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Ask Dr. Gourmet

Is tilapia good for those with gout?

I'm suffering with gout and wondering if tilapia is good for me to eat?

Dr. Gourmet Says...

sauteed tilapia

Gout is caused by the conversion of certain proteins to uric acid. For some of us we produce too much uric acid and a few of us cannot excrete the uric acid well enough. Either way, when there are higher levels of uric acid circulating in the bloodstream, it can form small crystals which get lodged in joints, causing gouty arthritis.

The key is to reduce the amount of purine rich foods, and the current recommendations are to reduce the amount of red meat and poultry. While some vegetables are high in purines, these seem to have less effect than animal based proteins. Fish fall somewhere in the middle and some seafoods may provoke gout as they are higher in purines — shrimp and mussels, for example. Fin fish are less likely to be high in purines, so eating those in moderation are generally a better choice than consuming red meat, pork or poultry.

Here is a brief guide to purine levels in foods.

Since they are fin fish, tilapia is an OK choice for your gout, but we are not a big fan of that fish here at Dr. Gourmet. Because most tilapia is farmed and fed on a diet of soy or corn products, they will often have higher levels of Omega-6 fats. If you are going to choose seafood for your gout, you would be better off with seafood that is lower in Omega-6 fats and higher in Omega-3 fats. When replacing your land animal protein with seafood, you should be cautious about your intake of mercury as well. Here's an article about mercury in fish vs. the omega-3 levels in fish.

It is best for your gout to consume mostly vegetable sources for your proteins (legumes, vegetables, nuts, seeds, and whole grains) first, then some seafood (being careful of those very high in purines, such as tuna, mackerel, sardines, mussels, and scallops), and only then consuming sparing amounts of red meat, poultry, and pork.

Thanks for writing.

Timothy S. Harlan, MD, FACP
Dr. Gourmet