The short version: water, coffee, and tea are safe and even helpful; low-fat milk and diet soda are fine; sugary soda, fruit juice, and sports drinks are the ones to cut. Alcohol is its own trigger, covered on the alcohol page.
Wondering about a specific smoothie, latte order, or whole meal? The Dish Decoder grades it ingredient by ingredient.
Hydration: the easy lever
Water helps your kidneys flush uric acid, and that flushing is most of why hydration matters for gout. Higher water intake is associated with roughly 46% fewer recurrent attacks. Treat that as suggestive, not proven: the main data behind it is an unpublished 2009 conference abstract, summarized in a later review. The signal points the right way, the easy win is real, but it is not airtight.
A practical target is about 2 liters, or 8 glasses, a day, and more in heat or with exercise. Plain water is the anchor; coffee and tea count toward your fluids too. Be honest with yourself about what this does: hydration helps and costs you nothing, but it is not a cure on its own.
Evidence: Helget & Mikuls 2022, Rheum Dis Clin (review; ~46% fewer recurrent attacks with higher water intake)
Summer is gout season
Gout is not evenly spread across the year. In a UK cohort of about 249,000 patients, flares ran roughly 1.46 times higher in July than in December, and serum urate peaked in the summer months. A separate US study found that days at 70–79°F carried about 43% higher attack risk than cooler days, and dry heat made it worse. The mechanism is the hydration lever running in reverse: you sweat more, fluid drops, and uric acid concentrates in the blood, which is exactly the condition crystals form in.
So the summer playbook is the same advice with the dial turned up. Drink ahead of thirst on hot days, not after it. Water is still the anchor; coconut water is a fine low-sugar option if you want electrolytes without the fructose load of a sports drink. And the two biggest summer traps are the ones that ride along with the weather: cold sugary drinks and alcohol at cookouts, both of which push urate up while the heat is already doing the same. Read the seasonality as real but not destiny: you cannot change July, but hydration and holding the line on sugar and alcohol are exactly the levers that blunt it.
Evidence: Abhishek et al. 2025, Clin Rheumatol (CPRD AURUM cohort; July flares 1.46x December)Neogi et al. 2014, Am J Epidemiol (temperature, humidity, and recurrent attacks)
Good choices
Most of what you reach for out of habit is fine. Water is the anchor. Coffee is linked to lower uric acid over the long run, and the nuance is worth getting right: a small within-subject study found decaf lowered urate while caffeinated coffee nudged it up in the short term, so the benefit seems to come from coffee's other compounds, not the caffeine. Either way, coffee is a good drink for gout. Tea is in the same camp. Low-fat milk is independently linked to lower uric acid. And diet soda is fine: artificial sweeteners are not fructose, and they are not linked to gout.
Evidence: Choi & Curhan 2007, Arthritis Rheum (coffee linked to lower uric acid)Towiwat et al. 2021, Clin Exp Rheumatol (decaf vs. caffeinated, within-subject)
On diet soda: the evidence is limited but reassuring. Artificial sweeteners do not carry the fructose load that drives the sugar-sweetened risk, so a diet version is the safer swap when you want something fizzy.
Limit these: the sugar trap
Sugary soda, sweetened drinks, sports drinks like Gatorade, and juice are where gout drinks go wrong, and the culprit is fructose. Fructose is the one sugar that directly raises uric acid as your body breaks it down.
Here is the part people do not expect, and it ties straight to our work on fructose: even 100% fruit juice raised gout risk. In women, one glass of orange juice a day was linked to about 41% higher risk, and two or more glasses to roughly 2.4 times the risk. In men, two or more glasses of fruit juice a day carried about 81% higher risk. It is worth being precise about why, because the usual explanation is wrong: fibre does not blunt the sugar. When researchers matched the dose, whole apple raised uric acid just as much as a pure fructose drink. What changes is how much you take in. A glass of juice is the fructose of several pieces of fruit, drunk in a minute; eating that much fruit is something appetite normally stops. Whole fruit is the safer form, and portion is the reason.
Evidence: Choi et al. 2010, JAMA (fruit juice and gout risk in women)Choi & Curhan 2008, BMJ (soft drinks and fructose in men)White et al. 2018, Am J Clin Nutr (whole apple vs. a fructose drink at matched dose: same urate rise)
Sports drinks: is Gatorade bad for gout?
The answer splits by which bottle you pick. Regular Gatorade grades D: purine-free, but carrying the fructose that raises uric acid on its own. Gatorade Zero and other zero-sugar versions grade C: the sugar problem is gone, but it is still a heavily processed drink. If you want the electrolytes, zero-sugar is the swap.
The reason is that two true things point in opposite directions. Staying hydrated helps your kidneys clear uric acid, so a sports drink looks like the hydration option. But a regular one is a sugar-sweetened beverage, and that is the category with the clearest evidence against it: a 2025 meta-analysis pooling 22 studies and 235,790 people put sugary drinks at about 21% higher gout risk, and dietary fructose at about 66% higher. There is no gout study on sports drinks specifically. There does not need to be. The sugar is the variable.
In fairness to Gatorade, it is not a cola. US sports drinks are sweetened with sucrose and dextrose rather than high-fructose corn syrup, so a bottle carries roughly a third the fructose of the same volume of regular cola. That is a real difference and it is why the two are not identical on our numbers. It is not enough to move it out of the limit band: a third of a lot is still a daily fructose habit if the bottle is a daily habit.
If you want the top of the ladder, skip the category: plain water, sparkling water, and coconut water all grade A. Coconut water is the one that actually carries electrolytes without the processing.
Worth saying plainly: if you are actually sweating hard, replacing fluid matters more than avoiding a single sugary drink. The problem is the daily habit, not the one bottle after a long run in the heat.
Evidence: Front Nutr 2025 meta-analysis, 22 studies / 235,790 participants (SSBs OR 1.21 for gout; dietary fructose OR 1.66)Choi & Curhan 2008, BMJ (soft drinks and fructose in men)
Every drink we rate
Each grade combines purine load with fructose, the same A to E scale used across the site. Tap a drink for its full breakdown.
| Food | Grade | Purine /100g | Fructose /100g | Serving | Confidence |
|---|---|---|---|---|---|
| Black Tea | A | 0 mg | 0 g | 240 g | Low confidence |
| Coconut Water | A | 0 mg | 1.3 g | 240 g | Low confidence |
| Coffee | A | 0 mg | 0 g | 240 g | Low confidence |
| Green Tea Beverage | A | 1.7 mg | 0 g | 240 g | Moderate confidence |
| Green Tea Leaves (dried) | A | 204.3 mg | 0.5 g | 2 g | Moderate confidence |
| Sparkling Water | A | 0 mg | 0 g | 240 g | Low confidence |
| Vegetable Juice | B | 13.7 mg | 1.44 g | 240 g | Moderate confidence |
| Fresh Orange Juice | C | 5 mg | 2.45 g | 240 g | Moderate confidence |
| Mango Juice (nectar) | C | 3 mg | 4 g | 240 g | Moderate confidence |
| Sweetened Lemonade | C | 0 mg | 4.2 g | 240 g | Moderate confidence |
| Unsweetened Pineapple Juice | C | 5 mg | 2.72 g | 240 g | Moderate confidence |
| Zero-Sugar Sports Drink (Gatorade Zero) | C | 0 mg | 0 g | 591 g | Low confidence |
| Cola (Coca-Cola) | D | 0 mg | 5.84 g | 355 g | Moderate confidence |
| Cranberry Juice Cocktail | D | 3 mg | 6.7 g | 240 g | Low confidence |
| Fruit Juice | D | 1.1 mg | 6.98 g | 240 g | Moderate confidence |
| Fruit Punch Drink | D | 0 mg | 5 g | 240 g | Moderate confidence |
| Pomegranate Juice | D | 3 mg | 6.37 g | 240 g | Moderate confidence |
| Regular Energy Drink | D | 0 mg | 4.5 g | 473 g | Moderate confidence |
| Regular Lemon-lime Soda | D | 0 mg | 5.87 g | 355 g | Moderate confidence |
| Sports Drink (Gatorade) | D | 0 mg | 2.05 g | 591 g | Moderate confidence |
| Unsweetened Apple Juice | D | 5 mg | 6.36 g | 240 g | Moderate confidence |
| Unsweetened Grape Juice | D | 5 mg | 7.38 g | 240 g | Moderate confidence |
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Sources
- 1. Source: Choi HK, Willett W, Curhan G. Fructose-rich beverages and risk of gout in women. JAMA. 2010;304(20):2270-2278.
- 2. Source: Choi HK, Curhan G. Soft drinks, fructose consumption, and the risk of gout in men: prospective cohort study. BMJ. 2008;336(7639):309-312.
- 3. Source: Helget LN, Mikuls TR. Environmental Triggers of Hyperuricemia and Gout. Rheum Dis Clin North Am. 2022;48(4):891-906.
- 4. Source: Choi HK, Curhan G. Coffee, tea, and caffeine consumption and serum uric acid level: NHANES III. Arthritis Rheum. 2007;57(5):816-821.
- 5. Source: Towiwat P, Tangsumranjit A, Ingkaninan K, et al. Effect of caffeinated and decaffeinated coffee on serum uric acid and uric acid clearance: a randomised within-subject study. Clin Exp Rheumatol. 2021;39(5):1003-1010.
- 6. Source: Abhishek A, et al. Gout flares, serum urate and seasonality: a descriptive cohort study (CPRD AURUM, 249,157 patients). Clin Rheumatol. 2025. Flare rate 1.46x higher in July than December.
- 7. Source: Neogi T, Chen C, Niu J, et al. Relation of temperature and humidity to the risk of recurrent gout attacks. Am J Epidemiol. 2014;180(4):372-377.
- 8. Source: Sugar-sweetened beverages and risk of hyperuricemia and gout: systematic review and meta-analysis (22 studies, 235,790 participants). Front Nutr. 2025. SSBs OR 1.21 for gout; dietary fructose OR 1.66; fruit juice OR 1.15 for hyperuricemia.
Values are per 100g unless a note says otherwise, rounded to three significant figures; per-serving figures are calculated from the unrounded measurement, so recomputing from the rounded number can differ by a milligram or so. A single determination is normal in food composition tables, not a defect. Last reviewed July 18, 2026.
Drinking tonight? See alcohol and gout · the gout diet