- Following a diet
pattern similar to that of the DASH (Dietary approach to stop
hypertension) reduces the risk of gout in men.
- DASH diet
emphasizes increased consumption of whole grains, fruits, vegetables and
low-fat dairy products to reduce the risk of hypertension and
- A low purine diet
devoid of certain meats and seafood to which is currently recommended for
gout can now be replaced with the DASH diet.
A diet which is known to
reduce the risk of hypertension and cardiovascular disease may also reduce the
risk of gout. The results of a 25-year-follow up study done by the
investigators at the Massachusetts General Hospital suggest the DASH (Dietary
Approaches to Stop Hypertension) diet which emphasizes increased consumption of
fruits, vegetables and low-fat dairy products to lower the risk of gout.
diet is known to reduce the risk of hypertension and cardiovascular disease it
also reduces uric acid levels.
What is Gout?
is caused by a
defect in metabolism that results in an overproduction of uric acid, or a
reduced ability of the kidney to eliminate uric acid. When the body breaks down
purine, a compound found in the body, the resulting metabolite is uric acid.
is a condition with abnormally high levels of uric acid in the blood which
accumulates in the
deposits of hard lumps of uric acid in and around the joints cause
recurring attacks of joint inflammation (arthritis).
joint inflammation causes pain, heat and redness of the joint tissues.
is strongly associated with obesity, hypertension, hyperlipidemia and diabetes.
treatment for gout involves two approaches - medications and lifestyle changes.
Medications are used to treat the
hot, swollen joint and to prevent further pain. Changes in the diet, regular
physical activity and cutting down on alcohol are the lifestyle changes which
reduce the severity of gout.
‘The DASH (Dietary Approaches to Stop Hypertension) diet which is known to lower high blood pressure can also help reduce uric acid levels and the incidence of gout.’
Purine is found in foods such as meat,
liver, kidney, beef, pork, certain fish and shell fish - sardine, mackerel,
herring, crab, lobster, oyster, shrimp, mussels and vegetables - asparagus,
fava beans, mushrooms, peas, lentils, spinach and cauliflower among others.
current dietary recommendation for
care is a diet low in purines, which are found in certain meats
and seafood, but following such a diet has limited effectiveness and proves
challenging for many patients," says Hyon Choi, senior author of the
report, Director of the Gout and Crystal Arthropathy Center in the MGH Division
of Rheumatology, Allergy, and Immunology.
diet low in purine is recommended for those with high levels of uric acid and
Hence, avoiding or limiting the intake of foods
which contain purine can result in a low protein diet as the foods which contain purine are high in
Choi added, "This kind
of low-protein diet may also promote increased consumption of refined
carbohydrates and unhealthy fats - including trans fats - that can worsen
cardiovascular and metabolic problems common in gout patients."
DASH Diet For Gout
A typical western diet which includes breads,
cakes made of refined flour, red meat
and trans fat can worsen cardiovascular and metabolic problems
common in gout patients.
DASH diet is low in cholesterol, saturated fat, red meat,
sodium, sweets and includes whole grains, fruits, vegetables, poultry, fish and nuts
. Several studies have
confirmed its ability to reduce risks for hypertension and cardiovascular
recent clinical trial which analyzed the adherence of a diet which is rich in
fruits, vegetables and low fat dairy - resembling the DASH diet reduced uric
acid levels in those with gout.
About the Study
research team analyzed data from more than 50,000 male health professionals
aged between 40 to 75. They were part of the Health Professionals Follow-up
Study, which began in 1986.
two years, their body weight, medication use and medical conditions for which
they have been diagnosed were recorded. Details about their diet pattern, their frequency of
various types of food were recorded using a food frequency questionnaire.
participants were not assigned any particular diet. The research team applied
two scoring systems to assess the food intake of each participant. Information
provided by 44,444 participants who had no history of gout prior to joining the
study was analyzed.
high score for dash diet was seen in those with a regular intake of fruits,
vegetables, nuts and legumes, low-fat dairy products and whole grains. The
scores went down in those with increased consumption of red or processed meats,
sodium and sweetened beverages.
Western dietary pattern score indicated the intake of red meat, processed meat,
refined grains, sugar-sweetened beverages, sweets, desserts and fried food.
25 years of follow-up, from 1986 to 2012 - 1,731 participants were newly
diagnosed with gout. Generally, the risk factors for gout are age, body weight, high blood
pressure, kidney failure, intake of alcohol. None of the risk factors altered
the association - individuals with a higher DASH score were less likely to
be diagnosed with gout
. The risk of gout increased in those with an
elevated Western diet score.
Results of the Study
note that many individuals at risk for gout because of elevated uric acid
levels may also have hypertension and so the effect of DASH diet would do them
good. "For individuals at high risk for gout, especially those who also
have hypertension, the DASH diet is likely to be an ideal preventive
approach," said Sharan Rai, lead author, MGH Division of Rheumatology,
Allergy, and Immunology.
those who have been diagnosed with have kidney
disease should consult their doctor before starting the DASH diet
as it is high in potassium and
can affect the kidneys.
diet may also be a good option for patients with gout who have not reached a
stage requiring urate-lowering drugs or those who prefer to avoid taking drugs.
And since the vast majority of patients with gout also have hypertension,
following the DASH diet has the potential of 'killing two birds with one stone', addressing both
conditions together," said Rai.
- Gout Treatment - (http://www.arthritis.org/about-arthritis/types/gout/treatment.php)
Rai.K et al.,The Dietary Approaches to Stop Hypertension (DASH) diet, Western
diet, and risk of gout in men: prospective cohort study, The BMJ