Purine-rich foods, dairy and protein intake, and the risk of gout in men.
Level 3 - non-randomized controlled study
Prospective observational cohort study with 12 years of follow-up.
PubMed 15014182 · doi:10.1056/NEJMoa035700
What was done
Researchers prospectively followed 47,150 men with no prior history of gout over a 12-year period. Diet was evaluated every four years using a food-frequency questionnaire. New cases of gout were identified and confirmed using a supplementary questionnaire assessing American College of Rheumatology survey criteria.
What was found
Over 12 years, 730 new cases of gout occurred. Comparing the highest quintile of intake to the lowest quintile: - Meat intake was associated with an increased risk of gout (multivariate RR 1.41; 95% CI, 1.07 to 1.86; P for trend = 0.02). - Seafood intake was associated with an increased risk (multivariate RR 1.51; 95% CI, 1.17 to 1.95; P for trend = 0.02). - Dairy intake was associated with a decreased risk (multivariate RR 0.56; 95% CI, 0.42 to 0.74; P for trend < 0.001). - Purine-rich vegetable consumption and total protein intake showed no statistically significant association with gout risk.
Why it matters
This study challenges traditional broad dietary restrictions for gout by showing that purine sources matter: animal purines (meat and seafood) increase risk, dairy appears protective, and purine-rich vegetables do not increase risk.
Limits
The study is observational and cannot establish causality. Dietary intake was assessed via self-reported food-frequency questionnaires, which are susceptible to measurement error. The cohort consisted exclusively of men, limiting direct generalizability to women.
Cited by
- partial Gout is caused by fructose, and the theory that dietary protein causes gout has been debunked.