Did my diet cause my gout?

Ask the doctors

Q. I eat a lot of shellfish and recently developed gout in my knee. Did my diet cause the condition?

A. As you probably know, gout is a painful form of arthritis that occurs when high levels of a waste product called uric acid build up in the body. It can settle into joints, where it forms sharp crystals that can trigger inflammation, redness, and pain. Your diet may have aggravated the condition, but didn't cause it.

Many people who eat lots of shellfish and other foods associated with gout, such as alcohol and red meat, never get gout. Foods like these are high in substances called purines, which form uric acid when they break down. But it would be very difficult for someone who has normal levels of uric acid to eat enough of these foods to cause gout. Rather, these foods likely only trigger a problem in someone whose body already has levels of uric acid that are too high. These elevated uric acid levels likely occur because your body has an underlying condition that inhibits it from clearing uric acid from your system effectively, or causes it to produce too much uric acid — potentially both. Research has found that changing your diet alone also isn't enough to reduce gout attacks. But you can help prevent future attacks of gout by working with your doctor. To prevent a recurrence, she or he may recommend a urate-lowering medication, in addition to lifestyle changes, such as losing weight and eating a healthy diet.

— Toni Golen, M.D., and Hope Ricciotti, M.D.
Editors in Chief, Harvard Women's Health Watch