Long-Term Lignan Intake, Whole Grain Foods, and the Risk of Gout: Results From Two Prospective Cohort Studies

Multiple plant-based dietary patterns are inversely associated with gout, although the individual constituents driving this association remain unclear. Dietary lignans, a major group of phytoestrogens abundant in plant foods, are metabolized by the gut microflora and may modulate gout risk. We examined the associations between dietary lignan intake, certain whole grain foods rich in lignans, and incident gout.

We analyzed data from 122,680 individuals in the Health Professionals Follow-up Study and Nurses' Health Study. We administered a food frequency questionnaire every two to four years. We used Cox models to evaluate associations between dietary lignans, whole grain foods, and confirmed gout.

Higher intakes of matairesinol (hazard ratio [HR] comparing extreme quintiles, 0.78; 95% confidence interval [CI], 0.69-0.90; P trend = 0.002) and secoisolariciresinol (HR, 0.78; 95% CI, 0.68-0.89; P trend = 0.002) were both associated with lower gout risk, whereas pinoresinol and lariciresinol were not associated with gout. We found inverse associations of whole grain cold breakfast cereals (HR for those consuming ≥1 serving per day, 0.62; 95% CI, 0.53-0.73), cooked oatmeal/oat bran (HR for those consuming ≥2 servings per week, 0.78; 95% CI, 0.70-0.86), and bran added to food (HR for those consuming ≥2 servings per week, 0.84; 95% CI, 0.74-0.95), but not dark breads or other cooked breakfast cereals, with gout.

Higher intakes of matairesinol and secoisolariciresinol, as well as whole grain cold breakfast cereals, oatmeal, and added bran, were each significantly associated with lower gout risk. These findings support adherence to healthful plant-based diets for gout and support a potential role of the gut microbiome in gout pathogenesis.