More than nine million Americans live with gout, a painful form of arthritis that’s easily triggered by certain food and alcohol.
Left untreated, a gout flare-up can cause irreversible joint damage.
So if you have been diagnosed with gout or suspect that you have it, it’s important to understand which foods may trigger you.
Most people think of fat-laden meats as the main foods that trigger gout.
And while red meat and organ meats can cause flare-ups, other seemingly healthy foods—including tomatoes—can also trigger gout in certain people.
Here, I’ll break down what gout is, the relationship between tomatoes and gout flares, other common foods that trigger gout to be aware of, and when to see a doctor if you have a gout attack.
While you may have to limit or eliminate certain foods from your diet for the sake of your joints, you can still enjoy a wide variety of delicious flavors.
What Is Gout?
Once called “the disease of kings”, gout is a type of arthritis that causes very painful, swollen joints.
Gout happens when the body has too much uric acid.
This acid breaks down purines, chemicals found naturally in the body and also in certain foods.
Depending on a person’s dietary choices and genetics, their body may either produce too much uric acid or not excrete enough uric acid.
When this happens, uric acid crystals can accumulate in the joints—most commonly the big toe—and cause the pain and inflammation of gout.
While there is no cure, gout is manageable and preventable with a proper diet and medication.
Tomatoes and Gout Flares
Eating a diet rich in foods high in purine can trigger gout.
High-purine foods include:
- Red meat
- Organ meats like liver
- Seafood (particularly anchovies, sardines, mussels, scallops, trout, and tuna)
- Beverages high in fructose
Although tomatoes are low in purine, some research suggests they may cause gout flares.
In a study of more than 2,000 people diagnosed with gout, 20% said that tomatoes were a trigger, making it the fourth most common trigger food reported.
It’s unclear why tomato consumption causes gout flares in certain individuals.
Some scientists believe that because tomatoes contain high levels of glutamate—an amino acid that is often found in high-purine foods—they may stimulate or increase the creation of uric acid in some people.
Genetics likely plays a role in who responds this way to tomatoes.
How to Tell If Tomatoes Are a Trigger
Gout flare-ups often happen suddenly at night.
If you eat tomatoes regularly and are experiencing any of the following symptoms in one or more joints, tomatoes may be a trigger food for you:
- Limited range of motion
To determine if tomatoes are part of the problem, try eliminating all tomatoes and tomato-based products from your diet for 2-4 weeks.
Then add tomatoes back in and see how your body responds.
While you do this, it can help to keep a food journal to track details such as:
- What you eat and drink
- How much you eat and drink
- The time of day you eat and drink
- Any pain experienced, including where, when, and the intensity
If your gout symptoms improve or disappear when you stop eating tomatoes and then return or worsen when you begin to eat tomatoes again, the food is likely a trigger for you.
Other Foods to Avoid With Gout
Tomatoes aren’t the only food that may raise uric acid levels in some people.
If you have gout or experience gout flare-ups, consider avoiding or limiting the following common food triggers, all of which are high in purines:
- High-fructose corn syrup (HFCS)
- Wild game such as duck, veal, and venison
- Organ meat such as liver or kidney
- Shellfish, sardines, anchovies, tuna, cod, trout, and haddock
When to See a Doctor
Gout attacks can occur suddenly and usually happen in one joint at a time, such as the big toe.
Other commonly affected joints include other toes, the ankle, and the knee.
Symptoms of a flare are typically very noticeable and include:
- Intense pain
- Heat and tenderness
- Limited range of motion
If you experience any of the above, contact a physician as soon as possible.
Without proper treatment, these symptoms can lead to worsening pain, more frequent episodes, or permanent joint damage.
How K Health Can Help
Did you know you can get affordable primary care with the K Health app?
Download K to check your symptoms, explore conditions and treatments, and if needed text with a doctor in minutes. K Health’s AI-powered app is HIPAA compliant and based on 20 years of clinical data.
Frequently Asked Questions
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.
K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.
Eating Right With Arthritis: Arthritis Nutrition FAQs. (2010).
Gout and Hyperuricemia in the USA: Prevalence and Trends. (2019).
Positive Association of Tomato Consumption with Serum Urate: Support for Tomato Consumption as an Anecdotal Trigger of Gout Flares. (2015).
Tomato Juice Consumption Reduces Systemic Inflammation in Overweight and Obese Females. (2013).
Tomato Lycopene and Its Role in Human Health and Chronic Diseases. (2000).
Uric Acid and Plant-Based Nutrition. (2019).
Which Foods Are Safe for Gout?