While gout is associated with rich diets, there is not enough evidence to show that any specific diet prevents flares or lowers serum urate levels.[13]

Diets rich in purines may only account for raising uric acid levels by 1-2 mg/dl, but general dietary advice has included decreasing consumption of purine-rich foods. These include seafood (especially scallops, herring and anchovies), meat (especially organs like ‘sweetbreads’ or liver) and game.[6,11]

Fructose intake can also play a role in increasing uric acid levels. It goes through a two-part metabolic process, first phosphorylation before breaking the saccharide ring. The first step depletes phosphate levels and is much faster than the second, resulting in adenosine monophosphate and diphosphate breakdown as adenosine triphosphate cannot be formed. This releases adenosine for conversion into uric acid.[6]

Sucrose, sorbitol, lactose and methylxanthines (eg caffeine, theophylline or theobromine from coffee tea and chocolate) can increase uric acid levels – sorbitol is metabolised into fructose in the liver.[6]

Vitamin C may reduce uric acid levels by competitive inhibition of uric acid reabsorption in the kidneys by affecting the anion transportation system.

Beer increases uric acid levels due to a high purine content while the alcohol reduces uric acid secretion and increases uric acid production.