Learning how to manage gout can feel overwhelming, especially if you are dealing with it for the first time. Newcomers to the condition can get confused when recalling various foods labeled as high, moderate or low in purine content. For those searching for purine tables, you probably noticed there aren’t many available. Then realize there isn’t a clear authority or reference for purine values, unlike other nutrients readily available on food labels.

Since gout cases have surged over the past two decades, the USDA took a step forward in 2019 by releasing the Database for the Purine Content of Foods. While this database offers valuable insights on purine content, it is not without its limitations. This post aims to highlight truths and clarify misinterpretations surrounding the purine tables included in the database.

I. Purines To Gout

Definition: Purines

Purines are organic compounds, composed of carbon, hydrogen, nitrogen, and oxygen atoms. They play a crucial role in forming DNA and RNA, the molecules that carry genetic information.

Picture DNA and RNA as long chains made up of repeating smaller sections. Each section contains a sugar molecule paired with a nitrogenous base. As the two main types of nitrogenous bases within DNA and RNA, purines and pyrimidines act as a code, with specific pairings dictating the instructions for building and maintaining the body.

Individuals with gout, a condition related to high uric acid levels from purine conversion, are advised to limit these purine-rich foods. When purines break down, they form uric acid, potentially contributing to gout symptoms.

Purines in Food Sources

Your body naturally produces purines, but food serves as the primary source. Animal sources like red meat, organ meats, seafood, and legumes often contain higher amounts compared to plant-based food.

Most fruits, vegetables, and grains are low in purines, but keep an eye out for hidden purines found in processed foods, beverages, and condiments. These may include: hot dogs, sausages, deli meats, beer, drinks/candy containing high-fructose corn syrup, sauces and gravies.

Even though protein and purines are distinctly different in structure and function, they often show up together in the same foods, especially in meats and seafood. This creates a general assumption between high-protein diets and increased purine intake.

II. The Purine Table

Whats is a Purine Table?

A purines table is a reference chart that provides the amount of purines found in various foods. It essentially lists the purine concentration per serving, much like nutritional values for sugars, proteins or calories. A purine table aims to raise awareness of high-purine foods, assisting gout sufferers to compare and prioritize those with lower purine content to potentially reduce their uric acid levels.

How is Purine Concentration Determined?

To determine purine content in food, scientists typically follow a three-step process. First, the food sample undergoes a process called acid hydrolysis, which breaks down complex molecules like purines. Then, specialized techniques like high-performance liquid chromatography (HPLC) separate the individual purines. Finally, the amount of each purine is quantified, revealing the total purine content in the food sample.

Note, there is no universal standard used for purine calculations, various analytical techniques and methods are employed to determine purine content in food samples. These techniques involve more complex procedures and calculations than, for example, determining calorie content. This is because the specific calculations depends on the chosen methodology and instrumentation.

The USDA Develops the Database for the Purine Content of Foods

The USDA and ODS-NIH Purine Database, created by the United States Department of Agriculture (USDA) and The Office of Dietary Supplements (ODS), part of the National Institutes of Health (NIH), addresses the rising concern of hyperuricemia and gout. Initially released in 2019 and updated in 2023, this database compiles purine information of various foods and beverages.

Containing over 370 different foods across 20 food groups and 15 alcoholic beverages, the database provides a comprehensive resource for individuals seeking to manage their purine intake. It references data from fourteen international studies published between 1976 and 2020, organized into three seperate tables: studies from North America, studies from outside North America, and Alcohol/Beers.

Researchers focused on four key purine bases – adenine, guanine, hypoxanthine, and xanthine – to ensure data accuracy of each food’s purine content. Other studies were excluded from the database due to a lack of data on specific purine bases, undocumented procedures, or language barriers.

*If you would like me to send you my spreadsheet that combines, sorts, and simplifies the two large purine tables from the USDA Database (partly shown as the feature image), feel free to email me or connect on X.

III. Helpful and Basic Findings From USDA Purine Database

Gout sufferers can learn valuable insights from this purine database! Here are the key findings and points:

1. Dried or dehydrated food contains more purines than raw food

The studies reveal dried foods have significanly higher purines content compared to their raw counterparts per weight. Examples include: anchovies (dried: 1109 mg/100g vs. fresh: 303.9 mg/100g) and shiitake mushrooms (dried: 311.6 mg/100g vs. raw: 23.1 mg/100g). Notably, dried beans can have a much higher purine content than many realize. Dehydrated food products like beef jerky and refried beans are often underestimated as gout triggers.

Why do dried food contain more purines than raw food? Preserving food through drying techniques like dehydration or sun drying removes moisture content. When water is removed, the relative concentration of purines can remain the same or increase due to additives. Consequently, dried foods contain a greater contration of purines per serving size than their raw equivalents.

2. Organ meats contain the most purines than other parts

A significantly higher concentration of purines are found in organ parts than muscle parts from the same animal. In particular, the liver contained the most purines from both pork and beef, as shown below. (Purine Chart 1)

Purine Table from USDA database, organ meats vs muscle meats, confirms by different countries, goutproof.com, gout blog
Purine Chart 1: From USDA Database – Organ meats have much more purine than muscle meats. Samples mostly from Japan.

Why do organ meats have more purines than other cuts? In essence, the higher concentration of purine-rich enzymes in organ meats translates to a greater overall purine content compared to muscle cuts. This is because organ like the liver, kidney, and heart, are heavily involved in processes like detoxification, waste filtration, and nutrient breakdown. These functions require a high concentration of enzymes, and many of these enzymes are rich in purines. Skeletal muscles, on the other hand, primarily focus on movement and energy production, requiring less purine-rich enzymes.

3. Soups, sauces, and seasonings can have high concentrations of purines

According the purine values for the database, some producs from this food group can contain a considerable amount of purines. They can easily be sneaky gout triggers because many of them may contain large doses of the flavor enhancer, as MSG (monosodium glutamate). Some polular prodcuts listed are: Umami broth powder (685 mg/100g), soup consommé/stock (180 mg/100g), fish sauce (93.1 mg/100g), and oyster sauce (134 mg/100g).

Why do soups and sauces pack so much purine content? It’s primarily because powdered versions are often derived from meat-based ingredients, and the dehydration process increases purine concentration, similar to drying meats. Note, all these products were from Japan. With countless similar soup and sauce products available in North America, it’s essential for individuals managing gout to develop the habit of carefully reading food labels to avoid sneaky gout triggers.

4. Fish shows the most diversity in species and purine content

From to the database, the fish group consisted of the most variety, including over 30 types of fish with various differentiators like raw, skin, cooked, canned, dried, and processed. It also displayed the largest range of purine content amongst the same food group, where some fish can have over 300 mg/100g and some can have under 100 mg/100g. Again, dried samples had significantly more purines compared to its raw version.

Below, Purine Chart 2 lists 13 common types of fish eaten in North America, with values for raw or fresh cut fish selected for comparison. The table lists anchovies as the fish with the highest concentration of purines. Furthermore, the chart highlights that purine content between the same fish tested in Japan and the USA can vary greatly.

Purine Table for Common Fish, purine content for: Salmon, mackerel, herring, halibut, yellowtail, seabass, sardine, anchovies, tuna, by country, goutproof, gout blog,
Purine Chart 2: Comparison of 13 Common Fish, five from two source countries showing purine content disparities.

5. Shellfish & Mollusks are purine-rich, but shrimps stand out

Results from Japan, China, and the USA showed relatively similar values for raw clams, oysters, squid, and shrimp. In general, the purine range of shellfish and mollusks fall within the simila range to red meats. Shrimp recorded the highest purine content in this group. Keep in mind, there are over 300 species of shrimp from around the world.

This group leaves some questions for gout sufferers, as different individuals may have varying reactions to shellfish. Many stories claim gout sufferers experience flare-ups after consuming only certain shellfish, but others types do not affect them as severely.

The method of preparation and serving especially for shellfish can impact the purine content of the entire meal. For example, boiling or steaming may cause the release of purines from the shellfish into a broth or juice. If this broth is consumed as part of the meal, it can contribute to higher purine intake. Additionally, the broth may be used in other dishes or stews, potentially increasing overall purine consumption.

6. Beer is a major gout trigger

This group was almost excluded from this post due to small number of samples and studies, which do not reveal much. Testing purine levels in beer and liquors is challenging without knowing grain types, brewing methods, and yeast amounts for different brewers and distillers.

This purine study does indicate that dark beer has more purines than regular beer. Additionally, most beers have higher purine concentrations compared to other alcoholic beverages like sake, wine, and whiskey. These findings are from a 2019 study, which has shown that beer increases the risk of gout more than other spirits.

The burning questions among gout sufferers who drink are: Which alcoholic beverages won’t trigger gout? Which alcohol has the least purines? Sadly, all alcoholic drinks are brewed with purine-loaded yeast. Much more extensive research is required to find the answer. To confidently know which drink have the lowest purine content would be a game-changer for gout sufferers who still love to drink… a lot!

7. Legumes – Dried beans high, raw Tofu low

The purine data for legumes (including beans) is also scarce, as there exists hundreds of beans. What can be taken away is dried beans can have as much or more purines as other well known gout triggers. Additionally, any processed bean products are likely made from dried concentrates. It’s worth noting that raw tofu (from Japan) contains relatively low purines, but the dried version has much more.

8. Sausages and luncheon meats will have purines

This is another food group that is not often discussed as a major contributor to gout. Although the number of samples is small, and none are from North American studies, it acknowleges that sausages, cold cuts and luncheon meats can have high amounts of purines.

Cured meats like prosciutto and salami top the list of eight sausages and luncheon meats with the most purines. Their values fall near the range of beef and pork. More samples of different cold cuts and luncheon meats would be very helpful, especially from the USA, where deli meats are a staple in many diets.

Why are deli meats and sausages sneaky gout triggers? During the curing process of deli meats, enzymes break down proteins into purines. Also, the possible addition of certain seasonings, preservatives, and MSG can increase purine concentrations in cured meats.

9. Fruits and vegetables have are the safest

Fruits and vegetables showed the least amount of purines. It’s important to remember that vegetables contain some purines, but their concentrations are much lower than those found in other food groups like meats and seafood. Additionally, vegetables and fruits provide vitamins, minerals, and other compounds having antioxidants and anti-inflammatory properties, which help reduce uric acid production.

Furthermore, it’s worth noting the wide range of purine content found in mushrooms, similar to beans and legumes. However, the majority of mushrooms scored relatively low.

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IV. Limitations of the Purine Tables

Understanding these purine tables is key for individuals managing gout, as they help improve dietary choices by identifying which purine-rich foods to avoid. However, it’s crucial to highlight its limitations and uncertainties.

Archaic data from four decades ago

The majority of studies within the database date back four decades, with only three conducted in the past decade. Taking into account the advancements in farming methods and technology during this period, purine content would likely differ.

Furthermore, shifts in global weather patterns may impact the environments for farming, fishing and ranching, resulting in changes in purine levels. Therefore, it’s imperative to recognize the dynamic nature of purines in food and their susceptibility to the environment.

More samples needed from the USA

About 80% of the food samples originate from Japan, limiting the representation of different diets found in North America. To enhance the accuracy of purine concentration, researchers need to gather food samples from regions worldwide, especially from the USA, where gout cases continue to increase.

Moreover, the majority of meat samples are sourced from Japan, with no studies conducted on red meats from the USA, which would likely yield different results. The quality of meat is highly influenced by the environment in which cattle are raised. Factors like feed, activity, climate, and living conditions affect the health of livestock. As a result, overall nutritional composition including purine concentration can change.

Ideally, selecting samples from different locations and even seasons would allow for broader comparisons. Analyzing a wider range of samples can help identify factors influencing purine levels, leading to more precise dietary recommendations for gout.

Inconsistent purine values for the same food type from different studies

There were notable differences in purine content among limited samples of the same food type from multiple countries.

Purine table listing five sets of the same food types with different purine content from different studies. Shrimp, clams, sirloin, chicken breast, salmon.
Purine Chart 3: Showing same food type from different countries with wide variations of purine content.

Shown in the table are five examples with large discrepancies. Note, that values for shrimp and clams are from three different countries, where the content for clams were fairly similar. Nonetheless, chicken breast and salmon displayed the widest ranges of purines from different countries.

Chicken with more purines than other meats is not typical

Based on the data (Purine Chart 1), a newbie to gout might assume that poultry is the worst meat choice, as it lists chicken parts as having the highest purine content among meat groups. However, this is not typical because white meat contains fewer purines than red meat. This is due to its leaner muscle tissue, which has lower levels of purine-rich compounds and less fat.

No Standardized Test and Analytical Procedure for Purines

Many of the studies lacked clear descriptions of procedures, particularly regarding calculations and evaluation criteria. A lack of standardized procedures, not just for purines, but for any type of testing and analysis will undoubtedly lead to inconsistent results across studies. This makes purine comparisons unreliable and less credible, especially when considering data from older studies.

Reputable expert reviews on test method are essential to ensure data quality and consistent results. Ideally, an in-depth standardized procedure for purine content is needed, similar to those used for food or nutrient testing.

The Illusion of Purine Tables

Purine tables might present the illusion of consistency, where relying on specific values can be misleading. There’s a possibility to overgeneralize high-purine content for an entire food group, leading to unnecessary dietary restrictions when lower purine alternatives are available. For example (Purine Chart #2), the fish group has some types with very high purine levels, but also have several that are moderate to low.

The reality is, purine content can also differ within the same food group due to various factors. (Purine Chart #3) Different studies from different environments around the world are likely to yield very different results. This is why it is necessary to have purine studies from locations focusing on regional and relative food products.

These discrepancies point of the key principle about purine tables – relying solely on them can be misleading. While purine tables offer some valuable insights, it’s important to interpret them judiciously and consider additional factors when dealing with gout.

V. Beyond the Table: Holistic Approach To Gout Management

Optimal gout management requires a well-rounded and holistic approach, involving dietary improvements, lifestyle adjustments, and individual considerations.

1. Individual factors influence gout management

While understanding purine content in food is helpful, individual factors impact how your body processes them. This highlights why a “one-size-fits-all” approach isn’t always effective when managing gout. Genetics can predispose some to higher uric acid production or impaired excretion, making them more susceptible. Metabolic rate, weight, and certain health conditions can further complicate the picture.

Metabolism and Genetics – Like other nutrients, your body’s ability to break down and excrete purines is heavily influenced by your metabolism and genetics. Certain individuals naturally have a more efficient system for handling purines, whereas others might struggle with their breakdown (enzymes) and elimination (kidneys) resulting in elevated uric acid levels.

Weight and Other Health Conditions – Beyond metabolism and genetics, weight and other health conditions can also increase gout risk. Carrying excess weight can put additional strain on your kidneys, potentially hindering their ability to properly excrete uric acid. Additionally, certain health conditions like prediabetes and high blood pressure can also increase the risk of gout.

Age and Gender – While men are generally more susceptible to gout, and risk increases with age, women experiencing menopause can also be affected. As with aging in general, the body begins to slow down, including its ability to efficiently break down purines and eliminate uric acid.

2. Basics Dietary Improvements: Focus on nutrient-rich, low-purine food sources

While purine charts may highlight which purine-rich foods to avoid, managing gout effectively requires a broader holistic approach, taking into account your overall health and lifestyle. Medications like urate-lowering drugs and anti-inflammatory drugs can be prescribed to manage gout and uric acid levels. Nevertheless, their effectiveness will be negligible in the long run if your dietary choices and habits remain unhealthy.

  • Plant-based sources – Fruits and vegetables are not only low in purines, but also contain gout-fighting vitamins, minerals, and fiber. Eat more fresh produce rich in quercetin, resveratrol, and bromelain, such as berries, cherries, pineapples, grapes, leafy greens, and red cabbage—all of which aid in lowering uric acid levels.
  • Whole grains – Foods like whole-wheat bread, brown rice, quinoa, and oats, are beneficial for managing gout due to their high fiber and low purine content. They help lower uric acid levels and provide essential nutrients for overall health. The fiber in whole grains has anti-inflammatory properties and acts as a prebiotic, promoting gut health.
  • Alternative protein sources – Good alternatives for protein sources for gout sufferers cutting down on red meats include nuts, seeds, eggs, and greek yogurt. White meat from turkey and chicken, are typically safer choices.
  • Healthy cooking – Learning to cook low-purine meals is easier than you think. When you prepare your meals, you have the advantage of knowing precisely what you are eating, eliminating the uncertainty of whether potential gout triggers are hidden in a restaurant order.
  • Cut down on the junk food & drink: Fast food and processed food contain hidden gout triggers. It is advisable to avoid foods containing MSG (monosodium glutamate) and beverages made with HFCS (high fructose corn syrup) as they can cause an immediate spike in uric acid levels. Again, limiting alcohol consumption is emphasized, since they are produced with purine-loaded yeast.
  • Consult with a dietitian – Speaking to a dietician allows for real personalized guidance on nutrition, taking into account your health conditions and preferences. A dietitian can provide insights into effectively tracking purine intake, ensuring a balanced and sustainable plan for both overall health and gout.
  • Track & record food intake – If you’re unable to consult with a dietitian, a wise move would still be to track your food intake on your own for two weeks. Then, you will at least be able to identify and limit the major purine sources.

Remember, even low to moderate purine foods can raise to uric acid levels if consumed frequently and not removed sufficiently.

3. Simple Lifestyle Modifications, Big Impact on Purines and Gout

Besides the food and diet changes, some sustained awareness and adjustments can be very helpful in maintaining a goutproof lifestyle.

Proper Hydration – Rehydration is vital, as adequate water intake helps dilute uric acid and supports its excretion through urine. When the body is dehydrated, less uric acid filters through the kidneys to urine.

Regular Exercise – Regular work outs plays a pivotal role in enhancing cardiovascular health (circulation), promoting joint flexibility, and facilitating weight loss. Reduction of visceral fat decreases the risk of gout.

Sensible Fasting, Not Crash Diets – Gout sufferers need to approach fasting sensibly because rapid weight loss can lead to increased uric acid levels in the body, potentially triggering gout attacks. Moreover, crash diets can disrupt metabolic processes and exacerbate inflammation.

Dietary Supplements – Vitamin C, cherry extract, CBD, and several gout-fighting supplements are readily available. However, their effectiveness can vary based on factors like quality, dosage, and individual response. It’s important for gout sufferers to choose products from reputable manufacturers.

By following the dietary principles mentioned and incorporating healthy lifestyle habits, you can naturally reduce your risk of gout flare-ups. Remember, gout management is an ongoing process, and consulting healthcare professionals is always recommended.

VI. Why don’t health authorities have purine tables like they do for other nutritional values?

The lack of purine tables endorsed by health authorities and their exclusion from product labels can be attributed to these regulatory issues.

  • Priority and Focus – The USDA and FDA mainly concentrate on nutrients and components that have a more immediate impact on public health. Purines aren’t seen as primary nutrients with daily intake recommendations. Hence, their focus is on regulating and researching more critical nutritional factors.
  • Complexity & Cost of Dietary Studies – Researching purine levels in foods is complicated and expensive, as it involves complex methods and takes a lot of time. This makes it hard to gather comprehensive purine data in different foods.
  • Varied Individual Responses – Unlike nutrients with established daily values, individual responses to purines can differ considerably. Predicting and accommodating for different rates of purine metabolism remains unlikely. Therefore, recommended amounts for purines are not provided.

Final Thoughts

While the USDA Purine Database serves as a valuable resource, it’s important to know its limitations to prevent misinterpretations or assumptions. Purine tables point out foods with very high and low purine content, but cannot distinguish the actual range, or maximum/minimum limits. This also makes it very difficult in understanding the true meaning of “in moderation” or “moderate amounts”, as suggested by many health authorities. The database provides a starting point, but should not be relied upon as your sole guide for managing gout.

Surprisingly, there was a lack of credible and accurate purine studies from the USA, where gout cases continue to rise. This supports the need for future development by North American researchers to test more relative food sources. Expanding the database by including diverse food samples from around the world and with standardized testing procedures would lead to more practical values and comprehensive analysis. Additionally, recognizing external factors such as species, environment, and farming methods is critical for understanding disparities in purine content among foods.

The hard truth is that many gout sufferers have to learn through personal reactions on which particular foods, and from where, set off their uric acid levels. Back in my oblivious days, I avoided all seafood because of one major gout attack from eating too much lobster at certain restaurant (but it was probably the beer too!). I also recall other occassions feeling gouty from eating a regular serving of salmon or a bowl of clam chowder, but at another occassion not feel anything after eating king crab legs. Purine content can play a role, but gout usually strikes hardest when your uric acid levels are currently at your gout threshold. Hence, the next meal with purines pushes you over the top for a flare-up.

Despite these challenges, incorporating lifestyle changes beyond purine tables is essential to delay or prevent the next gout attack. By making simple dietary and fitness adjustments outlined here, you can achieve consistent progress towards better health and becoming GOUTPROOF!

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