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Role of Diet in Gout Risk

Diet has long been influential in gout care and risks. A large cohort study has shown that plant-based diets may reduce the risk of developing gout.

This prospective study assessed the risk of developing incident gout based on consumption of healthy and unhealthy plant-based diets.

Data from the Health Professionals Follow-Up Study (1986-2012) and Nurses’ Health Study (1984-2010) was used to identify an overall plant-based diet index (PDI), as well as healthy (hPDI) and unhealthy (uPDI) versions based on 18 food groups. The primary outcome was incident gout. 

From a total of 122 679 healthcare workers (mean age 50-54 years; 2.7 million person-years of follow-up), 2709 participants experienced incident gout. 

The diet (PDI) was not significantly associated with gout in either cohort.  A healthy plant based diet (hPDI) was associated with a lower risk of gout (Q5 vs Q1 HR, 0.79 [95% CI, 0.69-0.91]). Conversely, uPDI (unhealthy plant diet) was positively associated with a 17% increased risk of gout (Q5 vs Q1 HR, 1.17 [95% CI, 1.03-1.33]), especially in women (HR, 1.31).

A lower risk of gout was associated with higher intakes of certain healthy plant foods, including whole grains (HR  0.93), tea and coffee (HR 0.95) and dairy (HR 0.86).  Higher risk of incident gout was seen with higher intake of fruit juice (HR 1.06), and sugar-sweetened beverages (HR 1.16). 

These findings support dietary recommendations to increase consumption of healthy plant foods to mitigate gout risk.


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The author has no conflicts of interest to disclose related to this subject