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Link Between Purine Intake And Recurrent Gout Attacks



The findings of recent research show that the dietary intake of purine can increase by five times the chances of having recurrent gout attacks. The purine in question here is the one derived from animal sources and not from plants.

Annals of Rheumatic Diseases

Yuqing Zhang together with his colleagues described what they discovered in one of the articles that were published on the internet on May 30 known as Annals of Rheumatic Diseases. Yuqing Zhang is the Managing Director and Director of Science in the Clinical Epidemiology Research and Training Unit in the Department of medicine at Boston University.

In the explanations given by the researchers, it states that the intake of purine is associated with getting hyperuricemia together with a high risk of incident gout. They further went to explain that even though the purine-foods have been known for years to trigger gout attacks, nobody has ever examined whether they have any links at all with recurrent gout attacks within a short time.

This case cross-over study was done through a survey on the internet with the aim of determining the amounts of purine that the participants consumed and whether it came from plants or animals. It also sorts to unravel the associated risks of purine-foods which are gout attacks.

The survey was also geared towards discovering whether the results of eating purine-foods were dependent on some of the known factors associated with gout attacks, the absence or presence of these factors was taken into consideration.

There were 633 internet users who participated in this survey, they all had gout and were monitored for up to 12 months. Advertisements regarding the survey were posted on Google making sure as many people as possible participate.

Survey Requirements

The requirements were that the participant had to be 18years and above with a diagnosis of a gout attack in the previous year. The person also had to be living in the United States.

After clicking the link they would be redirected to a page where they would report about the gout attack that they had. To ensure genuine information was given the participants were required to submit medical records.

The participants had to give answers to several questions regarding the gout attack including the food that they ate two days before the attack. In addition to that, they also had to give information about any control period of two days when they did not experience any attacks at all.


Comparisons for the least quintile of purine intake within the two days gave odd ratios of the recurrent gout attack happening as 1.17, 1.38, 2.21, and 4.76 as the quintile of purine intake increased. When the results of purine from animals were considered the risks of a gout attack was found to be much higher, these were 1.42, 1.34, 1.77, and 2.41 with an increase in purine intake quintiles, than for the purine from plans, 1.21, 0.99, 1.32, and 1.39 with an increase in purine intake quintiles.

Contributing Factors

The effects attributed to the intake of purine continued to persist across all the subgroups due to some factors associated with the risk of a gout attack. These factors include sex, drinking of alcohol, nonsteroidal, anti-inflammatory drugs, colchicine, allopurinol, and diuretics.

Some of the limitations that were met during the study, according to the authors, were participants recalling their diets, the size, and number. This might have introduced the chance for bias due to the recall.

Apart from that, the estimations for purine intake were all based on the bioavailability values gotten from the raw foods which might be totally different from that gotten from foods that have been cooked.

The levels of serum urate of the participants were known together with the study characteristics.

In addition to that, the purine intake may also not be the true representation of that of United States patients with gout.

The researchers advised people to reduce or totally avoid foods that are rich in purine, especially coming from animals, as a way of reducing the risk of getting a recurrent gout attack.

Research Conclusion

They concluded that the research they did fully supported the notion that foods derived from plants should be the ideal source for proteins especially for patients with gout attacks. These are legumes and nuts, they have protein, vitamins, minerals, and fiber.

Arthritis Foundation, National Institute of Health, and American College Rheumatology Research supported the study. However, the authors have not mentioned any financial relationships between them.