Should Patients with Gout Consume Soyfoods?

Mark Messina, Ph.D.

Gout, which is a form of arthritis, is caused by excess uric acid in the body, or hyperuricaemia.   Elevated levels of uric acid can lead to needle-like crystals in joints but uric acid may also collect under the skin as lophi or in the urinary tract as kidney stones.  Excess uric acid occurs as a result of one, or a combination three factors:  increased production of uric acid by the body; under-elimination by the kidneys; and increased intake of purine-rich foods. 

Gout patients are generally advised to avoid consuming large servings of meat because of its high purine content, and alcohol (especially heavy beers) because alcoholic beverages increase uric acid levels.1   Soyfoods are also sometimes considered to be contraindicated for patients with gout because they can be high in purines.  However, epidemiologic research has shown that plant proteins are not a risk factor for gout.2  In fact, the British Society for Rheumatology and British Health Professionals in Rheumatology recommends that gout patients consume soyfoods and other vegetable sources of protein.3  This recommendation is consistent with clinical studies showing soy protein doesn’t substantially increase serum uric acid levels.4,5 

It is also important to recognize that patients with gout are at an increased risk of developing cardiovascular disease, hypertension and the metabolic syndrome.1  Therefore, dietary recommendations for gouty patients need to consider not only the effects of diet on gout but associated diseases.  The consumption of soyfoods is consistent with both these considerations.

References

1.         Choi HK. A prescription for lifestyle change in patients with hyperuricemia and gout. Curr Opin Rheumatol 2010;22:165-72.

2.         Choi HK, Atkinson K, Karlson EW, Willett W, Curhan G. Purine-rich foods, dairy and protein intake, and the risk of gout in men. N Engl J Med 2004;350:1093-103.

3.         Jordan KM, Cameron JS, Snaith M, Zhang W, Doherty M, Seckl J, Hingorani A, Jaques R, Nuki G. British Society for Rheumatology and British Health Professionals in Rheumatology guideline for the management of gout. Rheumatology (Oxford) 2007;46:1372-4.

4.         Yamakita J, Yamamoto T, Moriwaki Y, Takahashi S, Tsutsumi Z, Higashino K. Effect of Tofu (bean curd) ingestion and on uric acid metabolism in healthy and gouty subjects. Adv Exp Med Biol 1998;431:839-42.

5.         Garrel DR, Verdy M, PetitClerc C, Martin C, Brule D, Hamet P. Milk- and soy-protein ingestion: acute effect on serum uric acid concentration. Am J Clin Nutr 1991;53:665-9.