Many people suffer from gout, with it being the leading cause of arthritis in men. Two recent studies looked at who gets gout (is it genetics or lifestyle?), and another study examined what kind of diet is best for treating symptoms.
Gout is a type of inflammatory arthritis that causes sudden, severe attacks of pain, swelling, and tenderness in one or more joints. These attacks, which can last a week or two, frequently start in the big toe or a lower limb.
The first study found that genetics, and not lifestyle, determines who gets gout. Lifestyle is frequently blamed (rich foods!, being overweight!). From Science Daily: Study busts myths about cause of gout
".. eating red meat, can trigger gout attacks, the fundamental cause is high urate levels, crystals in the joints, and an immune system primed to 'attack' the crystals -- genetics plays an important role in all of these processes."
Another study found that a Mediterranean style, whole foods, and plant-based diet improves gout symptoms, but a low-calorie or animal-based, and low-carbohydrate diet does not. The Mediterranean style diet also lowered serum uric acid (a cause of the symptoms). It is thought that this is because animal meat and ultra-processed foods are pro-inflammatory, while plant-based foods are not.
Excerpts from Medscape: Plant-Based Diet Improves Uric Acid Levels, Gout Symptoms
A Mediterranean-inspired plant-based diet improved self-reported measures of gout as well as uric acid levels, a pilot study has found.
Some foods are considered to be proinflammatory and generally come from animal origins, including saturated fats and animal protein in addition to ultraprocessed foods. Foods that have anti-inflammatory properties are mostly plant based and unprocessed and often rich in fiber. “From recent interventional studies, we also know that the whole- foods plant-based diet has shown to be effective as treatments of the main comorbidities of gout, such as obesity, cardiovascular disease, or [osteoarthritis],” said Kretova, who is a registered dietitian and a researcher at the Reade Rehabilitation and Rheumatology Center, Amsterdam, the Netherlands.
Those findings led the researchers to develop a whole foods, plant-based diet and test its effect on serum uric acid in patients with gout, as well as gout disease activity and cardiovascular disease risk. Participants could not eat meat, fish, eggs, or dairy.
The trial included 33 individuals with gout who were randomized to a 16-week intervention with five consultations with a registered dietician (n = 18) or a wait-list control group (n = 15) who received standard care. The mean age overall was 52 years, and 91% were men. The mean body mass index (BMI) was 32.6 kg/m2, and the median uric acid level was 0.50 mmol/L (8.4 mg/dL).
Among gout-related outcomes, the researchers noted improvements in gout severity as measured by visual analog scale, pain as measured by VAS, and uric acid levels after adjustment for age, sex, and BMI....
At 16 weeks, “we concluded that a Mediterranean-inspired whole foods, plant-based diet significantly lowers serum uric acid in patients with gout and abdominal obesity, and additionally, the diet reduces gout-related pain and disease activity, promotes substantial weight loss, decreases weight circumference, and improves LDL cholesterol levels, and thus decreases [cardiovascular disease] risk in these patients,” Kretova said.