From the Journals

Weight loss may be paramount lifestyle change in preventing gout


 

FROM JAMA NETWORK OPEN

The new findings should give practicing rheumatologists more confidence in addressing lifestyle issues, particularly weight loss, with their patients, said Angelo Gaffo, MD, section chief of rheumatology at the Birmingham VA Medical Center and associate professor of medicine in the division of rheumatology at the University of Alabama at Birmingham.

Dr. Angelo Gaffo, Section Chief of Rheumatology at Birmingham, Alabama, Veterans Affairs Medical Center

Dr. Angelo Gaffo

“Our patients with gout are interested in what they can do in their lives that might help with their gout. In the past, we’ve had generic advice about changing their diet. But in general, the evidence for the impact of dietary changes has not been strong.”

Doctors can now recommend a DASH-style diet, allowing room for moderate consumption of red meat, so long as patients are working on their weight loss – and showing results. “Now we have the information to give advice that’s more evidence-based,” Dr. Gaffo said. “You can ask the question whether this study is applicable to patients who already have gout. It doesn’t directly address them. But it mainly builds on the narrative that weight loss is important.”

Other studies have also looked at how weight loss led to serum urate reduction. This study adds to a growing body of literature emphasizing that the most important lifestyle factor relative to gout risk is weight gain, and the simplest, most effective intervention is counseling patients about weight loss, he said.

This research was supported by grants from the National Institutes of Health. Dr. Choi reported receiving research support from Ironwood and Horizon and consulting fees from Ironwood, Selecta, Horizon, Takeda, Kowa, and Vaxart. No other relevant financial disclosures were reported.

SOURCE: McCormick N et al. JAMA Netw Open. 2020;3(11):e2027421. doi: 10.1001/jamanetworkopen.2020.27421.

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