Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2015

Open Access 01-12-2015 | Research article

Positive association of tomato consumption with serum urate: support for tomato consumption as an anecdotal trigger of gout flares

Authors: Tanya J Flynn, Murray Cadzow, Nicola Dalbeth, Peter B Jones, Lisa K Stamp, Jennie Harré Hindmarsh, Alwyn S Todd, Robert J Walker, Ruth Topless, Tony R Merriman

Published in: BMC Musculoskeletal Disorders | Issue 1/2015

Login to get access

Abstract

Background

Gout is a consequence of an innate immune reaction to monosodium urate crystals deposited in joints. Acute gout attacks can be triggered by dietary factors that are themselves associated with serum urate levels. Tomato consumption is an anecdotal trigger of gout flares. This study aimed to measure the frequency of tomato consumption as a self-reported trigger of gout attacks in a large New Zealand sample set, and to test the hypothesis that tomato consumption is associated with serum urate levels.

Methods

Two thousand fifty one New Zealanders (of Māori, Pacific Island, European or other ancestry) with clinically-ascertained gout were asked about gout trigger foods. European individuals from the Atherosclerosis Risk In Communities (ARIC; n = 7517) Study, Cardiovascular Health Study (CHS; n = 2151) and Framingham Heart Study (FHS; n = 3052) were used to test, in multivariate-adjusted analyses, for association between serum urate and tomato intake.

Results

Seventy one percent of people with gout reported having ≥1 gout trigger food. Of these 20 % specifically mentioned tomatoes, the 4th most commonly reported trigger food. There was association between tomato intake and serum urate levels in the ARIC, CHS and FHS combined cohort (β = 0.66 μmolL−1 increase in serum urate per additional serve per week; P = 0.006) - evident in both sexes (men: β = 0.84 μmolL−1, P = 0.035; women: β = 0.59 μmolL −1, P = 0.041).

Conclusions

While our descriptive and observational data are unable to support the claim that tomato consumption is a trigger of gout attacks, the positive association between tomato consumption and serum urate levels suggests that the self-reporting of tomatoes as a dietary trigger by people with gout has a biological basis.
Appendix
Available only for authorised users
Literature
1.
Campion EW, Glynn RJ, DeLabry LO. Asymptomatic hyperuricemia. Risks and consequences in the Normative Aging Study. Am J Med. 1987;82:421–6.CrossRefPubMed
2.
Robinson PC, Horsburgh S. Gout: Joints and beyond, epidemiology, clinical features, treatment and co-morbidities. Maturitas. 2014;78:245–51.CrossRefPubMed
3.
Martinon F, Petrilli V, Mayor A, Tardivel A, Tschopp J. Gout-associated uric acid crystals activate the NALP3 inflammasome. Nature. 2006;440:237–41.CrossRefPubMed
4.
Phipps-Green A, Merriman M, Topless R, Altaf S, Montgomery GW, Franklin C, Jones GT, van Rij AM, White D, Stamp LK, Dalbeth N, Merriman TR: Twenty-eight loci that influence serum urate levels: analysis of association with gout. Ann Rheum Dis 2014, Sep 3. pii: annrheumdis-2014-205877. doi: 10.​1136/​annrheumdis-2014-205877. (Epub ahead of print)
5.
Köttgen A, Albrecht E, Teumer A, Vitart V, Krumsiek J, Hundertmark C, et al. Genome-wide association analyses identify 18 new loci associated with serum urate concentrations. Nat Genet. 2013;45:145–54.CrossRefPubMed
6.
Merriman TR, Choi HK, Dalbeth N. The genetic basis of gout. Rheum Dis Clin North Am. 2014;40:279–90.CrossRefPubMed
7.
Merriman TR. Population heterogeneity in the genetic control of serum urate. Semin Nephrol. 2011;31:420–5.CrossRefPubMed
8.
Urano W, Taniguchi A, Inoue E, Sekita C, Ichikawa N, Koseki Y, et al. Effect of genetic polymorphisms on development of gout. J Rheumatol. 2013;40:1374–8.CrossRefPubMed
9.
Batt C, Phipps-Green A, Black MA, Cadzow M, Merriman ME, Topless R, et al. Sugar-sweetened beverage consumption: a risk factor for prevalent gout that interacts with SLC2A9 genotype-specific effects on serum urate and risk of gout. Ann Rheum Dis. 2014;73:2101–6.CrossRefPubMed
10.
Choi HK, Atkinson K, Karlson EW, Willett W, Curhan G. Alcohol intake and risk of incident gout in men: a prospective study. Lancet. 2004;363:1277–81.CrossRefPubMed
11.
Choi HK, Atkinson K, Karlson EW, Willett W, Curhan G. Purine-rich foods, dairy and protein intake, and the risk of gout in men. N Engl J Med. 2004;350:1093–103.CrossRefPubMed
12.
Choi HK, Liu S, Curhan G. Intake of purine-rich foods, protein, and dairy products and relationship to serum levels of uric acid: The Third National Health and Nutrition Examination Survey. Arthritis Rheum. 2005;52:283–9.CrossRefPubMed
13.
14.
Hak AE, Choi H. Menopause, postmenopausal hormone use and serum uric acid levels in US women - The Third National Health and Nutrition Examination Survey. Arthritis Res Ther. 2008;10:R116.CrossRefPubMedPubMedCentral
15.
Rasheed H, Phipps-Green A, Topless R, Hollis-Moffatt JE, Hindmarsh JH, Franklin C, et al. Association of the lipoprotein receptor-related protein 2 gene with gout and non-additive interaction with alcohol consumption. Arthritis Res Ther. 2013;15:R177.CrossRefPubMedPubMedCentral
16.
17.
Choi HK, Curhan G. Coffee, tea, and caffeine consumption and serum uric acid level: the third national health and nutrition examination survey. Arthritis Rheum. 2007;57:816–21.CrossRefPubMed
18.
19.
Choi HK, Willett W, Curhan G. Coffee consumption and risk of incident gout in men: a prospective study. Arthritis Rheum. 2007;56:2049–55.CrossRefPubMed
20.
Huang HY, Appel LJ, Choi MJ, Gelber AC, Charleston J, Norkus EP, et al. The effects of vitamin C supplementation on serum concentrations of uric acid: results of a randomized controlled trial. Arthritis Rheum. 2005;52:1843–7.CrossRefPubMed
21.
22.
Dalbeth N, Petrie KJ, House M, Chong J, Leung W, Chegudi R, et al. Illness perceptions in patients with gout and the relationship with progression of musculoskeletal disability. Arthritis Care Res. 2011;63:1605–12.CrossRef
23.
24.
Zhang Y, Woods R, Chaisson CE, Neogi T, Niu J, McAlindon TE, et al. Alcohol consumption as a trigger of recurrent gout attacks. Am J Med. 2006;119:e13–18.CrossRefPubMed
25.
Choi HK, Curhan G. Beer, liquor, and wine consumption and serum uric acid level: The Third National Health and Nutrition Examination Survey. Arthritis Care Res. 2004;51:1023–9.CrossRef
26.
Shulten P, Thomas J, Miller M, Smith M, Ahern M. The role of diet in the management of gout: a comparison of knowledge and attitudes to current evidence. J Hum Nutr Diet. 2009;22:3–11.CrossRefPubMed
27.
Winnard D, Wright C, Taylor WJ, Jackson G, Te Karu L, Arroll B, et al. National prevalence of gout derived from administrative health data in Aotearoa New Zealand. Rheumatology (Oxford). 2012;51:901–9.CrossRef
28.
29.
Flynn T, Phipps-Green A, Hollis-Moffatt JE, Merriman ME, Topless R, Montgomery GW, et al. Association analysis of the SLC22A11 (organic anion transporter 4) and SLC22A12 (urate transporter 1) urate transporter locus with gout in New Zealand case–control sample sets reveals multiple ancestral-specific effects. Arthritis Res Ther. 2013;15:R220.CrossRefPubMedPubMedCentral
30.
Wallace SL, Robinson H, Masi AT, Decker JL, McCarty DJ, Yu TF. Preliminary criteria for the classification of the acute arthritis of primary gout. Arthritis Rheum. 1977;20:895–900.CrossRefPubMed
31.
Investigators ARIC. The Atherosclerosis Risk in Communities (ARIC) Study: design and objectives. Am J Epidemiol. 1989;129:687–702.CrossRef
32.
Cushman M, Cornell ES, Howard PR, Bovill EG, Tracy RP. Laboratory methods and quality assurance in the Cardiovascular Health Study. Clin Chem. 1995;41:264–70.PubMed
33.
Crowley LV. Determination of uric acid an automated analysis based on a carbonate method. Clin Chem. 1964;10:838–44.PubMed
34.
Kumanyika S, Tell GS, Fried L, Martel JK, Chinchilli VM. Picture-sort method for administering a food frequency questionnaire to older adults. J Am Diet Assoc. 1996;96:137–44.CrossRefPubMed
35.
Rimm EB, Giovannucci EL, Stampfer MJ, Colditz GA, Litin LB, Willett WC. Reproducibility and validity of an expanded self-administered semiquantitative food frequency questionnaire among male health professionals. Am J Epidemiol. 1992;135:1114–26.PubMed
36.
Willett WC, Sampson L, Stampfer MJ, Rosner B, Bain C, Witschi J, et al. Reproducibility and validity of a semiquantitative food frequency questionnaire. Am J Epidemiol. 1985;122:51–65.PubMed
37.
Stevens J, Metcalf PA, Dennis BH, Tell GS, Shimakawa T, Folsom AR. Reliability of a food frequency questionnaire by ethnicity, gender, age and education. Nutr Res. 1996;16:735–45.CrossRef
38.
Buckley H. Epidemiology of Gout: Perspectives from the Past. Curr Rheum Rev. 2011;7:106–13.CrossRef
39.
Gosling AL, Matisoo-Smith E, Merriman TR. Gout in Māori: Modern affliction or ancestral trait? Rheumatology (Oxford). 2014;53:773–4.CrossRef
40.
Abete I, Perez-Cornago A, Navas-Carretero S, Bondia-Pons I, Zulet MA, Martinez JA. A regular lycopene enriched tomato sauce consumption influences antioxidant status of healthy young subjects: A crossover study. J Func Foods. 2013;5:28–35.CrossRef
41.
Engelhard YN, Gazer B, Paran E. Natural antioxidants from tomato extract reduce blood pressure in patients with grade-1 hypertension: A double-blind, placebo-controlled pilot study. Am Heart J. 2006;151:100.CrossRefPubMed
42.
Jacob K, Periago MJ, Bohm V, Berruezo GR. Influence of lycopene and vitamin C from tomato juice on biomarkers of oxidative stress and inflammation. Br J Nutr. 2008;99:137–46.CrossRefPubMed
43.
Lee C-YJ, Isaac HB, Huang SH, Long LH, Wang H, Gruber J, et al. Limited antioxidant effect after consumption of a single dose of tomato sauce by young males, despite a rise in plasma lycopene. Free Radic Res. 2009;43:622–8.CrossRefPubMed
44.
Todd AS, Macginley RJ, Schollum JB, Johnson RJ, Williams SM, Sutherland WH, et al. Dietary salt loading impairs arterial vascular reactivity. Am J Clin Nutr. 2010;91:557–64.CrossRefPubMed
45.
Todd AS, Macginley RJ, Schollum JB, Williams SM, Sutherland WH, Mann JI, et al. Dietary sodium loading in normotensive healthy volunteers does not increase arterial vascular reactivity or blood pressure. Nephrology. 2012;17:249–56.CrossRefPubMed
46.
Vinha AF, Barreira SV, Costa AS, Alves RC, Oliveira MB. Pre-meal tomato (Lycopersicon esculentum) intake can have anti-obesity effects in young women? Int J Food Sci Nutr. 2014;65:1019–26.CrossRefPubMed
47.
Wang L, Sweet DH. Potential for food-drug interactions by dietary phenolic acids on human organic anion transporters 1 (SLC22A6), 3 (SLC22A8), and 4 (SLC22A11). Biochem Pharmacol. 2012;84:1088–95.CrossRefPubMed
48.
49.
Mattila P, Kumpulainen J. Determination of free and total phenolic acids in plant-derived foods by HPLC with diode-array detection. J Ag Food Chem. 2002;50:3660–7.CrossRef
50.
Johnson RJ, Nakagawa T, Sanchez-Lozada LG, Lanaspa MA, Tamura Y, Tanabe K, et al. Umami: the taste that drives purine intake. J Rheumatol. 2013;40:1794–6.CrossRefPubMed
51.
Raivio KO, Seegmiller JE. Role of glutamine in purine synthesis and in guanine nucleotide formation in normal fibroblasts and in fibroblasts deficient in hypoxanthine phosphoribosyltransferase activity. Biochim Biophysic Acta. 1973;299:283–92.CrossRef
52.
McCarty JDJ. Mechanisms of the crystal deposition diseases - gout and pseudogout. Ann Intern Med. 1973;78:767–71.CrossRefPubMed
53.
Erwin CL, Nancollas GH. The crystallization and dissolution of sodium urate. J Crystal Growth. 1981;53:215–23.CrossRef
54.
Joosten LA, Netea MG, Mylona E, Koenders MI, Malireddi RK, Oosting M, et al. Engagement of fatty acids with toll-like receptor 2 drives interleukin-1β production via the ASC/caspase 1 pathway in monosodium urate monohydrate crystal-induced gouty arthritis. Arthritis Rheum. 2010;62:3237–48.CrossRefPubMedPubMedCentral
Metadata
Title
Positive association of tomato consumption with serum urate: support for tomato consumption as an anecdotal trigger of gout flares
Authors
Tanya J Flynn
Murray Cadzow
Nicola Dalbeth
Peter B Jones
Lisa K Stamp
Jennie Harré Hindmarsh
Alwyn S Todd
Robert J Walker
Ruth Topless
Tony R Merriman
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2015
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-015-0661-8

Other articles of this Issue 1/2015

BMC Musculoskeletal Disorders 1/2015 Go to the issue

Research article

Comorbidities, intensity, frequency and duration of pain, daily functioning and health care seeking in local, regional, and widespread pain—a descriptive population-based survey (SwePain)

Erratum

Erratum to: Internet based patient education improves informed consent for elective orthopaedic surgery: a randomized controlled trial

Research article

Corticosteroid or placebo injection combined with deep transverse friction massage, Mills manipulation, stretching and eccentric exercise for acute lateral epicondylitis: a randomised, controlled trial

Erratum

Erratum to: Early postoperative mortality after simultaneous or staged bilateral primary total hip arthroplasty: an observational register study from the Swedish Hip Arthroplasty Register

Research article

Predictive characteristic of simple bone cyst treated with curettage and bone grafting

Research article

Practicability for robot-aided measurement of knee stability in-vivo