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The role of diet in serum urate concentration

BMJ 2018; 363 doi: (Published 10 October 2018) Cite this as: BMJ 2018;363:k4140


Evaluation of the diet wide contribution to serum urate levels

  1. Lorraine Watson, research fellow1,
  2. Edward Roddy, reader1
  1. 1Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Staffordshire ST5 5BG, UK
  1. Correspondence to: L Watson l.watson{at}

Dietary patterns are substantially less important than genes

Hyperuricaemia is a well established risk factor for gout.1 The role of sustained hyperuricaemia in the pathogenesis of monosodium urate crystal formation and gout is well understood.2 Dietary factors have been thought to predispose individuals to hyperuricaemia and gout for centuries. Recent epidemiological studies have suggested a role for excessive consumption of meat, seafood, sugar sweetened soft drinks, fructose, and alcoholic drinks, particularly beer and spirits; whereas coffee, low fat dairy products, and vitamin C may have a protective effect.3

In a linked article, Major and colleagues (doi: 10.1136/bmj.k3951) report a meta-analysis of cross sectional food frequency questionnaire data from five US cohort studies to test individual foods for associations with serum urate and to compare the variance in serum urate levels explained by dietary factors with heritable factors.4 Their findings replicate the results of previous epidemiological studies, identifying seven foods …

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