Background/Purpose: Gout affects 8 million individuals in the US and is prevalent among patients with metabolic syndrome. Although there are many medications to control gout attacks and to lower serum uric acid (sUA), they come with potential side effects, and many patients are refractory to pharmacological treatment. Less emphasis has been placed on dietary counseling, which may provide a cost-effective benefit in controlling gout and as a supplement to medications. The aim of this study is to investigate if counseling gout patients on diet and lifestyle modifications will decrease the number of gout flares and further improve their risk factors for metabolic syndrome.

Methods: A retrospective study involving Long Beach Veteran Hospital patients was performed (N= 159). Gout patients were identified by their International Classification of Disease version ICD 9 or 10 from 2013 to 2016, and were grouped into those that received 1) no diet counseling (n=42), 2) diet counseling since their gout diagnosis (n=92) and 3) diet counseling 2 years after initial gout flare (n=25). Extensive electronic medical record review was performed for a 24-month period to evaluate the effectiveness of diet counseling in gout management based on the change in frequency of gout flares, renal function (eGFR) and sUA. Risk factors for metabolic syndrome, including blood pressure, BMI, lipid profile and HgA1c levels were obtained as outcome measures of diet modification that are associated with gout attacks.

Results: Patients who received diet counseling had fewer accumulative gout attacks (2.68 vs. 1.3 p=0.002) and more pronounced decrease in sUA (28.7% vs 3.1%, p =0.01) when compared to those without counseling over the 24-month period. With diet counseling, the patients’ HDL increased (10.1% p <0.05) and LDL decreased (7.5%, p<0.01) but their BMI and blood pressure were comparable irrespective to diet counseling.

Conclusion: Gout patients who underwent diet counseling had fewer gout attacks afterwards. Patients who received documented diet counseling by their primary care physicians or rheumatologists had more effective reduction in serum uric acid and cholesterol levels over 24 months. Diet counseling may further benefit gout patients by decreasing risk factors that contribute to metabolic syndrome to provide better control of gout flares long term. A larger study over a longer period of time is needed to elucidate the impact of the risk factors for metabolic disorders in relation to gout management.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/diet-modification-for-gout-patients-effects-on-gout-attacks-and-risk-factors-for-metabolic-syndrome/