ABSTRACT
Gout is a common inflammatory arthritis caused by sustained elevation of serum urate (SU) levels (hyperuricemia). The formation of monosodium urate (MSU) crystals in and around joints causes extremely painful inflammatory gout flares. Despite the availability of effective urate-lowering medication, the management of gout is often suboptimal. Gout is associated with many comorbidities including metabolic syndrome. Obesity and weight gain are important independent risk factors for incident gout. The risk of gout increases with body mass index (BMI) and having a BMI over 30 kg/m2 more than doubles the risk of gout. Studies of the relationship between obesity and flares in people with gout report conflicting findings, but BMI gain has been shown to increase the risk of flares. Dietary advice to support weight loss is recommended in international gout management guidelines, and there is low-to-moderate quality evidence of a beneficial effect of weight loss on SU levels and gout flares. However, there is a lack of evidence from well-designed randomized control trials of the benefit of weight loss from dietary interventions on clinical outcomes in gout.
