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March 13, 2009

Greater vitamin C intake from food and supplements equals lower gout risk

Greater vitamin C intake from food and supplements equals lower gout risk

Men who have a high intake of vitamin C may have a reduced risk of developing gout according to a report published in the March 9, 2009 issue of the American Medical Association journal Archives of Internal Medicine.

Gout is the most common type of inflammatory arthritis in men. The disease is characterized by higher than normal blood uric acid, which forms crystal deposits in the joints that cause inflammation and severe pain.

Researchers led by Hyon K. Choi, MD, DrPH at the University of British Columbia analyzed data from 46,994 participants in the Health Professionals Follow-Up Study of dentists, osteopaths, optometrists, podiatrists and veterinarians. Responses to dietary questionnaires completed by the subjects upon enrollment in 1986 and every four years through 2006 were evaluated for vitamin C content from food and supplements. Data concerning weight, medication use, and medical conditions were collected every two years.

Over the follow-up period, gout developed in 1,317 men. Men whose total vitamin C intake was 1500 milligrams per day or more experienced a 45 percent lower risk of gout compared with those whose intake was below 250 milligrams. The risk of gout was found to decrease by 17 percent for each 500 milligram increase in vitamin C consumption. A separate analysis of vitamin C from supplements found a 45 percent reduction in gout risk when those who consumed over 1500 milligrams per day were compared with those who did not report using supplements.

The study is the first to the authors' knowledge to provide prospective evidence concerning the relationship between increased vitamin C intake and a reduction in the risk of gout. In their commentary on the finding, the authors cite previous research which determined that vitamin C increases the excretion of uric acid, thereby lowering serum uric acid levels. They also note the possibility of vitamin C's antioxidant action having a protective effect against the inflammation that occurs in the disease.

"Epidemiologic studies suggest that the overall disease burden of gout is substantial and growing," the authors write. "The identification of the risk factors for gout that are modifiable with available measures is an important first step in the prevention and management of this common and excruciatingly painful condition."

"Given the general safety profile associated with vitamin C intake, particularly in the generally consumed ranges as in the present study, vitamin C intake may provide a useful option in the prevention of gout," they conclude.

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Health Concern Life Extension Highlight

Gout

Gout is a painful condition characterized by the deposition of uric acid crystals in the joints, which causes episodes of joint inflammation.

Uric acid is created as a byproduct of purine metabolism. If too much uric acid is created through increased cell destruction, or if the body’s system for clearing uric acid is compromised (usually by defects in the kidneys' ability to clear uric acid), gout may result.

Gout causes acute attacks of inflamed, painful joints that subside gradually, though it can progress to a chronic condition if untreated. It often affects a joint in the first toe, but may occur in the ankles and knees as well. The first episode of acute gout often occurs at night, with the joints swelling and becoming painful. They may appear warm, red, and excruciatingly tender. The attack often subsides within 3 to 10 days, and no symptoms will be present until the next attack occurs.

In a recent study, the effect of 500 mg of vitamin C daily on serum uric acid levels was compared to placebo in 184 healthy adults. The vitamin C increased the estimated glomerular filtration rate, a measure of kidney function. After two months, the test subjects had reduced serum uric acid compared to controls, suggesting that vitamin C might be beneficial in preventing and managing gout and other urate-related diseases (Huang HY et al 2005).

Grape seed procyanidins were found to have uric acid-lowering effects in rats with hyperuricemia. The procyanidin-treated animals exhibited normal growth compared to animals treated with allopurinol, which exhibited some retarded growth (Wang Y et al 2004b).

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