Daily intake of enriched skim milk powder can reduce the number of flares in patients with poorly-controlled gout, a
randomised trial in New Zealand has concluded.
Associate Professor Nicola Dalbeth and colleagues from the University of Auckland investigated 120 patients, mostly middle-aged Caucasian men, who had experienced at least two gout flares in the previous four months.
They were randomised to drink a daily vanilla shake, for three months, containing either lactose powder control, skim milk powder control, or skim milk powder enriched with a glycomacropeptide (GMP) and a milk fat extract (labelled G600). The two additives had previously been shown to have anti-inflammatory effects in experimental models of gout.
The frequency of gout flares was reduced in all three groups, but the decline was greatest in those randomised to GMP/G600.
“Greater improvements were also observed in pain and fractional excretion of uric acid, with trends to greater improvement in tender joint count,” the researchers said.
Similar adverse event rates and discontinuation rates were observed in all three groups.
Dietary modification was frequently recommended as a strategy to prevent and treat gout, but this was the first reported randomised controlled trial of dietary therapy for active gout, they said.
Observational studies had suggested a clear relationship between higher intakes of low-fat dairy products and a lower risk of developing gout, and short-term studies had shown that large amounts of milk proteins or skim milk had a urate-lowering effect.
In the present study, however, changes in urate levels were insufficient to explain the benefits of the low doses of milk products that were administered.
The results of this proof-of-concept trial could not yet be generalised to all patients with gout, the researchers warned. “The patients in this study had poorly controlled gout with high flare rates, inadequately controlled serum urate and relatively low use of allopurinol,” they said.