ASSOCIATION BETWEEN SUGAR-SWEETENED BEVERAGE CONSUMPTION AND GOUT IN THE NEW ZEALAND POPULATION

Background: Association between the consumption of high fructose corn syrup (HFCS; 55% fructose)-sweetened beverages and fruit, and the risk of hyperuricaemia and gout, has been reported in North America. Objectives: To examine the association of gout with sugar-sweetened beverages in a New Zealand (NZ) population. The population of NZ has an unique composition, and soft-drinks and fruit juices in NZ are predominantly sweetened with sucrose (50% fructose), rather than HFCS. Methods: Survey data from 753 people with, and 633 people without, gout as determined by ACR criteria, were used to examine the association between gout and intake of sugar-sweetened beverages, including fruit juice, and fruit. One unit of drink was defined as a can or large glass. Three ethnic groups were analysed; NZ Maori, Caucasian and Western Polynesian (Samoa, Tonga, Niue). Results: Significantly increased risk was apparent only in those drinking four or more sugar-sweetened beverages per day (Table). In NZ Maori, for example, ingestion of 4 or more such drinks per day is associated with a greater than 4-fold increased risk of gout. Consistent with one North American study, but not a second North American study, we observed a protective effect from daily fruit intake in the Caucasian participants (1 piece, adjusted OR=0.31, P=0.06; 2-3 pieces, OR=0.21, P=0.01; ≥4 pieces, OR=0.17, P=0.01). There were no significant associations with fruit intake in other ethnic groups. Table 1. Analysis of frequency of sugar sweetened beverage intake and gout Frequency of sugar-sweetened beverage intake (servings/day) 01-1.992-3.994+ Caucasian   Adjusted OR (95% CI)*1.001.05 (0.73,1.52)1.19 (0.81,1.74)2.68 (1.70,4.24)   P Value-0.7850.3802.3x10 NZ Maori   Adjusted OR (95% CI)*1.000.91 (0.42,2.01)1.57 (0.67,3.67)4.32 (1.81,10.32)   P Value-0.8240.3010.001 Western Polynesian   Adjusted OR (95% CI)*1.001.60 (0.65,3.98)1.52 (0.70,3.32)3.68 (1.54,8.76)   P Value-0.3100.2890.003 *Adjusted by sex, body mass index, age, alcohol intake, seafood intake and fruit intake. Conclusions: These results demonstrate association between increased intake of sugar-sweetened beverages and gout in all NZ ethnic groups studied. A possible mechanism for this association is the direct effect of fructose on serum urate concentrations through production of AMP and subsequently urate, as well as the long-term effects of fructose on insulin resistance and the renal excretion of urate. The protective effect of fruit, despite its fructose content, may be due to fruit containing gout-protective chemicals, or to fruit intake being a marker of a gout-protective diet. References: 1. Choi H et al. Arthritis Rheum. 2008;59:109. 2. Choi H and Curhan G. Br Med J. 2008;336:309. 3. Williams PT. Am J Clin Nutr. 2008;87:1480 Disclosure of Interest: None DeclaredCitation: Annals of the Rheumatic Diseases, volume 70, supplement 3, year 2011, page 180Session: Bone and crystal diseases (Poster Presentations )