Skip to main content

Advertisement

Log in

Effects of Dairy Intake on Hyperuricemia and Gout

  • Published:
Current Rheumatology Reports Aims and scope Submit manuscript

Abstract

Dietary modification is frequently recommended for patients with gout. Longitudinal observational studies have shown a clear inverse relationship between low-fat dairy intake and gout risk. Several checkpoints in gout pathogenesis may be targeted by dairy intake. Cross-sectional and short-term intervention studies of healthy volunteers have demonstrated that low-fat dairy intake has a moderate urate-lowering effect. In addition, certain dairy fractions, particularly glycomacropeptide and G600 milk fat extract, have anti-inflammatory properties in experimental models of acute gout. Such anti-inflammatory properties may contribute to the reduction in gout risk through inhibition of the inflammatory response to monosodium urate crystals within the joint. Well-controlled intervention studies in patients with gout are now needed to determine the clinical relevance of these observations in order to guide dietary recommendations for this disease.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Johnson RJ, Rideout BA. Uric acid and diet—insights into the epidemic of cardiovascular disease. N Engl J Med. 2004;350(11):1071–3.

    Article  PubMed  CAS  Google Scholar 

  2. Choi HK, Atkinson K, Karlson EW, et al. Purine-rich foods, dairy and protein intake, and the risk of gout in men. N Engl J Med. 2004;350(11):1093–103.

    Article  PubMed  CAS  Google Scholar 

  3. Choi HK, Curhan G. Dairy Consumption and Risk of Incident Gout in Women—The Nurses Health Study. American College of Rheumatology Annual Scientific Meeting, San Diego. 2005:Abstract number 185.

  4. Kanwar JR, Kanwar RK, Sun X, et al. Molecular and biotechnological advances in milk proteins in relation to human health. Curr Protein Pept Sci. 2009;10(4):308–38.

    Article  PubMed  CAS  Google Scholar 

  5. Webb BH, Johnson AH, Alford JA. Fundamentals of Dairy Chemistry, edn 2. Westport, CT: AVI Publishing Co 1974.

    Google Scholar 

  6. Haug A, Hostmark AT, Harstad OM. Bovine milk in human nutrition—a review. Lipids Health Dis. 2007;6:25.

    Article  PubMed  Google Scholar 

  7. Martin-Sosa S, Martin MJ, Garcia-Pardo LA, et al. Sialyloligosaccharides in human and bovine milk and in infant formulas: variations with the progression of lactation. J Dairy Sci. 2003;86(1):52–9.

    Article  PubMed  CAS  Google Scholar 

  8. Gaucheron F. The minerals of milk. Reprod Nutr Dev. 2005;45(4):473–83.

    Article  PubMed  CAS  Google Scholar 

  9. Fox PF, Kelly AL. Indigenous enzymes in milk: Overview and historical aspects—Part 1. International Diary Journal. 2006;16:500–16.

    Article  CAS  Google Scholar 

  10. Huffman LM, Harper WJ. Maximizing the value of milk through separation technologies. J Dairy Sci. 1999;82(10):2238–44.

    Article  PubMed  CAS  Google Scholar 

  11. Tomita M, Wakabayashi H, Shin K, et al. Twenty-five years of research on bovine lactoferrin applications. Biochimie. 2009;91(1):52–7.

    Article  PubMed  CAS  Google Scholar 

  12. MacGibbon AKH, Taylor MW. Composition and Structure of Bovine Milk Lipids. In: Fox PL, McSweeney PLH, eds. Advanced Dairy Chemistry edn 3. New York: Springer 2006.

    Google Scholar 

  13. Schaafsma G. Lactose and lactose derivatives as bioactive ingredients in human nutrition. International Dairy Journal 2008;18:458–65.

    CAS  Google Scholar 

  14. Tiemeyer W, Stohrer M, Giesecke D. Metabolites of nucleic acids in bovine milk. J Dairy Sci. 1984;67(4):723–8.

    Article  PubMed  CAS  Google Scholar 

  15. Indyk HE, Woollard DC. Determination of orotic acid, uric acid, and creatinine in milk by liquid chromatography. J AOAC Int. 2004;87(1):116–22.

    PubMed  CAS  Google Scholar 

  16. Roch-Ramel F, Guisan B. Renal Transport of Urate in Humans. News Physiol Sci. 1999;14:80–4.

    PubMed  CAS  Google Scholar 

  17. Merriman TR, Dalbeth N. The genetic basis of hyperuricaemia and gout. Joint Bone Spine. 2010.

  18. Loenen HM, Eshuis H, Lowik MR, et al. Serum uric acid correlates in elderly men and women with special reference to body composition and dietary intake (Dutch Nutrition Surveillance System). J Clin Epidemiol. 1990;43(12):1297–303.

    Article  PubMed  CAS  Google Scholar 

  19. Choi HK, Liu S, Curhan G. Intake of purine-rich foods, protein, and dairy products and relationship to serum levels of uric acid: the Third National Health and Nutrition Examination Survey. Arthritis Rheum. 2005;52(1):283–9.

    Article  PubMed  Google Scholar 

  20. Kuchan MJ, Ostrom KM, Smith C, et al. Influence of purine intake on uric acid excretion in infants fed soy infant formulas. J Am Coll Nutr. 2000;19(1):16–22.

    PubMed  CAS  Google Scholar 

  21. Ghadirian P, Shatenstein B, Verdy M, et al. The influence of dairy products on plasma uric acid in women. Eur J Epidemiol. 1995;11(3):275–81.

    Article  PubMed  CAS  Google Scholar 

  22. Garrel DR, Verdy M, PetitClerc C, et al. Milk- and soy-protein ingestion: acute effect on serum uric acid concentration. Am J Clin Nutr. 1991;53(3):665–9.

    PubMed  CAS  Google Scholar 

  23. •• Dalbeth N, Wong S, Gamble GD, et al. Acute effect of milk on serum urate concentrations: a randomised controlled crossover trial. Ann Rheum Dis. 2010;69(9):1677–82. This crossover clinical trial demonstrated that skim milk has an acute urate-lowering effect, and that the likely mechanism for this effect is the low purine content of milk, combined with increased uric acid excretion.

    Article  PubMed  CAS  Google Scholar 

  24. Choi HK, Curhan G. Soft drinks, fructose consumption, and the risk of gout in men: prospective cohort study. BMJ. 2008;336(7639):309–12.

    Article  PubMed  Google Scholar 

  25. Choi JW, Ford ES, Gao X, et al. Sugar-sweetened soft drinks, diet soft drinks, and serum uric acid level: the Third National Health and Nutrition Examination Survey. Arthritis Rheum. 2008;59(1):109–16.

    Article  PubMed  CAS  Google Scholar 

  26. Emmerson BT. Effect of oral fructose on urate production. Ann Rheum Dis. 1974;33(3):276–80.

    Article  PubMed  CAS  Google Scholar 

  27. Zawiasa A, Szklarek-Kubicka M, Fijalkowska-Morawska J, et al. Effect of oral fructose load on serum uric acid and lipids in kidney transplant recipients treated with cyclosporine or tacrolimus. Transplant Proc. 2009;41(1):188–91.

    Article  PubMed  CAS  Google Scholar 

  28. Dunzendorfer U, Schmidt-Gayk H. Parathyroid hormone, cAMP, electrolytes and uric acid after high dose CaCl2 in patients with idiopathic stone formation. Endokrinologie. 1981;77(3):353–9.

    PubMed  CAS  Google Scholar 

  29. Garg JP, Chasan-Taber S, Blair A, et al. Effects of sevelamer and calcium-based phosphate binders on uric acid concentrations in patients undergoing hemodialysis: a randomized clinical trial. Arthritis Rheum. 2005;52(1):290–5.

    Article  PubMed  CAS  Google Scholar 

  30. • Dalbeth N, Horne A, Gamble GD, et al. The effect of calcium supplementation on serum urate: analysis of a randomized controlled trial. Rheumatology (Oxford). 2009;48(2):195–7. This large randomized controlled trial showed that calcium supplementation does not have a urate-lowering effect.

    Article  CAS  Google Scholar 

  31. Martinon F, Petrilli V, Mayor A, et al. Gout-associated uric acid crystals activate the NALP3 inflammasome. Nature. 2006;440(7081):237–41.

    Article  PubMed  CAS  Google Scholar 

  32. Martinon F, Glimcher LH. Gout: new insights into an old disease. J Clin Invest. 2006;116(8):2073–5.

    Article  PubMed  CAS  Google Scholar 

  33. •• Dalbeth N, Gracey E, Pool B, et al. Identification of dairy fractions with anti-inflammatory properties in models of acute gout. Ann Rheum Dis. 2009;69(4):766–9. This laboratory-based study identified factors within milk that are capable of regulating the inflammatory response to MSU crystals.

    Article  PubMed  Google Scholar 

  34. Thoma-Worringer C, Sørensen J, Lopez-Fandino R. Health effects and technological features of caseinomacropeptide. International Dairy Journal. 2006;16(11):1324–33.

    Article  Google Scholar 

  35. Choi HK, Ford ES, Li C, et al. Prevalence of the metabolic syndrome in patients with gout: the Third National Health and Nutrition Examination Survey. Arthritis Rheum. 2007;57(1):109–15.

    Article  PubMed  Google Scholar 

  36. Choi HK, Curhan G. Independent impact of gout on mortality and risk for coronary heart disease. Circulation. 2007;116(8):894–900.

    Article  PubMed  Google Scholar 

  37. Choi HK, Ford ES. Haemoglobin A1c, fasting glucose, serum C-peptide and insulin resistance in relation to serum uric acid levels—the Third National Health and Nutrition Examination Survey. Rheumatology (Oxford). 2008;47(5):713–7.

    Article  CAS  Google Scholar 

  38. Krishnan E, Svendsen K, Neaton JD, et al. Long-term cardiovascular mortality among middle-aged men with gout. Arch Intern Med. 2008;168(10):1104–10.

    Article  PubMed  Google Scholar 

  39. • Elwood PC, Givens DI, Beswick AD, et al. The survival advantage of milk and dairy consumption: an overview of evidence from cohort studies of vascular diseases, diabetes and cancer. J Am Coll Nutr. 2008;27(6):723S–34S. This meta-analysis of observational studies showed that dairy intake is associated with reduced risk of ischemic heart disease, stroke, and incident diabetes in the general population.

    PubMed  Google Scholar 

  40. Ma J, Stevens JE, Cukier K, et al. Effects of a protein preload on gastric emptying, glycemia, and gut hormones after a carbohydrate meal in diet-controlled type 2 diabetes. Diabetes Care. 2009;32(9):1600–2.

    Article  PubMed  CAS  Google Scholar 

  41. Mortensen LS, Hartvigsen ML, Brader LJ, et al. Differential effects of protein quality on postprandial lipemia in response to a fat-rich meal in type 2 diabetes: comparison of whey, casein, gluten, and cod protein. Am J Clin Nutr. 2009;90(1):41–8.

    Article  PubMed  CAS  Google Scholar 

  42. Pal S, Ellis V, Dhaliwal S. Effects of whey protein isolate on body composition, lipids, insulin and glucose in overweight and obese individuals. Br J Nutr. 2010;104(5):716–23.

    Article  PubMed  CAS  Google Scholar 

  43. Pal S, Ellis V. The chronic effects of whey proteins on blood pressure, vascular function, and inflammatory markers in overweight individuals. Obesity (Silver Spring). 2010;18(7):1354–9.

    Article  CAS  Google Scholar 

  44. •• Choi HK. A prescription for lifestyle change in patients with hyperuricemia and gout. Curr Opin Rheumatol. 2010;22(2):165–72. This review is an excellent summary of dietary studies related to risk of hyperuricemia and gout, with recommendations for dietary modification based on these data.

    Article  PubMed  Google Scholar 

  45. Dessein PH, Shipton EA, Stanwix AE, et al. Beneficial effects of weight loss associated with moderate calorie/carbohydrate restriction, and increased proportional intake of protein and unsaturated fat on serum urate and lipoprotein levels in gout: a pilot study. Ann Rheum Dis. 2000;59(7):539–43.

    Article  PubMed  CAS  Google Scholar 

  46. Shulten P, Thomas J, Miller M, et al. The role of diet in the management of gout: a comparison of knowledge and attitudes to current evidence. J Hum Nutr Diet. 2009;22(1):3–11.

    Article  PubMed  CAS  Google Scholar 

Download references

Disclosure

Dr. Dalbeth has received research funding from LactoPharma (a joint venture between Fonterra Ltd., Fonterra R&D Ltd., and Auckland UniServices Ltd.), has served as a consultant for Novartis and Takeda Pharmaceuticals North America, and has had travel/accommodations expenses covered/reimbursed by Abbott Laboratories and Roche for attendance at meetings.

Dr. Palmano was previously an employee of Fonterra Co-operative Group Ltd and has served as a consultant for LactoPharma. She and Dr. Dalbeth are inventors on a patent application related to milk products and gout.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Nicola Dalbeth.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Dalbeth, N., Palmano, K. Effects of Dairy Intake on Hyperuricemia and Gout. Curr Rheumatol Rep 13, 132–137 (2011). https://doi.org/10.1007/s11926-010-0160-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11926-010-0160-8

Keywords

Navigation