Purine-Rich Foods, Dairy and Protein Intake, and the Risk of Gout in Men

Choi, Hyon K.; Atkinson, Karen; Karlson, Elizabeth W.; Willett, Walter C.; Curhan, Gary C.

doi:10.1056/nejmoa035700

Cited by 940 publications

(734 citation statements)

References 34 publications

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“…The mean serum acid level in individuals consuming Ն5 cups of coffee daily was lower than that in individuals consuming Ͼ1 cup by 0.4 mg/dl (P Ͻ 0.001), which is very similar to our results. This level of population mean difference of serum uric acid levels (19,20) can be translated into a clinically relevant difference in the risk for incident gout as demonstrated in our previous studies (21,22). For example, one daily serving increase in beer intake was associated with a …”

Section: Discussionmentioning

confidence: 64%

Coffee, tea, and caffeine consumption and serum uric acid level: The third national health and nutrition examination survey

Choi

Curhan

2007

Arthritis & Rheumatism

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209

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Objective. Coffee is one of the most widely consumed beverages in the world and may affect serum uric acid levels and risk of gout via various mechanisms. Our objective was to evaluate the relationship between coffee, tea, and caffeine intake and serum uric acid level in a nationally representative sample of men and women. Methods. Using data from 14,758 participants ages >20 years in the Third National Health and Nutrition Examination Survey (1988 -1994), we examined the relationship between coffee, tea, and caffeine intake and serum uric acid level using linear regression. Additionally, we examined the relationship with hyperuricemia (serum uric acid >7.0 mg/dl among men and >5.7 mg/dl among women) using logistic regression. Intake was assessed by a food frequency questionnaire. Results. Serum uric acid level decreased with increasing coffee intake. After adjusting for age and sex, serum uric acid level associated with coffee intake of 4 to 5 and >6 cups daily was lower than that associated with no intake by 0.26 mg/dl (95% confidence interval [95% CI] 0.11, 0.41) and 0.43 mg/dl (95% CI 0.23, 0.65; P for trend < 0.001), respectively. After adjusting for other covariates, the differences remained significant (P for trend < 0.001). Similarly, there was a modest inverse association between decaffeinated coffee intake and serum uric acid levels (multivariate P for trend 0.035). Total caffeine from coffee and other beverages and tea intake were not associated with serum uric acid levels (multivariate P for trend 0.15). The multivariate odds ratio for hyperuricemia in individuals with coffee intake >6 cups daily compared with those with no coffee use was 0.57 (95% CI 0.35, 0.94; P for trend 0.001). Conclusion. These findings from a nationally representative sample of US adults suggest that coffee consumption is associated with lower serum uric acid level and hyperuricemia frequency, but tea consumption is not. The inverse association with coffee appears to be via components of coffee other than caffeine.

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Section: Discussionmentioning

confidence: 64%

Coffee, tea, and caffeine consumption and serum uric acid level: The third national health and nutrition examination survey

Choi

Curhan

2007

Arthritis & Rheumatism

Self Cite

209

122

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“…Excess of dietary purine rich foods has been associated with an increased risk of gout [44]. However, Choi et al [10] suggested that the consumption of moderate amounts of purine rich vegetables and proteins was not associated with an increased risk in gout. Changes in the diet have been suggested as a means of reducing the incidence of gout in humans.…”

Section: Introductionmentioning

confidence: 99%

“…Antioxidant activity of sodium casein hydrolyzates has been demonstrated in cell culture of human Jurkat cells with an increase in cellular catalase activity and different effects on GSH depending on the hydrolyzate studied [69]. Milk and dairy products have also been associated with the prevention of gout in humans as they can reduce serum urate [10,11,17]. Various fractions of milk have been tested in a cell culture model of THP-1 cells for their anti-inflammatory properties [16].…”

Section: Introductionmentioning

confidence: 99%

Tryptophan-containing milk protein-derived dipeptides inhibit xanthine oxidase

2012

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“…3 In one study, 72% of men with gout reported hyperuricaemia. 5 On the other hand, there have been several studies that clearly indicated that increased serum urate might be an independent risk factor for hypertensionassociated morbidity and mortality. 1,6,7 While a specific relationship continues to be debated, there is considerable interest in the potential importance of SUA in patients with hypertension and how to best treat them.…”

Section: Introductionmentioning

confidence: 99%

Effects of losartan and irbesartan on serum uric acid in hypertensive patients with hyperuricaemia in Chinese population

et al. 2005

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Therapy with losartan compared to irbesartan was performed in a Chinese sample of hypertensive patients with elevated serum uric acid (SUA) levels. After 1 week of screening and a 2 week single-blinded placebo baseline period, patients were treated for 4 weeks with losartan 50 mg or irbesartan 150 mg. After 4 weeks, patients with SiDBPo90 mmHg and SiSBPo140 mmHg continued the same dose regimen for another 4 weeks. If blood pressure was not controlled after 4 weeks of treatment, the dose of either regimen was doubled to losartan 100 mg and irbesartan 300 mg. There were 351 patients randomized (176 to losartan and 175 to irbesartan), and of these, 325 patients completed the study (162 in the losartan group and 163 in the irbesartan group). At baseline, the median SUA level in the losartan group was 422 and 420 lmol/l in the irbesartan group. At 8 weeks of therapy, SUA decreased by 63 lmol/l in the losartan group compared to 12 lmol/l in the irbesartan group (Po0.0001). Blood pressure declined comparably in both groups from 151/92 mmHg at baseline to 137/83 and 135/83 (losartan and irbesartan, respectively, NS). No severe AEs were found for either treatment group. Therapy with losartan decreased SUA levels significantly more than irbesartan in Chinese patients with hypertension and elevated SUA levels, demonstrating the unique uricosuric effect of this ARB in this ethnic group.

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Purine-Rich Foods, Dairy and Protein Intake, and the Risk of Gout in Men

Abstract: Higher levels of meat and seafood consumption are associated with an increased risk of gout, whereas a higher level of consumption of dairy products is associated with a decreased risk. Moderate intake of purine-rich vegetables or protein is not associated with an increased risk of gout.

Cited by 940 publications

References 34 publications

Coffee, tea, and caffeine consumption and serum uric acid level: The third national health and nutrition examination survey

Coffee, tea, and caffeine consumption and serum uric acid level: The third national health and nutrition examination survey

Tryptophan-containing milk protein-derived dipeptides inhibit xanthine oxidase

Effects of losartan and irbesartan on serum uric acid in hypertensive patients with hyperuricaemia in Chinese population

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