A US prospective cohort study suggests that most gout cases could potentially be prevented by achieving and maintaining a normal weight, eating a DASH-style diet, and avoiding alcohol consumption and diuretic use. Men with obesity may not benefit from other modifications unless weight loss is addressed. The study included 44 654 male health professionals enrolled in 1986 (mean age, 54.0 years) with no history of gout at baseline. During 26 years of follow-up, 1741 (3.9%) developed incident gout. Among all participants, Population attributable risks (PAR) for the 4 risk factors combined (body mass index [BMI], diet, alcohol use, and diuretic use) was 77%. Among men with normal weight (BMI <25.0) and overweight (BMI 25.0-29.9), it was estimated that more than half of incident gout cases (69% and 59%, respectively) may have been prevented by the combination of DASH-style diet (a diet rich in vegetables, fruits, whole grains, fish, poultry, nuts, low-fat dairy, and low in salt, red/processed meats and sweetened beverages), no alcohol intake, and no diuretic use. However, among men with obesity (BMI ≥30), PAR was substantially lower and not significant (5%). The potential benefits of modifying lifestyle factors in the study are consistent with the PAR findings for other cardiovascular-metabolic conditions, such as type 2 diabetes and high blood pressure, and further strengthen public health recommendations to maintain a normal BMI and follow healthy lifestyles. Source: https://jamanetwork.com/
