Tomatoes can now be listed alongside red meat, seafood and beer as a possible trigger for the excruciatingly painful affliction of gout, according to New Zealand research out Wednesday.

The University of Otago study found, for the first time, a biological basis for the belief that eating tomatoes can cause the debilitating form of arthritis to flare up.

Gout affects about three times more men than women, with up to 5 percent of European men in New Zealand and up to 15 percent of Maori and Pacific island men suffering from it.

Eating certain foods could cause gout to flare up and a survey by Otago researchers found 20 percent of gout sufferers listed tomatoes as a trigger food.

Study co-author Tanya Flynn said tomatoes were found to be the fourth most commonly mentioned trigger, after seafood, alcohol and red meat.

The researchers analyzed data from 12,720 male and female members of three long-running U.S. health studies, which showed that tomato consumption was linked to higher levels of uric acid in the blood, which was the major underlying cause of gout.

"We found that the positive association between eating tomato and uric acid levels was on a par with that of consuming seafood, red meat, alcohol or sugar-sweetened drinks," said Flynn.

Gout sufferers could take medication to reduce uric acid levels rather than avoid tomatoes, she said.

"Further intervention studies are needed to determine whether tomatoes should be added to the list of traditional dietary triggers of gout flares, but this research is the first step in supporting this idea," said Flynn.