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Dietary and Lifestyle-Centered Approach in Gout Care and Prevention

  • Crystal Arthritis (M Pillinger and M Toprover, Section Editors)
  • Published:
Current Rheumatology Reports Aims and scope Submit manuscript

Abstract

Purpose of review

We aim to provide a comprehensive review of the available literature to inform dietary recommendations for patients with gout and hyperuricemia that have the potential to simultaneously lower serum urate and reduce gout morbidity while addressing gout’s cardiometabolic comorbidities holistically.

Recent findings

The global burden of gout is rising worldwide, particularly in developed nations as well as in women. Patients with gout are often recommended to follow a low-purine (i.e., low-protein) diet to avoid purine-loading. However, such an approach may lead to increased consumption of unhealthy carbohydrates and fats, which in turn contributes to metabolic syndrome and subsequently raises serum urate levels and leads to adverse cardiovascular outcomes. On the other hand, several well-established diets for cardiometabolic health, such as the Mediterranean and Dietary Approaches to Stop Hypertension (DASH) diets, in combination with weight loss for those who are overweight or obese, also have beneficial effects on relevant gout endpoints.

Summary

It is important to recognize not only the direct effect of diet on hyperuricemia and gout, but its mediated effect through obesity and insulin resistance. Thus, several preeminent healthy dietary patterns that have proven benefits in cardiometabolic health have the power to holistically address not only gout morbidity but also its associated comorbidities that lead to premature mortality among patients with gout.

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Funding

C. Y. is supported by T32 AR007258 and Rheumatology Research Foundation Scientist Development Award. N. M. is supported by a Fellowship Award from the Canadian Institutes of Health Research. H. C. is supported by R01 AR065944, P50 AR060772.

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  1. Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, 55 Fruit Street, Bulfinch 165, Boston, MA, 02114, USA

    Chio Yokose, Natalie McCormick & Hyon K. Choi

  2. Clinical Epidemiology Program, Mongan Institute, Massachusetts General Hospital, 55 Fruit Street, Bulfinch 165, Boston, MA, 02114, USA

    Chio Yokose, Natalie McCormick & Hyon K. Choi

  3. Arthritis Research Canada, Richmond, British Columbia, Canada

    Natalie McCormick

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Yokose, C., McCormick, N. & Choi, H.K. Dietary and Lifestyle-Centered Approach in Gout Care and Prevention. Curr Rheumatol Rep 23, 51 (2021). https://doi.org/10.1007/s11926-021-01020-y

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