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Rationale:
- Dietary intake of purines can be effectively manipulated.
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Evidence:
- Uric acid levels in normal controls consuming a low-purine diet have decreased within 1 week to an average of 3.1 mg/dL. Those
with hyperuricemia at baseline will have a larger increase in serum uric acid level relative to a fixed increase in purine
precursor intake (38).
- Consumption of high-purine foods from an animal source (meat and seafood) increases the likelihood of developing gout over
time (39).
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Comments:
- Just as patients with hypertension are encouraged to limit sodium intake, patients with gout should be advised to limit purine
intake. Weight reduction may decrease serum uric acid levels and uric acid production. Low-purine diets may influence production
of uric acid kidney stones.
- Diets high in fiber, vitamin C, and folate (e.g., high in fruits and vegetables), as well as dairy products, protect against
the development of gout (36; 39). The amounts of purine-rich vegetables and total protein consumed are not associated with increased risk of gout (39).
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Grace P. Teal, MD (deceased) has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
Howard A. Fuchs, MD, is a consultant for TAP Pharmaceuticals.
Steven E. Weinberger, MD, FACP, Acting Editor, PIER, has stock holdings in Glaxosmithkline and Abbott.
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The information included herein should never be used as a substitute
for clinical judgment and does not represent an official position of
ACP. Because all PIER modules are updated regularly, printed web pages
or PDFs may rapidly become obsolete. Therefore, PIER users should
compare the date of the last update on the website with any printout
to ensure that the information being referred to is the most current
available.
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PIER is copyrighted (c) 2009 by the American College of Physicians,
190 N. Independence Mall West, Philadelphia, PA 19106-1572, USA.
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Gout
> Non-drug Therapy
