THIS IS THE SECOND OF THREE PAGES ABOUT GOUT AND FRUCTOSE. THERE’S A LINK TO THE FIRST AND THIRD AT THE BOTTOM OF THIS ARTICLE.
This page on fructose and gout was last reviewed or updated on 11 July 2011.
Does a fruit sugar cause gout !!!.....but isn’t eating fruit the Holy Grail of nutrition?
It seems incredible. How could the main sugar found in fruits, and a sugar in many vegetables, both of which classes of foods are usually so gout benign and always heralded as healthy, lead to elevated uric acid and an increased risk of gout?
Even the purines in most fruits and vegetables have not been found, in a major study to raise uric acid. And if 100 grams of infused fructose in a study does not raise uric acid, could the much smaller amounts of fructose in fruits, and even less in vegetables, raise uric acid?
Perhaps they can in susceptible people. This website is in correspondence with a gout sufferer who thinks fructose causes gout. Why? Because of his previously high fruit consumption.
His gout almost disappeared when, after trying many remedies, he finally read about gout and fructose and then avoided sugar and fruit. He now thinks his gout seems to be under control.
But fruit does not have to be cut out completely. For most people, eating fruit is probably only a problem if you over-eat it. What is likely to matter more than fruit are other kinds of fructose – especially the fructose that is 50% of table sugar, and the artificial, now ubiquitous sweetener high-fructose corn syrup. Plus sources of fructose in other sweeteners - honey (very high in fructose), agave, maple syrup, molasses (treacle), fruit juices, colas and the rest.
How much should a daily fructose budget be?
The amount of fructose you have to consume to cause uric acid to rise – if it does – is not clear. But there is no need to throw up your hands in frustration and shock-horror wondering what on earth you can eat when you have gout or wish to avoid it. You can have some fructose. In Dr. Johnson’s The Sugar Fix he explains that 25 – 35 grams of fructose can be eaten daily without the risk of raising uric acid. At this level it’s highly unlikely you’ll do this. The online health newsletter writer, Dr. Mercola, thinks 25 grams is O.K., but 15 grams of this should be from fruit and 10 grams from the other sources of fructose.
But Peter Mayes in his study "Intermediary metabolism of fructose," the study that went into enormous detail about how fructose raises uric acid, thought the uric acid effects of fructose seemed minimal on normal diets. He thought those on very high fructose diets "may be at increased risk."(3)
Your consumption of fructose
The average daily consumption of fructose might be about 50 grams on many diets, but you are not an average. So you need to approximately establish how much fructose you consume daily. How many grams is it? Use the resources explained on the first page of our fructose section - click on the link at the bottom of this article.
When you have a rough idea (it won’t, and doesn’t need, to be 100% accurate) consider this. If you consume more than 150 grams a day (quite easy if you drink a lot of colas sweetened with HFCS), note that in at least one study (10), 167 grams of fructose has raised uric acid by 0.17 mg/dL over 2 hours before it fell back. And on the contrary, there has been a study where people’s uric acid did not rise from a fructose infusion of 100 grams. (11)
This website’s mascot, Toby Gout, has a motto "When there's doubt…...be careful!"
In my opinion there is enough in the fructose causes gout theory to limit, or at least monitor, your fructose intake. The more so if you have high uric acid (more than 6.8 mg/dL men, 5.7 mg/dL women), and especially if you already have gout. Remember, if you already have gout, your uric acid is more responsive to fructose (3). And be careful if you think you could be susceptible to fructose, as our gouty correspondent mentioned above believes.
You might learn if you are responsive yourself, by using a uric acid meter
to compare your uric acid level with your fructose consumption. Work with a health professional because accurately measuring all the consumables where fructose is found is not easy. You could use the low fructose diet in The Sugar Fix to lower fructose intake.
If you measure your uric acid regularly you have a good chance of spotting any increase, or decrease, due to increased or reduced fructose consumption.
The gout and fructose debate will rumble on. The medical and nutrition research community might take 20 years to reach true conclusions about gout and fructose. Don’t wait for this to be settled. In that time your uric acid (or hyperuricemia) will probably rise further, (and for other reasons too). Then it may precipitate to gout. So be aware of this gout and fructose factor and consider your fructose consumption carefully.
Study references for the second page about gout and fructose
(1) Jee Wong J. Choi, Earl S. Ford, Xiang Gao, and Hyon K.Choi Sugar-Sweetened Soft Drinks, Diet Soft Drinks, and Serum Uric Acid Level: The Third National Health and Nutrition Examination Survey. Arthritis & Rheumatism (Arthritis Care & Research) Vol. 59, No. 1, January 15, 2008, pp 109–116. </i>
(3) Mayes, Peter.A. Intermediary metabolism of fructose. American Journal of Clinical Nutrition 1993 Nov; 58 (Supp): 754S-765S.
(6) Richard Johnson MD (with Timothy Gower and Elizabeth Gollub PhD, RD), The Sugar Fix:The high-fructose fall out that’s making you fat and sick.The Pocket books division of Simon & Schuster Inc., New York 2008.
(7) Abstract. Robert G.Narins, Jerome S.Weisbergh, Allen R. Meyers Effects of carbohydrates on uric acid metabolism. Metabolism 1974; May; 23 (5):455-65.
(10) Sheldon Reiser, Andrea S.Powell, Daniel J.Scholfield, Pankaja Panda, Kathleeen C. Ellwood, John S.Canary. Blood lipids, lipoproteins, apoproteins, and uric acid in men fed diets containing fructose or high-amylose corn starch. American Journal of Clinical Nutrition 1989;49:832-9.
(11) Abstract. Curreri P.W., Pruitt B.A.Jr., Absence of fructose-induced hyperuricaemia in men. The Lancet 1970 Vol.1 pp.839.