Adherence to DASH Dietary Pattern and Its Association with Incident Hyperuricemia Risk: A Prospective Study in Chinese Community Residents

Association between dietary patterns and chronic kidney disease combined with hyperuricemia

Background and aims: Chronic kidney disease (CKD) combined with hyperuricemia is a concerning health issue, but the association between this condition and dietary patterns remains poorly understood. The aim of this study was to assess the associations between dietary patterns and CKD combined with hyperuricemia. Methods: This cross-sectional study was conducted involving 12 318 participants aged 18-79 years during 2018-2020. Dietary intake information was collected using a validated 110-item food frequency questionnaire. Factor analysis was used to identify major dietary patterns. CKD was defined as the presence of albuminuria or an estimated glomerular filtration rate <60 mL min-1 1.73 m-2. Hyperuricemia was defined as serum uric acid levels >420 μmol L-1 both in men and women. Logistic regression models were applied to assess the association between dietary patterns and the risk of CKD combined with hyperuricemia. Results: Five major dietary patterns were identified: 'healthy pattern', 'traditional pattern', 'animal foods pattern', 'sweet foods pattern', and 'tea-alcohol pattern', which together explained 38.93% of the variance in the diet. After adjusting for potential confounders, participants in the highest quartile of the traditional pattern had a lower risk of CKD combined with hyperuricemia (OR = 0.49, 95% CI: 0.32-0.74, Pfor trend < 0.01). Conversely, participants in the highest quartile of the sweet foods pattern had a higher risk compared to those in the lowest quartile (OR = 1.69, 95% CI: 1.18-2.42, Pfor trend < 0.01). However, no significant association was observed between the healthy pattern, animal foods pattern and tea-alcohol pattern and the risk of CKD combined with hyperuricemia. Conclusions: Our results suggest that the traditional pattern is associated with a reduced risk of CKD combined with hyperuricemia, whereas the sweet foods pattern is associated with an increased risk.

Dietary patterns, uric acid levels, and hyperuricemia: a systematic review and meta-analysis

Background: Studies investigating the effects of dietary intake on serum uric acid (SUA) and hyperuricemia have yielded inconsistent results. Therefore, we conducted a meta-analysis to assess the associations between various dietary patterns and SUA levels as well as hyperuricemia. Methods: We searched PubMed, Web of Science, and EMBASE databases for relevant articles examining the association between dietary intake and SUA levels and/or hyperuricemia published until March 2023. Dietary intake patterns were classified into plant-based, animal-based, and mixed dietary patterns based on predominant foods. The pooled effect sizes of eligible studies and their corresponding 95% confidence intervals (CIs) were estimated using random-effects models. Publication bias was assessed using Egger's test. Results: We included 41 studies, comprising 359 317 participants, that investigated the effects of dietary patterns on SUA levels (n = 25) and hyperuricemia (n = 19). Our findings suggested that a plant-based dietary pattern was associated with decreased SUA levels in both interventional (standard mean difference: -0.24 mg dL-1, 95% CI: -0.42, -0.06; I2 = 61.4%) and observational studies (odds ratio (OR): 0.92, 95% CI: 0.89, 0.95, I2 = 91.1%); this association was stronger in men (OR: 0.45, 95% CI: 0.35, 0.58; I2 = 0). We observed that plant- and animal-based dietary patterns were associated with a reduced risk (OR: 0.75; 95% CI: 0.67, 0.83, I2 = 93.3%) and an increased risk (OR: 1.38; 95% CI: 1.20, 1.59, I2 = 88.4%) of hyperuricemia, respectively. Conclusions: Collectively, a plant-based dietary pattern is negatively associated with SUA levels and hyperuricemia. Therefore, a plant-based dietary pattern should be recommended for the management of SUA levels and the prevention of hyperuricemia.

High-Fructose Diet-Induced Hyperuricemia Accompanying Metabolic Syndrome-Mechanisms and Dietary Therapy Proposals

Fructose is often used as a food ingredient due to its low production costs and sweetening power. In recent years, it has been noticed that people on a Western diet high in fructose have high levels of uric acid in their blood. It was recognized that the specific metabolism of fructose in the body might cause increased production of uric acid, which then may affect the intensification of lipogenesis and the development of metabolic syndrome (MetS), insulin resistance, gout, cardiovascular diseases, leptin resistance, or non-alcoholic fatty liver disease. So far, to treat hyperuricemia, it has been recommended to use a low-purine diet characterized by limiting protein-containing products. However, this recommendation often leads to an increased intake of carbohydrate-rich foods that may contain fructose. Increased fructose consumption may enhance the secretion of uric acid again and, consequently, does not have therapeutic effects. Therefore, instead of a low-purine diet, using healthy diets, such as DASH or the Mediterranean diet, which can benefit metabolic parameters, could be a better proposal. This article provides an overview of this approach, focusing on MetS and hyperuricemia among high-fructose dieters.