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Title: Gout Risk in Men Associated with Meat, Seafood, and Dairy Consumption, But not With Purine-Rich Vegetables or Protein

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N Engl J Med 2004;350:1093-103.
03/10/2004 04:38:00 PM
By Joene Hendry

High consumption of meat or seafood is associated with an increased risk of gout in men, but this is not the case for high consumption of animal or vegetable protein or purine-rich vegetables. Hyon K. Choi, MD, DrPH, Massachusetts General Hospital, Boston, the United States, and colleagues also found that consumption of low-fat dairy products reduces the risk of gout. "Each additional daily serving of meat was associated with a 21% increase in the risk of gout, and each additional weekly serving of seafood was associated with a 7% increase in risk," the researchers report, adding that, "This effect may be greater in patients who already have gout." To determine whether there is an association between dietary factors and new cases of gout, Dr. Choi and colleagues assessed 12-years of data on dietary intake among 47,150 participants of the Health Professionals Follow-up Study, collected every 4 years. Data was available on subjects' weight, medication use and medical conditions gathered every 2 years. During the study period, there were 730 new cases of gout, as determined by American College of Rheumatology criteria. The study included multivariate analysis adjusted for age, total energy intake, body mass index (BMI), diuretic use, alcohol intake, presence or absence of hypertension or renal failure, and intake of fluids, meats, seafood, purine-rich vegetables and dairy products. Results show that men in the highest total meat intake quintile had a relative risk (RR) of 1.41 for gout compared with men in the lowest quintile. But the investigators found that only intake of beef, pork or lamb as a main dish was associated with an increased risk of gout. The multivariate RR was 1.51 for gout among men in the highest quintile of seafood intake compared with those in the lowest quintile, and all seafood items were associated with this increased risk. The risk of gout from seafood intake was significantly stronger in men with a BMI lower than 25 compared with a BMI of 25 or higher ([P = .009 and P = .31 for trend, respectively). Conversely, the RR was 0.56 for gout among men in the highest quintile of dairy product intake compared with the lowest quintile, but this benefit was limited to the consumption of low-fat dairy products. Neither the consumption of purine-rich vegetables nor of total protein intake was associated with an increased risk of gout. Overall, these findings offer evidence that meat and seafood consumption are associated with an increased risk of gout and that low-fat dairy product consumption is associated with a decreased risk of gout, the authors conclude. Since this was an observational study, "we cannot rule out the possibility that unmeasured factors might contribute to the observed associations," the authors note.

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