Last reviewed: 2026-09-03 • Editorial Standards
Evidence-based comparison — data from USDA+ODS-NIH PURINE DATABASE Release 2 (March 2025)
The average across 7 Cod & Flatfish foods with lab-measured data. Foods below this average are better-than-typical choices within this category.
The purine ranking is sorted from lowest to highest. Rank #1 is the lowest-purine food in the category. Foods in the top half (above median) should be consumed with more awareness of portion and frequency. The difference between adjacent ranks varies: in some categories, rank #5 and #10 might be only 10 mg apart; in others, the gap can be 100+ mg. Always check the actual milligram value, not just the position. Rankings do not account for fructose or alcohol — use individual food pages for a complete risk assessment.
The American College of Rheumatology recommends that gout patients focus on purine awareness rather than complete food group elimination. Within any category, there is a wide purine range. The goal is to shift toward lower-purine choices within categories you already eat, rather than eliminating entire food groups. This ranking helps you identify which specific items to prioritize and which to limit.
Japanese guidelines recommend under 400 mg of total dietary purines per day. Using this ranking, you can estimate how much of budget each food uses per typical serving.
Each item here is scored by a three-factor risk engine covering purines, fructose, and alcohol. Purine values draw on the USDA+ODS-NIH PURINE DATABASE Release 2 (March 2025) and Kaneko et al. (Biol Pharm Bull 37(5):709-721, 2014, PMID: 24553148); fructose comes from USDA SR28 tables. Classification uses ACR 2020 thresholds — Safe under 50 mg purine and 2 g fructose with no alcohol, Moderate in between, Avoid above, or when alcohol is present. Each food page labels its data quality as T1 (lab-measured), T2 (measured plus consensus), or T3 (category estimate).
This comparison is provided for informational purposes only and does not constitute medical advice. Individual tolerance to purines and fructose varies. Consult a healthcare professional for personalized dietary guidance. Last reviewed: 2026-09-03.