Soft drinks, fructose consumption, and the risk of gout in men: prospective cohort study

doi:10.1136/bmj.39449.819271.BE

BMJ 2008;336:309-312 (9 February), doi:10.1136/bmj.39449.819271.BE (published 31 January 2008)

Research

Soft drinks, fructose consumption, and the risk of gout in men: prospective cohort study

Hyon K Choi, associate professor of medicine¹, Gary Curhan, associate professor of medicine²

¹ Arthritis Research Centre of Canada, Department of Medicine, Vancouver General Hospital, University of British Columbia, Vancouver, BC V5Z 1L7, Canada, ² Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

Correspondence to: H K Choi hchoi{at}arthritisresearch.ca

Objective To examine the relation between intake of sugar sweetenedsoft drinks and fructose and the risk of incident gout in men.

Design Prospective cohort over 12 years.

Setting Health professionals follow-up study.

Participants 46 393 men with no history of gout at baselinewho provided information on intake of soft drinks and fructosethrough validated food frequency questionnaires.

Main outcome measure Incident cases of gout meeting the AmericanCollege of Rheumatology survey criteria for gout.

Results During the 12 years of follow-up 755 confirmed incidentcases of gout were reported. Increasing intake of sugar sweetenedsoft drinks was associated with an increasing risk of gout.Compared with consumption of less than one serving of sugarsweetened soft drinks a month the multivariate relative riskof gout for 5-6 servings a week was 1.29 (95% confidence interval1.00 to 1.68), for one serving a day was 1.45 (1.02 to 2.08),and for two or more servings a day was 1.85 (1.08 to 3.16; Pfor trend=0.002). Diet soft drinks were not associated withrisk of gout (P for trend=0.99). The multivariate relative riskof gout according to increasing fifths of fructose intake were1.00, 1.29, 1.41, 1.84, and 2.02 (1.49 to 2.75; P for trend<0.001). Other major contributors to fructose intake suchas total fruit juice or fructose rich fruits (apples and oranges)were also associated with a higher risk of gout (P values fortrend <0.05).

Conclusions Prospective data suggest that consumption of sugarsweetened soft drinks and fructose is strongly associated withan increased risk of gout in men. Furthermore, fructose richfruits and fruit juices may also increase the risk. Diet softdrinks were not associated with the risk of gout.

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