Purine-rich foods, dairy and protein intake, and the risk of gout in men

Summary

This 12-year prospective cohort study of 47,150 men from the Health Professionals Follow-up Study is the canonical evidence on dietary purines and gout risk. Of the men who had no history of gout at baseline, 730 developed gout over the follow-up period. The headline findings: men in the highest quintile of meat consumption had a 41 percent higher risk of gout than those in the lowest quintile (relative risk 1.41), and men in the highest quintile of seafood consumption had a 51 percent higher risk (RR 1.51). Dairy intake worked the opposite direction — highest-quintile dairy was protective, with a 44 percent lower risk (RR 0.56). Notably, purine-rich vegetables (peas, beans, mushrooms, spinach, cauliflower) showed no association with gout risk despite their purine content. The mechanism appears to be that different purine sources convert to uric acid at different rates, and the food matrix matters as much as total purine load.