Sugar-sweetened soft drinks consumption and risk of hyperuricemia: Results of the ELSA-Brasil study

Nutr Metab Cardiovasc Dis. 2021 Jun 30;31(7):2004-2013. doi: 10.1016/j.numecd.2021.04.008. Epub 2021 Apr 18.


Background and aims: The prospective association between sugar-sweetened beverages consumption and hyperuricemia is controversial. The aim was to investigate the association of the consumption of sugar-sweetened soft drinks and unsweetened fruit juices with the incidence of hyperuricemia and the levels of serum uric acid in the participants of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

Methods and results: Longitudinal analysis in ELSA-Brasil participants (baseline 2008-2010 and follow-up 2012-2014). The sample consisted of 10,072 civil servants (35-74 years, both sexes). The consumption of beverages estimated by a food frequency questionnaire (baseline) was divided into five categories: nonconsumption and quartiles (≥0.1 mL/day). Hyperuricemia was defined as uric acid ≥7.0 mg/dL (men) and ≥5.7 mg/dL (women). Poisson regression with robust variance and multiple linear regression were tested. The average consumption of soft drinks was 84 ± 191 mL/day in men and 42 ± 128 mL/day in women. After 4 years of follow-up, the higher consumption of soft drinks (men: 401 ± 303 mL/day; women: 390 ± 290 mL/day) increased the relative risk of hyperuricemia by 30% (men) and 40% (women), and was associated with increased mean uric acid (men: β = 0.14 mg/dL; 95% CI 0.41-0.24; women: β = 0.11 mg/dL; 95% CI 0.00-0.21). The consumption of unsweetened juice was not associated with hyperuricemia.

Conclusion: High consumption of sugar-sweetened soft drinks is associated with an increased relative risk of hyperuricemia and elevated serum uric acid levels in Brazilian adults.

Keywords: Cohort studies; Fruit juices; Hyperuricemia; Sugar-sweetened soft drinks; Uric acid.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Biomarkers / blood
  • Brazil / epidemiology
  • Female
  • Humans
  • Hyperuricemia / blood
  • Hyperuricemia / diagnosis*
  • Hyperuricemia / epidemiology*
  • Incidence
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Nutritive Value
  • Risk Assessment
  • Risk Factors
  • Sugar-Sweetened Beverages / adverse effects*
  • Time Factors
  • Uric Acid / blood*


  • Biomarkers
  • Uric Acid