Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Jul 1;23(7):51.
doi: 10.1007/s11926-021-01020-y.

Dietary and Lifestyle-Centered Approach in Gout Care and Prevention

Chio Yokose  1   2 , Natalie McCormick  3   4   5 , Hyon K Choi  3   4
Affiliations
Review

Dietary and Lifestyle-Centered Approach in Gout Care and Prevention

Chio Yokose et al. Curr Rheumatol Rep. .

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. 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.

Keywords: Cardiovascular disease; Diet; Gout; Hyperuricemia; Metabolic syndrome; Nutrition.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Confluence of several different factors all feeding into the modern gout epidemic
Fig. 2
Fig. 2
Comparison of mediterranean and DASH diets *Fish & Seafood are exceptions where short-term recommendations (for gout flares) and long-term recommendations (for cardiometabolic health) may be contradictory. Long-term, patients with gout would still benefit from moderate fish & seafood consumption if their gout/hyperuricemia is sufficiently controlled by other measures.
See this image and copyright information in PMC

References

    1. Safiri S, Kolahi AA, Cross M, Carson-Chahhoud K, Hoy D, Almasi-Hashiani A, et al. Prevalence, incidence, and years lived with disability due to gout and its attributable risk factors for 195 countries and territories 1990–2017: a systematic analysis of the Global Burden of Disease Study 2017. Arthritis Rheumatol. 2020;72(11):1916–27. - PubMed

    2. Analysis of the Global Burden of Disease Study which revealed that the burden of gout increased worldwide from 1990 to 2017. New Zealand, Australia, and the USA had the highest age-standardized point prevalence estimates of gout in 2017.

    1. Xia Y, Wu Q, Wang H, Zhang S, Jiang Y, Gong T, et al. Global, regional and national burden of gout, 1990–2017: a systematic analysis of the Global Burden of Disease Study. Rheumatology (Oxford). 2020;59(7):1529–38. - PubMed

    2. Analysis of the Global Burden of Disease Study which revealed that the global burden of gout increased worldwide, especially in high sociodemographic index countries. Additionally identified high BMI as the leading risk factor for the buden of gout.

    1. Elfishawi MM, Zleik N, Kvrgic Z, Michet CJ Jr, Crowson CS, Matteson EL, et al. The rising incidence of gout and the increasing burden of comorbidities: a population-based study over 20 years. J Rheumatol. 2018;45(4):574–9. - PMC - PubMed

    2. A population-based study out of Olmsted County, Minnesota, which reported on the rising incidence of gout, as well as higher comorbidity burden among patients with gout at time of diagnosis.

    1. Elfishawi MM, Zleik N, Kvrgic Z, Michet CJ Jr, Crowson CS, Matteson EL, et al. Changes in the presentation of incident gout and the risk of subsequent flares: a population-based study over 20 years. J Rheumatol. 2020;47(4):613–8. - PMC - PubMed
    1. Yokose C, McCormick N, Choi HK. The role of diet in hyperuricemia and gout. Curr Opin Rheumatol. 2021;33(2):135–44. - PMC - PubMed

Publication types