Fruit juice, sugar-sweetened beverages raise gout risk
Click Here to Manage Email Alerts
Key takeaways:
- A healthy plant diet was linked to lower gout risk, while unhealthy plant foods were associated with higher risk.
- An overall plant-based diet showed no association with gout risk.
Individuals who follow a diet of healthy plant foods demonstrate a lower risk for gout, while those with a greater intake of unhealthy plant foods had a higher risk, according to data published in JAMA Network Open.
For plant-based diets that included both healthy and unhealthy plant foods, there was no association with gout risk, the researchers wrote.
“By now, we know that various healthy eating patterns are inversely associated with gout risk,” Sharan K. Rai, PhD, of the Harvard T.H. Chan School of Public Health, told Healio. “These eating patterns share some common features, including emphasizing greater intakes of certain healthy plant-based foods.
“However, prior work hadn’t yet looked at whether a diet that de-emphasized all animal products was associated with gout,” she added. “Given the dual benefits of plant-based diets for other related cardiometabolic diseases, as well as for planetary health, this was an important research question for us to address.”
For a more detailed view of gout risk with plant-based diets, Rai and colleagues conducted a prospective study of two population-based U.S. cohorts — the Health Professionals Follow-up Study and the Nurses’ Health Study — which they analyzed separately. The researchers examined gout incidence among people eating either a “healthy” or “unhealthy” version of a plant-based diet, as well as an overall mixture of the two.
The healthiness of plant foods was classified based on how much the current evidence linked them with cardiometabolic outcomes, including type 2 diabetes, cardiovascular disease, obesity and hypertension. The researchers cited whole grains as an example of healthy plant-based food, while fruit juice and other sugar-sweetened beverages were considered unhealthy plant-based foods.
Dietary data were collected every 4 years through a semiquantitative food frequency questionnaire. The food that participants reported eating contributed to their scores on three indices — an overall plant-based diet index, a healthy plant-based diet index and an unhealthy plant-based diet index. A higher score on an index indicated greater adherence to the index, while higher scores across all three meant overall lower animal food intake. Each index was split into quintiles of adherence, and the associations between the quintiles and gout risk were assessed using Cox proportional hazard regression models.
Out of a total of 122,679 study participants, 2,709 demonstrated incident gout during 2,704,899 person-years of follow-up. Adherence to an overall plant-based diet was not associated with gout in either cohort, according to the researchers.
Pooled analysis of the two cohorts revealed that the healthy plant-based diet index was significantly inversely associated with gout risk (fifth quintile vs. first quintile HR = 0.79; 95% CI, 0.69-0.91), while the unhealthy index was positively associated with gout risk (fifth quintile vs. first quintile HR = 1.17; 95% CI, 1.03-1.33). The latter trend was observed “particularly in women” (fifth quintile vs. first quintile HR = 1.31; 95% CI, 1.05-1.62), the researchers wrote.
According to Rai, the research team was “surprised and excited” to find an inverse association between whole grain foods and gout risk, noting “limited” prior research on that relationship.
“Certain food groups included in the diet indices showed individual inverse associations with gout, including whole grain intake, coffee and tea,” Rai said. “Meanwhile, foods like sugar-sweetened beverages and fruit juice were positively associated with gout. We did additionally find a significant interaction with physical activity level, suggesting that those who were less physically active may have benefited further from eating a healthy plant-based diet.
“A plant-based diet such as the one in our study is intended to de-emphasize animal products rather than fully eliminate them, and is likely more feasible at the population level,” she added. “Importantly, this healthy plant-based diet adds to the growing list of candidate healthy dietary patterns for gout prevention, with the added benefit of promoting planetary health.”
Collapse
Read more about
Click Here to Manage Email Alerts