Sugar, Fructose and Gout: Enjoying Holiday Desserts Without a Flare
Yule log, cookies, fruitcake, chocolate: holiday desserts are low in purines, but sugar and fructose raise uric acid. What actually matters with gout, slice by slice.
Sugar, Fructose and Gout: Enjoying Holiday Desserts Without a Flare
The short answer: desserts are the easy part of the holidays when it comes to purines. A slice of yule log has under 10 mg, a couple of gingerbread cookies around 5 mg, against a daily guide of about 400 mg. The real issue is sugar, and more precisely the fructose in it, which raises uric acid on its own. It's less the desserts themselves than how they pile up, and above all the sweet drinks that come with them.
Why desserts contain so few purines
Purines are mostly found in meat, organ meats, fish and shellfish. Baked goods are made from ingredients that contain very few, or none at all:
| Ingredient | Purines (mg per 100 g) |
|---|---|
| Egg | 0 to 5 |
| Butter, sugar, cream | Very little or none |
| Honey | 0.9 |
| Dark chocolate | 8.1 |
| Cake flour | 15.7 |
| Pastry and bread flour | 25.8 |
| Almond | 25 to 31 |
Sources: Kaneko et al., Biological and Pharmaceutical Bulletin, 2014 (flours, almond, honey, egg); Gout-Cha! food database (dark chocolate, cream).
Holiday desserts, slice by slice
No study has measured the purines in a whole yule log or fruitcake, so these are estimates based on the measured ingredients above:
| Dessert | Estimated purines per serving | Where they come from |
|---|---|---|
| Chocolate yule log (about 3.5 oz slice) | under 10 mg | Flour in the sponge, chocolate |
| Gingerbread cookies (2) | about 5 mg | Flour |
| Almond cake or frangipane tart (one slice) | about 10 to 15 mg | Almonds, flour |
| Dark chocolate truffles (2 or 3) | about 2 mg | Chocolate |
| Clementines (2) | about 10 mg | 7.5 mg per 100 g |
Even at the high end, a dessert serving is under 5% of a 400 mg daily guide. For comparison, a serving of roast turkey has close to 200 mg. Pumpkin, apple and pecan pie are covered in our Thanksgiving with gout guide, the rest of the menu in Christmas dinner with gout, and chocolate in is chocolate bad for gout?
The real issue: sugar and fructose
Table sugar is half fructose. And fructose is a special case: when the liver processes it, it burns through a lot of energy, and that process produces uric acid. So unlike the rest of the dessert, sugar does raise uric acid, even with no purines.
In a large study that followed more than 46,000 men for 12 years, drinking two or more sugar-sweetened sodas a day raised the risk of gout by 85%, while diet sodas had no effect (Choi and Curhan, BMJ, 2008). That is why the American College of Rheumatology recommends limiting high-fructose corn syrup, which is found mostly in sweetened drinks (ACR guideline, 2020).
So over the holidays, the biggest fructose sources are not necessarily the desserts:
- Sweet drinks: soda, fruit juice, punch, eggnog, cocktails and liqueurs. A big glass of juice goes down fast and holds the sugar of several fruits.
- Dried and candied fruit: dates, dried figs and the candied peel in fruitcake concentrate the fruit's sugar.
- The pile-up: dessert at every meal from Thanksgiving to New Year's.
Whole fruit is not the enemy: a clementine has little sugar, along with fiber and water.
Enjoying dessert: 6 habits
- One slice, not two: dessert isn't the problem, the third slice is.
- Water at the table rather than soda or juice with dessert.
- Fresh fruit as an option: clementines, kiwi, pineapple, a fruit salad.
- Dark chocolate rather than very sweet candy: it has few purines and less sugar.
- Share the leftovers: send the cookie tin home with guests instead of finishing it over the week.
- Watch boozy desserts: rum cake, spiked eggnog and mulled wine add alcohol, which also raises uric acid (see alcohol and gout).
See your holidays at a glance
With the Gout-Cha! app, you snap a photo of your plate, dessert included, and see its purine total and what's left of your daily budget. Handy to keep the big picture over a week of celebrations, and to spot what comes before your flares.
Frequently asked questions
Does sugar raise uric acid?
Yes, because of fructose, which makes up half of table sugar. The liver produces uric acid as it processes it. Sweetened drinks are the main concern: two or more sugary sodas a day have been linked to an 85% higher risk of gout.
Are desserts bad for gout?
Not because of purines: a slice of yule log or cake has only a few milligrams. Their drawback is sugar. One reasonable serving is fine; it's the accumulation over several days, and sugary drinks, that matter.
Is fruitcake OK with gout?
It is low in purines, but dried and candied fruit make it very sugary. A thin slice is fine; it's not something to snack on all week.
Should you avoid fruit because of fructose?
No. Studies mainly point to sweetened drinks and juice. A piece of whole fruit has far less sugar than a big glass of juice, plus fiber. This article is not a substitute for medical advice.
