Shulten P, Thomas J, Miller M, Smith M, Ahern M
Department of Nutrition and Dietetics, Flinders University, Adelaide, SA, Australia.
J Hum Nutr Diet. 2009 Feb;22(1):3-11. doi: 10.1111/j.1365-277X.2008.00928.x.
Evidence supports dietary modifications in the management of gout. Despite this, the degree of implementation of this evidence by nutrition professionals and rheumatologists and those affected by gout is unknown. The present study aimed to compare usual dietary practices of patients with gout to evidence for dietary management of gout and to investigate whether the knowledge and attitudes of nutrition professionals and rheumatologists reflects current evidence.
A food frequency questionnaire was used to determine usual dietary intake of patients with gout, a separate questionnaire examined gout-related dietary modifications (n = 29). Online questionnaires to examine attitudes towards dietary management of gout were completed by nutrition professionals and rheumatologists.
Proportions of participants whose reported intakes were inconsistent with current evidence for the dietary management of gout were: alcohol, n = 14 (48%); beer, n = 18 (62%); seafood, n = 29 (100%); meat, n = 7 (24%); beef/pork/lamb, n = 24 (83%); dairy products, n = 12 (41%); vitamin C supplementation, n = 29 (100%). Of the 61 rheumatologists and 231 nutrition professionals who completed the online survey, the majority considered that weight loss and decreased alcohol intake were important or very important outcomes. Proportions were lower for decreased purine intake. Thirty-four (56%) rheumatologists do not refer patients with gout to dietetic services and, of those who do, the majority refer less than half.
Overall, patients with gout in the present study were not implementing evidence for dietary management of their condition and complex dietary issues were evident.
有证据支持饮食调整在痛风管理中的作用。尽管如此，营养专业人员、风湿病学家以及痛风患者对这一证据的实施程度尚不清楚。本研究旨在比较痛风患者的日常饮食习惯与痛风饮食管理的证据，并调查营养专业人员和风湿病学家的知识与态度是否反映了当前的证据。
使用食物频率问卷来确定痛风患者的日常饮食摄入量，另一份问卷则调查与痛风相关的饮食调整情况（n = 29）。营养专业人员和风湿病学家通过在线问卷来表达对痛风饮食管理的态度。
报告摄入量与当前痛风饮食管理证据不一致的参与者比例如下：酒精，n = 14（48%）；啤酒，n = 18（62%）；海鲜，n = 29（100%）；肉类，n = 7（24%）；牛肉/猪肉/羊肉，n = 24（83%）；乳制品，n = 12（41%）；补充维生素C，n = 29（100%）。在完成在线调查的61名风湿病学家和231名营养专业人员中，大多数人认为体重减轻和减少酒精摄入量是重要或非常重要的结果。减少嘌呤摄入量的比例较低。34名（56%）风湿病学家不将痛风患者转介至饮食服务部门，而在那些转介的医生中，大多数转介的患者不到一半。
总体而言，本研究中的痛风患者未遵循其病情饮食管理的证据，复杂的饮食问题很明显。
