August 10, 2026, is National S'mores Day, and across the United States, camping stoves and backyard fire pits will turn out thousands of the classic campfire treat — a golden-toasted marshmallow and a square of chocolate squeezed between two graham crackers. If you live with gout, it is reasonable to ask whether this sweet ritual is off the table. The honest answer is reassuring: an occasional s'more is unlikely to be the thing that triggers a flare. Purines are not the central concern here — added sugar is. Here is a straight look at each ingredient, what the research says, and how to enjoy the moment sensibly.
Purines and sugar: two different gout levers
Gout risk from food operates through two distinct channels, and keeping them separate clarifies a lot. The first is purines: compounds that break down into uric acid. The second is fructose and other rapidly absorbed sugars, which raise uric acid acutely by accelerating purine breakdown in the liver. Our purine vs. fructose guide walks through the difference in more detail.
By those two yardsticks, the s'more is an interesting mix. Chocolate and cocoa sit in the low-to-moderate purine range, and refined grain products like graham crackers are low in purines. Marshmallows are essentially sugar, water, and gelatin — nearly zero purines, but very high in sugar. So the main lever for a gout patient isn't purines; it is total added sugar.
Chocolate: not the villain many assume
Chocolate gets a reputation as a gout trigger, but the evidence is thinner than the folklore. Cocoa is generally classified as low to moderate in purine content, and no large clinical study has shown that eating chocolate meaningfully increases the risk of gout flares. Reviews of dietary risk factors for gout tend not to single out chocolate at all, and it does not appear on the short list of foods that cohort studies most consistently associate with risk.
That said, not all chocolate is equal. Milk chocolate and white chocolate are higher in added sugar, and the classic s'more bar is usually milk chocolate. If you want to trim sugar, a darker chocolate with a higher cocoa percentage delivers more flavor for less sugar. The 2020 American College of Rheumatology gout guideline does not ban chocolate; it emphasizes total dietary pattern, moderation, and reducing the foods with the strongest evidence links, such as red meat, processed meat, and sugary drinks.
Marshmallow and graham crackers: doing the sugar math
The marshmallow is where the added sugar concentrates. One 28-gram marshmallow delivers about 19 grams of sugar — approaching the American Heart Association's recommended daily added-sugar cap of 36 grams for men and 25 grams for women in a single serving. Since most people eat at least two s'mores in a sitting, the sugar can add up fast.
Why does sugar matter for gout? Because fructose is the one carbohydrate clearly shown to raise serum uric acid. In the 2008 BMJ prospective study of 46,393 men, men who drank two or more sugar-sweetened soft drinks a day had a 1.85-times higher risk of gout than those who drank less than one a month, and men in the highest fifth of fructose intake carried a 2.02-times higher risk. Marshmallows are sweetened with corn syrup and sugar, both of which deliver the glucose-and-fructose combination behind that risk.
Graham crackers are the mildest player: refined wheat, low in purines, with a modest amount of added sugar. Two graham squares add flavor and structure without moving the needle much. The practical question is portion control and the total sugar load of the evening rather than any single cracker.
A note on "low purine" doesn't mean "flare-proof"
It is worth repeating a nuance that comes up constantly in gout care: uric acid responds to several inputs, and sugar is only one of them. Portion sizes, hydration, weight, alcohol, and medication adherence all matter. The occasional s'more is far less influential than the pattern of your whole week. Think of treats like s'mores as part of a larger budget rather than isolated villains — and keep the budget mostly filled with vegetables, fruit, dairy, legumes, and moderate proteins.
How to enjoy s'mores without gambling on a flare
A single s'more, occasionally, fits comfortably within most gout management plans — especially if the rest of your day is built around vegetables, dairy, fruit, and moderate proteins, and you are not in the middle of a flare.
Three habits keep it reasonable. First, portion: one or two s'mores, not six, and not three nights in a row. Second, watch what else is sweet that day — a s'more on top of sugary drinks and other desserts stacks the sugar load. Third, and most important for gout, don't pair it with beer: alcohol — especially beer — is independently associated with higher gout risk, and combining alcohol with a sugary treat is the strongest way to stack the odds against you. See our dark beer page and our alcohol guide for the numbers.
Variations can help, too. Swapping in strawberry slices or banana adds volume and nutrients with modest sugar, dark chocolate cuts the sugar load, and toasting one marshmallow instead of two keeps the treat in proportion. Whatever the variation, the uric acid math is the same: count the total sugar, keep the alcohol away, and stop before the sugar starts to compound.
Staying well hydrated, keeping the rest of the meal modest, and using your own history as a guide are the practical keys. If you have had recent flares or very high uric acid, this is the time for extra restraint and a conversation with your clinician — and if you want to check where chocolate or other sweets land before a campfire trip, search the ingredient name in the FoodCanEat database. Knowing your flare triggers is the best defense at any celebration.
Frequently Asked Questions
Does chocolate cause gout flares?
There is no strong clinical evidence that chocolate causes gout flares. Cocoa is low to moderate in purines, and it does not appear on the short list of foods that large cohort studies most consistently associate with gout risk. That does not make chocolate a free pass — milk chocolate is high in added sugar, and sugar matters for uric acid through the fructose pathway. For most people, a modest square of chocolate, especially darker varieties with less sugar, is a reasonable occasional treat. If you have noticed flares after chocolate specifically, your own experience is the best signal, but the general research case against chocolate is weak.
Is marshmallow high in purines?
No — marshmallow is essentially sugar, corn syrup, and gelatin, so it contains almost no purines at all. The gout-relevant issue is the opposite one: it is almost entirely added sugar. A single 28-gram marshmallow contains about 19 grams of sugar, which is close to the daily added-sugar cap recommended for most adults. Because the fructose and glucose in that sugar rapidly raise serum uric acid, several marshmallows in one sitting can meaningfully add to your uric acid load, even though the purine count is negligible. Enjoy one marshmallow as a treat rather than a handful, and factor it into your day's total sugar.
Can I have s'mores while trying to prevent a gout flare?
An occasional s'more — say, one or two, once in a while — is unlikely on its own to trigger a flare, provided you are otherwise following your management plan. The bigger risks come from stacking: pairing s'mores with beer, adding them to a day already full of sugary drinks, or making them a nightly habit. If you are in an active flare or your uric acid is well above target, restraint is wise — skip the dessert and recheck with your clinician. In general, the research points to total dietary pattern over single foods, so one s'more at a campfire is a far smaller concern than the way you eat most days.
References: Choi HK, Curhan G. Soft drinks, fructose consumption, and the risk of gout in men: prospective cohort study. BMJ. 2008;336:309-312. | Choi HK, Atkinson K, Karlson EW, et al. Purine-rich foods, dairy, and protein intake, and the risk of gout in men. N Engl J Med. 2004;350:1093-1103. | Fitzgerald JD, et al. 2020 American College of Rheumatology Guideline for the Management of Gout. Arthritis Care Res (Hoboken). 2020;72(6):744-760. | USDA FoodData Central, "Candies, marshmallows" (FDC ID 171696).