Abstract
The prevalence of gout in Japan has increased markedly since the 1960s. This phenomenon is thought to be attributed to the westernization of the Japanese diet since 1955. The objective of this article is to propose a preventive method for gout through the evaluation of recent dietary habits in Japanese people. In this article, the author suggests what foods should be chosen in proper diet or dietary pattern in Japanese people referencing the results of clinical research reported. Furthermore, this article suggests essentials of behavior for prevention of gout and its comorbidities. Diet and dietary pattern for the prevention of gout in Japanese people (especially adults) are suggested as follows: avoidance of purine-rich diet, uric acid-prone dietary pattern, animal foods dietary pattern, and the Western diet; encourage high fruit and soybean products diet, less protein-rich and more vegetable/fruit-rich materials diet, soybean products and fruit dietary pattern, polyphenol-rich dietary pattern, higher adherence to the Mediterranean diet (the traditional Mediterranean diet) and its dietary pattern, higher adherence to the Dietary Approaches to Stop Hypertension (DASH) diet and its dietary pattern, and vegetarian diet (plant-based diet). Referring to or adopting dietary patterns such as the Mediterranean diet, the DASH diet, and vegetarian diet (plant-based diet), the author wishes to emphasize that Japanese people should eat a diet in which consciously selects foods rich in dietary fiber, vitamin A, vitamin B<sub>1</sub>, vitamin B<sub>2</sub>, vitamin B<sub>6</sub>, calcium, potassium, magnesium, and zinc and decreases intakes of fat (especially animal fat) and salt. Modification of behavior (diet, alcohol, body weight, physical activity, and tobacco) for the prevention of gout and its comorbidities in Japanese adult people is suggested as follows: avoidance of the Western diet and its dietary pattern; encourage higher adherence to the Mediterranean diet (the traditional Mediterranean diet) and its dietary pattern, higher adherence to the DASH diet and its dietary pattern, and vegetarian diet (plant-based diet); limiting alcohol consumption; weight management including proper calorie intake; weight loss for overweight and obese people; adequate physical exercise (e.g., moderate intensity aerobic exercise for 30 minutes on 5-7 days per week, vigorous intensity aerobic physical activity for 75 minutes per week); and smoking cessation. The above behavior for the prevention of gout may also play a helpful role in the prevention of gout and its comorbidities.
Highlights
The global burden of gout is substantial and seems to have been increasing in many parts of the world including Japan over the past 50 years [1,2,3,4]
A polyphenol-rich dietary pattern, such as the Mediterranean diet, is likely to play a role in its anti-inflammatory effect and downregulation of cellular and circulating inflammatory biomarkers related to atherosclerosis in subjects at high risk of cardiovascular disease (CVD), as reviewed in detail by Ríos-Hoyo et al [76], Mena et al [79], and Medina-Remón et al [80]. suggest that high polyphenol intake improves cardiovascular risk factorsmainly systolic and diastolic blood pressure and the lipid profile
The objective of this article was to propose a preventive method for gout through the evaluation of recent eating habits in Japan
Summary
The global burden of gout is substantial and seems to have been increasing in many parts of the world including Japan over the past 50 years [1,2,3,4]. In the articles in this series reported by Koguchi [10,11,12], modification of dietary habits for the prevention of gout in Japanese people (especially adults) is suggested as follows: avoidance of excessive intake of saturated fatty acids and cholesterol; replacement of saturated fatty acids with monoand polyunsaturated ones (especially n-3 polyunsaturated fatty acids); limiting the intake of meat, organ meats high in purine content (e.g., liver, kidney), confectioneries (sugary foods including desserts and sweets), and sugar-sweetened beverages; limiting or decreasing intake of fat (especially animal fat), salt, oils and fats, and seasonings and condiments (soy paste, soy sauce, and sauce); limiting alcohol and alcoholic beverage consumption; encourage intake of fiber-rich foods (e.g., cereals, whole grains, high-fiber bread), eggs, milk and dairy products (especially low-fat dairy products), legumes, seeds and nuts, fruit, vegetables, and coffee; increase intake of foods rich in dietary fiber, vitamin A, vitamin B1, vitamin B2, vitamin B6, calcium, potassium, magnesium, and zinc; and maintenance of good hydration. Abbreviation: The DASH diet, The Dietary Approaches to Stop Hypertension diet; PUA, plasma uric acid; SUA, serum uric acid
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