. Total purine and purine base content of common foodstuffs. Biol Pharm Bull 2014;37(5):709-721, doi:10.1248/bpb.b13-00967 (accessed 2026-10-12)
- Evidence cards: each study above links to its source. Card review dates are listed in our methodology.
Agency pages checked 2026-10-12. Bioma Learn provides information, not medical advice.