Food Sources of Protein and Risk of Incident Gout in the Singapore Chinese Health Study

Arthritis Rheumatol. 2015 Jul;67(7):1933-42. doi: 10.1002/art.39115.


Objective: Prospective studies evaluating diet in relation to the risk of gout in Asian populations are lacking. The purpose of this study was to examine the relationship between the consumption of dietary protein from each of its major sources and the risk of gout in a Chinese population.

Methods: We used data from the Singapore Chinese Health Study, a prospective cohort of 63,257 Chinese adults who were 45-74 years old at recruitment during the years 1993-1998. Habitual diet information was collected via a validated semiquantitative food frequency questionnaire, and physician-diagnosed gout was self-reported during 2 followup interviews up to the year 2010. Cox proportional hazards models were used to calculate the hazard ratios (HRs) and 95% confidence intervals (95% CIs), with adjustment for potential confounders, among 51,114 eligible study participants who were free of gout at baseline and responded to our followup interviews.

Results: A total of 2,167 participants reported physician-diagnosed gout during the followup period. The multivariate-adjusted HRs (with 95% CIs) of gout, comparing the first quartile with the fourth quartile, were as follows: 1.27 (1.12-1.44; P for trend < 0.001) for total protein, 1.27 (1.11-1.45; P for trend < 0.001) for poultry, 1.16 (1.02-1.32; P for trend = 0.006) for fish and shellfish, 0.86 (0.75-0.98; P for trend = 0.018) for soy food, and 0.83 (0.73-0.95; P for trend = 0.012) for nonsoy legumes. No statistically significant associations were found with protein intake from other sources (red meat, eggs, dairy products, grains, or nuts and seeds).

Conclusion: In this Chinese population living in Singapore, higher total dietary protein intake from mainly poultry and fish/shellfish was associated with an increased risk of gout, while dietary intake of soy and nonsoy legumes was associated with a reduced risk of gout.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Aged, 80 and over
  • Asian People*
  • Cohort Studies
  • Dietary Proteins / adverse effects*
  • Fabaceae / adverse effects
  • Female
  • Fish Products / adverse effects*
  • Follow-Up Studies
  • Gout / epidemiology*
  • Gout / ethnology*
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Poultry Products / adverse effects*
  • Proportional Hazards Models
  • Prospective Studies
  • Retrospective Studies
  • Risk Factors
  • Singapore / epidemiology
  • Soybean Proteins / adverse effects
  • Surveys and Questionnaires


  • Dietary Proteins
  • Soybean Proteins