Excess body weight is associated with higher uric acid levels and risk of gout[1] and diets that produce weight loss appear to reduce uric acid, with at least one noncontrolled study indicating diet-induced weight loss can reduce the rate of gout attacks.[2] In another study, weight loss led to reductions in uric acid regardless of whether the diet was low fat, low carbohydrate, or a Mediterranean diet.[3]
Milk and dairy products may reduce uric acid levels, with a couple of trials observing reductions in uric acid following the consumption of milk.[4][5] However, one randomized, controlled trial found no effect of skim milk powder on uric acid or gout symptoms in people with gout, though there was an indication of benefits to some gout symptoms when two milk extracts (known as GMP and C600) were added the skim milk powder.[6]
Two prospective cohort studies, one on men[7] and the other on women,[8] each found that higher coffee consumption was associated with a lower risk of developing gout. One Mendelian randomization study also observed that a genetically predicted increase in coffee consumption was linked to lower uric acid levels and a reduced risk of gout.[9] However, the effect of coffee on gout has not yet been tested in clinical trials and at least one randomized controlled trial failed to find an effect of coffee (either caffeinated or decaffeinated) on uric acid levels.[10]
Several clinical trials have observed a reduction in uric acid with increasing salt intakes, particularly when comparing low sodium intakes (1200–1380 mg per day) to either moderate or high sodium intakes.[11][12][13] However, such studies have not yet been conducted on people with gout. Because some research suggests sodium in joints may increase the tendency of uric acid to crystallize,[14] whether increasing salt intake will reduce the likelihood of gout remains uncertain.
Both extended fasting[15] and very low carbohydrate diets[16][17] have been at times shown to produce a rise in uric acid levels, in both cases potentially due to ketones inhibiting uric acid excretion. This effect may diminish over time.
References
- ^Dagfinn Aune, Teresa Norat, Lars J VattenBody mass index and the risk of gout: a systematic review and dose-response meta-analysis of prospective studiesEur J Nutr.(2014 Dec)
- ^P H Dessein, E A Shipton, A E Stanwix, B I Joffe, J RamokgadiBeneficial effects of weight loss associated with moderate calorie/carbohydrate restriction, and increased proportional intake of protein and unsaturated fat on serum urate and lipoprotein levels in gout: a pilot studyAnn Rheum Dis.(2000 Jul)
- ^Chio Yokose, Natalie McCormick, Sharan K Rai, Na Lu, Gary Curhan, Dan Schwarzfuchs, Iris Shai, Hyon K ChoiEffects of Low-Fat, Mediterranean, or Low-Carbohydrate Weight Loss Diets on Serum Urate and Cardiometabolic Risk Factors: A Secondary Analysis of the Dietary Intervention Randomized Controlled Trial (DIRECT)Diabetes Care.(2020 Nov)
- ^Nicola Dalbeth, Sumwai Wong, Greg D Gamble, Anne Horne, Barbara Mason, Bregina Pool, Lynette Fairbanks, Fiona M McQueen, Jillian Cornish, Ian R Reid, Kate PalmanoAcute effect of milk on serum urate concentrations: a randomised controlled crossover trialAnn Rheum Dis.(2010 Sep)
- ^Anna Surowska, Prasanthi Jegatheesan, Vanessa Campos, Anne-Sophie Marques, Léonie Egli, Jérémy Cros, Robin Rosset, Virgile Lecoultre, Roland Kreis, Chris Boesch, Bertrand Pouymayou, Philippe Schneiter, Luc TappyEffects of Dietary Protein and Fat Content on Intrahepatocellular and Intramyocellular Lipids during a 6-Day Hypercaloric, High Sucrose Diet: A Randomized Controlled Trial in Normal Weight Healthy SubjectsNutrients.(2019 Jan 21)
- ^Nicola Dalbeth, Ruth Ames, Greg D Gamble, Anne Horne, Sumwai Wong, Barbara Kuhn-Sherlock, Alastair MacGibbon, Fiona M McQueen, Ian R Reid, Kate PalmanoEffects of skim milk powder enriched with glycomacropeptide and G600 milk fat extract on frequency of gout flares: a proof-of-concept randomised controlled trialAnn Rheum Dis.(2012 Jun)
- ^Hyon K Choi, Walter Willett, Gary CurhanCoffee consumption and risk of incident gout in men: a prospective studyArthritis Rheum.(2007 Jun)
- ^Hyon K Choi, Gary CurhanCoffee consumption and risk of incident gout in women: the Nurses' Health StudyAm J Clin Nutr.(2010 Oct)
- ^Susanna C Larsson, Mattias CarlströmCoffee consumption and gout: a Mendelian randomisation studyAnn Rheum Dis.(2018 Oct)
- ^Patapong Towiwat, Anothai Tangsumranjit, Kornkanok Ingkaninan, Katechan Jampachaisri, Nattiya Chaichamnong, Bodin Buttham, Worawit LouthrenooEffect of caffeinated and decaffeinated coffee on serum uric acid and uric acid clearance, a randomised within-subject experimental studyClin Exp Rheumatol.(Sep-Oct 2021)
- ^Alwyn S Todd, Robert J Walker, Robert J MacGinley, Jaimon Kelly, Tony R Merriman, Tanya J Major, Richard J JohnsonDietary Sodium Modifies Serum Uric Acid Concentrations in HumansAm J Hypertens.(2017 Nov 6)
- ^Stephen P Juraschek, Allan C Gelber, Hyon K Choi, Lawrence J Appel, Edgar R Miller 3rdEffects of the Dietary Approaches to Stop Hypertension (DASH) Diet and Sodium Intake on Serum Uric AcidArthritis Rheumatol.(2016 Dec)
- ^Yang Wang, Chao Chu, Ke-Ke Wang, Jia-Wen Hu, Yu Yan, Yong-Bo Lv, Yu-Meng Cao, Wen-Ling Zheng, Xi-Long Dang, Jing-Tao Xu, Wei Chen, Zu-Yi Yuan, Jian-Jun MuEffect of Salt Intake on Plasma and Urinary Uric Acid Levels in Chinese Adults: An Interventional TrialSci Rep.(2018 Jan 23)
- ^Ashika Chhana, Gerald Lee, Nicola DalbethFactors influencing the crystallization of monosodium urate: a systematic literature reviewBMC Musculoskelet Disord.(2015 Oct 14)
- ^I H Fox, M L Halperin, M B Goldstein, E R MarlissRenal excretion of uric acid during prolonged fastingMetabolism.(1976 May)
- ^Schwartz RM, Boyes S, Aynsley-Green AMetabolic effects of three ketogenic diets in the treatment of severe epilepsyDev Med Child Neurol.(1989 Apr)
- ^Nazarewicz RR, Ziolkowski W, Vaccaro PS, Ghafourifar PEffect of short-term ketogenic diet on redox status of human bloodRejuvenation Res.(2007 Dec)