Sources
- 1. Source: Chen Z, Xue X, Ma L, et al. Effect of low-purine diet on the serum uric acid of gout patients in different clinical subtypes: a prospective cohort study. Eur J Med Res. 2024;29:449.
- 2. Source: FitzGerald JD, et al. 2020 American College of Rheumatology Guideline for the Management of Gout. Arthritis Care Res. 2020;72(6):744–760.
- 3. Source: Choi HK, Atkinson K, Karlson EW, Willett W, Curhan G. Purine-rich foods, dairy and protein intake, and the risk of gout in men. N Engl J Med. 2004;350(11):1093–1103.
- 4. Source: Choi HK, Atkinson K, Karlson EW, Willett W, Curhan G. Alcohol intake and risk of incident gout in men: a prospective study. Lancet. 2004;363(9417):1277–1281.
- 5. Source: Choi HK, Curhan G. Soft drinks, fructose consumption, and the risk of gout in men: prospective cohort study. BMJ. 2008;336(7639):309–312.
- 6. Source: Zhang T, et al. Ultra-processed food consumption, genetic predisposition, and the risk of gout: the UK Biobank study. Rheumatology (Oxford). 2024;63(1):165–173.
- 7. Source: Rai SK, et al. The DASH diet, Western diet, and risk of gout in men: prospective cohort study. BMJ. 2017;357:j1794.
- 8. Method: Monteiro CA, et al. Ultra-processed foods: what they are and how to identify them (NOVA classification). Public Health Nutr. 2019;22(5):936–941.
- 9. Method: American Heart Association. Added Sugars (recommended daily limits: ~25 g/day for women, ~36 g/day for men). 2021.
- 10. Method: World Health Organization. Guideline: Sugars intake for adults and children. Geneva: WHO; 2015. Free sugars below 10% of energy (strong recommendation), with a conditional suggestion of below 5% (~25 g on 2,000 kcal).
- 11. Method: EFSA Panel on Nutrition (Turck D, et al.). Tolerable upper intake level for dietary sugars. EFSA Journal. 2022;20(2):e07074. Concluded a safe level of sugars intake could not be identified and set no upper limit, recommending added and free sugars be as low as possible.
- 12. Method: Wang DD, Sievenpiper JL, de Souza RJ, et al. The effects of fructose intake on serum uric acid vary among controlled dietary trials. J Nutr. 2012;142(5):916–923. Isocaloric exchange of fructose for other carbohydrate did not raise serum uric acid; only hypercaloric supplementation at extreme doses did.
- 13. Source: Choi HK, Curhan G. Coffee, tea, and caffeine consumption and serum uric acid level: NHANES III. Arthritis Rheum. 2007;57(5):816–821.
- 14. Source: Choi HK, Willett W, Curhan G. Coffee consumption and risk of incident gout in men: a prospective study. Arthritis Rheum. 2007;56(6):2049–2055.
- 15. Source: Zhang Y, Neogi T, Chen C, et al. Cherry consumption and decreased risk of recurrent gout attacks. Arthritis Rheum. 2012;64(12):4004–4011.
- 16. Source: Zhang M, Zhang Y, Terkeltaub R, Chen C, Neogi T. Effect of Dietary and Supplemental Omega-3 Polyunsaturated Fatty Acids on Risk of Recurrent Gout Flares. Arthritis Rheumatol. 2019;71(9):1580–1586.
- 17. Source: Juraschek SP, Gelber AC, Choi HK, Appel LJ, Miller ER. Effects of the DASH Diet and Sodium Intake on Serum Uric Acid. Arthritis Rheumatol. 2016;68(12):3002–3009.
- 18. Method: Dietary purine target of ~400 mg/day per the Japanese Guideline for the Management of Hyperuricemia and Gout, as reviewed in: Daily Amount of Purine in Commonly Recommended Well-Balanced Diets. Nutrients. 2024.
- 19. Source: Major TJ, Topless RK, Dalbeth N, Merriman TR. Evaluation of the diet wide contribution to serum urate levels: meta-analysis of population based cohorts. BMJ. 2018;363:k3951.
- 20. Source: Lu Y, et al. Sugar-sweetened beverages and the risk of hyperuricemia and gout: a meta-analysis. Front Nutr. 2025;12:1669129.
- 21. Source: Shirai Y, et al. Coffee Consumption Reduces Gout Risk Independently of Serum Uric Acid Levels: Mendelian Randomization Analyses Across Ancestry Populations. ACR Open Rheumatol. 2022;4(6):534–539.
- 22. Source: Ayoub-Charette S, et al. Different Food Sources of Fructose-Containing Sugars and Fasting Blood Uric Acid Levels: A Systematic Review and Meta-Analysis of Controlled Feeding Trials. J Nutr. 2021;151(8):2409–2421. Sugar-sweetened beverages raised uric acid 0.42 mg/dL (substitution, GRADE high); whole fruit and dried fruit null, but on only 2–6 comparisons and not GRADE-rated. Note the dissent: in these feeding trials 100% fruit juice LOWERED fasting uric acid by 0.28 mg/dL (addition trials, GRADE high), the opposite of the cohort finding below. We follow the cohorts on juice because incident gout, not fasting urate, is the outcome in question.
- 23. Source: White SJ, Carran EL, Reynolds AN, Haszard JJ, Venn BJ. The effects of apples and apple juice on acute plasma uric acid concentration: a randomized controlled trial. Am J Clin Nutr. 2018;107(2):165–172. At a matched 26.7 g fructose dose, whole apple raised plasma urate the same as a pure fructose drink: the food matrix did not blunt the response.
- 24. Source: Ayoub-Charette S, 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. Fruit juice RR 1.77 for incident gout; whole fruit RR 0.85 but with 93% heterogeneity and very low certainty.
- 25. Source: Choi HK, Willett W, Curhan G. Fructose-rich beverages and risk of gout in women. JAMA. 2010;304(20):2270–2278. One glass of orange juice a day carried RR 1.41 for incident gout; two or more, RR 2.42.
Values are per 100g unless a note says otherwise, rounded to three significant figures. Per-serving figures are calculated from the unrounded measurement, so recomputing from the rounded number can differ by a milligram or so. A single determination is normal in food composition tables, not a defect. The fructose figure is derived, not a label value: it counts free fructose plus half of sucrose, because sucrose is half fructose and the body treats both the same way. A sucrose-sweetened food therefore carries roughly twice this much total sugar.
Last reviewed August 11, 2026.
Not medical advice. This is general information, not a substitute for care from
your doctor or dietitian.
See also: foods to avoid · what actually helps · the gout diet · new to gout? start here