Women who drank two cans or more of non-diet soda a day, or 12 ounces or more of orange juice a day, were more than twice as likely to develop gout. Women who drank just one soda or 6-ounce glass of juice per day were at 74 percent and 41 percent greater risk, respectively.
"The culprit appears to be fructose ... [F]ructose increases levels of the chemical uric acid, which causes gout. When uric acid levels in the body get too high, the acid hardens into sharp crystals that are deposited in joints."
Gout is a type of arthritis characterized by painful, stiff and inflamed joints. It can occur in any joint of your body, but most commonly occurs in your big toe.
The stiffness and swelling are a result of excess uric acid forming crystals in your joints, and the pain associated with this disease is caused by your body's inflammatory response to the uric acid crystals.
Gout affects between 2 million and 5 million Americans, and the prevalence is increasing, both in the US and other developing countries.
This comes as no surprise, because the principal reason for the rising incidence of this painful type of arthritis stems from our modern diet, which is chockfull of fructose, mainly in the form of high fructose corn syrup (HFCS).
New Evidence Confirms Fructose/Uric Acid/Gout Connection
The latest JAMA study, cited above, used data from the 22-year long Nurses' Health Study, which included nearly 79,000 women.
The analysis showed that women who drank more than two cans of soda per day were more than twice as likely to develop gout, compared with women who rarely drank soda.
Drinking 12 ounces or more of orange juice daily had the roughly the same effect.
Additionally, as reported by CNN:
"Women who had just one soda or 6-ounce glass of OJ per day were at 74 percent and 41 percent greater risk, respectively, compared with women who rarely drank either.
The culprit appears to be fructose, says the lead author of the study, Dr. Hyon Choi, M.D., a professor of medicine at Boston University School of Medicine."
In that study, men who drank two or more sugary soft drinks a day had an 85 percent higher risk of gout than those who drank less than one a month.
The risk significantly increased among men who drank five to six servings of sugary soft drinks a week. Fruit juice and fructose-rich fruits such as oranges and apples also increased the risk.
This is why I always recommend paying equal attention to the fructose consumed in the form of fruit juices and even whole fruits, and not just that from soda and processed foods. For a helpful chart showing the fructose content of common fruits, please see this link.
As a general rule, I recommend limiting your total fructose intake to 25 grams per day, from ALL sources.
Since virtually all processed foods contain HFCS, it's a wise move for most people to also limit total fructose from fruit to 15 grams per day. You could easily exceed the max of 25 grams due to this 'hidden' fructose in your diet, even if you consumed no soda or fruit...
Fructose is the ONLY Sugar that Raises Uric Acid
I became fully aware of the dramatic and devastating impact fructose has on your uric acid levels when I interviewed Dr. Richard Johnson on this topic, earlier this year.
Dr. Johnson's research focuses on how fructose -- which is the number one source of calories in the American diet – causes obesity, diabetes, and a number of other common diseases, including:
- High blood pressure
- High cholesterol and high triglycerides
- Kidney disease
- Heart disease
- Fatty liver disease
As it turns out, a major component of all of these diseases is elevated uric acid, and more recent research shows that fructose is the ONLY type of sugar that will raise your uric acid levels!
Fructose is distinctly different from other sugars as it's metabolized through very specific pathways that differ from those of glucose, for example, and it is through this distinct metabolic action that uric acid is generated.
In fact, fructose typically generates uric acid within minutes of ingestion.
However... Glucose Boosts Harmful Effects of Fructose!
Yes, although glucose will not increase uric acid levels, it will accelerate fructose absorption! So when you MIX glucose and fructose together, you actually absorb more fructose than if you consumed fructose alone.
This is an important piece of information for people who want to make a better effort at controlling their weight and prevent disease.
At What Point Does Uric Acid Start Creating Disease?
According to Dr. Johnson's research, uric acid appears to take on a lead role in creating health problems when it reaches levels in your body of 5.5 mg per dl or higher.
At this level, uric acid is associated with an increased risk for developing high blood pressure, as well as diabetes, obesity and kidney disease.
Dr. Johnson believes the ideal range for uric acid lies between 3 to 5.5 mg per dl.
How to Limit Your Fructose Consumption
According to Dr. Johnson's research, a quarter of the US population consumes a whopping 134 grams of fructose a day. This is a staggering amount of fructose when you consider the fact that you need to restrict your fructose intake to below 25 grams a day in order to maintain good health.
This makes it pretty easy to see how so many fructose-related diseases have peaked to such unfathomable levels.
For example, this statistic dovetails nicely with the statistics showing that one in four Americans is also either pre-diabetic or has type 2 diabetes.
So, just how much fructose are you consuming every day?
I strongly advise you take a look at all the labels of everything you put in your mouth, and make sure you're taking the serving size into account...
In his book, The Sugar Fix, Dr. Johnson provides detailed tables showing the content of fructose in different foods – an information base that isn't readily available when you're trying to find out exactly how much fructose is in various foods.
I do realize that reducing sugar/fructose in your diet can be tough for some people. After all, sugar is just as addictive as cocaine! But it is possible, and Dr. Johnson provides helpful guidelines for doing so in his book.
It calls for following a very low fructose diet for two weeks, which has the effect of "rebooting" your system and re-sensitizing your body to the fructose.
Additional Guidelines for Preventing and Treating Gout
If left untreated gout can become increasingly painful and lead to joint damage. So if you experience sudden, intense pain in your joints, especially your big toe, it's important to seek help.
However, I strongly recommend avoiding drug therapies for gout, and drugs specifically designed to reduce uric acid levels. It makes little sense to gamble with side effects when most people can successfully reduce their uric acid levels simply by limiting or eliminating excessive fructose from their diet!
In addition, the following strategies can help you successfully address (or prevent) gout:
- Modify your diet to fit your nutritional type. To help determine your nutritional type, take my free online nutritional typing test. We have charged thousands of people $29 for this test in the past, but now we’re able to offer the test entirely free of charge, so please, take advantage of this beneficial tool.
- Avoid drinking soda, fruit juice and other sweet beverages. As discussed above, these types of drinks are a primary source of excessive fructose. Instead, drink plenty of pure water, as the fluids will help to remove uric acid from your body. Cutting back on all forms of sugar and grain in your diet is also important.
- Limit or eliminate alcohol consumption, particularly beer. Alcohol in general, and beer specifically, may also raise the levels of uric acid in your blood.
- Exercise. Being overweight increases your risk of gout, and regular exercise will help you to maintain a healthy weight and improve your overall health.
- Try tart cherries or concentrated tart cherry juice. Tart cherries contain two powerful compounds, anthocyanins and bioflavonoids. Both of these compounds slow down the enzymes Cyclo-oxyygenase-1 and -2, which helps to relieve and prevent gout and arthritis in your body.
Interestingly, we have had many readers state that alfalfa tablets have provided a fair measure of relief and improvement from gout as well. I have no experience with this but it would certainly seem another avenue to explore since it is a natural product with virtually no downside or side effects.
Nutmeg has also shown promise for relieving gout symptoms, so if you enjoy this spice feel free to add it liberally to your diet.