What nutritional factors affect the risk of gout?

Abstract

A recent report published in the New England Journal of Medicine looked at the relationship between diet and gout using data from the Health Professionals’ Follow-Up Study. This all-male study explores men’s health issues, relating nutritional factors to the incidence of disease, and complements the all-female Nurses’ Health Study. The researchers investigated the reported intake of purine-rich foods, dairy foods, and protein, as well as the incidence of gout in 47,150 men who had no history of gout at baseline ( 1 Choi H.K. Atkinson K. Karlson E.W. Willett W. Curhan G. Purine-rich foods, dairy and protein intake, and the risk of gout in men. N Engl J Med. 2004; 340: 1093-1103 Google Scholar ). This ongoing study of male nonphysician health professionals begun in 1986 included food frequency questionnaires. Responses regarding the individual food items were converted to average daily servings, and the average daily intakes of individual items were combined in order to compute the totals for four food groups: meat, seafood, purine-rich vegetables, and dairy products. This large prospective cohort study found evidence that meat consumption and seafood consumption are associated with an increased risk of gout. By contrast, moderate intake of purine-rich vegetables or protein is not associated with an increased risk of gout, and consumption of dairy products, especially low-fat dairy products, is associated with a substantially reduced risk of gout. Having one no-fat or low-fat dairy product per day reduced gout risk by approximately 21%, and having two or more servings was associated with a 50% risk reduction. The researchers suggest that the milk proteins casein and lactalbumin may help reduce gout risk by increasing elimination of uric acid, an end product of purine metabolism, from the body. This article was written by Eleese Cunningham, RD, of ADA’s Knowledge Center Team in Chicago, IL.