Is Cheese Bad for Gout? Dietary Impact Explained

March 13, 2024

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Gout is a common form of inflammatory arthritis caused by excess uric acid buildup in the bloodstream. This buildup leads to the formation of urate crystals that deposit in joints and soft tissues, resulting in sudden and severe attacks of pain, swelling, and tenderness known as gout flares. Key risk factors for gout include obesity, high blood pressure, diabetes, and a diet high in purines – compounds found naturally in some foods that can raise uric acid levels.

When it comes to gout diet and lifestyle changes for preventing attacks, dairy products tend to be a source of confusion for many patients. In particular, a common question those with gout ask is: is cheese bad for gout? Along with whether other dairy foods like milk and yogurt are safe or should be avoided.

Can Cheese Cause Gout Flares?

Cheese itself does not directly cause gout flares or symptoms in most people. However, some varieties are higher in purines and fat content than others. Consuming high levels of purines from some types of meat, seafood, and protein-rich plant foods is associated with increased uric acid production. But most dairy products are low to moderate sources rather than being high purine foods.

In fact, emerging research shows that low-fat and non-fat dairy foods may actually lower serum urate levels to help reduce recurrent gout attacks. A number of studies have found that higher intakes of low-fat milk and yogurt are linked to lower gout risk. As milk proteins may have an uric acid-lowering effect to promote more efficient excretion from the body.

Therefore, quite a lot of dairy products can be safely consumed as part of a gout-friendly diet, with some precautions for higher fat varieties like cheese, cream and butter.

Is All Cheese Equally Safe?

Cheese does still contain moderate amounts of purines – 80 to 120 milligrams per 100 gram serving on average. Cheddar, parmesan, swiss and blue cheese tend to be among the highest. Whereas low-fat cheeses have less than a third of the purine content of regular varieties.

Fortunately, cheese and other dairy foods have a low overall effect on uric acid production since their proteins offset the mild purine content. But if having trouble with recurring flare-ups, it’s still smart to limit intake of high-fat cheeses more significantly.

Choosing the healthiest cheese options involves some general guidelines like:

  • Go for low-fat varieties – try part-skim mozzarella, ricotta, cottage cheese, goat cheese.
  • Limit high-fat hard cheeses – parmesan, cheddar, swiss, gouda, bleu, brie.
  • Watch portion sizes – no more than 1 to 2 oz a day.

Pairing cheese with other anti-inflammatory foods allows enjoying small amounts more safely. For example, having a slice of veggie pizza with tomato sauce rather than ordering an extra cheesy pizza with pepperoni. Dairy also combines well with cherries, berries, lemon juice, parsley and turmeric as gout-friendly ingredients.

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Can Milk, Yogurt and Other Dairy Help Prevent Gout?

The good news is that other dairy products can be an asset rather than an avoidance in your menu planning. Yogurt, milk, buttermilk and whey are among the safest choices for those prone to gout.

Yogurt and Greek Yogurt

Most studies analyzing gout rates based on dietary factors have found yogurt consumption lowers uric acid and is helpful for avoiding symptoms. Men who ate at least 2 servings of yogurt daily had a 35% lower likelihood of developing gout compared to none.

Both regular yogurt and Greek yogurt contain gut-friendly probiotics to support digestion and inflammation regulation. Just opt for low sugar varieties and avoid pre-sweetened or fruit-added flavors – which can worsen metabolic uric acid production. When buying Greek-style yogurt, choose non-fat to limit heavy saturated fats.

Low-Fat Milk

Like other fermented dairy, the proteins in milk increase uric acid excretion from the body efficiently. In combination with its low purine levels, buildup of painful crystals is prevented.

Skim (nonfat) milk has been found superior when it comes to dealing with high urate levels compared to full-fat milk. Men drinking skim daily rather than full-fat had a 17% reduced gout risk. If opting for cow’s milk, stick to just 1% to 2% milk fat at most.

Whey Protein Products

Whey protein powder that comes from dairy has an ability to enhance normal uric acid function for optimal waste elimination. Older research found that consuming whey leads to nearly a 30% reduction in plasma urate levels compared to other proteins.

Newer studies also show that taking just 10 grams of whey protein isolate for 3 months successfully reduces tissue swelling and joint tenderness for people that have frequent, recurring gouty arthritis.

Are There Any Dairy Foods to Avoid?

Full-fat dairy products can be troublesome for those with existing gout or metabolically-driven high urates. Some examples include:

  • Butter – high in saturated fat, linked to greater inflammation.
  • Cream – contains saturated fat and hormones that can raise uric acid.
  • Full fat cheese – cheddar, gouda, brie have too much saturated fat and protein.
  • Sour cream – often triggers attacks due to cool serve temp.
  • Ice cream – spikes blood sugar and contains fat, cool temps.

In small amounts, most people can handle them with no flare-ups. But those struggling with recurrent gout likely find eliminating full-fat dairy leads to better control.

Lactose-intolerant individuals can experience problems, as undigested lactose sugars ferment in the colon and become uric acid. Taking lactase enzyme tablets helps improve tolerance and digestion.

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Best and Worst Foods for Gout: Fruit, Veggies & More

Alongside understanding where dairy and cheese fits in, a combination diet matters most for gout management. What other foods raise or help lower uric acid?

Fruits and Veggies

Produce supplies antioxidants, fiber and nutrients – but their purine content varies. Fruits and veggies with high water content are great. Examples include strawberries, blueberries, pineapple, oranges, tomatoes and cucumbers.

Avoid Produce Higher in Purines: asparagus, mushrooms, cauliflower, spinach, peas.

Fruit Juices & Sweet Produce: Grapes, cherries and oranges are healthy fruits that don’t trigger gout. But sweet juices may increase insulin resistance and sugar crash.

Grains, Starches & Beans

Most grains, rice, bread, potatoes and pasta can be enjoyed freely without impacting gout. Whole grains over refined provide better fiber for detoxification. Beans and lentils are healthy plant-protein, not linked to gout despite a misconception.

Go Easy On: alcohol grain-based beer, sweet bakery goods raise insulin and inflammation.

Meat, Poultry & Fish

Highest in Purines = Highest Gout Risk. Organ meats like liver are absolutely off limits, with shellfish, sardines, trout and tuna being risky. Lean meats like chicken breast and plant-proteins are better.

Best Proteins: eggs, low-fat dairy, vegetable protein supplements.

Limit Intake Of: beef, pork, duck, veal, scallops, mussels – no more than 3 to 6 ounces a few times a week.

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Key Takeaways – Cheese and Dairy Recommendations for Gout:

  • Low-fat dairy like yogurt, milk, whey offers protective benefits by lowering uric acid levels from the body.
  • Hard, full-fat cheeses higher in purines need strict portion control – but can be included in moderation.
  • Lactose-intolerant patients can experience gout flares from dairy. Take lactase enzymes to improve digestion.
  • For best gout management, combine dairy with produce, whole grains and plant proteins rather than meat and seafood.

Frequently Asked Questions

Is cheese considered a high purine food that causes gout?

No, most cheese is low to moderate in purines – hard types like cheddar and swiss are higher but still only moderately so. Cheese causes problems indirectly if eating very large amounts that add up over time. But other factors like obesity, alcohol abuse, genetics and lack of exercise play a bigger role.

Are nuts and seeds OK if you have gout?

Yes, most nuts and seeds can be included in a gout diet, even though plant proteins. Moderation with portion sizes is key, as overdoing intake of almonds, cashews, nut butters and oils can increase purine intake. Those with kidney dysfunction may need to limit nuts more strictly for kidney stone risk.

Is yogurt good or bad for gout sufferers?

Yogurt is considered excellent for gout diets. Studies show daily yogurt consumption lowers urate levels substantially to help avoid painful flares. Choose Greek yogurt for higher protein content able to decrease gout incidence compared to other dairy products.

What bread is lowest in purines and okay to eat for gout?

All types of bread, including whole wheat bread, rye, sourdough and bread rolls are minimal in purines and fine for gout diets. Grains get mistakenly assumed as inflammatory, but serve as harmless energy sources that don’t trigger increased uric acid. The exception is beer and brewer’s yeast, which are higher in purines than bread.

Should those with gout avoid all high-protein foods?

No, not necessarily. Lean meats and standard dietary protein should be no problem. But excessive protein intake can burden kidneys to trigger higher urate levels. Sticking to low-fat proteins like dairy, eggs or vegetable sources may work better for those with recurring gout.

References:

  • Choi HK1, Liu S, Curhan G. Intake of purine-rich foods, protein, and dairy products and relationship to serum levels of uric acid: the Third National Health and Nutrition Examination Survey. Arthritis Rheum. 2005 Jan;52(1):283-9. doi: 10.1002/art.20761.
  • Major TJ, Dalbeth N, Stahl EA, Oddson S, Gunderson TM, Iglehart M, Sheane B, Kannangara DR, Niu J, Neogi T, Choi HK, Weaver AL, Mikuls TR. Dietary Fat Intake, Meat Consumption and Risk of Incident Gout in Women: The Nurses’ Health Studies. Am J Med. 2022 Nov;135(11):1372-1381. doi: 10.1016/j.amjmed.2022.06.036. Epub 2022 Aug 12.
  • Juraschek SP, Miller ER 3rd, Gelber AC; Health Professionals Follow-up Study. Effect of Oral Vitamin C Supplementation on Serum Uric Acid: A Meta-analysis of Randomized Controlled Trials. Arthritis Care Res (Hoboken). 2011 Sep 27. doi: 10.1002/acr.20634.

So in summary, cheese is not directly problematic for those with gout or trying to prevent gout symptoms. Choosing low-fat varieties and keeping intake moderate allows including dairy for benefits against high uric acid.

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