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Last reviewed: 2026-09-03 • Editorial Standards

Milk & Buttermilk Ranked by Purine Content

Evidence-based comparison — data from USDA+ODS-NIH PURINE DATABASE Release 2 (March 2025)

Lowest Purine Milk & Buttermilk

#1milk, 2%0.0 mg
#2milk, reduced fat, fluid, 2% milkfat, with added vitamin a and vitamin d0.0 mg
#3milk, 1%0.0 mg
#4milk, skim0.0 mg
#5milk, lowfat, fluid, 1% milkfat, with added vitamin a and vitamin d0.0 mg
#6milk, nonfat, fluid, with added vitamin a and vitamin d (fat free or skim)0.0 mg
#7milk, whole0.0 mg
#8milk, whole, 3.25% milkfat, with added vitamin d0.0 mg
#9buttermilk, low fat0.0 mg
#10buttermilk, lowfat0.0 mg

Highest Purine Milk & Buttermilk

#11buttermilk, low fat0.0 mg
#10milk, whole, 3.25% milkfat, with added vitamin d0.0 mg
#9milk, whole0.0 mg
#8milk, nonfat, fluid, with added vitamin a and vitamin d (fat free or skim)0.0 mg
#7milk, lowfat, fluid, 1% milkfat, with added vitamin a and vitamin d0.0 mg
#6milk, skim0.0 mg
#5milk, 1%0.0 mg
#4milk, reduced fat, fluid, 2% milkfat, with added vitamin a and vitamin d0.0 mg
#3milk, 2%0.0 mg
#2milk, 2% fat0.6 mg

Category Average: 0.1 mg/100g

The average across 11 Milk & Buttermilk foods with lab-measured data. Foods below this average are better-than-typical choices within this category.

How to Use This Ranking

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.

ACR 2020 Guideline Context

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.

How This Comparison Is Built

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.

Frequently Asked Questions

Is milk bad for gout?
No. Milk is essentially purine-free — every milk and buttermilk entry in our database measures between 0.0 and 0.6 mg/100g. Cohort research has associated low-fat dairy with lower uric acid levels and lower gout risk, which makes milk one of the safest beverage choices for gout. Whole milk adds saturated fat and calories, so low-fat versions are the usual recommendation.
Which milk is lowest in purines?
All regular milks — whole, 2%, 1%, and skim — measure 0.0 mg/100g in our database, with one 2% milk entry at 0.6 mg/100g. Buttermilk is also 0.0 mg. Since purines are equal across types, the choice comes down to fat and calories: skim and 1% are the lower-calorie options, and there is no purine reason to avoid any of them.
Can I drink milk with gout?
milk is one of the most gout-friendly beverages. Our database measures all milk types at 0.0 mg/100g, and observational studies have linked low-fat dairy intake with lower uric acid. Drinking milk or using it in smoothies is a reasonable way to add protein and calcium without purine load, and it can help with hydration compared with sugary drinks.
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References

• ACR 2020 Guideline for the Management of Gout
• USDA+ODS-NIH PURINE DATABASE Release 2, March 2025
• Kaneko K, et al. Biol Pharm Bull 37(5):709-721, 2014. PMID: 24553148

Medical Disclaimer: This website provides informational content only and does not constitute medical advice.
Last reviewed: 2026-09-03