High blood plasma omega-3 fatty acid levels may be protective against gout

A new case-control study of a cohort of middle-aged/elderly men has revealed for the first time that the severity and frequency of gout attacks is related to blood plasma omega-3 levels. The results suggest omega-3 fatty acid interventions could be useful in the prevention and treatment of gout.

Gout is an extremely painful condition caused by a deposition of monosodium urate crystals in the joints, often in the big toe, causing serious inflammation and swelling which can effectively immobilize the patient. The symptoms occur quickly (over a few hours) and then persist for around three to ten days. The condition is recurrent and attacks become more frequent if the condition is not treated. Mild cases can normally be treated by diet modification, but more severe cases require pharmaceutical intervention (e.g., treatment with allopurinol) to prevent serious damage in the longer term to the kidneys and cartilaginous tissues. Treatment aims to maintain the plasma uric acid levels below 300 μmol/L (2).

Gout is classically regarded as afflicting those who eat and drink to excess and is particularly prevalent in overweight and obese individuals. However, it has long been known that purine-rich foods and beverages (such as red meats, fortified wines and dark beers) raise uric acid levels. More recent studies have implicated dietary fructose as an important factor in the development of gout (3), with increased fruit juice consumption giving cause for concern for those individuals at risk.

Many of the metabolic pathways that cause the inflammation due to monosodium urate crystal formation are those that can be down-regulated by the action of marine omega-3 fatty acids, e.g., toll-like receptor activation, neutrophil chemotaxis and prostaglandin synthesis. A new case control (1) study was carried out on a cohort of men (n=112) of an average age of ca. 60 years and who were diagnosed as suffering from gout. Blood serumomega-3 levels were measured and a detailed history of gout attacks over the past 12 months taken. There was a clear, significant association between high omega-3 fatty acid levels and infrequent attacks of gout. Those individuals with the lowest omega-3 levels had over twice as many attacks as those with the highest levels. This novel finding suggests that omega-3 fatty acid supplementation could be used to prevent acute attacks of gout, though controlled intervention trials are required to substantiate this.

1. Abhishek A, Valdes AM & Doherty M (2015); “Low omega-3 fatty acid levels associate with frequent gout attacks: a case control study”; Annals of the Rheumatic Diseases, published online 29th December 2015. doi.org/10.1136/annrheumdis-2015-208767
2. Jordan KM, Stewart Cameron J, Snaith M, Zhang WD, Pherty M, Seck J et al; British Society for Rheumatology and British Health Professional guideline for the management of gout, 2007. www.rheumatology.org/uk/guidelines/guidelines_other/goutguide
3. Underwood M; “Sugary drinks, fruit and increased risk of gout” – editorial; BMJ 2008; 336:285-6