People with high urate levels have an elevated chance of developing gout. But modifying four key risk factors may help halt the painful and incurable disease’s onset, investigators say.

In a study that included data from over 14,600 U.S. adults, four factors – body mass index, diet, alcohol consumption, and diuretic use – appear to contribute to the high urate levels found in hyperuricemia, gout’s precursor condition.

Excess weight and obesity accounted the highest risk of hyperuricemia incidence, at 44%, followed by people who took diuretics, those who did not adhere to a healthy diet and people who consumed alcohol.

Promoting a healthy diet and obesity prevention could help reduce the frequency of hyperuricemia and eventually the risk of gout in the general population, wrote lead author Hyon K. Choi, M.D., of Massachusetts General Hospital and Harvard Medical School.

“These findings suggest that modifiable factors have an important place in the primary prevention of hyperuricemia and likely gout,” Choi said in a statement.

Gout, an arthritic condition found most often in the elderly, is prevalent in the United States. Symptoms can be effectively alleviated with strict adherence to uric-acid lowering medication, namely allopurinol. But McKnight’s has recently reported that the condition is generally undertreated and poorly managed.