Meat of the Matter: Fish, flesh feed gout, but milk counters it

Alexander the Great had it. Benjamin Franklin and Charles Darwin also suffered from what was once known as the “patrician malady.” Their common affliction was gout, an arthritic condition that causes spells of intense pain, most often in the big toe.

Nutrition research now consolidates an ancient notion that a rich-man’s diet, heavy in meat and seafood, contributes to the disease. Not all animal products are bad, however. Low-fat dairy foods offer protection, at least for men who haven’t yet developed gout.

The disease’s link to overconsumption of meat, as well as alcohol, has been assumed for centuries. Once found mainly in wealthy men, gout has spread along with the availability of meat. Today, gout affects about 5 million U.S. residents, mostly men and postmenopausal women.

Scientists have long known that gout develops when joints become fouled with crystals of uric acid, which is a natural digestion product of purine. Because meat, seafood, and many legumes are rich in purine, doctors have advised that eating too much of these foods might overwhelm the body’s capacity to eliminate uric acid through the kidneys.

Taking anti-inflammatory drugs and drinking plenty of water can shorten an attack of gout from several days to less than 24 hours. Alcohol consumption and kidney problems worsen gout by slowing down the body’s elimination of uric acid.

To pin down the link between gout and dietary purine, Hyon K. Choi and his colleagues at Harvard Medical School in Boston followed 47,150 men who had volunteered for a broad study of diet and health. Every fourth year, each man completed a questionnaire about his eating habits. None of the men had gout initially, but 730 of them developed it during the 12-year study.

Men who consumed the most meat, including chicken and organ meat, were

41 percent more likely to develop gout than men who ate the least meat were, Choi and his colleagues report in the March 11 New England Journal of Medicine. The result for seafood was similar.

The team estimates that each daily serving of meat increased gout risk by 21 percent, while each daily serving of fish or shellfish increased it by 7 percent.

The men who consumed low-fat dairy products most frequently had just half the risk of gout as men who ate the fewest such products did. Each daily serving of skim milk or low-fat yogurt reduced gout risk by about 21 percent, the data suggest.

Neither high-fat dairy products nor purine-rich vegetables appear to influence gout risk, the researchers found.

Each daily serving of beer elevates gout risk by 49 percent, but other alcoholic beverages have less effect, Choi reported at a scientific meeting last October.

The study provides “scientific validation” of the suspected relationships between gout and meat, says Richard J. Johnson of the University of Florida in Gainesville. Meat-rich modern diets are already implicated in rising global epidemics of diabetes, obesity, and heart disease, he adds, and “it appears that gout should be considered part of that spectrum.”