Sunday, March 26, 2023

Can we prevent gout?

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For many people, gout seems to be a disease of the past. Cartoons from 200 years ago portrayed as a condition afflicting the wealthy (“kings disease”), which gluttonous consumption of food and drink was thought to cause attacks of debilitating arthritis.

All these years later, much about gout is still poorly understood. Shame, derision, and the belief that the person with gout deserves the disease persist. And rather than being a disease of the past, gout is quite common – and rates are rising. Estimates suggest that gout affects almost 4% of the adult population in the United States, an increase over previous decades. And it’s not a disease limited to the well-to-do; it affects people of all economic classes.

The most likely explanations for the increase in gout rates are an aging population and being overweight. Both are major risk factors for the disease. The expanding waistline of the average American probably plays a larger role than age, as overweight and obesity have increased faster than the average age of Americans in recent decades.

Gout Study Suggests Ways To Avoid It

Although research has identified some preventable risk factors for gout, the impact of changing them is uncertain. Now a new study Posted in JAMA network open found that over three quarters of gout cases in men could be completely prevented. And since gout affects men more often than women, this finding is notable.

Researchers analyzed data from nearly 45,000 men who completed detailed surveys about their health, habits, and medications every two years for 25 years. By comparing those who developed gout (almost 4%) with those who did not, four factors were identified as protective:

  • normal body mass index (BMI), a measure of weight and height (see calculator)
  • no alcohol consumption
  • no use of a diuretic drug (a drug that increases urination, commonly used to treat high blood pressure and other conditions)
  • next to a DASH-type diet, a heart-healthy diet originally developed for high blood pressure.

The analysis suggested that 69% of all gout cases in men could be prevented with these four measures. Most of this benefit applied to men who were not obese. Obese men (BMI of 30 or more) saw little benefit. According to the researchers, this suggests that weight loss is necessary to take advantage of the other three protective factors.

As with all research, this study has limitations. For example, the analysis relied heavily on self-reporting, which may be inaccurate. This included information on diet, alcohol consumption, medication use, and even the diagnosis of gout. And it’s possible that other unmeasured factors of gout risk (such as genetic factors) may have contributed to the results. Study participants were all male healthcare professionals (dentists, optometrists, osteopaths, pharmacists, podiatrists and veterinarians), and 91% were white, so the results may not apply to all people with disabilities. risk of gout.

In the real world, is this study a game-changer?

While the results can be seen as changing, we don’t know what impact they will actually have. For example, if every household in the country received this information, how many people would switch to and stick to the DASH diet? How many people who usually drink alcohol would give it up? And how many overweight and obese people would achieve and maintain a normal BMI?

When it comes to the use of 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 medications available for lowering blood pressure. So, if someone is diagnosed with gout taking a diuretic, it is worth considering switching to another medication.

The bottom line

The idea that a painful and sometimes debilitating condition like gout can be prevented without medication is certainly appealing. But knowing how to prevent gout and how to prevent it are two different things. At the very least, this new research adds one more reason to adopt a healthy diet, moderate alcohol consumption, and maintain a healthy weight: Not only could it improve your overall health, but you could also save yourself from it. drop.

Follow me on twitter @RobShmerling

The post office Can we prevent gout? appeared first on Harvard Health Blog.


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