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The Dietary Approaches to Stop Hypertension (DASH) diet, Western diet, and risk of gout in men: prospective cohort study.

Abstract

Objective To prospectively examine the relation between the Dietary Approaches to Stop Hypertension (DASH) and Western diets and risk of gout (ie, the clinical endpoint of hyperuricemia) in men.Design Prospective cohort study.Setting The Health Professionals Follow-up Study.Participants 44 444 men with no history of gout at baseline. Using validated food frequency questionnaires, each participant was assigned a DASH dietary pattern score (based on high intake of fruits, vegetables, nuts and legumes, low fat dairy products, and whole grains, and low intake of sodium, sweetened beverages, and red and processed meats) and a Western dietary pattern score (based on high intake of red and processed meats, French fries, refined grains, sweets, and desserts).Main outcome measure Risk of incident gout meeting the preliminary American College of Rheumatology survey criteria for gout, adjusting for potential confounders, including age, body mass index, hypertension, diuretic use, and alcohol intake.Results During 26 years of follow-up, 1731 confirmed cases of incident gout were documented. A higher DASH dietary pattern score was associated with a lower risk for gout (adjusted relative risk for extreme fifths 0.68, 95% confidence interval 0.57 to 0.80, P value for trend <0.001). In contrast, a higher Western dietary pattern score was associated with an increased risk for gout (1.42, 1.16 to 1.74, P=0.005).Conclusion The DASH diet is associated with a lower risk of gout, suggesting that its effect of lowering uric acid levels in individuals with hyperuricemia translates to a lower risk of gout. Conversely, the Western diet is associated with a higher risk of gout. The DASH diet may provide an attractive preventive dietary approach for men at risk of gout.

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  • Authors+Show Affiliations

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    Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA. Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. Arthritis Research Canada, Richmond, BC, Canada.

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    Department of Nutrition, Simmons College, Boston, MA, USA. Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA.

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    Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA. Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.

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    Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA.

    ,

    Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. Division of Renal (Kidney) Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.

    Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA hchoi@partners.org. Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. Arthritis Research Canada, Richmond, BC, Canada.

    Source

    BMJ (Clinical research ed.) 357: 2017 May 09 pg j1794

    MeSH

    Adult
    Aged
    Diet Surveys
    Diet, Western
    Follow-Up Studies
    Gout
    Health Personnel
    Humans
    Hypertension
    Incidence
    Longitudinal Studies
    Male
    Middle Aged
    Multivariate Analysis
    Proportional Hazards Models
    Prospective Studies
    Risk
    Treatment Outcome

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    28487277

    Citation

    Rai, Sharan K., et al. "The Dietary Approaches to Stop Hypertension (DASH) Diet, Western Diet, and Risk of Gout in Men: Prospective Cohort Study." BMJ (Clinical Research Ed.), vol. 357, 2017, pp. j1794.
    Rai SK, Fung TT, Lu N, et al. The Dietary Approaches to Stop Hypertension (DASH) diet, Western diet, and risk of gout in men: prospective cohort study. BMJ. 2017;357:j1794.
    Rai, S. K., Fung, T. T., Lu, N., Keller, S. F., Curhan, G. C., & Choi, H. K. (2017). The Dietary Approaches to Stop Hypertension (DASH) diet, Western diet, and risk of gout in men: prospective cohort study. BMJ (Clinical Research Ed.), 357, pp. j1794. doi:10.1136/bmj.j1794.
    Rai SK, et al. The Dietary Approaches to Stop Hypertension (DASH) Diet, Western Diet, and Risk of Gout in Men: Prospective Cohort Study. BMJ. 2017 May 9;357:j1794. PubMed PMID: 28487277.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - The Dietary Approaches to Stop Hypertension (DASH) diet, Western diet, and risk of gout in men: prospective cohort study. AU - Rai,Sharan K, AU - Fung,Teresa T, AU - Lu,Na, AU - Keller,Sarah F, AU - Curhan,Gary C, AU - Choi,Hyon K, Y1 - 2017/05/09/ PY - 2017/5/11/entrez PY - 2017/5/11/pubmed PY - 2017/6/6/medline SP - j1794 EP - j1794 JF - BMJ (Clinical research ed.) JO - BMJ VL - 357 N2 - Objective To prospectively examine the relation between the Dietary Approaches to Stop Hypertension (DASH) and Western diets and risk of gout (ie, the clinical endpoint of hyperuricemia) in men.Design Prospective cohort study.Setting The Health Professionals Follow-up Study.Participants 44 444 men with no history of gout at baseline. Using validated food frequency questionnaires, each participant was assigned a DASH dietary pattern score (based on high intake of fruits, vegetables, nuts and legumes, low fat dairy products, and whole grains, and low intake of sodium, sweetened beverages, and red and processed meats) and a Western dietary pattern score (based on high intake of red and processed meats, French fries, refined grains, sweets, and desserts).Main outcome measure Risk of incident gout meeting the preliminary American College of Rheumatology survey criteria for gout, adjusting for potential confounders, including age, body mass index, hypertension, diuretic use, and alcohol intake.Results During 26 years of follow-up, 1731 confirmed cases of incident gout were documented. A higher DASH dietary pattern score was associated with a lower risk for gout (adjusted relative risk for extreme fifths 0.68, 95% confidence interval 0.57 to 0.80, P value for trend <0.001). In contrast, a higher Western dietary pattern score was associated with an increased risk for gout (1.42, 1.16 to 1.74, P=0.005).Conclusion The DASH diet is associated with a lower risk of gout, suggesting that its effect of lowering uric acid levels in individuals with hyperuricemia translates to a lower risk of gout. Conversely, the Western diet is associated with a higher risk of gout. The DASH diet may provide an attractive preventive dietary approach for men at risk of gout. SN - 1756-1833 UR - https://www.unboundmedicine.com/medline/citation/28487277/The_Dietary_Approaches_to_Stop_Hypertension__DASH__diet_Western_diet_and_risk_of_gout_in_men:_prospective_cohort_study_ L2 - http://www.bmj.com/cgi/pmidlookup?view=long&amp;pmid=28487277 DB - PRIME DP - Unbound Medicine ER -