Can tomatoes trigger gout attacks?

Many sufferers of gout name tomatoes as a possible cause of a gout attack, even though tomatoes contain very low levels of purine. So, if you struggle with gout, should you avoid eating them?


How can we identify foods that trigger gout?

Some foods can trigger painful gout attacks. A classic example is beer, which inhibits the excretion of uric acid but is also high in purine – an unfavorable combination. The exact circumstances that lead to a particular food triggering gout are not well understood. Popular belief holds that some foods cause the uric acid level in the blood to rise after consumption, and many nutritional studies lean on this view, since the level of uric acid in the blood can be easily measured. However, increases in uric acid level are not the sole explanation for what triggers violent flare-ups of gout.

Tomatoes are often cited as a trigger

Gout sufferers when surveyed repeatedly cite tomatoes as a trigger for an attack. Yet establishing whether this observation is indeed true, or whether it is just a perceived causality, is by no means easy, given that tomatoes and tomato-based products are so commonly consumed.

You can find some studies – most involving an admittedly small number of participants – that examine the effects of different foods on uric acid levels, but the results are mixed. Some showed that tomatoes increased uric acid levels, while others showed no such result.

A meta-analysis by Major et al. (2018) went one better and evaluated every study conducted on the subject, comparing them against various nutritional strategies to better filter out interference from other foods on uric acid levels.

No effect detectable

Again, though, the results were inconclusive. Taken as a whole, the studies revealed that products like alcoholic beverages and meat demonstrated a very clear rise in uric acid levels post consumption, but the results for tomatoes were ambiguous and not statistically significant. In view of the available data, we cannot therefore state with any certainty that avoiding tomatoes or tomato-based products would be appropriate for treating or preventing gout.

So instead of relying on medically unproven recommendations and potentially cutting tomatoes out of your diet completely unnecessarily, it is better to rely on established strategies when it comes to dealing with gout. There are no quick fixes; instead, it must be managed over time.

Why do we care so much about this topic?

We have been developing our "OxiPur" app about gout and oxalates for many years and are happy to share our knowledge with you. Check it out:

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