Study Suggests High Fructose Increases Gout in Women

BOSTONWomen who regularly drink beverages with high fructose content have a 74-percent higher risk of developing gout compared to females who drink them one a month or less, according to a new study published in the Journal of the American Medical Association (JAMA). The researchers also noted that the risk is modest because gout is not common among females.

Researchers at Boston University School of Medicine used data gathered from the Nurses' Health Study (1984-2006) and examined 78,906 adult females with no history of gout when their study began. Food frequency questionnaires had been used to file data on their fructose and drink consumption.

There were 778 cases of women diagnosed with gout during a 22-year follow-up period. The investigators saw a clear link between sugar-sweetened sodas and a higher risk of gout. Women who drank at least one serving per day were 74 percent more likely to develop gout than those who consumed one per month or less. The risk was 2.4 times greater for those consuming at least two servings of sugar-sweetened sodas per day. They found no link between gout risk and diet sodas.

Orange juice consumption was also linked to gout risk. Women consuming one 6-ounce serving per day of orange juice had a 41-percent higher risk of gout compared to those who drank juice once a month; two servings per day increased the risk by 2.4.

Fructose-rich beverages such as sugar-sweetened soda and orange juice can increase serum uric acid levels and, thus, the risk of gout, but prospective data on the relationship are limited," the researchers wrote.

Responding to the study, the American Beverage Association issued the following statement:

This study fails to be meaningful when it comes to informing Americans about the real causes of gout. In fact, suggesting that fructose intake causes gout is not based on modern day science, but rather centuries-old theory. In reality, the compendium of research conducted on gout shows foods and beverages high in purinessuch as alcohol, beer and certain meatsare strongly linked to uric acid metabolism, and therefore gout. As the authors themselves note, neither soft drinks nor orange juicethe beverages discussed in this studycontain purines.

Moreover, it is misleading to label these beverages as fructose-rich' given that at least 45 percent, and possibly as much as 58 percent, of the sweeteners they contain are in fact glucose, not fructose. Even so, for the authors to reference the effects of fructose infusion as compared to oral intake of a sweetened beverage is like comparing apples to oranges. The physiological effects of injecting something versus ingesting it are worlds apart. Furthermore, the authors also suggest that consuming fruit juices, but not eating whole fruit, would lead to increased risk for gout. Yet, the percentage of fructose content in both fruit and fruit juice are identical. This clearly suggests that it is not the fructose content that is leading to the increased risk for gout.

Equally as important, the authors of this paper look at association, not causation. They also note that the contribution, if any, of these fructose-rich' beverages to incidence of gout is likely modest given the low incidence rate among women.

The fact remains that the strongest risk factor for developing gout is family historyif your mom or your dad has gout, you are at a greater risk of developing it. Those who have a family history of gout, or are interested in learning the facts about this arthritic condition, should visit the website of the National Institutes of Health National Institute for Arthritis and Musculoskeletal and Skin Diseases."