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Tim Smith joined the MJH Life Sciences team as an assistant editor for HCPLive in August 2022. He graduated from UC Berkeley with a degree in political science, working in multimedia journalism as a staff writer prior to joining MJH. In his spare time, he enjoys reading, watching TV, listening to podcasts, and rock climbing. You can contact him at 

Increased matairesinol and secoisolariciresinol consumption—in addition to oatmeal, whole grain cold breakfast cereals, and bran—are each significantly linked with diminished risk of 

These data align with recommendations for adherence to plant-based, health-focused diets for individuals with gout and could point to the potential influence of the gut microbiome in the pathogenesis of the rheumatological disease. The findings were released in a study authored by Sharan K. Rai, PhD, of the Harvard T.H. Chan School of Public Health, and a set of coauthors.

Rai and colleagues noted the connection between gut dysbiosis and gout, adding that dietary lignans, found in plant foods, are metabolized by the gut microflora and may help to module risk of developing gout.

“Therefore, we analyzed data collected in two large ongoing prospective cohorts of US men and women to examine the associations between habitual dietary lignan intake and the risk of incident gout,” Rai and coauthors wrote.

 “Moreover, to enhance clinical applicability, we also examined the associations between commonly consumed wholegrain foods that are rich in lignans and the risk of gout.”

The investigative team highlighted that the Nurses’ Health Study (NHS), which began in 1976, had involved a total of 121,700 female registered nurses between the ages of 30 - 55 who completed a mailed survey detailing their lifestyle choices and health history. By 1986, the launch of the Health Professionals Follow-up Study (HPFS) took place, with 51,529 male health professionals aged 40 - 75 who completed a comparable questionnaire being included.

Every 2 years since their inception, both cohorts have been surveyed and maintained approximately a 90% response rate for each follow-up cycle. In their recent analysis, Rai and coauthors did not include individuals in the study if they had a history of gout at the point of baseline, did not have dietary lignan reported in their data, or reported implausible daily caloric intake (<500 or >3,500 kcal among women; <800 or >4,200 kcal among men). As such, the final sample size of this study was 78,977 women drawn from the NHS and 43,703 men drawn from the HPFS.

In order to evaluate the relationship between whole grain intake, dietary lignan consumption, and incident gout, Cox proportional hazards models were utilized. Dietary data were gathered by the investigative team via food frequency questionnaires that were given out every 2 to 4 years. The team's analyses were performed independently within each cohort, and the findings were combined using a fixed-effects meta-analysis approach.

An association between greater intake of specific lignans—namely matairesinol and secoisolariciresinol—was identified with a statistically significant gout risk reduction among these patients. In their comparison of participants in the highest versus lowest quintiles of lignan intake, Rai et al linked matairesinol to a hazard ratio (HR) of .78 (95% CI: .69 to .90; 

 = .002). Secoisolariciresinol had an identical HR of .78 (95% CI: .68 to .89; 

 = 0.002). They did not find such a link with pinoresinol or lariciresinol intake.

In their assessment of subjects' whole grain food consumption, the investigators identified inverse associations with gout for several items: consuming at least a single daily serving of whole grain cold breakfast cereals had an association with a HR of 0.62 (95% CI: 0.53 - 0.73); eating cooked oatmeal or oat bran at least 2 times per week was linked with an HR of 0.78 (95% CI: 0.70 - 0.86); and bran consumption added to food at the same frequency was linked to an HR of 0.84 (95% CI: 0.74 - 0.95).

Rai and colleagues did not find significant associations for dark breads or for any other types of cooked breakfast cereals. Additional stratified analyses examined the possibility of effect modification. Overall, there were not significant interactions detected between consumption of lignans and other variables such as physical activity, body mass index (BMI), total intake of fiber, hypertension, or bowel movement frequency (

“These findings support adherence to a healthful plant-based diet for gout prevention and highlight the potential role of the gut microbiome in gout pathogenesis,” the investigative team concluded.

Rai SK, Hu Y, Sun Q, et al. Long-term lignan intake, whole grain foods, and the risk of gout: results from two prospective cohort studies. Arthritis Care Res (Hoboken). 2025 Jul 7. 

Terkeltaub R, Dodd D. The Gut Microbiome in Hyperuricemia and Gout. Arthritis Rheumatol.Jan 19 2025; doi:10.1002/art.43118. 

Articles

Increased consumption of lignans, particularly matairesinol and secoisolariciresinol, along with whole grain foods like oatmeal and bran, is associated with a reduced risk of gout. This aligns with recommendations for plant-based diets and suggests a potential role of the gut microbiome in gout pathogenesis. The study analyzed data from two large cohorts, the Nurses’ Health Study and the Health Professionals Follow-up Study, using Cox proportional hazards models. Significant inverse associations were found for specific lignans and whole grain foods, but not for dark breads or other cereals.

This study highlights the impact of increased matairesinol and secoisolariciresinol consumption on gout.

Long-Term Intake of Lignans, Whole Grain Foods Linked to Decrease in Gout Risk

Chelsie Derman is an associate editor for 

who covers psychiatry, sleep medicine, geriatrics, migraine, and allergy. She joined MJH Life Sciences in September 2023 after graduating from The College of New Jersey with a bachelor’s degree in journalism and professional writing. In her free time, she enjoys creative writing and reading.

experience impaired hand function, including grip strength and manual dexterity.

Research has shown that gout can cause structural changes in the hand joints and surrounding tissues, leading to joint damage, inflammation, tophus formation, and alterations to tendons or ligaments that impair task performance.

 These changes weaken grip strength and grip endurance.

 Gout flares and the fatigue that often follows also impede a person’s ability to participate in daily activities, contributing to functional losses.

Investigators sought to compare the hand function of participants with gout or rheumatoid arthritis (RA) versus healthy controls. Both RA and gout have a large impact on hand function, but no studies have compared the hand function of these rheumatology conditions.

In a case-controlled, single-center study conducted at the Ankara Etlik City Hospital Rheumatology Clinic between March and August 2024, the team assessed grip strength and grip endurance via a hand dynamometer (Jamar Hand-Dynamometer, USA), manual dexterity via the Nine-Hole Peg Test, and perceived hand functional disability via the Duruöz Hand Index. Participants with gout met the 2015 ACR-EULAR Gout classification criteria, and those with RA met the 2010 ACR/EULAR RA classification criteria.

“We…found that gout had worse dexterity than [healthy controls],” wrote investigators, led by Oguzhan Mete, from the University of Health Sciences, Gülhane Faculty of Physiotherapy and Rehabilitation in Turkey. “Additionally, except for the non-dominant removing time, it was as poor as RA. It was surprising that, although RA mainly affects the hand joints and worse manual dexterity was well-known, participants with gout also experience manual dexterity impairments that are nearly equivalent to RA. It is an important issue that needs to be addressed.”

Participants with gout and healthy controls had similar grip strength (

 > .05), but those with gout had lower dominant (

 = .001) grip endurance. Individuals with gout had greater dominant placing (

 < .001) time than controls, indicating that it takes them longer to complete tasks with the dominant hand. Those with gout also had greater non-dominant placing (

“It is an important issue that needs to be addressed,” investigators wrote. “Manual dexterity involves skillful hand and arm movements that rely on strong sensorimotor functions that are important to perform daily living activities properly. Therefore, the causes, including clinical, kinetic, and kinematic analyses of impairment in hand dexterity in gout, should be further investigated.”

Additionally, participants with gout had a greater Duruöz Hand Index (range, 0 – 90) than healthy controls (2 vs 0) but lower than in patients with RA (2 vs 10) (

“The perceived hand function was impaired in gout, although not as severely as in RA,” investigators wrote.

The team said the lack of ultrasound or X-ray findings limited the findings. They could not assess the extent of the structural damage in the joints and had to rely on other measures, like the dynaometer. Investigators said future studies should examine the relationship between structural damage and hand function.

“These results provide valuable insights into the characteristics of hand function in gout. Assessing hand function during clinical examinations of patients with gout should be considered…it is clinically important to address these issues collaboratively with rheumatologists, physicians, and hand therapists.”

Mete O, Apaydin H, Varol F, Gülöksüz EGA, Pamukcu M. Hand function in gout: a comparative study with rheumatoid arthritis and healthy. Rev Assoc Med Bras (1992). 2025 Jul 7;71(6):e20250054. doi: 10.1590/1806-9282.20250054. PMID: 40638474; PMCID: PMC12245048.

Xu H, Qin H, Hua Y, Dalbeth N. Contributions of joint damage-related events to gout pathogenesis: new insights from laboratory research. 

. 2023;82(12):1511-1515. doi:10.1136/ard-2023-224679

Gout significantly impairs hand function, affecting grip strength, endurance, and manual dexterity due to structural changes in hand joints and surrounding tissues. A study compared hand function in individuals with gout, rheumatoid arthritis (RA), and healthy controls, revealing that gout patients exhibit similar grip strength but reduced grip endurance and manual dexterity compared to controls. The study highlights the need for further investigation into the causes of hand dexterity impairment in gout and suggests incorporating hand function assessments in clinical examinations for gout patients to improve management and treatment strategies.

A new study reveals that gout significantly affects hand function, with manual dexterity impairments nearly as severe as those seen in rheumatoid arthritis.


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On the HCPLive gout page, resources on the topics of medical news and expert insight into gouty arthritis can be found. Content includes articles, interviews, videos, podcasts, and breaking news on gout, and more.

Gout Impairs Hand Dexterity, Grip Endurance Comparable to RA, Study Finds

Diabetes Dialogue: Technology, Therapeutics, and Real-World Perspectives!

Diabetes Dialogue: Upcoming Research on Type 1 Diabetes in Pregnancy with Carol Levy, MD

In this episode of Diabetes Dialogue, cohosts Diana Isaacs, PharmD, an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and co-director of Endocrine Disorders in Pregnancy at the Cleveland Clinic, and Natalie Bellini, DNP, program director of Diabetes Technology at University Hospitals Diabetes and Metabolic Care Center, sit down with Carol Levy, MD, director of the Mount Sinai Diabetes Center and 

 Clinical Research, to discuss the upcoming T1D Pregnancy and Me – or PRAM T1D – clinical study.

Levy explains that the motivation for the study arose from ongoing clinical uncertainty regarding optimal Continuous Glucose Monitor (CGM)-derived metrics during pregnancy, despite data from previous studies such as CONCEPTT that support CGM use. She underscores the limitations of existing guidelines, which were based primarily on fingerstick glucose targets, and notes that while targets like >70% time in range (TIR 63–140 mg/dL) are widely cited, there is insufficient evidence around how factors such as mean glucose, glycemic variability, and fasting values impact maternal and neonatal outcomes.

The study is designed to enroll at least 500 pregnant individuals with type 1 diabetes during their first trimester, with a goal of completing recruitment in under two years. Participants will be followed throughout pregnancy, and the study will collect both glycemic and pregnancy-related data through CGM and AID system uploads as well as patient-reported outcomes. Importantly, the study is intentionally designed to reflect real-world management—recruiting not only from major academic centers but also through self-enrollment from individuals across the U.S., including those receiving care in community settings. This decentralized model allows for broad inclusion across diverse geographies and practice types, helping address the gap in understanding how diabetes in pregnancy is managed outside tertiary care environments.

A key strength of the study lies in its technology-agnostic design. All CGM and insulin delivery devices are eligible, and the study aims to capture how current technologies—many of which are used off-label in pregnancy—are being applied in practice. By not restricting enrollment based on device type, the research team will be able to analyze patterns of use, self-management strategies, and variations in outcomes across platforms, laying the groundwork for future clinical guidance and product development.

Dr. Levy highlights that the study is also collecting data on quality of life, treatment satisfaction, and hypoglycemia-related fear, noting the real psychological burden that accompanies tight glucose management in pregnancy. These insights are expected to be critical in informing both clinician counseling and future research on patient-centered care. The data will be curated in partnership with the JAEB Center for Health Research, which will also provide statistical support for future analyses. The research team intends for the final dataset to become a resource for the broader clinical and scientific community.

Though the study’s current focus is on singleton pregnancies in individuals using any type of diabetes technology, Dr. Levy notes that the team has plans to adapt the protocol to account for emerging devices and future research questions, including expanded enrollment if supported by additional funding. She emphasizes the importance of generating robust, generalizable data to guide both clinical practice and the development of pregnancy-specific diabetes technologies—a long-neglected area in industry research.

The conversation concludes with a shared sense of urgency and optimism. As CGM and AID use continues to rise among individuals with type 1 diabetes, the need for pregnancy-specific data, tools, and targets becomes increasingly critical. Dr. Levy calls on endocrinologists, obstetricians, and maternal-fetal medicine specialists alike to engage with the study and help bridge the current evidence gaps. With enrollment already well underway, this initiative has the potential to transform care for pregnant individuals with type 1 diabetes by informing not only best practices but also product innovation and policy.

Relevant disclosures for Levy include Sequel, Eli Lilly and Company, Tandem Diabetes, and Dexcom. Relevant disclosures for Isaacs include Eli Lilly and Company, Novo Nordisk, Sanofi, Abbott Diabetes Care, Dexcom, Medtronic, and others. Relevant disclosures for Bellini include Abbott Diabetes Care, MannKind, Provention Bio, and others.

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Isaacs, Bellini, and Levy discuss a currently recruiting trial investigating Continuous Glucose Monitor metrics in pregnant individuals with type 1 diabetes.

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Elevated body mass index (BMI) and nail psoriasis may incur a greater risk of juvenile 

, according to findings from a recent study.

The cross-sectional study leveraged data for 80 pediatric patients seen at outpatient clinics in Egypt and described clinical risk factors potentially involved in the development of psoriatic arthritis, noting age and sex did not appear to influence this risk.

According to the National Psoriasis Foundation, in the United States, juvenile arthritis occurs in an estimated 20-45 children per 100,000 children. Of those who develop juvenile arthritis, as many as 5% have psoriatic arthritis. Additionally, up to one-third of adults with psoriasis may develop psoriatic arthritis, but estimates of risk in children with psoriasis are limited.

“In adults, the severity of psoriasis, smoking, obesity, hypercholesterolemia, trauma, uveitis, and depression has been identified as clinical risk factors in the development of PsA. These triggers may stimulate an inflammatory cascade, ultimately leading to arthritis, enthesitis, and dactylitis,” Dina Hamdy Mohammed Abdella, PhD, of the Rheumatology & Rehabilitation and Physical Medicine Department at Tanta University in Egypt, and colleagues wrote.

 “However, for juvenile psoriatic arthritis, little is known about its risk factors for development among children with psoriasis.”

To address this gap in research, investigators conducted a cross-sectional study of 80 children seen at 2 outpatient clinics in Egypt. They divided them into 2 groups:

Group I included children with psoriasis without arthritis seen at the Outpatient Clinic of Dermatology and Venereology Department.

Group II included children with juvenile psoriatic arthritis diagnosed according to ILAR criteria seen at the Outpatient Clinic of Rheumatology, Rehabilitation and Physical Medicine Department.

In total, Group I included 40 children with psoriasis without arthritis; 24 females and 16 males with a mean age of 12.1 ± 2.95 years. Group II included 40 children with juvenile psoriatic arthritis; 27 females and 13 males with a mean age of 11.0 ± 2.53 years. Investigators noted there were no significant differences between the groups regarding age, sex, or family history of psoriasis.

Upon analysis, passive smoking was non-significantly significantly greater in Group II (37.5%) than Group I (25%; 

 = .228) Regarding BMI, a significant difference was observed between the 2 groups (

 <.001), with a higher percentage of overweight and obesity detected in Group II (47.5% and 32.5%, respectively) than in Group I (2.5% and 15%).

Further analysis of disease duration of psoriasis revealed a significantly greater duration in Group I compared to Group II (

 <.001), but no significant difference was detected regarding PASI score (

 = .392). Of note, the groups showed significant differences regarding site of psoriasis, with 65% of Group II having nail psoriasis compared to 22.5% in Group I. Additionally, Group II had a significantly higher ESR and CRP compared to Group I (

By binary logistic regression, overweight, obesity, and nail psoriasis were identified as predictors for developing juvenile psoriatic arthritis (

“Different clinical risk factors may be involved in the development of juvenile psoriatic arthritis in children with psoriasis, including higher BMI and nail psoriasis,” investigators concluded.

 Factors predicting juvenile psoriatic arthritis in children with psoriasis. 

https://doi.org/10.1186/s43166-025-00344-2

National Psoriasis Foundation. PsA in Kids and Teens. April 28, 2021. Accessed July 18, 2025. 

https://www.psoriasis.org/advance/psa-in-kids-and-teens/

A recent study highlights that elevated BMI and nail psoriasis may increase the risk of juvenile psoriatic arthritis in children with psoriasis. The cross-sectional study involved 80 pediatric patients in Egypt, divided into two groups: those with psoriasis without arthritis and those with juvenile psoriatic arthritis. Significant differences were found in BMI and nail psoriasis prevalence between the groups. Overweight, obesity, and nail psoriasis were identified as predictors for developing juvenile psoriatic arthritis. The study emphasizes the need for further research on risk factors in children with psoriasis.

Findings suggest clinical risk factors involved in the development of psoriatic arthritis in children with psoriasis, including BMI and psoriasis location.

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Obesity, Nail Psoriasis May Increase Psoriatic Arthritis Risk in Children with Psoriasis

Assistant Professor, Endocrinology, Diabetes and Clinical Pharmacology, University of Kansas Medical Center

What Clinicians Need to Know About Intermittent Fasting for T2D, with Felicia Steger, MD

A 6-month lifestyle intervention found that both time-restricted eating (TRE) and intermittent energy restriction (IER) led to clinical improvements in HbA1c, glucose AUC, and body weight in people with type 2 diabetes (T2D).

Findings from the intervention were presented by primary investigator Felicia Steger, PhD, RD, Assistant Professor, Endocrinology, Diabetes and Clinical Pharmacology, University of Kansas Medical Center, at the 

2025 American Diabetes Association (ADA) Scientific Sessions

 spoke with Steger during the meeting to learn more about IER and TRE, also known as intermittent fasting, and its potential benefits for people with T2D. She emphasized that these are just 2 of many diet interventions that have demonstrated some efficacy in managing T2D, and it is important to better determine who might benefit more from 1 intervention or another. Ideally, this would be determined by comparative studies that could inform guidelines on best-fit patient populations. Besides clinical baseline factors, willingness and adherence are paramount for IER and TRE and may be more feasible for some patients compared to others. She also gave advice for clinicians on navigating conversations with patients that may be interested in IER and TRE, and on important considerations when managing patients engaged in these interventions, especially frequent monitoring of glucose levels.

“Intermittent fasting currently is sort of the new exciting approach to dietary modification, and like I mentioned earlier, we really don't have a lot of data to suggest that it's more effective than changing what you're eating, starting an exercise program, etc,” Steger said. “So, I think it's important to talk to the patient and really try to understand, are they assuming that intermittent fasting might be an easier approach to follow? Or what are their reasons for wanting to try intermittent fasting as opposed to another recommended approach that we have really good, strong longitudinal data to support?”

Steger has no relevant disclosures to report.

Steger F, Grdinovac K, Donnelly J, et al. Effects of a 6-Month Lifestyle Intervention for Type 2 Diabetes Featuring Intermittent Energy Restriction or Time-Restricted Eating on Glucose Tolerance and Body Weight. Presented at: ADA 2025; June 20-23; Chicago, Illinois. Poster #1910 LB

Steger discussed the importance of tailoring diet strategies to patients with type 2 diabetes.

Type 2 Diabetes

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What Clinicians Need to Know About Intermittent Fasting for Type 2 Diabetes, with Felicia Steger, MD

Panelists discuss how the Level Up study demonstrated that patients who didn’t achieve Eczema Area and Severity Index 75 (EASI-75) on dupilumab could be successfully switched to upadacitinib without washout, with two-thirds achieving EASI-75 and one-third achieving EASI-90 within just 4 weeks of switching.

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Switching From a Biologic to Upadacitinib in Atopic Dermatitis: Key Learnings From the Level Up Study

Panelists discuss how switching from biologics to Janus kinase (JAK) inhibitors should be considered when patients don’t achieve adequate disease control within 3 to 6 months, experience tolerability issues, or continue to have significant quality-of-life impacts despite apparent skin improvement.

Clinical Rationale for Switching From Biologics to JAK Inhibitors in Atopic Dermatitis

Panelists discuss how oral Janus kinase (JAK) inhibitors offer advantages over biologics in specific clinical scenarios including patients needing rapid onset of action, those with comorbid arthralgia, head and neck involvement, needle fatigue, and environmental trigger sensitivity due to their broad anti-inflammatory effects.

Therapeutic Positioning of Oral JAK Inhibitors in Atopic Dermatitis

Host Brendon Neuen is joined by guests Tor Biering-Sørensen and Kristoffer Skaarup to discuss NUDGE-CKD and implementation trial design.

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Chronic Kidney Disease

Kidney Compass: NUDGE-CKD and the Power of Pragmatic Trials

Ryan Livingston joined the MJH Life Sciences team in March of 2025, shortly after graduating from TCNJ with a bachelor’s degree in English. He enjoys creative writing, reading, and scuba diving. He can be reached at rlivingston@mjhlifesciences.com.

Announced by Aldeyra Therapeutics, Inc. on July 17, the FDA also assigned a PDUFA target action date of December 16, 2025.

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FDA Accepts Reproxalap Application for Dry Eye Disease

Philis-Tsimikas emphasized the impact of nonmedical factors on health and how clinicians can be cognizant of them in their patient management.

Reframing Diabetes Guidelines to Address Real-World Barriers, with Athena Philis-Tsimikas, MD

Shah discusses the results from the ADJUST-T1D trial comparing semaglutide to placebo, which saw a significant disparity in semaglutide’s favor.

ADJUST-T1D Suggests Semaglutide Efficaciously Treats Type 1 Diabetes, with Viral Shah, MD

In this Q&A, Alva discusses how to identify tardive dyskinesia, approaches for treatment-resistant depression, and emerging therapies.

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Strategies for Managing Tardive Dyskinesia, With Alejandro Alva, MD

A panelist discusses how aprocitentan, a dual endothelin receptor antagonist, represents a breakthrough treatment that blocks both A and B receptors to achieve clinically meaningful blood pressure reductions in resistant hypertension patients.

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Dual Endothelin Receptor Antagonists: A New Frontier in Resistant Hypertension

The most effective FMT strategy involved giving FMT as multiple-dose capsules or colonoscopy after an extended period of antibiotic pretreatment.

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Latest News

Long-Term Intake of Lignans, Whole Grain Foods Linked to Decrease in Gout Risk

Gout Impairs Hand Dexterity, Grip Endurance Comparable to RA, Study Finds

Diabetes Dialogue: Upcoming Research on Type 1 Diabetes in Pregnancy with Carol Levy, MD

Obesity, Nail Psoriasis May Increase Psoriatic Arthritis Risk in Children with Psoriasis

What Clinicians Need to Know About Intermittent Fasting for Type 2 Diabetes, with Felicia Steger, MD