Can Tomatoes Trigger Gout Attacks?
The main foods traditionally shown to trigger gout attacks are alcohol, red meat, and seafood. Some people, however, insist tomatoes prompt their attacks, so a team of researchers from New Zealand and Australia decided to explore the question: can tomatoes trigger gout attacks?
Gout, also known as gouty arthritis, is caused by having too much uric acid in the bloodstream. When the body cannot metabolize high levels of uric acid properly, urates can accumulate in the joints and form crystals, especially in the big toe. The result is burning pain, swelling, and stiffness.
New gout study
The study consisted of two parts. First, the researchers surveyed 2051 New Zealanders who had gout, and 71 percent of them said they had at least one food trigger. Tomatoes were named in 20 percent of cases, behind seafood, alcohol, and red meat.
Next, the investigators looked for a biological reason for tomatoes being named as a trigger. To accomplish this they analyzed data from 12,720 adults who participated in the Atherosclerosis Risk In Communities Study, Cardiovascular Health Study, and Framingham Heart Study.
The data revealed that eating tomatoes was linked to higher levels of uric acid in the bloodstream that were similar to those seen in foods that typically trigger gout. Therefore, although the study was not designed to prove that tomatoes are a trigger for gout attacks, the authors concluded “that the self-reporting of tomatoes as a dietary trigger by people with gout has a biological basis.”
In the study’s discussion, the authors noted that tomatoes may increase production of urates, which are the end product of the break down of purines. Foods high in purines (e.g., seafood, red meats, beer) are known gout attack triggers.
Tomatoes, however, have low purine levels. At the same time, they contain high amounts of an amino acid called glutamate, which is often present in foods that are rich in purines. Therefore, the glutamate may stimulate the production of urates and in this way provoke a gout attack in some people.
More research is needed to determine whether tomatoes should be considered a food that triggers an episode of gout. For now, however, this new research provides a biological basis for individuals who say tomatoes can trigger gout attacks.
In addition to the foods already mentioned, others that may trigger or contribute to a gout attack include chicken, beans, lentils, peas, mushrooms, cauliflower, and spinach. Treatment of gout typically includes nonsteroidal anti-inflammatory drugs, xanthine oxidase inhibitors (e.g., allopurinol), colchicine, and corticosteroids. On the natural front, cherries have been found to help provide relief.
Flynn TJ et al. Positive association of tomato consumption with serum urate: support for tomato consumption as an anecdotal trigger of gout flares. BMC Musculoskeletal Disorders 2015; 16(1).