Fructose-rich beverages and risk of gout in women.
Level 3 - non-randomized controlled study
Prospective longitudinal cohort study
PubMed 21068145 · doi:10.1001/jama.2010.1638
What was done
Researchers analyzed prospective cohort data from 78,906 women in the Nurses' Health Study with no history of gout at baseline over 22 years of follow-up (1984–2006). Beverage and fructose intake were assessed using validated food frequency questionnaires. The primary outcome was incident gout meeting American College of Rheumatology survey criteria.
What was found
During follow-up, 778 confirmed incident cases of gout occurred. Compared with consumption of <1 serving/month of sugar-sweetened soda, the multivariate relative risk (RR) of gout was 1.74 (95% CI, 1.19–2.55) for 1 serving/day and 2.39 (95% CI, 1.34–4.26) for ≥2 servings/day (P < .001 for trend), corresponding to absolute risk differences of 36 and 68 cases per 100,000 person-years. For orange juice, RRs were 1.41 (95% CI, 1.03–1.93) for 1 serving/day and 2.42 (95% CI, 1.27–4.63) for ≥2 servings/day (P = .02 for trend; risk differences of 14 and 47 cases per 100,000 person-years). Diet soft drinks showed no association (P = .27 for trend). The top versus lowest quintile of total fructose intake had a multivariate RR of 1.62 (95% CI, 1.20–2.19; P = .004 for trend; risk difference of 28 cases per 100,000 person-years).
Why it matters
This study provides prospective evidence that higher intake of fructose-rich beverages, including both sugar-sweetened soda and orange juice, is independently associated with increased incident gout risk in women, whereas diet beverages carry no such risk.
Limits
The observational design cannot exclude residual confounding, and dietary intake was self-reported via questionnaires. The study population was restricted to female nurses in the United States, potentially limiting generalizability, and absolute risk increases were modest due to low overall gout incidence in women.
Cited by
- context Gout is caused by fructose, and the theory that dietary protein causes gout has been debunked.