Sweeteners
fructose increases serum uric acid
Part of: • fructose
📅 Last reviewed: 2026-07-15 ⓘ
Evidence ladder
How far up the ladder this claim has climbed. A high consensus on a low rung means "consistent so far," not "proven in people."
Top evidence so far: All trials, pooled (Meta-analysis)
How the studies fall
What the evidence shows
Strong support, carried by observational meta-analyses: prospective-cohort and cross-sectional syntheses consistently link fructose and sugar-sweetened beverages to higher serum uric acid, hyperuricaemia and gout (SSB -> hyperuricaemia OR 1.33, 95% CI 1.23–1.44, across 15 studies in one meta-analysis).
The evidence (12)
| Source | Grade | Stance | Quality | Finding |
|---|---|---|---|---|
| Jamnik J, Rehman S, Blanco Mejia S, de Souza RJ, Khan TA, Leiter LA, Wolever TM, Kendall CW, Jenkins DJ, Sievenpiper JL 2016 · BMJ Open | meta-analysis | supports | low | SR/MA of prospective cohorts: higher fructose intake associated with increased risk of gout and hyperuricaemia. |
| Zhao H, Zhang Z, Chen X, Tang C, Song L, Lu Z, Lu Y 2026 · Foods (Basel, Switzerland) | animal | supports | low | Mouse model: 8-week 60% high-fructose diet + potassium oxonate raised serum uric acid to 133.6 umol/L in the model group vs 106.7-111.0 umol/L after probiotic/EPS intervention. Chronic fructose feeding used to establish hyperuricemia model |
| Lu Y, Wang Y, Huang R, Pan H, Xie Z, Wen C, Huang L, Li X 2025 · Front Nutr | meta-analysis | supports | moderate | SR/MA of 22 observational studies (235,790 participants; 14 cross-sectional, 7 cohorts, 1 case-control). SSB -> hyperuricemia: 'OR = 1.33, 95% CI (1.23, 1.44), I 2 = 72.4%' (15 studies), with Egger small-study effects (P = 0.012). Fructose -> hyperuricemia: OR 1.12, not significant (3 studies; CI given as 0.85-1.46 in abstract, 0.93-1.85 in text), same direction. Gout (off-object): SSB OR 1.21 (1.11-1.32), fructose OR 1.66 (1.27-2.18, 2 Choi studies). |
| Ma H, Ge H, Zhong Q, Li G, Wang Z 2026 · Medicine | observational | supports | moderate | NHANES 2001-2020 case-control (886 hyperuricemia cases vs 2171 matched controls): higher intake of sugars/sweets/beverages (OR 1.60), soft drinks (OR 1.11), sugar-sweetened soft drinks (OR 1.13), and sugar-sweetened tea (OR 1.86) were assoc |
| Sayehmiri K, Ahmadi I, Anvari E 2020 · Clin Nutr Res | animal | supports | moderate | SR/MA of feeding studies: high fructose intake raises serum uric acid (dose-related). |
| Chi X, Cen Y, Yang B, Zhang H, Pu Z, Feng J, Pan H, Zhang Y 2024 · Int J Food Sci Nutr | meta-analysis | supports | moderate | SR/MA of observational studies: sugar-sweetened beverages/fructose associated with higher hyperuricaemia and gout. |
| Yan L et al 2026 · Authorea Preprints | animal | supports | low | Mouse hyperuricemia model induced using potassium oxonate, yeast extract, and fructose; a novel compound (EJM) then reduced serum uric acid and renal/intestinal damage in this fructose-containing induction model. |
| Huang Y, Chen Z, Chen B, Li J, Yuan X, Li J, Wang W, Dai T, Chen H, Wang Y, Wang R, Wang P, Guo J, Dong Q, Liu C, Wei Q, Cao D, Liu L 2023 · BMJ | meta-analysis | mixed | moderate | Umbrella review of meta-analyses: 'The search identified 73 meta-analyses and 83 health outcomes'; abstract reports '18 endocrine/metabolic outcomes' with harmful associations and SSB-gout ('4% higher risk of gout'); uric-acid estimate not in abstract. Review — zero weight. |
| Pengnet S, Chonpathompikunlert P, Suttikul S, Lekchaoum T, Sitdhipol J, Tunsophon S, Malakul W 2026 · Probiotics Antimicrob Proteins | animal | supports | moderate | All the rats drank 20% fructose water for 12 weeks; what varied was the oral treatment - vehicle, the probiotic Bifidobacterium pseudolongum TISTR 2737 (2 x 10^8 CFU/rat), or metformin. Every comparison reported is against the fructose-fed vehicle group: the probiotic significantly lowered serum uric acid, glucose, total cholesterol, triglycerides, LDL-C and endothelin-1. The report gives no numerical values and no comparison of fructose-fed against fructose-free animals, so it does not measure what fructose itself does to serum uric acid. |
| Li R, Yu K, Li C 2018 · Asia Pac J Clin Nutr | meta-analysis | supports | moderate | MA of dietary factors: fructose/SSB among factors raising gout and hyperuricaemia risk. |
| Ojo OA, Brown N, Yaceczko S, Scotland KB 2025 · Current urology reports | observational | supports | low | Narrative review on diet and kidney-stone pathogenesis states plainly that 'fructose increases serum and urinary uric acid levels,' citing this as part of the diet-purine-urate pathway relevant to uric acid stone formation. |
| Ebrahimpour-Koujan S, Saneei P, Larijani B, Esmaillzadeh A 2020 · J Hum Nutr Diet | meta-analysis | mixed | moderate | SR/MA: SSB–serum-urate association present but with conflicting/heterogeneous primary evidence. |
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