A recent cohort study conducted explored the association between the quality of plant-based diets and gout risk among 122,679 U.S. men and women.
Published in JAMA Network Open, the investigators found that overall adherence to a plant-based diet did not significantly impact gout risk. However, the study showed the quality of the plant-based diet made the difference: adherence to a healthy plant-based diet (hPDI), rich in whole grains, fruits, vegetables, and legumes, was associated with a lower risk of gout.
In contrast, adherence to an unhealthy plant-based diet (uPDI), high in refined grains, fruit juices, and dairy, was linked to an increased gout risk, particularly among women. “This may reflect the effect of estrogen, which is known to play a role in gout onset,” noted investigators.
The study analyzed data from the Health Professionals Follow-Up Study and the Nurses' Health Study, tracking participants who were free of gout at baseline. The participants had a mean age of 53.8 years among 43,703 men and 50.9 years among 78,976 women and were followed over 2,704,899 person-years. Incident cases of gout were confirmed using a supplementary questionnaire based on the American College of Rheumatology criteria.
The results demonstrated that higher adherence to the hPDI was significantly associated with decreased gout risk (HR, 0.79; 95% CI, 0.69-0.91; P for trend = .002), whereas higher adherence to the uPDI was linked to an increased risk (HR, 1.17; 95% CI, 1.03-1.33; P for trend = .02). Specifically, the risk increase was more apparent in women (Q5 vs Q1 HR, 1.31; 95% CI, 1.05-1.62; P for trend = .01).
The dietary data were collected every four years using a validated semiquantitative food frequency questionnaire, assessing habitual consumption of approximately 130 food and beverage items. The study adjusted for total energy intake, BMI, history of hypertension, history of kidney failure, diuretic use, physical activity, and alcohol intake.
In analysis of individual food groups, higher intakes of whole grains (pooled HR per 1 serving/d, 0.93; 95% CI, 0.89-0.97) and tea and coffee (pooled HR per 1 serving/d, 0.95; 95% CI, 0.92-0.97) were independently associated with a lower risk of gout. In contrast, selected unhealthy plant foods such as fruit juice (pooled HR per 1 serving/d, 1.06; 95% CI, 1.00-1.13) and sugar-sweetened beverages (pooled HR per 1 serving/d, 1.16; 95% CI, 1.07-1.26) were associated with increased risk of gout.
“To our knowledge, this is the first prospective evaluation of a plant-based diet (and plant food quality) in association with gout,” noted investigators. “These findings support current dietary recommendations to increase consumption of healthy plant foods while lowering intake of less healthy plant foods to mitigate gout risk.”
This study was funded by research grants from the National Institutes of Health. The authors reported no conflicts of interest.
