Dietary Diversity and Risk of Developing Gout: A Cohort Study of 161,213 Participants

Various epidemiological studies have shown the effects of certain foods on the risk of developing gout. However, these associations have not been comprehensively confirmed in prospective studies. We aim to investigate the association between dietary diversity and the incidence of gout in a large prospective cohort.

Using data from 161,213 participants (54.32% female) with a mean age of 56.5 years in a large cohort, we examined the association between the food intake of five major groups (grain, vegetables, fruits, meat, and dairy product) and gout. The diet diversity score (DDS) was calculated using five rounds of 24-hour dietary recall records. Genetic risk for gout was characterized using a weighted polygenic risk score. The International Classification of Diseases, Tenth Revision code was used to identify gout cases. Cox proportional hazard models were used to estimate the hazard ratios (HRs) for each food group and the total DDS with the outcome of gout. Restricted cubic spline regressions were used to examine the dose-response association between DDS and gout risk.

During a median follow-up of 13.26 years, 2,004 cases of gout occurred. After fully adjusting for confounders, intermediate (HR 0.798, 95% confidence interval [CI] 0.707-0.900) and high (HR 0.807, 95% CI 0.701-0.928) DDS as well as consumption of grain products (HR 0.852, 95% CI 0.789-0.919), dairy products (HR 0.889, 95% CI 0.846-0.933), vegetables (HR 0.960, 95% CI 0.927-0.993), and fruits (HR 0.924, 95% CI 0.879-0.972), were all associated with a reduced risk of gout (all P < 0.05). The protective association of dairy products with gout was particularly notable in the high genetic risk subgroup (HR 0.885, 95% CI 0.832-0.942; P = 1.089 × 10^-4).

Our findings support dietary recommendations that advocate for moderately diverse diets rich in specific healthy foods as an effective measure for gout prevention, especially in high-risk populations.