What fish will not cause gout? The low-purine guide

According to the Arthritis Foundation, highly distilled fish oil supplements should not affect gout, but certain types of fish should be limited. A balanced approach is key for managing uric acid levels, so understanding what fish will not cause gout is crucial for those susceptible to painful flare-ups.

Quick Summary

This guide provides a comprehensive breakdown of fish purine levels, detailing which fish are safe for a gout-friendly diet and which high-purine varieties to avoid. Learn about cooking techniques to minimize purines and how to incorporate moderate-purine, omega-3 rich fish safely.

Key Points

• Choose Low-Purine Fish: Select options like cod, sole, flounder, and whitefish to minimize purine intake and reduce gout flare-up risk.

• Practice Moderation with Omega-3 Fish: Enjoy moderate-purine, omega-3-rich fish like salmon and canned light tuna in controlled portions (1-2 servings per week), as they offer anti-inflammatory benefits.

• Avoid High-Purine Seafood: Strictly limit or avoid fish such as anchovies, sardines, herring, mackerel, and most shellfish, which can trigger gout attacks.

• Select Healthy Cooking Methods: Opt for steaming, poaching, or grilling over frying, and consider boiling to further reduce purine content.

• Consider Fish Oil Supplements: For omega-3 benefits without the purine load, highly purified, molecularly distilled fish oil supplements are a safe alternative.

• Remove Fish Skin: Some purines are concentrated in the skin of marine fish, so removing it can help lower the purine level of your meal.

Understanding Purines and Uric Acid

Gout is a painful form of inflammatory arthritis caused by an excess of uric acid in the blood, a condition known as hyperuricemia. This excess uric acid can form sharp, needle-like crystals in the joints, leading to sudden, severe pain, swelling, and redness during a gout flare-up. Uric acid is a byproduct of the body's breakdown of purines, which are chemical compounds naturally found in many foods. While purines are essential for cellular function, consuming excessive amounts of high-purine foods can elevate uric acid levels, increasing the risk of an attack. Seafood contains varying levels of purines, making it important for those with gout to choose their fish and shellfish wisely. Foods with more than 150mg of purines per 100 grams are generally considered high-risk.

The Best Fish for a Gout-Friendly Diet

Fortunately, a gout diagnosis does not mean you must completely eliminate fish from your diet. Several types of fish are low-to-moderate in purines and can be enjoyed in moderation. Choosing these options allows you to benefit from the nutrients in fish without significantly increasing your risk of a flare-up.

Low-Purine Fish to Prioritize

• Cod: Known for its flaky texture and mild flavor, cod has a low purine content, with around 98 mg per 100 grams, making it a safe and excellent choice for a gout-friendly diet.
• Sole and Flounder: These delicate whitefish are also low in purines and are great options for regular consumption.
• Catfish and Tilapia: Found in the moderate purine category, these can be incorporated into your meals with careful portion control.
• Whitefish: The category of whitefish generally includes low-purine choices that are recommended for people with gout.
• Salmon: While slightly higher in purines than the options above, many types of salmon are considered moderate and can be consumed in moderation. Wild Alaskan king and sockeye salmon are noted for having lower purine levels compared to other varieties. Furthermore, the high omega-3 content in salmon may offer some anti-inflammatory benefits that help manage gout.

Moderate-Purine Fish to Enjoy in Moderation

• Canned Light Tuna: Skipjack and canned albacore tuna are typically lower in purines than fresh tuna and can be included in a gout-friendly diet, with the FDA recommending two to three servings per week. Always opt for canned light tuna over other varieties.
• Crab and Shrimp: While some shellfish are high in purines, shrimp and crab are generally lower and can be eaten in small, controlled portions.

Fish High in Purines to Avoid

Certain fish and shellfish contain significantly high levels of purines and should be avoided, particularly during a flare-up. For many individuals, these foods can trigger a painful attack.

High-purine seafood to eliminate or severely restrict:

• Anchovies
• Sardines
• Herring
• Mackerel
• Trout
• Mussels
• Scallops
• Oysters
• Other shellfish

Omega-3 Fatty Acids: A Complex Relationship

Fish is a renowned source of omega-3 fatty acids, which have potent anti-inflammatory properties that can be beneficial for overall health and may help limit the symptom burden from acute gout flares. This creates a nuanced situation for gout sufferers, as many omega-3-rich fish, such as mackerel and salmon, also contain moderate-to-high levels of purines.

For those seeking the anti-inflammatory benefits of omega-3s without the purine load, highly purified, molecularly distilled fish oil supplements are a viable option. These supplements are processed to remove the purines found in the fish's meat. It's important to consult with a healthcare provider before starting any new supplement regimen.

A Comparison of Fish Purine Levels

Fish Type	Purine Level (mg/100g)	Gout Status	Notes
Anchovies	~273	High	Avoid
Canned Sardines	~480	High	Avoid
Cod	~98	Low-Moderate	Safe in moderation
Salmon	~63-177	Moderate	Safe in moderation
Canned Light Tuna	~84-117	Moderate	Safe in moderation
Sole	~133	Moderate	Safe in moderation
Trout	~180	High	Avoid
Mussels	~293	High	Avoid

How to Prepare Fish for Gout Management

How you cook your fish can also impact its purine content. The following tips can help you minimize purine intake and maximize health benefits:

• Choose cooking methods wisely: Opt for baking, grilling, poaching, or steaming over frying, which can add excess fat that contributes to uric acid retention.
• Boil to reduce purines: Boiling fish has been shown to reduce its purine content, especially if you discard the cooking water afterward.
• Remove the skin: The skin of marine fish can contain higher concentrations of purines, so removing it before cooking may further reduce your risk.
• Season simply: Use fresh herbs, spices, lemon juice, or lime juice instead of high-sodium or high-fat sauces to flavor your fish.

The Bottom Line

Living with gout doesn't require giving up fish entirely, but it does demand a strategic and informed approach to your diet. By focusing on low-purine fish like cod, sole, and flounder, and enjoying moderate-purine options like salmon and canned light tuna in controlled portions, you can safely include seafood in your diet. Avoiding high-purine choices like anchovies and sardines is critical for managing uric acid levels and preventing flare-ups. Remember to prioritize healthy preparation methods like steaming or grilling over frying. For the anti-inflammatory benefits of omega-3s without the purine risk, consider discussing highly purified fish oil supplements with your doctor. By making these mindful choices, you can enjoy the health benefits of fish while keeping your gout in check. Healthline's Gout Diet Tips

Sample Gout-Friendly Fish Meals

• Baked Cod with Lemon and Herbs: A simple, flavorful meal using a low-purine fish. Serve with steamed vegetables and a side of quinoa.
• Grilled Tilapia with a Fresh Mango Salsa: The mild, moderate-purine tilapia pairs perfectly with a low-sugar fruit salsa. Great for a light, summery dinner.
• Salmon Salad with Canned Light Tuna: A mixed salad featuring a small portion of moderate-purine salmon or canned light tuna, served with leafy greens and a vinaigrette dressing. Ideal for lunch.
• Poached Flounder with Dill: Poaching is an excellent cooking method for reducing purine content. Serve with brown rice and a side of steamed green beans.

A Final Word

Always remember that individual tolerance to foods can vary. Pay attention to how your body reacts to different foods, and consult with a healthcare provider or a registered dietitian to create a personalized diet plan that best manages your gout. Regular monitoring of uric acid levels is also crucial for preventing future flare-ups.

Frequently Asked Questions

Can I eat salmon if I have gout?

Yes, salmon is generally considered a moderate-purine fish and can be consumed in moderation as part of a gout-friendly diet. It also contains beneficial omega-3 fatty acids, which have anti-inflammatory effects.

Which fish are highest in purines and should be avoided?

Fish with significantly high purine levels that should be avoided include anchovies, sardines, herring, mackerel, and trout. Shellfish like mussels and scallops also have high purine content.

Is canned tuna safe to eat with gout?

Canned light tuna, particularly skipjack and albacore varieties, has moderate purine levels and is safe to eat in moderation. The FDA suggests two to three servings per week.

Do cooking methods affect the purine content in fish?

Yes, boiling can reduce the total purine content in fish, especially if you discard the cooking water afterward. Opting for baking, grilling, or poaching over frying is also a healthier choice.

Are fish oil supplements a safe alternative for omega-3s?

Highly purified, molecularly distilled fish oil supplements are a great way to get the anti-inflammatory benefits of omega-3s without the purines found in fish meat. Consult a doctor before taking them.

How much fish can I eat with gout?

For moderate-purine fish like salmon or canned tuna, one to two servings per day is often recommended, with a single serving equivalent to 2-3 cooked ounces. Always pair it with low-purine foods.

Can removing the skin of a fish help with gout?

Yes, for many marine fish, the skin contains higher concentrations of purines. Removing the skin before cooking may help lower the purine content of your meal.