GOUTY TOE ?...GIVE IT THE BOOT
Westport, Aug 15 (Reuters Health) - In patients with gout, dietary modifications similar to those recommended for patients with insulin resistance appear to reduce the frequency of gouty attacks. This finding from a small study by South African researchers is published in the July issue of Annals of the Rheumatic Diseases.
Dr. P. H. Dessein of the University of Witwatersrand, Johannesburg, and colleagues evaluated the effects of dietary modification on body mass index, lipids, serum uric acid levels and frequency of gouty attacks in 13 men with acute intermittent gout. "Each patient had had at least two gouty attacks during the 4 months before enrollment," the authors note.
The intervention consisted of a diet limited to 1600 calories a day, 40% of which were derived from complex carbohydrates, 30% from protein, and 30% from mono- and polyunsaturated fat.
After 16 weeks of dietary modification, mean body mass index decreased by 2.7 kg/meter squared, and mean serum uric acid levels declined by 18%, the authors report. "This was accompanied by a 67% reduction in monthly gout attack frequency," they add.
At study outset, dyslipidemia was present in a number of subjects. At the end of the 16-week intervention, an improvement in dyslipidemia was observed as well, the researchers indicate.
They also note that eight out of nine patients have now been followed for a median of 12 months. The fact that body mass index, serum uric acid levels and lipid values have all "remained constant" over this follow-up interval--and have been accompanied by a further decline in gouty attacks--"is encouraging," they observe.
Current dietary recommendations for patients with gout include limitation of foods high in purine and protein, alcohol restriction and weight reduction. Since the diet used in this study included higher than normal intakes of protein and did not limit purine intake, "current dietary recommendations for gout may need re-evaluation," the authors suggest.
Ann Rheum Dis 2000;59:539-543.