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Paleo, Uric Acid + Fructose

by (1655)
Updated October 30, 2014 at 3:06 AM
Created June 22, 2010 at 5:14 PM

We have on PH an excellent thread on paleo, uric acid, and gout, with many great pointers, here: http://paleohacks.com/questions/988/the-connection-between-paleo-and-gout but I have one important question that is unclear to me:

the (paleo + modern-scientific) consensus seems to be that fructose is the primary cause of gout. BUT: if you have very high uric acid levels, although very low fructose/glucose/etc levels, are you still at risk for gout?

Very selfish reason for asking: just got my blood checked, first time since I went mostly paleo and first time since I started my mostly-offal diet. My sugar and cholesterol and inflammation-related numbers are off-the-chart amazing, I'm super happy. Except my uric acid # is off-the-chart terrible. Traditional interpretations would, I think, put me at super-high risk for gout now; but since I eat almost no fructose/sugar/etc, I'm not sure if I should be concerned about the high uric acid and change my eating patterns or not....

Thanks!

morgan

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1973 · June 23, 2010 at 3:34 AM

Here is the reference for uric acids role in primate life span http://www.ncbi.nlm.nih.gov/pubmed/6532339

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1973 · June 23, 2010 at 3:33 AM

Here's the reference for lifespan http://www.drproctor.com/rev/cutler1.htm

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3703 · June 23, 2010 at 3:18 AM

EXACTLY! It's the carbs from grains and fructose from hone/fruit that go along w/ lobster, sweet meats and other high-purine categorized foods... Please refer for more details to Tourgeman's account (he's a nephrologist): http://nephropal.blogspot.com/search/label/uric%20acid

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56616 · June 23, 2010 at 3:07 AM

It's hard for me to believe that purines are so terrible when organ meats, shellfish, and other high uric acid foods have long had a large role in the Human diet.

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2181 · June 23, 2010 at 2:08 AM

Other primates have uricase, an enzyme that breaks down uric acid. Your second assumption about human adaptation is most likely correct. One line of thinking is that since higher uric acid results in higher blood pressure, that this was selected in humans to raise the blood pressure which was necessary for walking erect.

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10502 · June 22, 2010 at 8:25 PM

Read the missing chapter on goat from GCBC by Taubes: http://www.fourhourworkweek.com/blog/2009/10/05/gout/

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4 Answers

1a8020e101199de55c1b3b726f342321
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1973 · June 22, 2010 at 7:24 PM

The paleo + modern-scientific consensus is not really as strong as you state it, it's more speculation that excessive fructose intake across a population may lead to increased gout incidence.

There are some serious confounding factors to take into account. We seem to have higher levels of uric acid than most other primates, and it may be related to our lifespan.

High uric acid concentrations could be a human specific adaptation for whatever reason, and in certain circumstances it brings about something negative (gout).

485bcefe7f1f7a6df1a293a826bf6137
2181 · June 23, 2010 at 2:08 AM

Other primates have uricase, an enzyme that breaks down uric acid. Your second assumption about human adaptation is most likely correct. One line of thinking is that since higher uric acid results in higher blood pressure, that this was selected in humans to raise the blood pressure which was necessary for walking erect.

1a8020e101199de55c1b3b726f342321
1973 · June 23, 2010 at 3:34 AM

Here is the reference for uric acids role in primate life span http://www.ncbi.nlm.nih.gov/pubmed/6532339

1a8020e101199de55c1b3b726f342321
1973 · June 23, 2010 at 3:33 AM

Here's the reference for lifespan http://www.drproctor.com/rev/cutler1.htm

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2181 · June 23, 2010 at 2:11 AM

As usual, no studies have been done on people eating paleo, so we don't know if it's the uric acid itself or the fructose/glucose causing or in combination with uric acid which results in gout. I'm inclined to believe the latter.

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1451 · June 22, 2010 at 8:35 PM

In The Sugar Fix, Richard Johnson, MD demonstrates that people with elevated uric acid are at higher risk for a lot more than just gout: high blood pressure, obesity, heart disease, stroke, kidney disease, and others. He and his team have been studying the effects of uric acid on health, mainly hypertension, for many years. His book grew out of the recognition that fructose elevates uric acid, but it's not the only factor.

If eliminating fructose is not doing the trick, Johnson recommends also avoiding foods high in purines. They have been known for some time to cause elevated uric acid levels. Unfortunately, your offal or organ meats are very high in purines. Beer is very high, as are certain seafoods such as anchovies, clams, herring, lobster, mackerel, mussels, oysters, sardines, scallops, and shrimp. He actually recommends eating these foods no more than once a month, if your uric acid is high.

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3703 · June 23, 2010 at 3:18 AM

EXACTLY! It's the carbs from grains and fructose from hone/fruit that go along w/ lobster, sweet meats and other high-purine categorized foods... Please refer for more details to Tourgeman's account (he's a nephrologist): http://nephropal.blogspot.com/search/label/uric%20acid

9d43f6873107e17ca4d1a5055aa7a2ad
56616 · June 23, 2010 at 3:07 AM

It's hard for me to believe that purines are so terrible when organ meats, shellfish, and other high uric acid foods have long had a large role in the Human diet.

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0 · June 22, 2010 at 6:26 PM

For what its worth, the wikipedia page for gout says that "most people with raised uric acid levels never develop gout."

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