Gout is a type of arthritis that causes sudden, severe joint pain, and it is caused by having too much uric acid in the blood (NHS). The 2020 American College of Rheumatology guideline says diet changes likely make only small changes to uric acid levels, but that dietary factors may act as triggers for attacks (FitzGerald et al., 2020). This guide covers the meal you eat at work: the packed lunch.
This article is general information, not medical advice. If you have gout, follow the food list and treatment your own doctor gives you.
Pack the box the night before, not the morning of
Mornings are short. Pack the lunchbox right after dinner while the kitchen is already out, and in the morning you only need to take it from the fridge on the way out the door.
One container, three compartments
Rice or noodles in one section, a protein in another, vegetables filling the rest. The NHS suggests basing meals on higher-fibre starchy foods such as brown rice or wholewheat pasta, and including at least one starchy food with each main meal (NHS eight tips). It says these can help you feel full for longer.
For the protein slot, a study of purine intake gives some numbers. In a case-crossover study of 633 people with gout, a 2-day period in the highest fifth of purine intake carried 4.76 times the odds of a gout attack compared with a 2-day period in the lowest fifth (Zhang et al., 2012). The top fifth of animal purine had odds of 2.41, against 1.39 for plant purine. The researchers' list of high-purine foods includes meats, organ meats, meat extracts and gravies, seafood, beans, peas, lentils, oatmeal, spinach, asparagus, mushroom, yeast, beer and other alcoholic drinks. Even so, they wrote that plant foods, especially nuts and legumes, should be the preferred protein sources for people with gout. A dhal or bean dish in the protein slot on some days follows that advice.
Packing one box also helps you keep lunch to a normal size. The NHS lists eating a very large meal, along with drinking too much alcohol, among the things that can trigger a gout attack.
Pack the dates with lunch, not the desk drawer
A stash of dates in the desk drawer for the 3pm slump sounds sensible, but the NHS advice points the other way. Its 5 A Day page counts a 30 g portion of dried fruit, dates included, as one of your 5 A Day, and says it should be eaten at mealtimes, not as a snack between meals, to reduce the impact on teeth (NHS). Put one weighed 30 g portion in the lunchbox and eat it at the end of the meal.
Dates are also a fructose-rich fruit. USDA FoodData Central lists 32.0 g of fructose per 100 g of Medjool dates and 19.6 g per 100 g of Deglet Noor dates. In a 12-year study of 46,393 men, fructose-rich fruits (apples and oranges) and fruit juice were linked with a higher risk of gout (Choi and Curhan, 2008). None of the studies here tested dates themselves, so they give no evidence either way on dates and gout attacks. If you want something at the desk, the NHS gout page says to drink plenty of fluids to avoid getting dehydrated, so a bottle of water is the simpler choice.
Skip the sweet drink at the canteen
In that study of men, two or more sugar-sweetened soft drinks a day carried a relative risk of gout of 1.85 compared with less than one a month. Diet soft drinks were not linked with gout. A 22-year study of 78,906 women recorded 778 new cases (Choi et al., 2010). Compared with less than one serving a month, two or more servings a day of sugar-sweetened soda carried a relative risk of 2.39, and two or more of orange juice 2.42. The authors said these drinks likely make a modest contribution to gout across the population, because gout is not common in women. The NHS gout page says not to have lots of sugary drinks and snacks.
Batch it on Sunday, reheat on Tuesday
One hour of cooking on the weekend, a curry or a stir-fry, split across four containers covers four lunches. Portion it into single-meal containers so each lunch stays a normal size, and label each one with the date you cooked it.
Not a substitute for medical advice
The NHS says your doctor may give you a list of foods to include or limit, and that uric acid-lowering medicine should be taken regularly, even when you no longer have symptoms. Vitamin C is one place where sources differ. The NHS says to ask a GP about vitamin C supplements, while the ACR guideline conditionally recommends against adding them, after two small trials of 29 and 40 patients showed clinically insignificant changes in uric acid. A lunchbox routine supports your doctor's plan. It does not replace it.
A gout-aware packed lunch comes down to a few habits: pack it the night before, watch the protein slot, keep the dates with the meal and drink water instead of something sweet.
For dates to pack with lunch, browse what's available at Kurma Online. There is more about Kurma Online on our about page, and the contact page has our WhatsApp number.
References
- NHS. Gout. https://www.nhs.uk/conditions/gout/
- NHS. 8 tips for healthy eating. https://www.nhs.uk/live-well/eat-well/how-to-eat-a-balanced-diet/eight-tips-for-healthy-eating/
- NHS. 5 A Day: what counts? https://www.nhs.uk/live-well/eat-well/5-a-day/5-a-day-what-counts/
- FitzGerald JD, et al. 2020 American College of Rheumatology Guideline for the Management of Gout. Arthritis Care Res (Hoboken). 2020;72(6):744-760. PMID 32391934
- Zhang Y, et al. Purine-rich foods intake and recurrent gout attacks. Ann Rheum Dis. 2012;71(9):1448-53. PMID 22648933
- Choi HK, Curhan G. Soft drinks, fructose consumption, and the risk of gout in men: prospective cohort study. BMJ. 2008;336(7639):309-12. PMID 18244959
- Choi HK, Willett W, Curhan G. Fructose-rich beverages and risk of gout in women. JAMA. 2010;304(20):2270-8. PMID 21068145
- USDA FoodData Central (SR Legacy). Dates, medjool, FDC 168191. https://fdc.nal.usda.gov/food-details/168191/nutrients
- USDA FoodData Central (SR Legacy). Dates, deglet noor, FDC 171726. https://fdc.nal.usda.gov/food-details/171726/nutrients