A Randomized Pilot Study of DASH Patterned Groceries on Serum Urate in Individuals with Gout.
Nutrients
; 13(2)2021 Feb 07.
Article
en En
| MEDLINE
| ID: mdl-33562216
ABSTRACT
The Dietary Approaches to Stop Hypertension (DASH) diet reduces serum urate (SU); however, the impact of the DASH diet has not been previously evaluated among patients with gout. We conducted a randomized, controlled, crossover pilot study to test the effects of ~$105/week ($15/day) of dietitian-directed groceries (DDG), patterned after the DASH diet, on SU, compared with self-directed grocery shopping (SDG). Participants had gout and were not taking urate lowering therapy. Each intervention period lasted 4 weeks; crossover occurred without a washout period. The primary endpoint was SU. Compliance was assessed by end-of-period fasting spot urine potassium and sodium measurements and self-reported consumption of daily servings of fruit and vegetables. We randomized 43 participants (19% women, 49% black, mean age 59 years) with 100% follow-up. Mean baseline SU was 8.1 mg/dL (SD, 0.8). During Period 1, DDG lowered SU by 0.55 mg/dL (95% CI 0.07, 1.04) compared to SDG by 0.0 mg/dL (95% CI -0.44, 0.44). However, after crossover (Period 2), the SU difference between groups was the opposite SDG reduced SU by -0.48 mg/dL (95% CI -0.98, 0.01) compared to DDG by -0.05 mg/dL (95% CI -0.48, 0.38; P for interaction by period = 0.11). Nevertheless, DDG improved self-reported intake of fruit and vegetables (3.1 servings/day; 95% CI 1.5, 4.8) and significantly reduced total spot urine sodium excretion by 22 percentage points (95% CI -34.0, -8.6). Though relatively small in scale, this pilot study suggests that dietitian-directed, DASH-patterned groceries may lower SU among gout patients not on urate-lowering drugs. However, behavior intervention crossover trials without a washout period are likely vulnerable to strong carryover effects. Definitive evaluation of the DASH diet as a treatment for gout will require a controlled feeding trial, ideally with a parallel-design.
Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Ácido Úrico
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Proyectos Piloto
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Enfoques Dietéticos para Detener la Hipertensión
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Gota
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Hipertensión
Tipo de estudio:
Clinical_trials
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Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Nutrients
Año:
2021
Tipo del documento:
Article
País de afiliación:
Estados Unidos