Drinks high in fructose raise gout risk for women

Drinks high in fructose raise gout risk for women

Women who regularly consume drinks with a high fructose content have a 74% higher risk of developing gout compared to females who consume such drinks once per month or less, researchers from Boston University School of Medicine wrote in JAMA (Journal of the American Medical Association). The authors add that because gout is not common among females, the total female incidence from fructose-rich beverages will not change the male-female ratio incidence balance by much.

The authors explain that the increased incidence of gout over the last few decades coincides with a similar increase in soft drink and fructose intake. In 1977 there were 16 cases of gout for every 100,000, compared to 42 per 100,000 in 1996.

The authors wrote, "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."

Hyon K. Choi, M.D., Dr.P.H. and team set out to find out what impact fructose-rich drinks and just fructose might have on gout risk in a large group of females. They gathered information from the Nurses' Health Study, which spans from 1984 to 2006. They focused on 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% 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, the authors revealed. Women consuming 1 six-ounce serving per day of orange juice had a 41% higher risk of gout compared to those who had such drinks just once per month at the most. Two servings per day increased the risk by 2.4.

The researchers emphasized that the absolute risk was still modest for high fructose female drinkers because of the already low incidence of the disease among women.

The authors wrote "Our data provide prospective evidence that fructose poses an increased risk of gout among women, thus supporting the importance of reducing fructose intake."

When an individual has a gout attack, uric acid has been building up in the blood until levels become excessive (hyperuricemia), resulting in uric acid deposits forming in the joints. This causes inflammation and severe pain. Uric acid usually dissolves and is expelled in urine via the kidneys. However, if a person's body is producing too much uric acid, or if the kidneys are not working properly, it accumulates. The build-up results in sharp urate crystals which look like needles accumulating in the joints and surrounding tissue.

Gout is much more common among men than women. Women who do develop gout tend to do so after the menopause.

"Fructose-Rich Beverages and Risk of Gout in Women"

Hyon K. Choi, MD, DrPH; Walter Willett, MD, DrPH; Gary Curhan, MD, ScD

JAMA. Published online November 10, 2010. doi:10.1001/jama.2010.1638

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Section Issues On Medicine: Disease