Plan of Action?
Transforming research into a clinical plan of action is a thorny issue, Dr. Choi notes, because measuring “the consumption of food and alcohol is multifaceted. Promoting individual behavior changes must be done on the private and public fronts simultaneously. We need broader policy changes targeting sugary drinks, labeling reforms, federal nutrition programs addressing obesity and more. It is important to know that 44% of hyperuricemia was coming from obesity, but we have to look more closely at what is causing obesity. For example, we will likely have to invest more in behavioral and psychological interventions for obesity.”
Concerned that prior research has led patients to think their food and alcohol choices are irrelevant, Dr. Choi states, “It is not helpful if researchers take a misguided approach to this. The public puts its trust in us, and we must have what it takes to get it right. We cannot just blame genetics and close the book on hyperuricemia. That would be equivalent to blaming genetics entirely for the current obesity epidemic and recommending nothing about diet and exercise.”
Limitations
“Of course, our study contained limitations, namely that the measurement error for diet and alcohol underestimates the impact of these variables,” says Dr. Choi. “Unfortunately, that is the nature of this type of study. There is just no way to accurately assess how much food and alcohol someone is consuming over an extended period of time—especially because people tend to report consuming less alcohol than they actually imbibe.”
He says, “Going forward I would like to see more high-level longitudinal, prospective studies that measure exposures before endpoints of interest, particularly regarding the risk of gout.”
With one in five people having a high uric acid level, this research has the potential for a widespread impact.4
Elizabeth Hofheinz, MPH, MEd, is a freelance medical editor and writer based in the greater New Orleans area.
References
- Richette P, Bardin T. Gout. Lancet. 2010 Jan 23;375(9711):318–328.
- Kuo C-F, Grainge MJ, Zhang W, Doherty M. Global epidemiology of gout: Prevalence, incidence and risk factors. Nat Rev Rheumatol. 2015 Nov;11(11):649–662.
- Choi HK, McCormick N, Lu N, et al. Population impact attributable to modifiable risk factors for hyperuricemia. Arthritis Rheumatol. 2020 Jan;72(1):157–165.
- High uric acid level: Definition. Mayo Clinic.