Most gout food advice reads like a list of everything you have to give up. It is easier to treat it the way you would any eating change: fix one habit at a time, starting with the easiest swap. Gout itself is caused by too much uric acid in the blood, which can lead to crystals forming around the joints and sudden, severe joint pain (NHS).
This is general information, not medical advice. Your doctor's food list and any medicine you are prescribed come first.
Swap one: sugary drinks and juice
Drinks are the simplest place to start because the swap is easy. A 22-year study of 78,906 women with no history of gout recorded 778 new cases (Choi, Willett and Curhan, 2010). Compared with less than one serving a month, one sugar-sweetened soda a day carried a relative risk of 1.74, and one serving of orange juice a day 1.41. Diet soft drinks were not linked to gout. The authors added that these drinks probably contribute only modestly to gout in the population, because gout is uncommon among women.
A 12-year study of 46,393 men found the same pattern for sugar-sweetened soft drinks, and also linked total fruit juice and fructose-rich fruits such as apples and oranges with higher risk (Choi and Curhan, 2008). The NHS gout page puts it plainly: do not have lots of sugary drinks and snacks, and drink plenty of fluids so you do not get dehydrated.
Swap two: less meat and seafood, more plant protein
In a study that followed 633 people with gout online for a year, the highest fifth of purine intake over 2 days came with 4.76 times the odds of an attack compared with the lowest fifth (Zhang et al., 2012). Purine from meat and seafood mattered more than purine from plant foods. The authors suggested plant-derived foods, especially nuts and legumes, as the preferred protein sources for people with gout.
Swap three: alcohol
The NHS advises some alcohol-free days each week and no more than 14 units a week. The 2020 American College of Rheumatology guideline conditionally recommends limiting alcohol, purine intake and high-fructose corn syrup for everyone with gout, and a weight-loss programme for those who are overweight (FitzGerald et al., 2020). It rated the evidence for each as low or very low certainty, so treat these as sensible habits rather than guarantees.
Where dates sit in all this
None of the studies above tested dates, so they say nothing about dates causing or preventing gout. Dates are, though, a sugary fruit: USDA FoodData Central lists 32.0 g of fructose per 100 g of Medjool dates. Iranian Piarom or Mazafati dates are still dates, and the same caution applies.
So the swap is about timing and amount. The NHS 5 A Day page says a 30 g portion of dried fruit such as dates counts as one of your 5 A Day, and should be eaten at mealtimes, not as a snack between meals, to reduce the impact on teeth (NHS). A few dates after dinner fits that. A jar on the desk for the 3pm slump does not, because that makes dates the between-meal snack the NHS 5 A Day page advises against.
If you are comparing varieties, our piece on Medjool from Palestine and Iranian dates explains how they differ in where they grow.
Things the evidence does not settle
The ACR guideline also reviewed cherries and dairy, and found the evidence too weak, mostly observational and of low or very low certainty, to make a specific recommendation. Vitamin C is split: the NHS says to ask a GP about vitamin C supplements, while the ACR guideline conditionally recommends against adding them after two small trials (29 and 40 patients) found clinically insignificant changes in uric acid. Ask your doctor before you buy supplements.
Keep one swap at a time
Keep one swap until it is automatic, then move to the next. If you are buying dates for a household or a small shop, see our sourcing page, or message us through the contact page, and plan to serve them with meals.
References
- NHS. Gout. https://www.nhs.uk/conditions/gout/
- NHS. 5 A Day: what counts? https://www.nhs.uk/live-well/eat-well/5-a-day/5-a-day-what-counts/
- Choi HK, Willett W, Curhan G. Fructose-rich beverages and risk of gout in women. JAMA. 2010;304(20):2270-8. PMID 21068145
- 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
- Zhang Y, et al. Purine-rich foods intake and recurrent gout attacks. Ann Rheum Dis. 2012;71:1448-53. PMID 22648933
- 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
- USDA FoodData Central (SR Legacy, 2019). Dates, medjool, FDC 168191. https://fdc.nal.usda.gov/food-details/168191/nutrients