Gout and gout prevention

Hyperuricemia (excess of uric acid in the blood) is the precursor of gout, which is the most common inflammatory arthritis in men. Excess uric acid builds up in the blood and is deposited as crystals rather than being excreted by the kidneys. These crystals typically form in the toe joints and can graduate to other joints. I [the author] have suffered from mild gout since 2013. I say mild but it was still excruciating, my left toe felt like it was broken and it wasn't diagnosed as gout in a UK hospital (quite how a swollen big left toe that wasn't broken, on a man in his 40's wasn't spotted baffles me). Many hours of research seemed to point to food, beer and hydration. Not drinking enough water and sweating from hard exercise seemed to been the trigger for me. The healthcare advice seems to blame eating too many "purines" and drinking alcohol.  But I actually now, 5 years later, believe that gout coverage in the media and on the internet is deliberately misguiding (blaming shellfish and liver!).

Gout

The literature seems to suggest not eating high purine containing healthy foods (shellfish, oily fish, organ meats) and completely ignores the utter poison that is fructose, added sugar and HFCS. The doctors and "health professionals" conveniently never mention fructose. You could ask 100 gout sufferers and not one would mention fructose. But they would all know about Allopurinol (the drug doctors put you on for life). The causes of gout are not the same as the triggers for gout. Vegetables and fruits also have "high" purines such as raisins, broccoli, brussel sprouts, banana and spinach. Only a fool would exclude these from their diet... forget the purines, ditch the sugar!

Purines

Gout attacks can be avoided (drug free) by:

  • Constant hydration (especially if you exercise heavily or go on a ski holiday or an activity break).
  • NO FRUCTOSE: Stay away from sugary drinks (cola, orange juice, tonics, fruit juices) and processed food. Fruits contain fructose, but they digest slowly and don't overload the liver.
  • Drink lemon water regularly (the citric acid will help).
  • Take apple cider vinegar daily. Apple cider vinegar (ACV) is one the oldest and most effective remedies for gout.
  • Moderating or changing your alcohol consumption (switch away from beers heavy in brewers yeast, add ice or soda water to your drinks).
  • Good electrolyte intake (salt, potassium, magnesium, calcium, zinc). Eat More potassium-rich foods: Potassium deficiency is sometimes seen in people with gout, and potassium citrate, which is known to alkalize your urine, helps your body to excrete uric acid. Gerolsteiner mineral water is a great option as it's very high in magnesium.
  • Eating some gout friendly foods See below).
  • Eat lots of celery (see below).
  • Drink aronia juice (see below).
  • Drink dandelion tea.
  • Supplement with L-Glutamine.
  • Eat vitamin A and vitamin C rich foods
  • Lose some weight and control insulin. When people are overweight or obese, their bodies produce more insulin. Higher levels of insulin circulating throughout the body inhibit uric acid elimination by the kidneys. This excess uric acid can lead to gout. An elevated serum uric acid is also one of the best independent predictors of diabetes and commonly precedes the development of both insulin resistance and diabetes. So if you are eating and drinking sugary foods and processed carbs, you will have high levels of insulin and get fat. A 2010 Oxford study also documented that weight reduction leads to a considerable reduction of serum uric acid levels.
  • Correct your vitamin and mineral intake (see below).
    • Antioxidant and anti-inflammatory foods
    • Promoting liver and kidney health.
    • Promoting circulatory health.
    • Promoting joint health. Gout is serious and it can escalate to debilitating arthritis.

How much uric acid is in the blood?

Uric acid levels can vary based on sex. Normal values for women are 2.5 to 7.5mg/dL  and for men 4.0 to 8.5 mg/dL. Because only some purines are taken in from diet, someone with a high score of 9 would only drop to an eat eating a perfect low purine food diet.

Hyperuricemia

Hyperuricemia is also associated with several metabolic and other conditions, including diabetes and coronary artery disease. Serum uric acid levels and the frequency of gout have been rising during past decades (along with obesity and metabolic syndrome). This ties in with rising sugar-sweetened soft drinks and added sugar (high fructose corn syrup, HFCS) into processed food over the last few decades.

White sugar is 50% glucose and 50% fructose. Glucose can be absorbed throughout the body for use as energy, but fructose is targeted like a guided missile to the liver. It's the only place fructose can be metabolised. HFCS in soft drinks and many foods is the HFCS55 variety that contains 55% fructose. Alcohol and fructose are both metabolised in the liver. Fructose has been described as "alcohol without the buzz". The fuctose content of drinks is even worse than you think. Popular beverages made with HFCS have a fructose-to-glucose ratio of approximately 60:40, and thus contain 50% more fructose than glucose. Some pure fruit juices have twice as much fructose as glucose.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3197219/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3197219/

Shocking fructose levels in soft drinks and juices

Actual fructose consumption levels are difficult to estimate because of the unlabeled quantity of fructose in beverages. A 2014 study shows fructose levels way higher than was thought. Popular beverages made with HFCS have a fructose-to-glucose ratio of approximately 60:40, and thus contain 50% more fructose than glucose. Some pure fruit juices have twice as much fructose as glucose. Shocking!!!

    Fructose %       Glucose %      Fructose g/litre
 Coca-cola  59.4%  39.6%  62.5g (total sugars: 105.2g)
 Pepsi  60% 40%  65.7g (total sugars: 109.5g)
 Dr Pepper  60.2%  38.8%  61.4g (total sugars: 102.0g)
 Sprite  60%  39%  62.5g (total sugars: 104.2g)
 Mountain Dew  59.5%  39.6%  72.3g (total sugars: 121.5g)
 Iced Tea  59.4%  39.6%  59.3g (total sugars: 99.8g)
 Tonic Water  55%  45%  49.0g (total sugars: 89.0g)
 Red-Bull  55%  45%  55.0g (total sugars: 100.0g)
 Tropicana Orange Juice  52%  48%  52.4g (total sugars: 99.5g)
 Apple Juice (Minute Maid)  67%  33%  73.4g  (total sugars: 109.6g)
 Oceanspray Cranberry Juice    58.4%  41.6%  59.0g (total sugars: 99.4g)

There are 4g of sugar in a sugar lump. So drinking 1 litre of Pepsi equates to 27 sugar lumps (the equivalent of 18 lumps are  fructose which would go straight to the liver).


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