April 16, 2004

Studies clarify impact of foods, alcohol on gout

For hundreds of years the painful joint malady gout has been associated with overindulgence in rich food and drink. Now two studies led by an MGH researcher have clarified the impact of foods and alcoholic beverages on gout, the most common form of inflammatory arthritis in men. In the March 11 New England Journal of Medicine (NEJM), MGH staff rheumatologist Hyon Choi, MD, DrPH, and colleagues report that consumption of purine-rich meats and seafood increases the risk of gout while dairy foods decrease the risk. In the April 17 issue of The Lancet, the same research team published the first conclusive data confirming that some alcoholic beverages raise the risk for gout.

Gout is caused by deposits of uric acid in connective tissue, often in joints of the feet or ankles, that lead to inflammatory arthritis. Symptoms include swelling, redness, stiffness and severe pain. Because uric acid is formed by the breakdown of compounds called purines, gout patients have long been advised to avoid purine-rich foods. Since many animal products are rich in purines, avoidance of animal proteins also has been recommended. The NEJM study confirmed that consumption of meat — particularly beef, pork and lamb — significantly increases gout risk but found no increased risk from purine-rich vegetables. In fact vegetable and dairy proteins appear to have a protective effect.

Alcohol increases uric acid levels in the blood, but no study had confirmed that it increased the risk for gout. The Lancet study found significant risk increases with consumption of beer and liquor, but no increase from moderate wine intake.

Choi notes that people with a history of gout should consult with their physicians about the results of these studies, since several of the involved foods have other health implications. Both studies were part of the Health Professionals Follow-up Study, based at the Harvard School of Public Health.