Gout is a medical condition that usually presents with recurrent attacks of acute inflammatory arthritis (red, tender, hot, swollen joint). It is caused by elevated levels of uric acid in the blood. The uric acid crystallizes and deposits in joints, tendons, and surrounding tissues.
I have heard that the pain experienced during an episode of gout is akin to having someone walk on your eyeballs. Sounds like some pretty serious stuff if you ask me.
We have all probably heard that gout is brought on by consuming too much red meat and alcohol. This misconception has been around for well over 100 years and just won't go away. This past Christmas, while enjoying a delicious feast of prime rib roast and wine with our extended family, someone chimed in, half joking, that we were all going to get gout. Where did this faulty science originate?
The faulty logic comes from the following: There is a protein compound known as purines that is found in every cell of your body as well as virtually every food; meat having the highest concentration. When these purines are broken down by your cells, uric acid is produced. If we go back to the definition of gout, we will see that gout is caused by elevated levels of uric acid in the blood. At first glance this seems to be solid science, but the problem is that the production of uric acid doesn't necessarily result in an elevated level in your blood.
If you're a little confused, think about this in terms of cholesterol. If you eat a lot of dietary cholesterol, that will not, in and of itself, have a direct effect on the level of cholesterol in your blood. This is because your body auto-regulates itself and slows down its own production of cholesterol if you are eating plenty of it. Back to uric acid, a high purine diet will have a negligible effect on uric acid levels in the blood because the kidneys increase their excretion of uric acid.
So what causes uric acid levels to increase? I know this will shock you, but like the other diseases of civilization, insulin resistance, hyperinsulinemia, and fructose are to blame. When one is insulin resistant, uric acid excretion by the kidney is decreased. Therefore, anything that raises insulin levels would in turn raise uric acid levels and cause gout.
Whereas glucose indirectly increases uric acid levels by decreasing uric acid excretion, fructose has a more profound, double whammy effect by not only increasing uric acid production, but by also reducing the excretion of uric acidy by the kidney.
Why then has the sugar/fructose hypothesis been ignored by the masses? It all comes down to money. In the 1960s, shortly after the formation of this hypothesis, allopurinol, a drug for curing gout, was discovered and funding for nutritional research was cut-off. Why spend time and money researching something that they could now cure?
Even more frustrating is a 2004 article in the New England Journal of Medicine by Walter Willett, Gary Curhan, and their Harvard colleagues reporting that men with gout seemed to eat more meat than healthy men. In it, Gary Curhan admits that he might have once known that fructose raised uric acid levels, but that it had slipped his mind. He also acknowledged that he never knew that sucrose was half fructose! Remember, this guy is regarded as the ultimate authority on gout. The establishment can truly be a scary thing.
To sum this all up, if someone you love is suffering from gout, have them avoid sugar, especially fructose, while still enjoying the oh so delicious rib eye steak.