For years they have been recommending to avoid coffee if you have gout. Now there's a study that shows that coffee can help to fend off gout:
Increased Coffee Consumption May Reduce Risk for Gout in Men CME/CE
News Author: Laurie Barclay, MD
CME Author: Laurie Barclay, MD
Disclosures
Release Date: May 25, 2007; Valid for credit through May 25, 2008
Credits Available
Physicians - maximum of 0.25 AMA PRA Category 1 Credit(s)™ for physicians;
Family Physicians - up to 0.25 AAFP Prescribed credit(s) for physicians;
Nurses - 0.25 nursing contact hours (None of these credits is in the area of pharmacology)
May 25, 2007 — Long-term consumption of coffee is associated with reduced risk for gout in men older than 40 years, according to the results of a prospective study reported in the June issue of Arthritis & Rheumatism.
"Coffee is one of the most widely consumed beverages in the world and may affect the risk of gout via various mechanisms," write Hyon K. Choi, MD, DrPH, from the University of British Columbia in Vancouver, Canada, and colleagues. "A study of a nationally representative sample of US adults showed that coffee consumption was associated with a lower serum level of uric acid and a lower frequency of hyperuricemia."
The study cohort from the Health Professionals Follow-Up Study consisted of 45,869 men with no history of gout at baseline. Validated questionnaires were used to measure intake of coffee, decaffeinated coffee, tea, and total caffeine every 4 years for 12 years, and a supplementary questionnaire was used to determine whether participants met the American College of Rheumatology survey criteria for gout.
During the 12-year study, there were 757 confirmed incident cases of gout. Increasing coffee intake was inversely associated with the risk for gout, with multivariate relative risks (RRs) for incident gout of 1.00, 0.97, 0.92, 0.60 (95% confidence interval [CI], 0.41 - 0.87), and 0.41 (95% CI, 0.19 - 0.88) for coffee consumption categories of 0, less than 1, 1 to 3, 4 to 5, and 6 or more cups per day, respectively (P for trend = .009).
For decaffeinated coffee, the multivariate RRs for 0, less than 1, 1 to 3, and 4 or more cups per day were 1.00, 0.83, 0.67 (95% CI, 0.54 - 0.82), and 0.73 (95% CI, 0.46 - 1.17), respectively (P for trend = .002).
These associations were independent of dietary and other risk factors for gout such as body mass index, age, hypertension, diuretic use, alcohol consumption, and chronic renal failure. Total caffeine from all sources and tea intake were not associated with the risk for gout.
"These prospective data suggest that long-term coffee consumption is associated with a lower risk of incident gout," the authors write.
Study limitations include self-report of coffee consumption, restriction to male healthcare professionals in the cohort, observational design, and inability to rule out the possibility that unmeasured factors might contribute to the observed associations.
The National Institutes of Health and TAP Pharmaceuticals supported this study. Some of the authors have disclosed various financial relationships with TAP and/or Savient Pharmaceuticals.
Arthritis Rheum. 2007;56:2048-2054.
Clinical Context
Gout is the most common inflammatory arthritis in adult men, and its incidence may be increasing. Therefore, identifying modifiable risk factors for gout is an important first step in preventing and managing this condition. Coffee consumption may affect the risk for gout by reducing serum uric acid levels and affecting insulin resistance, as well as by other mechanisms.
Because coffee is one of the most widely consumed beverages in the United States and worldwide, information about the health effects of coffee are important for public health, as well as to allow informed decisions regarding coffee consumption. The present prospective study evaluated the relationship between intake of coffee, decaffeinated coffee, tea, and total caffeine and the incidence of gout in a cohort of 45,869 men with no history of gout.
Study Highlights
* The Health Professionals Follow-Up Study is an ongoing longitudinal study of 51,529 male dentists, optometrists, osteopaths, pharmacists, podiatrists, and veterinarians who were predominantly white (91%) and aged 40 to 75 years in 1986.
* Of the 48,642 men who provided complete information on coffee, 2773 (5.7%) reported a history of gout on the baseline questionnaire and were excluded from this analysis.
* The cohort for this study consisted of 45,869 men with no history of gout at baseline. Validated questionnaires were used to measure intake of coffee, decaffeinated coffee, tea, and total caffeine every 4 years for 12 years, and a supplementary questionnaire was used to determine whether participants met the American College of Rheumatology survey criteria for gout.
* At baseline and every 2 years thereafter, participants provided information on weight, regular use of medications (including diuretics), and medical conditions (including self-reported clinician-diagnosed chronic renal failure and hypertension).
* During the 12-year study, there were 757 confirmed incident cases of gout.
* With increasing coffee intake, frequency of history of hypertension and diuretic use tended to decrease, but intakes of alcohol, meat, and high-fat dairy foods tended to increase.
* Increasing coffee intake was inversely associated with the risk for gout. Multivariate RRs for incident gout were 1.00, 0.97, 0.92, 0.60 (95% CI, 0.41 - 0.87), and 0.41 (95% CI, 0.19 - 0.88) for coffee consumption categories of 0, less than 1, 1 to 3, 4 to 5, and 6 or more cups per day, respectively (P for trend = .009).
* There was a modest inverse association between decaffeinated coffee consumption and incidence of gout. For decaffeinated coffee, the multivariate RRs for 0, less than 1, 1 to 3, and 4 or more cups per day were 1.00, 0.83, 0.67 (95% CI, 0.54 - 0.82), and 0.73 (95% CI, 0.46 - 1.17), respectively (P for trend = .002).
* These RRs for caffeinated and decaffeinated coffee did not change materially after additional adjustment for smoking. These associations were independent of dietary and other risk factors for gout such as body mass index, age, hypertension, diuretic use, alcohol consumption, total meat intake, and chronic renal failure.
* Total caffeine from all sources and tea intake were not associated with the risk for gout.
* Study limitations include self-report of coffee consumption, restriction to male healthcare professionals in the cohort, observational design, and inability to rule out the possibility that unmeasured factors might contribute to the observed associations.
Pearls for Practice
* In a large, long-term prospective study of male healthcare professionals aged 40 years and older, long-term caffeinated coffee consumption was associated with a lower risk for incident gout.
* In this study population, long-term consumption of decaffeinated coffee was associated with a modest reduction in risk for incident gout. Tea intake and caffeine intake from all sources were not associated with risk for gout.
Medscape Medical News 2007. ©2007 Medscape
