How does fructose influence gout?

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    Last Updated: October 25, 2023

    Fructose intake appears to increase uric acid levels, with one meta-analysis of randomized controlled trials reporting a 0.4 mg/dL reduction in uric acid when fructose was replaced with glucose and a 0.6 mg/dL reduction when sucrose was replaced with glucose.[1]

    The effect of fruit (a source of fructose) on uric acid is likely complicated. One study examined the impact of different fruits on uric acid in healthy women, reporting no effect of 300 grams of strawberries, 300 grams of kiwifruit, or 280 grams of red grapes and a possible reduction in uric acid following consumption of 280 grams of sweet cherries.[2] Another study found no differences in fasting uric acid when women on an energy restricted diet consumed a diet high in fructose-rich fruit (delivering roughly 45 grams of fructose per day).[3] However, in one study consuming 26.7 grams of fructose at on time from either 410 grams of apples, 170 mL of apple juice, or refined fructose all led to increases in uric acid, albeit in the short term (30 minutes after consumption).[4] Another trial reported increases in uric acid following consumption of 5 apples (containing an estimated 63.9 grams of fructose) compared to eating plain bagels with the same carbohydrate content.[5] Overall, the effect of fruit on uric acid may depend on quantity and type of fruit as well as the context in which it is consumed.

    References

    1. ^Lukas Schwingshackl, Manuela Neuenschwander, Georg Hoffmann, Anette E Buyken, Sabrina SchlesingerDietary sugars and cardiometabolic risk factors: a network meta-analysis on isocaloric substitution interventionsAm J Clin Nutr.(2020 Jan 1)
    2. ^Robert A Jacob, Giovanna M Spinozzi, Vicky A Simon, Darshan S Kelley, Ronald L Prior, Betty Hess-Pierce, Adel A KaderConsumption of cherries lowers plasma urate in healthy womenJ Nutr.(2003 Jun)
    3. ^Ana B Crujeiras, M Dolores Parra, M Cristina Rodríguez, Blanca E Martínez de Morentin, J Alfredo MartínezA role for fruit content in energy-restricted diets in improving antioxidant status in obese women during weight lossNutrition.(2006 Jun)
    4. ^Sara J White, Emma L Carran, Andrew N Reynolds, Jillian J Haszard, Bernard J VennThe effects of apples and apple juice on acute plasma uric acid concentration: a randomized controlled trialAm J Clin Nutr.(2018 Feb 1)
    5. ^Silvina B Lotito, Balz FreiThe increase in human plasma antioxidant capacity after apple consumption is due to the metabolic effect of fructose on urate, not apple-derived antioxidant flavonoidsFree Radic Biol Med.(2004 Jul 15)