We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
A Randomized Pilot Study of DASH Patterned Groceries on Serum Urate in Individuals with Gout.
- Authors
Juraschek, Stephen P.; Miller III, Edgar R.; Wu, Beiwen; White, Karen; Charleston, Jeanne; Gelber, Allan C.; Rai, Sharan K.; Carson, Kathryn A.; Appel, Lawrence J.; Choi, Hyon K.; Fantin, Francesco
- 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.
- Subjects
PILOT projects; FOOD habits; VEGETABLES; CONFIDENCE intervals; SODIUM; SELF-evaluation; POTASSIUM; RANDOMIZED controlled trials; DASH diet; SHOPPING; FRUIT; DESCRIPTIVE statistics; URIC acid; CROSSOVER trials; PATIENT compliance; URINALYSIS; GOUT
- Publication
Nutrients, 2021, Vol 13, Issue 2, p538
- ISSN
2072-6643
- Publication type
Article
- DOI
10.3390/nu13020538