Several studies suggest a favorable effect of 100% fruit juice (100%FJ) on cardio-metabolic risk. However, international dietary guidelines disagree on recommendations regarding fruit drink consumption, and the published European Food Safety Authority draft, based only on epidemiological data, suggested a direct relationship between 100%FJ intake and the development of type 2 diabetes mellitus (T2DM) and gout. Thus, we performed a systematic review of both randomized controlled trials (RCT) and prospective studies that assessed the relationship between 100%FJ intake, uric acid metabolism, and glucose profile. Concerning previous meta-analyses, no new prospective studies were identified for the evaluation of T2DM, and no studies were identified for the assessment of gout risk in the general population; conversely, 3 studies were detected for the assessment of gestational diabetes risk. Moreover, new RCTs were detected and included in an updated meta-analysis on glucose profile and uric acid. 100%FJ intake was associated with a decrease in uric acid, and neutral associations were found for different markers of glucose metabolism and the risk of gestational diabetes. In summary, this meta-analysis confirmed that there was no difference between 100%FJ intake and the comparator on glucose metabolism. It also showed that 100%FJ intake resulted in lower levels of uric acid than the comparator. In addition, the analysis indicated a neutral effect of 100%FJ on gestational diabetes. Finally, the systematic review confirmed the neutral effect of 100%FJ on T2DM and suggested the need for further studies to evaluate the risk of gout.
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