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Arthritis Special Report

Gout and Soda: What’s the Connection?

Statistics show that the rate of self-reported gout in the United States has swelled from two to three million since 1995. Rising rates of obesity and an aging population are partly to blame, but there appears to be another factor: our love of sugary soft drinks.

A group of researchers from Canada and the United States noticed that the rise in gout coincided with a dramatic increase in the consumption of soft drinks and other beverages containing fructose, a simple sugar and the only carbohydrate linked to gout.

To test whether there was a connection between gout and soft drink consumption, the investigators examined the diets, medical histories, and medication use of more than 46,000 male health professionals during a 12-year period. At the start of the study, known as the Health Professionals Follow-up Study and reported in the journal BMJ, none of the men had a history of gout. But over the years, those who drank two or more servings of sugary soft drinks a day were 85% more likely to develop gout than those who drank only one serving a month. The risk was 45% higher in those who drank one soda a day. Diet sodas, however, did not raise the risk of gout.

Although these findings don't prove that sugary soft drinks increase the risk of gout, they do provide strong evidence of a link. The relationship between nondiet soft drinks and gout persisted even when the researchers controlled for other factors, such as body weight, high blood pressure, kidney failure, and other foods and beverages known to affect the risk of gout.

The gout-soft drink study drives home the fact that diet appears to play a key role both in preventing and limiting attacks of gout. If you have gout or a high uric acid level (hyperuricemia), aim to maintain a healthy weight and to eat a healthful diet rich in complex carbohydrates like whole grains, vegetables, and fruits. Although fruit juice and fruits high in fructose like apples and pears also raise the risk of gout, the nutrients they provide are important in preventing conditions such as high blood pressure, heart disease, stroke, and cancer. So rather than avoiding fruits completely, focus on those that are low in purines. You'll also want to get only about 15% of your daily calories from proteins—preferably low-fat proteins, and no more than 30% from fat (only 10% from animal fat). More suggestions for ways to manage your diet are listed below.

Foods To Limit -- You don't need to avoid these foods and beverages altogether; just consume them in moderation.

  • Nondiet soft drinks. Obviously, the results of the study stress the need to replace sugary soft drinks and drinks made with high fructose corn syrup with healthier choices. Try drinking diet soda, or, even better, club soda or water with lemon, lime, or orange slices. You'll cut calories as well as the risk of gout.
  • Other fructose-containing foods. Fruit juices and many fruits are naturally high in fructose, so choose bananas, cantaloupe, fresh figs, grapefruit, nectarines, peaches, and berries instead of higher-fructose choices like apples, grapes and pears. To avoid gout always choose fresh over dried fruits, since the dried versions are concentrated sources of fructose. You may also want to avoid honey, which is also high in fructose.
  • Alcohol. More than one drink a day, particularly of beer, raises gout risk. In a separate review of data from the Health Professionals Follow-Up Study reported in The Lancet, researchers found that men who drank two or more beers a day were 2.5 times more likely to develop gout as those who didn't drink. Men who drank the same amounts of spirits had 1.6 times the risk. However, moderate wine drinkers had no increased risk of developing gout.
  • Red meat, especially organ meats, and seafood. Eating excessive amounts of meats, such as organ meats, game birds, lamb, bacon, and veal, increases uric acid levels. Some types of seafood like herring, mussels, smelt, sardines, anchovies, scallops, and trout also are high in purines.
  • Saturated fats. Skip the fried version of anything, pull the skin off poultry, and put the butter dish away. Try to hold butter, oil, or dressings to 3 to 6 tsp per day.

Posted in Arthritis on August 17, 2009

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