Keith’s GoutPal Story 2020 Forums Please Help My Gout! Fructose and Uric Acid

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    Most of us know that uric acid serves an important purpose – it acts as the body's primary anti-oxident (neutralizer of free-radicals).

    I came across the following URL today that made me wonder if we gouties are focusing too much on foods that have high levels of purines (e.g. beef, beer and shellfish) and not enough on the other things in our life that cause uric acid to rise…namely stuff like fructose.

    Please take a minute to read this and let me know what you think (while this person champions the benefits of fructose, I see a direct application to our problem…)

    Copied from (all bolding mine)


    Summary: Apples and other fruit are
    considered to be healthy, in part due to the antioxidant flavonoids they
    contain. However, these flavonoids are poorly absorbed into the bloodstream. We
    found that the consumption of apples by volunteers resulted in a large increase
    in the antioxidant capacity of their plasma, indicating that something other
    than flavonoids may be responsible.
    Our further investigations showed that
    fructose, a fruit sugar, in apples stimulated the production of uric acid in the
    which provided the plasma antioxidant capacity.

    Regular consumption
    of fruits and vegetables lowers the risk of cardiovascular diseases, certain
    types of cancer, and other chronic diseases. These beneficial effects of fruits
    and vegetables have been partly attributed to their high content of flavonoids,
    the intake of which is also inversely associated with the incidence of many
    chronic diseases.

    Flavonoids are
    compounds that protect plants from pathogens, ultraviolet light, and other
    stress and are responsible for the deep colors of flowers and fruits. Many
    flavonoids are polyphenols, and their antioxidant properties are probably
    related to their polyphenolic chemical structure.

    The mechanisms by
    which flavonoids may lower chronic disease risk, however, remain to be fully
    elucidated. Most flavonoids have antioxidant properties, and extracts and juices
    of fruits and vegetables exhibit substantial antioxidant capacity in the test
    tube. Therefore, it is conceivable that the health benefits of flavonoid-rich
    foods are related to the antioxidant protection of biological macromolecules,
    such as lipids, proteins, and DNA. However, this remains controversial. Although
    some studies have failed to show a short- or long-term antioxidant effect of
    fruits, vegetables, or flavonoid consumption in humans, other studies have
    reported positive results, especially an acute increase in the antioxidant
    capacity of plasma. However, flavonoids cannot explain the observed increases in
    plasma antioxidant capacity because their concentration in plasma is quite low.
    Moreover, the metabolism of flavonoids may greatly affect their antioxidant
    capacity. After consumption, flavonoids are poorly absorbed in humans. After
    absorption, flavonoids are metabolized into glucuronides, which undergo further
    chemical modifications, such as methylation or sulfation. Consequently, the
    concentration of flavonoid metabolites in plasma is very low, yet the reported
    increase in antioxidant capacity of plasma after flavonoid-rich foods are
    consumed often greatly exceeds the increase in plasma flavonoids. This paradox
    intrigued us.

    Apples are one of the main sources
    of flavonoids in the Western diets, providing approximately 22% of the total
    phenols consumed per capita in the United States. Other dietary sources of
    flavonoids are tea, wine, onions, fruit, and chocolate. An increased intake of
    apples has been correlated with a decreased risk of heart disease, type 2
    diabetes, and incidence of thrombotic stroke. Because we suspected that
    flavonoids may be responsible for the health benefits of apples, exerting their
    effects by antioxidant mechanisms, we conducted a study on apple consumption in
    humans. First, we characterized the antioxidant capacity and flavonoid content
    of apples. In collaboration with Dr. Ronald Wrolstad in the Department of Food
    Science and Technology at Oregon State University, we extracted flavonoids from
    the edible portion?flesh and skin?of different varieties of apples, including
    Red Delicious, Granny Smith, and Fuji. We then measured the total phenol content
    and the antioxidant capacity of these apple extracts by two assays: FRAP, ferric
    reducing antioxidant potential, which determines the antioxidant capacity by the
    ability to reduce iron, and ORAC, oxygen radical absorbance capacity, which
    evaluates the antioxidant capacity by the ability to reduce peroxyl radicals.
    Apple extracts, especially from Red Delicious, were powerful antioxidants, which
    significantly correlated with the total phenol content. When added to human
    plasma in the laboratory, Red Delicious apple extracts were remarkably
    protective against oxidation. This effect could be clearly attributed to the
    antioxidant polyphenol/flavonoid content in the apple extracts, which prevented
    or delayed the oxidation of other plasma antioxidants and constituents, such as
    lipids or proteins.

    Subsequently, we
    studied the short-term effect of apple consumption in humans by evaluating the
    plasma resistance to oxidation after apple consumption. Additionally, we
    measured the total plasma antioxidant capacity, as an estimation of the total
    amount of antioxidants present in the plasma after apple consumption. After an
    eight-hour fast, six healthy, nonsmoking volunteers (three men and three women,
    average age of 36 years) consumed five whole Red Delicious apples with a total
    weight of about 2.3 pounds. We collected blood samples from these subjects
    before and 1, 2, 3, 4, and 6 hours after they ate the apples. For comparative
    purposes, the same subjects consumed 2 plain bagels and water on a different
    day, which provided a flavonoid-free control. We collected blood samples from
    the subjects at the same time points.

    When the plasma of
    these subjects was exposed to chemical oxidation in the laboratory, no
    significant increase in antioxidant protection was observed in plasma components
    after apple consumption, in contrast to the in vitro results with apple
    extracts. These results suggest that apple flavonoids are not absorbed in
    sufficient amounts to significantly contribute to the antioxidant protection of
    plasma components in the body. When we measured the total antioxidant capacity
    of plasma after apple consumption, we observed a large, statistically
    significant increase in plasma antioxidant capacity. This indicated that,
    indeed, there were more antioxidants present in plasma after apple consumption.
    The results obtained after apple consumption differed remarkably from those
    obtained after bagel consumption. But if flavonoids weren?t responsible, what
    was? Apples also contain vitamin C?about 10 mg per apple?that could also make an
    important contribution to the plasma antioxidant capacity. However, neither
    vitamin C nor flavonoids explained the increase in antioxidant capacity after
    apple consumption. Surprisingly, the plasma antioxidant capacity increased
    concomitantly with transient increases in plasma uric acid, which is an
    important biological antioxidant.

    A significantly
    large and unexpected increase in plasma uric acid was observed 1-2 hours after
    the subjects ate apples, and rapidly decreased to basal levels after 3 hours,
    paralleling the increases in antioxidant capacity. The healthy participants in
    this study had baseline levels of uric acid within the normal range, and the
    consumption of apples did not increase uric acid beyond the previously
    established healthy range of plasma uric acid.

    The increase in
    uric acid after apple consumption was a very surprising finding, since apples do
    not contain uric acid or its dietary precursors, such as inosine or other
    purines. So where did this uric acid come from? It has been known for over 30
    years that fructose?a sugar present in large quantities in fruits?may increase
    plasma uric acid. Fructose is quickly absorbed and taken up by the liver, where
    it is rapidly metabolized. This rapid metabolism stimulates the production of
    uric acid in the liver, which is subsequently excreted into plasma. The fructose
    content of apples and other fruits is quite high. Thus, we hypothesized that the
    fructose content in apples caused the transient increase in plasma uric acid?and
    antioxidant capacity?after apple consumption. To prove this hypothesis, we
    conducted a third experiment in which our healthy volunteers consumed a liter of
    fructose-containing water, which matched the fructose content in their apples.
    Our analyses indicated that the consumption of fructose closely mimicked the
    effects of apple consumption on plasma antioxidant capacity and uric acid
    concentrations, thus supporting our hypothesis.

    Increases in plasma
    uric acid after consumption of tea, coffee, wine, spinach, and strawberries have
    been described in some previously published short-term studies. However, none of
    the investigators could explain the reason. With our observations, we can now
    offer the explanation that fruits may transiently increase plasma uric acid due
    to the metabolism of fructose, and the contribution of this antioxidant to the
    measured total antioxidant capacity of plasma is, indeed, much more significant
    than the possible antioxidant contribution of the flavonoids.

    These results lead
    to another question: does this transient increase in uric acid after fruit
    consumption represent a beneficial effect for human health? Without any doubt
    the consumption of fruits and vegetables has been long associated with a lower
    risk of chronic diseases and much better quality of life. Uric acid is an
    important physiological antioxidant, normally present in high concentrations in
    plasma, but whose metabolic functions remain unclear. Excessive uric acid in
    blood causes gout in susceptible individuals, and it has been suggested that
    high levels of uric acid may be linked to cardiovascular diseases. Additionally,
    the long-term consumption of excessive fructose in the diet from manufactured
    foods and beverages has been correlated with chronic diseases like hypertension,
    hyperlipidemia, and type 2 diabetes. However, consumption of fructose in fruit
    has not been shown to be harmful in healthy individuals, and several health
    benefits have recently been described for uric acid, especially its possible
    protection against multiple sclerosis and other inflammatory

    Based on our data,
    it is conceivable that the presumed antioxidant role of flavonoids in plasma
    after fruit consumption reported in numerous previous studies may have been
    confounded by uric acid. The potential, specific beneficial effect of these
    transient increases in uric acid after fruit consumption remains uncertain but
    deserves further investigation. On the other hand, we continue to explore the
    mechanism by which low concentrations of flavonoids and their metabolites may
    exert health benefits. Clearly, our apple study has demonstrated that the
    consumption of fruit may have a greater impact on human health and potential
    health benefits for more reasons than we expected.

    updated November 2004


    In my view, excess calories and excess iron are almost certainly worse offenders than excess purines.

    I've not made my mind up about fructose yet. There seems to be a lot of noise about it, but little solid investigation work (by which I mean double-blind randomized controls). Common sense tells me there must be a point above which fructose consumption is bad, but I've seen nothing that clearly states what that limit is. An apple a day seems sensible, but a gallon of apple juice probably breaks the “everything in moderation” rule.


    Actually GLUCOSE is the body's primary antioxidant.??Fructose probably comes in second being convertible to glucose.

    An antioxidant is nothing more or less than a reducing agent.


    Hi Guys. Its been a while since I posted. I had my first attack, the classic big toe last April (2010) and had another in August. I tried loads of stuff and had the gout tingles up until around December…. I got a self test Kit and my uric acid was around 9mg – 11mg at this time (I cannot remember the scale chars exactly, its the measure used in the UK, although I'm currently in NZ). I was driving all and sundry crazy with my fear of the gout, but once you have experienced that pain you will go to extraordinary lengths to cure your self (drinking baking soda, buying Apple Cider Vinegar, getting a test kit, over dosing on cherries, drinking more water than humanly possible and researching alkaline diets… but to name a few)


    Then I stumbled across the fructose thing…. I ditched fruit Juice and only occasionally have the odd piece of fruit. I stopped testing myself as to be fair I didn't get the twinges after a while? I personally don't know if there is anything in it or that I'm simply in the early stages of gout (I'm 38).. but I've been fine since. I drink a little more coffee these days to flush the kidneys and always put salt on my chips now as well!?But I've just tested myself and?my reading is?6.2. I'm still drinking a few pints a week and don't really watch what I eat anymore and have even started on the fish again! I also weigh about 6lbs more than this time last year! Maybe I'm in crystal deposit mode?


    Although wine seems like a bad move for me and sometimes get the odd twinge or itchy feet (on the base of my feet) which strangely seems to be a pre-cursor to an?attack. I have read that the huge increase in fructose in our diet maybe responsible?for the rise in gout world wide? I remember as a kid that Orange Juice was a bit of a treat, now its a mainstay in our diets (if you want it!). Disease of the Rich, I guess in days gone by your average Monarch would eat more fruit?


    I also know that gout is a complicated and very individual disorder from all the posts I read, so this will not apply to all… But I'd definitely give it a go….




    Gilles Corno

    Stellato,D., Morrone, L.F., Di Giorgio, C., & Gesualdo, L., ?<Uric acid: a starring role in the intricate scenario of metabolic syndrome with cardio-renal damage?>, Intern Emerg Med, August 13, 2011.

    Brymoro, A., Flisinki, M., Johnson, R.J., ?et al., <Low-fructose diet lowers blood pressure and inflammation in patients with chronic kidney disease>, Nephrol Dial Transplant, May 25, 2011.

    Recent studies which seems to bring light on the subject. ?There seems to be a difference between fructose sources ie. Fresh fruits vs processed foods containing corn syrup. Should fructose from corn syrup be responsible for uric acid formation sheds a very important factor to consider, since the best home diet which would be free of corn syrup fructose, will be curtail by having restaurant food containing minute amounts of the substance???

    ?I'm submitting the information to the forum for your comments?

    Thank you.


    Gilles said:

    ?I'm submitting the information to the forum for your comments?

    Thank you.

    Gilles, instead of us, since you are the one who wants to know all about fructose, especially HFCS, I suggest that you put HFCS into the search field at the upper right-hand corner. I guarantee you, that you will/can spend 24 hours or 24 days to read what has been said/written about fructose/HFCS.

    Any ?experience with fructose/HFCS of a gouty member of this forum, while probably important to that person, is/may be totally irrelevant for you. Please, keep that in mind.


    Remember two parts of a syllogism:

    HFCS is made from corn and is a competitor with cane sugar for $$$$

    The? cane sugar industry is VERY rich.


    Thus the cane sugar money will excoriate the HFCS money and?so “YES, it can be definitively shown that fructose causes all diseases, all wars, pestilence and evil”?except in Oregon and Washington?where apples CURE all diseases and also in Florida and California where CITRUS cures all disease.

    It is best not to get involved in these food fads driven solely by BIG AGRIGULTURE, which can buy and sell “researchers” and cherry pick information with complete abandon.


    Fructose, High fructose corn syrup, glucose, sucrose…let them gas on but know well these?foods??are of very little consequence in gout.


    P.S. I remember a diet fad 30 years ago where FRUCTOSE was guaranteed to be the ONLY way to lose weight…the ONLY sugar it was safe to consume. It really is all so silly.

    Gilles Corno

    Great you guys, always good to brought back to reality… ?For some reason i keep being influenced by food impacting gout while it's some 15%!

    Again thanks, I'll try to keep it in mind.

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