Gout - Kick the Caffine Keep the Coffee

Flurry of interest in two health studies on Gout

Two studies published Friday

Arthritis & Rheumatism Volume 56, Issue 6 , Pages 2049 - 2055 and
Arthritis Care & Research Volume 57, Issue 5 , Pages 816 - 821

according to one news aggregator, spawned over 45 news articles in a matters of hours about the supposed benefit of coffee to persons at risk of developing gout. What is not clear is why.

The cliff notes version:

Heavy coffee drinkers were less likely to develop gout,

tea drinkers developed gout at the same rate as the general population.

There was speculation that caffeine was not the cause of the gout reduction.

Why the level of interest other than the opportunity for good headlines and another story of something generally assumed to be bad for your health has some healthy side benefits. Another red wine, butter, egg, fat like issue.

But there is more to it then that, part of most treatments for gout include dietary recommendations and one common recommendation is cutting coffee from the diet. These two studies may influence some to remove the coffee restriction from their diet, with or without physician support. However neither of these studies address what impact coffee may or may not have on people that have already developed Gout.

The study in Arthritis and Rheumatism covered Research 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 involving 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 provide compelling evidence that drinking 4 or more cups of coffee a day dramatically reduces the risk of gout for men.

A related study by the same lead researcher was published in Arthritis Care & Research.

This study indicated it was not the caffeine in coffee that influenced the results in the larger longitudinal study.

Using data from 14,758 participants over 20 years old in the Third National Health and Nutrition Examination Survey (1988-1994), examined the relationship between coffee, tea, and caffeine intake and serum uric acid level using linear regression. Additionally, we examined the relationship with hyper-uricemia (a leading indicator of susceptibility to Gout)

These findings from a nationally representative sample of US adults suggest that coffee consumption is associated with lower serum uric acid level and hyperuricemia frequency, but tea consumption is not. The inverse association with coffee appears to be via components of coffee other than caffeine.

I would caution readers to remember that different forms of tea have widely varying levels and generally lower levels of caffeine than coffee.

Speculation on the results

The general indication I draw from the results is that if you are a heavy long term drinker of coffee you will be less likely to develop gout and that if you switched to decaffeinated that would probably not increase your risk, but even that is subject to question. The decaffeinating process may change other components of the coffee besides the caffeine levels. Of course none of this addresses the other health effects of heavy coffee drinking, got ulcers? over reacting to stressful situations? Sleep difficulties? Maybe 6 plus cups of coffee is not a good idea regardless.

In reference to the study on uric acid levels, The team claims that coffee drinking can lead to lower insulin levels in the blood, and that there is an established link between higher insulin levels and higher uric acid levels.

The results back the findings of an earlier, much smaller, Japanese study.

They just can not stop doing it. Researchers are continuing to speculate on the wider meaning of their results.

In a telephone interview with Reuters the Lead Researcher on these two studies said

"We found that when they are drinking four to five cups of coffee, there was a 40-percent reduction. Drinking six or more cups resulted in a 50- to 60-percent reduction (in the risk for gout),"

"Coffee intake may be beneficial in the prevention and management of gout," said research leader Dr. Hyon Choi, a University of B.C. professor and rheumatologist at the Mary Pack Arthritis Centre and Vancouver General Hospital. "I guess the main message is that if you are a coffee drinker, and may be at risk of gout, then don’t stop drinking — but that doesn’t mean you should start drinking lots of coffee to avoid gout."

While an elevated blood level of uric acid (hyperuricemia) may indicate an increased risk of gout, the relationship between hyperuricemia and gout is unclear. Many people with hyperuricemia do not develop gout, while some patients with repeated gout attacks have normal or low blood uric acid levels.

So the jury is still out on this issue.

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