9 December 2020

Non-drug options to avoid gout

Clinical Nutrition Rheumatology

More than three-quarters of cases of gout could be prevented by adhering to just four lifestyle factors, US researchers have estimated.

According to findings from a large cohort study published in JAMA Network Open, 77% of all incident cases of gout could be prevented by having a healthy weight, eating a DASH-style diet, not drinking alcohol and not taking diuretics.

Researchers analysed data from the Health Professionals Follow-up Study which included detailed medical and lifestyle information on almost 45,000 men, with an average age of 54 years at baseline who were then followed for 26 years. Over the course of the study, almost 4% experienced gout.

It comes as no surprise that lifestyle factors play a role as to who gets this painful inflammatory condition. What is new, according to the study authors, is the extent to which each of these factors can influence the incidence of gout.

“Twenty-two per cent of gout cases could have been prevented through adherence to a DASH-style diet,” they explained. The Dietary Approaches to Stop Hypertension (DASH) diet does discourage purine-rich red meat and fructose rich food so you’d expect it to help to some degree.

But far and away, what this study confirms, is that having a healthy BMI is your best protection if you want to avoid gout.

“Excess adiposity was the most important risk factor for developing gout,” the researchers stated.

They estimated that 31% of incident cases could be attributed to overweight and obesity alone.

But more importantly, it appears that obesity renders men resistant to any benefit from modifying any of the other factors – so that if you are obese you can’t significantly lower your risk of getting gout by giving up alcohol, for example.

“Men with obesity may not benefit from other modifications unless weight loss is addressed,” they explained.

It may seem nihilistic but it may help patients direct their energies to where they are going to get the most benefit.

Once a person gets under that magic BMI number of 30, then, according to these results at least, they can make significant changes to their gout risk through diet and avoiding alcohol and diuretics.

“Among those in both the normal weight and overweight categories, we estimated that more than half of cases of incident gout (69% and 59%, respectively) could theoretically have been prevented by the combination of a DASH-style diet, no alcohol intake, and no diuretic use,” the study authors said.

Yet another reason to lose those COVID kilos.

This piece was originally published at Healthed.com.au.

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DR J N Parikh
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DR J N Parikh
2 months 14 days ago

common sense advice but hard to follow Loosing 10 % of body weight is a win win situation. Avoiding alcohol in Australia is a cultural shock and of course with 50 % heart failure patient avoiding diuretic is not easy.
It is a complete disaster for 90 % of sufferrers

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