Plant-rich DASH diet linked to lower risk of gout

A study that followed more than 44,000 men for 26 years finds that compared with a "Western" style diet, a plant-rich diet that is known to reduce blood pressure and is recommended for preventing heart disease is linked to a lower risk of developing gout, a painful arthritic condition that typically starts in the big toe.

The study - by a team that includes members from Harvard Medical School in Boston, MA, and Arthritis Research Canada in Richmond, BC - is published in The BMJ.

Gout is a painful condition that affects the joints - primarily those in the big toe, although it can also affect other joints and areas around them.

It is a type of arthritis that occurs when there is too much of the waste product uric acid in the blood (a condition known as hyperuricemia), causing the body to deposit it as "needle-like crystals" in the joints.

As the uric acid deposits accumulate, they cause the joint to become inflamed, red, and stiff, giving rise to bouts of intense, intermittent pain.

In their study paper, the researchers note that the prevalence of gout in the United States and the United Kingdom has risen over recent decades to reach 3.9 percent and 3.2 percent of adults, respectively.

The DASH diet

The authors also cite evidence supporting that many people who have gout also have other conditions. For example, 74 percent of patients with gout also have high blood pressure, and 63 percent have metabolic syndrome.

Fast facts about gout

  • A lot of people with gout have a family history of the condition.
  • Uric acid crystals may also build up in the kidneys, giving rise to kidney stones.
  • Gout is most common in men aged 40 and older.

Learn more about gout

The Dietary Approaches to Stop Hypertension (DASH) diet is high in fruit, vegetables, whole grains, legumes, nuts, and low-fat dairy, and low in red and processed meats, salt, and sugary drinks.

It is known to lower blood pressure and is recommended for the prevention of heart disease.

Recent research shows that the DASH diet reduces uric acid in the blood, and the team wondered if this means that it might also lower the risk of gout.

Thus, they decided to use data from the Health Professionals Follow-up Study to examine the link between diet and gout risk by comparing the DASH diet with a Western diet - which is typically high in red and processed meats, refined grains, French fries, sweets, and desserts.

The team analyzed data on 44,444 men aged between 40 and 75 years who had no history of gout at the start of the study. The men were followed from 1986 to 2012, during which time they filled in detailed food questionnaires at study baseline and then every 4 years.

DASH diet linked to reduced risk of gout in men

The researchers gave each participant a score that reflected how closely their diet matched the DASH one (the DASH score), and another score that reflected how closely they followed the Western diet (the Western pattern score).

When they analyzed the 26 years of follow-up data, the team found that a higher DASH score was tied to a lower risk of developing gout, whereas a higher Western pattern score was linked to a higher risk.

The team found that the links were not affected by other known risk factors for gout, including age, body mass index (BMI), high blood pressure, coffee intake, and alcohol intake.

The authors explain that as their study was observational, it is not possible to draw conclusions about whether the DASH diet causes the reduction in gout risk. However, what they can say is that it does not contradict the idea, and they conclude:

"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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