High-protein, low-fat [sic] diet may promote the onset of gout

By ANDRÉ PICARD, PUBLIC HEALTH REPORTER

Thursday, March 11, 2004 - Page A6

http://www.theglobeandmail.com/serv...OUT11/TPHealth/

U.S. scientists have confirmed what medical practitioners have known anecdotally for centuries, that eating a diet rich in meat and seafood can cause gout.

The findings also raise a red flag for followers of popular high-protein weight-loss regimens such as the Atkins diet.

They have also learned that eating low-fat dairy products can help prevent the painful inflammatory disease and that eating vegetables rich in purine, such as peas and beans, does not contribute to the condition, as previously believed.

"The association of purine-rich foods with gout had long been suspected but never proven," said Hyon Choi, a rheumatologist at the Massachusetts General Hospital in Boston. "This is the first evidence that dairy products can be strongly protective."

Dr. Choi, whose research is published in today's edition of the New England Journal of Medicine, said the findings suggest that "dietary manipulation and behavioural modification to reduce the risk of gout may have a much more substantial impact than currently believed."

Gout is a form of arthritis that affects an estimated half million Canadians, most of them men who are overweight.

"The relationship between gluttony and gout has been known for a long time," said Adel Fam, a professor of medicine at the University of Toronto and an international expert on gout. "But changing dietary habits and expanding waistlines over the past 20 years mean the number of people with gout is increasing rapidly."

Dr. Fam said the new research is important because "it clearly establishes the connection between diet and gout," and because it comes at a time when prevalence of the age-old disease is soaring as a result of the obesity epidemic. He also believes the popularity of diets such as Atkins may lead to the consumption of more red meat, resulting in more gout.

To conduct the research, Dr. Choi and his colleagues used data from the Health Professionals Follow-up Study, a massive research project that has been tracking the health and nutritional habits of a large group of male health professionals -- dentists, osteopaths, optometrists, pharmacists, veterinarians and podiatrists -- since 1986.

At the outset, none of the 47,150 participants had gout, but by 1998 the condition was present in 730 of them. The researchers analyzed the dietary information, including data on 130 foods, to see what distinguished those who developed gout from those who did not. The study confirmed suspicions about the role of red meat and seafood.

Gout was 51 per cent more likely to develop in the group with the highest seafood consumption (particularly lobster and shrimp), and 41 per cent more likely in the group with the highest consumption of beef, pork and lamb, compared with the lowest consumption groups. The group with the highest consumption of low-fat dairy products was 42 per cent less likely to develop gout.

There was no association between gout and high intake of high-fat dairy products or vegetables rich in purine. (The new study did not examine alcohol consumption, another known risk factor for gout.)

Purine is a compound in the genetic material of each cell, but the amount inside cells varies from food to food. Digestion breaks down purine into uric acid. Gout is caused by too much uric acid in the blood. The excess uric acid forms crystal deposits in joints, particularly in the big toe, feet and ankles.

Once a disease of the wealthy, gout now hits poor minorities disproportionately hard.

A healthy diet plays a role in treating gout, as do drugs and medications that lower uric acid in the blood.

Don't be put off by the title - the article actually says something quite different.

I believe that I am developing gout myself - in the last couple of weeks there has been a steady, annoying tingle in my left big toe. (Gout usually strikes one joint at a time.) A couple of times this tickle has increased to the point of being a bit painful but it is still nothing but an inconvenience. (My left leg has poor circulation due to two deep venous thromboses I developed on an international flight back in 1990.)

Now, my diet includes a lot of red wine and beer, certainly in excess of levels that a true-blue Atkins dieter would approve of. Red wine in particular is associated with gout.

I'm going to discuss this with my doctor soon. I understand there are meds that can treat this, and in addition, I'm increasing my water, and decreasing (sob) the booze.

My sympathy, gotbeer. A drinking buddy of mine is now reduced to sipping iced tea at our get togethers, lest he end up with a painful bout of gout.

They write that article as if people on LC plans couldn't possibly do it without red meat.

Thanks, Kristine. I'm actually more perturbed at the prospect of decreasing or losing the red wine than I am the tickle.

My father suffered a bout of gout about a year ago. The docs treated it with medication and of course reducing the wine intake. He's fine now and back to drinking his usual over-consumption level of wine.

Gout was 51 per cent more likely to develop in the group with the highest seafood consumption (particularly lobster and shrimp), and 41 per cent more likely in the group with the highest consumption of beef, pork and lamb, compared with the lowest consumption groups. The group with the highest consumption of low-fat dairy products was 42 per cent less likely to develop gout.



Once a disease of the wealthy, gout now hits poor minorities disproportionately hard.

Since when do poor minorities eat large quantities of lobster, shrimp, beef, pork and lamb???

I am determined, no doubt, to rout this bout of gout.

Co worker had bad case of gout. I had him drink at least 120 oz. of water a day. No more gout.

Thanks, Zuleikaa. I'm off to refill my glass.