Gout and orange juice. Impact of Orange Juice and Cola on Metabolic Health: A Comprehensive Analysis

27.07.202309.06.2023 by alexxlab

How does high intake of orange juice and cola affect metabolic risk in healthy individuals. What are the differences in metabolic responses between these popular beverages. Can orange juice consumption lead to increased risk of gout and type 2 diabetes.

Содержание

The Metabolic Effects of Orange Juice vs Cola: Key Findings

A groundbreaking study published in Clinical Nutrition has shed new light on the differential metabolic impacts of orange juice and cola consumption in healthy individuals. While both beverages are sugar-containing, their effects on metabolic risk factors appear to be markedly different.

The research, conducted by a team of scientists from the University of Hohenheim and the University of Kiel, aimed to investigate whether the consumption of cola, often perceived as unhealthy, and orange juice, generally viewed as a healthier alternative, would have similar effects on metabolic health markers.

Study Design and Methodology

The study employed a randomized controlled trial design, involving healthy subjects who were assigned to consume either orange juice or cola in high quantities. The researchers meticulously monitored various metabolic parameters to assess the impact of these beverages on the participants’ health.

Orange Juice Consumption: Metabolic Implications

Contrary to its healthy image, high intake of orange juice was found to have significant metabolic effects. Does orange juice increase the risk of gout? The study suggests that it might. Orange juice consumption led to elevated levels of uric acid in the blood, a key factor in the development of gout.

Additionally, the research indicated that orange juice intake could potentially increase the risk of type 2 diabetes. This finding challenges the common perception of orange juice as a wholly beneficial beverage and highlights the importance of moderation even in consuming seemingly healthy drinks.

Nutritional Composition of Orange Juice

High in natural sugars (primarily fructose)
Rich in vitamin C and other antioxidants
Contains flavonoids and other bioactive compounds

Cola Consumption: A Different Metabolic Profile

While cola is often demonized for its high sugar content and lack of nutritional value, the study revealed some unexpected findings. How does cola consumption affect metabolic risk factors? The research showed that cola intake had a distinct metabolic profile compared to orange juice.

Cola consumption did not lead to the same increase in uric acid levels observed with orange juice. This suggests that the risk of gout may not be as pronounced with cola intake. However, cola consumption was associated with other metabolic changes that could potentially impact health in different ways.

Key Components of Cola

High in added sugars (typically high fructose corn syrup)
Contains caffeine
Includes phosphoric acid

Fructose: The Common Denominator

Both orange juice and cola contain significant amounts of fructose, albeit from different sources. How does fructose metabolism contribute to metabolic risk? Fructose metabolism differs from that of glucose and has been linked to various metabolic disturbances.

When consumed in large quantities, fructose can lead to increased uric acid production, lipogenesis (fat formation), and insulin resistance. These factors collectively contribute to an elevated risk of metabolic disorders such as gout and type 2 diabetes.

Fructose Metabolism Pathways

Conversion to glucose in the liver
Formation of glycogen
Production of triglycerides
Generation of uric acid as a byproduct

Implications for Gout Risk

Gout, a form of inflammatory arthritis, is closely linked to elevated uric acid levels in the blood. Can orange juice consumption increase gout risk more than cola? The study’s findings suggest this may be the case.

The higher uric acid levels observed with orange juice consumption indicate a potentially greater risk for gout development or exacerbation. This challenges the notion that natural sugars from fruit juices are inherently less problematic than added sugars in soft drinks.

Mechanisms of Uric Acid Elevation

Increased purine metabolism from fructose breakdown
Reduced renal excretion of uric acid
Enhanced xanthine oxidase activity

Type 2 Diabetes Risk: Orange Juice vs Cola

The study’s findings on type 2 diabetes risk present a complex picture. Does orange juice increase diabetes risk more than cola? While both beverages contain substantial amounts of sugar, their effects on insulin sensitivity and glucose metabolism appear to differ.

Orange juice consumption was associated with changes in glucose metabolism that could potentially increase the risk of type 2 diabetes. However, the specific mechanisms and long-term implications require further investigation.

Factors Influencing Diabetes Risk

Glycemic index and load of the beverages
Effects on insulin sensitivity
Impact on pancreatic beta-cell function
Influence on body weight and fat distribution

Challenging Beverage Perceptions

This research challenges common perceptions about the healthfulness of different beverages. Are natural sugars in fruit juices healthier than added sugars in soft drinks? The study suggests that the answer is not straightforward.

While orange juice does offer some nutritional benefits, such as vitamin C and flavonoids, its high fructose content and potential metabolic effects warrant consideration. Conversely, while cola lacks nutritional value, its metabolic impact may differ from what was previously assumed.

Factors to Consider in Beverage Choice

Total sugar content
Fructose to glucose ratio
Presence of beneficial nutrients and compounds
Individual metabolic response
Overall dietary pattern and lifestyle

Implications for Public Health and Dietary Recommendations

The findings of this study have significant implications for public health policies and dietary recommendations. Should fruit juice consumption be limited in the same way as sugar-sweetened beverages? The research suggests that a more nuanced approach may be necessary.

While not advocating for increased cola consumption, the study highlights the need for a balanced perspective on beverage choices. It emphasizes the importance of moderation, even with seemingly healthy options like fruit juices.

Potential Recommendations

Limit consumption of all sugar-containing beverages
Encourage whole fruit consumption over fruit juices
Promote water as the primary beverage choice
Educate consumers on the sugar content of various beverages
Consider individual metabolic profiles in dietary advice

As research in this field continues to evolve, it becomes increasingly clear that the relationship between beverage consumption and metabolic health is complex and multifaceted. This study serves as a crucial step in unraveling these complexities and paves the way for more targeted and effective dietary recommendations.

The differential effects of orange juice and cola on metabolic risk factors underscore the need for personalized nutrition advice. As we move forward, it will be essential to consider not only the quantity but also the quality and source of sugars in our diets, as well as individual metabolic responses to different types of beverages.

Ultimately, this research reinforces the importance of a balanced and varied diet, moderate consumption of sugar-containing beverages, and the need for ongoing scientific inquiry into the nuanced effects of different food and drink choices on our health. As consumers, we must remain informed and critical, understanding that even foods and drinks with a healthy image may have unexpected impacts on our metabolic health.

Future studies will likely delve deeper into the mechanisms behind these differential effects, potentially uncovering new insights into how various components of our diet interact with our metabolism. This could lead to more refined dietary guidelines and potentially even targeted interventions for individuals at risk of metabolic disorders.

In the meantime, this study serves as a reminder that moderation is key, and that our understanding of nutrition and health is constantly evolving. It encourages us to approach dietary choices with an open mind, always ready to update our knowledge based on the latest scientific evidence.

High intake of orange juice and cola differently affects metabolic risk in healthy subjects

Randomized Controlled Trial

. 2019 Apr;38(2):812-819.

doi: 10.1016/j.clnu.2018.02.028.

Epub 2018 Mar 3.

Franziska Büsing¹, Franziska A Hägele¹, Alessa Nas², Laura-Verena Döbert³, Alena Fricker³, Elisabeth Dörner³, Daniel Podlesny³, Julian Aschoff⁴, Tobias Pöhnl⁴, Ralf Schweiggert⁴, W Florian Fricke³, Reinhold Carle⁵, Anja Bosy-Westphal⁶

Affiliations

¹ Institute of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany; Institute of Human Nutrition and Food Science, University of Kiel, Germany.
² Institute of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany.
³ Institute of Biological Chemistry and Nutritional Science, University of Hohenheim, Stuttgart, Germany.
⁴ Institute of Food Science and Biotechnology, University of Hohenheim, Stuttgart, Germany.
⁵ Institute of Food Science and Biotechnology, University of Hohenheim, Stuttgart, Germany; Biological Science Department, King Abdulaziz University, Jeddah, Saudi Arabia.
⁶ Institute of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany; Institute of Human Nutrition and Food Science, University of Kiel, Germany. Electronic address: [email protected].

PMID:
29571566
DOI:
10.1016/j.clnu.2018.02.028

Randomized Controlled Trial

Franziska Büsing et al.

Clin Nutr.

2019 Apr.

. 2019 Apr;38(2):812-819.

doi: 10.1016/j.clnu.2018.02.028.

Epub 2018 Mar 3.

Authors

Affiliations

¹ Institute of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany; Institute of Human Nutrition and Food Science, University of Kiel, Germany.
² Institute of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany.
³ Institute of Biological Chemistry and Nutritional Science, University of Hohenheim, Stuttgart, Germany.
⁴ Institute of Food Science and Biotechnology, University of Hohenheim, Stuttgart, Germany.
⁵ Institute of Food Science and Biotechnology, University of Hohenheim, Stuttgart, Germany; Biological Science Department, King Abdulaziz University, Jeddah, Saudi Arabia.
⁶ Institute of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany; Institute of Human Nutrition and Food Science, University of Kiel, Germany. Electronic address: [email protected].

PMID:
29571566
DOI:
10.1016/j.clnu.2018.02.028

Abstract

Background:

Higher consumption of sugar-containing beverages has been associated with an elevated risk of type 2 diabetes and gout. Whether this equally applies to cola with an unhealthy image and orange juice (OJ) having a healthy image remains unknown.

Methods:

In order to investigate whether OJ and cola differently affect metabolic risk 26 healthy adults (24.7 ± 3.2 y; BMI 23.2 ± 3.3 kg/m²) participated in a 2 × 2-wk intervention and consumed either OJ or caffeine-free cola (20% Ereq as sugar from beverages) in-between 3 meals/d at ad libitum energy intake. Glycemic control, uric acid metabolism and gut microbiota were assessed as outcome parameters.

Results:

Fecal microbiota, body weight, basal and OGTT-derived insulin sensitivity remained unchanged in both intervention periods. Levels of uric acid were normal at baseline and did not change with 2-wk cola consumption (-0.03 ± 0.67 mg/dL; p > 0.05), whereas they decreased with OJ intervention (-0.43 ± 0.56 mg/dL; p < 0.01) due to increased uric acid excretion (+130.2 ± 130.0 mg/d; p < 0.001). Compared to OJ, consumption of cola led to a higher daylong glycemia (ΔiAUC: 36.9 ± 83.2; p < 0.05), an increase in glucose variability (ΔMAGE-Index: 0.29 ± 0.44; p < 0.05), and a lower 24 h-insulin secretion (ΔC-peptide excretion: -31.76 ± 38.61 μg/d; p < 0.001), which may be explained by a decrease in serum potassium levels (-0.11 ± 0.24 mmol/L; p < 0.05).

Conclusion:

Despite its sugar content, regular consumption of large amounts of OJ do not increase the risk of gout but may even contribute to lower uric acid levels. The etiology of impaired insulin secretion with cola consumption needs to be further investigated.

Keywords:

Cola; Insulin secretion; Insulin sensitivity; Microbiome; Orange juice; Uric acid.

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Goodbye to Gout by Patrick Holford

What is gout?

Gout is actually a form of arthritis, sometimes called gouty arthritis. The cause of gout is thought to be a build-up of uric acid, a substance in the blood that should be excreted from the body via the kidneys.

If you are unfortunate enough to suffer from the painful symptoms of gout, you will probably be prescribed NSAIDs (in the absence of kidney or digestive problems) or another form of drug to lower urate levels. Other measures include a low purine diet, weight loss in the case of obesity and lowering alcohol intake.

Reduce intake of purines and protein

Certain foods are rich in naturally occurring substances called purines, which are metabolised into uric acid. Purines are not bad for you as such – in fact they are essential, but excessive consumption is associated with increased risk for gout. The same is true with excessive consumption of protein. The most concentrated sources of purines are red meat, organ meat and oily fish (such as salmon, sardines, and herring), as well as lentils, peas and beans.

The list below shows you the richest foods:

Anchovies
Sardines (tinned)
Herrings (tinned)
Sardines (fresh)
Pork liver
Salmon
Mackerel (tinned)
Chicken liver
Blackeye beans
Lentils

If you are actively suffering from gout, it is best to limit your intake of these until the gout has gone away. Your ability to tolerate purine-rich foods, in moderation, will probably return once you are following a low GL diet.

Cut back on alcohol

The more alcohol you drink, the greater becomes your risk. Port and also red wines have been associated with gout for many years, however, a more recent study finds that beer is worse. Published in The Lancet, this study involved 50,000 men and found that while drinking alcohol is linked with an increased risk of developing gout, the consumption of beer had the strongest association, followed by spirits, then wine.¹ Also, make sure you drink plenty of water which helps to flush out excess uric acid and improve kidney clearance. Exercise also helps.

Avoid high-fructose drinks and foods

Fructose, the sugar in many fruits, cannot be directly used for energy and thus has to be converted into glucose by the liver. This process creates uric acid, which then promotes gout.² Also, the uric acid impedes the production of a substance called nitric oxide which keeps your blood pressure low. So too much fructose is also associated with high blood pressure. But most fructose is turned into LDL, making LDL cholesterol, and then put into storage as fat. Normally fruit in nature is supplied with lots of fibre, so you feel fuller and don’t eat too much.

But mankind, in his infinite wisdom, has learnt how to extract only the juice, or the fructose, and add it into foods. So, drinking any juice, including apple or orange juice, gives you quite high levels of fructose. Most fizzy drinks are absolutely loaded with ‘high-fructose corn syrup’ which is the worst sugar of all. That’s the theory but where’s the evidence? Three recent trials have confirmed this link. The first, published in the Journal of Pediatrics, studied almost 5000 adolescents and found that the more sweetened drinks they drank, the higher their uric acid level and their blood pressure ³. The second in the British Medical Journal studied 46,393 men without gout over 12 years, during which time 755 developed the condition. The more sweetened soft drinks these men drank, the greater was their risk of developing gout, with almost double the risk if drinking two or more sweetened drinks a day. Their total intake of fruit juices or fructose-rich fruits such as apples and oranges was also associated with increasing risk⁴. The third trial studied gout in women, which is becoming more common.

Out of almost 79,000 women studied over 22 years, 778 developed gout. Once again, the study found that increasing intake of sugar-sweetened drinks was associated with increasing risk of gout. Compared with women who consumed less than one serving per month, those who consumed one serving per day had a 74% increased risk of gout; and those with two or more servings per day had a 2.4 times higher risk ⁵. Orange juice intake was also associated with risk of gout. Compared with women who consumed less than a glass (6 oz) of orange juice per month, women who consumed one serving per day had a 41% higher risk of gout, and there was a 2.4 times higher risk with two or more servings per day. Also, compared with women in the lowest quintile (fifth) of fructose intake, women in the highest quintile had a 62% higher risk of gout. In the words of the researchers: “Our data provides prospective evidence that fructose poses an increased risk of gout among women, thus supporting the importance of reducing fructose intake. ” So, you want to stay away from high-fructose drinks, fruit juices and also eating too much high-fructose fruit.

Eat cherries, berries and plums and drink cherry juice

The good news is that not all fruit is high in fructose. The principal sugar in berries, cherries and plums is xylose which is not metabolised in the same way, so these are much better for you. Nine teaspoons of xylose (called xylitol when crystallized) has the same blood-glucose-raising effect as one teaspoon of sugar. There also seems to be something special about cherries in relation to gout. One study in particular points to the importance of cherries as a treatment regimen⁶. However, this study was conducted on sweet rather than tart or sour cherries, which are believed to be more effective. The use of cherries for treating gout goes back a long time. In 1950, a scientific review promoted daily cherry consumption as a means of alleviating gout attacks⁷. More recently, a 2003 study by the US Department of Agriculture (USDA), University of California at Davis, looked at the plasma urate levels, antioxidant and inflammatory markers of ten women consuming two servings (280g) of sweet cherries following an overnight fast. The results were striking. The USDA team demonstrated clearly that uric acid excretion increased significantly and blood uric acid levels declined. In the author’s words: “The decrease in plasma urate after cherry consumption supports the reputed anti-gout efficacy of cherries.”⁸ Generally it is now recognised that cherries are a genuine remedy for gout⁹. Animal studies confirm that cherries are potent anti-inflammatory agents and suggest that it is powerful antioxidant compounds called anthocyanidins that are likely to be the key components within cherry juice that yield the benefits for gout sufferers ¹⁰. Especially high in these antioxidants are the Montmorency variety of cherries, which provide 280mg of anthocyanidins in a 30ml shot of cherry concentrate, known as Cherry Active. Cherry Active is also sold in capsules. I recommend a shot a day, or three capsules, if you have gout.

Eat a low GL diet

My low-GL diet is the most rapid way to stabilise blood sugar levels and will, naturally, reduce the amount of both fructose and uric acid in your system. Eating a low-GL diet also improves your resistance to insulin – which is the hormone you produce to process sugar – and this helps to support healthy kidney function. The reason this is important is because it is the kidneys that need to excrete uric acid. I have had many people with gout who have reported instant relief when switching to a low-GL diet, even when eating previous high-purine trigger foods. If you follow my low-GL diet you will almost certainly find that your gout goes away, along with unwanted fat.

Improve kidney function

In the majority of gout sufferers, uric acid levels are high in the blood due to under-excretion of uric acid by the kidneys, rather than over-production¹¹. Nine out of ten people with high blood uric acid levels and gout have some level of kidney dysfunction¹². Both high blood glucose levels and high insulin levels, the hallmarks of metabolic syndrome (a precursor to diabetes), stress the kidneys. So as above, eating a low-GL diet is the solution. Also, many people with kidney problems have very high levels of homocysteine. This is worth getting checked, which you can do with a home-test kit. If your level is high then you are going to need certain supplemental B vitamins to normalise your level, as well as eating a better diet, with more beans and greens and less alcohol.

Vitamin C myths

A common myth is that supplementing large amounts of vitamin C raises uric acid levels and might increase the risk for gout. In fact, the opposite is true, according to a 2009 study published in the Archives of Internal Medicine. This 20-year trial involved 47,000 men and found that compared with those who did not take vitamin C supplements, men taking 1000-1499mg per day had a 34% lower risk of gout – and those taking 1500mg per day had a 45% lower risk. This was irrespective of other gout risk factors such as diet and alcohol use. Another common myth with vitamin C relates to the formation of oxalic acid, which is implicated in gout and especially kidney stones. Again, this is not true and turns out to be due to poor experimental methods, in which subjects were given vitamin C, their urine collected and not immediately analysed. Components in the urine oxidised and formed oxalic acid. However, in properly conducted trials, those taking several grams of vitamin C show no increase whatsoever in uric acid or oxalic acid. In the words of Professor Allen Rodgers from the Kidney Stone Research Laboratory of the University of Cape Town: “We conducted a controlled trial in which ten volunteer subjects were required to ingest 4g of vitamin C per day for five days. Urines (24h) were collected before, during and after the ingestion period. These were rigorously analysed for a host of independent physicochemical risk factors, all of which are regarded as powerful indicators of the risk of kidney stone formation. The results showed that these risk factors were not significantly altered. We concluded that ingestion of large doses of Vit C does not increase the risk of forming kidney stones. The results of this study were published internationally.” ¹³

Another study gave very high dose of intravenous vitamin C and again did not result in increases in oxalic acid associated with kidney stone formation.¹⁴

However, it is possible that high doses of niacin (above 1,000mg a day) taken to lower cholesterol, may exacerbate gout. So, if you are taking this, monitor carefully what happens.

Supplements for Gout

There are many nutrients involved in protein metabolism – B vitamins and especially B6, magnesium and zinc – which are also an essential part of a nutritional programme for preventing gout. Also, essential fats (both GLA and EPA) help prevent the excessive production of urate crystals¹⁵. I recommend the following:

2 x high-potency multivitamin and multi-mineral complexes.
2 × vitamin C 1000mg.
2 x essential omegas (both 3 & 6)

Make sure these are giving you 20mg of vitamin B6, 200mg of magnesium and 10mg of zinc.

References

HK Choi et al, Alcohol intake and risk of incident gout in men: a prospective study, The Lancet (2004), vol 363(9417), pp. 1277-81.
HK Choi & G Curhan G, Soft drinks, fructose consumption, and the risk of gout in men: prospective cohort study, BMJ (2008), vol 336(7639), pp 309-12. Epub 31 January 2008.
S Nguyen, HK Choi, RH Lustig, CY Hsu, Sugar-sweetened beverages, serum uric acid, and blood pressure in adolescents, Journal of Pediatrics (2009), vol 154(6), pp 807-13. Epub 17 April 2009.
HK Choi & G Curhan G, Soft drinks, fructose consumption, and the risk of gout in men: prospective cohort study, BMJ (2008), vol 336 (7639), pp 309-12. Epub 31 January 2008.
HK Choi et al, Fructose-Rich Beverages and Risk of Gout in Women, JAMA (2010), vol 304(20), pp 2270-2278.
AT Eggebeen AT, Gout: an update, American Family Physician (2007) vol 76(6), pp 801-8.
LW Blau, Cherry diet control for gout and arthritis, Texas Reports on Biology & Medicine (1950), vol 8(3), pp 309-11.
RA Jacob et al, Consumption of cherries lowers plasma urate in healthy women, Journal of Nutrition (2003), vol 133(6), pp 1826-9.
N Schlesinger, Dietary factors and hyperuricaemia, Current Pharmaceutical Design (2005), vol 11(32), pp 4133-8.
JM Tall et al, Tart cherry anthocyanins suppress inflammation-induced pain behavior in rat, Behavioural Brain Research (2004), vol 153(1), pp 181-8.
WN Kelley & HR Schumacher Jr, Crystal-associated synovitis, Textbook of Rheumatology (1993), 4th ed. Philadelphia: Saunders, pp 1291-1336.
RL Wortman, Gout and other disorders of purine metabolism, Harrison’s Principles of Internal Medicine (1998), edited by AS Fauci, 14th ed. New York: McGraw-Hill, pp 2158-65.
B Auer, D Auer, A Rodgers, Clinical Chemistry and Laboratory Medicine (1998), vol 36(3), pp 143-148.
L. Robitaille L et al., ‘Oxalic acid excretion after intravenous ascorbic acid administration.’ Metabolism. 2009 Feb;58(2):263-9
G. A. Tate et al., ‘Suppression of monosodium urate crystal-induced acute inflammation by diets enriched with gamma-linolenic acid and eicosapentaenoic acid’, Arthritis and Rheumatism, vol. 31 (12), 1988, pp. 1543–51.

Why is it worth drinking citrus juices for gout?

Treatment of gout is a desirable option for many gout sufferers. Gout affects the wrists, elbows, and toes, as well as other parts of the body. Gout can cause varying degrees of pain. The causes of gout are still being studied and the results are not conclusive. Gout is caused by excess uric acid in the kidneys. In 2003, 12 Spanish teenagers were subjected to a study in which they were given orange juice at various times. The results of the study showed that orange juice significantly reduced the level of uric acid.

Gout

Gout can be controlled by aggressively reducing the level of uric acid in the body. Orange juice is a good source of vitamin C. Most people are aware of this fact. However, they do not know how much orange juice can increase their vitamin C levels in their body and how long it takes. The study showed how much orange juice increases blood levels of the vitamin and how quickly it does so. Six men and six women drank two glasses of orange juice on the first day. For the next two weeks, they continued to drink orange juice daily, one glass in the morning and one glass in the evening.

Through this exercise, they were able to get 500 ml of vitamin C every day. This is twice the daily requirement. Each person received 250 mg more vitamin C daily. The men received 386 mg of vitamin C and the women 362 mg. Gout sufferers were delighted with the results. After two weeks of testing, uric acid levels in men dropped by about 12.5% and in women by 6.5%.

Uric acid level

Baseline uric acid level in women was lower than in men. By the end of the study, all participants had significantly reduced uric acid levels. Research into remedies for gout and its causes is still ongoing. Considering the study was only two weeks long and the supplemental dose of vitamin C was 250mg per day, the reduction in uric acid levels was impressive. The study suggests that gout attacks could have been prevented if subjects had continued to drink orange juice for six months or longer. The juice can be absorbed over a longer period of time, which may lead to better results. These were healthy young people aged 20-32. The results may be different if you have gout. The decrease in uric acid levels will be lower if you are taking medication.

Testing oranges will not be helpful for people with gout at normal or slightly above IC levels. However, orange juice is not a drug. Researchers aren’t sure why vitamin C lowers uric acid levels. One theory is that vitamin C stimulates the kidneys to produce more uric acid. Orange juice is high in potassium, which has an alkalizing effect on minerals and raises the pH or alkaline levels in the body. That is why the combination of vitamin C and potassium reduces gout problems.

Conclusion

Gout sufferers will be happy to know that orange juice contains certain flavonoids that aid in the absorption and retention of vitamin C. These flavonoids are not found in many vitamin C supplements or are deficient. However, some of them have them. In this study, freshly squeezed orange juice was used. It is the juice of fresh, raw oranges. It was not made from orange juice concentrate.

Interestingly, the vitamin C in fresh juice can lose its effectiveness over time. It is best to make fresh orange juice from scratch and drink it right away. It will lose its strength faster if it is left open or open after squeezing. It is better to take 500 mg of vitamin C every day. Orange juice can be used to treat gout. You can also drink plenty of water to treat gout. The causes of gout are still being studied. You may find a solution to your problem in the resource.

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The main harmful product that “feeds” this disease

The main reason for the growth of the disease is associated with the modern diet, filled to the limit with fructose.

Gout is a type of arthritis characterized by painful, stiff and inflamed joints. It can occur in any joint of the body, but most commonly affects the big toe. Stiffness and swelling are the result of excess uric acid causing crystals to form in the joints, and the pain associated with this disease is caused by the body’s inflammatory response to uric acid crystals.

Gout affects between 2 and 5 million Americans and is increasing in prevalence in both the US and other developing countries. This is not surprising, since the main reason for the increase in the incidence of this painful type of arthritis is associated with modern diets that are filled to the limit with fructose, mainly in the form of high fructose corn syrup (HFCS).

New evidence confirms fructose-uric acid-gout link

The last JAMA study mentioned above used data from a 22-year Nurse’s Health Study that included approximately 79,000 women.

The analysis showed that women who drank two cans of sweetened soda per day were twice as likely to develop gout compared to those who rarely drank such water.

Drinking 360 ml or more of orange juice daily has about the same effect.

In addition, according to CNN:

74 percent and 41 percent, respectively compared to women who rarely drank such drinks.

“Obviously fructose is the culprit,” says study lead author Dr. Hyun Choi, MD, professor of medicine at Boston University School of Medicine.

A similar study for men was published two years ago.

In this study, men who drank two or more sugary soft drinks a day had an 85 percent higher risk of gout than those who drank less than one drink a month.

Significantly increased risk in men who drank five to six servings of sugary soft drinks per week. Fruit juices and fruits rich in fructose, such as oranges and apples, also increase the risk.

That’s why I always recommend paying the same attention to fructose in the form of fruit juices and even whole fruits, not just soda and processed foods.

As a general rule, I recommend limiting your total fructose intake to 25 grams per day (from all sources).

Since HFCS is found in almost all processed foods, it would be reasonable for most people to limit total fructose from fruit to 15 grams per day.

The maximum level of 25 grams can be easily exceeded due to this “hidden” fructose in your diet, even if you do not consume sugary soda or fruit …

Fructose is the ONLY sugar that raises uric acid levels eyes on the dramatic and devastating effects of fructose on uric acid levels following an interview with Dr. Richard Johnson on the subject earlier in the year.

Dr. Johnson’s research aims to as fructose , which is the number one calorie source in the American diet, causes obesity, diabetes and a number of other common diseases, including:

Gout
High blood pressure
High cholesterol and high triglycerides
Kidney disease
Heart disease
Fatty liver disease

Elevated uric acid levels appear to be a major component of all these diseases, and more recent studies show that fructose is the ONLY type of sugar that raises uric acid levels!

Fructose is very different from other sugars because it is metabolized in very specific pathways other than glucose, for example, and uric acid is formed precisely as a result of this specific action.

Fructose typically forms uric acid within minutes of ingestion.

But… glucose enhances the harmful effects of fructose!

Yes, although glucose does not increase uric acid levels, it does increase fructose absorption! So when you MIX glucose and fructose, you are actually taking in more fructose than if you were eating fructose alone.

This is important information for those who want to control their weight even better and prevent disease.

At what level does uric acid begin to create disease?

Based on research by Dr. Johnson, Uric acid appears to be the main culprit in creating health problems when levels reach 5.5 mg/dl or higher in the body.

These levels of uric acid have been linked to an increased risk of high blood pressure as well as diabetes, obesity and kidney disease.

Dr. Johnson says the ideal uric acid level is between 3 and 5.5 mg/dL.

How to limit your fructose intake

According to Dr. Johnson’s research, a quarter of the US population consumes a whopping 134 grams of fructose per day. This is a staggering amount when you consider the fact that fructose intake must be limited to no more than 25 grams per day to maintain good health.

Therefore, it becomes, in general, understandable why the number of diseases associated with fructose has simply skyrocketed to an incomprehensible level.

For example, this statistic is linked to figures that show that one in four Americans has either prediabetes or type 2 diabetes.

So, how much fructose do you consume each day?

I strongly advise you to look at the labels of all the foods you put in your mouth and be sure to consider the serving size…

In his book The Sugar Fix, Dr. Johnson provides detailed tables showing the fructose content of various foods. This information is not so easy to find when you need to find out exactly how much fructose is in a particular product.

I fully understand that reducing sugar/fructose in the diet can be a very difficult task for some people. In the end, Sugar is addictive just like cocaine!

But it’s possible, and Dr. Johnson’s book gives helpful suggestions on how to make it happen.

This requires two weeks of very low fructose dieting to “reboot” the system and re-sensitize your body to fructose.

More Tips for Preventing and Treating Gout

If left untreated, gout will become more painful and cause joint damage.

Therefore, if you feel sudden, severe pain in your joints, especially in your big toe, it is important to seek help.

However, I strongly recommend avoiding medications for gout and drugs specifically designed to lower uric acid levels.

Why throw money away and suffer side effects when most people can successfully lower uric acid simply by limiting or eliminating excess fructose in their diet!

In addition, the following strategies will help to successfully treat (or prevent) gout:

Change your diet according to your nutritional type. To determine your nutritional type, use my free online nutritional type test (available in English only). This test used to cost $29, but now we offer this test completely free of charge, so please use this helpful tool.

Avoid sugary sodas, fruit juices, and other sugary drinks. As we have said, these types of drinks are the main source of excess fructose. Instead, drink plenty of pure water, as the liquid will help flush uric acid from the body. It is also important to cut out all sugars and grains in your diet.

Limit or eliminate alcohol, especially beer. Alcohol in general, and beer in particular, can also increase the level of uric acid in the blood.

Exercise. Being overweight increases your risk of gout, and regular exercise will help you maintain a healthy weight and improve your overall health.

Try cherries or cherry juice concentrate. Cherries contain two powerful compounds, anthocyanins and bioflavonoids.

Gout and orange juice. Impact of Orange Juice and Cola on Metabolic Health: A Comprehensive Analysis

The Metabolic Effects of Orange Juice vs Cola: Key Findings

Study Design and Methodology

Orange Juice Consumption: Metabolic Implications

Nutritional Composition of Orange Juice

Cola Consumption: A Different Metabolic Profile

Key Components of Cola

Fructose: The Common Denominator

Fructose Metabolism Pathways

Implications for Gout Risk

Mechanisms of Uric Acid Elevation

Type 2 Diabetes Risk: Orange Juice vs Cola

Factors Influencing Diabetes Risk

Challenging Beverage Perceptions

Factors to Consider in Beverage Choice

Implications for Public Health and Dietary Recommendations

Potential Recommendations

High intake of orange juice and cola differently affects metabolic risk in healthy subjects

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Abstract

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Goodbye to Gout by Patrick Holford

What is gout?

Reduce intake of purines and protein

Cut back on alcohol

Avoid high-fructose drinks and foods

Eat cherries, berries and plums and drink cherry juice

Eat a low GL diet

Improve kidney function

Vitamin C myths

Supplements for Gout

Why is it worth drinking citrus juices for gout?

Gout

Uric acid level

Conclusion

The main harmful product that “feeds” this disease

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