: Apple(Fructose) and Uric Acid Recently I've been reading about fruits to be consumed when you have high level of uric acid in blood. One thing I found contradicting is most of the reputed websites mention Apple is good to

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A medium apple (182 g) can contain ~10 grams of fructose (NutritionData).

1) The claims that apples lower blood uric acid are not supported by evidence.

Times of India says that apples, because they are high in malic acid, can lower blood uric acid and Livestrong says that apples have this effect, because they are high in vitamin C, but neither of them provide any evidence for that.

2) Apples increase blood uric acid shortly after ingestion.

In the study The effects of apples and apple juice on acute plasma uric acid concentration (AJCN, 2018), the ingestion of apples with 26.7 g fructose in total increased blood uric acid (measured 30 minutes after ingestion).

3) Frequent consumption of apples have been associated with an increased risk of gout.

The study Soft drinks, fructose consumption, and the risk of gout in men (BMJ, 2008) found an association, but not a direct cause-effect relationships, between high apple consumption and gout:

Other major contributors to fructose intake such as total fruit juice
or fructose rich fruits (apples and oranges) were also associated with
a higher risk of gout.

4) Moderate fructose intake does not increase uric acid levels in blood and the risk of cardiovascular disease.

Fructose Intake, Serum Uric Acid, and Cardiometabolic Disorders: A Critical Review (Nutrients, 2017):

In summary, a specific causal link between fructose consumption,
hyperuricemia, and CVD has not yet been established. There is an
association between UA and established cardiovascular risk factors,
and there is a limit to how much population-based studies can adjust
for confounding variables. As such, it is not yet possible to
conclude that fructose intake is the main contributor to an increase
in blood UA, and that this detrimentally affects vascular health.

...hypercaloric supplementation of control diets with fructose (+35%
excess energy) at extreme doses (213–219 g/day) significantly
increased serum UA compared with the control diets alone.

5) Fructose intake that does not contribute to excessive calorie intake does not increase the risk of gout.

The Effects of Fructose Intake on Serum Uric Acid Vary among Controlled Dietary Trials (The Journal of Nutrition, 2012):

These analyses do not support a uric acid-increasing effect of
isocaloric fructose intake in nondiabetic and diabetic participants.
Hypercaloric fructose intake may, however, increase uric acid
concentrations.

6) Fruits and gout

The effects of fruit consumption in patients with hyperuricaemia or gout (Rheumatology, 2019):

Fruits contain fructose, but not all studies suggest they increase the
risk for gout. Several reasons appear to account for this, including
the relatively small amount of fructose in an individual fruit and the
association with substances in fruits that slow absorption (e.g.
fibre), stimulate excretion (vitamin C) or block fructose metabolic
effects (epicatechin)...In addition, people
who ingest high amounts of fruit are often reducing their intake of
refined sugars, so that overall fructose intake may be low.

In summary, apples do not decrease but increase the levels of uric acid in blood, but an apple or two a day (10-20 g fructose) is unlikely to increase the risk of gout or other conditions related to blood uric acid levels.