Editing Gout (section)

===Lifestyle===
Dietary causes account for about 12% of gout,<ref name=Review08>{{cite journal |vauthors=Chen LX, Schumacher HR |title=Gout: an evidence-based review |journal=J Clin Rheumatol |volume=14 |issue=5 Suppl |pages=S55–S62 |date=October 2008 |pmid=18830092 |doi=10.1097/RHU.0b013e3181896921 |s2cid=6644013 }}</ref>  and include a strong association with the consumption of alcohol, sugar-sweetened beverages,<ref>{{cite journal |vauthors=Ebrahimpour-Koujan S, Saneei P, Larijani B, Esmaillzadeh A |title=Consumption of sugar sweetened beverages and dietary fructose in relation to risk of gout and hyperuricemia: a systematic review and meta-analysis |journal=Crit Rev Food Sci Nutr |volume=60 |issue=1 |pages=1–10 |date=2020 |pmid=30277800 |doi=10.1080/10408398.2018.1503155 |s2cid=52909165 }}</ref> meat, and seafood.<ref name="Neogi2016"/> The dietary mechanisms and nutritional basis involved in gout provide evidence for strategies of prevention and improvement of gout, and dietary modifications based on effective regulatory mechanisms may be a promising strategy to reduce the high prevalence of gout.<ref>{{Cite journal |last1=Zhang |first1=Yingling |last2=Chen |first2=Simin |last3=Yuan |first3=Man |last4=Xu |first4=Yu |last5=Xu |first5=Hongxi |date=2022-08-26 |title=Gout and Diet: A Comprehensive Review of Mechanisms and Management |journal=Nutrients |language=en |volume=14 |issue=17 |pages=3525 |doi=10.3390/nu14173525 |doi-access=free |pmid=36079783 |pmc=9459802 |issn=2072-6643 }}</ref> Among foods richest in [[purines]] yielding high amounts of uric acid are dried [[anchovy|anchovies]], shrimp, [[organ meat]], dried [[Edible mushroom|mushrooms]], [[Edible seaweed|seaweed]], and [[beer yeast]].<ref>{{cite journal |last1=Kaneko |first1=Kiyoko |last2=Aoyagi |first2=Yasuo |last3=Fukuuchi |first3=Tomoko |last4=Inazawa |first4=Katsunori |last5=Yamaoka |first5=Noriko |title=Total Purine and Purine Base Content of Common Foodstuffs for Facilitating Nutritional Therapy for Gout and Hyperuricemia |journal=Biological and Pharmaceutical Bulletin |date=2014 |volume=37 |issue=5 |pages=709–721 |doi=10.1248/bpb.b13-00967 |pmid=24553148 |doi-access=free }}</ref> Chicken and potatoes also appear related.<ref name=Maj2018>{{cite journal |last1=Major |first1=Tanya J |last2=Topless |first2=Ruth K |last3=Dalbeth |first3=Nicola|author3-link= Nicola Dalbeth |last4=Merriman |first4=Tony R |title=Evaluation of the diet wide contribution to serum urate levels: meta-analysis of population based cohorts |journal=BMJ |volume=363 |date=10 October 2018 |pages=k3951 |doi=10.1136/bmj.k3951|pmid=30305269 |pmc=6174725 }}</ref> Other triggers include [[physical trauma]] and surgery.<ref name=Lancet2010/>

Studies in the early 2000s found that other dietary factors are not relevant.<ref name=Epi2008/><ref name=Choi2004>{{cite journal |vauthors=Choi HK, Atkinson K, Karlson EW, Willett W, Curhan G |title=Purine-rich foods, dairy and protein intake, and the risk of gout in men |journal=[[N. Engl. J. Med.]] |volume=350 |issue=11 |pages=1093–1103 |date=March 2004 |pmid=15014182 |doi=10.1056/NEJMoa035700 |doi-access=free }}</ref> Specifically, a diet with moderate purine-rich vegetables (e.g., [[beans]], [[peas]], [[lentils]], and [[spinach]]) is not associated with gout.<ref name=Singh2011>{{cite journal|last1=Singh|first1=JA|last2=Reddy|first2=SG|last3=Kundukulam|first3=J|title=Risk factors for gout and prevention: a systematic review of the literature|journal=[[Current Opinion in Rheumatology]]|date=March 2011|volume=23|issue=2|pages=192–202|pmid=21285714|doi=10.1097/BOR.0b013e3283438e13|pmc=4104583}}</ref> Neither is [[Protein toxicity|total dietary protein]].<ref name=Choi2004/><ref name=Singh2011/> Alcohol consumption is strongly associated with increased risk, with wine presenting somewhat less of a risk than beer or [[distilled spirit|spirits]].<ref name="Singh2011" /><ref>{{cite journal |last1=Roddy |first1=E. |last2=Mallen |first2=C. D. |last3=Doherty |first3=M. |title=Gout |journal=BMJ |date=1 October 2013 |volume=347 |issue=oct01 3 |pages=f5648 |doi=10.1136/bmj.f5648 |pmid=24473446 |s2cid=220212466 }}</ref> Eating skim milk powder enriched with glycomacropeptide (GMP) and G600 milk fat extract may reduce pain but may result in diarrhea and nausea.<ref>{{cite journal|last1=Moi|first1=John HY|last2=Sriranganathan|first2=Melonie K|last3=Edwards|first3=Christopher J|last4=Buchbinder|first4=Rachelle|date=31 May 2013|title=Lifestyle interventions for chronic gout|journal=Cochrane Database of Systematic Reviews|volume=2013 |issue=5|pages=CD010039|doi=10.1002/14651858.cd010039.pub2|pmid=23728699|pmc=6759140|issn=1465-1858}}</ref>

Physical fitness, healthy weight, low-fat dairy products, and to a lesser extent, coffee and taking vitamin C, appear to decrease the risk of gout;<ref>{{cite journal |vauthors=Hak AE, Choi HK |title=Lifestyle and gout |journal=Curr Opin Rheumatol |volume=20 |issue=2 |pages=179–186 |date=March 2008 |pmid=18349748 |doi=10.1097/BOR.0b013e3282f524a2 |s2cid=205485689 }}</ref><ref>{{cite journal |author=Williams PT |title=Effects of diet, physical activity and performance, and body weight on incident gout in ostensibly healthy, vigorously active men |journal=[[Am. J. Clin. Nutr.]] |volume=87 |issue=5 |pages=1480–1487 |date=May 2008 |pmid=18469274 |pmc=4090353 |doi=10.1093/ajcn/87.5.1480 }}</ref><ref name=Life2010>{{cite journal |author=Choi HK |title=A prescription for lifestyle change in patients with hyperuricemia and gout |journal=Curr Opin Rheumatol |volume=22 |issue=2 |pages=165–172 |date=March 2010 |pmid=20035225 |doi=10.1097/BOR.0b013e328335ef38 |s2cid=19146212 }}</ref><ref>{{cite journal|last1=Park|first1=Kyu Yong|last2=Kim|first2=Hyun Jung|last3=Ahn|first3=Hyeong Sik|last4=Kim|first4=Sun Hee|last5=Park|first5=Eun Ji|last6=Yim|first6=Shin-Young|last7=Jun|first7=Jae-Bum|title=Effects of coffee consumption on serum uric acid: systematic review and meta-analysis|journal=Seminars in Arthritis and Rheumatism|date=April 2016|volume=45|issue=5|pages=580–586|doi=10.1016/j.semarthrit.2016.01.003|pmid=26905267}}</ref> however, taking vitamin C supplements does not appear to have a significant effect in people who already have established gout.<ref name="Dalbeth2016"/> Peanuts, brown bread, and fruit also appear protective.<ref name=Maj2018/> This is believed to be partly due to their effect in reducing [[insulin resistance]].<ref name=Life2010/>

Other than dietary and lifestyle choices, the recurrence of gout attacks is also linked to the weather. High ambient temperature and low relative humidity may increase the risk of a gout attack.<ref>{{cite journal |last1=Neogi |first1=Tuhina |last2=Chen |first2=Clara |last3=Niu |first3=Jingbo |last4=Chaisson |first4=Christine |last5=Hunter |first5=David J. |last6=Choi |first6=Hyon |last7=Zhang |first7=Yuqing |date=15 August 2014 |title=Relation of Temperature and Humidity to the Risk of Recurrent Gout Attacks |journal=American Journal of Epidemiology |volume=180 |issue=4 |pages=372–377 |doi=10.1093/aje/kwu147 |issn=0002-9262 |pmc=4184385 |pmid=24993733}}</ref>