The accompanying prospective cohort study by Choi and Curhan adds dietary fructose intake to the list of possible risk factors for gout.1 Laboratory evidence that dietary fructose increases serum urate already exists, and recent epidemiological studies have found an association between dietary fructose and hyperuricaemia in the United States.2 3 4 5

The health professionals follow-up study was established in 1986 to examine the relation between nutritional factors and disease onset in later life in more than 50 000 American men.1 Previous analyses have looked at the association of obesity, alcohol, and diet with the onset of gout.

This new analysis looks at the role of non-alcoholic drinks and fruit on the first onset of gout. It finds a strong association between sugar sweetened soft drinks, usually containing fructose, and gout. Consuming two servings a day of a sugar sweetened soft drink increased the risk of developing gout by 85% (relative risk 1.85, 95% confidence interval 1.08 to 3.16). This compares with an increased …