Skim milk may decrease risk of gout

By Richard Harkness
Knight Ridder Newspapers

Q. In your column on treating gout you only briefly mentioned foods that increased gout risk. Could you provide more details?

A. Gout is a form of inflammatory arthritis. It usually affects the big toe joint, but it can also affect other joints including the ankle, knee, wrist and fingers.

Gout is usually associated with high levels of uric acid, a breakdown product of purines, found in proteins. Eating protein foods high in purines raises uric acid levels in the blood.

The condition can occur when uric acid crystals accumulate in joints, causing severe pain, swelling, redness and stiffness. Repeated attacks may lead to permanent joint damage.

It should be emphasized that most people with high uric acid levels don’t develop gout, and the condition occasionally occurs in people with normal or low uric acid levels. Other factors, including genetics, likely play a role.

The New England Journal of Medicine study mentioned in the prior column looked at the effect of various foods on gout. The questionnaire-based study involved almost 50,000 men over 12 years.

Those who ate the highest amounts of seafood and red meats were substantially more likely to develop gout compared with those who ate the least amounts.

Meats moderately high in purines, but less likely to raise gout risk, include chicken, turkey, duck and ham.

There was no increase in risk associated with nonmeat protein vegetables rich in purines such as beans, peas, mushrooms, cauliflower and spinach.

Another surprising finding was that dairy foods actually helped prevent gout. The study author noted that drinking more than two cups (16 oz) of skim milk daily substantially reduced gout risk. Dairy products are relatively high in protein, but low in purines.