After 26 years of follow up, the DASH (Dietary Approaches to Stop Hypertension) diet, originally developed for hypertension, may also reduce the risk of gout. This trial increases the understanding of how the DASH diet impacts many aspects of human physiology including uric acid formation.

Gout is caused by excess uric acid build up, also known as hyperuricemia, and may lead to both acute, and chronic, inflammation and severe pain. Incidence of gout has been on the rise for decades in developed countries, increasing to 3.9% in the US. Gout has been associated with co-morbid conditions such as hypertension, obesity, cardiovascular disease, and diabetes. Therefore adhering to a diet that reduces hypertension may, in turn reduce the risk of gout.

The DASH diet emphasizes eight nutritional components that include a diet high in fruits, vegetables, nuts and legumes, as well as whole grains, in conjunction with reduced levels of sodium and dietary fat. Past research has shown the DASH diet reduces uric acid production, but the exact mechanism remains unclear. In contrast the Western diet remains high in processed meat and red meat; carbohydrates, especially sugar and other sweeteners; and fried foods.

Results from a recent study published in British Medical Journal in 2017 by Sharan K Rai et al., examined two different diets, DASH and Western, and their associated risk of gout.

Using data from the Health Professionals Follow-up Study (HPFS) the researchers evaluated information from over 40,000 men with a 26-year follow up. The HPFS is a longitudinal study started in 1986 that assessed dietary and lifestyle habits of men in various scientific and clinical professions. Participants who had gout prior to enrollment were not included in this cohort analysis. There were 1731 cases of gout over the 26-year study time-frame. Participants whose dietary pattern was similar to a DASH diet had a lower relative risk of 0.68 (p<0.001). Participants who had diets that aligned with a more Western diet had an increased risk for gout of 1.42 (p=0.005).

This study suggests compared to a Standard American Diet, the DASH diet may help prevent the onset of gout and support management of this condition. While this study did not investigate mechanism there is likely a link between the DASH diet and lowering serum uric acid levels, however, further research is needed.

The study results were published in the journal BMJ and can be viewed here.

Why is this Clinically Relevant?

The DASH diet, originally developed for hypertension, can also be prescribed in order to:   

  • Reduce the risk of gout while potentially reducing CVD risk
  • Aid in preventing and managing gout
  • Potentially reduce serum concentration of uric acid

Reference

Link to abstract    

1 The Dietary Approaches to Stop Hypertension (DASH) diet,

Western diet, and risk of gout in men: prospective cohort study

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