Effects of the Dietary Approaches to Stop Hypertension (DASH) Diet and Sodium Intake on Serum Uric Acid

Objective: Randomized trial data guiding dietary recommendations to lower serum uric acid (UA), the etiologic precursor of gout, are scarce. We undertook this study to examine the effects of the Dietary Approaches to Stop Hypertension (DASH) diet (a well-established diet that lowers blood pressure) and levels of sodium intake on serum UA. Methods: We conducted an ancillary study of a randomized, crossover feeding trial in 103 adults with prehypertension or stage I hypertension. Participants were randomly assigned to receive either the DASH diet or a control diet (typical of the average American diet) and were further fed low, medium, and high levels of sodium for 30 days, each in random order. Body weight was kept constant. Serum UA levels were measured at baseline and following each feeding period. Results: Trial participants were 55% women and 75% black with a mean ± SD age of 51.5 ± 9.7 years and a mean ± SD serum UA level of 5.0 ± 1.3 mg/dl. The DASH diet reduced serum UA (−0.35 mg/dl [95% confidence interval (95% CI) −0.65, −0.05], P = 0.02), with a higher effect (−1.29 mg/dl [95% CI −2.50, −0.08]) among participants (n = 8) with a baseline serum UA level of ≥7 mg/dl. Increasing sodium intake from the low level decreased serum UA during the medium sodium intake period (−0.3 mg/dl [95% CI −0.5, −0.2], P < 0.001) and during the high sodium intake period (−0.4 mg/dl [95% CI −0.6, −0.3], P < 0.001). Conclusion: The DASH diet lowered serum UA, and this effect was greater among participants with hyperuricemia. Moreover, we found that higher sodium intake decreased serum UA, which enhances our knowledge of urate pathophysiology and risk factors for hyperuricemia.