What is the association between sugary drinks (fructose) and gout attacks? (Fructose metabolism and uric acid production)

Let's put it this way, these two are deeply intertwined, you could even call them "intimate allies."

You can imagine our body as a factory. The sugary drinks we consume mostly contain a raw material called "fructose" (many beverages use "high-fructose corn syrup," which is essentially the same thing).

When this "fructose" raw material enters the "body" factory, the factory starts working to process it, converting it into energy. The problem is, during the processing of fructose, a byproduct is generated: "uric acid."

Under normal circumstances, if you occasionally eat some fruit, the fructose content isn't high. The small amount of uric acid byproduct produced by the factory is easily excreted by the body through the kidneys (i.e., urine), causing no issues.

However, when you chug down a large bottle of soda or fruit juice, a massive amount of "fructose" raw material floods into the factory all at once. The factory has to work overtime, processing it frantically, which results in an explosive production of "uric acid" byproduct. The quantity is so large that your kidneys simply can't excrete it all in time.

This excess, unexcreted uric acid then circulates throughout your bloodstream. When the concentration of uric acid in the blood becomes too high, it crystallizes in the cooler extremities of your body, such as your big toe, ankles, and knees, forming tiny, needle-like crystals.

Imagine suddenly having a bunch of tiny needles in your joints; every movement stabs you. Wouldn't that make it red, swollen, hot, and excruciatingly painful? — This, is a gout attack.

So, to briefly summarize this chain: Drinking sugary drinks -> High fructose intake -> Large production of uric acid in the body -> Uric acid cannot be excreted sufficiently -> Crystallization in joints -> Gout attack.

That's why doctors and experienced gout patients will always tell you that the first step to controlling gout is often: cutting out all sugary drinks and fruit juices. This is more effective than anything else.