Is Cheese Bad for Gout? Which Types Are Safest

Cheese is not bad for gout - in fact, dairy products are one of the few food groups that research consistently links to lower gout risk. Cheese is low in purines, and the proteins found in dairy have a uricosuric effect, meaning they actively help your kidneys excrete uric acid. If anything, cheese deserves a spot on your plate, not a place on your worry list.

How does dairy actually lower uric acid?

This is one of the more encouraging findings in gout nutrition research. Dairy doesn’t just avoid raising uric acid - it appears to actively lower it through multiple mechanisms.

A 2004 study in the New England Journal of Medicine tracked over 47,000 men for 12 years and found that those with the highest dairy intake had a 44% lower risk of developing gout compared to those with the lowest intake. That’s a significant protective effect, and it held up after controlling for other dietary and lifestyle factors.

Like milk, cheese is among the most effective foods that lower uric acid. The mechanisms behind this effect include:

• Uricosuric proteins: Casein and lactalbumin (the two main proteins in milk and cheese) promote uric acid excretion through the kidneys. A clinical study in the Annals of the Rheumatic Diseases showed that consuming milk acutely lowered serum uric acid levels within hours.
• Orotic acid: A compound found in milk that also promotes renal uric acid excretion.
• Anti-inflammatory properties: Milk fat globule membrane (MFGM) and glycomacropeptide (GMP) in dairy have demonstrated anti-inflammatory effects that may reduce the inflammatory response to urate crystals.

This is a case where the metabolic context of a food dramatically outweighs its purine content. Cheese contains minimal purines (typically 5-20mg per 100g), and the proteins in cheese actively support the excretion pathways that most gout sufferers need help with. Remember, most people with gout are “under-excreters” - their kidneys don’t clear uric acid efficiently enough, often due to insulin resistance or genetic factors. Dairy proteins work directly on this bottleneck.

What are the purine levels in different cheeses?

All cheese is low in purines, but here’s how common varieties compare:

Cheese	Purines per 100g	Protein per 100g	Notes
Cottage cheese	~8mg	11g	High protein, low fat options available
Mozzarella (part-skim)	~10mg	25g	Excellent protein-to-purine ratio
Cheddar	~10mg	25g	Widely available, versatile
Swiss	~12mg	27g	High protein
Parmesan	~15mg	36g	Very high protein per serving
Cream cheese	~8mg	6g	Lower protein, higher fat
Brie	~12mg	21g	Moderate protein
Gouda	~10mg	25g	Similar profile to cheddar

For comparison, a serving of chicken breast contains ~141mg of purines per 100g and a serving of beef liver contains ~554mg. Cheese is in an entirely different league.

Which cheeses are best for gout management?

While all cheese is safe from a purine standpoint, some choices are better when you consider the full metabolic picture:

Best choices

• Part-skim mozzarella: High protein with lower saturated fat, delivers plenty of casein for the uricosuric effect
• Cottage cheese (low-fat): Excellent protein density, versatile, and easy to incorporate into meals
• Reduced-fat Swiss: High protein, moderate calories
• Parmesan: Used in smaller amounts but extremely protein-dense - a tablespoon grated on a dish adds dairy protein with minimal calories

Perfectly fine choices

• Cheddar, Gouda, Provolone: Staple cheeses that are all low-purine and provide beneficial dairy proteins. Higher in saturated fat than low-fat options, but moderate portions are reasonable for most people.
• Feta: Works well in salads and Mediterranean-style dishes

Less optimal (but still safe for gout)

• Cream cheese: Low protein relative to calories, so less uricosuric benefit per serving
• Processed cheese products: Often contain added ingredients and less actual dairy protein. Some contain added sugars - check labels.
• Cheese-flavored snacks: Not real cheese, often loaded with refined carbohydrates and artificial ingredients

The distinction here isn’t about purine content - it’s about maximizing the metabolic benefits. Higher-protein, lower-fat cheeses give you more of the casein and lactalbumin that promote uric acid excretion, with less caloric load that could contribute to weight gain and insulin resistance.

Does the fat content in cheese matter for gout?

This is where nuance matters. Some older guidelines specifically recommend “low-fat” dairy for gout, based partly on the original epidemiological studies. But the picture is more complex:

The uricosuric effect comes from the protein fraction of dairy, not the fat. So from a uric acid excretion standpoint, full-fat and low-fat cheese both deliver the beneficial proteins.

However, the metabolic context argues in favor of moderation with high-fat cheese:

• Caloric density: Full-fat cheese is calorie-dense (about 400 calories per 100g for cheddar). Excess calorie intake contributes to weight gain, which drives insulin resistance - the single biggest metabolic factor in gout for many people.
• Saturated fat and insulin sensitivity: High saturated fat intake may impair insulin sensitivity in some individuals. A 2016 study in the American Journal of Clinical Nutrition found that replacing saturated fat with unsaturated fat improved insulin sensitivity.
• Overall metabolic health: Conditions commonly associated with gout - hypertension, metabolic syndrome, type 2 diabetes - are all influenced by dietary fat quality and quantity.

The practical takeaway: don’t avoid full-fat cheese, but don’t eat unlimited quantities either. A few slices of cheddar or a portion of brie is perfectly reasonable. The goal is enjoying cheese as part of a metabolically healthy eating pattern, not treating it as a free food because of its low purine content.

How does cheese compare to other protein sources for gout?

When you need protein, cheese is among the safest options:

• Cheese (any type): 5-20mg purines per 100g, actively promotes uric acid excretion
• Eggs: 2-5mg purines per 100g, no effect on gout risk
• Tofu: ~70mg purines per 100g, no associated gout risk despite moderate purines
• Chicken breast: ~141mg purines per 100g, moderate gout risk increase
• Beef: ~110-150mg purines per 100g, moderate gout risk increase
• Organ meats: 400-800mg purines per 100g, significant gout risk increase

Combining cheese with eggs and plant proteins gives you a protein foundation that carries essentially zero gout risk while actively supporting uric acid excretion.

What about lactose intolerance?

If you’re lactose intolerant, you can still benefit from dairy’s uricosuric effect:

• Aged cheeses (Parmesan, aged cheddar, Swiss) are naturally very low in lactose because the aging process breaks it down
• Hard cheeses generally contain less lactose than soft cheeses
• Lactase supplements taken with dairy can allow you to consume cheese comfortably
• Lactose-free cheese products retain the beneficial dairy proteins

If dairy is truly off the table, other strategies for supporting uric acid excretion include staying well hydrated, maintaining a healthy weight, and limiting fructose intake - since fructose is the only sugar that directly impairs renal uric acid clearance.

Tracking your personal response

While the population-level data on cheese and gout is strongly positive, individual responses can vary. Some people report that certain rich or aged cheeses seem to precede flares - whether due to the cheese itself, the wine that accompanied it, or other factors in that meal. Using a tracking app like Urica to log your meals alongside flare data can help you identify whether any specific cheeses correlate with your symptoms, so you can make decisions based on your own patterns rather than guesswork.

The overall message on cheese and gout is genuinely good news. Low purines, beneficial proteins that promote uric acid excretion, and strong epidemiological evidence of a protective effect make cheese one of the more confident additions to a gout-friendly diet.

This article is for informational purposes only and is not medical advice. Consult your rheumatologist or healthcare provider about your specific dietary needs.