Rational approach to nutrition for patients with gout

Abstract

Gout is a complex multifactorial disease associated with the deposition of crystals of sodium monourate in various tissues of the body and the emergence, in this regard, of chronic hyperuricemia, which is clinically manifested by acute recurrent arthritis and the formation of gouty nodes – tofus. Methods of treating gout can be divided into two groups: lifestyle modification / change in eating habits and pharmacotherapy. But, before drugs appeared, diet was the only way to treat the disease. Since ancient times, gout has been associated with excessive nutrition and excessive consumption of alcoholic beverages. In the Middle Ages, gout was often called the “disease of the kings”, explaining this, firstly, by constant plentiful meals without any measure, and therefore the kidneys of the “abusers” could not cope with the removal of a huge concentration of uric acid. And secondly, the high prevalence of this disease among male aristocrats. Ordinary people ate on a limited basis and could not afford food rich in purines, so they fell ill less often. However, in the last decade, wider knowledge has been gained about dietary factors associated with hyperuricemia and gout. Obesity, excessive consumption of red meat and excess alcohol have already been recognized as causative factors. Legumes and purine-rich vegetables have been justified after numerous studies. New risk factors have been described, such as fructose and sweetened drinks. Finally, protective factors such as low fat dairy products have been studied. Patients with gout are forced to follow a diet throughout their lives, and not only during periods of exacerbation, but now it has become easier to adhere to it, since the diet allowed for food has expanded significantly. Although most of the prerequisites for dietary recommendations have been assigned ratings of medium / low or very low quality, this article will provide the basis for changes in eating habits in patients with hyperuricemia and gout in accordance with large international studies.