Gout in X-ray of left foot. Credit: Hellerhoff/Wikipedia.

Dietary factors have a far smaller influence on urate levels (a precursor to gout) than previously envisaged, new University of Otago research reveals.

The research, led by Post-Doctoral Fellow Dr. Tanya Major, found that a healthy diet can be linked to having lower levels of serum urate, which protects from gout. But the amount of influence diet has on urate levels is very low overall.

Historically, diet has been linked to gout because certain foods can trigger gout flares and diet is often used as a disease management tool for gout patients. Many studies have looked at specific foods and their relationship with gout or serum urate, but this study published in the BMJ today went a step further by assessing how much variation in serum urate each food was responsible for.

Importantly, the study found no single food explained more than 1 per cent of variation in serum urate levels and when all foods in combination were considered, less than half a per cent of the urate variation was explained.

In contrast, genetic variants explained substantially more of the variation in serum urate among the participants involved in the research.

"It came as no surprise to us that genetic factors have a larger influence on serum urate than dietary factors, but what did surprise us was the magnitude of this difference; an almost 100-fold increase," Dr. Major explains.

The research shows that diet has very little influence on urate levels, she says.

"This is contrary to popular medical opinion and the common perceptions of the general public. We hope it will encourage medical practitioners to focus on other ways to manage urate levels and prevent gout flares, such as allopurinol use, rather than focusing on dietary modifications which are likely to be of little help to the patient."

However, Dr. Major urges some caution around the results as the study was conducted in a healthy population.

"This is the first-step of our project. The research now needs to be carried out among people with gout. We cannot say for certain that there won't be a greater influence from diet in the urate levels of those people," she explains.

"However, for diet to explain so little of such an essential component in the cause of gout is an important finding."

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More information: Tanya J Major et al. Evaluation of the diet wide contribution to serum urate levels: meta-analysis of population based cohorts, BMJ (2018). Journal information: British Medical Journal (BMJ) Tanya J Major et al. Evaluation of the diet wide contribution to serum urate levels: meta-analysis of population based cohorts,(2018). DOI: 10.1136/bmj.k3951