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At the times of gout flares (hazard period) and during gout flare\u2013free periods (control periods), participants completed questionnaires regarding exposures, including supplements and diet, during the preceding 48 hours. We examined the relationship of self\u2010reported n\u20103 <jats:styled-content style=\"fixed-case\">PUFA<\/jats:styled-content>\u2013rich supplements and fish intake with the risk of recurrent gout flares using conditional logistic regression, adjusting for total purine intake, diuretic use, and other urate\u2010lowering or flare prophylactic medications (allopurinol, nonsteroidal antiinflammatory drugs, or colchicine).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 724 participants, 85% met the 1977 American College of Rheumatology preliminary criteria for the classification of the acute arthritis of primary gout. Twenty\u2010two percent of the participants reported some form of n\u20103 <jats:styled-content style=\"fixed-case\">PUFA<\/jats:styled-content> consumption (supplements, 4.6%; dietary fatty fish, 19%) in the 48 hours preceding a gout flare or flare\u2010free period. The adjusted odds ratios were 1.01 (95% confidence interval [95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>] 0.63\u20131.60; <jats:italic>P<\/jats:italic> = 0.98) for all 3 supplements combined and 0.74 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.54\u20130.99; <jats:italic>P<\/jats:italic> = 0.04) for consumption of \u22652 n\u20103 <jats:styled-content style=\"fixed-case\">PUFA<\/jats:styled-content>\u2013rich fish servings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Dietary n\u20103 <jats:styled-content style=\"fixed-case\">PUFA<\/jats:styled-content>\u2013rich fish consumption, when adjusted for total purine intake, was associated with lower risk of recurrent gout flares, whereas n\u20103 <jats:styled-content style=\"fixed-case\">PUFA<\/jats:styled-content> supplementation alone, as taken in a self\u2010directed manner, was not. Consumption of specific sources and adequate doses of n\u20103 <jats:styled-content style=\"fixed-case\">PUFA<\/jats:styled-content> for gout flare prevention warrants further study in an adequately powered clinical trial.<\/jats:p><\/jats:sec>","DOI":"10.1002\/art.40896","type":"journal-article","created":{"date-parts":[[2019,3,25]],"date-time":"2019-03-25T12:54:15Z","timestamp":1553518455000},"page":"1580-1586","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":41,"title":["Effect of Dietary and Supplemental Omega\u20103 Polyunsaturated Fatty Acids on Risk of Recurrent Gout Flares"],"prefix":"10.1002","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0087-1039","authenticated-orcid":false,"given":"MaryAnn","family":"Zhang","sequence":"first","affiliation":[{"name":"Brigham and Women\u2019s Hospital and Harvard Medical School  Boston 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