Risk of arthritic ailment cut by nearly 60 per cent in men who drink six or more cups a day
Pamela Fayerman
Sun
Phenol chlorogenic acid, an antioxidant, is likely behind the beneficial effects of coffee. Tim Boyle, Agence France-Presse, Getty Images, Files
Coffee drinkers should receive an extra boost with two B.C.-led studies published today that show the more coffee an individual consumes, the greater the reduction in their risk of gout, a painful and common form of inflammatory arthritis that often settles in the large joint of the big toe.
“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,” he said.
Gout affects about 10 per cent of men over the age of 50 and 10 per cent of women over the age of 60.
In the June issue of Arthritis and Rheumatism, Choi and his co-authors report on their 12-year study on nearly 46,000 male health professionals (such as dentists, optometrists, pharmacists and veterinarians) over age 40. They found the risk of gout was 59 per cent lower for men who drank six cups of coffee or more per day compared to men who drank no coffee. The risk of gout was 40 per cent lower for men who drank four to five cups of coffee a day. Tea did not have an effect on reducing the incidence of gout but decaffeinated coffee consumption had a somewhat favourable effect on risk reduction.
Choi, who collaborated with researchers at Brigham and Women’s Hospital in Boston, Harvard Medical School and Harvard School of Public Health in Boston, said in an interview that while he cannot rule out a protective role for caffeine, it’s probably components other than caffeine which reduce risk of gout, particularly an antioxidant in coffee called phenol chlorogenic acid.
He said previous research has shown that the same antioxidant is protective against type two diabetes, an interesting finding since the same risk factors for diabetes — hypertension, being overweight and inactive — are also risk factors for gout. Phenol chlorogenic acid has been shown in research to reduce blood glucose concentrations.
Uric acid crystals are the culprit in the development of gout and elevated levels occur when the kidneys can’t eliminate enough uric acid or when too much is produced. Decreased insulin resistance and insulin levels associated with coffee are thought to lower uric acid levels.
“The body doesn’t like these uric acid crystals. They are treated like a foreign body and that’s what prompts an intense reaction,” Choi said.
While there are some medications to treat the most serious cases, changes in diet can often resolve the symptoms of gout. In a pivotal study Choi led, published in the New England Journal of Medicine in 2004, researchers found that high levels of red meat and seafood led to an increased risk of gout while dairy products were protective against it. Choi tells gout patients to eat less red meat, fish, eggs and alcohol, and to eat high-fibre food, low-fat dairy products and plant oils like olive, soy, sunflower and other vegetable oils.
In the second study, in Arthritis Care and Research, Choi based results on a U.S. national health and nutrition survey which included 14,000 men and women between 1988 and 1994. Participants consented to a medical exam and provided blood and urine specimens and then answered questions about coffee and tea consumption. The results showed that levels of uric acid decreased as coffee intake rose. The study noted a beneficial effect of chlorogenic acid in coffee.
Choi said the diagnosis of gout is sometimes challenging for family doctors because symptoms may be similar to conditions like toe fractures, osteoarthritis, psoriasis, infections in the toe and other types of arthritis.
“Some people who need treatment don’t get it. More people should be referred to a rheumatologist when gout is suspected.”
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