Apple juice is very low in purines but contains naturally occurring fructose (about 6–7 g per 100 ml), which can acutely raise serum uric acid. A 2022 trial found that 340 ml (about 1.5 cups) raised uric acid by ~17 µmol/L within 30 minutes. Epidemiological data shows men who consumed 2+ servings/day of apple or orange juice had a 1.82× higher gout risk. However, the fruit matrix (vitamin C, polyphenols) may partly offset the effect — some trials even showed 100% fruit juice decreased uric acid in addition studies. Current guidelines (ACR, Austrian, Chinese) conditionally recommend limiting high-fructose juices, while NICE takes a more lenient view. For people with well-controlled gout, an occasional small glass (100–150 ml) is unlikely to be harmful. For those with active gout or frequent flares, it is prudent to limit intake to no more than one small serving occasionally, or choose whole apples instead for the fiber and lower glycemic load.

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