title: Effects of skim milk powder enriched with glycomacropeptide and G600 milk fat extract on frequency of gout flares: a proof-of-concept randomised controlled trial.
abstract: OBJECTIVE
  Previous laboratory studies have identified two dairy fractions, glycomacropeptide (GMP) and G600 milk fat extract (G600), with anti-inflammatory effects in models of acute gout. The aim of this proof-of-concept clinical trial was to test the hypothesis that daily intake of skim milk powder (SMP) enriched with GMP and G600 can prevent gout flares.
  
  
  METHODS
  This was a 3-month randomised double-blind controlled trial of milk products for prevention of gout flares. One hundred and twenty patients with recurrent gout flares were randomised to one of three arms: lactose powder control, SMP control and SMP enriched with GMP and G600 (SMP/GMP/G600). The primary end point was change in the frequency of gout flares using a daily flare diary measured monthly for 3 months.
  
  
  RESULTS
  The frequency of gout flares reduced in all three groups over the 3-month study period compared with baseline. Over the 3-month study period there was a significantly greater reduction in gout flares in the SMP/GMP/G600 group (analysis of covariance p(group)=0.031, Tukey post hoc test compared with lactose control, p=0.044). Following treatment with SMP/GMP/G600 over the 3-month period, greater improvements were also observed in pain and fractional excretion of uric acid, with trends to greater improvement in tender joint count. Similar adverse event rates and discontinuation rates were observed between the three groups.
  
  
  CONCLUSIONS
  This is the first reported controlled trial of dietary intervention in patients with gout, and suggests that SMP enriched with GMP and G600 may reduce the frequency of gout flares.
authors.affiliation: Bone and Joint Research Group, Department of Medicine, University of Auckland, Auckland, New Zealand. n.dalbeth@auckland.ac.nz
authors.forename: Nicola
authors.initials: N
authors.lastname: Dalbeth
authors.forename: Ruth
authors.initials: R
authors.lastname: Ames
authors.forename: Greg D
authors.initials: GD
authors.lastname: Gamble
authors.forename: Anne
authors.initials: A
authors.lastname: Horne
authors.forename: Sumwai
authors.initials: S
authors.lastname: Wong
authors.forename: Barbara
authors.initials: B
authors.lastname: Kuhn-Sherlock
authors.forename: Alastair
authors.initials: A
authors.lastname: MacGibbon
authors.forename: Fiona M
authors.initials: FM
authors.lastname: McQueen
authors.forename: Ian R
authors.initials: IR
authors.lastname: Reid
authors.forename: Kate
authors.initials: K
authors.lastname: Palmano
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D002364:Caseins / Q000008:administration & dosage* / Q000009:adverse effects; D003611:Dairy Products / Q000009:adverse effects; D005260:Female; D005527:Food, Fortified / Q000009:adverse effects; D006017:Glycolipids / Q000008:administration & dosage* / Q000009:adverse effects; D006023:Glycoproteins / Q000008:administration & dosage* / Q000009:adverse effects; D006073:Gout / Q000178:diet therapy* / Q000276:immunology / Q000517:prevention & control*; D006801:Humans; D066292:Lipid Droplets; D008297:Male; D008875:Middle Aged; D008894:Milk Proteins / Q000008:administration & dosage* / Q000009:adverse effects; D010446:Peptide Fragments / Q000008:administration & dosage* / Q000009:adverse effects; D011208:Powders; D055502:Secondary Prevention; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D002364:Caseins; D006017:Glycolipids; D006023:Glycoproteins; D008894:Milk Proteins; D010446:Peptide Fragments; D011208:Powders; C065989:caseinomacropeptide; C110367:milk fat globule