Patients should be made aware of the signs, symptoms and causes of gout. They should also be advised of any risk factors they have for gout, for example:[53]National Institute for Health and Care Excellence. Gout: diagnosis and management. June 2022. [internet publication].
https://www.nice.org.uk/guidance/ng219
Genetics
Excess body weight or obesity
Medicine they may be taking
Comorbidities such as kidney disease or hypertension.
Patients should understand that gout is a lifelong condition, and that disease progression will occur without long term urate lowering treatment to eliminate urate crystals and prevent flares, shrink tophi and prevent long term joint damage.[53]National Institute for Health and Care Excellence. Gout: diagnosis and management. June 2022. [internet publication].
https://www.nice.org.uk/guidance/ng219
Patients should be advised that foods with a high purine content (i.e., alcohol, seafood, and offal) are associated with higher risk for elevated uric acid and gout.[15]Choi HK, Atkinson K, Karlson EW, et al. Purine-rich foods, dairy and protein intake and the risk of gout in men. N Engl J Med. 2004;350:1093-1103.
https://www.nejm.org/doi/full/10.1056/NEJMoa035700
http://www.ncbi.nlm.nih.gov/pubmed/15014182?tool=bestpractice.com
Reducing intake of alcohol, especially beer, lowers the risk of gout.[141]Choi HK, Atkinson K, Karlson EW, et al. Alcohol intake and risk of incident gout in men: a prospective study. Lancet. 2004;363:1277-1281.
http://www.ncbi.nlm.nih.gov/pubmed/15094272?tool=bestpractice.com
Reducing seafood and meat intake helps to a lesser degree.
Reducing fructose and concentrated sweets might help to reduce uric acid and the risk for gout attacks.
Dairy products reduce the risk of gout.[14]Li R, Yu K, Li C. Dietary factors and risk of gout and hyperuricemia: a meta-analysis and systematic review. Asia Pac J Clin Nutr. 2018;27(6):1344-56.
http://apjcn.nhri.org.tw/server/APJCN/27/6/1344.pdf
http://www.ncbi.nlm.nih.gov/pubmed/30485934?tool=bestpractice.com
[37]Singh JA, Reddy SG, Kundukulam J. Risk factors for gout and prevention: a systematic review of the literature. Curr Opin Rheumatol. 2011;23:192-202.
http://www.ncbi.nlm.nih.gov/pubmed/21285714?tool=bestpractice.com