Studies Link Gout Flares to Consuming Sodas

A systematic review and meta-analysis published in the July 19 issue of the Journal of Human Nutrition and Dietetics finds that consuming sugar-sweetened beverages is significantly associated with increased serum uric acid concentrations associated with gout flares.

The review, which was conducted by Iranian physicians, was narrowed down to five cross-sectional studies that were published between 2007 and 2013. The size of the studies ranged from 483 patients to 14,761 and most controlled for age, body mass index, weight and sex.

"We found that individuals in the highest category of sugar-sweetened beverages intake had 0.18 mg dL-1 greater concentrations of serum uric acid compared to those in the lowest category (summary effect size: 0.18 mg dL-1 ; 95% confidence interval = 0.11-0.25)," the authors wrote.

Prior to the publication of this study, the evidence suggesting an association between fructose-sweetened beverages and hyperuricemia leading to gout flares was conflicting. Other studies have shown that poor diet and obesity can exacerbate pre-existing conditions that can lead to gout flares. Alcohol, and purine-rich foods such as red meat and some seafoods, have been shown to elevate hyperuricemia levels.

Cross-sectional studies have shown that increased intakes of sugar-sweetened beverages and fructose were associated with increased serum uric acid levels. A randomized, controlled cross-over trial found that the consumption of high fructose corn syrup, compared to sucrose-sweetened soft drinks, resulted in immediate increased concentrations of serum uric acid levels in healthy subjects.

The mechanisms by which consuming fructose-sweetened beverages may lead to elevated hyperuricemia is not clear. Researchers suspect that fructose can produce uric acid by increasing the degradation of adenosine triphosphate (ATP) hydrolysis, which is involved in the production of uric acid. And, consuming high doses of fructose, can induce insulin resistance, impair glucose tolerance and hyperuricemia.

The findings from the new study need to be confirmed in follow-up studies, the authors wrote.

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REFERENCE

Ebrahimpour-Koujan S, Saneei P, Larijani B, Esmaillzadeh A. onsumption of sugar-sweetened beverages and serum uric acid concentrations: a systematic review and meta-analysis [published online ahead of print, 2020 Jul 19]. J Hum Nutr Diet. 2020;10.1111/jhn.12796.