Background Lifestyle intervention is an important component in uricemic control. Diets with low purine and fructose content, as well as limited alcohol consumption, are recommended for people with hyperuricemia/gout.1 It has been reported that a 2-day fast can lead to higher serum uric acid (sUA) levels, with a concomitant decrease in urinary uric acid excretion.2 This work explores whether a shorter fast, such as simply skipping breakfast, affects sUA levels.
Objectives To study the effect on sUA of skipping breakfast.
Methods Two successive experiments were conducted with the same group of healthy subjects (N=30). In the first experiment the subjects consumed all three meals during the day, whereas in the second experiment the subjects did not eat breakfast but had the other two meals as usual. sUA and fractional excretion of uric acid (FEUA) were measured throughout the 24 hr experiment period. In addition, corresponding sUA levels were simulated based on the measured FEUA in order to evaluate the contribution of FEUA to the effects of breakfast on measured sUA.
Results At 6, 12 and 24 hr after breakfast (∼8 am), the mean±SE change from baseline (pre-breakfast) in sUA was -0.3±0.09, -0.4±0.1 and +0.1±0.09 mg/dL, respectively, when the group ate breakfast (Figure). These changes average to a decrease in sUA of 0.2±0.08 mg/dL over 24 hrs. In comparison, the change in sUA from baseline was +0.3±0.05, +0.1±0.09 and +0.3±0.07 mg/dL at 6, 12 and 24 hr when they did not eat breakfast. These changes average to an elevation in sUA of 0.2±0.05 mg/dL over 24 hrs. As a result, the difference in sUA (no breakfast - breakfast) was +0.4±0.09 mg/dL (p<0.0001). In the first 6 hrs after breakfast, FEUA were 7.3±0.45 with breakfast and 5.7±0.33 without breakfast (Figure, p<0.01). However, when sUA levels are simulated based on the observed FEUA, the difference in FEUA between breakfast and no breakfast cannot fully explain the difference in their observed sUA.
Conclusions Skipping breakfast leads to a 0.4 mg/dL elevation in sUA over 24 hr. A decreased FEUA is partially responsible for the difference in sUA; however, there are likely other mechanisms involved as well. Routinely skipping breakfast might lead to even higher elevations in sUA.
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Acknowledgement Research sponsored by Ardea Biosciences/AstraZeneca. Editorial support was provided by PAREXEL and funded by AstraZeneca.
Disclosure of Interest S. Liu Employee of: Ardea Biosciences, Inc., J. Miner Employee of: Ardea Biosciences, Inc.