Quick answer: For most types of arthritis, no single food reliably triggers flares. The clearest exception is gout, where alcohol, very large meals, sugary drinks and dehydration can trigger attacks. Limiting sugary, highly processed foods and alcohol helps overall health and weight. Do not cut out whole food groups without advice from your GP or a dietitian.
Search online for "foods to avoid with arthritis" and you will find long lists telling you to give up tomatoes, potatoes, dairy, gluten, red meat, sugar and more. It is easy to end up anxious about every meal. The reality is more reassuring. For most people with arthritis, there is no single food that reliably triggers symptoms. There are some clear exceptions, especially for gout, and some foods that are worth limiting for your overall health and weight. This guide separates what is supported by good evidence from what is not, and shows you how to test a suspected trigger safely.
The short answer by type of arthritis
| Type | Food and drink triggers with good evidence | What usually helps most |
|---|---|---|
| Gout | Alcohol (especially beer and spirits), very large meals, sugary drinks, dehydration; foods high in purines can raise urate levels | Treatment to lower urate if needed, healthy weight, alcohol-free days, plenty of fluids |
| Osteoarthritis | No specific trigger foods | Healthy weight if overweight, exercise, a balanced diet |
| Rheumatoid and other inflammatory arthritis | No specific trigger foods for most people | Effective medical treatment, a balanced diet such as a Mediterranean-style pattern, not smoking |
| Coeliac disease with joint pain | Gluten (only after diagnosis) | Strict gluten-free diet after a confirmed diagnosis |
Gout: the clearest link between food and flares
Gout is caused by high levels of uric acid (urate) forming crystals in a joint. Diet affects urate levels, which is why food matters more in gout than in other types of arthritis. The NHS lists things that can trigger an attack, including drinking too much alcohol, eating a very large meal, getting dehydrated, an illness with a high temperature, a joint injury and some medicines.
To help prevent attacks, the NHS advises:
- Lose weight if you are overweight, but avoid crash diets, which can themselves trigger attacks
- Eat a healthy diet; your doctor may give you a list of foods to include or limit
- Have some alcohol-free days each week, and try not to drink more than 14 units a week
- Drink plenty of fluids to avoid dehydration
- Do not have lots of sugary drinks and snacks
- Exercise regularly, avoiding very intense exercise or heavy pressure on joints
Purine-rich foods
Purines are broken down into uric acid. Foods high in purines include offal such as liver and kidneys, some seafood such as anchovies, sardines, mussels and shellfish, and large amounts of red meat. Many people with gout are advised to limit these. NICE's gout guideline (NG219) focuses on medicines to lower urate as the main long-term treatment for people with frequent attacks, with lifestyle advice alongside. Diet changes alone are often not enough to control gout, so do not rely on them instead of treatment your doctor recommends.
Our gout flare diet guide goes into more detail.
Alcohol
Alcohol matters for several reasons, beyond gout:
- Sleep: it may help you fall asleep but tends to disturb sleep later, and poor sleep makes pain harder to cope with.
- Weight: alcohol is high in calories, and extra weight puts more load on knees and hips.
- Medicines: some arthritis medicines carry advice about alcohol. For example, the NHS says it is usually OK to drink alcohol if you take a low weekly dose of methotrexate (25mg or less) for an inflammatory condition, but you should ask your doctor if you take higher doses. Anti-inflammatory painkillers and alcohol together can increase the risk of stomach irritation. Always check the leaflet or ask your pharmacist.
- Falls: alcohol affects balance, which matters if your joints are already unsteady.
The UK Chief Medical Officers' low-risk guideline is not to drink more than 14 units a week on a regular basis, spread over three or more days. If you have gout or take medicines affected by alcohol, your doctor may advise less.
Foods worth limiting for overall health
These are not proven arthritis triggers, but limiting them supports a healthy weight, heart health and general wellbeing, all of which matter when you live with arthritis. The NHS Eatwell Guide recommends eating these less often and in small amounts.
- Sugary drinks and snacks: high in calories and linked to weight gain. For gout specifically, the NHS advises not having lots of them.
- Highly processed foods high in salt, sugar and saturated fat, such as many ready meals, processed meats, pastries and crisps.
- Too much salt: worth watching if you take steroid tablets, which can raise blood pressure.
- Large portions: if you are overweight, gradually reducing portion sizes is one of the most useful things you can do. NICE's osteoarthritis guideline (NG226) recommends weight loss for people with osteoarthritis who are overweight, and notes that any amount of weight loss is likely to help.
Popular "trigger foods" with little evidence
Nightshades (tomatoes, potatoes, peppers, aubergines)
The idea that nightshade vegetables worsen arthritis is widespread, but there is no good scientific evidence that they cause flares or harm joints. These vegetables are nutritious and part of a Mediterranean-style diet. If you are convinced they affect you, you can test it carefully (see below), but there is no need to avoid them by default.
Dairy
There is no good evidence that dairy foods trigger arthritis flares for most people. Dairy is a useful source of calcium and protein, both important for bones and muscles, which matters if you have arthritis, take steroids, or are at risk of osteoporosis. If you avoid dairy, make sure you get calcium from other sources.
Gluten
Gluten only causes joint symptoms in people with coeliac disease or a confirmed gluten-related condition. Coeliac disease can sometimes cause joint pain. If you think gluten affects you, ask your GP about testing before you cut it out, because the NHS advises that you need to keep eating gluten for the tests to be accurate. For everyone else, there is no evidence a gluten-free diet helps arthritis.
Citrus fruit and acidic foods
There is no good evidence that citrus fruit or "acidic" foods worsen arthritis. Fruit and vegetables are an important part of a healthy diet.
Red meat
Large amounts of red meat matter for gout, and processed meat is worth limiting for general health. For other types of arthritis, there is no strong evidence that moderate amounts of red meat cause flares.
Our guide to arthritis diet myths looks at more of these claims.
Food and medicine interactions
Some foods and drinks matter because of the medicines you take, rather than the arthritis itself:
- Methotrexate: the NHS says there are no specific foods to avoid, but as it can reduce your ability to fight infection it is best to avoid unpasteurised milk and soft cheeses, and to avoid too much caffeine, which can stop it working as well as it should.
- Steroid tablets: can raise blood sugar and blood pressure and increase appetite, so watching sugar, salt and portion sizes helps. They can also affect bone health, so adequate calcium and vitamin D matter.
- Herbal supplements: some, such as St John's wort, and high doses of some supplements can interact with medicines. Tell your pharmacist about anything you take.
- Grapefruit: interacts with a number of medicines. Check the leaflet for each medicine you take.
Our guide to food, drink and arthritis medicines covers this in more detail.
What to eat more of
Focusing on what to add is often more useful than what to cut. A Mediterranean-style diet, rich in vegetables, fruit, wholegrains, beans and lentils, nuts, olive oil and oily fish, with less red and processed meat, is one of the best studied eating patterns for health and is widely recommended for people with arthritis. Oily fish provides omega-3 fats. Our Mediterranean diet guide and diet hub explain how to start.
How to test a suspected trigger food safely
If you really believe a particular food makes your symptoms worse, you can test it in a careful, limited way, ideally with support from your GP or a registered dietitian.
- Keep a food and symptom diary for two weeks without changing anything. Record what you eat, your daily pain score, stiffness and any swelling. Our pain tracking journal can help.
- Pick one food at a time. Do not cut out several foods at once, or you will not know which made a difference.
- Remove it for two to four weeks, keeping everything else the same, including medicines and activity.
- Reintroduce it and watch for a clear, repeated change over the following days.
- Be honest with the results. Arthritis naturally varies, so one bad day after eating something does not prove a link. A pattern that repeats is more meaningful.
- Do not cut out whole food groups, such as dairy or all grains, without advice, because this can lead to missing important nutrients.
If you have lost weight without trying, are eating very little, or have a history of eating difficulties, speak to your GP before changing your diet.
When to get medical help
- Call NHS 111 or go to A&E for a suddenly hot, red, swollen, very painful joint with fever or feeling unwell, as it may be an infection rather than gout.
- See your GP if you think you have gout for the first time, or your usual gout treatment is not helping. The NHS says to get treatment as soon as you feel an attack starting.
- See your GP if you have joint pain with diarrhoea, bloating, weight loss or tiredness, which could suggest coeliac disease or inflammatory bowel disease.
- See your GP or pharmacist if you are unsure whether foods, alcohol or supplements are safe with your medicines.
- Call 999 for signs of a severe allergic reaction, such as swelling of the lips or throat or difficulty breathing.
Are there foods that make arthritis worse?
For most types of arthritis, there is no single food proven to make it worse. Gout is the main exception: alcohol, very large meals, sugary drinks and purine-rich foods can raise urate and trigger attacks. For everyone, limiting sugary, highly processed foods supports a healthy weight.
Should I stop eating tomatoes and potatoes for arthritis?
There is no good evidence that nightshade vegetables such as tomatoes, potatoes and peppers worsen arthritis. They are nutritious. If you strongly suspect one affects you, remove it alone for a few weeks and then reintroduce it to see if there is a clear, repeated change.
What foods trigger gout attacks?
The NHS lists drinking too much alcohol and eating a very large meal among triggers, along with dehydration. Foods high in purines, such as offal, some seafood and large amounts of red meat, can raise urate levels. Sugary drinks are best limited. Medicines to lower urate are the main long-term treatment.
Is dairy bad for arthritis?
There is no good evidence that dairy triggers arthritis for most people. Dairy provides calcium and protein, which help keep bones and muscles strong. If you avoid dairy, make sure you get enough calcium from other foods or as your GP advises.
Can I drink alcohol if I have arthritis?
Many people can drink within the UK low-risk guideline of no more than 14 units a week, spread over several days. If you have gout, take methotrexate at higher doses, or take other medicines affected by alcohol, check with your doctor or pharmacist, who may advise less.
Should I try an elimination diet?
Only in a careful, limited way. Test one food at a time for a few weeks while keeping a symptom diary, and do not cut out whole food groups without advice from your GP or a dietitian. Strict elimination diets can lead to missing important nutrients.
Sources and further reading
- NHS: Gout
- NHS: The Eatwell Guide
- NHS: Common questions about methotrexate
- NHS: Coeliac disease
- NHS: The risks of drinking too much
- NICE NG219: Gout
- NICE NG226: Osteoarthritis in over 16s
Educational information for people in the United Kingdom — not a diagnosis or personal medical advice. Charity no. 1218461. Pending clinical review. Everyone's situation is different, so always follow the advice of your own GP, pharmacist or rheumatology team. If you feel very unwell, call 999 or go to A&E. For urgent advice, contact NHS 111.
Continue with related help
- Diet hub — eating well with arthritis
- Mediterranean diet — the most studied eating pattern
- Gout flare diet — more on gout and food
- Diet myths — claims to be wary of
- Food and medicines — what not to mix
- Anti-inflammatory eating — what to eat more of
Related practical guidance
Practical diet guidance for rheumatoid arthritis — Read affordable meal ideas and the limits of anti-inflammatory claims.