New Perspective for Dietary Treatment of Gout Patients

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1 CHINESE JOURNAL OF ALLERGY & CLINICAL IMMUNOLOGY #, (, ) :,,, ;,,,, : ; : R589.7; R459.3 : A : (2008) New Perspective for Dietary Treatment of Gout Patients LI Yang, TIAN Xin-ping # (Department of Rheumatology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing , China) Gout is one of the most prevalent metabolic diseases that can lead to inflammatory arthritis. Because some food can increase serum uric acid level in most of patients, so the importance of dietary treatment in the prevention and treatment of gout attack is prominent. The traditional dietary invention is primarily focused on limiting the intake of purine-rich food, however, there is no solid scientific evidence to support this. In addition, the influence of other dietary supplements such as coffee and fructose on gout remains unclear. The results of some prospective trials and metabolic researches conducted in past few years will change our ways of dietary suggestions for gout patients. This article provides a comprehensive review of the literature and shade some lights on the new perspectives for dietary treatment of gout patients. Key words: gout; dietary treatment Chin J Allergy Clin Immunol, 2008, 2(4): ,,,,, [1,, # : , : 302 December, 2008

2 , 1.45,,,,,, (, ),,, [5-6,, Health Professional Follow -up Study (HPFS) [2,, (<75 mg/ ( 100 g), ; ) ( 75~150 mg/100 g),, 1988~1994 ( 150~1 000 mg/100 g), ( Third National Health and Nutrition Examination Survey, NHNESIII), Miao [7, [3, 5 003,,, NHNESIII, [3 HPFS, ( 1.51 ), [2,,, HPFS, , 12 Ghadirian [ , 4,, NHNESIII, , ; 2 [3 1 HPFS, 50% [2,, Williams [ , 55% [2, 7.74, 228 (0.79%), [9,,, Vol. 2 No

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4 C, (Lond), 1997, 92: [ 7 Miao Z, Li C, Chen Y, et al. Dietary and lifestyle Huang [20 changes associated with high prevalence of hyperuricemia and gout in the Shandong coastal cities of eastern China, 184 [J. J Rheumatol, 2008, 35: ,, C (500 mg/), [8 Ghadirian P, Shatenstein B, Verdy M, et al. The influ- 2 C ence of dairy products on plasma uric acid in women 0.5 mg/dl Gao [21 C [J. Eur J Epidemiol, 1995, 11: [9 Garrel DR, Verdy M, Petit C, et al. Milk- and soy-protein C, ingestion: acute effect on serum uric acid concentra- C tion [J. Am J Clin Nutr, 1991, 53: [10 Lyu LC, Hsu CY, Yeh CY, et al. A case-control study of the association of diet and obesity with gout in Taiwan [J. Am J Clin Nutr, 2003, 78: , [ 11 Yamakita J, Yamamoto T, Moriwaki Y, et al. Effect of, Tofu (bean curd) ingestion and on uric acid metabolism, in healthy and gouty subjects [ J. Adv Exp Med Biol,, ; 1998, 431: ,, [12 Kiyohara C, Kono S, Honjo S, et al. Inverse association between coffee drinking and serum uric acid concentra- [1 Arromdee E, Michet CJ, Crowson CS, et al. Epidemiology of gout: is the incidence rising [ J? J Rheumatol, 2002, 29: [ 2 Choi HK, Atkinson K, Karlson EW, et al. Purine-rich foods, dairy and protein intake, and the risk of gout in men [J. N Engl J Med, 2004, 350: [3 Choi HK, Liu S, Curhan G. Intake of purine-rich foods, protein, and dairy products and relationship to serum levels of uric acid: the third national health and nutrition examination survey [ J. Arthritis Rheum, 2005, 52: [4 Williams PT. Effects of diet, physical activity and performance, and body weight on incident gout in ostensibly healthy, vigorously active men [ J. Am J Clin Nutr, 2008, 87: [5 Christiansen E, Schnider S, Palmvig B, et al. Intake of a diet high in trans monounsaturated fatty acids or saturated fatty acids. Effects on postprandial insulinemia and glycemia in obese patients with NIDDM [ J. Diabetes Care, 1997, 20: [ 6 Ter Maaten JC, Voorburg A, Heine RJ, et al. Renal handling of urate and sodium during acute physiological hyperinsulinaemia in healthy subjects [ J. Clin Sci tions in middle-aged Japanese males [ J. Br J Nutr, 1999, 82: [ 13 Choi HK, Curhan G. Coffee, tea, and caffeine consumption and serum uric acid level : the third national health and nutrition examination survey [ J. Arthritis Rheum, 2007, 57: [14 Choi HK, Willett W, Curhan G. Coffee consumption and risk of incident gout in men : a prospective study [ J. Arthritis Rheum, 2007, 56: [ 15 Drum DE, Goldman PA, Jankowski CB. Elevation of serum uric acid as a clue to alcohol abuse [ J. Arch Intern Med, 1981, 141: [ 16 Choi HK, Atkinson K, Karlson EW, et al. Alcohol intake and risk of incident gout in men - a prospective study [J. Lancet, 2004, 363: [ 17 Gibson T, Rodgers AV, Simmonds HA, et al. Beer drinking and its effect on uric acid [ J. Br J Rheumatol, 1984, 23: [ 18 Choi HK, Curhan G. Soft drinks, fructose consumption, and the risk of gout in men : a prospective cohort study [J. BMJ, 2008, 336: [19 Choi JJW, Ford ES, Gao X, et al. Sugar-sweetened soft drinks, diet soft drinks, and serum uric acid level : the third national health and nutrition examination survey [J. Arthritis Rheum, 2008, 59: Vol. 2 No

5 [ 20 Huang HY, Appel LJ, Choi MJ, et al. The effects of vitamin C supplementation on serum concentrations of uric acid: results of a randomized controlled trial [ J. Arthritis Rheum, 2005, 52: [ 21 Gao X, Curhan G, Forman JP. Vitamin C intake and serum uric acid concentration in men [ J. J Rheumatol, 2008, 35: ( ) 306 December, 2008

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