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Published on Leave a comment on A Mediterranean Style Diet Feeds Beneficial Gut Bacteria

The incidence of both intestinal bowel diseases (IBD) and colorectal cancer is rapidly increasing in developed countries (e.g., US, Canada, Europe). There are many theories over why this is occurring, with most researchers thinking a person's diet plays a role. A big suspect in promoting IBD and colorectal cancer is the Western diet, which has lots of ultra-processed foods and is also low in fiber.

A recent large study looked at 6 major diets and how they impact the gut microbiome. The six dietary patterns were: Western diet, Mediterranean diet, high-fiber diet, plant-based diet, high protein diet, and ketogenic diet.

And surprise, surprise - eating a Western diet resulted in having an increase in gut bacterial species linked to chronic inflammation, heart disease, colorectal cancer, IBD, and diabetes. The Mediterranean style diet had an increase in bacterial species linked to a lower risk of cardiovascular disease, IBD, and type 2 diabetes. In fact, all 6 diets had distinct bacterial profiles in the gut.

Bottom line: The foods a person eats can either feed and nourish beneficial bacteria or harmful bacteria (linked to cancer and IBD). Best for health is a Mediterranean style diet (lots of fruits, vegetables, whole grains, legumes, seeds, nuts), and avoiding ultra-processed foods. You are what you eat!

From Medical Xpress: Western diets pose greater risk of cancer and inflammatory bowel disease, study finds

Western diets pose a greater risk of inflammatory bowel disease (IBD) and colorectal cancer, according to a milestone review of what people eat around the world. ...continue reading "A Mediterranean Style Diet Feeds Beneficial Gut Bacteria"

Published on Leave a comment on Highly processed food increases risk of cancer
Fast food Credit: Wikipedia

Bad news keeps coming about the highly processed foods we love to eat. So convenient, so addictive (e.g., potato chips, soda!), but so bad for our health. A recent study found more harms from eating highly processed foods (also called ultra-processed foods). They are associated with a higher risk of ovarian cancer and other cancers, and also death from cancer.

Even worse, the more one eats ultra-processed foods daily, the higher the risk of developing and dying from a variety of cancers. The ovarian and brain cancer association was especially strong.

The large study of 197,246 people, conducted in the UK, looked at the association between eating highly processed foods and the risk of developing 34 different types of cancers over a 10 year period. They found that highly processed foods were generally between 9.1% to 41.4% of the foods eaten daily. Highly processed foods averaged 48.6% of the daily calories, and ranged from 28.4% to 68.7% of daily calories.

Chips Credit: Wikipedia

As the researchers point out, the highly processed foods are replacing what should be eaten (fruits, vegetables, whole grains, seeds, nuts, legumes). Thus, diets rich in highly processed foods are generally nutritionally inferior, and are higher in energy, fats, salt, sugars, and lower in fiber and some micronutrients.

Chemicals in highly processed foods and packaging (e.g., acrylamide, endocrine disruptors) are ingested and cause harm to humans. Additionally, additives found in highly processed foods (e.g., emulsifiers) have negative effects on the gut microbiome and gut (intestinal) lining.

Bottom line: Eat fewer highly processed foods. Eat more foods that are unprocessed or minimally processed (fruits, vegetables, legumes, seeds, nuts, whole grains). Read the list of ingredients on labels.

Excerpts from Medical Xpress: Ultra-processed foods may be linked to increased risk of cancer

Higher consumption of ultra-processed foods may be linked to an increased risk of developing and dying from cancer, an Imperial College London-led observational study suggests. ...continue reading "Highly processed food increases risk of cancer"

Published on Leave a comment on Doctors Recommend Mediterranean Style Diet For Health
Fast food Credit: Wikipedia

Say it over and over to yourself: Don't eat highly processed foods, don't eat foods with additives (e.g., emulsifiers, colors), don't eat foods/beverages with high fructose corn syrup, don't eat lots of pre-packaged foods or fast foods.

Why? This kind of high fat, low-fiber Western diet (which most of us eat), is linked to lots of health problems  and also an unhealthy gut microbiome. Cancer, diabetes, heart disease!

Instead, eat a Mediterranean style diet - a diet rich in fruits and vegetables, whole grains, seeds, nuts, whole grains, legumes. Also, lots of olive oil. This is a high fiber diet linked to good health and a healthy gut microbiome.

Research finds harms (e.g., harmful alterations of the gut microbiome or intestinal lining, cancer) from ingredients added to highly processed foods, such as emulsifiers, carrageenan, artificial sweeteners, maltodextrin, carboxymethyl cellulose, polysorbate-80, artificial colors and flavors, high fructose corn syrup, etc. Bottom line: Try to avoid any ingredient that's not normally in your kitchen! Read ingredient lists on labels.

Excerpts from a commentary (transcript of podcast) by Dr. D. Johnson from Medscape: Forget Fad Diets, Here's the One You Need

Hello. I'm Dr David Johnson, professor of medicine and chief of gastroenterology at Eastern Virginia Medical School in Norfolk, Virginia. Welcome back to another GI Common Concerns.

All of us routinely see diet recommendations on the Internet — like TikTok — or in new books. Every possible diet seems to receive this promotional push, although the evidence behind them is often lacking.

So what do we mean when we talk about a "healthy diet"? ...continue reading "Doctors Recommend Mediterranean Style Diet For Health"

Published on Leave a comment on Farts and Good Gut Health

Those who enjoy a little "potty humor" will like the results of a recent nutrition study comparing the results of a Western style diet (high fat, low fiber) to a high fiber Mediterranean diet. The high fiber diet resulted in much larger, softer stools, and an increase in stomach noises and farting. (Yes, they weighed their stools and counted daily farts!) There was no change in the number of stools per day.

In the study 18 healthy men followed both types of diets for two week periods (first one diet, then a break, and then the other diet). The high fiber diet (54.2 grams fiber per day) resulted in numerous beneficial changes, especially nurturing healthy gut bacteria and metabolic improvements. The low fiber Western diet only had an intake of 4.7 g fiber per day. Interestingly, all participants were told to avoid fermented dairy products (e.g. yogurts) during the study.

The high fiber diet resulted in greater numbers of beneficial bacteria in the gut without any major changes in the core microbiome (microbial community). There were also numerous gut microbial metabolic improvements while on this diet. Interestingly, men who already had a more diverse gut microbiota (which is a sign of health) and routinely already ate more fiber rich plants foods, had less farting and stomach noises during the study.

Think of it this way: your diet is what feeds and nurtures the microbes living in your gut. Some microbes are associated with chronic diseases, and some with health - so you want to nurture the health-associated bacteria by eating a diet rich in plant foods (Mediterranean style diet).

By the way, a recent study found that eating fermented foods is a quick way to increase gut microbial diversity and health. It's beneficial to add some fermented foods (e.g. yogurt, kimchi, sauerkraut, kefir) to your regular diet.

From New Scientist: Men fart more when eating a plant-based diet due to good gut bacteria

Plant-based diets cause men to fart more and have larger stools, researchers have found – but that seems to be a good thing, because it means these foods are promoting healthy gut bacteria.  ...continue reading "Farts and Good Gut Health"

Published on Leave a comment on What You Eat Determines The Type Of Bacteria Living In Your Gut

Another study has confirmed that if a person wants to have beneficial gut microbes that are associated with lower rates of chronic inflammation and many health conditions and diseases, then you need to eat a diet that nourishes the beneficial gut microbes. And once again, research finds that it is a plant based diet that does this.

A plant based diet is one rich in fruits, vegetables, whole grains, legumes (beans), nuts, and seeds, thus containing lots of fiber - and these nourish beneficial gut microbes. In this group is also oily fish. This is an anti-inflammatory diet. It feeds short-chain fatty acid (SCFA)-producing microbes (this is good). A great example of plant foods also containing bacteria, as well as nutrients and fiber: one raw apple has about 10 million bacteria!

On the other hand, a diet rich in processed foods and lots of meat (an animal derived diet), is associated with microbes linked to intestinal inflammation - thus an inflammatory diet . Also includes foods with high amounts of sugar and alcohol. This type of diet is low fiber and considered a Western diet.

To arrive at these conclusions, researchers in the Netherlands looked at the gut microbiome of 1425 persons in 4 groups - those with Crohn's disease, ulcerative colitis, irritable bowel syndrome, and the general healthy population. They found 38 associations between dietary patterns and microbial clusters, as well as 61 individual foods and nutrients with 61 bacterial species. They found that specific foods and nutrients were associated with species known to give mucosal protection and have anti-inflammatory effects.

These beneficial bacterial species are NOT found in probiotics or supplements. You must eat the foods on a daily basis. [Another study with similar findings.] Studies show changes will occur very quickly - within two weeks, both in microbes and effects on the intestines.  Think of the saying: You are what you eat. Yes!

From Medical Xpress: Diet rich in animal foods, alcohol and sugar linked to 'inflammatory' gut microbiome

A high dietary intake of animal products, processed foods, alcohol and sugar is linked to a gut microbiome that encourages inflammation, finds research published online in the journal Gut.  ...continue reading "What You Eat Determines The Type Of Bacteria Living In Your Gut"

Published on Leave a comment on Feed Your Gut Microbes With A Mediterranean Diet

Once again a study found that a diet rich in fruits, vegetables, whole grains, seeds, legumes, nuts, fish, and extra virgin olive oil is beneficial to the huge numbers of microbes living in our gut (the gut microbiome). This type of fiber-rich dietary pattern is generally called the Mediterranean diet.

The Mediterranean diet is associated with health in a number of ways: lower frailty in elderly persons, lowered risk of death and a number of diseases, as well as lowered levels of inflammation. Chronic inflammation is linked to cancers and a number of diseases - thus the goal is to keep inflammation levels down.

Researchers found that elderly persons eating a Mediterranean style diet for one year had beneficial effects on their gut microbes (after all, they were feeding the good gut microbes), which in turn resulted in less frailty, better cognitive function (including memory), and lower levels of chronic inflammation. There was an increase in beneficial microbes that are associated with health and lower levels of inflammation.

On the other hand, the group of persons eating their usual Western style diet (low in fiber, high in fats , meats, sugar, highly processed foods) did not show beneficial changes in their gut microbiome. They showed negative changes (deterioration) in the type of gut microbes,  and also higher levels of chronic inflammation. After all, they were feeding the microbes associated with poor health and inflammation.

What was interesting was that they looked at the gut microbial communities of 612 persons (aged 65-79 years) who lived in five different countries (Poland, Netherlands, UK, France and Italy) - both at the start (baseline) and after a year. At baseline they could see that country-specific patterns in dietary habits were also reflected in the microbiome profiles.

And after a year there were similar positive changes in the gut microbes in all of those eating a Mediterranean style diet, especially with an increase in "keystone species" - those that are especially important for gut health, but also linked to better health and better cognitive (mental) functioning.

Some of the beneficial bacteria that increased in the Mediterranean diet group: Faecalibacterium prausnitzii, along with Roseburia (R.hominis), Eubacterium (E. rectale, E. eligens, E. xylanophilum), Bacteroides thetaiotaomicron ,Anaerostipes hadrus, and Prevotella copri. A majority of these species are associated with health benefits [e.g. production of short chain fatty acids (SCFAs) and lower risk of frailty] and with anti-inflammatory properties. They also are associated with a lower risk for diseases such as type 2 diabetes and colorectal cancer. 

In contrast, the control group that ate a normal Western diet (fats, processed foods, low in fiber, high in meat and sugar) had an increase in  Ruminococcus torques, Collinsella aerofaciens, Coprococcus comes, Dorea formicigenerans, Clostridium ramosum, Veillonella dispar, Flavonifractor plautii and Actinomyces lingnae. An increase in the abundances of R. torques, C. aerofaciens, C. ramosum and V. dispar have been associated with type 2 diabetes and colorectal cancer, atherosclerosis, cirrhosis, and inflammatory bowel disease.

A key finding was that the findings suggest that eating a Mediterranean style diet "modulates the microbiome in a direction positively associated with health". In other words, the benefit of the diet was that it fed beneficial gut microbes that improved health.

Note that these beneficial microbes are NOT found in any supplements or probiotics. You must eat the fiber-rich whole foods!

From Medical Xpress: Mediterranean diet promotes gut bacteria linked to 'healthy ageing' in older people  ...continue reading "Feed Your Gut Microbes With A Mediterranean Diet"

Published on Leave a comment on A Person’s Diet And Age-Related Macular Degeneration

Once again a study finds an association between a Western diet (lots of processed meat, red meat, fried food, desserts, low fiber, high in refined grains, sugar sweetened beverages, and high-fat dairy) and a poor health outcome - this time a significantly higher incidence of late-stage age-related macular degeneration (AMD).

Interestingly though, a Western dietary pattern did not seem to be associated with whether a person developed early AMD - only with whether it would progress to late-stage AMD. And late-stage AMD is the one that results in loss of central vision (in the retina), which means a person will then be unable to drive.

This study followed 1278 people over an 18 year period. Those who ate a Western style diet (considered unhealthy) had a 3 times higher rate of late-stage AMD as compared to those who had a "prudent" (healthy) dietary pattern. Out of 1278 persons - 117 developed early AMD and 27 developed late AMD (20 of them progressed from no AMD to late AMD over the 18 years, and 7 progressed from early AMD to late AMD).

What kinds of foods seemed especially protective? The researchers said that eating the following  foods appeared protective: cruciferous (e.g. broccoli), foods high in carotene (e.g. carrots), dark green leafy and other vegetables, poultry, fresh fruits, legumes, fish and sea foods - what they called part of a "prudent" diet, but can also be thought of as a Mediterranean dietary pattern.

One thing I question is whether "high fat dairy" (which they said was margarine & butter) should have lumped together margarine and butter. After all, margarine is a concoction made with trans fats and linked to health problems, while butter (made from milk/cream) is very different.

From Science Daily: Poor diet linked to age-related macular degeneration  ...continue reading "A Person’s Diet And Age-Related Macular Degeneration"

Published on Leave a comment on Blood Pressure Doesn’t Always Increase With Age

In the US and other developed countries it is generally accepted that blood pressure increases with age -  that a blood pressure rise starts in childhood and that it's a normal part of aging. However, a new study found that this is not true - a South American rainforest tribe (the Yanomami) who do not eat a western diet (at all!) and have an active lifestyle, have the exact same blood pressure throughout life. This was true for all the individuals studied - from age 1 to 60. A nearby village of the Yekwana tribe have some western influences on lifestyle and diet, had the same low blood pressure in childhood, but showed increases with age.

The researchers feel that a Western diet and lifestyle play a role in the blood pressure increasing over the life span. They are now looking at the gut microbes of the two tribes to see what role they have in these blood pressure differences. Bottom line: get off your butt  and get active, and eat a high fiber, whole food diet (to feed the beneficial microbes) -  and avoid highly processed foods if you can. Easier said than done. From Science Daily:

Study of two tribes sheds light on role of Western-influenced diet in blood pressure

...continue reading "Blood Pressure Doesn’t Always Increase With Age"

Published on Leave a comment on Diet, Gut Microbes, and Colon Cancer

There have been many posts on this blog about diet, fiber, microbes, and the association of diet with various diseases, such as cancer. A recent journal article by M. Song and A. Chan reviewed studies that looked at the link between diet, gut microbes (the gut microbiota or gut microbiome), and colorectal cancer (what we typically call colon cancer).

In summary, research from the last 20 years has found that diet and colorectal cancer (CRC) go hand in hand, and that diet determines the microbes (microbiota) living in the gut - that is, what you feed the microbes determines what microbes will live and thrive in the gut. Also, certain microbes in the gut are linked to inflammation and cancer formation, and others to its prevention. In other words, there is potential to prevent colorectal cancer with certain diets, and to increase the odds of colorectal cancer with other diets.

What are main dietary factors linked to colorectal cancer? Western diet (lots of processed foods, red and processed meat, low in fiber, refined grains), low levels of dietary fiber, low intake of omega-3 fatty acids from seafood (or fish oil), and obesity. The researchers point out that a Western diet is associated with gut dysbiosis (microbial imbalance), loss of gut barrier integrity, and increased levels of inflammation.

What should one do? Basically think to yourself: "I need to feed the beneficial microbes in my gut, so I need to eat lots of fruits, vegetables, whole grains, and seafood (omega-3 fatty acids)" - this is what the researchers call a "prudent pattern diet". And try to maintain a normal weight.

Some excerpts from Current Colorectal Cancer Reports: Diet, Gut Microbiota, and Colorectal Cancer Prevention: a Review of Potential Mechanisms and Promising Targets for Future Research

Abstract: Diet plays an important role in the development of colorectal cancer. Emerging data have implicated the gut microbiota in colorectal cancer. Diet is a major determinant for the gut microbial structure and function. Therefore, it has been hypothesized that alterations in gut microbes and their metabolites may contribute to the influence of diet on the development of colorectal cancer.We review several major dietary factors that have been linked to gut microbiota and colorectal cancer, including major dietary patterns, fiber, red meat and sulfur, and obesity. 

Colorectal cancer (CRC) is the third most commonly diagnosed cancer and the fourth leading cause of cancer death in the world. Over the past few decades, numerous epidemiologic studies have identified a range of dietary factors that may potentially promote or prevent CRC. Likewise, increasing evidence has implicated the gut microbiota in CRC development. Biological plausibility is supported by habitation of numerous gut microbes in the large intestine and the functional importance of the gut microbiota in maintenance of the gut barrier integrity and immune homeostasis, the disruptions of which are among the most important mechanisms in colorectal carcinogenesis. Given the critical role of diet in the configurations of gut microbial communities and production of bacterial metabolites, it has been proposed that diet may influence CRC risk through modulation of the gut microbial composition and metabolism that in turn shape the immune response during tumor development.

Although gut bacterial abundance may respond rapidly to extreme changes in diet, predominant microbial community membership is primarily determined by long-term diet, and substantial inter-individual variation persists despite short-term dietary change. .... Thus, this review focuses on the dietary factors that have strong mechanistic support, including dietary pattern, fiber, red meat and sulfur, and omega-3 fatty acid. Given the close link between diet and obesity and the predominant role of obesity in CRC as well as the substantial data linking the gut microbiome to obesity, we also include obesity at the end of the review.

DIETARY PATTERNS: Convincing data indicate that a “Western dietary pattern,” characterized by high intake of red or processed meat, sweets, and refined grains, is associated with higher risk of colorectal neoplasia; in contrast, diets that are rich in fruits, vegetables, and whole grains (“prudent pattern diet”) are associated with lower risk of CRC. Western diets are associated with gut dysbiosis (microbial imbalance), loss of gut barrier integrity, increased levels of inflammatory proteins, and dysregulated immune signatures.

A potential role of the gut microbiota in mediating the dietary associations with CRC risk is suggested by the dramatic difference of the gut microbial structures between populations consuming different diets. Rural Africans, whose diet is high in fiber and low in fat, have a strikingly different gut microbial composition than urban Europeans or African Americans consuming a Western diet, which parallels the lower CRC rates in Africa than Western countries. For example, the African gut microbiota is characterized by a predominance of Prevotella genus that are involved in starch, hemicellulose, and xylan degradation, whereas the American microbiota is predominated by Bacteroides genus with a higher abundance of potentially pathogenic proteobacteria, such as Escherichia and Acinetobacter. .... 

Moreover, a crossover study indicates that switching African Americans to a high-fiber, low-fat diet for 2 weeks increases production of SCFAs, suppresses secondary bile acid synthesis, and reduces colonic mucosal inflammation and proliferation biomarkers of cancer risk.

Fiber: Numerous prospective studies have linked higher fiber intake to lower risk of CRC. The most recent expert report from the World Cancer Research Fund and the American Institute for Cancer Research in 2011 concludes that evidence that consumption of foods containing dietary fiber protects against CRC is convincing. Besides systemic benefits for insulin sensitivity and metabolic regulation, which have been implicated in colorectal carcinogenesis, fiber possesses gut-specific activities, such as diluting fecal content, decreasing transit time, and increasing stool weight, thereby minimizing exposure to intestinal carcinogens.

Moreover, soluble fiber can be fermented by bacteria in the lumen of the colon into SCFAs [short-chain fatty acids], including butyrate, acetate,and propionate. Higher fiber intake has been shown to enrich butyrate-producing bacteria in the gut, such as Clostridium, Anaerostipes, Eubacterium, and Roseburia species, and increase production of SCFAs. SCFAs have been suggested as the key metabolites linking the gut microbes to various health conditions, especially CRC. 

Red Meat and Sulfur: There is convincing evidence that red and processed meats are associated with increased risk of CRC. Recently, the Int. Agency for Research on Cancer has classified processed meat as a carcinogen to humans. Mechanisms underlying the pro-cancer effects of red or processed meats include heme iron, N-nitroso compounds, or heterocyclic amines, and hydrogen sulfide production. Hydrogen sulfide has been implicated in inflammatory disorders associated with risk of CRC, such as ulcerative colitis, and directly with CRC.

Omega-3 Fatty Acid: Marine omega-3 polyunsaturated fatty acid, including eicosapentaenoic acid, docosahexaenoic acid, and docosapentaenoic acid, possesses potent anti-inflammatory activity and may protect against CRC. Fish oil, a rich source of omega-3 fatty acid, is the most popular natural product used by US adults. Substantial data support the beneficial effect of omega-3 fatty acid on CRC prevention and treatment.

Dietary fat composition is a major driver of the gut microbial community structure. Compared to other types of fat, omega-3 fatty acid have been associated with higher intestinal microbiota diversity and omega-3 fatty acid-rich diet ameliorates the gut dysbiosis induced by omega-6 polyunsaturated fatty acid or antibiotics.

Obesity: Since the 1970–1980s, the prevalence of obesity has markedly increased worldwide. The obesity epidemic is believed to be largely driven by global westernization characterized by overconsumption of easily accessible and energy-dense food and a sedentary lifestyle. Obesity is an established risk factor for CRC and several other cancers. Possible mechanisms include increased insulin levels and bioavailability of insulin-like growth factor 1, altered secretion of adipokines and inflammatory cytokines, and changes in sex hormone levels.

Published on Leave a comment on Could Changing Your Diet Prevent Gout?

Gout is something that is not discussed that much, but it has been increasing in recent years and now afflicts about  3.9% of adults in the US. Gout is a form of inflammatory arthritis, characterized by recurrent attacks of pain, tenderness, and swelling of a joint, frequently the joint of the big toe. It is caused by elevated levels of uric acid in the blood (known as hyperuricaemia).

Gout occurs more commonly in men ages 40 and older, who eat a lot of meat and seafood, drink a lot of alcohol (especially beer) or sweetened drinks, have high blood pressure, metabolic syndrome, or are overweight.  Gout used to be known as "the disease of kings" or "rich man's disease". [On the other hand, past research has shown that consumption of coffee, cherries, vitamin C foods, and dairy products, losing weight and physical fitness seems to decrease the risk.]

Recent research showed that the DASH diet reduces blood pressure and reduces uric acid in the blood, which is why a research team (study in The BMJ) now looked at  whether it lowers the risk of gout. The Dietary Approaches to Stop Hypertension or DASH diet is high in fruit, vegetables, whole grains, legumes, nuts, and low-fat dairy, and low in red and processed meats, salt, and sugary drinks. On the other hand, the typical Western diet has higher intakes of red and processed meats, sweetened beverages, sweets, desserts, French fries, and refined grains. The researchers analysed data on a total of 44,444 male health professionals, who had no history of gout at the start of the study. During the 26 years of the observational study, they documented 1731 cases of gout.

The researchers found that eating a more DASH type diet - a diet rich in fruits, vegetables, legumes, nuts, whole grains, and low in salt, sugary drinks, and red and processed meats, is associated with a lower risk of gout. On the other hand, a more 'Western' diet is associated with a higher risk of gout. They found that the effects are dose dependent - the more DASH-type diet, the lower the risk of gout. Bottom line: Once again, eating lots of fruits, vegetables, nuts, legumes, and whole grains is linked to health benefits. From Science Daily:

Diet rich in fruit, vegetables and whole grains may lower risk of gout

A diet rich in fruit and vegetables, nuts and whole grains and low in salt, sugary drinks, and red and processed meats, is associated with a lower risk of gout, whereas a typical 'Western' diet is associated with a higher risk of gout, finds a study published by The BMJ.

Gout is a joint disease which causes extreme pain and swelling. It is most common in men aged 40 and older and is caused by excess uric acid in the blood (known as hyperuricaemia) which leads to uric acid crystals collecting around the joints. The Dietary Approaches to Stop Hypertension (DASH) diet reduces blood pressure and is recommended to prevent heart disease. It has also been found to lower uric acid levels in the blood. Therefore, the DASH diet may lower the risk of gout.

To investigate this further, a team of US and Canada based researchers examined the relationship between the DASH and Western dietary patterns and the risk of gout. They analysed data on over 44,000 men aged 40 to 75 years with no history of gout who completed detailed food questionnaires in 1986 that was updated every four years through to 2012.

Each participant was assigned a DASH score (reflecting high intake of fruits, vegetables, nuts and legumes, such as peas, beans and lentils, low-fat dairy products and whole grains, and low intake of salt, sweetened beverages, and red and processed meats) and a Western pattern score (reflecting higher intake of red and processed meats, French fries, refined grains, sweets and desserts). During 26 years of follow-up, a higher DASH score was associated with a lower risk for gout, while a higher Western pattern was associated with an increased risk for gout.

 Gout. Credit: NHS in the UK