Soft drinks, fructose consumption, and the risk of gout in men: prospective cohort study
Choi HK, Curhan G • BMJ
Key Finding
≥2 sugar-sweetened soft drinks/day associated with RR 1.85 (95% CI 1.08-3.16) for gout; highest fructose quintile RR 2.02 (95% CI 1.49-2.75)
Key Findings
- 1≥2 sugar-sweetened soft drinks/day: RR 1.85 (95% CI 1.08-3.16) for gout
- 2Highest fructose quintile: RR 2.02 (95% CI 1.49-2.75) vs lowest
- 3Diet soft drinks showed no significant association (p=0.99)
- 4Dose-response relationship: trend p=0.002 for soft drinks, p<0.001 for fructose
Original title: “Soft drinks, fructose consumption, and the risk of gout in men: prospective cohort study”
Plain English Summary
Prospective cohort study of 46,393 men with 12-year follow-up examining association between sugar-sweetened soft drinks, fructose intake, and incident gout. 755 confirmed gout cases identified.
In-Depth Analysis
Study Details
Authors: Hyon K Choi, Gary Curhan
Journal: BMJ, 2008 Feb 9; 336(7639):309-12
PMID: 18244959 | PMCID: PMC2234536
Key Statistics (from original paper)
Study Population
- •N = 46,393 men
- •No baseline history of gout
- •Follow-up: 12 years
- •Incident gout cases: 755
Sugar-Sweetened Soft Drink Consumption and Gout Risk
| Consumption | Relative Risk | 95% CI |
|---|---|---|
| <1 serving/month | 1.00 (reference) | - |
| 5-6 servings/week | 1.29 | 1.00-1.68 |
| 1 serving/day | 1.45 | 1.02-2.08 |
| ≥2 servings/day | 1.85 | 1.08-3.16 |
Trend p-value: 0.002
Fructose Intake by Quintiles
Relative risks: 1.00, 1.29, 1.41, 1.84, 2.02
Highest vs lowest quintile: RR 2.02 (95% CI 1.49-2.75)
Trend p-value: <0.001
Diet Soft Drinks
No significant association (p=0.99)
Source: PubMed abstract (PMID 18244959) and PMC full text (PMC2234536)
Paradigm Relevance
How this study applies to different clinical perspectives:
Standard Medical
RelevantConventional clinical guidelines used by most doctors
Why it matters:
Supports limiting sugar-sweetened beverages for gout prevention. Diet drinks do not increase risk.
Research Consensus
RelevantCurrent scientific understanding, often ahead of guidelines
Why it matters:
Establishes fructose as key driver of hyperuricemia independent of obesity. Mechanism well-understood through ATP depletion pathway.
Metabolic Optimization
RelevantProactive targets for optimal health, not just disease absence
Why it matters:
Strong evidence to eliminate fructose-sweetened beverages for uric acid optimization. Fruit juice is not a healthy alternative — similar risk profile.
Study Details
- Type
- Cohort Study
- Methodology
- N = 46,393 men with no baseline gout. 12-year follow-up. 755 incident confirmed gout cases. Prospective cohort design.
Evidence Quality
Grade A - Large prospective cohort with long follow-up. PMC2234536. Demonstrates dose-response relationship.
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Original Source
DOI (Digital Object Identifier) is a permanent link to this publication. Unlike website URLs that can change, a DOI always resolves to the correct source.
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