Although the consumption of a number of foods is thought to trigger painful gout flair-ups, the results of a recent study have substantiated the belief that tomatoes are one of these foods. The study, published in BMC Musculoskeletal Disorders, surveyed 2051 patients with gout, 71% of whom reported 1 or more food triggers. Of these patients, 20% listed tomatoes as a trigger, making it the fourth most commonly mentioned food after seafood, alcohol, and red meat. The research team then analyzed data on 12,720 patients across 3 studies and found that the consumption of tomatoes was associated with high levels of uric acid, the primary cause of gout.

The study authors clarified that the consumption of tomatoes does not necessarily cause the gout flair-ups directly, but instead elevates a patient’s uric acid levels to those comparable to other gout triggers. They noted that although cutting back on tomatoes may reduce gout flair-ups, a far more effective solution is to lower uric acid levels with the use of appropriate medications.

“Avoiding tomatoes may be helpful for people who have experienced a gout attack after eating them, but with proper treatment, this doesn’t have to be a long-term avoidance,” said study author Tanya Flynn in a press release. “Further intervention studies are needed to determine whether tomatoes should be added to the list of traditional dietary triggers of gout flares, but this research is the first step in supporting this idea.”