Soft drinks

AvoidCaution

3 studies · 2 recommendations

Last updated: February 4, 2026

Avoid2 studies

Avoid sugar-sweetened soft drinks to reduce uric acid levels and prevent gout flares

Two major clinical guidelines from the American College of Rheumatology (2020) and British Society for Rheumatology provide strong consensus against sugar-sweetened soft drink consumption in gout patients. The British guideline specifically recommends avoidance of fructose-containing soft drinks with 92% recommendation strength (Level III evidence), citing their direct impact on serum uric acid elevation. The ACR guideline, developed through systematic review of 57 PICO questions examining lifestyle and medication strategies, identified sugar-sweetened beverages as a modifiable dietary factor with gout flare designated as the critical outcome measure. Both guidelines position soft drink avoidance within broader dietary modifications for uric acid reduction and attack prevention, with particular emphasis for overweight patients pursuing gradual weight management.

Evidence

2020 American College of Rheumatology Guideline for the Management of Gout

Authors: Abeles, Aryeh M., Bae, Sangmee Sharon, Brignardello‐petersen, Romina, Dalbeth, Nicola, Danve, Abhijeet, FitzGerald, John D., Gelber, Allan C., Guyatt, Gordon, Harrold, Leslie R., Khanna, Dinesh, Khanna, Puja P., Kim, Seoyoung C., King, Charles, Lenert, Aleksander, Levy, Gerald, Libbey, Caryn, Mikuls, Ted, Mount, David, Neogi, Tuhina, Pillinger, Michael H., Poon, Samuel, Qasim, Anila, Rosenthal, Ann, Sehra, Shiv T., Sharma, Tarun Sudhir Kumar, Sims, James Edward, Singh, Jasvinder A., Smith, Benjamin J., Toprover, Michael, Turgunbaev, Marat, Turner, Amy S., Wenger, Neil S., Zeng, Linan, Zhang, Mary Ann

Published: June 1, 2020

The 2020 American College of Rheumatology Guideline addresses sugar-sweetened beverage consumption as part of lifestyle recommendations for gout patients. Developed through systematic literature review with 57 PICO questions covering lifestyle and medication strategies, the guideline incorporated evidence on dietary factors affecting serum urate. Gout flare was specified as the critical outcome for management of lifestyle factors in the guideline development process.

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The British Society for Rheumatology Guideline for the Management of Gout.

Authors: Mallen, Roddy

Published: May 26, 2017

The British Society for Rheumatology guideline (Level of Evidence III, Strength of Recommendation 92%) recommends that sugar-sweetened soft drinks containing fructose should be avoided in all patients with gout. This recommendation is part of comprehensive dietary modifications aimed at reducing serum uric acid levels and preventing gout attacks. The guideline emphasizes that dietary modification should be encouraged in overweight patients to achieve gradual weight reduction and maintenance.

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Caution1 studies

Soft drinks may contribute to gout development

Sugar-sweetened beverages contain fructose, which increases uric acid production and reduces its excretion. While the association was weaker than other factors in this study, limiting soft drink consumption may help reduce gout risk.

Evidence

Risk Factors in the Incidence of Gouty Arthritis in Masohi Town, Central Maluku Regency in 2010

Authors: Amiruddin, R. (Ridwan), Arsin, A. A. (A), Talarima, B. (Bellytra)

Published: December 1, 2012

The case-control study of 196 participants found soft drink consumption had an odds ratio of 1.33 (95% CI: 0.72-2.45) for gouty arthritis incidence. While the confidence interval crosses 1.0 indicating the association did not reach statistical significance, the elevated point estimate suggests a possible trend toward increased risk that warrants caution.

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