Dietary inflammation plays a key role in female gout risk, with pro-inflammatory diets increasing risk and anti-inflammatory diets offering strong protection.
According to the findings from 3 prospective cohort studies, inflammation-driven dietary patterns markedly impact gout risk in women, with pro-inflammatory diets elevating risk and anti-inflammatory diets reducing it. Researchers followed 79,104 women from Nurses’ Health Study (NHS; 1984–2016) and 93,454 from NHSII (1991–2017), using validated food frequency questionnaires to examine dietary inflammatory potential every 4 years.
The Empirical Dietary Inflammatory Pattern (EDIP) score, a food-based index predictive of systemic inflammation, was used to categorize participants’ diets. For comparison, the study also incorporated data from 45,445 men in the Health Professionals Follow-up Study (1986–2016).
Using Cox proportional hazards models, the connection between EDIP and incident, physician-diagnosed gout was explored. Researchers also tested whether this connection remained independent of guideline-based healthy eating patterns (like Dietary Approaches to Stop Hypertension [DASH] and Alternative Health Eating Index [AHEI]), which have shown benefits for gout.
Over a follow-up period covering 4,372,320 person-years, 5,425 new cases of female gout were recorded. Analysis showed a strong association between pro-inflammatory diets and gout risk in women. Women in the highest EDIP quintile (most pro-inflammatory diet) had twice the risk of developing gout as opposed to those in the lowest quintile (hazard ratio [HR] = 2.02). Even after adjusting for body-mass index, a known risk factor for gout, the connection remained significant (HR=1.71).
In contrast, females with the most anti-inflammatory diets exhibited the strongest protective effect, minimizing gout risk by 42% (HR=0.58). This protective effect was greater than that observed for other guideline-based healthy diets, including DASH diet (HR=0.80) and AHEI quintiles (HR=0.81). Interestingly, the impact of diet on gout risk was substantially lower in men. The HR for the highest vs. lowest EDIP quintile in men was only 1.24, suggesting a potential sex-specific difference in dietary influence on gout development.
These findings underscore the important role of diet-induced inflammation in female gout risk. While previous research has focused on purine-rich foods and their direct link to hyperuricemia, this study highlights a broader inflammatory mechanism driving gout onset. Thus, dietary modifications, specifically reducing pro-inflammatory food intake, may serve as a preventive strategy for women at risk of gout.
Arthritis & Rheumatology
Pro-inflammatory dietary pattern and the risk of female gout: sex-specific findings from three prospective cohort studies
Sharan K Rai et al.
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