Patients with gout often self-report foods like tomatoes and tomato products as dietary triggers, but consumption of these foods as a trigger of gout flares may not be supported by empirical evidence. A study in BMC Musculoskeletal Disorders reports on a positive association between tomato consumption and serum urate levels, but suggests that there may be a biological basis.

Tanya Flynn, a PhD student at the University of Otago in Dunedin, New Zealand, and colleagues surveyed 2,051 patients aged >17 with a confirmed diagnosis of gout on their self-reported food and/or drink triggers for gout. Trigger foods were categorized into ten groups: alcohol, dairy products, fruit, poultry, red meat, seafood/fish, sugar-sweetened beverages, tomatoes, vegetables, and other.

Overall, 70.6% self-reported at least one food or drink trigger of acute gout attacks; of these, 62.5% specified seafood or fish as a trigger, 47.1% alcohol, 35.2% red meat, and 20.2% tomatoes. Vegetables, fruit, and sugar-sweetened drinks ranked fifth, sixth, and seventh among the most commonly reported trigger foods, respectively. Because the top three dietary triggers have been shown to be positively correlated with serum urate level, the authors hypothesized that tomatoes may also be linked to increased serum urate levels. Pooled and analyzed data from 12,720 participants in three long-running health studies in the United States also indicated that tomato consumption was associated with higher levels of uric acid in the blood.

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Although these findings do not support tomato consumption as a definite trigger of gout attacks, they do support tomatoes as a food that can alter uric acid levels similarly to other commonly accepted gout trigger foods. Proper treatment is most effective in preventing gout attacks, but avoiding tomatoes may also be helpful for those patients who have experienced a gout attack after consuming tomatoes and tomato products.

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