What lifestyle modifications or preventive strategies should I advise to patients with recurrent episodes of CPPD?

Lifestyle modifications and preventive strategies for patients with recurrent calcium pyrophosphate dihydrate (CPPD) crystal deposition disease should focus on managing modifiable risk factors and minimizing triggers of acute attacks.

• Maintain optimal hydration and avoid rapid fluctuations in serum calcium and phosphate levels,1.
• Address and monitor metabolic conditions such as hyperparathyroidism, hypomagnesemia, and hemochromatosis, since correcting these underlying disorders can reduce CPPD crystal deposition and flare frequency NICE NG219 Zhang et al. 2011.
• Encourage weight management and physical activity tailored to joint health, as obesity and joint stress may exacerbate symptoms and contribute to osteoarthritis, which often coexists with CPPD NICE NG219 Flood et al. 2023.
• Avoid joint trauma and repetitive joint stress, which can trigger crystal shedding and acute attacks Stack & McCarthy 2021.
• Educate patients on early recognition of symptoms and prompt treatment of acute flares, to reduce joint damage and improve quality of life NICE NG219.
• Consider dietary advice to maintain balanced mineral intake, although no specific diet has proven efficacy, avoiding excessive calcium or phosphate supplementation unless indicated is prudent Zhang et al. 2011.

Overall, preventive strategies emphasize controlling metabolic abnormalities, protecting joints from injury, and maintaining general musculoskeletal health to reduce the frequency and severity of CPPD episodes NICE NG219 Flood et al. 2023 Stack & McCarthy 2021.