Is Pineapple Good for Gout? Bromelain Benefits vs. Fructose Risk

Pineapple occupies a genuinely nuanced position in gout management. Unlike most foods that are clearly helpful or clearly problematic, pineapple contains bromelain, an enzyme with real anti-inflammatory properties, alongside a moderate fructose load that can increase uric acid production. The answer to whether pineapple is good for gout depends on how much you eat and in what form.

What is bromelain and why does it matter for gout?

Bromelain is a mixture of proteolytic enzymes found naturally in pineapple, with the highest concentration in the stem and core. It has been studied extensively for its anti-inflammatory and analgesic properties, and it is sold as a dietary supplement for various inflammatory conditions.

The relevance to gout is direct. Gout flares are driven by an acute inflammatory response when monosodium urate crystals activate the NLRP3 inflammasome in joint tissue. This triggers a cascade of inflammatory mediators including IL-1 beta, TNF-alpha, prostaglandins, and other cytokines that cause the pain, swelling, and redness characteristic of a gout attack.

Bromelain acts on several points in this inflammatory cascade:

• Inhibits COX-2 activity, reducing prostaglandin production (similar to NSAIDs like ibuprofen, though weaker)
• Reduces pro-inflammatory cytokines including TNF-alpha and IL-1 beta
• Modulates the kinin-kallikrein system, which contributes to pain and swelling
• Has fibrinolytic activity, which may help reduce edema around inflamed joints

A 2004 review published in Evidence-Based Complementary and Alternative Medicine concluded that bromelain has demonstrated anti-inflammatory effects across multiple study types and is a promising agent for inflammatory conditions. A 2012 study in Biotechnology Research International confirmed that bromelain reduces inflammatory markers in both acute and chronic inflammatory models.

How much bromelain is actually in pineapple?

Here is where the nuance becomes important. Most clinical studies on bromelain use supplemental doses ranging from 500mg to 2,000mg per day of concentrated bromelain extract. The amount of bromelain in a cup of fresh pineapple flesh is considerably lower.

Fresh pineapple flesh contains bromelain, but the concentration varies depending on ripeness, variety, and which part of the fruit you eat:

• Pineapple core: Highest bromelain concentration
• Flesh near the core: Moderate concentration
• Outer flesh: Lower concentration
• Pineapple juice: Minimal active bromelain (processing and pasteurization degrade the enzyme)
• Canned pineapple: Very little active bromelain (heat destroys the enzyme)

Eating fresh pineapple, especially including the core (which is edible, just firmer), provides some bromelain. But it would be misleading to suggest that eating pineapple delivers the same therapeutic dose used in clinical studies. The effect from fresh fruit is real but modest compared to supplementation.

If you are interested in bromelain specifically for its anti-inflammatory properties, discuss supplementation with your healthcare provider. Bromelain supplements can interact with blood thinners and certain antibiotics.

What about pineapple’s fructose content?

A cup of fresh pineapple chunks contains approximately 7 grams of fructose. This places it in the moderate range among common fruits:

Fruit (per cup or medium piece)	Fructose
Strawberries (1 cup)	~3.5g
Blueberries (1 cup)	~5g
Orange (1 medium)	~6g
Pineapple (1 cup)	~7g
Banana (1 medium)	~7-8g
Grapes (1 cup)	~8g
Apple (1 medium)	~10-13g
Mango (1 cup)	~12g

At 7g per cup, pineapple’s fructose content is moderate. It is meaningfully higher than berries but substantially lower than apples, grapes, or mangoes. The concern with fructose and gout is the liver pathway described earlier: fructose is rapidly phosphorylated by fructokinase, depleting ATP and generating uric acid as a byproduct.

The key question is whether the anti-inflammatory benefit from bromelain offsets the uric acid increase from fructose. At one cup per day, the fructose load is manageable, especially when the fruit’s fiber (about 2.3g per cup) slows absorption. At three cups per day - as some wellness blogs recommend for gout - the fructose load reaches 21g in a form that still hits the liver faster than whole oranges or apples due to pineapple’s relatively lower fiber density.

Does pineapple’s vitamin C help with uric acid?

One cup of pineapple provides approximately 79mg of vitamin C, which is about 88% of the daily recommended intake. Vitamin C supports uric acid management by competing with uric acid for reabsorption in the kidney tubules, effectively increasing uric acid excretion.

A meta-analysis in Arthritis Care & Research found that 500mg/day of supplemental vitamin C reduced serum uric acid by an average of 0.35 mg/dL. A cup of pineapple contributes meaningfully to daily vitamin C intake, though it does not provide the full therapeutic dose studied in trials.

The vitamin C in pineapple is an additional point in its favor, partially counterbalancing the fructose content by supporting the excretion side of the uric acid equation.

How does the glycemic impact factor in?

Pineapple has a glycemic index (GI) of about 59, which places it in the medium range. More relevant is its glycemic load (GL) per serving, which is approximately 7-8 for one cup. This is moderate and unlikely to cause significant insulin spikes in the context of a mixed meal.

Why does this matter? Insulin resistance is a major driver of reduced uric acid excretion. When insulin levels are chronically elevated, the kidneys retain more uric acid. Foods that cause large insulin spikes contribute to this pattern over time. Pineapple’s moderate glycemic load, especially when eaten with protein or fat (which further blunts the insulin response), makes it a reasonable choice from a metabolic standpoint.

Fresh pineapple vs. pineapple juice vs. canned

The form of pineapple you choose makes a significant difference:

Fresh pineapple is the best option. It retains active bromelain (especially the core), provides intact fiber, and has no added sugars. The fiber slows fructose absorption and supports gut health.

Pineapple juice is substantially worse for gout. An 8oz glass of pineapple juice contains roughly 12-16g of fructose with zero fiber. Pasteurization also destroys most of the bromelain enzyme, eliminating the primary benefit. Pineapple juice gives you the fructose problem without the bromelain solution.

Canned pineapple in juice is a moderate option. It retains some nutrients but loses most active bromelain due to heat processing. The juice adds extra fructose. If choosing canned, select pineapple packed in its own juice rather than heavy syrup.

Canned pineapple in heavy syrup is the worst option. The added sugar can more than double the fructose per serving, and the bromelain is degraded by processing.

Frozen pineapple retains nutrients reasonably well and can still have some active bromelain depending on the freezing process. It is a practical alternative when fresh pineapple is unavailable.

What is the best way to eat pineapple with gout?

If you want to include pineapple in a gout-friendly diet, these strategies maximize the benefits and minimize the risks:

Stick to about one cup of fresh pineapple per day. This keeps fructose at a moderate 7g while providing meaningful vitamin C and some bromelain.

Eat the core. The core contains the highest concentration of bromelain. It is tougher than the outer flesh but perfectly edible. Chop it into smaller pieces or blend it into smoothies (with the fiber retained).

Pair it with protein or dairy. Eating pineapple with Greek yogurt, cottage cheese, or as part of a savory dish slows sugar absorption and provides casein and lactalbumin, dairy proteins that research has shown promote uric acid excretion. Cherries are another fruit with strong research backing for gout.

Avoid pineapple juice. The fructose concentration is high and the bromelain is mostly destroyed. If you enjoy pineapple flavor in beverages, blend fresh pineapple with water and keep the pulp.

Track your response. Because pineapple sits in a genuinely ambiguous zone for gout, personal tracking is especially valuable. An app like Urica can help you log pineapple intake alongside flare data and see whether it correlates positively, negatively, or neutrally with your individual patterns over time.

Does pineapple interact with gout medications?

If you take gout medications, be aware of a few potential interactions:

Bromelain and blood thinners: Bromelain has mild blood-thinning properties. If you take warfarin or other anticoagulants (which some gout patients take for comorbid cardiovascular conditions), discuss pineapple consumption with your doctor.

Bromelain and antibiotics: Some research suggests bromelain may increase the absorption of certain antibiotics, including amoxicillin. This is generally considered a beneficial interaction but should be discussed with your prescriber if you are taking antibiotics during a gout flare.

Vitamin C and allopurinol: High vitamin C intake has not been shown to interfere with allopurinol’s effectiveness, and some researchers have suggested the two may work synergistically.

The bottom line

Pineapple is neither clearly good nor clearly bad for gout - it is genuinely nuanced. The bromelain provides anti-inflammatory benefits backed by research, the vitamin C supports uric acid excretion, and the moderate fructose content (about 7g per cup) is manageable in reasonable portions. The key is choosing fresh pineapple over juice, keeping portions to about one cup per day, and considering your total daily fructose intake from all sources. If your overall fructose load is already low, a cup of pineapple is a reasonable and potentially beneficial choice. If you are already consuming significant fructose from other sources, the additional load may not be worthwhile. For more on how different foods interact with gout, see our gout and food guide.

This article is for informational purposes only and is not medical advice. Consult your rheumatologist or healthcare provider about your specific dietary needs.