Lifestyle interventions for acute gout (Protocol)

John HY Moi, Melonie K Sriranganathan, Christopher L Edwards, Rachelle Buchbinder

Research output: Contribution to journalArticleResearchpeer-review

9 Citations (Scopus)


Description of the condition Gout is a potentially progressive and debilitating form of chronic inflammatory arthritis, caused by deposition ofmonosodiumurate crystals in synovial fluid and other tissues (Neogi 2011). It affects 1 to 2 of adults in developed countries (Richette 2010) and can have a significant adverse impact upon a person?s quality of life. People who suffer from recurrent attacks frequently experience pain and disability, reduced health-related quality of life (HRQoL), reduced productivity and increased morbidity (Singh 2011a). Both its incidence and prevalence have appeared to rise in recent decades (Choi 2005a; Richette 2010). The reasons behind this are probably multi-factorial and potentially related to increasing longevity, rising rates of obesity and the metabolic syndrome, and shifts in dietary habits and lifestyle (Choi 2005a; Choi 2005b; Neogi 2011; Richette 2010). Much of our current understanding of the lifestyle factors associated with gout is derived from large, cross-sectional, observational studies such as the Health Professionals Follow-up Study (HPFS) and the Third National Health and Nutrition Examination Survey (NHANES III) (Choi 2007c; Choi 2004c; Choi 2005b; Choi 2005c; Choi 2007b; Choi 2007c). The relationship between various lifestyle factors and gout can be summarised according to whether their association is regarded to be harmful, neutral or beneficial. Lifestyle factors considered ?harmful? include increased dietary intake of purine-rich foods (particularly meat and seafood), ethanol (particularly beer and spirits), fructose-sweetened drinks and sweet fruits (apples, oranges), weight gain and obesity, all of which promote gout development (Choi 2004a; Choi 2004b; Choi 2010b;Neogi 2011; Singh 2011b).On the contrary, protein and purine-rich vegetable intake is regarded as ?neutral?, having been vindicated as risk factors for gout, while ingestion of dairy products (low fat, skim milk), decaffeinated coffee, vitamin C and weight loss are considered to be ?beneficial?, playing a protective role against gout development (Choi 2010b;Neogi 2011; Richette 2010). For these reasons, lifestyle modifications are commonly recommended in combination with medications for treating both acute attacks of gouty arthritis, and for helping to reduce the risk of gout recurrence and chronic arthropathy developing in the long term (Neogi 2011; Richette 2010).
Original languageEnglish
Article numberCD010519
Number of pages17
JournalCochrane Database of Systematic Reviews
Issue number5
Publication statusPublished - 2013

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