Impact of lifestyle factors and dietary patterns on serum uric acid levels and disease activity in gout: a systematic review

Abstract Background Gout is a common type of inflammatory arthritis caused by monosodium urate (MSU) crystal deposition in the joints. This leads to pain, swelling, and restricted motion. Although pharmacological treatments are effective, lifestyle and dietary factors play crucial roles in managing...

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Main Authors: Mohammad Mustafa, Shahad Alshamrani, Lama Alghamdi, Hala Danish, Dana Alamoudi, Ghala Alshamrani, Abdullah Alagha, Adnan Alshaikh, Saher Alqarni, Yasser Bawazir
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Journal of Health, Population and Nutrition
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Online Access:https://doi.org/10.1186/s41043-025-00982-4
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author Mohammad Mustafa
Shahad Alshamrani
Lama Alghamdi
Hala Danish
Dana Alamoudi
Ghala Alshamrani
Abdullah Alagha
Adnan Alshaikh
Saher Alqarni
Yasser Bawazir
author_facet Mohammad Mustafa
Shahad Alshamrani
Lama Alghamdi
Hala Danish
Dana Alamoudi
Ghala Alshamrani
Abdullah Alagha
Adnan Alshaikh
Saher Alqarni
Yasser Bawazir
author_sort Mohammad Mustafa
collection DOAJ
description Abstract Background Gout is a common type of inflammatory arthritis caused by monosodium urate (MSU) crystal deposition in the joints. This leads to pain, swelling, and restricted motion. Although pharmacological treatments are effective, lifestyle and dietary factors play crucial roles in managing gout and its flares. Aim This systematic review aimed to assess the effect of lifestyle factors, physical activity, and dietary patterns on serum uric acid levels and gout activity. Methods A search of PubMed, BMJ journals, and Google Scholar identified eight studies (five prospective cohort studies, two case-cross-over studies, and one randomized controlled trial), involving 47,879 participants (predominantly males [78.5–95.3%], aged 55–66 years). Eligible studies focused on adults with gout and examined the lifestyle or dietary factors affecting uric acid levels or gout activity. The review followed a pre-specified protocol (PROSPERO registration CRD42024594359). To optimize the quality, the bias risk was assessed using the Newcastle-Ottawa scale for observational studies and the Cochrane Risk of Bias 1.0 tool for randomized controlled trials. Results The findings suggest that consuming polyunsaturated fatty acid-rich fish, regular physical activity, and increased vegetable intake may reduce gout flares. Conversely, high purine intake (especially animal sources), excessive alcohol consumption, and obesity are risk factors for gout exacerbation. Some studies have reported reduced serum uric acid levels with dietary changes, whereas others have found no significant effect. Despite the variability and recall bias, dietary and lifestyle modifications may help manage gout and reduce disease activity. Conclusion The findings of this systematic review emphasize the importance of dietary and lifestyle factors in managing serum uric acid levels and reducing the risk of gout flares. Further research is required to establish clinical recommendations to improve patient outcomes.
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spelling doaj-art-8e43ff34f30b459b956fa218e23c5bc42025-08-20T03:45:35ZengBMCJournal of Health, Population and Nutrition2072-13152025-07-0144111210.1186/s41043-025-00982-4Impact of lifestyle factors and dietary patterns on serum uric acid levels and disease activity in gout: a systematic reviewMohammad Mustafa0Shahad Alshamrani1Lama Alghamdi2Hala Danish3Dana Alamoudi4Ghala Alshamrani5Abdullah Alagha6Adnan Alshaikh7Saher Alqarni8Yasser Bawazir9Department of Medicine, University of JeddahMedical Student, College of Medicine, University of JeddahMedical Student, College of Medicine, University of JeddahMedical Student, College of Medicine, King Saud Bin Abdulaziz for Health SciencesMedical Student, College of Medicine, University of JeddahMedical Student, College of Medicine, University of JeddahMedical Intern, College of Medicine, King Abdulaziz UniversityMedical Intern, College of Medicine, King Abdulaziz UniversityMedical Student, College of Medicine, King Abdulaziz UniversityMedical department, King Abdulaziz UniversityAbstract Background Gout is a common type of inflammatory arthritis caused by monosodium urate (MSU) crystal deposition in the joints. This leads to pain, swelling, and restricted motion. Although pharmacological treatments are effective, lifestyle and dietary factors play crucial roles in managing gout and its flares. Aim This systematic review aimed to assess the effect of lifestyle factors, physical activity, and dietary patterns on serum uric acid levels and gout activity. Methods A search of PubMed, BMJ journals, and Google Scholar identified eight studies (five prospective cohort studies, two case-cross-over studies, and one randomized controlled trial), involving 47,879 participants (predominantly males [78.5–95.3%], aged 55–66 years). Eligible studies focused on adults with gout and examined the lifestyle or dietary factors affecting uric acid levels or gout activity. The review followed a pre-specified protocol (PROSPERO registration CRD42024594359). To optimize the quality, the bias risk was assessed using the Newcastle-Ottawa scale for observational studies and the Cochrane Risk of Bias 1.0 tool for randomized controlled trials. Results The findings suggest that consuming polyunsaturated fatty acid-rich fish, regular physical activity, and increased vegetable intake may reduce gout flares. Conversely, high purine intake (especially animal sources), excessive alcohol consumption, and obesity are risk factors for gout exacerbation. Some studies have reported reduced serum uric acid levels with dietary changes, whereas others have found no significant effect. Despite the variability and recall bias, dietary and lifestyle modifications may help manage gout and reduce disease activity. Conclusion The findings of this systematic review emphasize the importance of dietary and lifestyle factors in managing serum uric acid levels and reducing the risk of gout flares. Further research is required to establish clinical recommendations to improve patient outcomes.https://doi.org/10.1186/s41043-025-00982-4ArthritisGoutDietary patternLifestyle factorPhysical activityUric acids cohort study
spellingShingle Mohammad Mustafa
Shahad Alshamrani
Lama Alghamdi
Hala Danish
Dana Alamoudi
Ghala Alshamrani
Abdullah Alagha
Adnan Alshaikh
Saher Alqarni
Yasser Bawazir
Impact of lifestyle factors and dietary patterns on serum uric acid levels and disease activity in gout: a systematic review
Journal of Health, Population and Nutrition
Arthritis
Gout
Dietary pattern
Lifestyle factor
Physical activity
Uric acids cohort study
title Impact of lifestyle factors and dietary patterns on serum uric acid levels and disease activity in gout: a systematic review
title_full Impact of lifestyle factors and dietary patterns on serum uric acid levels and disease activity in gout: a systematic review
title_fullStr Impact of lifestyle factors and dietary patterns on serum uric acid levels and disease activity in gout: a systematic review
title_full_unstemmed Impact of lifestyle factors and dietary patterns on serum uric acid levels and disease activity in gout: a systematic review
title_short Impact of lifestyle factors and dietary patterns on serum uric acid levels and disease activity in gout: a systematic review
title_sort impact of lifestyle factors and dietary patterns on serum uric acid levels and disease activity in gout a systematic review
topic Arthritis
Gout
Dietary pattern
Lifestyle factor
Physical activity
Uric acids cohort study
url https://doi.org/10.1186/s41043-025-00982-4
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