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Depiction of a nutritional pyramid according to the Mediterranean diet and Western-type diet. The pyramid in Figure 1 was remodelled and modified based on: The Traditional Healthy Mediterranean Diet Pyramid (Courtesy Oldways Preservation and Exchange Trust, www.oldwayspt.org.
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The effect of diet habits in the induction of hyperuricemia and gout is extensively studied and several nutritional factors exacerbating the disease have been identified. In this review, we discuss the data so far obtained of the beneficial role on controlling hyperuricemia of Mediterranean diet, which is full of mono-unsaturated fatty acids and fl...
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Gout is one of the most prevalent inflammatory rheumatic disease. It is preceded by hyperuricemia and associated with an increased risk for cardiovascular disease, both related to unhealthy diets. The objective of this systematic review is to better define the most appropriate diet addressing both disease activity and traditional cardiovascular ris...
Citations
... Large-scale projects demonstrated that the advantageous effects on the well-being of the participants seem to be attributed mainly to healthy mono-unsaturated fatty acids (MUFAs) in olive oil and flavonoids in red wine, nuts, spices and more (8)(9)(10)(11). These effects are accomplished through the anti-inflammatory and anti-oxidative actions of these components, leading to the decrease of inflammation and oxidative stress (8). ...
... Large-scale projects demonstrated that the advantageous effects on the well-being of the participants seem to be attributed mainly to healthy mono-unsaturated fatty acids (MUFAs) in olive oil and flavonoids in red wine, nuts, spices and more (8)(9)(10)(11). These effects are accomplished through the anti-inflammatory and anti-oxidative actions of these components, leading to the decrease of inflammation and oxidative stress (8). Yet, it's important to also highlight the significant contribution of fiber from fruits and vegetables (1). ...
The nutritional habits regulate the gut microbiota and increase risk of an autoimmune disease. Western diet is rich in sugars, meat, and poly-unsaturated fatty acids, which lead to dysbiosis of intestinal microbiota, disruption of gut epithelial barrier and chronic mucosal inflammation. In contrast, the Mediterranean Diet (MedDiet) is abundant in ω3 fatty acids, fruits, and vegetables, possessing anti-inflammatory properties that contribute to the restoration of gut eubiosis. Numerous studies have extensively examined the impact of MedDiet and its components on both health and various disease states. Additionally, specific investigations have explored the correlation between MedDiet, microbiota, and the risk of autoimmune diseases. Furthermore, the MedDiet has been linked to a reduced risk of cardiovascular diseases, playing a pivotal role in lowering mortality rates among individuals with autoimmune diseases and comorbidities. The aim of the present review is to specifically highlight current knowledge regarding possible interactions of MedDiet with the patterns of intestinal microbiota focusing on autoimmunity and a blueprint through dietary modulations for the prevention and management of disease’s activity and progression.
... They are characterized primarily by a high content of fresh vegetables and fruits, an increase in fiber, a reduction in saturated fats and an increase in unsaturated fats [71]. Many studies confirmed the effectiveness of the DASH and Mediterranean diets in the case of therapy aimed at lowering blood uric acid and preventing hyperuricemia [72][73][74]. Detailed assumptions of these diets are presented in Table 3. The Mediterranean diet and the DASH diet, according to research, have a number of positive aspects that, in the long term, reduce the amount of fructose in the diet and lower the concentration of uric acid in the blood [77]. ...
Fructose is often used as a food ingredient due to its low production costs and sweetening power. In recent years, it has been noticed that people on a Western diet high in fructose have high levels of uric acid in their blood. It was recognized that the specific metabolism of fructose in the body might cause increased production of uric acid, which then may affect the intensification of lipo-genesis and the development of metabolic syndrome (MetS), insulin resistance, gout, cardiovascular diseases, leptin resistance, or non-alcoholic fatty liver disease. So far, to treat hyperuricemia, it has been recommended to use a low-purine diet characterized by limiting protein-containing products. However, this recommendation often leads to an increased intake of carbohydrate-rich foods that may contain fructose. Increased fructose consumption may enhance the secretion of uric acid again and, consequently, does not have therapeutic effects. Therefore, instead of a low-purine diet, using healthy diets, such as DASH or the Mediterranean diet, which can benefit metabolic parameters, could be a better proposal. This article provides an overview of this approach, focusing on MetS and hyperuricemia among high-fructose dieters.
... 42 For example, the Mediterranean diet, rich in fiber, antioxidants, and mono-unsaturated fatty acids, can improve UA levels and reduce inflammatory status and oxidative stress. 43 The same diet has improved erectile function. 44,45 Likewise, physical exercise has beneficial effects on gout 46 as well on male and female sexual health and function, 47,48 possibly also mediated by its effect on body weight and inflammatory status 45 : the effects of physical exercise on the endocrine milieu can promote a favorable antiinflammatory profile, increasing levels of anti-inflammatory cytokines (such as IL-10) and reducing levels of pro-inflammatory cytokines such as TNF-a, IL-6, and IL-1b, 49,50 positively acting on both gout and sexual health. ...
Introduction
Gout is the most prevalent inflammatory crystal arthropathy worldwide and is a chronic disease requiring strict, lifelong adherence to drug therapy and healthy lifestyles. Gout has a heavy burden on the patient's sexual health, owing to the associated inflammatory status, long-term complications, and chronic pain; however, the effects of gout also extend to the partner's sexual health.
Aims
We aimed to investigate how the presence of a partner could influence the complex interaction between risk factors for sexual dysfunctions in gout in order to define novel strategies to improve sexual health and disease management.
Methods
Clinical and experimental data on the role of the couple in chronic diseases, as well as on the association between gout and sexual health, were searched through Pubmed.
Main outcome measures
Evidence from studies describing how the presence of a couple and leveraging sexual health can improve management and clinical outcomes for chronic diseases.
Results
Treatment adherence can improve the sexual health of gout patients and their partners; likewise, by leveraging sexual health, it would be possible to promote better health-seeking behaviors, ultimately improving gout management.
Clinical implications
Promoting awareness of the sexual health relevance of gout can potentially be a pivotal strategy to improve disease management and prevent the progression of sexual dysfunctions from subclinical to overt forms.
Strengths and limitations
Identifying a bidirectional association between sexual health and disease management paves the way for improved disease control and can potentially prevent the development of sexual dysfunctions in couples affected by gout. However, the relevance of the couple has not been adequately addressed in gout management, and most evidence comes from other chronic diseases.
Conclusion
Improving gout management results in better sexual health, and vice-versa promoting better sexual health can improve disease control for gout. The presence of a partner improves the behavioral well-being of gout patients, with beneficial effects on both sexual health and gout management.
Sansone A, Reisman Y, Meto S, et al. The Role of the “Anti-Inflammatory” Couple for the Management of Hyperuricemia With Deposition. Sex Med 2022;XX:XXXXXX.
... No recommendation [34] Ketogenic diet underscores the importance of a holistic assessment of the individual's hyperuricemia or gout risk beyond specific genetic factors and selected dietary habits to account for the disproportionate disease excess among selected population groups. Moreover, the social context of the person's life can significantly influence the risk of exposure, degree of susceptibility, and course and outcome of diseases, such as hyperuricemia and gout. ...
Gout is a metabolic disorder, and one of the most common inflammatory arthritic conditions, caused by elevated serum urate (SU). Gout is globally rising, partly due to global dietary changes and the growing older adult population. Gout was known to affect people of high socioeconomic status. Currently, gout disproportionately affects specific population subgroups that share distinct racial and ethnic backgrounds. While genetics may predict SU levels, nongenetic factors, including diet, cultural traditions, and social determinants of health (SDOH), need to be evaluated to optimize patient treatment outcomes. This approach would allow clinicians to assess whether certain cultural norms, or some SDOH, could be contributing to their patient’s risk of developing gout or recurrent gout flares. A cultural assessment may inform the development of culturally tailored dietary recommendations for patients with gout. Causal and association studies investigating the interaction between diet, genetics, and gout, should be cautiously interpreted due to the lack of reproducibility in different racial groups. Optimal gout management could benefit from a multidisciplinary approach, involving pharmacists and nurses. While data on the effect of specific dietary recommendations on managing hyperuricemia and gout may be limited, counseling patients with gout on the role of a healthy diet to optimally control their gout flares and other comorbidities should be part of patient education. Future research investigating the role of a gene–diet interaction in the context of hyperuricemia and gout is needed. Optimal care for patients with gout needs to include a holistic assessment for gout and gout-related comorbidities. Additionally, addressing health beliefs and culture-specific lifestyle factors among patients with gout may reduce their risk of gout flare, improve adherence to urate-lowering therapy (ULT), and achieve health equity in gout management.
... Even diets that are not primarily focused on low purine content, such as the Mediterranean diet, calorie reduction, low-carb and low-fat, can likely also trigger a reduction in SUA and blood lipids (cholesterol and triglycerides) [21]. Reducing insulin concentrations via weight reduction and thereby a reduction in insulin resistance, thus positively influences cardiovascular risk factors [22]. ...
Background
Gout is the most frequent inflammatory joint disease in the western world and has a proven genetic background. Additionally, lifestyle factors like increasing life span and wealth, sufficient to excess nutritional status and a growing prevalence of obesity in the population, as well as e.g. alcohol consumption contribute to the rising incidence of hyperuricemia and gout. Apart from an adequate medication, medical advice on nutrition and lifestyle is an essential part of the management of gout patients, being at high risk of internal comorbidities.
Objective
In 2015, the ÖGR (Österreichische Gesellschaft für Rheumatologie und Rehabilitation) working group for osteoarthritis and crystal arthropathies already published nutrition and lifestyle recommendations for patients with gout and hyperuricemia. Since then, a multitude of literature has been published addressing this topic, what required an update.
Methods
First, the authors performed a hierarchical literature search to screen the meanwhile published literature. Also considering references of the first publication, the relevant literature was selected, and the 2015 recommendations were either kept as published, reformulated or newly produced. Finally, the evidence level and the level of agreement with each recommendation were added.
Results
Following this process, ten recommendations were generated instead of the initial nine. Like in the original publication, a colored icon presentation was provided to complement the written text.
Conclusion
The Austrian nutrition and lifestyle recommendations for patients with gout and hyperuricemia were updated incorporating the most recent relevant literature, serving as education material for patients and updated information for physicians.
... Средиземноморская диета, одна из самых известных моделей здорового питания, оказывает положительное влияние на уровень МК и, следовательно, на риск развития подагры. Результаты исследований IKARIA (281 женщина и 257 мужчин без ССЗ), ATTICA (2380 мужчин и женщин без ССЗ и заболеваний почек) и PREDIMED (4449 лиц 55-80 лет с СД или 3 ФР ССЗ) продемонстрировали обратную ассоциацию приверженности к данной диете и риска ГУ [38,39]. В исследовании PREDIMED у 43,8% людей отмечено снижение МК при соблюдении средиземноморской диеты без потери массы тела и увеличения физической активности. ...
The association of hyperuricemia (HU) with cardiovascular disease (CVD), diabetes, metabolic syndrome, and kidney disease has been demonstrated in numerous studies. НU is the main pathogenetic factor in the development of gout and is associated with an increase in overall and cardiovascular mortality. НU is included in the list of factors determining cardiovascular risk. According to epidemiological studies, there is a high prevalence of HU in the world and its increase in recent decades. A number of factors have been identified that contribute to the increased risk of НU. Non-modifiable factors include gender, age, genetic factors, and modifiable factors include diet and lifestyle. Nutritional unbalances, increased life expectancy, increased prevalence of obesity, and increased use of drugs (especially diuretics) are seen as contributing factors to the rise in НU. The review was carried out to summarize the available information on the effect of dietary habits, individual foods and nutrients on serum uric acid (SUA) levels and the risk of developing HU. The review presents the results of scientific studies demonstrating the relationship of НU with the consumption of foods rich in purines (offal, red meat, fish, seafood, legumes), alcohol consumption, drinks sweetened with fructose, coffee, dairy products, vegetables and fruits. Diet correction is an important and necessary step in the prevention and treatment of НU. The article reviews the basic principles of dietary management in HU and provides dietary recommendations for patients. For effective prevention and treatment of НU, a mandatory correction of the diet is required.
... This work demonstrated that the consumption of specific nutrients (beer, liquor, wine, potato, poultry, soft drinks, and meat) increased serum urate levels, while others (eggs, cheese, peanuts) were associated with lower levels. These data are in line with observations linking Mediterranean diet (in which red meat intake is moderate) with reduced gout incidence (25). However, the mechanisms by which nutrition modifies urate production and impacts on gout crises remain elusive. ...
Gout is the most frequent form of inflammatory arthritis in the world. Its prevalence is particularly elevated in specific geographical areas such as in the Oceania/Pacific region and is rising in the US, Europe, and Asia. Gout is a severe and painful disease, in which co-morbidities are responsible for a significant reduction in life expectancy. However, gout patients remain ostracized because the disease is still considered “self-inflicted”, as a result of unhealthy lifestyle and excessive food and alcohol intake. While the etiology of gout flares is clearly associated with the presence of monosodium urate (MSU) crystal deposits, several major questions remain unanswered, such as the relationships between diet, hyperuricemia and gout flares or the mechanisms by which urate induces inflammation. Recent advances have identified gene variants associated with gout incidence. Nevertheless, genetic origins of gout combined to diet-related possible uric acid overproduction account for the symptoms in only a minor portion of patients. Hence, additional factors must be at play. Here, we review the impact of epigenetic mechanisms in which nutrients (such as ω-3 polyunsaturated fatty acids) and/or dietary-derived metabolites (like urate) trigger anti/pro-inflammatory responses that may participate in gout pathogenesis and severity. We propose that simple dietary regimens may be beneficial to complement therapeutic management or contribute to the prevention of flares in gout patients.
... 21 For example, a recent study suggested that intermittent fasting can ameliorate psoriatic arthritis severity, defined by psoriatic arthritis disease activity scores. 22 A review of the literature performed by Stamostergiou et al., 23 showed that adherence to the Mediterranean dietary pattern appears promising for the management of patients with hyperuricemia and/or gout. In conclusion, incorporating social media in health research has many advantages and may even help in promoting evidence-based medicine. ...
Social media platforms have become a part of our lives, as users spend on average two and a half hours per day. Facebook, Instagram, and Twitter consist the most pop- ular social media channels. Nowadays, more and more people are signing in to social media in order to search for medical and nutritional advices about their condition. Approximately 2/3 of Americans use social networking applications. Today, Twitter has become one of the most well-known social media platforms, with patients and health professionals exchanging opinions concerning healthcare.
Keywords: diet, social media, infodemiology, rheumatic diseases.
... It is widely accepted that diet habits play a role in the development of hyperuricemia as well as in exacerbating of disease [81][82][83]. The risk of attacks is increased after high intakes of purine-rich foods. ...
Since ancient times, the quality of nourishment is a milestone for the maintenance of health and as it is stated 'prevention is better than cure', amongst the so-called 'healthy' diets Mediterranean diet (MD) claims the lion's share. It stands in good stead because of a variety of valuable macro-and micronutrients. So, adherence to a MD is associated with the reduction of inflammation and non-communicable (NCD) OR chronic diseases. Numerous studies try to scrutinize the role of MD components as regards reducing inflammation, lowering rate, and mortality for disorders and illnesses, and preventing NCD. MD regime of the inhabitants of the Mediterranean basin includes a variety of ethnic nutritional habits and regulates an array of effects and epigenetic changes that affect human wellbeing. The research is still ongoing and endeavors to elucidate every aspect of this issue. This review focuses on the impact of MD on inflammation highlights positive results regarding NCD and indicates the need for more high-quality experiments and trials in order to overcome any discrepancies.
... Виявлено, що дотримання середземноморської дієти асоційоване зі зниженням рівня уратів у периферичній крові та не залежить від статі, маси тіла, наявності артеріальної гіпертензії, аномального метаболізму глюкози і споживання алкоголю або кави. Тим самим підкреслюється потенційна роль середземноморської дієти для профілактики і лікування гіперурикемії [71]. ...
Gout is an inflammatory arthritis caused by the deposition of sodium monourate crystals in the synovial joints and soft tissues. Current guidelines focus more on aggressive drug therapy for the treatment of gout, while less attention is paid to recommendations for lifestyle changes and appropriate nutrition. This literature review provides a thorough analysis of the lifestyle impact, foods and food components on the risk of hyperuricemia developing, gout and its clinical manifestations, based on the most recent studies. The mechanisms underlying the influence of the characteristics of certain products on the level of serum uric acid are considered. The importance of dietary counseling for patients with gout, the need for weight control and regular moderate exercise to improve the prognosis of the course of this disease are emphasized.
