Ahhhh, there’s nothing quite like that first cup of coffee in the morning -- unless it’s that fourth cup at around 3:00 in the afternoon. New research into the coffee-consuming habits of Americans and their rates of developing gout indicate the more coffee you drink, the less likely you are to develop this excruciatingly painful joint inflammation. 

Two separate studies showed drinking four or more cups of coffee a day dramatically reduced the risk of gout for men, and that levels of uric acid in the blood (high levels are associated with gout) significantly decreased with increasing coffee intake for men and women. In the first investigation, researchers at the Arthritis Research Centre of Canada, University of British Columbia in Canada, Brigham and Women’s Hospital, Harvard Medical School, and Harvard School of Public Health in Boston studied 45,869 men older than age 40 with no history of gout at baseline. Over 12 years of follow-up, Hyon K. Choi, MD, DrPH, and his associates evaluated the relationship between coffee intake and the incidence of gout in this high-risk population. The second study was also led by Dr. Choi and was based on the U.S. Third National Health and Nutrition Examination Survey, conducted between 1988 and 1994. It included more than 14,000 men and women at least 20 years old who consented to a medical exam.

In the larger study, participants selected from nine choices regarding their beverage intake to record their average consumption of coffee, decaffeinated coffee, tea, and other caffeine-containing items, such as cola and chocolate. Then, researchers determined the relative risk of developing gout for long-term coffee drinkers as well as for regular drinkers of decaffeinated coffee, tea, and other caffeinated beverages. The risk of gout was 40 percent lower for men who drank four to five cups a day and 59 percent lower for men who drank six or more cups a day than for men who never drank coffee. There was also a modest risk reduction with decaffeinated coffee consumption. These findings were independent of all other risk factors for gout, such as body mass index, history of hypertension, alcohol use, and a diet high in red meat and high-fat dairy foods. Tea drinking and total caffeine intake were both shown to have no effect on the incidence of gout among the participants.

Their findings, featured in the June 2007 issue of Arthritis & Rheumatism, provide evidence that drinking four or more cups of coffee a day dramatically reduces the risk of gout for men.

In the second study, participants answered a food questionnaire that assessed coffee and tea consumption over the previous month. Uric acid levels were determined from the blood and specimens that were obtained during the medical exam. The results, published in the June 2007 issue of Arthritis Care & Research, showed that levels of uric acid in the blood significantly decreased with increasing coffee intake, but not with tea intake. In addition, there was no association between total caffeine intake from beverages and uric acid levels. “These findings suggest that components of coffee other than caffeine contribute to the observed inverse association between coffee intake and uric acid levels,” the researchers state.

Although not prescribing four or more cups a day, these studies can help individuals make an informed choice regarding coffee consumption. Dr. Choi notes, however, “Given the potential influence of female hormones on the risk of gout in women and an increased role of dietary impact on uric acid levels among patients with existing gout, prospective studies of these populations would be valuable.”

Choi HK, Willett W, Curhan G. Coffee consumption and risk of incident gout in men: a prospective study. Arthritis Rheum. June 2007 (DOI: 10.1002/art.22712).
Choi HK, Curhan G. Coffee, tea, and caffeine consumption and serum uric acid level: the Third National Health and Nutrition Examination Survey. Arthritis Rheum (Arthritis Care Res). June 2007 (DOI: 10.1002/art.22762). 
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