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Purine-rich foods, dairy and protein intake, and the risk of gout in men.

Abstract

BACKGROUND

Various purine-rich foods and high protein intake have long been thought to be risk factors for gout. Similarly, the possibility that the consumption of dairy products has a role in protecting against gout has been raised by metabolic studies. We prospectively investigated the association of these dietary factors with new cases of gout.

METHODS

Over a 12-year period, we prospectively examined the relationship between purported dietary risk factors and new cases of gout among 47,150 men who had no history of gout at base line. We used a supplementary questionnaire to ascertain whether participants met the American College of Rheumatology survey criteria for gout. Diet was assessed every four years by means of a food-frequency questionnaire.

RESULTS

During the 12 years of the study, we documented 730 confirmed new cases of gout. The multivariate relative risk of gout among men in the highest quintile of meat intake, as compared with those in the lowest quintile, was 1.41 (95 percent confidence interval, 1.07 to 1.86; P for trend = 0.02), and the corresponding relative risk associated with seafood intake was 1.51 (95 percent confidence interval, 1.17 to 1.95; P for trend = 0.02). In contrast, the incidence of gout decreased with increasing intake of dairy products; the multivariate relative risk among men in the highest quintile, as compared with those in the lowest quintile, was 0.56 (95 percent confidence interval, 0.42 to 0.74; P for trend <0.001). The level of consumption of purine-rich vegetables and the total protein intake were not associated with an increased risk of gout.

CONCLUSIONS

Higher levels of meat and seafood consumption are associated with an increased risk of gout, whereas a higher level of consumption of dairy products is associated with a decreased risk. Moderate intake of purine-rich vegetables or protein is not associated with an increased risk of gout.

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  • Authors+Show Affiliations

    ,

    Rheumatology Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA 02114, USA. hchoi@partners.org

    , , ,

    Source

    The New England journal of medicine 350:11 2004 Mar 11 pg 1093-103

    MeSH

    Adult
    Aged
    Alcohol Drinking
    Biological Availability
    Body Mass Index
    Dairy Products
    Diet
    Diet Surveys
    Dietary Proteins
    Gout
    Humans
    Incidence
    Male
    Meat
    Middle Aged
    Multivariate Analysis
    Proportional Hazards Models
    Prospective Studies
    Purines
    Risk
    Risk Factors
    Seafood
    Surveys and Questionnaires
    Vegetables

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    15014182

    Citation

    Choi, Hyon K., et al. "Purine-rich Foods, Dairy and Protein Intake, and the Risk of Gout in Men." The New England Journal of Medicine, vol. 350, no. 11, 2004, pp. 1093-103.
    Choi HK, Atkinson K, Karlson EW, et al. Purine-rich foods, dairy and protein intake, and the risk of gout in men. N Engl J Med. 2004;350(11):1093-103.
    Choi, H. K., Atkinson, K., Karlson, E. W., Willett, W., & Curhan, G. (2004). Purine-rich foods, dairy and protein intake, and the risk of gout in men. The New England Journal of Medicine, 350(11), pp. 1093-103.
    Choi HK, et al. Purine-rich Foods, Dairy and Protein Intake, and the Risk of Gout in Men. N Engl J Med. 2004 Mar 11;350(11):1093-103. PubMed PMID: 15014182.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Purine-rich foods, dairy and protein intake, and the risk of gout in men. AU - Choi,Hyon K, AU - Atkinson,Karen, AU - Karlson,Elizabeth W, AU - Willett,Walter, AU - Curhan,Gary, PY - 2004/3/12/pubmed PY - 2004/3/17/medline PY - 2004/3/12/entrez SP - 1093 EP - 103 JF - The New England journal of medicine JO - N. Engl. J. Med. VL - 350 IS - 11 N2 - BACKGROUND: Various purine-rich foods and high protein intake have long been thought to be risk factors for gout. Similarly, the possibility that the consumption of dairy products has a role in protecting against gout has been raised by metabolic studies. We prospectively investigated the association of these dietary factors with new cases of gout. METHODS: Over a 12-year period, we prospectively examined the relationship between purported dietary risk factors and new cases of gout among 47,150 men who had no history of gout at base line. We used a supplementary questionnaire to ascertain whether participants met the American College of Rheumatology survey criteria for gout. Diet was assessed every four years by means of a food-frequency questionnaire. RESULTS: During the 12 years of the study, we documented 730 confirmed new cases of gout. The multivariate relative risk of gout among men in the highest quintile of meat intake, as compared with those in the lowest quintile, was 1.41 (95 percent confidence interval, 1.07 to 1.86; P for trend = 0.02), and the corresponding relative risk associated with seafood intake was 1.51 (95 percent confidence interval, 1.17 to 1.95; P for trend = 0.02). In contrast, the incidence of gout decreased with increasing intake of dairy products; the multivariate relative risk among men in the highest quintile, as compared with those in the lowest quintile, was 0.56 (95 percent confidence interval, 0.42 to 0.74; P for trend <0.001). The level of consumption of purine-rich vegetables and the total protein intake were not associated with an increased risk of gout. CONCLUSIONS: Higher levels of meat and seafood consumption are associated with an increased risk of gout, whereas a higher level of consumption of dairy products is associated with a decreased risk. Moderate intake of purine-rich vegetables or protein is not associated with an increased risk of gout. SN - 1533-4406 UR - https://www.unboundmedicine.com/medline/citation/15014182/Purine_rich_foods_dairy_and_protein_intake_and_the_risk_of_gout_in_men_ L2 - https://www.nejm.org/doi/10.1056/NEJMoa035700?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=www.ncbi.nlm.nih.gov DB - PRIME DP - Unbound Medicine ER -