Plant-based diets: Are they good for gout?

Are you struggling with gout or know someone who is? Gout, the most common inflammatory arthritis in the US, affects about 4% of adults and is known for its painful flare-ups [1]. 

Key to managing gout is understanding how various dietary factors influence its risk. Today, we’re diving into whether plant-based diets can be good or bad for gout sufferers.

What is gout?

Gout is a type of arthritis caused by uric acid buildup in the joints. It leads to severe pain and inflammation [2]. 

Traditionally, gout dietary advice has emphasized reducing purine-rich foods like red meat and seafood, which can increase uric acid levels [3]. 

However, this approach does not consider the overall dietary pattern, which can influence gout risk more comprehensively.

How do plant-based diets impact gout?

Recent studies have shifted focus from individual food items to overall dietary patterns, like the plant-based diet, which is gaining popularity for its benefits on heart health and its minimal environmental impact. But how does it fare against gout?

Research findings

A comprehensive study involving over 122,000 participants from the Health Professionals Follow-Up Study and the Nurses’ Health Study examined the association between plant-based diets and gout risk [4]. 

To measure adherence to these diets, researchers used the Plant-Based Diet Indices (PDI) [4]. These tools categorize diets into three types, taking into account both healthy and unhealthy plant foods:

  • Overall PDI: Includes both healthy and unhealthy plant foods.
  • Healthy PDI (hPDI): Emphasizes whole grains, fruits, vegetables, nuts, and legumes.
  • Unhealthy PDI (uPDI): Includes items like sweets, refined grains, and sugar-sweetened beverages.

Conducted over several years, the study revealed some intriguing results [4]:

  • Overall PDI: No significant association was found between adherence to an overall plant-based diet and gout risk.
  • Healthy PDI (hPDI): A higher adherence to a healthy plant-based diet was significantly associated with a lower risk of gout. Specifically, the highest quintile of hPDI adherence had a 21% lower risk of gout compared with the lowest quintile.
  • Unhealthy PDI (uPDI): In contrast, greater adherence to an unhealthy plant-based diet was linked to an increased risk of gout. This association was particularly pronounced in women, where the highest quintile of uPDI adherence had a 31% higher risk of gout compared with the lowest quintile.

Why is there an increased risk with unhealthy plant-based diets?

The increased gout risk with a high adherence to an unhealthy plant-based diet, especially in women, can be attributed to several factors [4]:

1. Sugar-sweetened beverages and fruit juices

These are high in fructose, which can increase uric acid production, leading to a higher risk of gout.

2. Refined grains and sweets

These foods often have high glycemic indices, which can increase blood sugar and insulin levels and increase uric acid levels.

3. Gender differences

Women might experience a more significant impact due to hormonal differences that affect uric acid metabolism. 

Estrogen, for instance, promotes the excretion of uric acid, and its lower levels in postmenopausal women can increase hyperuricemia and gout​​ risk.

How to adopt a plant-based diet for gout prevention

To mitigate the risk of gout through diet, here are practical tips:

  • Opt for whole, unprocessed plant foods while limiting high-sugar and refined options.
  • Include low-fat dairy and coffee in your diet for their potential protective effects.
  • If not excluding, then moderate the intake of animal products, focusing on quality and quantity.

Adopting a healthy plant-based diet can be a strategic move in managing and preventing gout, emphasizing the quality of plant-based foods rather than eliminating animal products. 

As dietary patterns shift towards plant-based choices for various health and environmental reasons, understanding their impact on conditions like gout is crucial. 

For those suffering from gout or at risk, focusing on a healthy plant-based diet could offer a promising avenue for prevention and management.

[1] https://www.ncbi.nlm.nih.gov/books/NBK518992/ 
[2] https://www.niams.nih.gov/health-topics/gout
[3] https://arthritiscare.com.au/gout-and-your-diet-what-foods-to-avoid-with-gout/
[4] https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2818869

Photograph: Deniskarpenkov/Envato
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