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Date: September 3, 2024
Summary: A recent study published in Nutrients has revealed that specific types and sources of carbohydrates may offer protection against gout, a chronic inflammatory condition characterized by high serum uric acid levels. The research highlights the contrasting effects of different carbohydrates and underscores the role of genetic susceptibility in gout risk.
Background: Gout is an inflammatory arthritic disorder marked by elevated serum uric acid, leading to the deposition of monosodium urate crystals in joints. It is associated with several chronic conditions, including cardiovascular disease and metabolic syndrome. Diet plays a significant role in gout’s etiology, with low-carbohydrate diets often showing a reduction in urate levels. However, the relationship between carbohydrate intake and gout risk has been unclear, with certain carbohydrates like fructose and sugar-sweetened beverages known to exacerbate the condition.
About the Study: Researchers from the UK investigated how various carbohydrates—such as starch, fiber, and sugars—affect gout risk, considering also individual genetic susceptibility. The study involved 187,387 participants from the United Kingdom Biobank, aged 40 to 69 years, who provided detailed dietary assessments and biological samples between 2006 and 2010.
The study utilized a comprehensive dietary questionnaire, evaluating the intake of 206 foods and 32 beverages. It analyzed both free and non-free (added) sugars and other carbohydrate types. Gout diagnoses were confirmed using ICD-9 and ICD-10 codes, while genetic susceptibility was assessed using 33 loci known to be associated with gout.
Results: Over a median follow-up period of 12 years, 2,548 participants developed gout. The study found that overall carbohydrate consumption was linked to a reduced risk of gout (Hazard Ratio [HR], 0.7). Specifically, non-added sugars, total sugars, fiber, and different types of starch (including refined and whole-grain) also showed protective effects, with HR values ranging from 0.7 to 0.9. In contrast, free sugars were associated with an increased risk (HR, 1.2).
The research further indicated that individuals with a lower genetic risk score (GRS) who consumed higher amounts of total sugars, carbohydrates, fiber, and starch were least likely to develop gout. However, those with high GRS and high added sugar intake had the highest risk. The study also highlighted that serum urate levels played a significant role in mediating the association between carbohydrate intake and gout risk.
Conclusion: The study suggests that increasing consumption of beneficial carbohydrates while reducing intake of free sugars can help lower gout risk. For individuals with high genetic susceptibility, stratified management involving dietary adjustments and healthy lifestyle practices is recommended. Emphasizing a diet rich in useful carbohydrates, plant-based foods, and maintaining a balanced lifestyle—including modest alcohol consumption and regular physical activity—could significantly reduce the societal burden of gout.
Journal Reference: Hua, B., Dong, Z., Yang, Y., Liu, W., Chen, S., Chen, Y., Sun, X., Ye, D., Li, J., Mao, Y. (2024). Dietary Carbohydrates, Genetic Susceptibility, and Gout Risk: A Prospective Cohort Study in the UK. Nutrients, 16, 2883. Link to Study
