Efficacy of a Low-Purine, Energy-Restricted and Balanced Diet on Hyperuricemia and Metabolic Profiles in Gout Patients: A Randomized Controlled Trial

Background/Objectives: Nutritional therapy has emerged as a promising therapeutic strategy for the management of chronic metabolic diseases. This study aims to evaluate the efficacy of a low-purine, energy-restricted, and balanced diet (LPEB diet) in ameliorating gout conditions and improving related metabolic risk factors. Methods: A total of 90 patients with gout were randomly allocated to either the intervention group or the control group, with 45 cases in each group. Patients in the control group received routine basic nutritional health education. Based on the conventional education, the intervention group underwent a 42-day structured dietary intervention characterized by low purine intake, energy restriction, and balanced nutritional composition. Results: Compared with the control group, the intervention group showed a significant reduction in serum uric acid (sUA) level by 112.4 μmol/L (p = 0.007). Meanwhile, the fractional excretion of uric acid (FEUA) showed a significantly greater increase of 0.87% in the intervention group compared with the control group (p = 0.003), while daily purine intake was significantly reduced by 262 mg (p = 0.001) in the intervention group. Moreover, notable improvements in body composition were observed in the intervention group. Specifically, body mass index (BMI) decreased by 0.50 kg/m2 (p < 0.001) and visceral fat area (VFA) was reduced by 12.1 cm2 (p < 0.001), with significant intergroup differences confirmed for both indicators. Conclusions: This study demonstrates that an LPEB diet not only effectively reduces sUA levels by enhancing FEUA but also significantly ameliorates central adiposity and related metabolic risk factors in patients with gout.