Gout: epidemiology and lifestyle choices.

PURPOSE OF REVIEW: Recent scientific data serve to illuminate the links between dietary and other factors and the incidence of gout. This review summarizes recent literature about the prevalence and incidence of gout as well as risk factors for gout.

RECENT FINDINGS: Epidemiologic studies suggest that the overall disease burden of gout is substantial and growing. Gout seems to be relatively common not only in men but also in older women. A recent large prospective study investigated several purported dietary factors for gout and confirmed some of the long-standing suspicions (red meats, seafood, beer, and liquor), exonerated others (total protein, wine, and purine-rich vegetables), and also identified potentially new protective factors (dairy products). A study based on the Third National Health and Nutrition Examination Survey suggested that these factors affect serum uric acid levels parallel to the direction of risk of gout. In addition, adiposity, weight gain, hypertension, and diuretics were all found to be independent risk factors for incident gout, whereas weight loss was found to be protective.

SUMMARY: The disease burden of gout remains substantial and may be increasing. Some of the recently confirmed lifestyle factors may explain the increasing incidence of gout. The public health implications of dietary and lifestyle recommendations should take into account other associated health benefits and risks, because many of these factors have health effects beyond their influence on gout.