Chapter 10 - Gout: The role of diet, functional foods, and the microbiome and their interplay prevalent in North America and globally

Abstract

Gout has a long history with the human race since the dawn of civilization or even earlier. It is reported in medical writings and is frequently attributed to gluttony and overindulgence. Gout is a complex disease that manifests by inflammatory arthritis and other systemic problems. It is caused by the deposition of monosodium urate crystals in different tissues. Diet has a major role in the pathophysiology and management of gout. Although the evidence comes mainly from observational and animal studies, the potential health benefits are too good to be ignored. The most important dietary modifications that are recommended by different guidelines are: a low purine diet, limiting alcohol intake, and limiting intake of high fructose corn syrup. Nonetheless, an alkaline diet, omega-3 polyunsaturated fatty acids, and different vitamins have possible benefits for patients with gout. The hypouricemic and uricosuric effects of some bioactive ingredients in functional foods are promising and should be compared to conventional gout medications in well-conducted clinical trials to assess their full potential. Furthermore, intestinal microbiota play vital diagnostic and therapeutic roles in gout management. Designing nutritional plans based on gout-specific microbiota signature aids in lowering the uric acid pool and better management of disease- and medication-related physiologic abnormalities.