Quality of plant-based diet influences gout risk

Key takeaways:

• A healthy plant-based diet, including foods like whole grains, dairy, tea and coffee, was associated with a reduced risk for gout.
• But an unhealthy plant-based diet was associated with a higher risk.

A healthy plant-based diet can help mitigate gout risk, especially for women, according to the results of research published in JAMA Network Open.

Plant-based diets have become increasingly popular recently, partially because of their health benefits and environmental impact, but not much is known about how the diet relates to gout risk, Sharan K. Rai, PhD, a postdoctoral research fellow at Harvard T.H. Chan School of Public Health, and colleagues wrote.

“While the contributions of selected individual food and beverage items (and nutrients) to gout risk are generally well characterized, these data are challenging to translate into dietary practices for gout prevention because foods are not eaten in isolation,” they wrote. “Moreover, some foods that are positively associated with gout are simultaneously inversely associated with other cardiometabolic diseases (eg, fish). Therefore, it is not surprising that conventional purine-focused dietary advice for gout has confused patients.”

For their prospective cohort study, Rai and colleagues evaluated data from population-based cohorts of participants enrolled in the Nurses’ Health Study (1984-2010) and the Health Professionals Follow-Up Study (1986-2012). The analysis included 122,679 participants — 43,703 men (mean age, 53.8 years) and 78,976 women (mean age, 50.9 years) — who did not have gout at baseline. More than 2,700 participants were later diagnosed with gout.

The researchers divided participants into quintiles based on their adherence to plant-based diets. They then compared gout risk among those in extreme quintiles of healthy vs. unhealthy plant-based diets.

Rai and colleagues found that adhering to an overall plant-based dietary pattern that did not differentiate between healthy and unhealthy plant foods was not linked to gout (pooled HR = 1.02; 95% CI, 0.89-1.17). However, an unhealthy plant-based diet was linked to a higher risk for gout (pooled HR = 1.17; 95% CI, 1.03-1.33), especially for women (pooled HR = 1.31; 95% CI, 1.05-1.62). Additionally, higher intake of a healthy plant-based diet was linked to a lower risk for gout (pooled HR = 0.79; 95% CI, 0.69-0.91).

“We also found that higher intakes of certain food groups, such as whole grains, coffee and tea, dairy products, and, unexpectedly, sweets and desserts, were each independently inversely associated with incident gout,” they wrote.

The pooled HRs per one daily serving for individual foods were:

• 0.93 (95% CI, 0.89-0.97) for whole grains;
• 0.95 (95% CI, 0.92-0.97) for tea and coffee;
• 0.86 (95% CI, 0.82-0.9) for dairy; and
• 0.91 (95% CI, 0.87-0.96) for sweets and desserts.

Other food groups were positively associated with gout risk. The pooled HRs per one daily serving for these foods were:

• 1.06 (95% CI, 1-1.13) for fruit juice;
• 1.16 (95% CI, 1.07-1.26) for sugar-sweetened beverages; and
• 1.26 (95% CI, 1.09-1.44) for fish.

“These findings support current dietary recommendations to increase consumption of healthy plant foods while lowering intake of less healthy plant foods to mitigate gout risk,” Rai and colleagues concluded.