Empirical dietary index predicts risk of gout

A replicated empirical index predicting lower plasma urate shows a significant association with reduced risks of gout and related cardiometabolic conditions, reports a study.

Researchers developed an Empirical Dietary Index for Normo-Uricemia (EDINU) using 7-day diet records and plasma urate concentrations in the Lifestyle Validation Study (LVS). They assessed prospective links between the EDINU and disease risks using multivariable Cox regression in the Nurses’ Health Study (NHS) and Health Professionals Follow-up Study (HPFS).

Replications were carried out in the National Health and Nutrition Examination Survey (NHANES) and UK Biobank.

Using the EDINU, the following foods were ranked as negative predictors of urate: low-fat milk, blueberries, grapes, and cheese. On the other hand, a diet including mixed vegetables, liquor, red meat, liver, artificially sweetened beverages, tomato products, wine, and salad dressing was tagged as positive predictors of urate.

The EDINU revealed significant associations with plasma urate concentrations in both discovery and replication studies (Spearman correlation, –0.23 in LVS and –0.33 in NHANES). 

Higher EDINU scores correlated with a lower risk of gout in three independent cohort studies, with a hazard ratio of 0.48 (95 percent confidence interval [CI], 0.42–0.55) in the NHS/HPFS and 0.65 (95 percent CI, 0.48–0.88) in the UK Biobank, when comparing extreme quintiles.

Furthermore, the EDINU showed an inverse association with a lower risk of hypertension, stroke, and type 2 diabetes, but not coronary artery disease, in the NHS/HPFS.

“Consuming such a diet with lower uricemic potentials could be a novel, promising approach to preventing gout,” the researchers said.