Dietary Management

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There has been a substantial change in the predominant view regarding the relationship between diet and gout. It has even been said that ''dietary considerations now play a minor role in the treatment of hyperuricemia, despite a fascinating history and abundant literature."

The relationship between gout and gluttony (overindulgence of food and alcohol) dates back to ancient times. In the fifth- century bc, Hippocrates attributed gout to dietary excesses of food and wine; he advised dietary restriction and reduction of alcohol consumption. Historically, the dietary management of gout has focused on two goals: (i) reducing the amount of uric acid that may be deposited as crystals in joints or soft tissues, leading to the clinical syndrome of gout, and (ii) managing the disorders that occur with increased frequency among patients with gout, including diabetes mellitus, obesity, hyperlipidemia, hypertension, and atherosclerosis.

Although some practitioners may still advocate the traditional low-purine, low-protein, alcohol-restricted diet, there is increasing support for the more 'contemporary' view that dietary management should focus on weight reduction with a restricted intake of calories and carbohydrates along with proportional increases in both protein and unsaturated fats and no restriction of purine content.

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