Clinical Edge

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Risk of Gout with DASH Diet & Western Diet

BMJ; ePub 2017 May 9; Rai, Fung, et al

The Dietary Approaches to Stop Hypertension (DASH) diet is associated with a lower risk of gout and may provide a preventive dietary approach for men at risk of gout, while the Western diet is associated with a higher risk of gout. This according to a prospective cohort study that included 44,444 men with no history of gout at baseline. Each participant was assigned a DASH dietary pattern score and a Western diet pattern score. Researchers found:

  • During 26 years of follow-up, 1,731 confirmed cases of incident gout were documented.
  • A higher DASH dietary pattern score was associated with a lower risk for gout.
  • Conversely, a higher Western dietary pattern score was associated with an increased risk for gout.

Citation:

Rai SK, Fung TT, Lu N, Keller SF, Curhan GC, Choi HK. The Dietary Approaches to Stop Hypertension (DASH) diet, Western diet, and risk of gout in men: prospective cohort study. [Published online ahead of print May 9, 2017]. BMJ. doi:10.1136/bmj.j1794.

Commentary:

The DASH diet emphasizes fruits, vegetables, low-fat dairy products, whole grains, poultry, fish, and nuts. It has low amounts of saturated fatty acids, red meat, sweets, and beverages containing added sugars. It's well-known and recommended for reducing blood pressure and is even more effective at treating hypertension when combined with a low-salt diet.1 Patients with gout have a high rate of concomitant metabolic abnormalities, with 75% of patients with gout also having hypertension and 63% having the metabolic syndrome.2 The typical low purine diet recommended for gout, which is low in protein, often ends up being higher in sugars and trans-fats, which is contrary to diets recommended for treatment of hypertension and cardiovascular risk reduction. This stufy suggests that we can recommend a DASH diet to patients with gout and hypertension and know that we are improving both problems through the same dietary changes. —Neil Skolnik, MD

  1. Van Horn L, Carson JAS, Appel LJ, et al. Recommended dietary pattern to achieve adherence to the American Heart Association/American College of Cardiology (AHA/ACC) guidelines. A scientific statement from the American Heart Association. Circulation. 2016;134:e505–e529. doi:10.1161/CIR.0000000000000462.
  2. Choi HK, Ford ES, Li C, Curhan G. Prevalence of the metabolic syndrome in patients with gout: The Third National Health and Nutrition Examination Survey. Arthritis Rheum. 2007;57:109-115. doi:10.1002/art.22466.