Fructose Sugar Gout

Fructose and Gout: What’s the Link?

Most of us know how sugar affects our waistline. Too much of the sweet stuff contributes to obesity, and with it, diseases like diabetes and heart disease. Overdoing it on one type of sugar in particular—the high fructose corn syrup found in sodas and processed foods—can also set off painful gout. Considering that the average American eats 22 to 30 teaspoons of sugar daily, gout is yet another health risk worth noting.

Fructose is a natural sugar found in fruit and honey. High fructose corn syrup is a man-made sweetener produced from corn. It’s composed of 55 percent fructose and 45 percent glucose. Why is this type of sugar harder on your joints than other forms, like glucose? “Fructose is metabolized differently from glucose,” explains Peter Simkin, MD, emeritus professor of medicine in the University of Washington School of Medicine division of Rheumatology.

As the body breaks down fructose, chemical compounds called purines are released. The breakdown of purines produces uric acid—the substance that forms painful crystals in the joints and causes gout. Within minutes after you drink high fructose corn syrup-sweetened soda, your uric acid levels rise.

Soft Drinks and the Rise of Gout

Gout used to be known as a “rich man’s disease,” because at one time, wealthy men were the only people who could afford the rich foods—veal, scallops, red meat, alcohol—that caused it. Today, gout is any man’s disease—and many women’s, too.

The number of people living with this painful form of arthritis has doubled in the past few decades, an increase experts link to rising soda consumption in the U.S. A 2008 study found that men who drink two or more sugary sodas daily have an 85 percent higher risk for gout than men who drink less than one soda a month.

The Obesity Connection

Sugary soft drinks and processed foods also contribute to obesity, which is itself a risk for gout. People who are overweight produce more uric acid, and their kidneys don’t remove it as quickly.

One study found that the relative risk for gout is nearly double in people who are obese compared to those who aren’t obese. And, very overweight people get gout an average of three years sooner than those of normal weight.

Does Fruit Cause Gout Too?

Researchers have also linked fruit juice and certain types of fruit, such as apples and oranges, with gout risk. In one study, men who drank two glasses or more of fruit juice a day were nearly twice as likely to get gout as those who drank less than a glass daily.

Yet that doesn’t mean you should abandon fruit in your diet. “I think it’s probably a question of quantity,” Simkin says. Fruit is high in nutrition; you just don’t want to overdo it. It’s especially important to watch your portion size when it comes to fruit juice, which is more concentrated in fructose—especially if you’re already at risk for gout because of your weight or other factors.

Controlling Gout Risk

Limiting or avoiding sugary sodas and processed foods is one way to lower your odds of getting gout. Once you have the disease, diet should be just one part of your strategy. Medicine should be another.

“If you can control hyperuricemia [high uric acid levels] you can control gout. But it’s a lifelong problem. It doesn’t go away,” Simkin says.

Drugs called xanthine oxidase inhibitors—allopurinol (Aloprim, Lopurin, Zyloprim) and febuxostat (Uloric)—reduce the amount of uric acid your body makes. Probenecid (Probalan) helps your kidneys remove more uric acid.

Simkin recommends taking your medicine continuously, even if you start to feel better. And watch out for all foods that increase uric acid in your body—including meat, seafood, and alcohol. “With adherence to medication and diet, we can help most gout patients very much,” he says.

 

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