In 1876, Alfred Garrod (1819–1917) identified a link between uric acid and gout. More recent research about uric acid identified rising levels and suggests that it may more causative in the development of metabolic disease than realized previously. In other words high uric acid levels may directly activate insulin resistance leading to high blood pressure, cardio vascular disease, type-2 diabetes, Alzheimer’s, dementia, kidney disease, etc. Who knew?
This study (https://doi.org/10.6133/apjcn.201811_27(6).0022) highlights the leading dietary causes of elevated uric acid according to the following relative risk scale:
(1.00 = no change, over 1.00 and up = more risk, less than 1.00 and below, possible benefit)
Alcohol = 2.06; Fructose = 1.85; seafood = 1.47; some meats = 1.24; High Purine vegetables = 1.10; Coffee for women = 1.58; Coffee for Men = 0.76; Dairy products = 0.50)
Highest risks come from Alcohol and Fructose, (beer has both), with the lowest risks coming from dairy food. (High purine vegetables include: Asparagus, dried beans (especially fava, mung, soy and garbanzo), mushrooms, peas, spinach). (High purine meats were primarily organ meats.) Traditional dietary advice about eating to minimize uric acid seems to ignore fructose.
The above study suggests that after alcohol, fructose is the biggest danger for raising the risk of uric acid. This leads us to a new awareness that regular drinking of sugar sweetened beverages, energy drinks and sports drinks is akin to ingesting liquid sugar and the uric acid produced may become a major player in the development of metabolic syndrome leading to Type-2 Diabetes, Hypertension, Obesity, Cancer, Kidney disease, Alzheimer’s disease and Heart Disease.
The traditional focus on uric acid coming from purines alone, leads to the following type of confusing dietary advice from different health websites:
Apples have a high dietary fiber content which helps in lowering uric acid levels. Fibre absorbs uric acid from the bloodstream and eliminates the excess uric acid from your body.
Apples too are a storehouse of natural fructose. Too much consumption of apples can worsen the gout condition even more.
Check out these research studies:
Uric acid & fructose: potential biological mechanisms - https://doi.org/10.1016/j.semnephrol.2011.08.006
A causal role for uric acid in fructose-induced metabolic syndrome - https://doi.org/10.1152/ajprenal.00140.2005
The quantity of uric acid becomes the problem with women more at risk after menopause. A human can manage about 5gm of uric acid per day, which is about one apple, so an apple is not a problem, but juicing those apples or any fruit and the total quantity of fruit, and therefore fructose goes way up. A glass of orange juice has an almost identical nutrition profile to a glass of cola.
An apple a day keeps the doctor away but, 5 apples a day and the doctor you will pay.
Seek professional medical advice before making dietary changes, particularly if you are on medication.  Contact me if you have questions.  Good health, George Elder, Diet Researcher, Dip. Nutrition.