Sugar is associated with increased inflammation.¹ One form of sugar called fructose, primarily found naturally in fruit, honey, and high-fructose corn syrup, can contribute to a form of arthritis called gout.²

People with gout go through periods of flare-ups, which usually affect one joint at a time. Symptoms of a gout flare-up include redness, tenderness, swelling, and stiffness in the affected area.³

This article examines the relationship between sugar and gout.

Why Is Sugar Bad for Gout?

Frequent consumption of added sugar can cause inflammation.¹ Fructose is a specific type of sugar that is especially problematic for gout when consumed in large amounts.⁴

When you ingest fructose, it causes the release of purines, a chemical compound that becomes uric acid (a waste product in urine) when digested. Uric acid produces crystals that can build up in the joints, leading to the joint pain associated with gout.⁵

In addition to fructose, other sources of sugar can impact joint pain with gout.

High-Fructose Corn Syrup

High-fructose corn syrup (HFCS) is an artificial ingredient that significantly sweetens foods. It’s made by turning cornstarch into glucose and then a concentrated source of fructose.

Consuming foods and beverages sweetened with HFCS has been associated with a higher risk of gout among adults.⁶

Siqueira JH, Mill JG, Velasquez-Melendez G, et al. Sugar-sweetened soft drinks and fructose consumption are associated with hyperuricemia: Cross-sectional analysis from the brazilian longitudinal study of adult health (ELSA-Brasil). Nutrients. 2018;10(8):981. Published 2018 Jul 27. doi:10.3390/nu10080981^7,8

Natural Sugars

Honey and agave nectar are natural sugars high in fructose, which can contribute to gout flare-ups if eaten frequently.^9,10

Whole fruits contain natural sugars, including fructose. However, they also offer beneficial nutrients like fiber, antioxidants, vitamins, and minerals, which can help outweigh the downsides of the sugar in fruit for most people with gout.¹¹

Research suggests that whole fruits do not cause adverse effects in people with gout.¹² Of course, if certain types of fruits worsen your joint pain, you may want to steer clear of them anyway.

Generally, it’s best to avoid fruit products, like fruit juice or applesauce, that are highly concentrated sources of fructose without those other nutrients.

Brown Sugar and White Sugar

Brown and white sugars impact gout similarly to the way natural sugars do. While brown and white sugars don’t contain fructose, consuming them regularly has been linked to inflammation.¹

Furthermore, eating a diet high in refined sugars like these is associated with other conditions that can worsen gout, like type 2 diabetes, heart disease, and obesity.¹³

Sugary Gout Foods and Drinks to Avoid

If you have gout, avoiding high-fructose food and drinks is best to prevent gout flare-ups.

Some of the most sugary drinks are:

• Soda
• Fruit juice
• Sports drinks
• Energy drinks

Sodas and sports drinks are frequently sweetened using HFCS, and fruit juices are naturally high in fructose and don’t contain the fiber of whole fruit.

Many packaged foods are sweetened with HFCS. These may include:

• Snack foods
• Baked goods
• Condiments
• Canned foods
• Peanut butter

Reading the ingredients list on packaged items is an excellent habit to get into in an effort to avoid foods and drinks containing fructose or HFCS. Additionally, avoid natural sweeteners like honey and agave, and limit your intake of fruit juices.

Reading Food Labels

To determine whether a specific food product contains sugar, check the list for the following ingredients:¹⁴

• Sugar, honey, agave, or maple syrup
• Corn sweetener or corn syrup
• Dextrose, fructose, or high fructose corn syrup

Gout-Friendly Sugar Alternatives

Substituting a small amount of cane sugar or brown sugar in place of honey, agave nectar, or other fructose-rich sweeteners can add sweetness with less impact on gout symptoms.

Whole fruits are naturally sweet and may contribute to joint health. For example, cherries have been studied for their ability to lower uric acid levels, which may help reduce inflammation and support joint health.¹⁵

Summary

Gout flare-ups can be very painful and include symptoms like redness, swelling, and tenderness. One of the most significant diet-related contributors to gout flare-ups is the frequent consumption of fructose sugar. As part of a healthy diet, avoiding foods high in fructose can help limit gout flare-ups.

FREQUENTLY ASKED QUESTIONS

• Does sugar always make gout worse?

Not all types of sugar contain fructose, which is the primary type of sugar that contributes to gout flare-ups. Still, sugar isn’t a healthy food, and eating too much of it can promote inflammation, which worsens gout symptoms in some people.

• Why does sugar trigger inflammation?

When you frequently eat fructose, your body releases compounds called purines. When these break down, they become uric acid, a waste product that can form crystals that accumulate around your joints, making them inflamed and painful.

• What else shouldn’t you eat with gout?

In addition to concentrated sources of fructose, people with gout should avoid foods rich in purines. Eating purine can prolong a gout flare-up.¹⁶ Some purine-rich foods include alcohol, organ meats, yeast, wild game, and certain types of seafood.

Sources:

1. Ma X, Nan F, Liang H, et al. Excessive intake of sugar: An accomplice of inflammation. Front Immunol. 2022;13.
2. Roman YM. The daniel k. inouye college of pharmacy scripts: perspectives on the epidemiology of gout and hyperuricemia. Hawaii J Med Public Health. 2019;78(2):71-76.
3. Johns Hopkins Arthritis Center. Symptoms and diagnosis of gout.
4. Li L, Zeng C, Zhang C, Zhang Y. Recent advances in fructose intake and risk of hyperuricemia. Biomedicine & Pharmacotherapy. 2020;131:110795.
5. Beyl RN Jr, Hughes L, Morgan S. Update on importance of diet in gout. Am J Med. 2016;129(11):1153-1158. doi:10.1016/j.amjmed.2016.06.040
6. Siqueira JH, Mill JG, Velasquez-Melendez G, et al. Sugar-sweetened soft drinks and fructose consumption are associated with hyperuricemia: Cross-sectional analysis from the brazilian longitudinal study of adult health (ELSA-Brasil). Nutrients. 2018;10(8):981. Published 2018 Jul 27. doi:10.3390/nu10080981
7. Danve A, Sehra ST, Neogi T. Role of diet in hyperuricemia and gout. Best Pract Res Clin Rheumatol. 2021;35(4):101723. doi:10.1016/j.berh.2021.101723
8. Bray GA. Energy and fructose from beverages sweetened with sugar or high-fructose corn syrup pose a health risk for some people. Adv Nutr. 2013;4(2):220-225. Published 2013 Mar 1. doi:10.3945/an.112.002816
9. Bobiş O, Dezmirean DS, Moise AR. Honey and diabetes: The importance of natural simple sugars in diet for preventing and treating different type of diabetes. Oxid Med Cell Longev. 2018;2018:4757893. Published 2018 Feb 4. doi:10.1155/2018/4757893
10. Saraiva A, Carrascosa C, Ramos F, Raheem D, Raposo A. Agave syrup: chemical analysis and nutritional profile, applications in the food industry and health impacts. International Journal of Environmental Research and Public Health. 2022; 19(12):7022. https://doi.org/10.3390/ijerph19127022
11. Hainer BL, Matheson E, Wilkes RT. Diagnosis, treatment, and prevention of gout. Am Fam Physician. 2014;90(12):831-836.
12. Ayoub-Charette S, Liu Q, Khan TA, et al. Important food sources of fructose-containing sugars and incident gout: a systematic review and meta-analysis of prospective cohort studies. BMJ Open. 2019;9(5):e024171. Published 2019 May 5. doi:10.1136/bmjopen-2018-024171
13. Ma J, Fox CS, Jacques PF, et al. Sugar-sweetened beverage, diet soda, and fatty liver disease in the Framingham Heart Study cohorts. J Hepatol. 2015;63(2):462-469. doi:10.1016/j.jhep.2015.03.032
14. NIH National Institute on Aging. How to read food and beverage labels.
15. Vreman RA, Goodell AJ, Rodriguez LA, Porco TC, Lustig RH, Kahn JG. Health and economic benefits of reducing sugar intake in the USA, including effects via non-alcoholic fatty liver disease: a microsimulation model. BMJ Open. 2017;7(8):e013543. Published 2017 Aug 3. doi:10.1136/bmjopen-2016-013543
16. Zhang Y, Chen C, Choi H, et al. Purine-rich foods intake and recurrent gout attacks. Ann Rheum Dis. 2012;71(9):1448-1453. doi:10.1136/annrheumdis-2011-201215

Important Notice: This article was originally published at www.thehealthy.com by Lauren Panoff, MPH, RD where all credits are due.

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