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Dietary Factors Affecting Gout

Researchers have found yet another reason to watch what you eat. Apparently, the choices you make at the dinner table can affect your risk of developing gout, the most common form of inflammatory arthritis.

For years, doctors have been advising their patients with gout to avoid frequent consumption of purine-rich foods such as meat, seafood, animal protein, and purine-rich vegetables. Their advice is based on evidence that suggests high purine intake leads to increased levels of uric acid in the blood. When uric acid levels get too high, crystals may form in the joints, leading to gout.

Many doctors also believe a diet rich in dairy products may help prevent gout. They point to evidence from studies showing that dairy proteins actually lower uric acid levels in the blood. This in turn, they say, may protect against gout.

Until now, though, physicians did not have conclusive proof of how dietary choices affect the actual risk of developing gout. A new study in the New England Journal of Medicine gives this proof.

The study looked at the relationship between diet and new cases of gout in over 47,000 men over a 12-year period. Through periodic questionnaires, the men recorded their average intake of numerous food items. The men also reported new diagnoses of gout, either from a physician or self-diagnosis according to American College of Rheumatology criteria.

Data from the study revealed men who consumed the most meat had a risk of developing gout that was1.41 times the risk of men who consumed the least amount of meat. Each additional daily serving of meat, particularly beef, pork, and lamb, led to a 21% increase in risk of gout. Similarly, men who consumed the most seafood had a risk of developing gout that was 1.51 times the risk of men who consumed the least amount of seafood. Each additional weekly serving of seafood led to a 7% increase in risk.

High intake of animal or vegetable protein did not lead to an increased risk of gout. Purine-rich vegetables, such as peas, beans, mushrooms, cauliflower, and spinach also did not increase the risk. In addition, the study found men who consumed more dairy products had a lower risk of gout. Low-fat dairy products, in particular, seemed to reduce the likelihood of gout. These relationships were independent of other factors.

This news suggests some dietary changes may be in order, particularly for people with a personal or family history of gout or other risk factors, such as alcohol consumption. For starters, limiting your intake of beef, pork, and lamb may be one way to reduce your risk of the condition. Since red meat is also a suspect in colon cancer and diabetes risk, the health benefits of eating less is multiple. On the other hand, you may not want to totally eliminate your intake of seafood, given the protective effect this food can offer against heart disease and other illnesses. Increasing your intake of low-fat diary products may be a simple way to reduce your risk of gout.

Talk with your dietitian or physician about how such changes in your diet may affect other health issues. And don't forget the good news; you can stop avoiding those purine-rich vegetables, such as spinach and cauliflower.

November 2004 Update

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