Dietary Interventions for Gout and Effect on Cardiovascular Risk Factors: A Systematic Review

• Published in: Nutrients Vol. 11; no. 12; p. 2955
• Main Authors: Vedder, Daisy, Walrabenstein, Wendy, Heslinga, Maaike, de Vries, Ralph, Nurmohamed, Michael, van Schaardenburg, Dirkjan, Gerritsen, Martijn
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 04-12-2019; MDPI
• Subjects: Arthritis; Blood pressure; Cardiovascular disease; Cardiovascular diseases; Clinical trials; Diet; Fasting; Gout; Health risk assessment; Health risks; Hypertension; Hyperuricemia; Hypocaloric diet; Intervention; Legumes; Lifestyles; Metabolic syndrome; Mortality; Nutrient deficiency; Nutrition research; Patients; Review; Rheumatism; Rheumatology; Risk analysis; Risk factors; Seafood; Systematic review; Uric acid; blood pressure; cardiovascular disease; hyperuricemia; Mediterranean diet; gout; cholesterol; diet; DASH; metabolic syndrome x; purine low diet
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu11122955

Gout is one of the most prevalent inflammatory rheumatic disease. It is preceded by hyperuricemia and associated with an increased risk for cardiovascular disease, both related to unhealthy diets. The objective of this systematic review is to better define the most appropriate diet addressing both disease activity and traditional cardiovascular risk factors in hyperuricemic patients. We included clinical trials with patients diagnosed with hyperuricemia or gout, investigating the effect of dietary interventions on serum uric acid (SUA) levels, gout flares and-if available-cardiovascular risk factors. Eighteen articles were included, which were too heterogeneous to perform a meta-analysis. Overall, the risk of bias of the studies was moderate to high. We distinguished four groups of dietary interventions: Calorie restriction and fasting, purine-low diets, Mediterranean-style diets, and supplements. Overall, fasting resulted in an increase of SUA, whilst small (SUA change +0.3 to -2.9 mg/dL) but significant effects were found after low-calorie, purine-low, and Mediterranean-style diets. Studies investigating the effect on cardiovascular risk factors were limited and inconclusive. Since Mediterranean-style diets/DASH (Dietary Approach to Stop Hypertension) have shown to be effective for the reduction of cardiovascular risk factors in other at-risk populations, we recommend further investigation of such diets for the treatment of gout.