Too much uric acid is known to cause gout – a painful inflammation in the joints, usually in the big toe.
Many foods can increase uric acid levels, including seafood, red meat, and beer, and people suffering from gout are advised to avoid them.
But uric acid has also been linked to weight gain, high blood pressure, insulin resistance (a precursor to type 2 diabetes) and chronic inflammation, according to a new book by a US neurologist and expert on nutritional approaches to disease.
The implication is that this understanding could open up new ways to tackle some of our biggest killers – like heart disease, stroke and dementia.
In fact, far from playing a minor role in our metabolic health, uric acid is more like a conductor, suggests the book’s author, Dr. David Perlmutter, Associate Professor at the University of Miami Miller School of Medicine.
Too much uric acid is known to cause gout – a painful inflammation in the joints, usually in the big toe
dr Perlmutter says that in the course of his research he “kept coming across studies that show that too much uric acid is not only bad for the brain, but can also be harmful to your health in a variety of ways”.
Many of the foods associated with uric acid production are high in purines. Another source of uric acid is the breakdown of the sugar fructose in the body.
Fructose, which naturally comes from the fruits and vegetables in our diet, isn’t a problem, says Dr. Mother-of-pearl, because “this fructose is combined with fiber, which is great for feeding your gut bacteria and a range of useful vitamins and minerals”.
But fructose isn’t as beneficial when it’s in the form of table sugar — standard sugar is a 50:50 combination of fructose and glucose. “And the fructose content triggers the increase in uric acid and the subsequent effects,” explains Dr. mother of pearl.
There is also fructose in the form of high fructose corn syrup, which is added to convenience foods such as cakes, cookies, and pizzas, primarily in the United States
Many foods can increase uric acid levels, including seafood, red meat, and beer, and people suffering from gout are advised to avoid them
dr Perlmutter says it’s not just people with gout who have elevated uric acid levels — but also those with other chronic conditions, like obesity, heart disease and type 2 diabetes.
For example, a 2008 study in the Journal of the American Medical Association showed that 90 percent of obese youth with high blood pressure had high levels of uric acid. However, when they were given the gout drug allopurinol to lower their uric acid levels, it improved their cardiovascular risk factors, including blood pressure and fats in their blood.
Then a 2011 review in the journal Seminars in Nephrology linked rising uric acid levels in the US population to increases in gout, obesity, and high blood pressure. The authors suggested sugar and fructose in soft drinks as likely causes.
Uric acid has also been linked to more specific conditions like impotence, irregular heart rhythms, sleep apnea, osteoporosis and blood clots in the legs, says Dr. Robert Lustig, Professor Emeritus of Pediatrics at the University of California, San Francisco and a leading researcher in the field of uric acid.
These studies don’t prove uric acid is the cause, warns Dr. Perlmutter, “but there are many ways that elevated uric acid can damage blood vessels, for example.”
High uric acid levels can reduce the supply of nitric oxide, which among other things keeps the arteries flexible and increases blood flow during an erection.
Fructose not only contributes to heart disease by causing inflammation, but “it also dampens the effects of three enzymes that are critical to the performance of mitochondria, the powerhouses of our cells,” adds Dr. Funny added.
But others are not convinced. “Fructose accounts for around 3.5 per cent of our energy intake in the UK and is not a cause for concern,” says Douglas Twenefour, deputy head of care at the charity Diabetes UK.
“In most studies that have linked fructose intake to insulin sensitivity or uric acid production, participants’ diets were supplemented with high doses of pure fructose and compared to high doses of glucose. This does not reflect what happens in real life.’
and dr merry says more research is needed to confirm the links. In the meantime, drug-free approaches could be beneficial. For example, getting enough sleep and exercise – a lack of either is known to increase uric acid.
More controversially, a low-carb diet might help, suggests Dr. David Unwin, a GP from Stockport in Lancashire who pioneered the use of this approach to treat type 2 diabetes.
“I’ve treated more than 1,000 diabetic patients on the low-carb diet over the past decade and none have developed gout,” he says.
“But the type 2 patients who don’t do the diet are very likely to suffer. So it seems very likely to me that elevated uric acid is a marker of a metabolic problem.”
On the recommendations of Dr. Mother-of-pearl includes vitamin C—since it helps clear uric acid—and tart cherries; and the antioxidant quercetin. These target an enzyme that makes uric acid.
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