The numbers of cases of gout have steadily risen in the US over the past 20 years. The inflammatory disease now affects 8.3 million Americans. Gout is caused by uric acid crystallization in the joints which leads to swelling and pain. Hyperuricemia is almost always seen in patients with gout. This condition suggests irregularity in purine metabolism and the excretion of uric acid from the kidneys. Many different factors play a role in the risk for developing gout including genetics, age, sex, medications, lifestyle, and other related medical conditions.1
The primary treatment for gout has been medication, but for some patients this doesn’t work. Furthermore, managing gout can be difficult since the disease is generally accompanied by obesity, diabetes, renal insufficiency, or hypertension. There have been many studies trying to relate hyperuricemia with diet and it has been found to be a complex issue.1
Studies suggest that certain diets may play a key role in the development of gout. In one study it was found that an increase in meat and seafood consumption had a positive correlation with gout development. At the same time consumption of dairy products, vegetable protein, and purine-rich vegetables did not have any adverse effects on gout formation. In addition, the study suggests that some foods and beverage like, low fat dairy and coffee may inversely relate to hyperuricemia. Also in regards to this study, high vitamin C intake was associated with a lower risk of gout. Similarly, there have been numerous other studies linking certain food types to gout. For example, studies have associated a high level of fructose consumption with an increase incidence of gout. Sugary beverages are a major source of fructose. These beverages lack health benefits and may increase the risk of hypertension and diabetes. Therefore it may be favorable to decrease consumption of these beverages. The primary dietary goal for those who suffer from gout is to decrease the amount of uric acid in the blood as much as possible. This is often done through trial and error with a doctor’s guidance.1 With that being said there is new evidence that suggests that a high-fiber diet may decrease gout inflammation caused by the acid crystals.2
Scientists combined the use of a high-fiber diet and short chained fatty acids to try to prevent the inflammation caused by injecting monosodium urate acid crystals into the knee joints of mice. Doing this caused neutrophil apoptosis and efferocytosis. In addition to inflammation resolution there was an increase in the production of anti-inflammatory cytokines in the knee joint which helped to prevent further knee damage.3 This research shows how understanding intestinal communities can have a great influence on immune and metabolic health.
The relationship between diet and disease is very complex. By understanding how food interacts with our gut flora diets can be created to help people with their diseases and overall health. Further research may lead to findings that can be used as practical treatments for gout, arthritis and other diseases.
- Marcason W. Gout: Is a Purine-Restricted diet still recommended? eatrightpro. http://www.eatrightpro.org/resource/news-center/nutrition-trends/diseases-and-conditions/gout-is-a-purine-restricted-diet-still-recommended. Accessed February 11, 2017.
- Federation of American Societies for Experimental Biology. High fiber diets may alleviate inflammation caused by gout: Action of gut microorganisms on dietary fibers likely reduces inflammation associated with gout. Science Daily. https://www.sciencedaily.com/releases/2017/01/170104114321.htm. Accessed February 11, 2017.
- Garcia CC, Galvão I, Macia LM, et al. Dietary fiber and the short-chain fatty acid acetate promote resolution of neutrophilic inflammation in a model of gout in mice. Journal of Leukocyte Biology. 2017;101(1):275–284. doi:10.1189/jlb.3A1015-453RRR. http://www.jleukbio.org/content/101/1/275. Accessed February 11, 2017.