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Blame Sweet Soda for Gout?

Soft Drinks Worse Than Hard Liquor for Gout, but Diet Sodas OK

Gout Risk: Food and Drink vs. Family History continued...

"When it occurs you suffer really a lot for a week to two weeks," says Choi, a rheumatologist. "It is very severe pain. Just putting your bed sheet on the joint hurts. Gout causes intense swelling and pain, one of the worst pains you can suffer."

Foods already known to cause gout have high levels of purine compounds. Such foods include red meat, organ meats, and shellfish. But diet isn't the only cause of gout. Many gout sufferers inherit a tendency to generate too much uric acid; others inherit an inability to efficiently eliminate uric acid in the urine.

That's why the American Beverage Association, which supports the soft drink industry, takes a dim view of the Choi findings. Maureen Storey, PhD, the association's senior vice president for science policy, says the Choi study failed to account for family history of gout.

"The most important risk factor for whether a person develops gout or not is family history," Storey tells WebMD. "All of the research that has been conducted on gout over the last century or so has shown that foods and beverages high in purines -- such as alcoholic beverages, beer, gravies, and certain kinds of meat -- are strongly linked to development of gout. Soft drinks don't have that in them."

What soft drinks do contain is high-fructose corn syrup. Unlike glucose, the sugar our bodies uses for fuel, fructose raises uric acid levels. High levels of uric acid are linked to gout. But Choi agrees with Storey that his study is the first to link fructose to gout.

Strengthening Choi's fructose hypothesis is his finding that diet sodas -- which don't have fructose -- don't alter gout risk. Moreover, Choi and colleagues find that people who eat lots of sweet fruits, such as apples and oranges, also up their gout risk.

"We find a similar level of increased gout risk from apples and oranges as from sweetened soft drinks, but the caution is misplaced here because these fruits offer benefits against other major disorders such as stroke, diabetes, and certain cancers," Choi says. "There may be certain limited situations, such as treatment-resistant severe gout, where reducing all sources of fructose may be of use. But overall, fruits are beneficial."

Choi and colleagues report their findings in the Jan. 31 online issue of the journal BMJ.

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