American Board of Internal Medicine (ABIM) Certification Practice Exam

What dietary modifications are recommended for managing gout?

1. Increased protein intake and reduced fiber

2. Weight gain and increased red meat

3. Reduction of high-fructose foods and alcohol restriction

4. High-purine foods and increased alcohol

The correct answer is: Reduction of high-fructose foods and alcohol restriction

Managing gout primarily revolves around reducing the levels of uric acid in the blood, as elevated uric acid can lead to the formation of urate crystals that cause painful joint inflammation. The correct dietary modification for managing gout includes the reduction of high-fructose foods and alcohol restriction because both of these dietary components are known to increase uric acid levels. High-fructose corn syrup, commonly found in sugary beverages and processed foods, can lead to increased purine metabolism and subsequent rise in uric acid production. Alcohol, particularly beer and other distilled spirits, can also contribute to elevated uric acid levels through various metabolic pathways. Thus, limiting or eliminating these substances from the diet is beneficial in managing and preventing gout attacks. In contrast to this, increasing protein intake, resulting in weight gain, or consuming high-purine foods would not align with the goal of managing gout, as these actions can exacerbate the condition rather than improve it.