Fructose has been known to raise uric acid levels since 1967. As obesity and diabetes among Americans soared in the 1990s, experts pointed out high fructose corn syrup consumption as a major contributing factor. Shortly after, gout cases rose which lead to studies linking fructose to hyperuricemia and gout.
Continue reading to learn how high fructose corn syrup causes uric acid production and contributes to health issues that make you prone to gout.
Find out which alkalizing fruits help flush uric acid out of your system: What And Why Alkalizing Foods Help With Your Gout
What Is Fructose?
Fructose is a natural sugar found in many fruits, as well as vegetables and honey. Pure fructose is much sweeter than other types of sugar. It is about one-and-a-half times sweeter than sucrose (table sugar).
Depending on its source, fructose can be an added sugar or a natural sugar.
It is considered a natural sugar when consumed from fresh produce or whole plant foods. Fructose is considered an added sugar when used as crystalline fructose or high fructose corn syrup to make food or drinks.
What is High Fructose Corn Syrup (HFCS)?
High fructose corn syrup (HFCS) is a liquid processed from corn and made up of 24% water. Cornstarch is refined down to make corn syrup, which is mostly glucose. Then, enzymes are added to convert glucose into fructose.
HFCS is the final liquid mixture of fructose and glucose. The two common HFCS mixtures are made of either 42% or 55% fructose. Fructose contents in raw products:
- Crystalline fructose = 98% fructose
- HFCS-42 = 42% fructose + 58% glucose
- HFCS-55 = 55% fructose + 45% glucose (most common)
- Table sugar (sucrose) = 50% fructose + 50% glucose
- Agave syrup = 82% fructose + 18% glucose
- Corn syrup = 100% glucose
Although derived from corn, HFCS is not considered a natural sugar by the FDA. It must be chemically modified in order to be made.
Here is a short and informative video about high fructose corn syrup:
How is High Fructose Corn Syrup Digested?
HFCS consists of glucose and fructose, but the body processes them in different ways. When digested, glucose travels to cells of tissues or muscles to use as energy.
Insulin from the pancreas helps cells absorb glucose from the blood. Glucose converts to energy only inside cells. Without insulin, excess glucose stays in the blood.
In contrast, fructose converts to energy slower than glucose. The liver metabolizes fructose to make energy compounds for cells to use. It does need insulin for cell absorption and will not raise blood glucose levels. This is why fructose has a lower glycemic index than starch-based food.
When and Why Was High Fructose Corn Syrup Introduced To The American Food market?
In 1970, HFCS entered the American food market due to soaring costs of sugar. The price of sugar doubled in 1981 because of a high tariff on imported sugar. Tariffs, plus the United States being the world’s largest producer of corn, made HFCS a much cheaper option to traditional sugar.
In 1984, Coke and Pepsi started using HFCS in all their products. This move propelled HFCS to be the prominent sweetener in the American food and beverage industry.
How Does Fructose Make You More Prone To Gout?
What Evidence Proves Fructose Is Directly Linked To Gout?
A 2021 meta-analysis of 47 separate studies established sugar-sweetened beverages (SSBs), packaged sweets and deserts (all with fructose) increased uric acid production. The sugar-sweetened beverages included soft drinks/soda, dairy-based drinks, and artificial fruit juices.
Researchers from the study concluded:
“Sugar-sweetened beverages (SSBs), sweets and desserts increased uric acid levels… while SSBs increased uric acid levels, and 100% fruit juice decreased uric acid levels in additional trials.”
This analysis also reinforced results from a long-term study from 2008 showing the number of gout flares increased based on daily soft drink consumption. Data from a 12-year period saw men who had two or more fructose-containing beverages a day had an 85% higher risk of gout than those who had less than one serving a month. Gout risk dropped to 45% for individuals who drank one soft drink a day.
Additionally, studies from Korea, Mexico, and Brazil concluded with similar results. An indication that fructose makes you more prone to gout flare-ups despite different ethnic diets.
How Does Fructose Increase Uric Acid Levels?
Fructose metabolism takes place primarily in the liver. Initially, fructose coverts into purines. Then, the breakdown of purines yields uric acid.
The simplified sequence of fructose metabolism is: Fructose to Purines to Uric Acid.
Fructose-rich products not only generate uric acid, but inhibits the kidney’s ability to filter uric acid. Without getting too technical, a gene called SLCA9 activates renal molecules (GLUT9) responsible for transporting uric acid into urine. Evidently, elevated blood sugar levels stunt SLCA9 activity which leads to excess uric acid remaining in the blood.
What Complications From High Blood Sugar Make You Prone To Gout?
HFCS increases uric acid levels, but also leads to ailments that make you more prone to a gout. A high-sugar diet causes health complications like high triglycerides levels, high blood pressure (hypertension), obesity, insulin resistance, and prediabetes. Since the 1970s, cases of these conditions surged as HFCS products flooded the US market.
Diabetes and Poor Kidney Function
Chronic kidney disease and chronic gout have a bi-directional relationship, which means one can lead to the other. Complications from diabetes weaken the kidneys. Over time, high sugar level cause the blood vessels in the kidneys to narrow and clog.
More so, too much sugar dehydrates the body and puts an additional strain on the kidneys. Dehydration prevents the kidneys from producing enough urine to remove waste products like uric acid.
To learn exactly how dehydration makes you more prone to a gout attack, read this post: The Real Reasons Why Dehydration Causes Gout
Insulin is responsible for removing sugar from the blood. Insulin resistance occurs when cells do not respond to insulin by not absorbing glucose. As a result, a excess sugar remains in the blood.
For people with gout, high blood sugar by consumption or insulin resistance impairs the kidney’s ability to filter out uric acid.
High triglycerides, Hypertension, And Obesity
Compared to other carbohydrates, fructose easily converts into fats. It raises triglycerides, a kind of fat that builds up cholesterol and hardens arteries.
The empty calories from HFCS contribute to weight gain. Despite having a lot of calories, fructose lacks the nutrients needed for metabolism. Thus, it depletes the body of vitamins, minerals, and enzymes during digestion.
An elevated blood sugar level can also impair how well the body uses nutrients from other food. Typically, high-sugar foods contain very little fiber and protein, which is why you tend to overeat sweets to feel full.
A US study from 2021 added more evidence associating obesity with gout. Results from this 7-year study displayed the obese test group were almost twice (1.84) as likely to get gout compared to the non-obese group. Furthermore, individuals that went from non-obese to obese experienced gout (1.65) more than non-obese individuals.
The overconsumption of fructose directly contributes to obesity and hypertension. Both conditions are risk factors for chronic gout. Keep in mind, most obese individuals produce more uric acid and have a harder time eliminating it.
Non-alcoholic fatty liver disease (NAFLD)
Cases for non-alcoholic fatty liver disease (NAFLD) in the United States have mirrored the rise of obesity and diabetes. Studies have determined the overconsumption of sugar-sweetened food influences NAFLD.
The liver breaks down fructose and converts it to fat, much like alcohol. Evidently, the liver performs poorly when there is too much fat in it.
Pertaining to gout, researchers determined that uric acid levels are higher in individuals with NAFLD than in those without.
NAFLD is more likely to develop in people with high triglycerides, high cholesterol, obesity and type 2 diabetes. If undiagnosed, the long-term effects of NAFLD can lead to cirrhosis.
Fructose in Fruits Does NOT Cause Gout, Unlike In Processed Foods
Does the fructose in fruits cause gout?
The body processes the natural fructose in fruits differently than the artificial fructose in HFCS. Natural fructose does not increase uric acid production, hence it will not make you prone to gout.
The fiber and antioxidants from fruits limit fructose conversion to purines. Accordingly, clinical studies have determined dietary fiber helps lower uric acid levels and reduce gout risk.
Besides fiber content, the nutrients and anthocyanins in fruits assist the kidneys in removing uric acid and other toxins. Fruits also help keep you hydrated since most are 90% water.
Find out what fruits fight off gout, this post breaks it down for you: Top 24 Fruits For The Kidneys And Gout
Foods With HFCS Often Overlooked
There are thousands of processed and packaged foods that contain HFCS or fructose. The most common ones are: candies, baked goods, soft drinks, juices, frozen deserts, yogurts, chocolate bars and cereals.
In addition, there are numerous sneaky foods with HFCS worth mentioning. The most overlooked products are often condiments eaten in small amounts: jelly, ketchup, salad dressings, soups, syrups, dips and sauces.
They may be safe when eaten occasionally. However, if eaten regularly, the combination of these condiments with HFCS can add up and raise uric acid levels.
It is a good idea to start checking the ingredient labels for fructose. It is astonishing how many different products use HFCS.
From the research of this post, the most intriguing info was from : The Secret History of Why Soda Companies Switched From Sugar to High-Fructose Corn Syrup.
It is no wonder that obesity, diabetes, and gout have shot up since using high fructose corn syrup to sweeten food and beverages. Fructose causes uric acid production as well as several health problems that make you more prone to gout. Experts continue to point out the adverse effects of this man-made sugar, yet millions continue to eat too much of it.
Don’t worry about the fructose in fruits. It is a natural sugar that won’t raise uric acid levels. The fiber and antioxidants from fruits help flush out uric acid. The man-made fructose formulated in HFCS is what you need to avoid.
HFCS is another gout trigger that seems harmless in moderation, but becomes a problem when consumed excessively. Countless products use this cheap and artificial sugar. This makes fructose hard to avoid and easily overlooked.
The combination of all the different products with HFCS adds up without you realizing it. If you aren’t already, check all ingredient labels for fructose whenever you can.
Back in my oblivious days, fructose was the most surprising gout trigger. Although my gout diet improved by consuming less red meat, alcohol, seafood, and fast food, a surprise gout attack would leave me grunting another “WTF? Gout again?”.
Not until a friend who dropped 50 pounds told me a major reason for his weight loss was avoiding high-sugar foods, including HFCS. Inspired, I read up on the nutritional value of sugars. That’s when I learned that fructose can cause gout. It was even more stunning to find several of my favorite food, drinks and condiments contained fructose.
It is a challenge to eat in “moderation” your favorite sugar-sweetened deserts and drinks. I know. However, you can choose many common food and drink alternatives without fructose. You will not only lose a few pounds, but also become more GOUTPROOF!
- Different Food Sources of Fructose-Containing Sugars and Fasting Blood Uric Acid Levels: A Systematic Review and Meta-Analysis of Controlled Feeding Trials – 2021
- Recent advances in fructose intake and risk of hyperuricemia – 2020
- SLC2A9—a fructose transporter identified as a novel uric acid transporter – 2008
- Soft drinks, fructose consumption, and the risk of gout in men: prospective cohort study – 2008
- Relationship Between High-Fructose Corn Syrup, Uric Acid, and Metabolic Syndrome – 2016
- The Effects of Fructose Intake on Serum Uric Acid Vary among Controlled Dietary Trials – 2012
- Uric acid activates aldose reductase and the polyol pathway for endogenous fructose prone to gout and fat production causing development of fatty liver in rats – 2019
- Fructose and metabolic diseases gout blog: too much to be good – 2021
- Incident gout and weight change patterns: a retrospective cohort study of US adults – 2021
- Fructose Intake, Serum Uric Acid, and Cardiometabolic Disorders: A Critical Review – 2017
- A critical examination of the evidence relating high fructose corn syrup and weight gain – 2007
- Is high fructose corn syrup worse than sugar? – 2018
- Is fructose bad for you? – 2021
- Sugar-sweetened beverage consumption: a risk factor for prevalent gout with SLC2A9 genotype-specific effects on serum urate and risk of gout – 2013