Long-Term Intake of Lignans, Whole Grain Foods Linked to Decrease in Gout Risk

Increased matairesinol and secoisolariciresinol consumption—in addition to oatmeal, whole grain cold breakfast cereals, and bran—are each significantly linked with diminished risk of gout risk, recent findings suggest.1

These data align with recommendations for adherence to plant-based, health-focused diets for individuals with gout and could point to the potential influence of the gut microbiome in the pathogenesis of the rheumatological disease. The findings were released in a study authored by Sharan K. Rai, PhD, of the Harvard T.H. Chan School of Public Health, and a set of coauthors.

Rai and colleagues noted the connection between gut dysbiosis and gout, adding that dietary lignans, found in plant foods, are metabolized by the gut microflora and may help to module risk of developing gout.2

“Therefore, we analyzed data collected in two large ongoing prospective cohorts of US men and women to examine the associations between habitual dietary lignan intake and the risk of incident gout,” Rai and coauthors wrote.1 “Moreover, to enhance clinical applicability, we also examined the associations between commonly consumed wholegrain foods that are rich in lignans and the risk of gout.”

Trial and Notable Findings

The investigative team highlighted that the Nurses’ Health Study (NHS), which began in 1976, had involved a total of 121,700 female registered nurses between the ages of 30 - 55 who completed a mailed survey detailing their lifestyle choices and health history. By 1986, the launch of the Health Professionals Follow-up Study (HPFS) took place, with 51,529 male health professionals aged 40 - 75 who completed a comparable questionnaire being included.

Every 2 years since their inception, both cohorts have been surveyed and maintained approximately a 90% response rate for each follow-up cycle. In their recent analysis, Rai and coauthors did not include individuals in the study if they had a history of gout at the point of baseline, did not have dietary lignan reported in their data, or reported implausible daily caloric intake (<500 or >3,500 kcal among women; <800 or >4,200 kcal among men). As such, the final sample size of this study was 78,977 women drawn from the NHS and 43,703 men drawn from the HPFS.

In order to evaluate the relationship between whole grain intake, dietary lignan consumption, and incident gout, Cox proportional hazards models were utilized. Dietary data were gathered by the investigative team via food frequency questionnaires that were given out every 2 to 4 years. The team's analyses were performed independently within each cohort, and the findings were combined using a fixed-effects meta-analysis approach.

An association between greater intake of specific lignans—namely matairesinol and secoisolariciresinol—was identified with a statistically significant gout risk reduction among these patients. In their comparison of participants in the highest versus lowest quintiles of lignan intake, Rai et al linked matairesinol to a hazard ratio (HR) of .78 (95% CI: .69 to .90; P = .002). Secoisolariciresinol had an identical HR of .78 (95% CI: .68 to .89; P = 0.002). They did not find such a link with pinoresinol or lariciresinol intake.

In their assessment of subjects' whole grain food consumption, the investigators identified inverse associations with gout for several items: consuming at least a single daily serving of whole grain cold breakfast cereals had an association with a HR of 0.62 (95% CI: 0.53 - 0.73); eating cooked oatmeal or oat bran at least 2 times per week was linked with an HR of 0.78 (95% CI: 0.70 - 0.86); and bran consumption added to food at the same frequency was linked to an HR of 0.84 (95% CI: 0.74 - 0.95).

Rai and colleagues did not find significant associations for dark breads or for any other types of cooked breakfast cereals. Additional stratified analyses examined the possibility of effect modification. Overall, there were not significant interactions detected between consumption of lignans and other variables such as physical activity, body mass index (BMI), total intake of fiber, hypertension, or bowel movement frequency (P > .05).

“These findings support adherence to a healthful plant-based diet for gout prevention and highlight the potential role of the gut microbiome in gout pathogenesis,” the investigative team concluded.1

References

1. Rai SK, Hu Y, Sun Q, et al. Long-term lignan intake, whole grain foods, and the risk of gout: results from two prospective cohort studies. Arthritis Care Res (Hoboken). 2025 Jul 7. doi: 10.1002/acr.25596. Epub ahead of print. PMID: 40621718.

2. Terkeltaub R, Dodd D. The Gut Microbiome in Hyperuricemia and Gout. Arthritis Rheumatol.Jan 19 2025; doi:10.1002/art.43118.