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Gout is often thought of as a disease of the joints, usually associated with a suddenly swollen, intensely painful big toe.
But gout is more than a painful joint.
It is an inflammatory disease driven by the buildup of uric acid crystals, and it often occurs alongside conditions such as hypertension, kidney disease, obesity, and cardiovascular disease.
A new study published in The Journal of Nutrition asked an interesting question: Could an overall healthy dietary pattern also lower the risk of developing gout?
The researchers looked specifically at the EAT-Lancet diet, a dietary pattern designed to support both human health and environmental sustainability.
What Is Gout?
Uric acid is a normal part of human metabolism. It is produced when the body breaks down purines, compounds that are essential building blocks of DNA and RNA.
Purines come from two main sources: our own cells, as they naturally turn over and break down, and the foods we eat. Meat and seafood contain cells and therefore are rich in purines.
Normally, the kidneys remove uric acid through the urine. But when uric acid builds up in the blood, it can form sharp monosodium urate crystals that deposit in joints. The immune system recognizes these crystals as a threat, triggering a powerful inflammatory response.
The result can be a gout flare: sudden pain, swelling, redness, and tenderness, sometimes developing within hours.
But the inflammation doesn't necessarily stop at the joint.
What process leads to gout?
Gout and Your Blood Vessels
Gout and cardiovascular disease frequently occur together, and people with gout have an increased risk of cardiovascular disease. One possible connection is chronic inflammation.
Urate and gout-related inflammation can impair vascular function by increasing oxidative stress, reducing nitric oxide availability, and contributing to endothelial dysfunction. Researchers are also investigating a potential link to angiogenesis, the growth of new blood vessels. Urate crystals activate inflammatory pathways that release cytokines such as IL-1β and TNF, which can increase VEGF, a key driver of angiogenesis. Small studies have found higher VEGF levels in people with gout, while gouty joints and tophi can show new vessel growth.
This may be relevant to cardiovascular disease because fragile blood vessels that form within atherosclerotic plaques can contribute to plaque instability. However, the link between gout, VEGF, and angiogenesis remains preliminary, with much of the evidence coming from small or preclinical studies.
→ It is also unclear how much of gout’s cardiovascular risk is directly attributable to uric acid versus shared risk factors such as obesity, hypertension, kidney disease, and metabolic dysfunction.
What Does the EAT-Lancet Diet Have to Do With Gout?
If you've heard of a “gout diet,” you may already know the basic advice: limit foods particularly high in purines, especially organ meats and certain seafood, and reduce alcohol and sugar-sweetened beverages. The goal is to reduce factors that can contribute to elevated uric acid and gout flares.
The EAT-Lancet diet, also called the Planetary Health Diet, shares several of these principles. It emphasizes:
🥬 Vegetables and fruits
🌾 Whole grains and starchy vegetables
🫘 Legumes and nuts
🐟 Limited amounts of animal protein
while limiting red meat, added sugars, and saturated fat.
What Did the Study Find?
Researchers analyzed dietary, genetic, and metabolic data from 91,479 UK Biobank participants who did not have gout at the beginning of the study.
Over a median follow-up of 11.6 years, 1,444 participants developed gout.
Participants with the highest adherence to the EAT-Lancet diet had a 26% lower risk of developing gout compared with those with the lowest adherence after adjusting for demographic, lifestyle, and health factors. The researchers also identified a 67-metabolite signature associated with the diet. Participants with the most favorable metabolic signature had an even lower risk of gout.
Interestingly, this metabolic profile appeared to partially offset genetic susceptibility. Even among people with a high genetic risk for gout, having a more favorable metabolic profile was associated with substantially lower risk.
The takeaway
This study doesn't show that the EAT-Lancet diet prevents gout, but it adds to evidence that a diet rich in plants, whole grains, fiber, and unsaturated fats may support metabolic health in ways that extend beyond blood glucose and cholesterol, potentially influencing inflammatory diseases such as gout.
Your joints, blood vessels, and metabolism may have more in common than you think.
Best wishes,
- The Angiogenesis Foundation
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