Consuming four sugar beverages daily increases gout risk by almost seven times greater
A past study from researchers at from the Universities of British Columbia and Harvard in a study that was part of a large prospective cohort study found that consuming non-diet fizzy drinks and fructose increases the risk of developing gout.
In this new study Associate Professor Tony Merriman from the Department of Biochemistry at the University of Otago and colleagues tested the association between sugar (sucrose)-sweetened beverage (SSB) consumption and prevalent gout. They had also tested the hypothesis that SLC2A9 genotype and SSB consumption interact to determine gout risk. When the SLC2A9 gene performs correctly it transports uric acid out of the blood stream and aids its expulsion through the blood stream.
Gout is characterized by sudden, severe attacks of pain, redness and tenderness in joints, often the joint at the base of the big toe. Gout occurs when urate crystals accumulate in the joints.
Research has demonstrated that people of European ancestry who consume high-fructose corn syrup sweetened soft drinks are at an increased risk for gout. This new study looks at the risk of these sugary sweetened beverages and the risk of gout where sucrose is used as a sweetener, in New Zealanders, ,Māori and Pacific Island people.
For the study researchers recruited 925 patients who had been diagnosed with gout and 709 controls. They also included 7,075 participants in the U.S. Atherosclerosis Risk in Communities (ARIC) study as additional controls between 2007 and 2012.
Researchers examined blood samples that were genotyped for rs11942223 and ARIC for rs6449173 among New Zealanders.
In addition all participants had answered questionnaires regarding their consumption of sugar-sweetened soft drink and fruit juice. Medical information had been obtained to verify for the presence of gout or the absence of gout. Among the patients five percent of European, 1.4% of Māori and 16.6% of Pacific Islanders reported consuming over one liter of sugar sweetened soft drinks or fruit drinks each day.
On an unadjusted analysis, there was no evidence of an association between sugar-sweetened drink consumption and gout. However, significant differences emerged after adjustment for gout risk factors including age, sex, body mass index, hypertension, renal disease, and alcohol and fruit consumption.
The study revealed with each extra daily serving of sugar sweetened beverage, carriers of the gout-protective allele of SLC2A9 associated with a 15% increase in risk compared to 12% of those who were did have the gene.
In their conclusion the team writes “Association of SSB consumption with prevalent gout supports reduction of SSB in management. The interaction data suggest that SLC2A9-mediated renal uric acid excretion is physiologically influenced by intake of simple sugars derived from SSB, with SSB exposure negating the gout risk discrimination of SLC2A9.”
Professor Merriman comments "This study shows that sugary drinks reverse the benefits of a gene variant which would usually protect against gout. The evidence is now even stronger against sugary drinks." Each daily 300ml (10 fl oz.) serving of sugar-sweetened drink increases the chance of gout by 13%.”
In closing Professor Merriman said gout attacks can be prevented by the prescribed daily use of the medicine allopurinol, which lowers the production of uric acid in the blood. He recommends that people with gout should not consume any sugary drinks.
This study appears in the Annals of the Rheumatic Diseases.