4.4 Review

The role of diet in hyperuricemia and gout

Journal

CURRENT OPINION IN RHEUMATOLOGY
Volume 33, Issue 2, Pages 135-144

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/BOR.0000000000000779

Keywords

diet; gout; hyperuricemia; metabolic syndrome; nutrition

Categories

Funding

  1. Rheumatology Research Foundation Scientist Development Award [T32 AR007258]
  2. [R01 AR065944]
  3. [P50 AR060772]

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Gout is closely associated with insulin resistance and is considered a manifestation of the metabolic syndrome. Recent research suggests that healthy diets like the Mediterranean or DASH diets, along with weight loss for overweight or obese individuals, can significantly improve cardiometabolic risk factors and outcomes. By treating gout as part of the metabolic syndrome and shifting dietary recommendations to healthy patterns, the beneficial effects on gout endpoints can be naturally achieved.
Purpose of review Although gout's cardinal feature is inflammatory arthritis, it is closely associated with insulin resistance and considered a manifestation of the metabolic syndrome. As such, both gout and hyperuricemia are often associated with major cardiometabolic and renal comorbidities that drive the persistently elevated premature mortality rates among gout patients. To that end, conventional low-purine (i.e., low-protein) dietary advice given to many patients with gout warrant reconsideration. Recent findings Recent research suggests that several healthy diets, such as the Mediterranean or Dietary Approaches to Stop Hypertension (DASH) diets, in combination with weight loss for those who are overweight or obese, can drastically improve cardiometabolic risk factors and outcomes. By treating gout as a part of the metabolic syndrome and shifting our dietary recommendations to these healthy dietary patterns, the beneficial effects on gout endpoints should naturally follow for the majority of typical gout cases, mediated through changes in insulin resistance. Dietary recommendations for the management of hyperuricemia and gout should be approached holistically, taking into consideration its associated cardiometabolic comorbidities. Several healthy dietary patterns, many with similar themes, can be tailored to suit comorbidity profiles and personal preferences.

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