Food Sources of Protein and Risk of Incident Gout in the Singapore Chinese Health Study

Authors

  • Gim Gee Teng,

    Corresponding author
    1. National University Health System, Singapore, Singapore, and National University of Singapore, Yong Loo Lin School of Medicine, Singapore
    • Address correspondence to Gim Gee Teng, MBBS, MD, University Medicine Cluster, Division of Rheumatology, National University Health System, NUHS Tower Block, 1E Kent Ridge Road, Singapore 119228, Singapore (e-mail: gim_gee_teng@nuhs.edu.sg); or to Woon-Puay Koh, MBBS, PhD, Office of Clinical Sciences, Duke–NUS Graduate Medical School Singapore, 8 College Road Level 4, Singapore 169857, Singapore (e-mail: woonpuay.koh@duke-nus.edu.sg).

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  • An Pan,

    1. National University of Singapore, Saw Swee Hock School of Public Health, Singapore, and Huazhong University of Science and Technology, School of Public Health and Tongji Medical College, Wuhan, China
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  • Jian-Min Yuan,

    1. University of Pittsburgh Cancer Institute, and University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
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  • Woon-Puay Koh

    Corresponding author
    1. Duke–NUS Graduate Medical School, Singapore, and National University of Singapore, Saw Swee Hock School of Public Health, Singapore
    • Address correspondence to Gim Gee Teng, MBBS, MD, University Medicine Cluster, Division of Rheumatology, National University Health System, NUHS Tower Block, 1E Kent Ridge Road, Singapore 119228, Singapore (e-mail: gim_gee_teng@nuhs.edu.sg); or to Woon-Puay Koh, MBBS, PhD, Office of Clinical Sciences, Duke–NUS Graduate Medical School Singapore, 8 College Road Level 4, Singapore 169857, Singapore (e-mail: woonpuay.koh@duke-nus.edu.sg).

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Abstract

Objective

Prospective studies evaluating diet in relation to the risk of gout in Asian populations are lacking. The purpose of this study was to examine the relationship between the consumption of dietary protein from each of its major sources and the risk of gout in a Chinese population.

Methods

We used data from the Singapore Chinese Health Study, a prospective cohort of 63,257 Chinese adults who were 45–74 years old at recruitment during the years 1993–1998. Habitual diet information was collected via a validated semiquantitative food frequency questionnaire, and physician-diagnosed gout was self-reported during 2 followup interviews up to the year 2010. Cox proportional hazards models were used to calculate the hazard ratios (HRs) and 95% confidence intervals (95% CIs), with adjustment for potential confounders, among 51,114 eligible study participants who were free of gout at baseline and responded to our followup interviews.

Results

A total of 2,167 participants reported physician-diagnosed gout during the followup period. The multivariate-adjusted HRs (with 95% CIs) of gout, comparing the first quartile with the fourth quartile, were as follows: 1.27 (1.12–1.44; P for trend < 0.001) for total protein, 1.27 (1.11–1.45; P for trend < 0.001) for poultry, 1.16 (1.02–1.32; P for trend = 0.006) for fish and shellfish, 0.86 (0.75–0.98; P for trend = 0.018) for soy food, and 0.83 (0.73–0.95; P for trend = 0.012) for nonsoy legumes. No statistically significant associations were found with protein intake from other sources (red meat, eggs, dairy products, grains, or nuts and seeds).

Conclusion

In this Chinese population living in Singapore, higher total dietary protein intake from mainly poultry and fish/shellfish was associated with an increased risk of gout, while dietary intake of soy and nonsoy legumes was associated with a reduced risk of gout.

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