This review summarizes recent epidemiologic research findings on gout, and attempts to put them into the context of clinical and public health decision-making aimed at prevention and improved management of gout.
A large prospective study found that coffee consumption was inversely associated with risk of gout and that consumption of sugar-sweetened soft drinks or fructose was strongly associated with an increased gout risk. Studies based on the Third National Health and Nutrition Examination Survey (NHANES III) suggest that these consumptions affect serum uric acid levels parallel to the direction of gout risk. Furthermore, data from NHANES III show a remarkably high prevalence of the metabolic syndrome among individuals with gout. Prospective studies found an increased risk of myocardial infarction and cardiovascular mortality in gout patients.
Lifestyle and dietary recommendations for gout patients should consider other health benefits, since gout is often associated with major chronic disorders such as the metabolic syndrome and an increased risk for cardiovascular disease and mortality. In addition to recent dietary recommendations, gout patients should be advised to limit fructose intake. The inverse link between coffee and the risk of gout suggests that coffee could be allowed among gout patients.
aDepartments of Internal Medicine and Rheumatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
bDepartment of Medicine, Division of Rheumatology, Immunology and Allergy, Section of Clinical Sciences, Brigham and Women's Hospital, Boston, Massachusetts, USA
cChanning Laboratory, Department of Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, USA
dDepartment of Medicine, Division of Rheumatology, Arthritis Research Centre of Canada, Vancouver General Hospital, University of British Colombia, Vancouver, Canada
Correspondence to Hyon K. Choi, MD, Dr PH, Division of Rheumatology, Department of Medicine, University of British Colombia, Arthritis Research Center of Canada, 895 West 10th Avenue, Vancouver, BC, Canada V5Z 1L7 Tel: +1 604 871 4542; fax: +1 604 879 3971; e-mail: email@example.com