Gout Patient Education

• Patient education, appropriate lifestyle advice and shared decision making are core aspects of the management
• Often improves patient’s understanding and compliance when done at the start of therapy
• Educate patient regarding the disease, its treatment options, duration and side effects, and associated comorbidities
• Give advice on possible changes of life habits that can lead to an improvement in overall metabolic profile of the patient
• Patients should be made to understand that genetics contribute to risk factors more than indulgent food and drinks, therefore the need for urate-lowering therapy may be long-term

• The goal of lifestyle modification is to help prevent both gouty attacks and complications, together with its comorbidities
• It is a part of long-term management of gout

Body Mass Index (BMI)

• Aim to have ideal body weight through gradual weight loss (0.5-1 kg/week), with gradual caloric restriction and regular exercise
  • Avoid “crash dieting” and high-protein/low-carbohydrate diets since these may cause ketosis and result to hyperuricemia
  • Daily or at least 45-minute, 4-times-a-week, low-impact (eg walking, biking, swimming) or aerobic exercise is recommended

Dietary Management 

• Dietary restriction can decrease the occurrence of gouty attacks but has little role in lowering serum urate levels in patients with gout
• Restrict consumption of high purine foods (eg brain, liver, kidney, anchovies, sardines, mackerel, seafood, shellfish)
• Reduce intake of meat (beef, lamb, pork)
• High intake of high-fiber fruits, vegetables, nuts, legumes, vegetable protein reduces the risk of gout (lower serum uric acid)
• Consumption of low-fat dairy products or skim milk up to 2 servings daily
• Limit sugar-sweetened softdrinks and beverages containing fructose

Alcohol Intake 

• Restrict alcohol consumption to <21 units/week for men and 14 units/week for women
  • Have at least 3 alcohol-free days/week
• Avoid alcohol intake when suffering from frequent gout attacks or when gout symptoms are poorly controlled

Smoking 

• Complete cessation of smoking is recommended

Adequate Fluid Intake 

• Recommended fluid intake is 2-3 L/day
• Restrict fluid intake in some patients (eg with heart failure or severe renal insufficiency)