Second, regarding the comment on the potential ranking of attributable proportions of each cohort, it is important to note that there was very high overlap in the 95% confidence intervals (95% CIs) between the estimates (eg, proportion due to gene-diet interaction, 45% [95% CI 22%-68%] versus that due to genetic susceptibility alone, 46% [95% CI, 36%-56%]) and the randomeffects framework to combine the cohorts was a standard approach. Regardless, the key message of our findings was that diet (alone or in combination with genetic factors) contributed to the development of the majority of excess cases of female gout (Figure 1), 55% in the NHS and 71% in the three replication cohorts. From a public health viewpoint, these findings support a healthy guideline-based diet such as the DASH for primary prevention of gout, given that diet is modifiable but genes currently are not.Third, regarding not including sodium intake in the UK Biobank (UKBB), we found that our results did not change materially with or without the UKBB cohort included (51% attributable to the gene-diet interaction in both cases). Because higher sodium intake has been shown to lower serum urate levels in randomized trials but also to raise blood pressure, no clinical or public health recommendations can be made to increase sodium intake for urate lowering for gout prevention.In summary, we appreciate the comments but wish the readers to take away our manuscript's principal finding, that low adherence to a DASH-style diet amplifies the deleterious effects of genetic predisposition on risk of incident female gout, whereas this genetic predisposition can be overcome by high DASH adherence.