Yoghurt for gout. (Yogurt for gout) This page was last reviewed or updated on 7 November 2018
What is yoghurt (yogurt)? Yoghurt is produced by the bacterial fermentation of milk, usually cow’s milk. The bacteria are called yoghurt (yogurt) cultures. The two most used starter ones are Lactobacillus bulgaricus and Streptococcus thermophiles.
The milk used in yoghurt most likely is pasteurised - heated to destroy unwanted organisms. And homogenised - pasteurised milk is passed through a valve under pressure to break fat globules into a smaller size so that they suspend in the milk.
And it could be raw – raw milk for making yoghurt (yogurt) has its fans.
What do the starter cultures do? They ferment lactose (milk sugar) to produce lactic acid. The increase of lactic acid causes the milk to clot and this produces the familiar texture of yoghurt and its tart flavour (flavor).To produce yoghurt, the basics are that milk is heated to around 85 degrees C (185 degrees F) for 30 minutes to denature it. This means nutrients lose their functional properties but not the gout important milk protein, casein. (Lactalbumin comes from whey). Then it is cooled to 45 degrees C (113 degrees F).The bacterial yoghurt starter culture is added and mixed in at this temperature which is maintained for 4 – 12 hours whilst the mixture ferments to yoghurt.
Yoghurt with added bluebetries to make it more gout friendly
How many purines are in yoghurt (yogurt) ?
You don't have to be concerned about the purines in yoghurt.
Like milk, yoghurt is low purine. One table has an amount of just 8.1 mg of uric acid produced from 100 grams of yoghurt with 3.5% fat content. That is about the same as some cheeses. Few foods are lower than this.
Another study’s measurement has 5.2 mg of purines in 100 grams of yoghurt. Or if calculated as uric acid in this study there were 6.2 mg/100 grams.
Which nutrients in milk lower uric acid ?
From the studies described on the milk and gout and milk for gout pages it seems that milk can lower uric acid somewhat. And have a positive effect on inflammation and even pain. The substances that do this are thought to be its two proteins, casein and lactalbumin and its orotic acid. G600 milk fat extract and glycomacropeptide (GMP) have been found in a study to inhibit Interleukin IL-1B which is associated with gout flares, inflammation and pain. Pain scores in this study were lowered but not eliminated.
It has been proposed that Vitamin D in milk might lower uric acid too. But it does not have much and in fact in the USA milk is fortified with Vitamin D. (But not fortified in most other countries).For calcium, see below. There may also be some assist to uric acid reduction from other milk nutrients which have been though to lower uric acid - pantothenic acid and folic acid. But that is not precisely known. These two are also found in some yoghurts but only in small amounts. They are not likely to have an effect.
Because yoghurt is similar to cow's milk, it should have a similar effect on uric acid, that is, consume more and uric acid will be lower. Consume less and uric acid could be higher.
Calcium in milk and yoghurt (yogurt) - its effect on uric acid is uncertain
Many would think that milk’s lowering effect on uric acid would be part caused by its best known mineral, namely calcium. There is almost as much calcium in yoghurt as in milk, but it is uncertain that calcium has any effect on uric acid.
In an intervention study about this very question, (1) trialists took calcium and their uric acid levels were measured. It found that calcium did NOT lower uric acid meaningfully which makes it likely it would not in yoghurt either. However, a limited association between calcium and lowered uric acid has been observed. More studies are needed.
THREE STUDIES ON YOGHURT FOR GOUT
So what do studies that have yoghurt in their measurements say about yoghurt for gout ?
Three large population analysis studies that looked at the dietary intake of very large numbers of people and their uric acid levels or their risk of gout have found yoghurt has a positive gout effect.
First study Intake of Purine-rich foods, Protein and Dairy Products and Relationship to Serum Levels of Uric Acid (2).Using data from nearly 15,000 participants in the Third National Health and Nutrition Examination Survey, dairy foods’ consumption was found to be inversely associated with serum uric acid in participants.
What does inversely associated mean? Two variables are inversely related when an increase in one variable causes or is associated with a reduction in the other variable. Or a decrease in one variable causes, or is associated with, a rise in the other. In this study, inversely associated means when dairy foods consumption was higher, serum (blood) uric acid was lower.
Specific to our main interest here, there were figures in this study for yoghurt. Participants who consumed yoghurt at least once every two days (over six years), had a lower uric acid level than those who did not consume yoghurt. And those who drank milk once a day (or more) had a lower blood uric acid level than those who did not.
Second study Yoghurt was specifically mentioned in the second study too - Purine-Rich Foods, Dairy and Protein Intake and the Risk of Gout in Men. (3) Whereas the first study looked at the uric acid level, this one looked at the risk of gout in men from consuming the foods. It found that a higher consumption of dairy products was associated with a decreased risk of getting gout.
Those men in the group that consumed most low fat dairy products had just over a half the risk of getting gout compared to those men who consumed the least. Participants who ate low fat yoghurt at least twice a week had a lower risk (about 25% lower) of getting gout than those who ate it once a week or only 1-3 times a month. (Editor’s note: If they had eaten yoghurt daily the risk would probably be still lower).
The multivariate risk from the 47 males who consumed one cup of low fat yoghurt at least twice a week was about 25% less than the risk of the 449 males who consumed a cup of yoghurt less than once a month. That’s not a huge difference but it’s useful.
Third study to specifically mention yoghurt was The Association of Dietary Intake or Purine Rich Vegetables, Sugar-Sweetened Beverages and Dairy with Plasma Urate “ (uric acid). (4). Skimmed milk and low calorie yoghurt were associated with lower urate (uric acid) Skimmed milk – 4.4 mmol/dL per serving ; low calorie yoghurt - 11.7 /mmol/dL per serving.
Additionally, two more studies have something to say about dairy or milk’s proteins
In The influence of dairy products on plasma uric acid in women.(5) 81 women ate dairy foods in their diet for 4 weeks and ate about 30 grams of dairy protein daily during it. 77 other women ate a diet consisting of no dairy foods. In the dairy group blood plasma uric acid did not change; but in the no dairy diet it increased by 7.8 mmol/L. So no eating of dairy in four weeks, meant raised uric acid.
And Milk-and soy-protein ingestion: acute effect on serum uric acid concentration.(6). In this study 12 healthy triallists were given 80 grams each of casein and lactalbumin (and soyabean (soybean) isolate). That’s much more than in the study above, 30 grams. Three hours after the ingestion of casein and lactalbumin, serum (blood) uric acid had fallen substantially and urci acid clearance increased.
And these positive figures in these studies for yoghurt for gout consumption and related gout factors were despite a substance in yoghurt, lactic acid, which could slow (maybe even halt) uric acid decreases.
YOGHURT FOR GOUT > RELATED PAGES
(1) N. Dalbeth A. Horne G. D. Gamble R. Ames B. Mason F. M. McQueen M. J. Bolland A. Grey I. R. Reid The effect of calcium supplementation on serum urate: an analysis of a randomised controlled trial Rheumatology, Volume 48, Issue 2, 1 February 2009, Pages 195–197
(2) Choi HK, Liu S, Curhan G. Intake of Purine-Rich food Protein and Dairy Products and relationship to serum levels of uric acid: the Third National Health and Nutrition Examination Survey. Arthritis Rheumatism. 2005 Jan;52(1):283-9.
(3) Choi HK, Atkinson K, Karlson EW, Willett W, Curhan G Purine Rich foods, Dairy and Protein Intake and the risk of gout in men New England Journal of Medicine 2004 Mar 11;350(11):1093-103
(4) Lina Zgaga et al The Association of Dietary Intake of Purine-Rich Vegetables, Sugar-Sweetened Beverages and Dairy with Plasma Urate, in a Cross-Sectional Study
(5) Abstract Ghadirian P, Shatenstein B, Verdy M, Hamet P. The influence of dairy products on plasma uric acid in women Eur J Epidemiol. 1995 Jun;11(3):275-81
(6) Garrel DR, Verdy M, PetitClerc C, Martin C, Brulé D, Hamet P Milk-and soy-protein ingestion: acute effect on serum uric acid concentration Am J Clin Nutr. 1991 Mar;53(3):665-9.