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Validated food frequency questionnaires were used to calculate Empirical Dietary Inflammatory Pattern (EDIP) (food\u2010based index predictive of circulating inflammatory biomarkers) scores every four years. Cox proportional hazards models were used to evaluate multivariable associations between EDIP and incident, physician\u2010diagnosed gout. We further tested whether these associations were independent of key guideline\u2010based healthy eating patterns that previously showed beneficial associations with gout (ie, Dietary Approaches to Stop Hypertension [DASH], Alternative Healthy Eating Index [AHEI]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We documented 5,425 incident female gout cases over 4,372,243 person\u2010years. EDIP was positively associated with female gout risk; hazard ratio (HR) (95% confidence interval [CI]) for the most versus least proinflammatory quintile was 2.02 (1.83\u20132.22). Additional adjustment for body mass index attenuated this association (HR 1.71 [95% CI 1.55\u20131.88]). Reversing the EDIP score, women in the most anti\u2010inflammatory EDIP quintile had the largest magnitude of protective association for gout (HR 0.58 [95% CI 0.53\u20130.65]) compared with HRs for healthiest DASH (HR 0.80 [95% CI 0.73\u20130.87]) and AHEI quintiles (HR 0.81 [95% CI 0.74\u20130.89]). The magnitude of association between EDIP and male gout was substantially smaller (HR 1.24 [95% CI 1.13\u20131.37];\n                      <jats:italic>P<\/jats:italic>\n                      \u2010heterogeneity &lt;0.0001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These findings support a pivotal role of inflammation as a potential modulator between diet and gout onset, particularly among women.<\/jats:p>\n                    <jats:p>\n                      <jats:boxed-text content-type=\"graphic\" position=\"anchor\">\n                        <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/art43127-toc-0001-m.png\">\n                          <jats:alt-text>image<\/jats:alt-text>\n                        <\/jats:graphic>\n                      <\/jats:boxed-text>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/art.43127","type":"journal-article","created":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T03:59:51Z","timestamp":1737950391000},"page":"1077-1086","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Proinflammatory Dietary Pattern and the Risk of Female Gout: Sex\u2010Specific Findings From Three Prospective Cohort Studies"],"prefix":"10.1002","volume":"77","author":[{"given":"Sharan K.","family":"Rai","sequence":"first","affiliation":[{"name":"Massachusetts General Hospital Harvard Medical School, Channing Division of Network Medicine, and The Mongan Institute, Massachusetts General Hospital, Boston, and Arthritis Research Canada  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyon K.","family":"Choi","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital Harvard Medical School, Channing Division of Network Medicine, and The Mongan Institute, Massachusetts General Hospital, Boston, and Arthritis Research Canada  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Na","family":"Lu","sequence":"additional","affiliation":[{"name":"Arthritis Research Canada  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7557-3303","authenticated-orcid":false,"given":"Chio","family":"Yokose","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital, Harvard Medical School, and The Mongan Institute, Massachusetts General Hospital  Boston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kehuan","family":"Lin","sequence":"additional","affiliation":[{"name":"Harvard T. H. Chan School of Public Health  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong Hoon","family":"Lee","sequence":"additional","affiliation":[{"name":"Harvard T. H. Chan School of Public Health, Boston, Massachusetts, and Yonsei University  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fred K.","family":"Tabung","sequence":"additional","affiliation":[{"name":"Harvard T. H. 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