Choi HK, Atkinson K, Karlson EW, et al: Purine-rich foods, dairy and protein intake, and the risk of gout in men. N Engl J Med 2004;350(11):1093-103.
Johnson RJ, Rideout BA: Uric acid and diet - insights into the epidemic of cardiovascular disease. N Engl J Med 2004;350(11):1071-2.(editorial)
Patients suffering from gout have been advised to avoid use of purine-rich foods such as meats, seafood, and purine-rich vegetables. However, these dietary risk factors have not been confirmed by prospective studies. Researchers analyzed the dietary patterns of 47,150 men aged 40 to 75 years who were enrolled in the Health Professionals Follow-up Study. Over 12 years, 730 cases of gout were confirmed.
The multivariate relative risk of gout among men in the highest quintile of meat intake, as compared with those in the lowest quintile, was 1.41 (95% CI 1.07 - 1.86; p <0.02). The corresponding increased risk associated with seafood intake was 1.51 (95% CI 1.17 - 1.95; p = 0.02). A higher consumption of dairy products was associated with reduced gout risk, with a relative risk of 0.56 for the men in the highest quintile, compared with those in the lowest (95% CI 0.42-0.74; p <0.001). The level of use of purine-rich vegetables and the total protein intake was not associated with an increased risk of gout. In this study, gout risk increased 21% for each additional portion of meat daily and increased 7% for each additional portion of seafood weekly.
Gout appears to be part of the global epidemics of obesity, hypertension, and diabetes. Diets rich in fruits, vegetables, and low-fat dairy foods may reduce not only high blood pressure, but also the risk of gout.