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Drinking lots of coffee reduces the risk of gout
Coffee is a habit for more than 50 percent
of Americans, who drink, on average, 2 cups per day. This widely
consumed beverage is regularly investigated and debated for its impact
on health conditions from breast cancer to heart disease. Among its
complex effects on the body, coffee or its components have been linked
to lower insulin and uric acid levels on a short-term basis or
cross-sectionally. These and other mechanisms suggest that coffee
consumption may affect the risk of gout, the most prevalent
inflammatory arthritis in adult males.
To examine how coffee consumption might
aggravate or protect against this common and excruciatingly painful
condition, researchers at the Arthritis Research Centre of Canada,
University of British Columbia in Canada, Brigham and Women's Hospital,
Harvard Medical School, and Harvard School of Public Health in Boston
conducted a prospective study on 45,869 men over age 40 with no history
of gout at baseline. Over 12 years of follow-up, Hyon K. Choi, MD,
DrPH, and his associates evaluated the relationship between the intake
of coffee and the incidence of gout in this high risk population. Their
findings, featured in the June 2007 issue of Arthritis &
provide compelling evidence that drinking 4 or more cups of coffee a
day dramatically reduces the risk of gout for men.
Subjects were drawn from an ongoing study
of some 50,000 male health professionals, 91 percent white, who were
between 40 and 75 years of age in 1986 when the project was initiated.
To assess coffee and total caffeine intake, Dr. Choi and his team used
a food-frequency questionnaire, updated every 4 years. Participants
chose from 9 frequency responses , ranging from never to 2 to 4 cups
per week to 6 or more per day , to record their average consumption of
coffee, decaffeinated coffee, tea, and other caffeine-containing
comestibles, such as cola and chocolate.
another questionnaire, the researchers documented 757 newly diagnosed
cases meeting the American College of Rheumatology criteria for gout
during the follow-up period. Then, they determined the relative risk of
incident gout for long-term coffee drinkers divided into 4 groups ,
less than 1 cup per day, 1 to 3 cups per day, 4 to 5 cups per day, and
6 or more cups per day , as well as for regular drinkers of
decaffeinated coffee, tea, and other caffeinated beverages. They also
evaluated the impact of other risk factors for gout , body mass index,
history of hypertension, alcohol use, and a diet high in red meat and
high-fat dairy foods among them , on the association between coffee
consumption and gout among the study participants.
Most significantly, the data revealed that
the risk for developing gout decreased with increasing coffee
consumption. The risk of gout was 40 percent lower for men who drank 4
to 5 cups a day and 59 percent lower for men who drank 6 or more cups a
day than for men who never drank coffee. There was also a modest
inverse association with decaffeinated coffee consumption. These
findings were independent of all other risk factors for gout. Tea
drinking and total caffeine intake were both shown to have no effect on
the incidence of gout among the subjects. On the mechanism of these
findings, Dr. Choi speculates that components of coffee other than
caffeine may be responsible for the beverage's gout-prevention
benefits. Among the possibilities, coffee contains the phenol
chlorogenic acid, a strong antioxidant.
While not prescribing 4 or more cups a
day, this study can help individuals make an informed choice regarding
coffee consumption. "Our findings are most directly generalizable to
men age 40 years and older, the most gout-prevalent population, with no
history of gout," Dr. Choi notes. "Given the potential influence of
female hormones on the risk of gout in women and an increased role of
dietary impact on uric acid levels among patients with existing gout,
prospective studies of these populations would be valuable."
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