Uric Acid Isn’t Just About Gout Anymore

We used to think that Gout was a result of kidney disease or an old man’s problem. He drank too much beer and alcohol and ate too many animal products. But new research pins uric acid (UA) levels to more than just a marker of Gout.

A 2020 study in Scientific Reports involving over 500,000 participants checked annually for 7 years, showed that in men with a UA of 7 mg/dL or greater than 7, or women with a UA of 5 mg/dL, there was a significant increase in all cause mortality. Meaning that if your UA numbers were greater than 7 in men and 5 in women, you were more likely to die from any cause than in someone with a lower UA levels.

They looked into specific causes and found a 38% in cardiovascular mortality in both men and women with levels of uric acid above 7mg/dL and 5 mg/dL respectively. Deaths from stroke were also increased in this group by 32%. Further, for every 1 point increase in a person’s uric acid levels was equal to a 13% increase in all over mortality. And while these are correlated studies, it is significant and quite disturbing.

What is a stunning about this is that the normal lab values are 3.5- 7.2. Which means you have a normal uric acid level, but potentially have a 38% chance increase of dying from cardiovascular disease. And what is clear from the study is those people in the high end of normal range UA did in fact have more deaths than those in the lower range.

What is uric acid and why do we have it?

Uric Acid goes back to our old ancestor homosapiens and the metabolism of fructose. Fructose stimulates the production of uric acid. Those who had a genetic variation that prevented homosapiens from breaking down UA allowed them to get a bit fatter when the fall fruits, full of fructose, came to ripen. This prepared them to survive the winter when foods were more scarce.

Our bodies can make a little bit of fructose which also serves as a mechanism of survival. When we are dehydrated our bodies turn on a metabolic pathway to increase fructose into our bodies and thus store more fat. When we metabolize that fat we make carbon dioxide and water. So whether we are being couch potatoes or actually experiencing an episode of true scarcity, our bodies can turn on a mechanism to store or make us more fat.

But living in the 21st century in a modern country we almost never experience scarcity. In fact, we have an obesity epidemic. And fructose is everywhere. Anything with high fructose corn syrup is fructose, juice, fruit, especially dried fruit anything sweetened with cane sugar, beet sugar has fructose. Ketchup, salad dressings even most commercially made breads and crackers have fructose. You will find some source of fructose in almost all processed foods. If it is in a bag, box or bottle it probably has fructose in it.

So the survival of the fittest got us here but the truth is that now that we can go to any store in the middle of winter and fill a basket of food this uric acid gene isn’t really helping us.

What Can You Do?

Well the good news is you can do quite a lot. First you don’t even have to go to your doctor. You can order a very inexpensive UA test from even amazon. With Ultra Lab Tests  you can order the test, pay safely online and then go to one of 2500 lab draw stations across the country. They will email you when your results are in a private secure patient portal.  If you want to learn more about foods that are high in fructose check out My Food Data.

If your UA is above 5 mg/dL in women or 7 mg/dL in men you can lower it in the following ways:

• Reduce your alcohol intake, especially beer and spirits
• Reduce your intake of organ meats like liver, heart, tongue as well as red meats like beef, pork, lamb and venison
• Reduce your intake of shrimp, salmon, mussels, anchovies, sardines and lobster
• Add vitamin C to your diet.  Many fruits are high in Vitamin C but be careful about too much fructose which can contribute to high UA levels.  Tart Cherries are an excellent source.  Put a splash of Tart Cherry Juice in a glass of water for a refreshing treat that also clears out UA.  Berries and Cherries are you best bet for Vitamin C and fruits
• If you are taking Vitamin C start at 500 mg 1-2 times per day.   
• Black but especially green tea has been shown to reduce gout attacks
• Lower your sugar intake
• Take a 15 minute walk after meals.  Elevated levels of glucose are associated with UA levels and just taking a short walk after eating can do wonders for your blood sugar levels
• Stay hydrated.  Remember if your body thinks it is going into a place of scarcity it will cause you to store fat through the fructose and uric acid pathways. 
• When eating eat your protein and fat before your carbs.  Just this simple approach will help your blood sugar stay more stable which indirectly helps keep your UA levels down

When you are shopping at the super market try getting most of your items from the perimeter of the market not in the aisles which is where almost all of the processed foods are located.

Remember eating foods that look like they did when they were harvested from the ground, ocean or land are more likely to be less processed and less likely to have fructose.   Start reading labels.  Manufactures are labeling fructose under many different names as it becomes more clear that this cheap sugar has serious health consequences.  Here are the top name alternative names for fructoses:  high fructose corn syrup, corn syrup, glucose syrup, glucose/fructose syrup, maize syrup,  isoglucose, tapioca syrup, dahlia syrup, fruit fructose and crystalline fructose.  

Looking for recipe ideas?  Here are some of my favorite online recipe sources

• Food52.com – They have beautifully laid out photos. with many reviews.  Sometimes I just put in the ingredients I have in the fridge and see what pops up.
• The Mediterraneandish.com – This site has so many yummy recipes.  Great for hot weather as their salads are simply amazing

• The New York Times What to Cook – This is one of my go to for cooking.  If you have a subscription you can get a more extensive recipe list and  like Food 52 you can create your own favorites.
• Or just google “recipes  healthy Chinese”  or  “recipes  healthy Mexican” or my current favorite is Persian recipes.

So happy reading, cooking and healthy living