Recent Developments in Diet and Gout
Recent Developments in Diet and Gout
Purpose of Review: Gout is the most common inflammatory arthritis in men, affecting approximately 1-2% of adult men in Western countries. United States gout prevalence has approximately doubled over the past two decades. In recent years, key prospective epidemiological and open-labeled dietary studies, coupled with recent advances in molecular biology elucidating proximal tubular urate transport, have provided novel insights into roles of diet and alcohol in hyperuricemia and gout. This review focuses on recent developments and their implications for clinical practice, including how we advise patients on appropriate diets and alcoholic beverage consumption.
Recent Findings: Studies have observed an increased risk of gout among those who consumed the highest quintile of meat, seafood and alcohol. Although limited by confounding variables, low-fat dairy products, ascorbic acid and wine consumption appeared to be protective for the development of gout.
Summary: The most effective forms of dietary regimen for both hyperuricemia and gout flares remains to be unidentified. Until confirmed by a large, controlled study, it is prudent to advise patients to consume meat, seafood and alcoholic beverages in moderation, with special attention to food portion size and content of non-complex carbohydrates which are essential for weight loss and improved insulin sensitivity.
Gout has been recognized for centuries and is currently the most common inflammatory arthritis in men, affecting approximately 1-2% of adult men in Western countries. Classically, gout presents as a recurrent, acute, monoarticular or oligoarticular arthritis. In some cases, it can progress to a chronic polyarticular arthritis associated with bony deformities. Gout is a multifactorial disease characterized by hyperuricemia and monosodium urate monohydrate crystal deposition in the joint and uric acid calculi in the urinary tract.
The associations of gout with obesity and overindulgence in alcohol and certain foods are classical observations. Traditionally, many patients with gout had been advised to restrict their alcohol use and ingestion of all purine-rich foods, including vegetables. Several key prospective epidemiological studies by Choi et al. and an open-labeled dietary study by Dessein et al., coupled with recent advances in molecular biology elucidating the cellular mechanism for urate transport, however, have shed new insights into the role of diet on the development of hyperuricemia and gout. Here, we focus on some of these key studies and their implications for clinical practice, how we specifically advise patients and future research directions.
Purpose of Review: Gout is the most common inflammatory arthritis in men, affecting approximately 1-2% of adult men in Western countries. United States gout prevalence has approximately doubled over the past two decades. In recent years, key prospective epidemiological and open-labeled dietary studies, coupled with recent advances in molecular biology elucidating proximal tubular urate transport, have provided novel insights into roles of diet and alcohol in hyperuricemia and gout. This review focuses on recent developments and their implications for clinical practice, including how we advise patients on appropriate diets and alcoholic beverage consumption.
Recent Findings: Studies have observed an increased risk of gout among those who consumed the highest quintile of meat, seafood and alcohol. Although limited by confounding variables, low-fat dairy products, ascorbic acid and wine consumption appeared to be protective for the development of gout.
Summary: The most effective forms of dietary regimen for both hyperuricemia and gout flares remains to be unidentified. Until confirmed by a large, controlled study, it is prudent to advise patients to consume meat, seafood and alcoholic beverages in moderation, with special attention to food portion size and content of non-complex carbohydrates which are essential for weight loss and improved insulin sensitivity.
Gout has been recognized for centuries and is currently the most common inflammatory arthritis in men, affecting approximately 1-2% of adult men in Western countries. Classically, gout presents as a recurrent, acute, monoarticular or oligoarticular arthritis. In some cases, it can progress to a chronic polyarticular arthritis associated with bony deformities. Gout is a multifactorial disease characterized by hyperuricemia and monosodium urate monohydrate crystal deposition in the joint and uric acid calculi in the urinary tract.
The associations of gout with obesity and overindulgence in alcohol and certain foods are classical observations. Traditionally, many patients with gout had been advised to restrict their alcohol use and ingestion of all purine-rich foods, including vegetables. Several key prospective epidemiological studies by Choi et al. and an open-labeled dietary study by Dessein et al., coupled with recent advances in molecular biology elucidating the cellular mechanism for urate transport, however, have shed new insights into the role of diet on the development of hyperuricemia and gout. Here, we focus on some of these key studies and their implications for clinical practice, how we specifically advise patients and future research directions.
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