Johns Hopkins Health Alert
Can Coffee Prevent Gout?
Worried about gout? Researchers recently discovered that drinking coffee may lower your risk. Read what the experts think …
Gout is believed to have a genetic component, as nearly one in five individuals who develop gout has a family history of the disease. Other gout risk factors are gender (men outnumber women by nine to one); age (it is more common in adults than in children); being over weight; excessive consumption of alcohol; the presence of kidney disease, high blood pressure, high cholesterol, or diabetes; and exposure to lead. A high consumption of purine-rich foods also increases the risk of having a gout attack. Purine-rich foods include certain meats and fish, poultry, liver, dried beans, asparagus, mush- rooms, cauliflower, peas, and spinach.
Recently researchers in Canada sorted through data on more than 14,000 men and women from the six-year Third National Health and Nutrition Examination Survey and found that people who drank four or more cups of coffee a day lowered their risk of gout by 40-60%. The participants, who filled out questionnaires about their diets over the previous month, ranged in age from 40 to 75 and had no history of gout.
Coffee -- and, to a lesser extent, decaffeinated coffee -- significantly lowered the amount of uric acid in the blood. The build up of uric acid causes gout. However tea and other caffeinated beverages had little effect, leading researchers to conclude that elements other than caffeine in coffee, like an antioxidant called chlorogenic acid, caused the uric acid levels to drop. Researchers aren't suggesting that you drink four cups of coffee a day to ward off gout. But if you have gout or are at risk for it, go ahead and enjoy your morning brew.
[This data was reported in the journal Arthritis & Rheumatism, Volume 57, page 816.]
Posted in Arthritis on December 29, 2008
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There are several things to consider about studies that find a reduction in uric acid level related to fewer gout flares. 1) The level of uric acid is known to have significant fluctuation over the daily cycle, yet there is no standardization for the time and conditions under which it is measured. Endocrinologists have set up standards for the measurement of blood sugar, but gout researchers have not done that for the measurement of uric acid in the blood. As it's done now, it's junk science. 2) A much more important method than drinking coffee to reduce gout flares is making sure that the gout sufferer doesn't experience sleep apnea. Pulmonology journal articles over twenty years ago began describing two mechanisms by which the reduction of oxygen in the blood from the repeated periods of no breathing during sleep can cause a gout flare in short order. First, the oxygen reduction causes the cells to undergo a catabolic process which culminates irreversibly in their generation of excess uric acid fed into the blood, which can be viewed as an uric acid flare. Second, the oxygen reduction makes the blood more acidic, which increases the likelihood of precipitation from the blood of the urate crystals that cause a new gout flare. 3) If uric acid were to be measured several hours after awakening, the kidneys will have had enough time to dispose of the excess uric acid, so the uric acid flare from sleep apnea will go unmeasured. 4) Gout is often the first early warning of sleep apnea, early enough to do something about the sleep apnea before life-threatening consequences develop from it. The wise approach is for all gout sufferers to be screened for sleep apnea, and diagnosed and treated if warranted. 5) Gout experts haven't figured this out yet. They're too busy focusing on how much coffee or other food and drink is ingested.
Posted by: Burt Abrams | January 3, 2009 3:10 PM