3. Results and Discussion
3.1. Relationship Between the Number of Gout Patients and Micronutrient Intake
The results on the correlation between the number of gout patients and intake of micronutrient or salt in Japanese people are shown in
Tables 1 and 2. Since gout patients of Japanese people were aged 15 year or older in 1998-2022, this article evaluated the intake of nutrients in Japanese people aged 15 year or older.
Table 1. Correlation between number of gout patients and intake of micronutrient or salt in Japanese people in 1986-2019 and 1986-2022.
Year | 1986-2019 | 1986-2022 |
Micronutrient | coefficient | coefficient |
Vitamins | | |
Vitamin A†, †† | - 0.893*** | - 0.888*** |
Vitamin B1†, †† | - 0.880*** | - 0.832*** |
Vitamin B2 | - 0.756** | - 0.747** |
Vitamin C | - 0.900*** | - 0.894*** |
Minerals or salt | | |
Salt††††† | - 0.913*** | - 0.926*** |
Calcium†, †† | - 0.757** | - 0.793** |
Iron | - 0.894*** | - 0.887*** |
| 2001-2019 | 2001-2022 |
| coefficient | coefficient |
Vitamins | | |
Vitamin D | - 0.891** | - 0.912** |
Vitamin E†, †† | - 0.706 | - 0.709* |
Vitamin K | - 0.615 | - 0.412 |
Niacin††† | 0.677 | 0.793* |
Pantothenic acid | - 0.138 | 0.112 |
Vitamin B6 | - 0.413 | - 0.488 |
Folate†, †† | - 0.748 | - 0.747* |
Vitamin B12†††† | - 0.812* | - 0.873** |
Minerals or salt | | |
Potassium†, †† | - 0.624 | - 0.592 |
Magnesium†, †† | - 0.620 | - 0.590 |
Phosphorus | - 0.554 | - 0.440 |
Copper††† | - 0.852* | - 0.875** |
Zinc† | - 0.304 | - 0.138 |
| 1995-2019 | 1995-2022 |
| coefficient | coefficient |
Sodium | - 0.964*** | - 0.959*** |
The Pearson Product Moment Correlation coefficient, * for P<0.05, ** for P<0.01, *** for P<0.001.
†The daily micronutrient intake of Japanese people (aged ≥ 15 years) in 2019 were below the Recommended Dietary Allowances (RDAs) or the Adequate Intakes (AIs). ††The daily micronutrient intake of Japanese people (aged ≥ 15 years) in 2022 were below the Recommended Dietary Allowances (RDAs) or the Adequate Intakes (AIs). †††The daily copper intake of Japanese people (aged ≥ 15 years) in 2022 were above the Recommended Dietary Allowances (RDAs). ††††The daily vitamin B12 intake of Japanese people (aged ≥ 15 years) in 2019 and 2022 were above the Recommended Dietary Allowances (RDAs). †††††The daily salt intake of Japanese people (aged ≥ 1 year) in 2019 and 2022 exceeded the Tentative Dietary Goal for Preventing Lifestyle-related Diseases (DG).
Table 2. Correlation between number of gout patients and intake of micronutrient or salt in Japanese adult population, adult men, and adult women in 2004-2022.
Year | Adults | Adult men | Adult women |
2004-2022 | | coefficient | |
Micronutrient | | | |
Vitamins | | | |
Vitamin A† | - 0.604 | - 0.644 | 0.730 |
Vitamin D | - 0.910** | - 0.926** | 0.331 |
Vitamin E† | - 0.755** | - 0.740 | 0.626 |
Vitamin K | - 0.022 | 0.222 | 0.521 |
Vitamin B1† | - 0.808* | - 0.768* | 0.276 |
Vitamin B2 | - 0.822* | - 0.807* | 0.295 |
Niacin†† | 0.833* | 0.813* | - 0.094 |
Pantothenic acid | 0.692 | 0.700 | 0.317 |
Vitamin B6 | - 0.842* | - 0.843* | 0.273 |
Folate† | - 0.647 | - 0.654 | 0.546 |
Vitamin B12†† | - 0.822* | - 0.826* | 0.573 |
Vitamin C | - 0.857* | - 0.865* | 0.507 |
Minerals or salt | | | |
Salt††† | - 0.917** | - 0.942** | 0.571 |
Calcium† | - 0.830* | - 0.792* | 0.718 |
Potassium† | - 0.291 | - 0.352 | 0.680 |
Magnesium† | - 0.254 | - 0.424 | 0.669 |
Phosphorus | 0.119 | - 0.042 | 0.603 |
Iron | - 0.755* | - 0.788* | 0.564 |
Copper†† | - 0.863* | - 0.927** | 0.750 |
Zinc | 0.325 | 0.050 | 0.425 |
The Pearson Product Moment Correlation coefficient, * for P<0.05, ** for P<0.01, *** for P<0.001.
†The daily micronutrient intake of Japanese people (aged ≥ 15 years) in 2022 were below the Recommended Dietary Allowances (RDAs) or the Adequate Intakes (AIs). ††The daily micronutrient intake of Japanese people (aged ≥ 15 years) in 2022 were above the Recommended Dietary Allowances (RDAs) or the Adequate Intakes (AIs). †††The daily salt intake of Japanese people (aged ≥ 1 year) in 2019 and 2022 exceeded the Tentative Dietary Goal for Preventing Lifestyle-related Diseases (DG).
3.1.1. Vitamins
Vitamin A
The daily vitamin A (retinol equivalent) intake of Japanese people in 2022 was higher compared to that in 1960, 1965, and 1975 and was lower compared to that in 1986, 1989, 1992, 1995, 1998, 2001, 2004, 2007, 2010, 2013, 2016, and 2019 (1960: 354.0 µgRAE; 1965: 397.2 µgRAE; 1975: 480.6 µgRAE; 1986: 650.7 µgRAE; 1989: 806.1 µgRAE; 1992: 794.7 µgRAE; 1995: 852.0 µgRAE; 1998: 810.3 µgRAE; 2001: 981.0 µgRAE; 2004: 879.0 µgRAE; 2007: 615.0 µgRAE; 2010: 529.0 µgRAE; 2013: 516.0 µgRAE; 2016: 524.0 µgRAE; 2019: 534.0 µgRAE; 2022: 515.0 µgRAE). The daily vitamin A intake was negatively correlated with the number of gout patients in 1986-2019 (r= -0.893, p= 0.0000933) and in 1986-2022 (r= -0.888, p= 0.0000493) (
Table 1).
The daily vitamin A intake of Japanese adult population (aged ≥ 20 years) in 2022 was lower compared to that in 2019 (2019: 547.0 µgRAE; 2022: 516.0 µgRAE). The intake of vitamin A did not show a significant correlation with the number of gout patients in the adult population (aged ≥ 20 years) in 2004-2019 (r= -0.585, p=0.222) and in 2004-2022 (r= -0.604, p= 0.151)(
Table 2). The daily vitamin A intake of Japanese adult men (aged ≥ 20 years) and adult women (aged ≥ 20 years) in 2022 were lower compared to those in 2019, respectively (men: 2019: 564.0 µgRAE; 2022: 538.0 µgRAE, women: 2019: 532.0 µgRAE; 2022: 497.0 µgRAE). The intake of vitamin A did not show a significant correlation with the number of gout patients in adult men (aged ≥ 20 years) in 2004-2019 (r= -0.636, p= 0.175) and in 2004-2022 (r= -0.644, p= 0.119) (
Table 2). The intake of vitamin A tended to be positively correlated with number of gout patients in adult women (aged ≥ 20 years) in 2004-2019 (r= 0.806, p= 0.0526) and in 2004-2022 (r= 0.730, p= 0.0626) (
Table 2).
The daily vitamin A (retinol equivalent) intake of Japanese men (aged ≥ 15 years) and women (aged ≥ 15 years) in 2022 were 420-673 µgRAE/day and 402-612 µgRAE/day, respectively, and were below the RDAs established by the MHLW in Japan [men (aged ≥ 15 years): 800-900 µgRAE/day; women (aged ≥ 15 years): 650-700 µgRAE/day]
and those established by the IOM of the National Academy of Sciences in the U.S. [men (aged ≥ 14 years): 900 µgRAE/day; women (aged ≥ 14 years): 700 µgRAE/day]
| [42] | Institute of Medicine of the National Academy of Sciences. Food and Nutrition Board. Dietary Reference Intakes: The essential guide to nutrient requirements. Washington, D.C. The National Academy Press. Available from: https://www.nap.edu/catalog/11537.html (accessed 14 October 2021). |
[42]
.
Vitamin A, which is also called retinol, is a potent exogenous antioxidant for humans
| [10] | Hayden, M. R., Tyagi, S. C. Uric acid: A new look at an old risk marker for cardiovascular disease, metabolic syndrome, and type 2 diabetes mellitus: The urate redox shuttle. Nutr. Metab (Lond). 2004, 1, 10. https://doi.org/10.1186/1743-7075-1-10 |
| [16] | Ighodaro, O. M., Akinloye, O. A. First line defence antioxidants-superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPX): their fundamental role in the entire antioxidant defence grid. Alexandria Journal of Medicine. 2018, 54(4), 287-293. https://doi.org/10.1016/j.ajme.2017.09.001 |
| [50] | Goodman, D. S. Vitamin A and retinoids in health and disease. N Engl J Med. 1984, 310(16), 1023-1031. https://doi.org/10.1056/NEJM198404193101605 |
[10, 16, 50]
. A cross-sectional study in Korea showed that subjects with hyperuricemia [SUA concentration ≥ 7.0 mg/dL (416.4 µmol/L) in men and ≥ 6.0 mg/dL (356.9 µmol/L) in women] had lower retinol intakes than controls
| [51] | Ryu, K. A., Kang, H. H., Kim, S. Y., Yoo, M. K., Kim, J. S., Lee, C. H., Wie, G. A. Comparison of nutrient intake and diet quality between hyperuricemia subjects and controls in Korea. Clin Nutr Res. 2014, 3(1), 56-63. https://doi.org/10.7762/cnr.2014.3.1.56 |
[51]
. Retinol intake was not significantly associated with SUA concentrations both in the Australian cohort and the Norwegian cohort
| [52] | Zykova, S. N., Storhaug, H. M., Toft, I., Chadban, S. J., Jenssen, T. G., White, S. L. Cross-sectional analysis of nutrition and serum uric acid in two Caucasian cohorts: the AusDiab Study and the Tromsø study. Nutr J. 2015, 14, 49. https://doi.org/10.1186/s12937-015-0032-1 |
[52]
.
A cross-sectional study survey using the National Health and Nutrition Examination Survey (NHANES) 2009-2014, the daily intake of total retinol and animal-derived retinol were inversely associated with hyperuricemia risk among U.S. adult men and women (aged ≥ 20 years) [SUA concentration ≥ 7.0 mg/dL (416.4 µmol/L) in men and ≥ 6.0 mg/dL (356.9 µmol/L) in women]
| [26] | Zhang, P., Sun, J., Guo, Y., Han, M., Yang, F., Sun, Y. Association between retinol intake and hyperuricaemia in adults. Public Health Nutr. 2021, 24(8), 2205-2214. https://doi.org/10.1017/S1368980020000324 |
[26]
. This article revealed that participants in the highest level of the daily intake of total retinol (≥ 861.00 RAE, mcg/day) and animal-derived retinol (≥ 371.50 RAE, mcg/day) were 29.0% and 24.0% less likely to be hyperuricemia [SUA concentration ≥ 7.0 mg/dL (416.4 µmol/L) in men and ≥ 6.0 mg/dL (356.9 µmol/L) in women] compared to those subjects in the lowest intake level of total retinol (< 283.50 RAE, mcg/day) and animal-derived retinol (< 98.00 RAE, mcg/day) [total retinol: OR = 0.71 (95% confidence interval, 0.520-0.960); animal-derived retinol: OR = 0.76 (95% confidence interval, 0.590-0.960)], respectively
| [26] | Zhang, P., Sun, J., Guo, Y., Han, M., Yang, F., Sun, Y. Association between retinol intake and hyperuricaemia in adults. Public Health Nutr. 2021, 24(8), 2205-2214. https://doi.org/10.1017/S1368980020000324 |
[26]
. Though there was no significant association between plant-derived retinol intake and hyperuricemia risk in U.S. adult men and women (aged ≥ 20 years) [SUA concentration ≥ 7.0 mg/dL (416.4 µmol/L) in men and ≥ 6.0 mg/dL (356.9 µmol/L) in women], participants in the highest level of the daily plant-derived retinol intake (≥ 544.50 RAE, mcg/day) were 8.0% less likely to be hyperuricemia compared to those subjects in the lowest intake level of plant-derived retinol (< 102.50 RAE, mcg/day) [OR = 0.92 (95% confidence interval, 0.720-1.170)]
| [26] | Zhang, P., Sun, J., Guo, Y., Han, M., Yang, F., Sun, Y. Association between retinol intake and hyperuricaemia in adults. Public Health Nutr. 2021, 24(8), 2205-2214. https://doi.org/10.1017/S1368980020000324 |
[26]
. In a cross-sectional survey, retinol intake was not significantly associated with hyperuricemia risk
| [27] | Yu, K-H., See, L-C., Huang, Y-C., Yang, C-H., Sun, J-H. Dietary factors associated with hyperuricemia in adults. Semin Arthritis Rheum. 2008, 37(4), 243-250. https://doi.org/10.1016/j.semarthrit.2007.04.007 |
[27]
. The mechanism underlying the association between retinol intake and hyperuricemia remains poorly understood. However, Zhang et al.
| [26] | Zhang, P., Sun, J., Guo, Y., Han, M., Yang, F., Sun, Y. Association between retinol intake and hyperuricaemia in adults. Public Health Nutr. 2021, 24(8), 2205-2214. https://doi.org/10.1017/S1368980020000324 |
[26]
have stated that retinol intake reduces oxidative stress and inflammatory response and further decreases UA synthesis, thereby providing a potential mechanism for retinol to reduce the risk of hyperuricemia.
Judging from the data of food composition [47-49], it is important for Japanese people (aged ≥ 14 years) to eat organ meats (liver, breast), seafood (salmon, tuna, herring, firefly squid, eel, conger eel, sablefish), potatoes, grains (fortified ready-to-eat cereals), nuts (pistachio nuts), legumes (black-eyed peas, baked beans), seaweed, fruit (apricots, mangos, cantaloupes), vegetables (spinach, carrots, peppers, broccoli, Jew’s mallows, perillas), dairy products (milk, cheese, yogurt), eggs to take in more vitamin A to reach the RDAs established by the MHLW in Japan
and those established by the IOM of the National Academy of Sciences in the U.S.
| [42] | Institute of Medicine of the National Academy of Sciences. Food and Nutrition Board. Dietary Reference Intakes: The essential guide to nutrient requirements. Washington, D.C. The National Academy Press. Available from: https://www.nap.edu/catalog/11537.html (accessed 14 October 2021). |
[42]
. Serum vitamin A (retinol) levels were positively associated with SUA concentrations
| [53] | Kim, Y., Choi, J. H., Kang, J., Kim, G-T., Lee, S-G. Associations serum retinol and α-tocopherol levels with uric acid concentrations: analysis of a population-based, nationally representative sample. Nutrients. 2020, 12(6), 1797. https://doi.org/10.3390/nu12061797 |
| [54] | Liu, Y., Xia, Y., Wu, Q., Chang, Q., Zhao, Y. Associations between serum vitamins and serum uric acid in a population of Shenyang, China. J Nutr Sci Vitaminol. 2021, 67(2), 77-83. https://doi.org/10.3177/jnsv.67.77 |
[53, 54]
and hyperuricemia risk
| [53] | Kim, Y., Choi, J. H., Kang, J., Kim, G-T., Lee, S-G. Associations serum retinol and α-tocopherol levels with uric acid concentrations: analysis of a population-based, nationally representative sample. Nutrients. 2020, 12(6), 1797. https://doi.org/10.3390/nu12061797 |
[53]
. It seems that Japanese people (aged ≥ 20 years) need to decrease retinol intake or pay attention to not to excessive intake of retinol.
Vitamin D
The daily vitamin D of Japanese people in 2022 was lower compared to that in 2001, 2004, 2007, 2010, 2013, 2016, and 2019 (2001: 8.4 µg/day; 2004: 7.9 µg/day; 2007: 7.6 µg/day; 2010: 7.3 µg/day; 2013: 7.5 µg/day; 2016: 7.5 µg/day; 2019: 6.9 µg/day; 2022: 6.2 µg/day). The daily vitamin D intake was negatively correlated with the number of gout patients in 2001-2019 (r= -0.891, p= 0.00709) and in 2001-2022 (r= -0.912, p= 0.00161) (
Table 1).
The daily vitamin D intake of Japanese adult population (aged ≥ 20 years) in 2022 was lower compared to that in 2019 (2019: 7.2 µg/day; 2022: 6.5 µg/day). The intake of vitamin D was negatively correlated with the number of gout patients in the adult population (aged ≥ 20 years) in 2004-2019 (r= -0.886, p= 0.0187) and in 2004-2022 (r= -0.910, p= 0.0044) (
Table 2). The daily vitamin D intake of Japanese adult men (aged ≥ 20 years) and adult women (aged ≥ 20 years) in 2022 were lower compared to those in 2019, respectively (men: 2019: 7.9 µg/day; 2022: 7.1 µg/day, women: 2019: 6.6 µg/day; 2022: 6.1 µg/day). The intake of vitamin D was negatively correlated with the number of gout patients in adult men (aged ≥ 20 years) in 2004-2019 (r= -0.932, p= 0.00677) and in 2004-2022 (r= -0.926, p= 0.00278) (
Table 2). The intake of vitamin D did not show a significant correlation with the number of gout patients in adult women (aged ≥ 20 years) in 2004-2019 (r= 0.684, p= 0.134) and in 2004-2022 (r= 0.331, p= 0.469) (
Table 2). This result suggests that the correlation of daily vitamin D intake with the number of gout patients tends to vary with gender and is stronger in adult men than in adult women.
The daily vitamin D intake of Japanese men (aged 15-69 years) and women (aged ≥15 years) in 2022 were 5.0-7.5 µg/day and 4.0-7.7 µg/day, respectively, and were below the AIs established by the MHLW in Japan [men (aged 15-69 years): 8.5-9.0 µg/day; women (aged ≥ 15 years): 8.5 µg/day]
. The daily vitamin D intake of Japanese men (aged ≥ 70 years) in 2022 was 8.6-9.2 µg/day and was above the AIs established by the MHLW in Japan [men (aged ≥ 70 years): 8.5 µg/day]
. The AIs for vitamin D in the U.S. men and women (aged 0-50 years), men and women (aged 51-70 years), men and women (aged ≥ 71 years) established by the IOM of the National Academy of Sciences in the U.S. are 5 µg/day, 10 µg/day and 15 µg/day, respectively
| [42] | Institute of Medicine of the National Academy of Sciences. Food and Nutrition Board. Dietary Reference Intakes: The essential guide to nutrient requirements. Washington, D.C. The National Academy Press. Available from: https://www.nap.edu/catalog/11537.html (accessed 14 October 2021). |
[42]
. The daily vitamin D intake of Japanese men (aged 15-49 years) was 5.0-6.1 µg/day and was above the AIs established by the IOM of the National Academy of Sciences in the U.S. [men (aged 0-50 years): 5 µg/day]
| [42] | Institute of Medicine of the National Academy of Sciences. Food and Nutrition Board. Dietary Reference Intakes: The essential guide to nutrient requirements. Washington, D.C. The National Academy Press. Available from: https://www.nap.edu/catalog/11537.html (accessed 14 October 2021). |
[42]
. Whereas the daily vitamin D intake of Japanese men (aged ≥ 60 years) and Japanese women (aged ≥ 50 years) were 7.5-9.2 µg/day and 5.4-7.7 µg/day, respectively, and were below the AIs established by the IOM of the National Academy of Sciences in the U.S. [men (aged 51-70 years): 10.0 µg/day; men (aged > 70 years): 15.0 µg/day; women (aged 20-39 years): 5.0 µg/day; women (aged 50-69 years): 10.0 µg/day; women (aged ≥ 70 years): 10.0-15.0 µg/day]
| [42] | Institute of Medicine of the National Academy of Sciences. Food and Nutrition Board. Dietary Reference Intakes: The essential guide to nutrient requirements. Washington, D.C. The National Academy Press. Available from: https://www.nap.edu/catalog/11537.html (accessed 14 October 2021). |
[42]
. The RDAs for vitamin D in the U.S. men and women (aged 19-70 years), men and women (aged ≥ 71 years) established by the Food and Nutrition Board at IOM in the U.S. are 15 µg/day and 20 µg/day, respectively
| [55] | Institute of Medicine. Food and Nutrition Board. Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: The National Academy Press; 2011. |
[55]
. Though the daily vitamin D intake of Japanese men (aged ≥ 20 years) and women (aged ≥ 15 years) in 2022 were 5.0-9.2 µg/day and 4.3-7.7 µg/day, respectively, the daily vitamin D intake of them were below the RDAs established by the Food and Nutrition Board at IOM in the U.S.
| [55] | Institute of Medicine. Food and Nutrition Board. Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: The National Academy Press; 2011. |
[55]
.
Vitamin D and vitamin D receptor signaling together have a suppressive role on autoimmunity and an anti-inflammatory effect
. Vitamin D intake was inversely associated with hyperuricemia risk among U.S. adult participants in the NHANES 2007-2014
. The average daily vitamin D intake of Japanese men (aged ≥ 20 years) and women (aged ≥ 20 years) in 2022 were 7.1 µg/day and 6.1 µg/day, respectively. From the results of this article, male subjects in the fourth level of vitamin D intake (4.6-7.6 µg/day) were 32% less likely to be hyperuricemia [SUA concentration ≥ 7.0 mg/dL (416.4 µmol/L) in males and ≥ 6.0 mg/dL (356.9 µmol/L) in females] compared to those subjects in the lowest intake level (< 1.1 µg/day). Female subjects in the fourth level of vitamin D intake (3.7-6.2 µg/day) were 19% less likely to be hyperuricemia compared to those subjects in the lowest intake level (< 0.9 µg/day)
. From the result of this article
, it seems that Japanese adult population (aged ≥ 20 years) need to take in more vitamin D. In an analysis of the NHANES 2007-2014, serum 25-hydroxyvitamin D concentrations might be inversely associated with hyperuricemia risk in general U.S. adults (aged ≥ 18 years)
| [56] | Han, Y., Han, K., Zhang, Y., Zeng, X. Serum 25-hydroxyvitamin D might be negatively associated with hyperuricemia in U.S. adults: an analysis of the National Health and Nutrition Examination Survey 2007-2014. J Endocrinol Invest. 2022, 45(4), 719-729. https://doi.org/10.1007/s40618-021-01637-x |
[56]
. Vitamin D deficiency was associated with hyperuricemia
| [57] | Isnuwardana, R., Bijukchhe, S., Thadanipon, K., Ingsathit, A., Thakkinstian, A. Association between vitamin D and uric acid in adults: A systematic review and meta-analysis. Horm Metab Res. 2020, 52(10), 732-741. https://doi.org/10.1055/a-1240-5850 |
[57]
. A review reported by Charoenngam
suggests that correcting vitamin D deficiency (serum 25-dihydroxyvitamin D concentration < 20 ng/mL) and insufficiency (serum 25-dihydroxyvitamin D concentration 20- < 30 ng/mL) has a mild uric acid (UA)-lowering effect (~0.3-0.6 mg/dL), which is thought to be mediated by the suppression of parathyroid hormone, which is known to downregulate the ATP-binding cassette transporter G2 (ABCG2) in the kidneys, leading to a reduction in the renal clearance of UA
. These reports suggest importance of vitamin intake to prevent hyperuricemia. Furthermore, serum UA, CRP, and interleukin-22 (IL-22) levels were significantly higher in acute gouty arthritis patients than in healthy controls
| [31] | Chen, Y., Ma, H., Du, Y., Dong, J., Jin, C., Tan, L., Wei, R. Functions of 1,25-dihydroxy vitamin D3, vitamin D3 receptor and interleukin-22 involved in pathogenesis of gout arthritis through altering metabolic pattern and inflammatory responses. PeerJ. 2021, 9, e12585. https://doi.org/10.7717/peerj.12585 |
[31]
. Whereas serum 1,25-dihydroxy vitamin D3 levels were significantly lower in acute gouty arthritis patients than in healthy controls
| [31] | Chen, Y., Ma, H., Du, Y., Dong, J., Jin, C., Tan, L., Wei, R. Functions of 1,25-dihydroxy vitamin D3, vitamin D3 receptor and interleukin-22 involved in pathogenesis of gout arthritis through altering metabolic pattern and inflammatory responses. PeerJ. 2021, 9, e12585. https://doi.org/10.7717/peerj.12585 |
[31]
. These results indicate that vitamin D3 plays a protective role in gout.
Judging from the data of food composition
| [47] | The Council for Science and Technology, Ministry of Education, Culture, Sports, Science and Technology in Japan. Standard tables of food composition in Japan -2020- (Eighth Revised Edition), Report of the Subdivision Resources. Available from: https://www.mext.go.jp/content/20201225-mxt_kagsei-mext_01110_011.pdf (accessed 16 May 2020). |
| [48] | The Council for Science and Technology, Ministry of Education, Culture, Sports, Science and Technology in Japan. Food Composition Database. Available from: https://fooddb.mext.go.jp/ (accessed 16 October 2024). |
| [49] | U.S. Department of Health & Human Services. National Institutes of Health. Office of Dietary Supplements. Dietary Supplement Fact Sheets. Available from: https://ods.od.nih.gov/factsheets/list-all/ (accessed 17 May 2020). |
[47-49]
and roles in the body of vitamin D (promotion of calcium absorption, reduction of inflammation, modulation of such processes as cell growth, neuromuscular and immune function, and glucose metabolism)
| [49] | U.S. Department of Health & Human Services. National Institutes of Health. Office of Dietary Supplements. Dietary Supplement Fact Sheets. Available from: https://ods.od.nih.gov/factsheets/list-all/ (accessed 17 May 2020). |
[49]
, it is important for Japanese men (aged ≥20 years) and Japanese women (aged ≥20 years) to eat meats (ground beef), organ meats (beef liver, chicken breast, monkfish liver), seafood (salmon, trout, swordfish, sturgeon, cisco, whitefish, mackerel, tuna, sardines, rockfish, tilapia, flatfish, bonito, dried whitebait, Japanese pilchard, herring, salmon roe, mullet roe, herring roe, anchovy, sand eel), fish oil (cod liver), grains (ready-to-eat cereal fortified with 10% Daily Value vitamin D, brown rice, whole wheat bread), legumes (lentils, edamame), seeds and nuts (almonds, sunflower seeds), mushrooms (wood ear, maitake mushrooms, shiitake mushrooms), milks (whole milk, whole chocolate milk, soy milk, almond milk), fruit (bananas, apples), vegetables (spinach, carrots, broccoli), dairy products (yogurt, cheese), eggs to take in more vitamin D to reach the RDAs set by the Food and Nutrition Board at IOM in the U.S. [men and women (aged 19-70 years): 15.0 µg/day; men and women (aged ≥ 71 years): 20 µg/day]
| [55] | Institute of Medicine. Food and Nutrition Board. Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: The National Academy Press; 2011. |
[55]
. However, it must be careful not to exceed the ULs of the daily vitamin D intake [men (aged ≥ 1 year): 50 µg/day; women (aged ≥ 1 year): 50 µg/day].
Vitamin E
The daily vitamin E intake of Japanese people in 2022 was lower compared to that in 2001, 2004, 2007, and 2010 and was higher compared to that in 2013, 2016, and 2019 (2001: 8.5 mg/day; 2004: 10.5 mg/day; 2007: 8.6 mg/day; 2010: 7.9 mg/day; 2013: 6.4 mg/day; 2016: 6.4 mg/day; 2019: 6.7 mg/day; 2022: 6.8 mg/day). The daily vitamin E intake did not show a significant correlation with the number of gout patients in 2001-2019 (r= -0.706, p= 0.0762) (
Table 1). Whereas the daily vitamin E intake was negatively correlated with the number of gout patients in 2001-2022 (r= -0.709, p= 0.0491) (
Table 1).
The daily vitamin E intake of Japanese adult population (aged ≥ 20 years) was higher compared to that in 2019 (2019: 6.9 mg/day; 2022: 7.0 mg/day). The daily vitamin E intake did not show a significant correlation with the number of gout patients in the adult population (aged ≥ 20 years) in 2004-2019 (r= -0.773, p= 0.0712) (
Table 2). Whereas the daily vitamin E intake was negatively correlated with the number of gout patients in the adult population (aged ≥ 20 years) in 2004-2022 (r= -0.755, p= 0.0050) (
Table 2). The daily vitamin E intake of Japanese adult men (aged ≥ 20 years) and adult women (aged ≥ 20 years) in 2022 were the same as those in 2019, respectively (men: 2019: 7.2 mg/day; 2022: 7.2 mg/day; women: 2019: 6.6 mg/day; 2022: 6.6 mg/day). The daily vitamin E intake tended to be negatively correlated with the number of gout patients in adult men (aged ≥ 20 years) in 2004-2019 (r= -0.793, p= 0.0600) and in 2004-2022 (r= -0.740, p= 0.0571) (
Table 2). The daily vitamin E intake did not show a significant correlation with the number of gout patients in adult women (aged ≥ 20 years) in 2004-2019 (r= 0.703, p= 0.119) and in 2004-2022 (r= 0.626, p= 0.133) (
Table 2).
The daily vitamin E intake of Japanese men (aged ≥ 15 year) and women (aged ≥ 15 year) in 2022 were 6.7-7.8 mg/day and 5.8-7.3 mg/day, respectively, and were above the AIs established by the MHLW in Japan [men (aged ≥ 15 years): 6.0-7.0 mg/day; women (aged ≥ 15 years): 5.0-6.5 mg/day], and were below the ULs established by the MHLW in Japan [men (aged ≥ 15 year): 750-900 mg/day; women (aged ≥ 15 year): 650-700 mg/day]
. The EARs and the RDAs for vitamin E in the U.S. men (aged ≥ 14 years) and women (aged ≥ 14 years) established by the IOM of the National Academy of Sciences in the U.S. are 12 mg/day and 15 mg/day, respectively
| [42] | Institute of Medicine of the National Academy of Sciences. Food and Nutrition Board. Dietary Reference Intakes: The essential guide to nutrient requirements. Washington, D.C. The National Academy Press. Available from: https://www.nap.edu/catalog/11537.html (accessed 14 October 2021). |
[42]
. In Dietary Reference Intakes for Japanese established by the MHLW in Japan, the daily vitamin E intake in Japanese men (aged ≥ 15 years) and women (aged ≥ 15 years) appears to be very unlikely to cause a deficiency. However, judging from Dietary Reference Intakes established by the IOM of the National Academy of Sciences in the U.S.
| [42] | Institute of Medicine of the National Academy of Sciences. Food and Nutrition Board. Dietary Reference Intakes: The essential guide to nutrient requirements. Washington, D.C. The National Academy Press. Available from: https://www.nap.edu/catalog/11537.html (accessed 14 October 2021). |
[42]
, Japanese men (aged ≥ 15 years) and women (aged ≥ 15 years) need to take in more vitamin E to reach the RDAs.
Vitamin E suppressed the elevation of SUA concentrations and hypertension in deoxycorticosterone-salt-treated hypertensive rats via the uricosuric (increasing or promoting the excretion of UA in urine) effect
. The co-administration of ethanol and vitamin E suppressed the elevation of SUA concentrations induced by ethanol consumption in both men and women
| [61] | Onyesom, I., Uzuegbu, U. E., Nwangwa, E. K., Umukoro, G. K., Aninyel, I. R. Effect of vitamin E on ethanol-induced increase in some cardiovascular parameters and blood uric acid levels in man. Int J Biol Chem. 2007, 1(3), 156-161. |
[61]
. Vitamin E intake was not significantly associated with SUA concentrations both in the Australian cohort and the Norwegian cohort
| [52] | Zykova, S. N., Storhaug, H. M., Toft, I., Chadban, S. J., Jenssen, T. G., White, S. L. Cross-sectional analysis of nutrition and serum uric acid in two Caucasian cohorts: the AusDiab Study and the Tromsø study. Nutr J. 2015, 14, 49. https://doi.org/10.1186/s12937-015-0032-1 |
[52]
. In the NHANES 2009-2014, dietary vitamin E intake was inversely associated with hyperuricemia risk in U.S. adult population (aged ≥ 20 years), especially among males and participants aged ≥ 60 years
| [17] | Zhang, L., Shi, X., Yu, J., Zhang, P., Ma, P., Sun, Y. Dietary vitamin E intake was inversely associated with hyperuricemia in US adults: NHANES 2009-2014. Ann Nutr Metab. 2020, 76(5), 354-360. https://doi.org/10.1159/000509628 |
[17]
. This article revealed that the risk of hyperuricemia reached a relatively low level when the dietary vitamin E intake was close to 10.0 mg/day
| [17] | Zhang, L., Shi, X., Yu, J., Zhang, P., Ma, P., Sun, Y. Dietary vitamin E intake was inversely associated with hyperuricemia in US adults: NHANES 2009-2014. Ann Nutr Metab. 2020, 76(5), 354-360. https://doi.org/10.1159/000509628 |
[17]
. The average daily vitamin E intake of Japanese men (aged ≥ 20 years) and women (aged ≥ 20 years) in 2022 were 7.3 mg/day and 6.6 mg/day, respectively. It seems that Japanese adult population (aged ≥ 20 years) need to take in 10.0 mg/day of vitamin E or the AIs set by the IOM of the National Academy in the U.S.
Vitamin E is a potent antioxidant
| [10] | Hayden, M. R., Tyagi, S. C. Uric acid: A new look at an old risk marker for cardiovascular disease, metabolic syndrome, and type 2 diabetes mellitus: The urate redox shuttle. Nutr. Metab (Lond). 2004, 1, 10. https://doi.org/10.1186/1743-7075-1-10 |
[10]
. Vitamin E protects cell membranes from oxidative damage by inhibiting free radical production and reducing oxidative stress
| [62] | He, Y., Chen, X., Ma, Z., Wang, J., Lin, K. Association of oxidative balance score with hyperuricemia and gout: NHANES 2009-2018. Front Endocrinol. 2024, 15, 1402369. https://doi.org/10.3389/fendo.2024.1402369 |
[62]
. He et al.
| [62] | He, Y., Chen, X., Ma, Z., Wang, J., Lin, K. Association of oxidative balance score with hyperuricemia and gout: NHANES 2009-2018. Front Endocrinol. 2024, 15, 1402369. https://doi.org/10.3389/fendo.2024.1402369 |
[62]
have stated that vitamin E may mitigate the negative impact of oxidative stress on UA metabolism, thereby lowering hyperuricemia risk. A possible mechanism of higher vitamin E intake associated with lower hyperuricemia risk could be that vitamin E inhibits the activity of xanthine oxidase
| [63] | Mohd Fahami, N. A., Ibrahim, I. A., Kamisah, Y., Mohd Ismail, N. Palm vitamin E reduces catecholamines, xanthine oxidase activity and gastric lesions in rats exposed to water-immersion restraint stress. BMC Gastroenterol. 2012, 12, 54. https://doi.org/10.1186/1471-230X-12-54 |
[63]
and has uricosuric (increasing or promoting the excretion of UA in urine) effect
and antioxidant activity
| [10] | Hayden, M. R., Tyagi, S. C. Uric acid: A new look at an old risk marker for cardiovascular disease, metabolic syndrome, and type 2 diabetes mellitus: The urate redox shuttle. Nutr. Metab (Lond). 2004, 1, 10. https://doi.org/10.1186/1743-7075-1-10 |
| [62] | He, Y., Chen, X., Ma, Z., Wang, J., Lin, K. Association of oxidative balance score with hyperuricemia and gout: NHANES 2009-2018. Front Endocrinol. 2024, 15, 1402369. https://doi.org/10.3389/fendo.2024.1402369 |
[10, 62]
.
Judging from the data of food composition
| [47] | The Council for Science and Technology, Ministry of Education, Culture, Sports, Science and Technology in Japan. Standard tables of food composition in Japan -2020- (Eighth Revised Edition), Report of the Subdivision Resources. Available from: https://www.mext.go.jp/content/20201225-mxt_kagsei-mext_01110_011.pdf (accessed 16 May 2020). |
| [48] | The Council for Science and Technology, Ministry of Education, Culture, Sports, Science and Technology in Japan. Food Composition Database. Available from: https://fooddb.mext.go.jp/ (accessed 16 October 2024). |
| [49] | U.S. Department of Health & Human Services. National Institutes of Health. Office of Dietary Supplements. Dietary Supplement Fact Sheets. Available from: https://ods.od.nih.gov/factsheets/list-all/ (accessed 17 May 2020). |
[47-49]
, it is important for Japanese men (aged ≥ 15 years) and women (aged ≥ 15 years) to eat organ meats (sweetfish liver, monkfish liver), seafood (salmon roe), wheat germ, seeds and nuts (sunflower seeds, almonds, hazelnuts, peanuts), vegetables (spinach, broccoli, tomatoes, chili pepper), and fruit (kiwifruit, mangos), eggs (egg yolk), fats and oils (peanut butter, margarine, wheat germ oil, sunflower oil, corn oil, soybean oil, rapeseed oil, mayonnaise, shortening), green tea and matcha, tea to take in more vitamin E to reach the RDAs established by the IOM of the National Academy of Sciences in the U.S..
Vitamin K
The daily vitamin K intake of Japanese people in 2022 was lower compared to that in 2001 and was higher compared to that in 2004, 2007, 2010, 2013, 2016, and 2019 (2001: 267 µg/day; 2004: 242 µg/day; 2007: 235 µg/day; 2010: 227 µg/day; 2013: 220 µg/day; 2016: 225 µg/day; 2019: 240 µg/day; 2022: 245 µg/day). The daily vitamin K intake did not show a significant correlation with the number of gout patients in 2001-2019 (r= -0.615, p=0.142) and in 2001-2022 (r= -0.412, p= 0.310) (
Table 1).
The daily vitamin K intake of Japanese adult population (aged ≥ 20 years) in 2022 was higher compared to that in 2019 (2019: 250 µg/day; 2022: 253 µg/day). The daily vitamin K intake did not show a significant correlation with the number of gout patients in the adult population (aged ≥ 20 years) in 2004-2019 (r= -0.318, p= 0.540) and in 2004-2022 (r= -0.022, p= 0.963) (
Table 2). The daily vitamin K intake of Japanese adult men (aged ≥ 20 years) and adult women (aged ≥ 20 years) in 2022 were higher compared to those in 2019, respectively (men: 2019: 258 µg/day; 2022: 264 µg/day, women: 2019: 243 µg/day; 2022: 244 µg/day). The daily vitamin K intake did not show a significant correlation with the number of gout patients in adult men (aged ≥ 20 years) in 2004-2019 (r= -0.162, p= 0.759) and in 2004-2022 (r= 0.222, p= 0.633) (
Table 2). The daily vitamin K intake did not show a significant correlation with the number of gout patients in adult women (aged ≥ 20 years) in 2004-2019 (r= 0.505, p= 0.306) and in 2004-2022 (r= 0.521, p= 0.230) (
Table 2).
The daily vitamin K intake of Japanese men (aged ≥ 15 year) and women (aged ≥ 15 year) in 2022 were 223-288 µg/day and 169-295 µg/day, respectively, and were above the AIs established by the MHLW in Japan [men (aged ≥ 15 years): 150-160 µg/day; women (aged ≥ 15 years): 150 µg/day]
. The AIs for vitamin K in the U.S. men (aged 14-18 years), men (aged ≥ 19 years), women (aged 14-18 years), and women (aged ≥ 19 years) established by the IOM of the National Academy of Sciences in the U.S. are 75 µg/day, 120 µg/day, 75µg/day, and 90 µg/day, respectively
| [42] | Institute of Medicine of the National Academy of Sciences. Food and Nutrition Board. Dietary Reference Intakes: The essential guide to nutrient requirements. Washington, D.C. The National Academy Press. Available from: https://www.nap.edu/catalog/11537.html (accessed 14 October 2021). |
[42]
. This suggests that the daily vitamin K intake in Japanese men (aged ≥ 14 years) and women (aged ≥ 14 years) appears to be very unlikely to cause a deficiency.
Vitamin K-rich foods are meat (ground beef, chicken breast, chicken liver, ham), seafood (salmon, shrimp), seaweed (wakame, nori, hijiki), legumes (soybeans, edamame), soy products (natto), nuts (cashew nuts, pine nuts, mixed nuts), fruit (blueberries, grapes), vegetables (collards, turnip greens, spinach, kales, broccoli, carrots, Jew’s mallows, perillas, iceberg lettuces, pumpkins, okra, parsley), oil (soybean oil, olive oil, canola oil), dairy products (milk, cheddar cheese, mozzarella cheese), eggs, green tea and matcha, tea, carrot juice, vegetable juice
| [47] | The Council for Science and Technology, Ministry of Education, Culture, Sports, Science and Technology in Japan. Standard tables of food composition in Japan -2020- (Eighth Revised Edition), Report of the Subdivision Resources. Available from: https://www.mext.go.jp/content/20201225-mxt_kagsei-mext_01110_011.pdf (accessed 16 May 2020). |
| [48] | The Council for Science and Technology, Ministry of Education, Culture, Sports, Science and Technology in Japan. Food Composition Database. Available from: https://fooddb.mext.go.jp/ (accessed 16 October 2024). |
| [49] | U.S. Department of Health & Human Services. National Institutes of Health. Office of Dietary Supplements. Dietary Supplement Fact Sheets. Available from: https://ods.od.nih.gov/factsheets/list-all/ (accessed 17 May 2020). |
[47-49]
. It seems that Japanese people need to decrease vitamin K intake or pay attention to not to excessive intake of vitamin K.
Vitamin B1
The daily vitamin B
1 intake of Japanese people in 2022 was lower compared to that in 1960, 1965, 1975, 1986, 1989, 1992, 1995, and 1998 and was higher compared to that in 2001, 2004, 2007, 2010, 2013, and 2016 and was the same as that in 2019 (1960: 1.05 mg/day; 1965: 0.97 mg/day; 1975: 1.11 mg/day; 1986: 1.35 mg/day; 1989: 1.23 mg/day; 1992: 1.25 mg/day; 1995: 1.22 mg/day; 1998: 1.16 mg/day; 2001: 0.89 mg/day; 2004: 0.86 mg/day; 2007: 0.87 mg/day; 2010: 0.83 mg/day; 2013: 0.80 mg/day; 2016: 0.86 mg/day; 2019: 0.95 mg/day; 2022: 0.95 mg/day). The daily vitamin B
1 intake was negatively correlated with the number of gout patients in 1986-2019 (r= -0.880, p= 0.000157) and in 1986-2022 (r= -0.832, p= 0.000042) (
Table 1).
The daily vitamin B
1 intake of Japanese adult population (aged ≥ 20 years) in 2022 was the same as that in 2019 (2019: 0.95 mg/day; 2022: 0.95 mg/day). The daily vitamin B
1 intake was negatively correlated with the number of gout patients in the adult population (aged ≥ 20 years) in 2004-2019 (r= -0.831, p= 0.0404) and in 2004-2022 (r= -0.808, p= 0.0279) (
Table 2). The daily vitamin B
1 intake of Japanese adult men (aged ≥ 20 years) in 2022 was higher compared to that in 2019 (2019: 1.03 mg/day; 2022: 1.05 mg/day). The daily vitamin B
1 intake tended to be negatively correlated with the number of gout patients in adult men (aged ≥ 20 years) in 2004-2019 (r= -0.793, p= 0.0599) (
Table 2). The daily vitamin B
1 intake was negatively correlated with the number of gout patients in adult men (aged ≥ 20 years) in 2004-2022 (r= -0.768, p= 0.0435) (
Table 2). Whereas the daily vitamin B
1 intake of Japanese adult women (aged ≥ 20 years) in 2022 was lower compared to that in 2019 (2019: 0.88 mg/day; 2022: 0.87 mg/day). The daily vitamin B
1 intake did not show a significant correlation with the number of gout patients in adult women (aged ≥ 20 years) in 2004-2019 (r= 0.344, p= 0.505) and in 2004-2022 (r= 0.276, p= 0.550) (
Table 2). This result suggests that the correlation of daily vitamin B
1 intake with the number of gout patients tends to vary with gender and is stronger in adult men than in adult women.
The daily vitamin B
1 intake of Japanese [men (aged 15-19 years) and women (aged ≥ 50 years) in 2022 were 1.31 mg/day and 0.81-0.91 mg/day, respectively, and the daily vitamin B
1 intake of Japanese men (aged ≥ 15 years) and women (aged ≥ 15 years) in 2022 were 0.98-1.31 mg/day and 0.79-0.93 mg/day, respectively, and were below the RDAs established by the MHLW in Japan [men (aged 15-17 years): 1.5 mg/day; men (aged 18-49 years): 1.4 mg/day; men (aged 50-74 years): 1.3 mg/day; men (aged ≥ 75 years): 1.2 mg/day; women (aged 15-17 years): 1.2 mg/day; women (aged 18-74 years): 1.1 mg/day; women (aged ≥ 75 years): 0.9 mg/day]
and those established by the IOM of the National Academy of Sciences in the U.S. [men (aged ≥ 14 years): 1.2 mg/day; women (aged 14-18 years): 1.0 mg/day; women (aged ≥ 19 years): 1.1 mg/day]
| [42] | Institute of Medicine of the National Academy of Sciences. Food and Nutrition Board. Dietary Reference Intakes: The essential guide to nutrient requirements. Washington, D.C. The National Academy Press. Available from: https://www.nap.edu/catalog/11537.html (accessed 14 October 2021). |
[42]
.
Increased vitamin B
1 intake was associated with decreased SUA concentrations in the Australian cohort
| [52] | Zykova, S. N., Storhaug, H. M., Toft, I., Chadban, S. J., Jenssen, T. G., White, S. L. Cross-sectional analysis of nutrition and serum uric acid in two Caucasian cohorts: the AusDiab Study and the Tromsø study. Nutr J. 2015, 14, 49. https://doi.org/10.1186/s12937-015-0032-1 |
[52]
. In the NHANES 2017-2020, the daily vitamin B
1 intake was inversely associated with hyperuricemia risk among U.S. adult men (aged ≥ 20 years) but not in women (aged ≥ 20 years) [SUA concentration ≥ 7.0 mg/dL (416.4 µmol/L) in men and ≥ 6.0 mg/dL (356.9 µmol/L) in women]
| [64] | Li, Y-M., Xu, X-H., Xu, X-F., Yang, X-X., Dai, Y-L., Song, D-X., Jin, C-Q., Jia, Y-X. Association between vitamin B1 intake and hyperuricemia in adults. Sci Rep. 2024, 14, 16428. https://doi.org/10.1038/s41598-024-66384-4 |
[64]
. The average daily vitamin B1 intake of Japanese men (aged ≥ 20 years) and women (aged ≥ 20 years) in 2022 were 1.05 mg/day and 0.87 mg/day, respectively. From the results of this article, men in the second level of vitamin B1 intake (0.94-1.24 mg/day) was 25% less likely to be hyperuricemia [SUA concentration ≥ 7.0 mg/dL (416.4 µmol/L) in men] compared to those subjects in the lowest intake level (< 0.94 mg/day)
| [64] | Li, Y-M., Xu, X-H., Xu, X-F., Yang, X-X., Dai, Y-L., Song, D-X., Jin, C-Q., Jia, Y-X. Association between vitamin B1 intake and hyperuricemia in adults. Sci Rep. 2024, 14, 16428. https://doi.org/10.1038/s41598-024-66384-4 |
[64]
. It seems that Japanese adult population (aged ≥ 20 years) need to take in more vitamin B
1 to reach the RDAs established by the MHLW in Japan
and those established by the IOM of the National Academy of Sciences in the U.S.
| [42] | Institute of Medicine of the National Academy of Sciences. Food and Nutrition Board. Dietary Reference Intakes: The essential guide to nutrient requirements. Washington, D.C. The National Academy Press. Available from: https://www.nap.edu/catalog/11537.html (accessed 14 October 2021). |
[42]
.
Sadek et al.
| [65] | Sadek, K. M., Taha, N. M., Korshom, M., Mandour, A. Thiamine ameliorate hepatic, renal dysfunction and dyslipidaemia in diabetic rats. Glob J Biodivers Sci Manag. 2013, 3(1), 78-82. |
[65]
found that thiamine reduced UA levels and ameliorated hepatic, renal dysfunction and dyslipidemia in diabetic rats. Vatsalya et al.
| [66] | Vatsalya, V., Li, F., Frimodig, J., Shah, N., Sutrawe, A., Feng, W. Efficacy of thiamine and medical management in treating hyperuricemia in AUD patients with ALD: role of hyperuricemia in liver injury, gut-barrier dysfunction, and inflammation. Clin Exp Pharmacol. 2021, 11 (Suppl 7), 001. |
[66]
examined the effect of thiamine on SUA concentrations in alcohol use disorder (AUD) patients for three-weeks. This result revealed that dose of thiamine (200 mg/day) to alcohol use disorder (AUD) patients significantly decreased SUA concentrations at day 22 compared to the baseline
| [66] | Vatsalya, V., Li, F., Frimodig, J., Shah, N., Sutrawe, A., Feng, W. Efficacy of thiamine and medical management in treating hyperuricemia in AUD patients with ALD: role of hyperuricemia in liver injury, gut-barrier dysfunction, and inflammation. Clin Exp Pharmacol. 2021, 11 (Suppl 7), 001. |
[66]
. They
| [66] | Vatsalya, V., Li, F., Frimodig, J., Shah, N., Sutrawe, A., Feng, W. Efficacy of thiamine and medical management in treating hyperuricemia in AUD patients with ALD: role of hyperuricemia in liver injury, gut-barrier dysfunction, and inflammation. Clin Exp Pharmacol. 2021, 11 (Suppl 7), 001. |
[66]
also have stated that abstinence and treatment with thiamine could alleviate hyperuricemia in heavy drinkers with mild or no alcohol-associated liver disease (ALD).
Judging from the data of food composition
| [47] | The Council for Science and Technology, Ministry of Education, Culture, Sports, Science and Technology in Japan. Standard tables of food composition in Japan -2020- (Eighth Revised Edition), Report of the Subdivision Resources. Available from: https://www.mext.go.jp/content/20201225-mxt_kagsei-mext_01110_011.pdf (accessed 16 May 2020). |
| [48] | The Council for Science and Technology, Ministry of Education, Culture, Sports, Science and Technology in Japan. Food Composition Database. Available from: https://fooddb.mext.go.jp/ (accessed 16 October 2024). |
| [49] | U.S. Department of Health & Human Services. National Institutes of Health. Office of Dietary Supplements. Dietary Supplement Fact Sheets. Available from: https://ods.od.nih.gov/factsheets/list-all/ (accessed 17 May 2020). |
[47-49]
, it is important for Japanese people (aged ≥ 15 years) to eat meats (beef steak, pork, chicken), seafood (mussels, trout, tuna, walleye pollock, eel), mushrooms (maitake mushrooms), grains (white rice, egg noodle, bread, corn, barley, macaroni, whole wheat, brown rice, oatmeal, breakfast cereals fortified with 100% Daily Value thiamin), seaweed (nori), seeds and nuts (sunflower seeds, sesame seeds, chia seeds, Brazil nuts, peanuts), legumes (black beans, soybeans), fruit (avocados, apples), vegetables (broccoli, parsley), dairy products (milk, yogurt, cheddar cheese), eggs, orange juice to take in more vitamin B
1 to reach the RDAs established by the MHLW in Japan
and those established by the IOM of the National Academy of Sciences in the U.S.
| [42] | Institute of Medicine of the National Academy of Sciences. Food and Nutrition Board. Dietary Reference Intakes: The essential guide to nutrient requirements. Washington, D.C. The National Academy Press. Available from: https://www.nap.edu/catalog/11537.html (accessed 14 October 2021). |
[42]
.
Vitamin B2
The daily vitamin B
2 intake of Japanese people in 2022 was higher compared to that in 1960, 1965, 1975, 2010, 2013, and 2016 and was lower compared to that in 1986, 1989, 1992, 1995, 1998, 2001, and 2019 and was the same as that in 2004 and 2007 (1960: 0.72 mg/day; 1965: 0.83 mg/day; 1975: 0.96 mg/day; 1986: 1.26 mg/day; 1989: 1.33 mg/day; 1992: 1.36 mg/day; 1995: 1.47 mg/day; 1998: 1.42 mg/day; 2001: 1.22 mg/day; 2004: 1.17 mg/day; 2007: 1.17 mg/day; 2010: 1.13 mg/day; 2013: 1.10 mg/day; 2016: 1.15 mg/day; 2019: 1.18 mg/day; 2022: 1.17 mg/day). The daily vitamin B
2 intake was negatively correlated with the number of gout patients in 1986-2019 (r= -0.756, p= 0.00447) and in 1986-2022 (r= -0.747, p= 0.00334) (
Table 1).
The daily vitamin B
2 intake of Japanese adult population (aged ≥ 20 years) in 2022 was the same as that in 2019 (2019: 1.19 mg/day; 2022: 1.19 mg/day). The daily vitamin B
2 intake was negatively correlated with the number of gout patients in the adult population (aged ≥ 20 years) in 2004-2019 (r= -0.846, p= 0.0339) and in 2004-2022 (r= -0.822, p= 0.0231) (
Table 2). The daily vitamin B
2 intake of Japanese adult men (aged ≥ 20 years) and adult women (aged ≥ 20 years) in 2022 was higher compared to that in 2019 (2019: 1.25 mg/day; 2022: 1.26 mg/day). The daily vitamin B
2 intake was negatively correlated with the number of gout patients in adult men (aged ≥ 20 years) in 2004-2019 (r= -0.844, p= 0.0470) and in 2004-2022 (r= -0.807, p= 0.0281) (
Table 2). Whereas the daily vitamin B
2 intake of Japanese adult women (aged ≥ 20 years) in 2022 was lower compared to that in 2019 (2019: 1.13 mg/day; 2022: 1.12 mg/day). The daily vitamin B
2 intake did not show a significant correlation with the number of gout patients in adult women (aged ≥ 20 years) in 2004-2019 (r= 0.370, p= 0.470) and in 2004-2022 (r= 0.295, p= 0.521) (
Table 2). This result suggests that the correlation of daily vitamin B
2 intake with the number of gout patients tends to vary with gender and is stronger in adult men than in adult women.
The daily vitamin B
2 intake of Japanese men (aged 15-69 years) and women (aged 15-59 years) in 2022 were 1.13-1.35 mg/day and 0.92-1.12 mg/day, respectively, and were below the RDAs established by the MHLW in Japan [men (aged 15-69 years): 1.30-1.70 mg/day; women (aged 15-59 years): 1.20-1.40 mg/day]
. The daily vitamin B
2 intake of Japanese men (aged 15-59 years) and women (aged 15-49 years) in 2022 were 1.13-1.29 mg/day and 0.92-1.01 mg/day, respectively, and were below the RDAs established by the IOM of the National Academy of Sciences in the U.S. [men (aged ≥ 14 years): 1.30 mg/day; women (aged ≥ 14 years): 1.00-1.10 mg/day]
| [42] | Institute of Medicine of the National Academy of Sciences. Food and Nutrition Board. Dietary Reference Intakes: The essential guide to nutrient requirements. Washington, D.C. The National Academy Press. Available from: https://www.nap.edu/catalog/11537.html (accessed 14 October 2021). |
[42]
. The daily vitamin B
2 intake of Japanese men (aged ≥ 75 years) and women (aged ≥ 60 years) in 2022 were 1.34 mg/day and 1.18-1.23 mg/day, respectively, and were above the RDAs established by the MHLW in Japan [men (aged ≥ 75 years): 1.30 mg/day; women (aged ≥ 60 years): 1.0-1.2 mg/day]
. The daily vitamin B
2 intake of Japanese men (aged ≥ 60 years) and women (aged ≥ 50 years) in 2022 were 1.34-1.35 mg/day and 1.12-1.23 mg/day, respectively, and were above the RDAs established by the IOM of the National Academy of Sciences in the U.S. [men (aged ≥ 14 years): 1.30 mg/day; women (aged ≥ 19 years): 1.10 mg/day]
| [42] | Institute of Medicine of the National Academy of Sciences. Food and Nutrition Board. Dietary Reference Intakes: The essential guide to nutrient requirements. Washington, D.C. The National Academy Press. Available from: https://www.nap.edu/catalog/11537.html (accessed 14 October 2021). |
[42]
. Therefore, the daily vitamin B
2 intake of Japanese men (aged 15-59 years) and women (aged 15-49 years) in 2022 were below the RDAs, and those of Japanese men (aged ≥ 60 years) and women (aged ≥ 50 years) were above the RDAs established by the IOM of the National Academy of Sciences in the U.S.
| [42] | Institute of Medicine of the National Academy of Sciences. Food and Nutrition Board. Dietary Reference Intakes: The essential guide to nutrient requirements. Washington, D.C. The National Academy Press. Available from: https://www.nap.edu/catalog/11537.html (accessed 14 October 2021). |
[42]
.
Higher vitamin B
2 intake was associated with lower SUA concentrations both in the Australian cohort and the Norwegian cohort
| [52] | Zykova, S. N., Storhaug, H. M., Toft, I., Chadban, S. J., Jenssen, T. G., White, S. L. Cross-sectional analysis of nutrition and serum uric acid in two Caucasian cohorts: the AusDiab Study and the Tromsø study. Nutr J. 2015, 14, 49. https://doi.org/10.1186/s12937-015-0032-1 |
[52]
. Zykova et al.
| [52] | Zykova, S. N., Storhaug, H. M., Toft, I., Chadban, S. J., Jenssen, T. G., White, S. L. Cross-sectional analysis of nutrition and serum uric acid in two Caucasian cohorts: the AusDiab Study and the Tromsø study. Nutr J. 2015, 14, 49. https://doi.org/10.1186/s12937-015-0032-1 |
[52]
found that the average reduction of SUA concentration was significant in most group when intakes were above 2 mg per day (the recommended daily dose is 1.3 mg for men and 1.1 mg for women). It is possible that vitamin B
2 intake prevent gout through a reduction of SUA concentrations.
Judging from the data of food composition [47-49], it is important for Japanese men (aged 15-59 years) and women (aged 15-49 years) to eat meats (beef steak, pigeon), organ meats (beef liver, chicken breast, pork liver, pork kidneys, chicken liver), seafood (clams, salmon, cod), mushrooms (maitake mushrooms, shiitake mushrooms), grains (white rice, egg noodle, bread, macaroni, whole wheat, brown rice, oats, breakfast cereals fortified with 100% Daily Value riboflavin), seeds and nuts (sunflower seeds, almonds), legumes (kidney beans), seaweed (nori, dried wakame), fruit (apples), vegetables (spinach, asparaguses, tomatoes, cauliflowers, chili pepper, parsley), soy products (miso), dairy products (milk, cheese, yogurt), eggs, green tea and matcha to take in more vitamin B
2 to reach the RDAs established by the MHLW in Japan
and those established by the IOM of the National Academy of Sciences in the U.S.
| [42] | Institute of Medicine of the National Academy of Sciences. Food and Nutrition Board. Dietary Reference Intakes: The essential guide to nutrient requirements. Washington, D.C. The National Academy Press. Available from: https://www.nap.edu/catalog/11537.html (accessed 14 October 2021). |
[42]
.
Niacin (Vitamin B3)
The daily intake of niacin equivalent (niacin) of Japanese people in 2022 was higher compared to that in 2001, 2004, 2007, 2010, 2013, and 2016 and was lower compared to that in 2019 (2001: 27.0 mg NE /day; 2004: 26.7 mg NE /day; 2007: 26.7 mg NE /day; 2010: 25.4 mg NE /day; 2013: 25.9 mg NE /day; 2016: 25.8 mg NE /day; 2019: 30.7 mg NE /day; 2022: 30.5 mg NE /day). The daily niacin intake did not show a significant correlation with the number of gout patients in 2001-2019 (r= 0.677, p= 0.0946) (
Table 1). Whereas the daily niacin intake was positively correlated with the number of gout patients in 2001-2022 (r= 0.793, p= 0.019) (
Table 1).
The daily niacin intake of Japanese adult population (aged ≥ 20 years) was lower compared to that in 2019 (2019: 31.3 mg NE /day; 2022: 31.1 mg NE /day). The daily niacin intake did not show a significant correlation with the number of gout patients in the adult population (aged ≥ 20 years) in 2004-2019 (r=0.725, p= 0.103) (
Table 2). Whereas the daily niacin intake was positively correlated with the number of gout patients in the adult population (aged ≥ 20 years) in 2004-2022 (r= 0.833, p= 0.020) (
Table 2). The daily niacin intake of Japanese adult men (aged ≥ 20 years) and adult women (aged ≥ 20 years) in 2022 were lower compared to those in 2019, respectively (men: 2019: 34.5 mg NE /day; 2022: 34.2 mg NE /day, women: 2019: 28.5 mg NE /day; 2022: 28.4 mg NE /day). The daily niacin intake did not show a significant correlation with the number of gout patients in adult men (aged ≥ 20 years) in 2004-2019 (r=0.702, p= 0.120) (
Table 2). The daily niacin intake was positively correlated with the number of gout patients in adult men (aged ≥ 20 years) in 2004-2022 (r= 0.813, p= 0.0261) (
Table 2). The daily niacin intake did not show a significant correlation with the number of gout patients in adult women (aged ≥ 20 years) in 2004-2019 (r= -0.250, p= 0.633) and in 2004-2022 (r= -0.094, p= 0.841) (
Table 2). This result suggests that the correlation of daily niacin intake with the number of gout patients tends to vary with gender and is stronger in adult men than in adult women.
The daily niacin intake of Japanese men (aged ≥ 15 year) and women (aged ≥ 15 year) in 2022 were 33.4-38.3 mg NE /day and 25.4-30.3 mg NE /day, respectively, and were above the RDAs [men (aged ≥ 15 year): 13.0-17.0 mg NE /day; women (aged ≥ 15 year): 10.0-13.0 mg NE /day]
and those established by the IOM of the National Academy of Sciences in the U.S. [men (aged ≥ 14 year): 16.0 mg NE /day; women (aged ≥ 14 year): 14.0 mg NE /day]
| [42] | Institute of Medicine of the National Academy of Sciences. Food and Nutrition Board. Dietary Reference Intakes: The essential guide to nutrient requirements. Washington, D.C. The National Academy Press. Available from: https://www.nap.edu/catalog/11537.html (accessed 14 October 2021). |
[42]
. The daily niacin intake of Japanese men (aged 60-79 years) in 2022 were 35.0-35.1 mg NE /day and were above the ULs established by the IOM of the National Academy of Sciences in the U.S. [men (aged ≥ 19 years): 35.0 mg NE /day]
| [42] | Institute of Medicine of the National Academy of Sciences. Food and Nutrition Board. Dietary Reference Intakes: The essential guide to nutrient requirements. Washington, D.C. The National Academy Press. Available from: https://www.nap.edu/catalog/11537.html (accessed 14 October 2021). |
[42]
. It seems that the daily niacin intake of Japanese people except for men (aged 60-79 years) in 2022 appears to be very unlikely to cause a deficiency.
Niacin-rich foods are meat (beef, ground beef, tenderloin pork, chicken), organ meats (beef liver, smoked pork liver, chicken breast, turkey breast), seafood (salmon, tuna, cod roe, dried bonito, mackerel, bonito, sardines), grains (brown rice, breakfast cereals fortified with 25% Daily Value niacin, white rice, whole wheat bread, white bread), potatoes, seeds and nuts (peanuts, sunflower seeds, pumpkin seeds, cashew nuts), legumes (lentils, edamame, chickpeas), soy products (soymilk, tofu), mushrooms (maitake mushrooms, shiitake mushrooms), fruit (bananas, raisins, apples), vegetables (tomatoes, broccoli, onions, spinach), dairy products (milk, yogurt), eggs, coffee, marinara (spaghetti) sauce [47-49]. It seems that Japanese people need to decrease niacin intake.
Pantothenic Acid (Vitamin B5)
The daily pantothenic acid intake of Japanese people in 2022 was lower compared to that in 2001 and was higher compared to that in 2004, 2007, 2010, 2013, 2016, and 2019 (2001: 5.71 mg/day; 2004: 5.52 mg/day; 2007: 5.46 mg/day; 2010: 5.24 mg/day; 2013: 5.41 mg/day; 2016: 5.45 mg/day; 2019: 5.65 mg/day; 2022: 5.66 mg/day). The daily pantothenic acid intake did not show a significant correlation with the number of gout patients in 2001-2019 (r= -0.138, p= 0.769) and in 2001-2022 (r= 0.112, p= 0.792) (
Table 1).
The daily pantothenic acid intake of Japanese adult population (aged ≥ 20 years) in 2022 was higher compared to that in 2019 (2019: 5.65 mg/day; 2022: 5.67 mg/day). The daily pantothenic acid intake did not show a significant correlation with the number of gout patients in the adult population (aged ≥ 20 years) in 2004-2019 (r= 0.533, p= 0.276) and in 2004-2022 (r= 0.692, p= 0.085) (
Table 2). The daily pantothenic acid intake of Japanese adult men (aged ≥ 20 years) and adult women (aged ≥ 20 years) in 2022 were higher compared to those in 2019, respectively (men: 2019: 6.05 mg/day; 2022: 6.07 mg/day, women: 2019: 5.30 mg/day; 2022: 5.32 mg/day). The daily pantothenic acid intake did not show a significant correlation with the number of gout patients in adult men (aged ≥ 20 years) in 2004-2019 (r= 0.546, p= 0.262) and in 2004-2022 (r= 0.700, p= 0.080) (
Table 2). The daily pantothenic acid intake did not show a significant correlation with the number of gout patients in adult women (aged ≥ 20 years) in 2 in 2004-2019 (r= 0.284, p= 0.585) and in 2004-2022 (r= 0.317, p= 0.488) (
Table 2).
The daily pantothenic acid intake of Japanese men (aged ≥ 20 years) and women (aged ≥ 50 years) in 2022 were 5.74-6.37 mg/day and 5.33-5.81 mg/day, respectively, and were above the AIs established by the MHLW in Japan [men (aged 20-49 years): 5.0 mg/day; men (aged ≥ 60 years): 6.0 mg/day; women (aged ≥ 18 years): 5.0 mg/day]
. The daily pantothenic acid intake of Japanese women (15-49 years) in 2022 was 4.59-4.97 mg/day and was below the AIs established by the MHLW in Japan [women (aged ≥ 18 years): 5.0 mg/day]
. However, the daily pantothenic acid intake of Japanese men (aged ≥ 15 years) and women (aged ≥ 50 years) in 2022 were 5.74-6.93 mg/day and 5.33-5.81 mg/day, respectively, and were above the AIs established by the IOM of the National Academy of Sciences in the U.S. [men (aged ≥ 14 years): 5.0 mg/day; women (aged ≥ 14 years): 5.0 mg/day]
| [42] | Institute of Medicine of the National Academy of Sciences. Food and Nutrition Board. Dietary Reference Intakes: The essential guide to nutrient requirements. Washington, D.C. The National Academy Press. Available from: https://www.nap.edu/catalog/11537.html (accessed 14 October 2021). |
[42]
. The daily pantothenic acid intake of Japanese men (aged ≥ 20 years) and women (aged ≥ 20 years) were 6.07 mg/day and 5.32 mg/day, respectively, and were above the AIs established by the MHLW in Japan [men (aged ≥ 18 years): 5.0-6.0 mg/day; women (aged ≥ 18 years): 5.0 mg/day]
and those established by the IOM of the National Academy of Sciences in the U.S. [men (aged ≥ 14 years): 5.0 mg/day; women (aged ≥ 14 years): 5.0 mg/day]
| [42] | Institute of Medicine of the National Academy of Sciences. Food and Nutrition Board. Dietary Reference Intakes: The essential guide to nutrient requirements. Washington, D.C. The National Academy Press. Available from: https://www.nap.edu/catalog/11537.html (accessed 14 October 2021). |
[42]
.
The daily pantothenic acid intake in Japanese men (aged ≥ 20 years) and women (aged ≥ 20 years) appears to be very unlikely to cause a deficiency. Pantothenic acid-rich foods are meats (beef, ground beef, poultry, sparrow, pigeon), organ meats (chicken breast, chicken liver, smoked pork liver, pork liver, beef kidney, pork kidney), seafood (tuna, eel, cod roe, sardines), mushrooms (shiitake mushrooms, maitake mushrooms), grains (breakfast cereals fortified with 100% Daily Value pantothenic acid, whole wheat, brown rice, oats), potatoes, nuts (peanuts), seeds (sunflower seeds), legumes (chickpeas), fruit (avocados, apples, clementine), vegetables (broccoli, carrots, cabbage, tomatoes), dairy products (milk, cheddar cheese, Greek yogurt), eggs, green tea and matcha [47-49]. Serum vitamin B5 (pantothenic acid) concentrations were positively associated with SUA concentrations
| [54] | Liu, Y., Xia, Y., Wu, Q., Chang, Q., Zhao, Y. Associations between serum vitamins and serum uric acid in a population of Shenyang, China. J Nutr Sci Vitaminol. 2021, 67(2), 77-83. https://doi.org/10.3177/jnsv.67.77 |
[54]
. It seems that Japanese people need to decrease pantothenic acid intake or pay attention to not to excessive intake of pantothenic acid.
Vitamin B6
The daily vitamin B
6 intake of Japanese people in 2022 was lower compared to that in 2001, 2004, 2007, 2010, and 2019 and was higher compared to that in 2013 and 2016 (2001: 1.18 mg/day; 2004: 1.72 mg/day; 2007: 1.67 mg/day; 2010: 1.67 mg/day; 2013: 1.11 mg/day; 2016: 1.11 mg/day; 2019: 1.18 mg/day; 2022: 1.15 mg/day). The daily vitamin B
6 intake did not show a significant correlation with the number of gout patients in 2001-2019 (r= -0.413, p= 0.357) and in 2001-2022 (r= -0.488, p= 0.220) (
Table 1).
The daily vitamin B
6 intake of Japanese adult population (aged ≥ 20 years) in 2022 was lower compared to that in 2019 (2019: 1.20 mg/day; 2022: 1.18 mg/day). The daily vitamin B
6 intake was negatively correlated with the number of gout patients in the adult population (aged ≥ 20 years) in 2004-2019 (r= -0.857, p= 0.0291) and in 2004-2022 (r= -0.842, p= 0.0174) (
Table 2). The daily vitamin B
6 intake of Japanese adult men (aged ≥ 20 years) and adult women (aged ≥ 20 years) in 2022 were lower compared to those in 2019, respectively (men: 2019: 1.30 mg/day; 2022: 1.27 mg/day, women: 2019: 1.12 mg/day; 2022: 1.09 mg/day). The daily vitamin B
6 intake was negatively correlated with number of gout patients in adult men (aged ≥ 20 years) in 2004-2019 (r= -0.850, p= 0.0319) and in 2004-2022 (r= -0.843, p= 0.0173) (
Table 2). Whereas the daily vitamin B
6 intake did not show a significant correlation with the number of gout patients in adult women (aged ≥ 20 years) in 2004-2019 (r= 0.349, p= 0.497) and in 2004-2022 (r= 0.273, p= 0.553) (
Table 2). This result suggests that the correlation of daily vitamin B
6 intake with the number of gout patients tends to vary with gender and is stronger in adult men than in adult women.
The daily vitamin B
6 intake of Japanese men (aged ≥ 15 years) and women (aged 15-59 years) in 2022 were 1.14-1.39 mg/day and 0.92-1.08 mg/day, respectively, and were below the RDAs established by the MHLW in Japan [men (aged ≥ 15 years): 1.40-1.50 mg/day; women (aged 15-59 years): 1.10-1.30 mg/day]
. The daily vitamin B
6 intake of Japanese women (aged ≥ 60 years) in 2022 was 1.15-1.23 mg/day and was above the RDAs established by the MHLW in Japan (1.10 mg/day)
, but was below the RDAs established by the IOM of the National Academy of Sciences in the U.S. (1.50 mg/day)
| [42] | Institute of Medicine of the National Academy of Sciences. Food and Nutrition Board. Dietary Reference Intakes: The essential guide to nutrient requirements. Washington, D.C. The National Academy Press. Available from: https://www.nap.edu/catalog/11537.html (accessed 14 October 2021). |
[42]
. The RDAs for vitamin B
6 in the U.S. men (aged 14-50 years), men (aged ≥ 51 years), women (aged 14-50 years), and women (aged ≥ 51 years) are 1.3 mg/day, 1.7 mg/day, 1,2-1.3 mg/day, and 1.5 mg/day, respectively
| [42] | Institute of Medicine of the National Academy of Sciences. Food and Nutrition Board. Dietary Reference Intakes: The essential guide to nutrient requirements. Washington, D.C. The National Academy Press. Available from: https://www.nap.edu/catalog/11537.html (accessed 14 October 2021). |
[42]
. The daily vitamin B
6 intake of Japanese men (aged 20-49 years), men (aged ≥ 50 years), women (aged 20-49 years), and women (aged ≥ 50 years) in 2022 were 1.14-1.19 mg/day, 1.22-1.39 mg/day, 0.92-0.97 mg/day, and 1.08-1.23 mg/day, respectively.
Therefore, the daily vitamin B
6 intake of Japanese men (aged ≥ 20 years) and women (aged ≥ 15 years) were below the RDAs established by the IOM of the National Academy of Sciences in the U.S.
| [42] | Institute of Medicine of the National Academy of Sciences. Food and Nutrition Board. Dietary Reference Intakes: The essential guide to nutrient requirements. Washington, D.C. The National Academy Press. Available from: https://www.nap.edu/catalog/11537.html (accessed 14 October 2021). |
[42]
.
In the NHANES 2001-2014, no association between vitamin B
6 intake and hyperuricemia risk in both U.S. adult males and females (aged 20-85 years)
.
Judging from the data of food composition [47-49], it is important for Japanese men (aged ≥ 20 years) and women (aged ≥ 15 years) to eat meats (turkey, chicken, pork fin), organ meats (chicken breast, beef liver, pork liver), seafood (tuna, salmon, skipjack, sardines, mackerel, Nile tilapia, squid), grains (white rice, buckwheat, fortified ready-to-eat cereals), potatoes, seeds and nuts (sunflower seeds, pistachio nuts, sesame seeds), legumes (chickpeas), seaweed, vegetables (onions, garlic, tomatoes, peppers), fruit (bananas, raisins, watermelons), dairy products (cheese), soy products (tofu) to take in more vitamin B
6 to reach the RDAs set by the IOM of the National Academy of Sciences in the U.S.
| [42] | Institute of Medicine of the National Academy of Sciences. Food and Nutrition Board. Dietary Reference Intakes: The essential guide to nutrient requirements. Washington, D.C. The National Academy Press. Available from: https://www.nap.edu/catalog/11537.html (accessed 14 October 2021). |
[42]
. However, it must be careful not to exceed the ULs of the daily vitamin B
6 intake.
Folate (Vitamin B9)
The daily folate intake of Japanese people in 2022 was lower compared to that in 2001, 2004, 2007 and 2019 and was higher compared to that in 2013 and 2016 and was the same as that in 2010 (2001: 313.0 µg/day; 2004: 294.0 µg/day; 2007: 299.0 µg/day; 2010: 281.0 µg/day; 2013: 280.0 µg/day; 2016: 277.0 µg/day; 2019: 289.0 µg/day; 2022: 281.0 µg/day). The daily folate intake tended to be negatively correlated with the number of gout patients in 2001-2019 (r= -0.748, p= 0.0532) (
Table 1). Whereas the daily folate intake was negatively correlated with the number of gout patients in 2001-2022 (r= -0.747, p= 0.0333) (
Table 1).
The daily folate intake of Japanese adult population (aged ≥ 20 years) in 2022 was lower compared to that in 2019 (2019: 302.0 µg/day; 2022: 293.0 µg/day). The daily folate intake did not show a significant correlation with the number of gout patients in the adult population (aged ≥ 20 years) in 2004-2019 (r= -0.594, p= 0.214) and in 2004-2022 (r= -0.647, p= 0.116) (
Table 2). The daily folate intake of Japanese adult men (aged ≥ 20 years) and adult women (aged ≥ 20 years) in 2022 were lower compared to those in 2019, respectively (men: 2019: 310.0 µg/day; 2022: 302.0 µg/day, women: 2019: 295.0 µg/day; 2022: 285.0 µg/day). The daily folate intake did not show a significant correlation with the number of gout patients in adult men (aged ≥ 20 years) in 2004-2019 (r= -0.610, p= 0.199) and in 2004-2022 (r= -0.654, p= 0.111) (
Table 2). The daily folate intake did not show a significant correlation with the number of gout patients in adult women (aged ≥ 20 years) in 2004-2019 (r= 0.642, p= 0.169) and in 2004-2022 (r= 0.546, p= 0.205) (
Table 2).
The daily folate intake of Japanese men (aged ≥ 15 years) and women (aged ≥ 40 years) in 2022 were 243.0-350.0 µg/day and 242.0-339.0 µg/day, respectively, and were above the RDAs established by the MHLW in Japan [men (aged ≥ 15 years): 240.0 µg/day; women (aged ≥ 15 years): 240.0 µg/day]
. The daily folate intake of Japanese women (aged 15-39 years) in 2022 was 207.0-220.0 µg/day and were below the RDAs established by the MHLW in Japan [women (aged ≥ 15 years): 240.0 µg/day]
. However, the daily folate intake of Japanese men (aged ≥ 15 years) and women (aged ≥ 15 years) in 2022 were 243-350 µg/day and 207-339 µg/day, respectively, and were below the RDAs established by the IOM of the National Academy of Sciences in the U.S. [men (aged ≥ 14 years) and women (aged ≥ 14 years): 400 µg/day]
| [42] | Institute of Medicine of the National Academy of Sciences. Food and Nutrition Board. Dietary Reference Intakes: The essential guide to nutrient requirements. Washington, D.C. The National Academy Press. Available from: https://www.nap.edu/catalog/11537.html (accessed 14 October 2021). |
[42]
.
Folic acid (84 µg/kg) and zinc (4 mg/kg) decreased SUA concentrations and serum adenosine deaminase and xanthine oxidase activities and enhanced the abundance of probiotics bacteria and reduced the abundance of pathogenic bacteria in high-purine diet-induced hyperuricemic rats
| [68] | Sun, X., Wen, J., Guan, B., Li, J., Luo, J., Li, J., Wei, M., Qiu, H. Folic acid and zinc improve hyperuricemia by altering the gut microbiota of rats with high-purine diet-induced hyperuricemia. Front Microbiol. 2022, 13, 907952. https://doi.org/10.3389/fmicb.2022.907952 |
[68]
. These results suggest that folic acid and zinc ameliorate hyperuricemia by inhibiting UA biosynthesis and stimulating UA excretion by modulating the gut microbiota
| [68] | Sun, X., Wen, J., Guan, B., Li, J., Luo, J., Li, J., Wei, M., Qiu, H. Folic acid and zinc improve hyperuricemia by altering the gut microbiota of rats with high-purine diet-induced hyperuricemia. Front Microbiol. 2022, 13, 907952. https://doi.org/10.3389/fmicb.2022.907952 |
[68]
.
Increased folate intake was associated with decreased SUA concentrations in the Australian cohort
| [52] | Zykova, S. N., Storhaug, H. M., Toft, I., Chadban, S. J., Jenssen, T. G., White, S. L. Cross-sectional analysis of nutrition and serum uric acid in two Caucasian cohorts: the AusDiab Study and the Tromsø study. Nutr J. 2015, 14, 49. https://doi.org/10.1186/s12937-015-0032-1 |
[52]
and the 2016-2019 Korea National Health and Nutrition Examination Survey
| [69] | Chae, S-J., Lee, G-S., Kim, S-H., Ryu, H-S., Yun, M-E. The association between serum uric acid levels and the nutrients adequacy ration among male adult Koreans -Based on the 2016-2019 Korea National Health and Nutrition Examination Survey. J Korean Diet Assoc. 2022, 28, 169-181. |
[69]
. On the other hand, long-term supplementation with folic acid had no effect on SUA concentrations in Norwegian patients with coronary artery disease
| [70] | Dierkes, J., Seifert, R., Gregory, J. F., Nygãrd, O. Long-term supplementation with folic acid and vitamin B-12 has no effect on circulating uric acid concentrations in Norwegian patients with coronary artery disease. Am J Clin Nutr. 2018, 107(1), 130-132. https://doi.org/10.1093/ajcn/nqx017 |
[70]
.
Increased folate intake was associated with decreased hyperuricemia risk
and gout risk
| [71] | Lyu, L. C., Hsu, C. Y., Yeh, C. Y., Lee, M. S., Huang, S. H., Chen, C. L. A case-control study of the association of diet and obesity with gout in Taiwan. Am J Clin Nutr. 2003, 78(4), 690-701. https://doi.org/10.1093/ajcn/78.4.690 |
[71]
. It is possible that folate intake prevent gout through a decrease in SUA concentrations.
In the NHANES 2001-2014, folate intake was inversely associated with hyperuricemia risk among U.S. adult males (aged 20-85 years), but no association between folate intake and hyperuricemia risk among U.S. adult females (aged 20-85 years)
. The average daily folate intake of Japanese men (aged ≥ 20 years) and women (aged ≥ 20 years) in 2022 were 302 µg/day and 285 µg/day, respectively. From the results of this article, male subjects in the second level of folate intake (248-347 µg/day) was 13% less likely to be hyperuricemia [SUA concentration ≥ 7.0 mg/dL (416.4 µmol/L) in males] compared to those subjects in the lowest intake level (≤ 247 µg/day)
. Female subjects in the third level of folate intake (269-353 µg/day) was 18% less likely to be hyperuricemia [SUA concentration ≥ 6.0 mg/dL (356.9 µmol/L) in females] compared to those subjects in the lowest intake level (≤ 191 µg/day)
. From the result of this article
| [18] | Brzezińska, O., Styrzyński, F., Makowska, J., Walczak, K. The role of vitamin C in prophylaxis and treatment of gout- A literature review. Nutrients. 2021, 13(2), 701. https://doi.org/10.3390/nu13020701 |
[18]
, it seems that Japanese adult population (aged ≥ 20 years) need to take in more folate.
Judging from the data of food composition [47-49], it is important for Japanese men (aged ≥ 15 years) and women (aged ≥ 15 years) to eat meats (beef), organ meats (liver, breast), seafood (crab, halibut, sardines, sea urchin), mushrooms (maitake mushrooms, shiitake mushrooms), grains (white rice, spaghetti, bread, wheat, fortified ready-to-eat cereals), seeds and nuts (sunflower seeds, peanuts), legumes (black-eyed peas, kidney beans, green peas, soybeans, chickpeas), seaweed, fruit (avocados, oranges, papayas, bananas, mangos), vegetables (asparaguses, spinach, brussels sprouts, lettuces, broccoli, mustard greens, Jew’s mallows), dairy products (milk), eggs, green tea to take in more folate to reach the RDAs established by the IOM of the National Academy of Sciences in the U.S.
| [42] | Institute of Medicine of the National Academy of Sciences. Food and Nutrition Board. Dietary Reference Intakes: The essential guide to nutrient requirements. Washington, D.C. The National Academy Press. Available from: https://www.nap.edu/catalog/11537.html (accessed 14 October 2021). |
[42]
. Serum vitamin B9 (folate) concentrations were positively associated with SUA concentrations
| [54] | Liu, Y., Xia, Y., Wu, Q., Chang, Q., Zhao, Y. Associations between serum vitamins and serum uric acid in a population of Shenyang, China. J Nutr Sci Vitaminol. 2021, 67(2), 77-83. https://doi.org/10.3177/jnsv.67.77 |
[54]
. It seems that Japanese people need to decrease folate intake or pay attention to not to excessive intake of folate.
Vitamin B12
The daily vitamin B
12 intake of Japanese people in 2022 was lower compared to that in 2001, 2004, 2007, 2010, 2013, 2016, and 2019 (2001: 7.7 µg/day; 2004: 7.0 µg/day; 2007: 7.1 µg/day; 2010: 6.0 µg/day; 2013: 6.1 µg/day; 2016: 6.0 µg/day; 2019: 6.3 µg/day; 2022: 5.4 µg/day). The daily vitamin B
12 intake was negatively correlated with the number of gout patients in 2001-2019 (r= -0.812, p= 0.0264) and in 2001-2022 (r= -0.873, p= 0.0047) (
Table 1).
The daily vitamin B
12 intake of Japanese adult population (aged ≥ 20 years) in 2022 was lower compared to that in 2019 (2019: 6.5 µg/day; 2022: 5.6 µg/day). The daily vitamin B
12 intake did not show a significant correlation with the number of gout patients in the adult population (aged ≥ 20 years) in 2004-2019 (r= -0.707, p= 0.116) (
Table 2). Whereas the daily vitamin B
12 intake was negatively correlated with the number of gout patients in the adult population (aged ≥ 20 years) in 2004-2022 (r= -0.822, p= 0.0231) (
Table 2). The daily vitamin B
12 intake of Japanese adult men (aged ≥ 20 years) and adult women (aged ≥ 20 years) in 2022 were lower compared to those in 2019, respectively (men: 2019: 7.3µg/day; 2022: 6.3µg/day, women: 2019: 5.9 µg/day; 2022: 5.1 µg/day). The daily vitamin B
12 intake did not show a significant correlation with the number of gout patients in adult men (aged ≥ 20 years) in 2004-2019 (r= -0.723, p= 0.105) (
Table 2). Whereas the daily vitamin B
12 intake was negatively correlated with the number of gout patients in adult men (aged ≥ 20 years) in 2004-2022 (r= -0.826, p= 0.0219) (
Table 2). The daily vitamin B
12 intake was positively correlated with the number of gout patients in adult women (aged ≥ 20 years) in 2004-2019 (r= 0.881, p= 0.0205) (
Table 2). The daily vitamin B
12 intake did not show a significant correlation with the number of gout patients n adult women (aged ≥ 20 years) in 2004-2022 (r= 0.573, p= 0.178) (
Table 2). This result suggests that the correlation of daily vitamin B
12 intake with the number of gout patients varies with gender and is stronger in adult women than in adult men.
The daily vitamin B
12 intake for men (aged ≥ 15 years) and women (aged ≥ 15 years) in 2022 were 4.4-7.2 µg/day and 3.5-6.2 µg/day, respectively, and were above the RDAs established by the MHLW in Japan [men (aged ≥ 15 years): 2.4 µg/day; women (aged ≥ 15 years): 2.4 µg/day]
and those established by the IOM of the National Academy of Sciences in the U.S. [men (aged ≥ 14 years): 2.4 µg/day; women (aged ≥ 14 years): 2.4 µg/day]
| [42] | Institute of Medicine of the National Academy of Sciences. Food and Nutrition Board. Dietary Reference Intakes: The essential guide to nutrient requirements. Washington, D.C. The National Academy Press. Available from: https://www.nap.edu/catalog/11537.html (accessed 14 October 2021). |
[42]
. The MHLW in Japan
and the IOM of the National Academy of Sciences in the U.S.
| [42] | Institute of Medicine of the National Academy of Sciences. Food and Nutrition Board. Dietary Reference Intakes: The essential guide to nutrient requirements. Washington, D.C. The National Academy Press. Available from: https://www.nap.edu/catalog/11537.html (accessed 14 October 2021). |
[42]
have not set the ULs for healthy people.
Long-term supplementation with vitamin B
12 had no effect on SUA concentrations in Norwegian patients with coronary artery disease
| [70] | Dierkes, J., Seifert, R., Gregory, J. F., Nygãrd, O. Long-term supplementation with folic acid and vitamin B-12 has no effect on circulating uric acid concentrations in Norwegian patients with coronary artery disease. Am J Clin Nutr. 2018, 107(1), 130-132. https://doi.org/10.1093/ajcn/nqx017 |
[70]
.
In the NHANES 2001-2014, vitamin B
12 intake was inversely associated with hyperuricemia risk among U.S. adult males (aged 20-85 years), but no association between vitamin B
12 intake and hyperuricemia risk among U.S. adult females (aged 20-85 years)
. The average daily vitamin B
12 intake of Japanese men (aged ≥ 20 years) and women (aged ≥ 20 years) in 2022 were 6.3 µg/day and 5.1 µg/day, respectively. From the results of this article, male subjects in the fourth level of vitamin B
12 intake (5.59-8.43 µg/day) was 21% less likely to be hyperuricemia [serum uric acid (SUA) concentration ≥ 7.0 mg/dL (416.4 µmol/L) in males] compared to those subjects in the lowest intake level (≤ 2.27 µg/day)
. Female subjects in the fourth level of vitamin B
12 intake (3.92-5.93 µg/day) was 15% less likely to be hyperuricemia [serum uric acid (SUA) concentration ≥ 6.0 mg/dL (356.9 µmol/L) in females] compared to those subjects in the lowest intake level (≤ 1.56 µg/day)
.
Further research is necessary to assess association between vitamin B
12 intake and SUA concentrations or hyperuricemia risk. Harris et al.
| [72] | Harris, M. D., Siegel, L. B., & Alloway, J. A. (1999) Gout and hyperuricemia. Am Fam Physician, 59, 925-934. |
[72]
have stated that vitamin B
12 as drug associated with increased cellular turnover and destruction can lead to secondary hyperuricemia and gout.
Vitamin B
12-rich foods are meats (beef, ground beef), organ meats (beef liver, angler liver, pork liver, chicken liver, turkey breast, sweetfish liver, monkfish liver), seafood (clams, tuna, oysters, salmon, anchovy, freshwater, trout, lamprey eel, firefly squid, chub mackerel, salmon roe, sardines, mullet, sculpin), grains (bread, breakfast cereals fortified with 25% DV vitamin B
12), legumes and soybean processed foods (kidney beans, tempeh), seaweed (nori), fruit (bananas, strawberries), vegetables (spinach), dairy products (milk, yogurt, cheese), eggs
| [47] | The Council for Science and Technology, Ministry of Education, Culture, Sports, Science and Technology in Japan. Standard tables of food composition in Japan -2020- (Eighth Revised Edition), Report of the Subdivision Resources. Available from: https://www.mext.go.jp/content/20201225-mxt_kagsei-mext_01110_011.pdf (accessed 16 May 2020). |
| [48] | The Council for Science and Technology, Ministry of Education, Culture, Sports, Science and Technology in Japan. Food Composition Database. Available from: https://fooddb.mext.go.jp/ (accessed 16 October 2024). |
| [49] | U.S. Department of Health & Human Services. National Institutes of Health. Office of Dietary Supplements. Dietary Supplement Fact Sheets. Available from: https://ods.od.nih.gov/factsheets/list-all/ (accessed 17 May 2020). |
[47-49]
. It seems that Japanese people (aged ≥ 15 years) need to decrease vitamin B
12 intake or pay attention to not to excessive intake of vitamin B
12.
Vitamin C
The vitamin C intake of Japanese people in 2022 was higher compared to that in 1960, 1965, 2010, and 2016 and was lower compared to that in 1975, 1986, 1989, 1992, 1995, 1998, 2001, 2004, 2007, 2013, and 2019 (1960: 75.0 mg/day; 1965: 78.0 mg/day; 1975: 117.0 mg/day; 1986: 124.0 mg/day; 1989: 123.0 mg/day; 1992: 122.0 mg/day; 1995: 135.0 mg/day; 1998: 125.0 mg/day; 2001: 106.0 mg/day; 2004: 99.0 mg/day; 2007: 96.0 mg/day; 2010: 90.0 mg/day; 2013: 94.0 mg/day; 2016: 89.0 mg/day; 2019: 94.0 mg/day; 2022: 93.0 mg/day).
The daily vitamin C intake was negatively correlated with the number of gout patients in 1986-2019 (r= -0.900, p= 0.0000661) and in 1986-2022 (r= -0.894, p= 0.0000376) (
Table 1).
The daily vitamin C intake of Japanese adult population (aged ≥ 20 years) in 2022 was lower compared to that in 2019 (2019: 99.0 mg/day; 2022: 98.0 mg/day). The daily vitamin C intake was negatively correlated with the number of gout patients in the adult population (aged ≥ 20 years) in 2004-2019 (r= -0.879, p= 0.0211) and in 2004-2022 (r= -0.857, p= 0.0137) (
Table 2). The daily vitamin C intake of Japanese adult men (aged ≥ 20 years) and adult women (aged ≥ 20 years) in 2022 were lower compared to those in 2019, respectively (men: 2019: 96.0 mg/day; 2022: 95.0 mg/day, women: 2019: 101.0 mg/day; 2022: 100.0 mg/day). The daily vitamin C intake was negatively correlated with the number of gout patients in adult men (aged ≥ 20 years) in 2004-2019 (r= -0.873, p= 0.0233) and in 2004-2022 (r= -0.865, p= 0.0119) (
Table 2). The daily intake of vitamin C did not show a significant correlation with the number of gout patients in adult women (aged ≥ 20 years) in 2004-2019 (r= 0.600, p= 0.208) and in 2004-2022 (r= 0.507, p= 0.246) (
Table 2). This result suggests that the correlation of daily vitamin C intake with the number of gout patients tends to vary with gender and is stronger in adult men than in adult women.
The daily vitamin C intake of Japanese men (aged 15-59 years) and women (aged 15-59 years) in 2022 were 62.0-81.0 mg/day and 60.0-87.0 mg/day, respectively, and were below the RDAs established by the MHLW in Japan [men (aged ≥ 12 years): 100.0 mg/day; women (aged ≥ 12 years): 100.0 mg/day]
. Whereas the daily vitamin C intake of Japanese men (aged ≥ 60 years) and women (aged ≥ 60 years) were 103-128 mg/day and 111-133 mg/day, respectively, and were above the RDAs established by the MHLW in Japan [men (aged ≥ 12 years): 100.0 mg/day; women (aged ≥ 12 years): 100.0 mg/day]
. The RDAs for vitamin C in the U.S. men (aged ≥ 19 years) and women (aged ≥ 19 years) established by the IOM of the National Academy of Sciences in the U.S. are 90.0 mg/day and 75.0 mg/day, respectively
| [42] | Institute of Medicine of the National Academy of Sciences. Food and Nutrition Board. Dietary Reference Intakes: The essential guide to nutrient requirements. Washington, D.C. The National Academy Press. Available from: https://www.nap.edu/catalog/11537.html (accessed 14 October 2021). |
[42]
. The daily vitamin C intake of Japanese men (aged 20-59 years) and women (aged 20-49 years) in 2022 were 62.0-81.0 mg/day and 60.0-68.0 mg/day, respectively, and were below the RDAs established by the IOM of the National Academy of Sciences in the U.S.
| [42] | Institute of Medicine of the National Academy of Sciences. Food and Nutrition Board. Dietary Reference Intakes: The essential guide to nutrient requirements. Washington, D.C. The National Academy Press. Available from: https://www.nap.edu/catalog/11537.html (accessed 14 October 2021). |
[42]
. Whereas the daily vitamin C intake of Japanese men (aged ≥ 60 years) and women (aged ≥ 50 years) in 2022 were 103.0-128.0 mg/day and 87.0-133.0 mg/day, respectively, and exceeded the RDAs established by the IOM of the National Academy of Sciences in the U.S.
| [42] | Institute of Medicine of the National Academy of Sciences. Food and Nutrition Board. Dietary Reference Intakes: The essential guide to nutrient requirements. Washington, D.C. The National Academy Press. Available from: https://www.nap.edu/catalog/11537.html (accessed 14 October 2021). |
[42]
. Therefore, the daily vitamin C intake of Japanese men (aged 20-59 years) and women (aged 20-49 years) in 2022 were below the RDAs established by the MHLW in Japan
and those established by the IOM of the National Academy of Sciences in the U.S.
| [42] | Institute of Medicine of the National Academy of Sciences. Food and Nutrition Board. Dietary Reference Intakes: The essential guide to nutrient requirements. Washington, D.C. The National Academy Press. Available from: https://www.nap.edu/catalog/11537.html (accessed 14 October 2021). |
[42]
.
In clinical trials, vitamin C decreased SUA concentrations [73-77]. Vitamin C intake was not significantly associated with SUA concentrations both in the Australian cohort and the Norwegian cohort
| [52] | Zykova, S. N., Storhaug, H. M., Toft, I., Chadban, S. J., Jenssen, T. G., White, S. L. Cross-sectional analysis of nutrition and serum uric acid in two Caucasian cohorts: the AusDiab Study and the Tromsø study. Nutr J. 2015, 14, 49. https://doi.org/10.1186/s12937-015-0032-1 |
[52]
. On the other hand, increased intake of vitamin C was associated with decreased SUA concentrations [20, 23-25], hyperuricemia risk [23, 25, 27, 28], and gout risk [71, 78]. Vitamin C intake may prevent gout through reduced SUA concentrations and decreased hyperuricemia risk.
A possible mechanism of higher vitamin C intake associated with lower SUA concentration and reduced risk of hyperuricemia and gout are presumed to be due to the following four reasons: (1) vitamin C lowers SUA concentration through a uricosuric effect by competing with SUA on the urate transporter 1 (also known as solute carrier family 22, member 12, or SLC22A12) for re-absorption in the kidney proximal tubule [73. 75-77, 79]; (2) vitamin C inhibits the pro-oxidant actions of UA during copper-mediated low density lipoprotein cholesterol (LDL-cholesterol) oxidation, and could reduce oxidative stress and inflammation, and may be related to lower UA production
| [10] | Hayden, M. R., Tyagi, S. C. Uric acid: A new look at an old risk marker for cardiovascular disease, metabolic syndrome, and type 2 diabetes mellitus: The urate redox shuttle. Nutr. Metab (Lond). 2004, 1, 10. https://doi.org/10.1186/1743-7075-1-10 |
[10]
; (3) vitamin C, which exerts as an antioxidant, reduced uric acid-induced inflammation by inhibiting activation of responsible nucleotide-binding and oligomerization domain-like receptor, leucine-rich repeat and pyrin domain-containing 3 (NLRP3) inflammasome in monosodium urate (MSU)-induced inflammation
| [80] | Kim, S.-K., Choe, J.-Y., Park, K.-Y. TXNIP -mediated nuclear factor-ĸB signaling pathway and intracellular shuttling of TXNIP in uric acid-induced NLRP3 inflammasome. Biochem Biophys Res Commun. 2018, 511(4), 725-731. https://doi.org/10.1016/j.bbrc.2019.02.141 |
[80]
;(4) a higher serum vitamin C level has a positive effect on purine metabolism and favors the reduction of UA level, thus reducing the risk of monosodium urate crystal deposition in joints structures and soft tissue
| [18] | Brzezińska, O., Styrzyński, F., Makowska, J., Walczak, K. The role of vitamin C in prophylaxis and treatment of gout- A literature review. Nutrients. 2021, 13(2), 701. https://doi.org/10.3390/nu13020701 |
[18]
. The role of vitamin C in prophylaxis and treatment of gout including molecular role of vitamin C in the transport of UA in the proximal renal tubules and in inflammatory process regulation was reviewed in detail by Brzezińska et al.
| [18] | Brzezińska, O., Styrzyński, F., Makowska, J., Walczak, K. The role of vitamin C in prophylaxis and treatment of gout- A literature review. Nutrients. 2021, 13(2), 701. https://doi.org/10.3390/nu13020701 |
[18]
.
Choi et al.
found that vitamin C intake associated with lower gout risk have been approximately 500 mg/day or higher compared with vitamin C intake < 250 mg/day. UK Gout Society
has stated that taking additional vitamin C as a dietary supplement (500 to 1500 mg/day) can reduce blood UA levels.
Judging from the data of food composition [47-49], it is important for Japanese men (aged 20-59 years) and women (aged 20-49 years) to eat potatoes, legumes (green peas), seaweed (nori), fruit (oranges, grapefruit, cantaloupes, acerolas, guavas, yuzu, kiwifruit, lemons, strawberries, papayas, blackcurrants), vegetables (red pepper, green pepper, kales, peppers, parsley, broccoli, tomatoes, cauliflowers, peas, eggplants, brussels sprouts, Chinese cabbages, cabbages, mustard spinach, chili pepper, ginger), orange juice, tomato juice, acerola juice, green tea to take in more vitamin C to reach the RDAs established by the MHLW in Japan
and those established by the IOM of the National Academy of Sciences in the U.S.
| [42] | Institute of Medicine of the National Academy of Sciences. Food and Nutrition Board. Dietary Reference Intakes: The essential guide to nutrient requirements. Washington, D.C. The National Academy Press. Available from: https://www.nap.edu/catalog/11537.html (accessed 14 October 2021). |
[42]
.
3.1.2. Minerals
Sodium and Salt
Sodium
The daily sodium intake of Japanese people in 2022 was lower compared to that in 1995, 1998, 2000, 2002, 2005, 2007, 2010, 2013, 2016, and 2019 (1995: 5.18 g/day; 1998: 5.00 g/day; 2000: 4.85 g/day; 2002: 4.48 g/day; 2005: 4.32 g/day; 2007: 4.18 g/day; 2010: 4.00 g/day; 2013: 3.87 g/day; 2016: 3.77 g/day; 2019: 3.83 g/day; 2022: 3.71 g/day). The daily sodium intake was negatively correlated with the number of gout patients in 1995-2019 (r= -0.964, p= 0.000474) and in 1995-2022 (r= -0.959, p= 0.000166) (
Table 1).
The daily sodium intake of Japanese adult population (aged ≥ 20 years) in 2022 was lower compared to that in 2019 (2016: 2019: 3.96 g/day; 2022: 3.81 g/day). The daily sodium intake of Japanese adult men (aged ≥ 20 years) and adult women (aged ≥ 20 years) in 2022 were lower compared to those in 2019, respectively (men: 2019: 4.31 g/day; 2022: 4.15 g/day, women: 2019: 3.65 g/day; 2022: 3.53 g/day).
The Joint WHO/FAO Expert Consultation
| [82] | Nishida, C., Uauy, R., Kumanyika, S., Shetty, P. The joint WHO/FAO expert consultation on diet, nutrition and the prevention of chronic diseases: process, product and policy implications. Public Health Nutr. 2004, 7(1A), 245-250. https://doi.org/10.1079/phn2003592 |
[82]
has stated that the recommended intake of sodium is < 2 g/day. The daily sodium intake of Japanese men (aged ≥ 20 years) and women (aged ≥ 20 years) in 2022 were 3905-4363 mg/day and 3100-3789 mg/day, respectively, and exceeded the EARs established by the MHLW in Japan [men (aged ≥ 18 years): 600 mg/day; women (aged ≥ 18 years): 600 mg/day]
. On the other hand, the MHLW in Japan
have not set the AIs and the IOM of the National Academy of Sciences in the U.S.
| [42] | Institute of Medicine of the National Academy of Sciences. Food and Nutrition Board. Dietary Reference Intakes: The essential guide to nutrient requirements. Washington, D.C. The National Academy Press. Available from: https://www.nap.edu/catalog/11537.html (accessed 14 October 2021). |
[42]
and the IOM of the National Academies of Sciences, Engineering, and Medicine in the U.S.
| [43] | Institute of Medicine. National Academies of Sciences, Engineering, and Medicine, Health and Medicine Division, Food and Nutrition Board; Committee to review the Dietary Reference Intakes for Sodium and Potassium. Washington, DC: The National Academy Press; 2019. |
[43]
have not set the EARs and the RDAs. The AIs and the ULs for sodium in the U.S. people (aged ≥ 14 years) established by the IOM in the U.S. are 1500 mg/day and 2300 mg/day, respectively [42, 43]. U.S. Department of Agriculture and U.S. Department of Health and Human Services
have stated that the daily sodium intake of Americans should be less than 2300 mg/day and even less for children younger than age 14. The daily sodium intake of Japanese men (aged ≥ 20 years) and women (aged ≥ 20 years) in 2022 were above the ULs established by the IOM in the U.S. [42, 43]. It seems that the daily sodium intake of Japanese men and women in 2022 is excessive.
Sodium-rich foods are seafood (salted fish, anchovies canned, Alaska pollock, Pacific cod, salted shrimp), seaweed (dried wakame, kelp), soy products (miso, soy sauce), Chinese soup stock, bouillon, kelp tea
| [48] | The Council for Science and Technology, Ministry of Education, Culture, Sports, Science and Technology in Japan. Food Composition Database. Available from: https://fooddb.mext.go.jp/ (accessed 16 October 2024). |
[48]
.
Salt
The daily salt intake of Japanese people in 2022 was lower compared to that in 1975, 1980, 1985, 1986, 1995, 1998, 2001, 2004, 2007, 2010, 2013, 2016, and 2019 (1975: 13.5 g/day; 1980: 12.9 g/day; 1985: 12.1 g/day; 1986: 12.1 g/day; 1995: 13.2 g/day; 1998: 12.7 g/day; 2001: 11.5 g/day; 2004: 10.7 g/day; 2007: 10.6 g/day; 2010: 10.2 g/day; 2013: 9.8 g/day; 2016: 9.6 g/day; 2019: 9.7 g/day; 2022: 9.4 g/day). The daily salt intake was negatively correlated with number of gout patients in 1986-2019 (r= -0.913, p= 0.0000331) and in 1986-2022 (r= -0.926, p= 0.00000057) (
Table 1).
The daily salt intake of Japanese adult population (aged ≥ 20 years) in 2022 was lower compared to that in 2019 (2019: 10.1 g/day; 2022: 9.7 g/day). The daily salt intake was negatively correlated with the number of gout patients in the adult population (aged ≥ 20 years) in 2004-2019 (r= -0.884, p= 0.0195) and in 2004-2022 (r= -0.917, p= 0.0037) (
Table 2). The daily salt intake of Japanese adult men (aged ≥ 20 years) and adult women (aged ≥ 20 years) in 2022 were lower compared to those in 2019, respectively (men: 2019: 10.9 g/day; 2022: 10.5 g/day, women: 2019: 9.3 g/day; 2022: 9.0 g/day). The daily salt intake was negatively correlated with the number of gout patients in adult men (aged ≥ 20 years) in 2004-2019 (r= -0.916, p= 0.0102) and in 2004-2022 (r= -0.942, p= 0.0015) (
Table 2). The daily salt intake did not show a significant correlation with the number of gout patients in adult women (aged ≥ 20 years) in 2004-2019 (r= 0.749, p= 0.0864) and in 2004-2022 (r= 0.571, p= 0.181) (
Table 2). This result suggests that the correlation of daily salt intake with the number of gout patients tends to vary with gender and is stronger in adult men than in adult women.
The daily salt intake of Japanese men (aged ≥ 15 year) and women (aged ≥ 15 year) in 2022 were 9.9-11.1 g/day and 7.9-9.6 g/day, respectively, and exceeded the Tentative Dietary Goal for Preventing Lifestyle-related Diseases (DGs) established by the MHLW in Japan [men (aged ≥ 15 year): < 7.5 g/day; women (aged ≥ 15 year): < 6.5 g/day]
. It is speculated that a decrease in daily salt intake in the situation of exceeding the DGs is associated with the number of patients with gout. Thus, it is important for Japanese people to reduce salt intake.
In an interventional trial of 90 subjects (aged 18-65 years) on a normal diet for 3 days at baseline, a low-salt diet for 7 days (3.0 g/day, NaCl), and a high-salt diet for an additional 7 days (18.0 g/day, NaCl), plasma UA levels increased from baseline to low-salt diet and decreased from low-salt diet to high-salt diet and the 24 h urinary sodium excretions showed inverse correlation with plasma UA and positive correlation with urinary UA excretions
| [84] | Wang, Y., Chu, C., Wang, K-K., Hu, J-W., Yan, Y., Lv, Y-B., Cao, Y-M., Zheng, W-L., Dang, X-L., Xu, J-T., Chen, W., Yuan, Z-Y., Mu, J-J. Effect of salt intake on plasma and urinary uric acid levels in Chinese adults: an interventional trial. Sci Rep. 2018, 8(1), 1434. https://doi.org/10.1038/s41598-018-20048-2 |
[84]
.
The guidelines for management of gout established by 2012 American College of Rheumatology
| [5] | Khanna, D., Fitzgerald, J. D., Khanna, P. P., Bae, S., Singh, M. K., Neogi, T., Pillinger, M. H., Merill, J., Lee, S., Prakash, S., Kaldas, M., Gogia, M., Perez-Ruiz, F., Taylor, W., Lioté, F., Choi, H., Singh, J. A., Dalbeth, N., Kaplan, S., Niyyar, V., Jones, D., Yarows, S. A., Roessler, B., Kerr, G., King, C., Levy, G., Furst, D. E., Edwards, N. L., Mandell, B., Schumacher, H. R., Robbins, M., Wenger, N., Terkeltaub, R. 2012 American College of Rheumatology guidelines for management of gout. Part 1: systematic nonpharmacologic and pharmacologic therapeutic approaches to hyperuricemia. Arthritis Care Research. 2012, 64(10), 1431-1446. https://doi.org/10.1002/acr.21772 |
[5]
recommended the limit intake of salt in gout patients. The World Health Organization
has stated that keep salt intake to less than 5 g/day.
Calcium
The calcium intake of Japanese people in 2022 was higher compared to that in 1960 and 1965 and was lower compared to that in 1975, 1986, 1989, 1992, 1995, 1998, 2001, 2004, 2007, 2010, 2013, 2016, and 2019 (1960: 389.0 mg/day; 1965: 465.0 mg/day; 1975: 550.0 mg/day; 1986: 551.0 mg/day; 1989: 540.0 mg/day; 1992: 539.0 mg/day; 1995: 585.0 mg/day; 1998: 568.0 mg/day; 2001: 550.0 mg/day; 2004: 538.0 mg/day; 2007: 531.0 mg/day; 2010: 510.0 mg/day; 2013: 504.0 mg/day; 2016: 502.0 mg/day; 2019: 505.0 mg/day; 2022: 500.0 mg/day). The daily calcium intake was negatively correlated with the number of gout patients in 1986-2019 (r= -0.757, p= 0.00435) and in 1986-2022 (r= -0.793, p= 0.00123) (
Table 1).
The daily calcium intake of Japanese adult population (aged ≥ 20 years) in 2022 was lower compared to that in 2019 (2019: 498.0 mg/day; 2022: 495.0 mg/day). The daily calcium intake was negatively correlated with the number of gout patients in the adult population (aged ≥ 20 years) in 2004-2019 (r= -0.883, p= 0.0396) and in 2004-2022 (r= -0.830, p= 0.0207) (
Table 2). The daily calcium intake of Japanese adult men (aged ≥ 20 years) and adult women (aged ≥ 20 years) in 2022 were lower compared to those in 2019, respectively (men: 2019: 503.0 mg/day; 2022: 501.0 mg/day, women: 2019: 494.0 mg/day; 2022: 491.0 mg/day). The daily calcium intake tended to be negatively correlated with the number of gout patients in adult men (aged ≥ 20 years) in 2004-2019 (r= -0.781, p= 0.0668) (
Table 2). The daily calcium intake was negatively correlated with the number of gout patients in the adult men (aged ≥ 20 years) in 2004-2022 (r= -0.792, p= 0.0338) (
Table 2). Whereas the daily calcium intake tended to be positively correlated with the number of gout patients in adult women (aged ≥ 20 years) in 2004-2019 (r= 0.786, p= 0.0639) and in 2004-2022 (r= 0.718, p=0.0693) (
Table 2). This result suggests that the correlation of daily calcium intake with the number of gout patients tends to vary with gender.
The daily calcium intake of Japanese men (aged ≥ 15 year) and women (aged ≥ 15 year) in 2022 were 419-588 mg/day and 359-572 mg/day, respectively, and were below the RDAs established by the MHLW in Japan [men (aged ≥ 15 years): 700-800 mg/day; women (aged ≥ 15 years): 600-650 mg/day]
and the AIs established by the IOM of the National Academy of Sciences in the U.S. [men and women (aged 14-18 years): 1300 mg/day; men and women (aged 19-50 years): 1000 mg/day; men and women (aged ≥ 51 years): 1200 mg/day]
| [42] | Institute of Medicine of the National Academy of Sciences. Food and Nutrition Board. Dietary Reference Intakes: The essential guide to nutrient requirements. Washington, D.C. The National Academy Press. Available from: https://www.nap.edu/catalog/11537.html (accessed 14 October 2021). |
[42]
. It seems that Japanese population (aged ≥ 15 years) need to take in more calcium.
A randomized, placebo controlled clinical trial showed that a difference of calcium intake of 1200 mg per day was associated with a difference in SUA levels of 0.022 mmol/L
| [86] | Dalbeth, N., Horne, A., Gamble, G. D., Ames, R., Reid, I. R. The effect of calcium supplementation on serum urate; analysis of a randomized controlled trial. Rheumatology. 2009, 48(2), 195-197. https://doi.org/10.1093/rheumatology/ken416 |
[86]
. In epidemiological studies, increased intake of calcium was associated with decreased SUA concentrations [52. 68, 87] and hyperuricemia risk
| [27] | Yu, K-H., See, L-C., Huang, Y-C., Yang, C-H., Sun, J-H. Dietary factors associated with hyperuricemia in adults. Semin Arthritis Rheum. 2008, 37(4), 243-250. https://doi.org/10.1016/j.semarthrit.2007.04.007 |
[27]
. Zykova et al.
| [52] | Zykova, S. N., Storhaug, H. M., Toft, I., Chadban, S. J., Jenssen, T. G., White, S. L. Cross-sectional analysis of nutrition and serum uric acid in two Caucasian cohorts: the AusDiab Study and the Tromsø study. Nutr J. 2015, 14, 49. https://doi.org/10.1186/s12937-015-0032-1 |
[52]
found that the minimal intake associated with statistically significant SUA concentration reduction was at level of approximately 1000 mg of calcium per day for men and 650 mg per day for women. It is possible that calcium intake prevent gout through reduced SUA concentrations and decreased hyperuricemia risk.
In a mendelian randomization study, blood calcium concentration had no association with gout risk
| [88] | Cheng, W-W., Zhu, Q., Zhang, H-Y. Mineral nutrition and the risk of chronic diseases: A mendelian randomization study. Nutrients. 2019, 11(2), 378. https://doi.org/10.3390/nu11020378 |
[88]
.
Judging from the data of food composition [47-49], it is important for Japanese people (aged ≥ 15 years) to eat meats (sparrow), seafood (sardines, salmon, dried shrimp, dried flying fish, snails, crucian, carp, goby, loach), grains (breakfast cereals fortified with 10% Daily Value calcium, bread, tortillas), seeds and nuts (chia seeds, sesame seeds), potatoes (konjac), seaweed (hijiki, dried wakame), milks (almond milk, low-fat milk, skim milk, whole butter milk, whole chocolate milk), legumes (soybeans, beans, peas), fruit (apples), vegetables (spinach, okra, curly kale, Chinese cabbages, broccoli, parsley), dairy products (milk, cheese, yogurt, sour cream), soy products (soy milk, tofu), orange juice, to take in more calcium to reach the RDAs established by the MHLW in Japan
and the AIs established by the IOM of the National Academy of Sciences in the U.S..
Potassium
The daily potassium intake of Japanese people in 2022 was lower compared to that in 2001, 2004, 2007, and 2019 and was higher compared to that in 2010, 2013, and 2016 (2001: 2434 mg/day; 2004: 2321mg/day; 2007: 2306 mg/day; 2010: 2200 mg/day; 2013: 2231 mg/day; 2016: 2219 mg/day; 2019: 2299 mg/day; 2022: 2256 mg/day). The daily potassium intake did not show a significant correlation with the number of gout patients in 2001-2019 (r= -0.624, p= 0.134) and in 2001-2022 (r= -0.592, p= 0.122) (
Table 1).
The daily potassium intake of Japanese adult population (aged ≥ 20 years) in 2022 was lower compared to that in 2019 (2019: 2350 mg/day; 2022: 2305 mg/day). The daily potassium intake did not show a significant correlation with the number of gout patients in the adult population (aged ≥ 20 years) in 2004-2019 (r= -0.268, p= 0.608) and in 2004-2022 (r= -0.291, p= 0.527) (
Table 2). The daily potassium intake of Japanese adult men (aged ≥ 20 years) and adult women (aged ≥ 20 years) in 2022 were lower compared to those in 2019, respectively (men: 2019: 2439 mg/day; 2022: 2392 mg/day, women: 2019: 2273 mg/day; 2022: 2230 mg/day). The daily potassium intake did not show a significant correlation with the number of gout patients in adult men (aged ≥ 20 years) in 2004-2019 (r= -0.326, p= 0.529) and in 2004-2022 (r= -0.352, p= 0.438) (
Table 2). The daily potassium intake did not show a significant correlation with the number of gout patients in adult women (aged ≥ 20 years) in 2004-2019 (r= 0.709, p= 0.115) and in 2004-2022 (r= 0.680, p= 0.093) (
Table 2).
The daily potassium intake of Japanese men (aged 15-59 years) and women (aged 15-49 years) in 2022 were 2093-2297 mg/day and 1689-1932 mg/day, respectively, and were below the AIs established by the MHLW in Japan [men (aged 15-59 years): 2500-2700 mg/day; women (aged 20-39 years): 2000 mg/day]
. Whereas the daily potassium intake of Japanese men (aged ≥ 60years) and women (aged ≥ 50 years) in 2022 were 2532-2644 mg/day and 2174-2569 mg/day, respectively, and were above the AIs established by the MHLW in Japan [men (aged ≥ 60 years): 2500 mg/day; women (aged ≥ 40 years): 2000 mg/day]
. The daily potassium intake of Japanese men (aged ≥ 15 years) and women (aged ≥ 15 years) in 2022 were 2059-2644 mg/day and 1689-2569 mg/day, respectively, and were below the DGs established by the MHLW in Japan [men (aged ≥ 15 years): ≥ 3000 mg/day; women (aged ≥ 15 years): ≥ 2600 mg/day]
and were below the AIs established by the IOM of the National Academies of Sciences, Engineering, and Medicine in the U.S. [men (aged 14-18 years): 3000 mg/day; men (aged ≥ 19 years): 3400 mg/day; women (aged 14-18 years): 2300 mg/day; women (aged ≥ 19 years): 2600 mg/day]
| [43] | Institute of Medicine. National Academies of Sciences, Engineering, and Medicine, Health and Medicine Division, Food and Nutrition Board; Committee to review the Dietary Reference Intakes for Sodium and Potassium. Washington, DC: The National Academy Press; 2019. |
[43]
. It seems that Japanese men (aged ≥ 15 years) and women (aged ≥ 15 years) need to take in more potassium.
In three cross-sectional studies in adult individuals, increased potassium intake was associated with increased urinary uric acid (UUA) excretion, thus potentially protecting against hyperuricemia
| [89] | Ferraro, P. M., Mandel, E. I., Curhan, G. C., Gambaro, G., Taylor, E. N. Dietary protein and potassium, diet-dependent net acid load, and risk of incident kidney stones. Clin J Am Soc Nephrol. 2016, 11(10), 1834-1844. https://doi.org/10.2215/CJN.01520216 |
[89]
. The daily potassium intake of participants in these cohort studies were 3389 mg/d, 3002 mg/d, and 2955 mg/d, respectively, and the daily potassium intake of men was below the AIs established by the IOM of the National Academies of Sciences, Engineering, and Medicine in the U.S. [men (aged ≥ 19 years): 3400 mg/day; women (aged ≥ 19 years): 2600 mg/day]
| [43] | Institute of Medicine. National Academies of Sciences, Engineering, and Medicine, Health and Medicine Division, Food and Nutrition Board; Committee to review the Dietary Reference Intakes for Sodium and Potassium. Washington, DC: The National Academy Press; 2019. |
[43]
.
Judging from the data of food composition [47-49], it is important for Japanese men (aged ≥ 15 years) and women (aged ≥ 15 years) to eat meats (beef), organ meats (turkey breast, chicken breast), seafood (salmon, tuna), grains (brown rice, bread, white rice), potatoes (potato, konjac), legumes (kidney beans, soybeans, lentils), seeds and nuts (cashew nuts, flaxseed), seaweed (kelp, dried wakame, hijiki, nori), mushrooms (maitake mushrooms), fruit (banana, apricots, cantaloupe, prunes, raisins, apples), vegetables (squash, tomatoes, spinach, asparaguses, lettuces, broccoli, parsley, chili pepper), dairy products (milk, yogurt, mozzarella cheese), fats and oils (peanut butter, olive oil, corn oil, canola oil, soybean oil), eggs, soymilk, black tea, coffee, green tea and matcha, cocoa, orange juice to take in more potassium to reach the DG established by the MHLW in Japan
and the AIs established by the IOM of the National Academies of Sciences, Engineering, and Medicine in the U.S.
| [43] | Institute of Medicine. National Academies of Sciences, Engineering, and Medicine, Health and Medicine Division, Food and Nutrition Board; Committee to review the Dietary Reference Intakes for Sodium and Potassium. Washington, DC: The National Academy Press; 2019. |
[43]
. It is encouraged to replace meat with fish and legumes.
Magnesium
The daily magnesium intake of Japanese people in 2022 was lower compared to that in 2001, 2004, 2007, and 2019 and was higher compared to that in 2010, 2013, and 2016 (2001: 262 mg/day; 2004: 250 mg/day; 2007: 247 mg/day; 2010: 236 mg/day; 2013: 239 mg/day; 2016: 238 mg/day; 2019: 247 mg/day; 2022: 242 mg/day). The daily magnesium intake did not show a significant correlation with the number of gout patients in 2001-2019 (r= -0.620, p= 0.137) and 2001-2022 (r= -0.590, p= 0.124) (
Table 1).
The daily magnesium intake of Japanese adult population (aged ≥ 20 years) in 2022 was lower compared to that in 2019 (2019: 255 mg/day; 2022: 250 mg/day). The daily magnesium intake did not show a significant correlation with the number of gout patients in the adult population (aged ≥ 20 years) in 2004-2019 (r= -0.259, p= 0.620) and in 2004-2022 (r= -0.254, p= 0.582) (
Table 2). The daily magnesium intake of Japanese adult men (aged ≥ 20 years) and adult women (aged ≥ 20 years) in 2022 were lower compared to those in 2019, respectively (men: 2019: 270 mg/day; 2022: 263 mg/day, women: 2019: 242 mg/day; 2022: 238 mg/day). The daily magnesium intake did not show a significant correlation with the number of gout patients in adult men (aged ≥ 20 years) in 2004-2019 (r= -0.315, p= 0.495) and in 2004-2022 (r= -0.424, p= 0.343) (
Table 2). The daily magnesium intake did not show a significant correlation with the number of gout patients in adult women (aged ≥ 20 years) in 2004-2019 (r= 0.677, p= 0.140) and in 2004-2022 (r= 0.669, p= 0.100) (
Table 2).
The daily magnesium intake of Japanese men (aged ≥ 15 years) and women (aged ≥ 15 years) in 2022 were 224-287 mg/day and 180-270 mg/day, respectively, and were below the RDAs established by the MHLW in Japan [men (aged ≥ 15 years): 320-370 mg/day; women (aged ≥ 15 years): 260-310 mg/day]
and those established by the IOM of the National Academy of Sciences in the U.S. [men (aged ≥ 14 years): 400-420 mg/day; women (aged ≥ 14 years): 310-360 mg/day]
| [42] | Institute of Medicine of the National Academy of Sciences. Food and Nutrition Board. Dietary Reference Intakes: The essential guide to nutrient requirements. Washington, D.C. The National Academy Press. Available from: https://www.nap.edu/catalog/11537.html (accessed 14 October 2021). |
[42]
. It seems that Japanese men (aged ≥ 15 years) and women (aged ≥ 15 years) need to take in more magnesium.
A meta-analysis and systematic review reported that dietary magnesium intake was inversely associated with serum C-reactive protein (CRP) levels as biomarker of inflammation
| [90] | Dibaba, D. T., Xun, P., He, K. Dietary magnesium intake is inversely associated with serum C-reactive protein levels: Meta-analysis and systematic review. Eur J Clin Nutr. 2014, 68(4), 510-516. https://doi.org/10.1038/ejcn.2014.7 |
[90]
. SUA level is positively associated with several inflammatory markers (e.g., white blood cell count, CRP, interleukin-6)
| [4] | Ruggiero, C., Cherubini, A., Ble, A., Bos, A. J., Maggio, M., Dixit, V. D., Lauretani, F., Bandinelli, S., Senin, U., Ferrucci, L. Uric acid and inflammatory markers. Eur Heart J. 2006, 27(10), 1174-1181. https://doi.org/10.1093/eurheartj/ehi879 |
[4]
. This fact suggests that UA may have a role in inflammation and subsequent inflammatory related disease, such as gout. In an epidemiological study, increased magnesium intake was associated with decreased SUA concentrations
| [91] | Wang, Y. L., Zeng, C., Wei, J., Yang, T., Li, H., Deng, Z. H., Yang, Y., Zhang, Y., Ding, X., Xie, D. X., Yang, T. B., & Lei, G. H. (2015) Association between dietary magnesium intake and hyperuricemia. PLoS One, 10, e0141079. |
[91]
and hyperuricemia risk [91. 92]. Increased magnesium intake was significantly associated with decreased risk of hyperuricemia [SUA concentration ≥ 7.0 mg/ dL (416.4 µmol/L) in males and ≥ 6.0 mg/dL (356.9 µmol/L) in females] by analyses of the U.S. NHANES (2001-2014) databases involving 26,796 adults (aged 20-85 years)
. The average daily magnesium intake of Japanese men (aged ≥ 20 years) and women (aged ≥ 20 years) in 2022 were 263 mg/day and 238 mg/day, respectively. From the results of this article, male subjects in the second level of magnesium intake (200-265 mg/day) were 17% less likely to be hyperuricemia compared to those subjects in the lowest intake level (< 200 mg/day). Female subjects in the third level of magnesium intake (208-260 mg/day) were 14% less likely to be hyperuricemia compared to those subjects in the lowest intake level (< 158 mg/day)
. It seems that Japanese adult population (aged ≥ 20 years) need to take in ≥ 433 mg/day in men and ≥ 337 mg/day in women of magnesium or the RDAs established by the MHLW in Japan
and those established by the IOM of the National Academy of Sciences in the U.S.
| [42] | Institute of Medicine of the National Academy of Sciences. Food and Nutrition Board. Dietary Reference Intakes: The essential guide to nutrient requirements. Washington, D.C. The National Academy Press. Available from: https://www.nap.edu/catalog/11537.html (accessed 14 October 2021). |
[42]
. It is possible that magnesium intake prevent gout through reduced SUA concentrations and decreased hyperuricemia risk.
In a mendelian randomization study, blood magnesium concentration was inversely associated with gout risk (OR = 0.26, 95% CI = 0.09, 0.76, p = 0.013); that is to say, each 0.16 mmol/L increase in genetically predicted magnesium was associated with a 0.26-fold increased risk of gout
| [88] | Cheng, W-W., Zhu, Q., Zhang, H-Y. Mineral nutrition and the risk of chronic diseases: A mendelian randomization study. Nutrients. 2019, 11(2), 378. https://doi.org/10.3390/nu11020378 |
[88]
.
Judging from the data of food composition [47-49], it is important for Japanese men (aged ≥ 15 years) and women (aged ≥ 15 years) to eat meats (beef), organ meats (chicken breast), seafood (salmon, sardines), seeds and nuts (pumpkin seeds, chia seeds, sunflower seeds, almonds, peanuts, cashew nuts, sesame seeds, flaxseeds), grains (white rice, bread, brown rice, cereals, fortified ready-to-eat cereals, whole-wheat bread, oatmeal), potatoes, legumes (black beans, kidney beans, edamame), seaweeds, fruit (bananas, raisins, avocados, apples), vegetables (spinach, broccoli, carrots, parsley), dairy products (milk, yogurt), soy products (soy milk), tea, green tea to take in more magnesium to reach the RDAs established by the MHLW in Japan
and those established by the IOM of the National Academy of Sciences in the U.S.
| [42] | Institute of Medicine of the National Academy of Sciences. Food and Nutrition Board. Dietary Reference Intakes: The essential guide to nutrient requirements. Washington, D.C. The National Academy Press. Available from: https://www.nap.edu/catalog/11537.html (accessed 14 October 2021). |
[42]
.
Phosphorus
The daily phosphorus intake of Japanese people in 2022 was lower compared to that in 2001, 2004, and 2019 and was higher compared to that in 2007, 2010, 2013, and 2016 (2001: 1057 mg/day; 2004: 1013 mg/day; 2007: 1000 mg/day; 2010: 960 mg/day; 2013: 978 mg/day; 2016: 976 mg/day; 2019: 1007 mg/day; 2022: 1001 mg/day). The daily phosphorus intake did not show a significant correlation with the number of gout patients in 2001-2019 (r= -0.554, p= 0.197) and in 2001-2022 (r= -0.440, p= 0.275) (
Table 1).
The daily phosphorus intake of Japanese adult population (aged ≥ 20 years) in 2022 was lower compared to that in 2019 (2019: 1012 mg/day; 2022: 1006 mg/day). The daily phosphorus intake did not show a significant correlation with the number of gout patients in the adult population (aged ≥ 20 years) in 2004-2019 (r= -0.0215, p=0.968) and in 2004-2022 (r= 0.119, p= 0.799) (
Table 2). The daily phosphorus intake of Japanese adult men (aged ≥ 20 years) and adult women (aged ≥ 20 years) in 2022 were lower compared to those in 2019, respectively (men: 2019: 1084 mg/day; 2022: 1076 mg/day, women: 2019: 948 mg/day; 2022: 946 mg/day). The daily phosphorus intake did not show a significant correlation with the number of gout patients in adult men (aged ≥ 20 years) in 2004-2019 (r= -0.151, p= 0.775) and in 2004-2022 (r= -0.042, p= 0.929) (
Table 2). The daily phosphorus intake did not show a significant correlation with the number of gout patients in adult women (aged ≥ 20 years) in 2004-2019 (r= 0.593, p= 0.215) and in 2004-2022 (r= 0.603, p= 0.152) (
Table 2).
The daily phosphorus intake of Japanese men (aged ≥ 20 years) and women (aged ≥ 20 years) in 2022 were 1006-1128 mg/day and 810-1031mg/day, respectively, and were above the AIs [men (aged ≥ 20 years): 1000 mg/day; women (aged ≥ 20 years): 800 mg/day] and were below the ULs established by the MHLW in Japan [men (aged ≥ 20 years): 3000 mg/day; women (aged ≥ 20 years): 3000 mg/day]
. The daily phosphorus intake of Japanese men (aged ≥ 20 years) and Japanese women (aged ≥ 20 years) in 2022 were above the RDAs for phosphorus established by the IOM of the National Academy of Sciences in the U.S. [men (aged ≥ 19 years): 700 mg/day; women (aged ≥ 19 years): 700 mg/day]
| [42] | Institute of Medicine of the National Academy of Sciences. Food and Nutrition Board. Dietary Reference Intakes: The essential guide to nutrient requirements. Washington, D.C. The National Academy Press. Available from: https://www.nap.edu/catalog/11537.html (accessed 14 October 2021). |
[42]
. It seems that Japanese adult population (aged ≥ 20 years) need to decrease intake of phosphorus to reach the AIs established by the MHLW in Japan
and the RDAs established by the IOM of the National Academy of Sciences in the U.S.
| [42] | Institute of Medicine of the National Academy of Sciences. Food and Nutrition Board. Dietary Reference Intakes: The essential guide to nutrient requirements. Washington, D.C. The National Academy Press. Available from: https://www.nap.edu/catalog/11537.html (accessed 14 October 2021). |
[42]
/
Phosphorus-rich foods are meats (beef), organ meats (chicken breast), seafood (salmon, scallops, flying fish, sardines, silver-striped herring, mackerel, dried bonito, dried shrimp, dried squid, dried baby sardines), grains (brown rice, oatmeal, bread, tortillas), potatoes, legumes (lentils, kidney beans, peas), seeds and nuts (cashew nuts, sesame seeds, chia seeds, pumpkin seeds, sunflower seeds), fruit (apples, clementine), vegetables (asparaguses, tomatoes, cauliflowers), dairy products (low-fat yogurt, milk, cheese), soy products (tofu), eggs, green tea, carbonated cola [47-49]. It seems that Japanese people (aged ≥ 20 years) need to decrease phosphorus intake or pay attention to not to excessive intake of phosphorus.
Iron
The daily iron intake of Japanese in 2022 was lower compared to that in 1960, 1975, 1980, 1986, 1995, 1998, 2001, 2004, 2007, 2010, and 2019 and was higher compared to that in 2013 and 2016 (1960: 13.0 mg/day; 1975: 13.4 mg/day; 1980: 10.4 mg/day; 1986: 10.7 mg/day; 1995: 11.8 mg/day; 1998: 11.4 mg/day; 2001: 8.2 mg/day; 2004: 7.9 mg/day; 2007: 7.9 mg/day; 2010: 7.6 mg/day; 2013: 7.4 mg/day; 2016: 7.4 mg/day; 2019: 7.6 mg/day; 2022: 7.5 mg/day). The daily iron intake was negatively correlated with the number of gout patients in 1986-2019 (r= -0.894, p= 0.000054) and in 1986-2022 (r= -0.887, p= 0.000088) (
Table 1).
The daily iron intake of Japanese adult population (aged ≥ 20 years) in 2022 was lower compared to that in 2019 (2019: 7.9 mg/day; 2022: 7.7 mg/day). The daily iron intake did not show a significant correlation with the number of gout patients in the adult population (aged ≥ 20 years) in 2004-2019 (r= -0.718, p= 0.108) (
Table 2). Whereas the daily iron intake was negatively correlated with the number of gout patients in the adult population (aged ≥ 20 years) in 2004-2022 (r= -0.755, p= 0.0497) (
Table 2). The daily iron intake of Japanese adult men (aged ≥ 20 years) and adult women (aged ≥ 20 years) in 2022 were lower compared to those in 2019, respectively (men: 2019: 8.3 mg/day; 2022: 8.1 mg/day, women: 2019: 7.5 mg/day; 2022: 7.4 mg/day). The daily iron intake did not show a significant correlation with the number of gout patients in adult men (aged ≥ 20 years) in 2004-2019 (r= -0.721, p= 0.106) (
Table 2). Whereas the daily iron intake was negatively correlated with the number of gout patients in adult men (aged ≥ 20 years) in 2004-2022 (r= -0.788, p= 0.0353) (
Table 2). The daily iron intake did not show a significant correlation with the number of gout patients in adult women (aged ≥ 20 years) in 2004-2019 (r= 0.623, p= 0.186) and in 2004-2022 (r= 0.564, p= 0.187) (
Table 2). This result suggests that the correlation of daily iron intake with number of gout patients varies with gender
and is stronger in adult men than in adult women.
The daily iron intake of Japanese men (aged ≥ 20 years) and women (aged ≥ 20 year) in 2022 was 6.9-8.8 mg/day and 5.9-8.3 mg/day, respectively, and were above the EARs established by the MHLW in Japan [men (aged ≥ 20 years): 6.0-6.5 mg/day; women (aged ≥ 20 year): 5.0-5.5 mg/day]
. The daily iron intake of Japanese men (aged 20-29 years, aged 40-49 years) in 2022 were 6.9 mg/day and 7.2 mg/day, respectively, and were below the RDAs established by the MHLW in Japan [men (aged 20-49 years): 7.5 mg/day]
| [10] | Hayden, M. R., Tyagi, S. C. Uric acid: A new look at an old risk marker for cardiovascular disease, metabolic syndrome, and type 2 diabetes mellitus: The urate redox shuttle. Nutr. Metab (Lond). 2004, 1, 10. https://doi.org/10.1186/1743-7075-1-10 |
[10]
. Whereas the daily iron intake of Japanese men (aged 30-39 years, aged ≥ 50 years) in 2022 were 7.7 mg/day and 7.9-8.8 mg/day, respectively, and were above the RDAs established by the MHLW in Japan [men (aged ≥ 18 years): 7.5 mg/day]
. In women, women with menstruation were evaluated by Dietary Reference Intakes values established by the MHLW in Japan. The daily iron intake of Japanese women (aged 15-59 years) in 2022 were 5.9-7.2 mg/day, respectively, and were below the RDAs established by the MHLW in Japan [women with menstruation (aged 15-49 years): 10.5 mg/day; women with menstruation (aged 50-64 years): 11.0 mg/day]
. Whereas the daily iron intake of Japanese women (aged ≥ 65 years) in 2022 were 7.8-8.3 mg/day and were above the RDAs established by the MHLW in Japan [women (aged ≥ 65 years): 6.0 mg/day] and was below the ULs [men (aged ≥ 40 years): 40.0 mg/day]
. The daily iron intake of Japanese men (aged 20-59 years) and women (aged 20-69 years, ≥ 75 years) in 2022 were 6.9-7.9 mg/day and 5.9-7.9 mg/day, and 7.8 mg/day, respectively, and were below the RDAs established by the IOM of the National Academy of Sciences in the U.S. [men (aged 14-18 years): 11 mg/day; men (aged ≥ 15 years): 8 mg/day; women (aged 14-18 years): 15 mg/day; women (aged 19-50 years): 18 mg/day; women (aged ≥ 51 years): 8 mg/day]
| [42] | Institute of Medicine of the National Academy of Sciences. Food and Nutrition Board. Dietary Reference Intakes: The essential guide to nutrient requirements. Washington, D.C. The National Academy Press. Available from: https://www.nap.edu/catalog/11537.html (accessed 14 October 2021). |
[42]
. Whereas the daily iron intake for men (aged ≥ 60 years) and women (aged 70-79 years) were 8.7-8.8 mg/day and 8.3 mg/day, respectively, and exceeded the RDAs and was below the ULs established by the IOM of the National Academy of Sciences in the U.S. [men (aged ≥ 14 years): 45.0 mg/day; women (aged ≥ 14 years): 45.0 mg/day]
| [42] | Institute of Medicine of the National Academy of Sciences. Food and Nutrition Board. Dietary Reference Intakes: The essential guide to nutrient requirements. Washington, D.C. The National Academy Press. Available from: https://www.nap.edu/catalog/11537.html (accessed 14 October 2021). |
[42]
. Increased iron intake was associated with decreased SUA concentrations in the Australian cohort
| [52] | Zykova, S. N., Storhaug, H. M., Toft, I., Chadban, S. J., Jenssen, T. G., White, S. L. Cross-sectional analysis of nutrition and serum uric acid in two Caucasian cohorts: the AusDiab Study and the Tromsø study. Nutr J. 2015, 14, 49. https://doi.org/10.1186/s12937-015-0032-1 |
[52]
. Serum iron concentrations showed a positive correlation with SUA concentrations and the prevalence of hyperuricemia among 2824 subjects (mean age 52.2 ± 7.2) [hyperuricemia: SUA concentration ≥ 7.0 mg/dL (416.4 µmol/L) in men and ≥ 6.0 mg/dL (356.9 µmol/L) in women]; that is to say, subjects in the second level, the third level, the highest level of serum iron concentrations were 33%, 17%, 56% more likely to be hyperuricemia, compared to those subjects in the lowest intake level, respectively
| [93] | Wang, Y., Yang, Z., Wu, J., Xie, D., Yang, T., Li, H., Xiong, Y. Associations of serum iron and ferritin with hyperuricemia and serum uric acid. Clin Rheumatol. 2020, 39(12), 3777-3785. https://doi.org/10.1152/10.1007/s10067-020-05164-7 |
[93]
. Iron is pro-oxidants
| [62] | He, Y., Chen, X., Ma, Z., Wang, J., Lin, K. Association of oxidative balance score with hyperuricemia and gout: NHANES 2009-2018. Front Endocrinol. 2024, 15, 1402369. https://doi.org/10.3389/fendo.2024.1402369 |
[62]
, but metalloenzymes of catalase
| [22] | Machlin, L. J., Bendich, A. Free radical tissue damage: protective role of antioxidant nutrients. FASEB J. 1987, 1(6), 441-445. |
[22]
. It is possible that iron intake prevent gout through a reduction of SUA concentrations and hyperuricemia risk. In a mendelian randomization study, blood iron concentration was inversely associated with gout risk (OR = 0.71, 95% CI = 0.53, 095, p = 0.047); that is to say, each per-unit increase in genetically predicted iron was associated with a 0.71-fold increased risk of gout
| [88] | Cheng, W-W., Zhu, Q., Zhang, H-Y. Mineral nutrition and the risk of chronic diseases: A mendelian randomization study. Nutrients. 2019, 11(2), 378. https://doi.org/10.3390/nu11020378 |
[88]
.
From the data of food composition [47-49], it is important for Japanese men (aged 20-59 years) and women (aged 20-69 years, ≥ 75 years) including women with menstruation (aged 15-64 years) (aged ≥ 40 years) to eat lean meat and meats (beef, chicken, turkey), organ meats (beef liver, pork liver, sweetfish liver), seafood (oysters, sardines, tuna, lamprey eel, abalone, clams, snails, dried shrimp), potatoes (potato, konjac), nuts (cashew nuts, pistachio nuts, sesame seeds), grains (white rice, bread, spaghetti, brown rice, breakfast cereals fortified with 100% Daily Value iron), mushrooms (wood ear), legumes (kidney beans, white beans, lentils, green peas, chickpeas), seaweed (nori, hijiki), fruit (raisins, cantaloupes), vegetables (spinach, tomatoes, broccoli, parsley, ginger, chili pepper), dairy products (milk, cheese), soy products (tofu), eggs, dark chocolate, green tea, tea, cocoa to take in more iron to reach the RDAs established by the MHLW in Japan
or those established by the IOM of the National Academy of Sciences in the U.S.
| [42] | Institute of Medicine of the National Academy of Sciences. Food and Nutrition Board. Dietary Reference Intakes: The essential guide to nutrient requirements. Washington, D.C. The National Academy Press. Available from: https://www.nap.edu/catalog/11537.html (accessed 14 October 2021). |
[42]
. It must be careful not to exceed the ULs of the daily iron intake in Japanese men (aged ≥ 50 years) and women (aged ≥ 60 years).
Copper
The daily copper intake of Japanese people in 2022 was lower compared to that in 2001, 2004, 2007, 2010, 2013, 2016, and 2019 (2001: 1.25 mg/day; 2004: 1.19 mg/day; 2007: 1.16 mg/day; 2010: 1.12 mg/day; 2013: 1.12 mg/day; 2016: 1.11 mg/day; 2019: 1.12 mg/day; 2022: 1.09 mg/day). The daily copper intake was negatively correlated with the number of gout patients in 2001-2019 (r= -0.852, p= 0.0149) and in 2001-2022 (r= -0.875, p= 0.0044) (
Table 1).
The daily copper intake of Japanese adult population (aged ≥ 20 years) in 2022 was lower compared to that in 2019 (2019: 1.14 mg/day; 2022: 1.12 mg/day). The daily copper intake was negatively correlated with the number of gout patients in the adult population (aged ≥ 20 years) in 2004-2019 (r= -0.818, p=0.0469) and in 2004-2022 (r= -0.863, p=0.0124) (
Table 2). The daily copper intake of Japanese adult men (aged ≥ 20 years) and adult women (aged ≥ 20 years) in 2022 were lower compared to those in 2019, respectively (men: 2019: 1.23 mg/day; 2022: 1.20 mg/day, women: 2016: 2019: 1.07 mg/day; 2022: 1.05 mg/day). The daily copper intake was negatively correlated with the number of gout patients in adult men (aged ≥ 20 years) in 2004-2019 (r= -0.890, p= 0.0176) and in 2004-2022 (r= -0.927, p= 0.0027) (
Table 2). The daily copper intake was positively correlated with the number of gout patients in adult women (aged ≥ 20 years) in 2004-2019 (r= 0.880, p= 0.0207) (
Table 2). Whereas the daily copper intake tended to be positively correlated with the number of gout patients in adult women (aged ≥ 20 years) in 2004-2022 (r= 0.750, p= 0.0521) (
Table 2). This result suggests that the correlation of daily copper intake with the number of gout patients varies with gender and is stronger in adult men than in adult women.
The daily copper intake of Japanese men (aged ≥ 15 years) and women (aged ≥ 15 years) in 2022 were 1.11-1.28 mg/day and 0.88-1.15 mg/day, respectively, and exceeded the RDAs established by the MHLW in Japan [men (aged ≥ 15 year): 0.8-0.9 mg/day; women (aged ≥ 15 year): 0.7 mg/day]
and those established by the IOM of the National Academy of Sciences in the U.S. [men (aged ≥ 14 year): 0.89-0.90 mg/day; women (aged ≥ 14 year): 0.89-0.90 mg/day]
| [42] | Institute of Medicine of the National Academy of Sciences. Food and Nutrition Board. Dietary Reference Intakes: The essential guide to nutrient requirements. Washington, D.C. The National Academy Press. Available from: https://www.nap.edu/catalog/11537.html (accessed 14 October 2021). |
[42]
. The daily copper intake of Japanese men (aged ≥ 20 years) and women (aged ≥ 20 years) in 2022 were 1.11-1.26 mg/day and 0.88-1.15 mg/day, respectively, and were below the ULs established by the MHLW in Japan [men (aged ≥ 18 years): 7.0 mg/day; women (aged ≥ 18 years): 7.0 mg/day]
and those established by the IOM of the National Academy of Sciences in the U.S. [men (aged ≥ 19 years): 10.0 mg/day; women (aged ≥ 19 years): 10.0 mg/day]
| [42] | Institute of Medicine of the National Academy of Sciences. Food and Nutrition Board. Dietary Reference Intakes: The essential guide to nutrient requirements. Washington, D.C. The National Academy Press. Available from: https://www.nap.edu/catalog/11537.html (accessed 14 October 2021). |
[42]
. The daily copper intake of Japanese men (aged 15-19 years) and women (aged15-19 years) were 1.28 mg/day and 0.96 mg/day, respectively, and were below the ULs established by the IOM of the National Academy of Sciences in the U.S. [men (aged 14-18 years): 8.0 mg/day; men (aged ≥ 19 years): 10.0 mg/day; women (aged 14-18 years): 8.0 mg/day; women (aged ≥ 19 years): 10.0 mg/day]
| [42] | Institute of Medicine of the National Academy of Sciences. Food and Nutrition Board. Dietary Reference Intakes: The essential guide to nutrient requirements. Washington, D.C. The National Academy Press. Available from: https://www.nap.edu/catalog/11537.html (accessed 14 October 2021). |
[42]
. In healthy men and women, taking of copper supplementation should be careful so as not to exceed the ULs.
Copper is metalloenzymes of superoxide dismutase (SOD)
| [22] | Machlin, L. J., Bendich, A. Free radical tissue damage: protective role of antioxidant nutrients. FASEB J. 1987, 1(6), 441-445. |
[22]
. In a mendelian randomization study, blood copper concentration had no association with gout risk
| [88] | Cheng, W-W., Zhu, Q., Zhang, H-Y. Mineral nutrition and the risk of chronic diseases: A mendelian randomization study. Nutrients. 2019, 11(2), 378. https://doi.org/10.3390/nu11020378 |
[88]
.
Copper-rich foods are meats (beef, turkey), organ meats (beef liver, turkey giblets), seafood (oysters, crab, salmon, dried shrimp, squid, dried squid, lamprey eel, octopus, river snails), whole grains (cereals, millet), grains (pasta), potatoes, legumes (chickpeas), seeds and nuts (cashew nuts, sesame seeds, chia seeds, sunflower seeds, Brazil nuts, perilla seeds, hazelnuts), mushrooms (maitake mushrooms, shiitake mushrooms), fruit (avocados, apples), vegetables (spinach, asparaguses, tomatoes), dairy products (low-fat yogurt, nonfat milk), soy products (tofu, yuba), baking chocolate, dark chocolate, cocoa, tea
| [47] | The Council for Science and Technology, Ministry of Education, Culture, Sports, Science and Technology in Japan. Standard tables of food composition in Japan -2020- (Eighth Revised Edition), Report of the Subdivision Resources. Available from: https://www.mext.go.jp/content/20201225-mxt_kagsei-mext_01110_011.pdf (accessed 16 May 2020). |
| [48] | The Council for Science and Technology, Ministry of Education, Culture, Sports, Science and Technology in Japan. Food Composition Database. Available from: https://fooddb.mext.go.jp/ (accessed 16 October 2024). |
| [49] | U.S. Department of Health & Human Services. National Institutes of Health. Office of Dietary Supplements. Dietary Supplement Fact Sheets. Available from: https://ods.od.nih.gov/factsheets/list-all/ (accessed 17 May 2020). |
[47-49]
. It seems that Japanese people (aged ≥ 15 years) need to decrease copper intake or pay attention to not to excessive intake of copper.
Zinc
The daily zinc intake of Japanese people in 2022 was lower compared to that in 2001 and 2019 and was higher compared to that in 2007, 2010, 2013, and 2016 and was the same as that in 2004 (2001: 8.5 mg/day; 2004: 8.3 mg/day; 2007: 8.2 mg/day; 2010: 7.9 mg/day; 2013: 8.0 mg/day; 2016: 8.0 mg/day; 2019: 8.4 mg/day; 2022: 8.3 mg/day). The daily zinc intake did not show a significant correlation with the number of gout patients in 2001-2019 (r= -0.304, p= 0.508) and in 2001-2022 (r= -0.138, p= 0.744) (
Table 1).
The daily zinc intake of Japanese adult population (aged ≥ 20 years) in 2022 was lower compared to that in 2019 (2019: 8.4 mg/day; 2022: 8.3 mg/day). The daily zinc intake did not show a significant correlation with the number of gout patients in the adult population (aged ≥ 20 years) in 2004-2019 (r= 0.162, p= 0.759) and in 2004-2022 (r= 0.325, p= 0.477) (
Table 2). The daily zinc intake of Japanese adult men (aged ≥ 20 years) in 2022 was lower compared to that in 2019 (2019: 9.2 mg/day; 2022: 9.1 mg/day). The daily zinc intake did not show a significant correlation with the number of gout patients in adult men (aged ≥ 20 years) in 2004-2019 (r= -0.0973, p= 0.854) and in 2004-2022 (r= 0.050, p= 0.916) (
Table 2). Whereas the daily zinc intake of Japanese adult women (aged ≥ 20 years) in 2022 was the same as that in 2019 (2019: 7.7 mg/day; 2022: 7.7 mg/day). The daily zinc intake did not show a significant correlation with the number of gout patients in adult women (aged ≥ 20 years) in 2004-2019 (r= 0.408, p= 0.421) and in 2004-2022 (r= 0.425, p= 0.341) (
Table 2).
The daily zinc intake of Japanese men (aged ≥ 20 years) and women (aged 20-69 years, aged ≥ 80 years) in 2022 were 8.6-9.3 mg/day, 7.3-7.8 mg/day, and 7.3 mg/day, respectively and were below the RDAs established by the MHLW in Japan [men (aged ≥ 20 years): 10.0-11.0 mg/day; women (aged ≥ 20 years): 8.0 mg/day]
and those established by the IOM of the National Academy of Sciences in the U.S. [men (aged ≥ 14 years): 11.0 mg/day; women (aged 14-18 years): 9.0 mg/day; women (aged ≥ 19 years): 8.0 mg/day]
| [42] | Institute of Medicine of the National Academy of Sciences. Food and Nutrition Board. Dietary Reference Intakes: The essential guide to nutrient requirements. Washington, D.C. The National Academy Press. Available from: https://www.nap.edu/catalog/11537.html (accessed 14 October 2021). |
[42]
. The daily zinc intake of Japanese women (aged 70-79 years) in 2022 was 8.0 mg/day and reach the RDAs established by the MHLW in Japan
and those established by the IOM of the National Academy of Sciences in the U.S.
| [42] | Institute of Medicine of the National Academy of Sciences. Food and Nutrition Board. Dietary Reference Intakes: The essential guide to nutrient requirements. Washington, D.C. The National Academy Press. Available from: https://www.nap.edu/catalog/11537.html (accessed 14 October 2021). |
[42]
.
In a mendelian randomization study, blood zinc concentration had no association with gout risk
| [88] | Cheng, W-W., Zhu, Q., Zhang, H-Y. Mineral nutrition and the risk of chronic diseases: A mendelian randomization study. Nutrients. 2019, 11(2), 378. https://doi.org/10.3390/nu11020378 |
[88]
.
In a cross-sectional study in middle-aged and older men (aged ≥ 40 years) and women (aged ≥ 40 years) in China, in the minimally adjusted model (adjusted for age, body mass index (BMI) and energy intake), increased zinc intake was associated with decreased hyperuricemia risk in middle-aged and older men, but not in women [SUA concentration ≥ 7.0 mg/dL (416.4 µmol/L) in men and ≥ 6.0 mg/dL (356.9 µmol/L) in women]
| [94] | Xie, D-X., Xiong, Y-L., Zeng, C., Wei, J., Yang, T., Li, H., Wang, Y-L., Gao, S-G., Li, Y-S., Lei, G-H. Association between low dietary zinc and hyperuricaemia in middle-aged and older males in China: a cross-sectional study. BMJ Open. 2015, 5(10), e008637. https://doi.org/10.1136/bmjopen-2015-008637 |
[94]
. However, in the multivariable adjusted model, there was no significant association between dietary zinc intake and hyperuricemia risk in both middle-aged and older men and women
| [94] | Xie, D-X., Xiong, Y-L., Zeng, C., Wei, J., Yang, T., Li, H., Wang, Y-L., Gao, S-G., Li, Y-S., Lei, G-H. Association between low dietary zinc and hyperuricaemia in middle-aged and older males in China: a cross-sectional study. BMJ Open. 2015, 5(10), e008637. https://doi.org/10.1136/bmjopen-2015-008637 |
[94]
. In the NHANES 2001-2014, the daily zinc intake was inversely associated with hyperuricemia risk among U.S. adult men (aged ≥ 20 years) and women (aged ≥ 20 years) [hyperuricemia: SUA concentration ≥ 7.0 mg/dL (416.4 µmol/L) in men and ≥ 6.0 mg/dL (356.9 µmol/L) in women]
| [21] | Zhang, Y., Liu, Y., Qiu, H. Association between dietary zinc intake and hyperuricemia among adults in the United States. Nutrients. 2018, 10(5), 568. https://doi.org/10.3390/nu10050568 |
[21]
. This article revealed that increased zinc intake was associated with decreased hyperuricemia risk among U.S. adult men (aged ≥ 20 years) but not in women (aged ≥ 20 years)
| [21] | Zhang, Y., Liu, Y., Qiu, H. Association between dietary zinc intake and hyperuricemia among adults in the United States. Nutrients. 2018, 10(5), 568. https://doi.org/10.3390/nu10050568 |
[21]
. There was no significant association between zinc intake and hyperuricemia risk in both men and women with hypertension or diabetes
| [21] | Zhang, Y., Liu, Y., Qiu, H. Association between dietary zinc intake and hyperuricemia among adults in the United States. Nutrients. 2018, 10(5), 568. https://doi.org/10.3390/nu10050568 |
[21]
.
Zinc is metalloenzymes of superoxide dismutase (SOD)
| [22] | Machlin, L. J., Bendich, A. Free radical tissue damage: protective role of antioxidant nutrients. FASEB J. 1987, 1(6), 441-445. |
[22]
. Zinc has the antioxidant activity
. Zinc in human plays an important role in cell mediated immunity and is also an antioxidant and anti-inflammatory agent
. Nicotinamide adenine dinucleotide phosphate (NADPH) oxidases in inhibited by zinc, leading to reduced generation of reactive oxygen species (ROS), zinc is able to bind to sulfhydryl groups of various molecules, protecting them from oxidation
. In
in vitro study, UA stimulated an increase in nicotinamide adenine dinucleotide phosphate (NADPH) oxidase-derived reactive oxygen species (ROS) production in adipocytes, vascular smooth muscle cells, as well as vascular endothelial cells
| [97] | Corry, D. B., Eslami, P., Yamamoto, K., Nyby, M. D., Makino, H., Tuck, M. L. Uric acid stimulates vascular smooth muscle cell proliferation and oxidative stress via the vascular renin-angiotensin sysyem. J Hypertens. 2008, 26(2), 269-275. https://doi.org/10.1097/HJH.0b013e3282f240bf |
[97]
. Zhang et al.
| [21] | Zhang, Y., Liu, Y., Qiu, H. Association between dietary zinc intake and hyperuricemia among adults in the United States. Nutrients. 2018, 10(5), 568. https://doi.org/10.3390/nu10050568 |
[21]
have stated that dietary zinc intake maybe negatively associated with hyperuricemia through the antioxidant activity.
Judging from the data of food composition [47-49], it is important for Japanese men (aged ≥ 20 years) and women (aged 20-69 years, aged ≥ 80 years) to eat meats (beef, pork), processed meats (beef jerky), organ meats (turkey breast, pork liver), seafood (oysters, blue crab, shrimp, salmon, dried bonito, king crab, carp, mackerel, anchovy, sardines, snails, scallop, lamprey eel ), seeds and nuts (pumpkin seeds, peanuts, sesame seeds, flaxseeds, chia seeds), grains (breakfast cereals fortified with 25% Daily Value zinc, oatmeal, brown rice, bread), mushrooms (maitake mushrooms), legumes (lentils, kidney beans), seaweed, fruit (blueberries), vegetables (broccoli, cherry tomatoes), dairy products (milk, cheese, Greek yogurt), eggs, green tea and matcha, cocoa to take in more zinc to reach the RDAs established by the MHLW in Japan
and those established by the IOM of the National Academy of Sciences in the U.S.
| [42] | Institute of Medicine of the National Academy of Sciences. Food and Nutrition Board. Dietary Reference Intakes: The essential guide to nutrient requirements. Washington, D.C. The National Academy Press. Available from: https://www.nap.edu/catalog/11537.html (accessed 14 October 2021). |
[42]
.
3.2. Effect of Dietary Antioxidant on SUA Concentrations, Hyperuricemia, or Gout
Composite dietary antioxidant index
Lin et al.
| [98] | Lin, Z., Chen, H., Lan, Q., Chen, Y., Liao, W., Gao, X. Composite dietary antioxidant index is negatively associated with hyperuricemia in US adults: an analysis of NHANES 2007-2018. Int J Endocrinol. 2023, 2023, 6680229. https://doi.org/10.1155/2023/6680229 |
[98]
constructed a composite dietary antioxidant index (CDAI) consisting of food parameters for vitamin A, vitamin C, vitamin E, manganese, selenium, and zinc to represent an individual’s antioxidant intake status. In a cross-sectional study including 8761 participants was conducted based on the NHANES 2007-2018, there was a significant negative association between composite dietary antioxidant index and hyperuricemia [SUA concentration ≥ 7.0 mg/ dL (416.4 µmol/L) in males and ≥ 6.0 mg/dL (356.9 µmol/L) in females] in the U.S. adults
| [98] | Lin, Z., Chen, H., Lan, Q., Chen, Y., Liao, W., Gao, X. Composite dietary antioxidant index is negatively associated with hyperuricemia in US adults: an analysis of NHANES 2007-2018. Int J Endocrinol. 2023, 2023, 6680229. https://doi.org/10.1155/2023/6680229 |
[98]
. This article revealed that individuals in the second quartile (-1.177 to 0.796), third quartile (0.799 to 3.202), and fourth quartile (highest) (3.203 to 88.502) of composite dietary antioxidant index (CDAI) were 19%, 25%, and 35% decreased risk of hyperuricemia, respectively, compared to those individuals in the first quartile (lowest) of composite dietary antioxidant index (CDAI) (-7.177 to -1.178)
| [98] | Lin, Z., Chen, H., Lan, Q., Chen, Y., Liao, W., Gao, X. Composite dietary antioxidant index is negatively associated with hyperuricemia in US adults: an analysis of NHANES 2007-2018. Int J Endocrinol. 2023, 2023, 6680229. https://doi.org/10.1155/2023/6680229 |
[98]
.
Oxidative balance score
In twenty-one original articles shown in a review by Hernández-Ruiz et al.
| [99] | Hernández-Ruiz, Á., García-Villanova, B., Guerra- Hernández, E., Amiano, P., Ruiz-Canela, M., & Molina-Montes, E. A review of a priori defined oxidative balance scores relative to their components and impact on health outcomes. Nutrients. 2019, 11(4), 774. https://doi.org/10.3390/nu11040774 |
[99]
, all oxidative balance scores included a higher number of antioxidant components than pro-oxidant components, suggesting that higher oxidative balance scores indicated beneficial oxidative balance and predominance of antioxidant components. Wang et al. [100] examined the associations of oxidative balance score (OBS) with hyperuricemia and gout in U.S. adults (aged ≥ 20 years) using data from the NHANES from 2007 to 2018. This study showed that oxidative balance score consisted of dietary (16 dietary nutrients: dietary fiber, carotene, riboflavin, niacin, vitamin B
6, total folate, vitamin B
12, vitamin C, vitamin E, calcium, magnesium, zinc, copper, selenium, total fat, iron) and lifestyle (BMI, physical activity, alcohol consumption, smoking status) components and oxidative balance score is in favor of antioxidants and lower oxidative balance score indicates higher exposure to oxidants. Higher OBS (dietary OBS + lifestyle OBS), dietary OBS, and lifestyle OBS were associated with lower risk of hyperuricemia [SUA concentration > 7.0 mg/ dL (416.4 µmol/L) in males and > 5.7 mg/dL (339.1 µmol/L) in females], respectively [100]. There was no significant association between OBS (dietary OBS + lifestyle OBS) or dietary OBS and gout risk [100]. Higher lifestyle OBS was associated with lower gout risk [100].
He et al.
| [62] | He, Y., Chen, X., Ma, Z., Wang, J., Lin, K. Association of oxidative balance score with hyperuricemia and gout: NHANES 2009-2018. Front Endocrinol. 2024, 15, 1402369. https://doi.org/10.3389/fendo.2024.1402369 |
[62]
also examined the association of OBS (dietary OBS + lifestyle OBS) with hyperuricemia and gout in U.S. adults (aged ≥ 20 years) using data from the NHANES 2009-2018. In this study, the OBS incorporated 16 nutrients and 4 lifestyle factors as follows: pro-oxidants are total fat, iron, alcohol consumption, BMI, and cotinine; antioxidants are dietary fiber, β-carotene, riboflavin, niacin, vitamin B
6, total folate, vitamin B
12, vitamin C, vitamin E, calcium, magnesium, zinc, copper, selenium, and physical activity
| [62] | He, Y., Chen, X., Ma, Z., Wang, J., Lin, K. Association of oxidative balance score with hyperuricemia and gout: NHANES 2009-2018. Front Endocrinol. 2024, 15, 1402369. https://doi.org/10.3389/fendo.2024.1402369 |
[62]
. There was a negative correlation between OBS (dietary OBS + lifestyle OBS) and plasma UA, hyperuricemia risk or gout risk, respectively
| [62] | He, Y., Chen, X., Ma, Z., Wang, J., Lin, K. Association of oxidative balance score with hyperuricemia and gout: NHANES 2009-2018. Front Endocrinol. 2024, 15, 1402369. https://doi.org/10.3389/fendo.2024.1402369 |
[62]
. Higher OBS (dietary OBS + lifestyle OBS), dietary OBS, and lifestyle OBS were associated with lower risk of hyperuricemia [SUA concentration ≥ 7.0 mg/ dL (416.4 µmol/L) in males and ≥ 6.0 mg/dL (356.9 µmol/L) in females], respectively
| [62] | He, Y., Chen, X., Ma, Z., Wang, J., Lin, K. Association of oxidative balance score with hyperuricemia and gout: NHANES 2009-2018. Front Endocrinol. 2024, 15, 1402369. https://doi.org/10.3389/fendo.2024.1402369 |
[62]
. Higher OBS (dietary OBS + lifestyle OBS) and lifestyle OBS were associated with lower gout risk, respectively
| [62] | He, Y., Chen, X., Ma, Z., Wang, J., Lin, K. Association of oxidative balance score with hyperuricemia and gout: NHANES 2009-2018. Front Endocrinol. 2024, 15, 1402369. https://doi.org/10.3389/fendo.2024.1402369 |
[62]
. However, there was no significant association between dietary OBS and gout risk
| [62] | He, Y., Chen, X., Ma, Z., Wang, J., Lin, K. Association of oxidative balance score with hyperuricemia and gout: NHANES 2009-2018. Front Endocrinol. 2024, 15, 1402369. https://doi.org/10.3389/fendo.2024.1402369 |
[62]
. Wang et al. [100] and He et al.
| [62] | He, Y., Chen, X., Ma, Z., Wang, J., Lin, K. Association of oxidative balance score with hyperuricemia and gout: NHANES 2009-2018. Front Endocrinol. 2024, 15, 1402369. https://doi.org/10.3389/fendo.2024.1402369 |
[62]
found that lifestyle OBS was more effective in reducing the risk of hyperuricemia compared to dietary OBS.
Wu et al. [101] have stated that the pathogenesis of hyperuricemia and gout is multifactorial and complex, involving a mix of genetic, environmental factors (e.g., microclimate, season, ambient/indoor air pollution and extreme weather), and dietary factors. Several environmental factors have shown the ability to induce the production UA and regulate the innate immune pathway, involving in the pathogenesis of gout [101]. The guidelines have stated that important lifestyle changes in gout patients include weight control [5, 81, 102-104], physical activity [5, 102, 103], smoking cessation
| [5] | Khanna, D., Fitzgerald, J. D., Khanna, P. P., Bae, S., Singh, M. K., Neogi, T., Pillinger, M. H., Merill, J., Lee, S., Prakash, S., Kaldas, M., Gogia, M., Perez-Ruiz, F., Taylor, W., Lioté, F., Choi, H., Singh, J. A., Dalbeth, N., Kaplan, S., Niyyar, V., Jones, D., Yarows, S. A., Roessler, B., Kerr, G., King, C., Levy, G., Furst, D. E., Edwards, N. L., Mandell, B., Schumacher, H. R., Robbins, M., Wenger, N., Terkeltaub, R. 2012 American College of Rheumatology guidelines for management of gout. Part 1: systematic nonpharmacologic and pharmacologic therapeutic approaches to hyperuricemia. Arthritis Care Research. 2012, 64(10), 1431-1446. https://doi.org/10.1002/acr.21772 |
[5]
, and proper hydration [5, 81, 103]. Therefore, it seems that practicing selection and intakes of foods rich in antioxidant nutrients, achievement and maintenance of ideal body mass index (BMI), weight loss for overweight and obese people, adequate physical exercise (e.g., moderate intensity aerobic exercise for 30 minutes on 5-7 days per week, vigorous intensity aerobic physical activity for 75 minutes per week), smoking cessation, and proper hydration are essential for the prevention of gout. Cardiovascular disease (CVD) is hyperuricemia-related diseases
| [2] | Du, L., Zong, Y., Li, H., Wang, Q., Xie, L., Yang, B., Pang, Y., Zhang, C., Zhong, Z., Gao, J. Hyperuricemia and its related diseases: mechanisms and advances in therapy. Signal Transduction and Targeted Therapy. 2024, 9, 212. https://doi.org/10.1038/s41392-024-01916-y |
[2]
, comorbidities of hyperuricemia and gout
| [1] | Zhu, Y., Pandya, B. J., Choi, H. K. Prevalence of gout and hyperuricemia in the US general population: the National Health and Nutrition Examination Survey 2007-2008. Arthritis Rheum. 2011, 63(10), 3136-3141. https://doi.org/10.1002/art.30520 |
[1]
, and diseases implicated in oxidative stress [2, 16]. The contents of above-mentioned lifestyle (weight management, moderate intensity aerobic exercise, and smoking cessation) are consistent with those of healthy adults for the prevention of CVD recommended by the World Health Organization [105]. Since maintaining SUA concentrations 2.0-4.0 mg/dL (119.0-237.9 μmol/L), which have antioxidant activity, may help prevent not only hyperuricemia and gout, but also CVD, it seems that modifications of dietary nutrient (especially antioxidant) intakes and lifestyle are important for the prevention of the above-mentioned diseases in individuals with or without hyperuricemia.
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