Two sugary sodas a day double the risk of gout in men.
Original statement
ولهذا وجد Choi و Curhan في BMJ عام 2008 أن شرب علبتين سكريتين يومياً يضاعف خطر النقرس لدى الرجال.
verbatim according to source. Translation by the project; the Arabic wording is authoritative.
Translation
Two sugary sodas a day double the risk of gout in men.
Origin
- Source status
- Archive editors
- Attribution
- Archive editors (study selection and narrative are the archive's, not necessarily Elawady's)
- Origin
- https://eltayebat.com/rule/soda/
- Attribution uncertainty
- The archive homepage states that the forbidden-food section is supported by research 'independently of Dr. Diaa's words'. No evidence was found that Elawady himself cited these studies.
- Claimed mechanism
Fructose raises uric acid.
- Claimed health effect
Gout.
- Population concerned
Men
- Geographic restriction by Elawady
none found
Scientific assessment
Mostly true – Correct at its core, but with limitations or minor inaccuracies.
Certainty of evidence: moderate – Further research may still affect the assessment.
1. What was claimed?
Two daily sugary sodas double gout risk in men.
2. What is demonstrably correct?
Choi 2008 (A-SOD-06): RR 1.85 (1.08-3.16) for >=2 servings/day vs <1/month; diet soft drinks were not associated. Jamnik 2016 (I-SOD-05) meta-analysis of 2 cohorts: highest vs lowest fructose intake RR 1.62 (1.28-2.03).
3. What is wrong or exaggerated?
'Double' rounds 1.85 upward; the confidence interval is wide. It matches the highest-intake estimate of a meta-analysis of three cohorts (RR 2.08, I-SUG-109), but the broader umbrella review found about 35% higher risk (RR 1.35, 1.18-1.55; I-SUG-02); that umbrella review's results text attributes the per-serving gout estimate to artificially sweetened beverages, inconsistent with its abstract. Fruit juice was also associated with gout (Choi 2008; I-SUG-109 RR 1.77), which the archive does not mention.
4. What remains unclear?
Evidence outside white health professionals.
5. Which studies support it?
A-SOD-06, I-SOD-05, I-SUG-109 (meta-analysis: SSB RR 2.08, 1.40-3.08, moderate certainty; fruit juice RR 1.77), I-SUG-02 (RR 1.35 highest vs lowest), I-SUG-03 (EFSA: moderate certainty, >50-75% probability, of a causal SSB-gout relationship; external validity for Europe unclear).
6. Which studies contradict it?
None found.
7. What applies to Germany and Europe?
Applies; no EU-specific data reviewed.
8. What is known about Egypt?
Sugar-sweetened soft drinks are widely sold in Egypt. No Egypt-specific study was reviewed for this claim; the physiological mechanisms and cohort findings are not known to differ by country, but absolute risks depend on local consumption and disease rates.
9. What practical conclusion is appropriate?
People with gout are commonly advised to limit sugary drinks and juices.
Assessment details
- Rationale for certainty of evidence
Prospective cohorts with dose-response; a GRADE-assessed meta-analysis rated the SSB-gout association as moderate certainty (I-SUG-109, RR 2.08 highest vs lowest); EFSA 2022 rated causal certainty moderate (>50-75%); fructose raises uric acid (plausible mechanism). Evidence comes mostly from US health professionals (indirectness), and broader pooled estimates are smaller.
- Source quality
Number slightly rounded upward ('double' for RR 1.85, CI 1.08-3.16).
- Regional transferability
Moderate (cohorts from the US; physiology general).
- Individual exceptions
People with existing hyperuricaemia or gout are most concerned.
- Regional scope of the claim
- general (biological/medical)
- Last reviewed
- 26 October 2026 provisional
Scientific evidence in detail
Scientifically well supported – The claim agrees with consistent, high-quality evidence.
Research question: Do two or more sugary sodas a day about double gout risk in men?
Research question in detail (PECO)
- Population
- Adult men (and women)
- Intervention or exposure
- SSB >=2 servings/day
- Comparison
- <1 serving/month
- Geographic scope
- universal biology; data mainly US
- Outcomes
- Incident gout
- Hyperuricaemia
Study results as reported by the authors. Our assessment follows below.
What speaks for the claim?
Sugary drinks and juice linked to gout
Ayoub-Charette S et al.. BMJ Open 2019 · PMID 31061018 · DOI 10.1136/bmjopen-2018-024171 Meta-analysisabstract checkednewly addedMeta-analysis of three cohorts: highest vs lowest SSB intake RR 2.08 for gout (moderate certainty).
- Actual result
- RR 2.08 (1.40-3.08).
- Methodological quality
- moderate
- Relevance
- direct
- Limitations
- Includes the archive's cohort (A-SOD-06).
Soft drinks and gout in men
Choi HK, Curhan G. BMJ 2008 · PMID 18244959 · DOI 10.1136/bmj.39449.819271.BE Cohort studyabstract checkedChoi 2008 (46,393 men): >=2 SSB/day RR 1.85 (1.08-3.16).
- Actual result
- RR 1.85.
- Methodological quality
- moderate
- Relevance
- direct
- Limitations
- Wide CI.
What speaks against the claim?
Sugar and health: umbrella review
Huang Y et al.. BMJ 2023 · PMID 37019448 · DOI 10.1136/bmj-2022-071609 Systematic reviewfull text, structured risk-of-bias assessmentUmbrella review: highest vs lowest SSB intake RR 1.35 for gout (lower than 'double').
- Actual result
- RR 1.35 (1.18-1.55).
- Methodological quality
- high (umbrella)
- Relevance
- direct
- Limitations
- Different pooling and comparisons.
What does the overall evidence say?
Editorial assessment based on the studies above – not itself a study result.
Which position is better supported?
SSB are associated with gout; 'about double' matches the highest-intake estimates in the cohorts cited, while broader pooled estimates are smaller (about 20-35%).
Why some studies weigh more
Cohort meta-analyses with GRADE moderate; EFSA moderate causal certainty; fructose raises uric acid.
Is a causal relationship established? Probable Fructose metabolism increases uric acid production.
Remaining uncertainty
Magnitude outside US health professionals.
Justified conclusion
Mostly true.
Why do studies seem to disagree?
Pooled estimates differ (RR 2.08 vs 1.35 vs OR 1.21 in a 2025 meta-analysis not added) because of different exposure contrasts and included studies.
Does this depend on the country?
- General biological effects
- Universal.
A regional difference that changes the conclusion is not supported by robust data.
Statistical re-check
- Log-symmetry – RR 1.85 (1.08-3.16) symmetric; z 2.25 recalculated
- Log-symmetry – RR 2.08 (1.40-3.08) symmetric; z 3.64 recalculated
Certainty of the overall evidence (GRADE, simplified)
- Main outcome
- Incident gout with SSB
- Starting level
- low (observational studies)
- Reasons for downgrading
- indirectness (US health professionals)
- Reasons for upgrading
- dose-response
- plausible mechanism (uric acid)
- Result
- moderate
Simplified assessment by a single reviewer, following the GRADE approach; not a formal GRADE panel. GRADE rates the body of evidence for one outcome, not individual studies.
Search strategy
Documented literature searches for this review (search strings in the original database syntax).
| Database | Date | Search | Looking for | Hits | Included |
|---|---|---|---|---|---|
| PubMed | 26 October 2026 | (sugar-sweetened[ti] OR soft drink*[ti] OR fructose[ti]) AND (gout[ti] OR hyperuricemia[ti] OR uric acid[ti]) AND (meta-analysis[pt] OR systematic review[pt]) | both directions | 7 | |
| Europe PMC | 26 October 2026 | (gout) AND ("sugar-sweetened" OR "soft drinks") AND (women OR female) AND (cohort) | contradicting evidence | 452 |
Open questions
Data in women and non-US populations.
How deeply was this checked?
5 linked studies: 2 checked in full text (2 of them with a structured risk-of-bias assessment), 3 on the basis of the abstract, 0 bibliographically only. No formal assessment with two independent reviewers and no independent human expert review has taken place yet.
Last scientific review: 26 October 2026
History of the verdict
- 25 October 2026 · Phase 1 · Initial assessment: Mostly true (low)
- 26 October 2026 · Phase 4 (systematic evidence review) · Verdict changed: Mostly true (low) → Mostly true (moderate)
Certainty raised to moderate: a GRADE-assessed meta-analysis rated SSB-gout evidence moderate, EFSA rated causal certainty moderate, and dose-response is consistent.
New sources: I-SUG-109
In plain language
Men who drank two or more sugary sodas a day developed gout more often (about 85% more) in a large US study. A pooled analysis of fructose intake points the same way, but the evidence is limited to few studies. Fruit juice was also linked to gout in the same study.
Studies on this claim
Studies supporting the claim (5)
-
Soft drinks and gout in men
Choi HK, Curhan G. BMJ 2008 · PMID 18244959 · DOI 10.1136/bmj.39449.819271.BECohort studycited by the Tayebat archiveabstract checkedTwo or more sugary sodas a day: 85% higher gout risk; fruit juice also linked; diet soda not.
Does the study support the specific claim? Yes · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim
Original publication · Scientific details
Study explained simply
- What did the researchers want to find out?
Are sugar-sweetened soft drinks and fructose associated with incident gout in men?
- How was the study done?
Prospective cohort over 12 years (HPFS); validated FFQs.
- How many people, animals or samples were studied?
46,393; 755 incident gout cases; Male health professionals without gout
- What was actually found?
SSB 5-6/week RR 1.29 (1.00-1.68); 1/day 1.45 (1.02-2.08); >=2/day 1.85 (1.08-3.16); diet soft drinks not associated; fructose top fifth RR 2.02 (1.49-2.75); fruit juice and fructose-rich fruits also associated (P trend <0.05).
- How large was the observed effect?
RR 1.85 (1.08-3.16)
- What do the results mean in everyday life?
Sugary drinks and juices may raise gout risk.
- What are the study's limitations?
Men health professionals only; Wide CI at highest intake; Observational design; residual confounding possible; Self-reported dietary intake
- What does it say about Elawady's specific claim?
- Do the results apply to Germany and Europe?
Moderate.
- What can explicitly not be concluded from this study?
Effect in women; causation.
-
Fructose and gout: meta-analysis
Jamnik J et al.. BMJ Open 2016 · PMID 27697882 · DOI 10.1136/bmjopen-2016-013191Meta-analysisindependent cross-checkabstract checkedHigh fructose intake was linked with 62% higher gout risk in two cohorts; certainty low.
Does the study support the specific claim? Yes · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim
Original publication · Scientific details
Study explained simply
- What did the researchers want to find out?
Is fructose associated with incident gout/hyperuricaemia?
- How was the study done?
Systematic review and meta-analysis of prospective cohorts with GRADE.
- How many people, animals or samples were studied?
2 cohorts; 125,299; 1,533 gout cases; Predominantly white health professionals
- What was actually found?
RR 1.62 (1.28-2.03), I2 0%; GRADE low (indirectness).
- How large was the observed effect?
RR 1.62 (1.28-2.03)
- What do the results mean in everyday life?
Fructose from any source may matter for gout.
- What are the study's limitations?
Only 2 cohorts; Indirect population
- What does it say about Elawady's specific claim?
Supports C-SOD-05 (with limitations).
- Do the results apply to Germany and Europe?
Moderate.
- What can explicitly not be concluded from this study?
Causation.
-
Sugar and health: umbrella review
Huang Y et al.. BMJ 2023 · PMID 37019448 · DOI 10.1136/bmj-2022-071609Systematic reviewindependent cross-checkfull text, structured risk-of-bias assessment★ key studyAcross 73 meta-analyses, high sugar intake was linked to 45 adverse outcomes; authors advise under 25 g/day of added sugar.
Does the study support the specific claim? No · Methodological quality: high · Certainty of evidence: see overall assessment of the claim
Original publication · Scientific details
Study explained simply
- What did the researchers want to find out?
Quality and validity of evidence on sugar and health outcomes.
- How was the study done?
Umbrella review of 73 meta-analyses.
- How many people, animals or samples were studied?
73 meta-analyses; 83 outcomes; Humans free of acute/chronic disease
- What was actually found?
Significant harmful associations with 45 outcomes; moderate-quality: SSB and body weight, added sugars and ectopic fat; low-quality: +4% gout per SSB serving/week, +17% CHD and +4% all-cause mortality per 250 mL/day SSB; recommends free/added sugars <25 g/day and SSB <1 serving/week.
- How large was the observed effect?
CHD +17% per 250 mL/d SSB
- What do the results mean in everyday life?
High sugar intake is more harmful than beneficial.
- What are the study's limitations?
Most evidence is observational and of low certainty, and concerns sugary drinks rather than sugar in foods; sucrose intake was even linked to slightly lower diabetes risk in some cohorts; recommendations go beyond the strength of the evidence.
- What does it say about Elawady's specific claim?
- Do the results apply to Germany and Europe?
High.
- What can explicitly not be concluded from this study?
It cannot show that sugar in any form or small amount is harmful, nor precise effect sizes; it does not cover honey, fruit or sugars eaten in solid foods well.
-
EFSA: how much sugar is safe?
EFSA NDA Panel et al.. EFSA J 2022 · PMID 35251356 · DOI 10.2903/j.efsa.2022.7074Risk assessmentindependent cross-checkfull text, structured risk-of-bias assessment★ key studyEFSA found no safe intake level and advises keeping added and free sugars as low as possible.
Does the study support the specific claim? No · Methodological quality: high · Certainty of evidence: see overall assessment of the claim
Original publication · Scientific details
Study explained simply
- What did the researchers want to find out?
Can a UL or safe level for dietary sugars be set?
- How was the study done?
Regulatory scientific opinion with systematic reviews.
- How many people, animals or samples were studied?
Not applicable; General population
- What was actually found?
Sugars are a well-established hazard for caries; RCTs on surrogate endpoints show causal positive relationship of added/free sugars with obesity and dyslipidaemia (moderate certainty), NAFLD and T2D (low), hypertension (very low); no safe level identified; intake of added and free sugars should be as low as possible in a nutritionally adequate diet.
- How large was the observed effect?
Not applicable
- What do the results mean in everyday life?
Applies to sugar, honey and syrups alike.
- What are the study's limitations?
Trials looked at markers (weight, liver fat, blood fats) rather than diseases; cohort studies mostly compared sugar with other calories at equal total energy; few data below 10% of energy.
- What does it say about Elawady's specific claim?
Contradicts C-SUG-01, C-SUG-05 (health relevance); supports C-SOD-01.
- Do the results apply to Germany and Europe?
Directly applicable in EU/Germany.
- What can explicitly not be concluded from this study?
It cannot name a safe daily amount of sugar; it does not show that sugar is harmful when it does not add extra calories, except for tooth decay.
-
Sugary drinks and juice linked to gout
Ayoub-Charette S et al.. BMJ Open 2019 · PMID 31061018 · DOI 10.1136/bmjopen-2018-024171Meta-analysisindependent cross-checkabstract checkedPooled data from three large cohorts linked high sugary-drink intake with about twice the gout risk; fruit juice was also linked, but whole fruit was not.
SSB highest vs lowest RR 2.08 (moderate certainty).
Does the study support the specific claim? Yes · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim
Original publication · Scientific details
Study explained simply
- What did the researchers want to find out?
Assess which sugar sources are linked to gout.
- How was the study done?
Pooled three prospective cohorts.
- How many people, animals or samples were studied?
154,289 participants, 1761 gout cases.
- What was actually found?
Sugary drinks RR 2.08; juice 1.77; fruit no association.
- How large was the observed effect?
RR 2.08 (1.40-3.08).
- What do the results mean in everyday life?
People at risk of gout benefit from limiting sugary drinks and juices.
- What are the study's limitations?
Only three studies, mostly US professionals.
- What does it say about Elawady's specific claim?
Supports 'double the risk' for sugary drinks; shows juice is not exempt.
- Do the results apply to Germany and Europe?
Transferability moderate.
- What can explicitly not be concluded from this study?
Cannot prove causation.
No study in this group is marked as key.
Studies contradicting or limiting the claim (0)
No studies in this group.
Studies with mixed or unclear results (0)
No studies in this group.
Regional context
Germany / EU
Applies; no EU-specific data reviewed.
Egypt
Sugar-sweetened soft drinks are widely sold in Egypt. No Egypt-specific study was reviewed for this claim; the physiological mechanisms and cohort findings are not known to differ by country, but absolute risks depend on local consumption and disease rates.
What applies in my country?
General scientific assessment
Mostly true Sugary sodas are linked with gout with moderate certainty; 'about double' matches the highest-intake estimates, though broader pooled estimates are smaller.
The following areas of food safety are relevant to this statement:
- Additives and processing
Honey, sugar, sweets
Choose a country to see the checked information for it.
Limits: legal rules describe what is allowed, not what every single food contains. Measurement data come from samples and are meaningful only together with their method details.
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References
- Soft drinks, fructose consumption, and the risk of gout in men: prospective cohort study.. Choi HK, Curhan G. BMJ 2008 · PMID 18244959 · DOI 10.1136/bmj.39449.819271.BE
- Fructose intake and risk of gout and hyperuricemia: a systematic review and meta-analysis of prospective cohort studies.. Jamnik J et al.. BMJ Open 2016 · PMID 27697882 · DOI 10.1136/bmjopen-2016-013191
- Dietary sugar consumption and health: umbrella review.. Huang Y et al.. BMJ 2023 · PMID 37019448 · DOI 10.1136/bmj-2022-071609
- Tolerable upper intake level for dietary sugars.. EFSA NDA Panel et al.. EFSA J 2022 · PMID 35251356 · DOI 10.2903/j.efsa.2022.7074
- Important food sources of fructose-containing sugars and incident gout: a systematic review and meta-analysis of prospective cohort studies.. Ayoub-Charette S et al.. BMJ Open 2019 · PMID 31061018 · DOI 10.1136/bmjopen-2018-024171