LAUSR

OBJECTIVE This study aimed to examine the interactions between ultra-processed food (UPF) consumption and genetic predisposition with the risk of gout. METHODS This prospective cohort study analyzed 181 559 individuals from the UK Biobank study who were free of gout at baseline. UPF was defined according to the NOVA classification. The genetic predisposition for gout was developed by a genetic risk score of 33 single nucleotide polymorphisms. Cox proportional hazards were used to estimate the associations between UPF consumption, genetic predisposition and the risk of gout. RESULTS 1,558 patients developed gout over 1,648 167 person-years of follow-up. In the multivariable adjustment model, compared with the lowest quartile of UPF consumption, the hazard ratio (HR) and 95% confidence interval (CI) of the highest UPF consumption was 1.16 (1.01, 1.33) for gout risk, and there was a non-linear correlation between UPF consumption and the development of gout. In substitution analyses, replacing 20% of the weight of UPF in the daily intake for an equal amount of unprocessed or minimally processed food had a 13% lower risk of gout (HR: 0.87; 95% CI: 0.79, 0.95). In the joint effect analysis, the HR (95% CI) for gout was 1.90 (1.39, 2.60) in participants with high genetic predisposition and high UPF consumption, compared with those with low genetic predisposition and low UPF consumption. CONCLUSION In summary, UPF consumption is associated with a higher risk of gout, particularly in those combined with genetically predisposed to gout. Our study highlights that reducing UPF consumption is crucial for gout prevention.