A prescription for lifestyle change in patients with hyperuricemia and gout.
OBJECTIVE
This review summarizes the recent data on lifestyle factors that influence serum uric acid levels and the risk of gout and attempts to provide holistic recommendations, considering both their impact on gout as well as on other health implications.


RESULTS
Large-scale studies have clarified a number of long-suspected relations between lifestyle factors, hyperuricemia, and gout, including purine-rich foods, dairy foods, various beverages, fructose, and vitamin C supplementation. Furthermore, recent studies have identified the substantial burden of comorbidities among patients with hyperuricemia and gout.


CONCLUSIONS
Lifestyle and dietary recommendations for gout patients should consider overall health benefits and risk, since gout is often associated with the metabolic syndrome and an increased future risk of cardiovascular disease (CVD) and mortality. Weight reduction with daily exercise and limiting intake of red meat and sugary beverages would help reduce uric acid levels, the risk of gout, insulin resistance, and comorbidities. Heavy drinking should be avoided, whereas moderate drinking, sweet fruits, and seafood intake, particularly oily fish, should be tailored to the individual, considering their anticipated health benefits against CVD. Dairy products, vegetables, nuts, legumes, fruits (less sugary ones), and whole grains are healthy choices for the comorbidities of gout and may also help prevent gout by reducing insulin resistance. Coffee and vitamin C supplementation could be considered as preventive measures as these can lower urate levels, as well as the risk of gout and some of its comorbidities.
Choi
Hyon K
HK
Section of Rheumatology and the Clinical Epidemiology Unit, Boston, Massachusetts 02118, USA. hchoius@bu.edu
D004032:Diet; D015444:Exercise / Q000502:physiology; D005247:Feeding Behavior; D006073:Gout / Q000150:complications / Q000628:therapy*; D015438:Health Behavior; D006801:Humans; D033461:Hyperuricemia / Q000150:complications / Q000628:therapy*; D007333:Insulin Resistance; D008019:Life Style; D024821:Metabolic Syndrome / Q000150:complications; D012307:Risk Factors