Fructose & Gout

[Guest guest]

Fructose Intake Associated With an Increased Risk for Gout

Emma Hitt, PhD

November 16, 2010 (Atlanta, Georgia) — Consuming sugar-sweetened sodas,

orange juice, and fructose is associated with an increased risk for incident

gout, according to new research findings from the Nurses' Health Study.

Hyon K. Choi, MD, DrPH, from Boston University School of Medicine,

Massachusetts, presented the findings here at the American College of

Rheumatology

2010 Annual Meeting. The results were also published online November 10 in

the Journal of the American Medical Association.

The main message, said Dr. Choi, is that " if your patient has

hyperuricemia, or gout, and if they are consuming sugary beverages,

particularly

containing fructose (i.e., sugar, not artificial sweeteners), then I would

recommend them stopping or at least reducing their intake, " Dr. Choi told

Medscape

Medical News.

Dr. Choi and colleagues analyzed data from the Nurses' Health Study, an

American prospective cohort study spanning 22 years, from 1984 to 2006. Women

with no history of gout at baseline (n = 78,906) provided information about

their intake of beverages and fructose by filling out validated food

frequency questionnaires.

Over the course of the study, 778 incident cases of gout were reported.

Compared with the consumption of less than 1 serving per month of

sugar-sweetened soda, the consumption of 1 serving per day was associated with a

1.74-fold increased risk for gout, and the consumption of 2 or more servings per

day was associated with a 2.39-fold increased risk (P < .001 for trend).

Consumption of orange juice was associated with a 1.41-fold and 2.42-fold

increased risk for 1 and 2 servings per day, respectively (P = .02 for

trend).

For 1 and 2 servings of sugar-sweetened soda, the absolute risk differences

were 36 and 68 cases per 100,000 person-years, respectively; for 1 and 2

servings of orange juice, the absolute risk differences were 14 and 47 cases

per 100,000 person-years, respectively.

The consumption of diet soft drinks was not associated with the risk for

gout (P = .27 for trend).

Compared with the lowest quintile of fructose intake, the multivariate

relative risk for gout in the top quintile was 1.62 (95% confidence interval,

1.20 - 2.19; P = .004 for trend), indicating a risk difference of 28 cases

per 100,000 person-years.

According to Dr. Choi, the mechanism of fructose and its effect on the

pathology of gout is well understood.

" Administration of fructose to human subjects results in a rapid increase

in serum uric acid and increased purine synthesis, " he explained. " In

addition, this effect is more pronounced in individuals with hyperuricemia or a

history of gout. "

In the published paper, the authors point out that because " fructose intake

is associated with increased serum insulin levels, insulin resistance, and

increased adiposity, the overall negative health effect of fructose is

expected to be larger in women with a history of gout, 70% of whom have

metabolic syndrome. "

According to independent commentator Bray, MD, from the Pennington

Biomedical Research Center in Baton Rouge, Louisiana, this is another " nail

in the coffin for the overuse of fructose-containing beverages. "

" In a previous report, gout in men was associated with a higher intake of

fructose (either sugar or high-fructose corn syrup from beverages), " he told

Medscape Medical News. " This paper extends this using the Nurses' Health

Study to show that the higher intake of fructose (soft drinks and juices) is

associated with an increased risk of gout in women. "

Dr. Bray added that it would be a good idea to include the fructose content

of foods and beverages on the label for the public's information.

The study was not commercially funded. Dr. Choi reports receiving research

grants and consulting fees from Takeda Pharmaceuticals North America. Dr.

Bray has disclosed no relevant financial relationships.

JAMA. Published online November 10, 2010. _Abstract_ (http://www.n

cbi.nlm.nih.gov/pubmed/21068145)

ACR 2010 Annual Meeting: Abstract L5. Presented November 10, 2010.

Medscape Medical News © 2010 WebMD, LLC