For many people, gout seems to be a disease of the past. Cartoons from 200 years ago portrayed it as a condition afflicting the rich (“the sickness of kings”), whose voracious consumption of food and drink was supposed to produce attacks of debilitating arthritis.
All these years later, much about gout is still misunderstood. Shame, ridicule and the belief that the gout sufferer deserves the condition linger. And instead of being a disease of the past, gout is widespread – and rates are rising. It is estimated that gout affects nearly 4% of the adult population in the US, an increase over the previous decades. And it’s not a disease that is limited to the wealthy. it affects people of all economic classes.
The most likely explanations for the rising gout rates are an aging population and obesity. Both are major risk factors for the disease. The average American’s growing waistline probably plays a bigger role than age, given that overweight and obesity have increased faster than the average age of Americans in recent decades.
A study of gout suggests ways to avoid this
Although research has identified some preventable risk factors for gout, the effects of changing it are uncertain. Now a new study has been published in JAMA network open found that more than three-quarters of gout cases affecting men could be completely preventable. And since gout affects men more often than women, this finding is remarkable.
The researchers analyzed data from nearly 45,000 men who conducted detailed surveys every two years about their health, habits, and medication for 25 years. When comparing those who developed gout (almost 4%) with those who didn’t, four factors were identified as protective:
- normal body mass index (BMI), a measure of weight and height (see calculator)
- no alcohol consumption
- Not using a diuretic (a drug that increases urination and is commonly used to treat high blood pressure and other conditions)
- After a DASH diet, a heart-healthy diet was originally developed to counteract high blood pressure.
The analysis showed that 69% of all cases of gout in men could be avoided with these four measures. Most of this benefit was for men who were not overweight. Overweight men (BMI of 30 or higher) saw little benefit. According to the researchers, this suggests that weight loss is necessary in order to benefit from the other three protective factors.
As with all studies, this study has limitations. For example, the analysis relied heavily on self-reporting, which can be inaccurate. This included information about diet, alcohol consumption, medication use, and even diagnosing gout. And it is possible that other, unmeasured factors that contribute to the risk of gout (such as genetic factors) contributed to the results. The study participants were all male health professionals (dentists, opticians, osteopaths, pharmacists, podiatrists, and veterinarians) and 91% were white, so the results may not apply to all people at risk of gout.
Is this study a game changer in the real world?
While the results could be considered groundbreaking, we don’t know how much impact they will actually have. For example, if every household in the country were given this information, how many people would switch to the DASH diet and stick to it? How many people who normally drink alcohol would give it up? And how many overweight and obese people would manage to achieve and maintain a normal BMI?
When using diuretics, doctors often prescribe diuretics such as hydrochlorothiazide or furosemide for people with high blood pressure and other health problems. The risk of future gout is unlikely to change this. However, there are many alternative drugs that can be used to lower blood pressure. So, if a person taking a diuretic is diagnosed with gout, switching to a different drug is worth considering.
The final result
The idea that a painful and sometimes debilitating condition like gout can be prevented without medication is certainly appealing. But knowing how to prevent and actually prevent gout are two different things. At least this new research adds one more reason to eat healthily, moderate alcohol consumption, and maintain a healthy weight: Not only could this improve your overall health, but it can save you from gout as well.
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