Weight Loss Cuts Gout Risk

Losing weight is the best way to prevent gout, a major new study shows.

Obesity is known to be one risk factor for gout -- but now it appears to be much more important than previously thought.

Massachusetts General Hospital researcher Hyon K. Choi, MD, DrPH, and colleagues collected data on more than 47,000 middle-aged men for 12 years. The more weight the men gained, the higher their risk of gout. But over the course of the study, those who lost weight cut their gout risk.

"Weight loss greater than 10 pounds since the 1986 study baseline was associated with a substantially reduced risk of gout," Choi and colleagues report. "Our study is the first to document this important potential benefit of weight loss."

The findings appear in the April 11 issue of Archives of Internal Medicine .

More Pounds, More Gout Risk

Gout attacks when there's too much uric acid in the body. This makes one's joints fill up with uric acid crystals. The joints swell and are very painful. Attacks usually go away in a few days but return with greater frequency and severity if not treated. Gout is more common in men, and it usually strikes during middle age.

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Drinking alcoholic beverages is bad for gout because it raises uric acid production and slows its elimination. Foods rich in substances called purines -- especially those found in some meats and seafood -- also contribute to gout.

But Choi's team finds that whatever their diet, men who gain weight get gout more often. Compared with men who don't gain weight, overweight men ( body mass index or BMI body mass index or BMI of at least 25) are more than twice as likely to develop gout -- and obese men have triple the gout risk.

Men who gained 30 pounds or more since age 21 had twice the gout risk of men who didn't gain weight during adulthood.

Losing weight may help. Men who lost 10 pounds or more dropped their gout risk by 40%.

High Blood Pressure, Water Pills Also Play Role

But weight isn't the only risk factor. Choi and colleagues also found that having high blood pressure ups gout risk as much as being overweight. And using water pills (diuretics) also nearly doubled gout risk.

"Our findings are most directly generalizable to men over 40 years and older ... with no history of gout," they write. "Whether these findings apply to women or to men with existing gout remains to be studied."

By Daniel DeNoon Reviewed By Michael Smith, MD

SOURCE: Choi, H. Archives of Internal Medicine , April 11, 2005; vol 165: pp 742-748.
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