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Genetic risk score (GRS) was calculated from 114 urate\u2010associated loci.<\/jats:p><\/jats:sec>Results<\/jats:title>In the NHS and replication cohorts, association between diet and gout risk was larger and stronger among women with higher genetic risk. In all cohorts combined, compared to women with an unhealthy DASH score (less than the mean score), multivariable relative risk (RR) for incident gout among women with a healthy DASH score (greater than\/equal to the mean score) was 0.67 (95% confidence interval [95% CI] 0.60\u20130.76) among higher GRS (greater than\/equal to the mean score) and 0.91 (0.78\u20131.05) among lower GRS (P<\/jats:italic> for multiplicative interaction\u00a0=\u00a00.001); multivariable RR for higher versus lower GRS was 2.03 (95% CI 1.80\u20132.29) and 1.50 (95% CI 1.31\u20131.71) among unhealthy and healthy DASH score groups, respectively. Additive interaction was also significant, in both the discovery and replication cohorts (P<\/jats:italic>\u2009<\u20090.001), with 51% of the excess risk attributable to the additive gene\u2013diet interaction in all cohorts combined.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>The deleterious effect of genetic predisposition on risk of incident female gout was more pronounced among women with unhealthy diets, with nearly half the excess risk attributable to this gene\u2013diet interaction. 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