Adherence to heart-healthy DASH or Mediterranean diet, prevents new-onset female gout: JAMA

USA: A new study's large-scale, long-term prospective cohort findings extend the pleiotropic benefits of the 2020 to 2025 Dietary Guidelines for Americans to female gout prevention, with multiple healthy food habits that can be taken according to individual food preferences, traditions, and comorbidities, with multiple healthy diets that can be adapted to individual food traditions, preferences, and comorbidities. The findings of this study were published in the Journal of American Medical Association - Internal Medicine.

Despite reported variations in risk factors between men and women and a disproportionate worsening of illness and comorbidity burden internationally, research on female-specific gout is sparse. Multiple healthy eating patterns are recommended in the 2020 to 2025 Dietary Guidelines for Americans for the prevention of cardiovascular-metabolic outcomes, which may also be relevant in preventing female gout. As a result, Chio Yokose undertook this study with the goal of examining the relationships between dietary scores for the most recent guideline-based healthy eating habits and the incidence of incident female gout.

The Nurses' Health Study, which began in 1984 and comprised 80 039 US women, was followed up every two years using surveys. At the start of the trial, none of the participants had ever experienced gout, and the researchers relied on questionnaire replies until 2018. From September 2020 until August 2021, statistical analyses were conducted. Dietary Approaches to Stop Hypertension (DASH), Alternative Healthy Eating Index (AHEI), Alternate Mediterranean Diet Score, and Prudent are four healthy eating patterns, with scores obtained from verified food frequency surveys, including Western (unhealthy) for comparison. The primary outcomes were incident and physician-diagnosed female-specific gout.

The key findings are as follow:

1. This study recorded 3890 cases of incident female gout during the course of 34 years of follow-up.

2. Women in the most adherent quintile had a substantially reduced risk of incident gout than those in the least adherent quintile, with multivariable-adjusted hazard ratios (HRs) of 0.68, 0.88, 0.79, and 0.75. 

3. Women with the highest-quintile Western diet score, on the other hand, had a 49% increased risk of gout.

4. When comparing the most DASH-diet adherent women with normal BMI to the least adherent women with overweight or obese BMI, the most adherent women with normal BMI had a 68% lower risk of gout; when combining high DASH diet adherence with no diuretic usage, the risk reduction was 65%.

In conclusion, women at risk for gout should be urged to adopt one of these well-established dietary patterns, which have been shown to be inversely related to insulin resistance and inflammatory biomarkers, as well as other lifestyle changes. Personal tastes, dietary traditions, and comorbidity profiles can all influence diet selection — for example, people with hypertension might consider DASH.

Reference:

Yokose C, McCormick N, Lu N, Joshi AD, Curhan G, Choi HK. Adherence to 2020 to 2025 Dietary Guidelines for Americans and the Risk of New-Onset Female Gout. JAMA Intern Med. Published online January 31, 2022. doi:10.1001/jamainternmed.2021.7419