New gout management guidelines released

2 mins to read

The American College of Rheumatology has recently released guidelines for the treatment of gout. Andrew Cate highlights the lifestyle management tips that may improve quality of life for gout sufferers.

Arthritis, joint, bone & muscle

Gout is on the rise

Gout is one of the most common rheumatic diseases in adults, and the prevalence of gout has been on the rise over the past few decades.

This increased incidence of gout may be due, in part, to increased prevalence of comorbitities - conditions that may co-exist with gout- that promote elevated levels of uric acid.

These conditions include:

High blood pressure
High blood cholesterol levels
Excess body fat
Metabolic syndrome
Blood sugar disorders
Kidney disease

Dietary factors, age and different medication profiles can make the management of gout complicated, and treatment may vary significantly between individuals.

New gout management guidelines

The American College of Rheumatology has compiled a series of recommendations for the effective treatment of gout based on scientific evidence and formal consensus.

One important component of non-pharmacological treatment is patient education in diet, lifestyle, treatment objectives, and management of the types of comorbidities highlighted above. Following are three of the key recommendations on the management of gout from the American College of Rheumatology research.

1. Know your condition

It's suggested that gout sufferers work with their doctor to record the number and intensity of gout attacks that take place each year. The specific joint or joints where pain occurs should be noted.

Your doctor can also assess and treat comorbidity conditions that may be secondary causes of elevated uric acids levels (and gout). This may help to develop a better understanding of the condition, and help with prevention.

2. General lifestyle guidelines

Following are some general diet and lifestyle tips for gout patients that may help to decrease the frequency of acute gout attacks, and lower uric acid levels. These lifestyle tips help promote health, and may help to prevent comorbidity factors relating to gout that may place your health at risk.

Stop smoking
Exercise regularly, and achieve physical fitness
Stay well hydrated
Maintain a healthy, overall diet
Aim to achieve a healthy BMI if you are overweight

3. Specific dietary guidelines

A number of specific dietary recommendations were grouped into 3 categories, as detailed below.

Foods to avoid

Organ meats with a high purine content (eg, sweetbreads, liver and kidney)
Foods high in sugar such as soft drinks. Emphasis was placed on avoiding food and drinks using high fructose corn syrup, a type of sugar more commonly used in the United States
Excessive alcohol intake. This was defined as more than 2 servings per day for men
In advanced gout or during periods of high disease activity, all alcohol is best avoided

Foods to limit

Portions of beef, lamb, pork and seafood, especially seafood with a high purine content such as sardines and shellfish
Fruit juice
Sweetened beverages and desserts
Table sugar
Alcohol, particularly beer, but also wine and spirits

Encourage

Low-fat or non-fat dairy products
Vegetables

Prevention is better than a cure

The only non-pharmacological treatment that was recommended during an acute attack of gout was to eliminate alcohol. In other words, diet and lifestyle modification is more effective at preventing a build up of uric acid levels and the onset of gout rather than treating it when it occurs.

Following the dietary and lifestyle recommendations above may help to prevent gout, reduce the need for medication, and assist the prevention or treatment of other illnesses (gout co-morbidity factors).

References available on request