Saturday, November 27, 2010

Gout - Fructose & alcohol impact on uric acid

Has anyone of you miss work due to suffering from Gout? What is Gout? It is an arthritis-type of pain condition which cause swelling, inflammation and extreme pain mainly in the joints especially big toe. It is caused by elevated uric acid levels in the blood. Gout appears to be more common in men then women. It is one of the most frequently diagnosed conditions as well. Gout attacks can be sudden, lasting from few hours to days. 

All animals have uric acid in their blood. Most mammals, fish and amphibians, have very low levels of uric acid, because they possess an enzyme that converts uric acid to a substance called allantoin. Human evolved without this enzyme, so we tend to develop a high uric acid levels. Although humans evolved with relatively high uric acid, our grandparents and great grandparents probably had lower uric acid levels then we do. What causes elevation in uric acid? 

Sugar. Yes, particularly fructose. Doesn't make sense? Well, what does your doctor tells you of the root cause when you were diagnosed with Gout? If any of you would to know the unique metabolism of fructose in the liver,  you will know exactly what I meant. Fructose is so destructive, that I would personally called it a 'poison', if consumption is above 15g a day. I will not discuss in details about fructose of sugar right now, but I will write all about it in another post. 

When I mention to everyone (colleagues & friends) about what fructose can do to our body, they all looked stunned and unbelievable. Why? Because everyone thinks that fructose is fruit sugar. How can fruits be harmful? Yes, you are right. Fruits should be part of our daily consumption and they are an ideal source of fiber, vitamins and anti-oxidants. Well, not all fruits are considered 'healthy or good'. Why? Let's take watermelon as an example. This fruit is contaminated with pesticides and insecticides, as they are grown on the ground. Watermelon is also a high glycemic type of fruit, which easily cause blood sugar spike when eaten by itself. Watermelon is one of the most common fruit consumed in Malaysia. Most people thinks it is a healthy type of fruit. In fact, most people thinks FRUITS are healthy and recommended to consume plenty of servings everyday. 

I can talk about fruits all day long, but let's focus on fructose impact on uric acid and Gout. First of all, fructose raises uric acid. We consumed more of this sugar today then anytime in the history of mankind. Women appears to have better 'protection' due to estrogen hormone increases the amount of uric acid they eliminate in urine. But, once women reach menopause, their uric acid levels climb. 

Diet has major impact on how much of this compound is in your blood. Anyone loves beer or alcohol? How about regular clubbing getting drunk and intoxicated during the weekends? Alcohol not only raises the production of uric acid, but it also blocks the kidney from excreting the compound. Uric acid can also cause kidney stones and damage to the kidney. In theory, any form of alcoholic beverage will cause elevated uric acid levels. Beer seems to have a strong effect on uric acid. Anyone of you who has 'beer belly' or paunchy midsection, are developing metabolic problems! People who are overweight or obese have higher risk of getting Gout. A beer belly may signal that you already have something called 'Metabolic Syndrome'. I would love to write about Metabolic Syndrome one day and share it with all of you. 

Anyway, I will explain in details about how fructose metabolism in liver raises uric acid and blood pressure in a different post. Thus, most people who has Gout, tends to also suffer from Hypertension. So, avoid processed food such as peanut butter, yogurt drinks, soft drinks, cookies, sports drinks, fruit juices, cakes, candy bars, sweets, and all sugary foods. Avoid meat organs such as liver, kidneys, brains as they are high in purine. Limit yourself on shellfishes such as lobsters and shrimps as they normally contain high purine. Other foods which are quite high in purine are yeast, bacon, scallops, sardines, mutton, etc. More importantly, avoid alcohol especially beer and limit the servings of fruits on daily basis.

So, some of you might ask what diagnosis or test should I approach if I have Gout symptoms? One of the effective diagnosis is called Arthrocentesis. It is an examination of joint fluid using polarized light. I might not have covered everything about Gout or uric acid, but at least you should know by now to avoid food which are high in purine, fructose and alcohol. Good luck!


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