Abstract
The secular trend of hyperuricemia coincides with the substantial increase in the consumption of sugar-sweetened beverages. Our aim was to evaluate the association between the consumption of soft drinks, dietary fructose and unsweetened, non-processed fruit juices with hyperuricemia in a cross-sectional analysis of baseline data (2008–2010; n = 7173) of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). The explanatory variables were the consumption of soft drinks, fruit juice, and fructose using a validated semi-quantitative food frequency questionnaire. The outcomes were hyperuricemia and the uric acid concentration in serum. Regression models were tested, and a significance level of 5% was adopted. In men, the daily consumption of a portion of soft drink/day (250 mL) almost doubled the chance of hyperuricemia with a linear trend. In women, the consumption of ≥0.1 to <1.0 soft drink/day was associated with a higher chance of hyperuricemia, but there was no linear trend. High fructose consumption in men and moderate and high consumption in women were associated with hyperuricemia. All categories of soft drinks consumption were linearly associated with increased serum uric acid levels. Our findings suggest that the consumption of soft drinks and dietary fructose is positively associated with a higher chance of hyperuricemia and higher uric acid levels in Brazilian adults.
Highlights
A shift in dietary patterns has occurred in recent decades in several populations, including in Brazil, where a household survey reported an increase in the consumption of industrialized products [1]
Our objective was to verify whether there is an association between the consumption of sugar-sweetened soft drinks, fructose, and unsweetened beverages and the prevalence of hyperuricemia in the participants of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)
The consumption of dietary fructose in the upper quartile was associated with uric acid levels and hyperuricemia in men with a dose-response gradient, whereas the third and fourth quartiles of consumption were associated with hyperuricemia in women, but without a dose-response gradient
Summary
A shift in dietary patterns has occurred in recent decades in several populations, including in Brazil, where a household survey reported an increase in the consumption of industrialized products [1]. According to the nationwide household survey (2008/09), the average consumption of these beverages in Brazilian adults was approximately 100 mL/day [3]. The high consumption of soft drinks is associated with an increased prevalence of weight gain, obesity and metabolic changes [4,5]. One of these changes is hyperuricemia, which is characterized by sustained elevation of serum uric acid levels [6], a factor responsible for gout, the most common inflammatory arthritis in men [7]
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