Gout Alcohol And Fructose
Instead of blaming dietary purines, lets briefly entertain an alternate hypothesis and see whether it fits the facts better. What about the connection between gout and sugar ?
Just like purines, fructose increases the production of uric acid. But it also does something else: it reduces excretion. In terms of raising total uric acid levels, this is much worse, because it also affects the 2/3 of uric acid produced by the body itself. As this study puts it: hyperuricemia in gout is most commonly the result of relative urate underexcretion.
If youre producing more uric acid but then just peeing it all out again, you wont be sick at all. Total uric acid levels will only rise if you cant excrete the uric acid that you produce. Purine-rich foods wont do that, but fructose will.
Then theres the other supporting evidence:
- Gout is strongly associated with diabetes and metabolic syndrome. This suggests that there may be some kind of blood sugar connection, and theres evidence that it goes both ways. Insulin resistance contributes to hyperuricemia, and hyperuricemia induces insulin resistance.
- Alcohol, which behaves a lot like fructose metabolically, also increases production and reduces excretion of uric acid as anyone with gout could tell you after drinking a couple beers.
Gout Purines And Animal Protein
First of all, its important to recognize that there actually is some support for the advice to cut down on meat and seafood.
For one thing, theres the problem of association. Gout is a classic disease of civilization: ever since it was first named and described, its been recognized as a problem for people who have plenty of luxury food. Until very recently, meat was a luxury food, so its not hard to see how eating a lot of meat looked like the cause of gout.
With modern population research, we know that gout is indeed associated with meat intake. In this study, for example, each additional daily serving of meat was associated with a 21 percent increase in the risk of gout, and each additional weekly serving of seafood was associated with a 7 percent increase in risk.
And whats more, theres actually a reasonable explanation of why eating meat could make gout worse. Meat especially organ meats and seafood contains purines, chemical compounds that are broken down into uric acid. So eating more purine-rich food means more uric acid which means more goutright?
Unfortunately, there are a few inconvenient problems with this theory:
- First of all, theres the problem of vegetables. Even though most vegetables are low in purines, a few have a significant amount. But in the NEJM study linked above and in this one , purine-rich vegetables werent associated with gout at all.
This suggests that maybe focusing on purines is looking in the wrong place.
Processed Foods And Refined Carbs
The modern Western diet is often high in processed foods and refined carbohydrates. In addition, processed foods and refined carbohydrates have been linked to an increased risk of type 2 diabetes, heart disease, and weight gain.
A 2017 study looked at gout incidence in people who followed either a Western diet or the Dietary Approaches to Stop Hypertension diet. The researcher found the DASH diet was associated with a lower risk of gout, whereas the Western diet was associated with a higher risk of gout.
To help prevent gout symptoms, its best to limit highly processed foods and beverages and foods high in refined carbohydrates, such as sweets, baked goods and pastries, chips, crackers, cookies, candies, soda, ice cream, white breads, and some pre-made frozen meals.
Eating highly processed foods and refined carbohydrates in moderation will not only help with your gout, but your overall health as well.
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Does Fructose Cause Gout
Fructose is a sugar that is found in fruits and vegetables. It is also found in high levels in foods sweetened with corn syrup, such as bread, cereal, soft drinks and fruit juices. An American study found that men who drank five to six servings of fructose-sweetened soft drinks per week were more likely to have gout. However there is no research showing that fructose actually causes gout. Cutting down the amount of food artificially sweetened with high fructose corn syrup may be beneficial for your overall health. However naturally occurring fructose in fruit and vegetables also provides general health benefits and should not be completely avoided without advice from your doctor or dietitian.
Alternatives To High Fructose Corn Syrup
There are much healthier ways to sweeten your food besides using high fructose corn syrup. Here are some good substitutes for it.
Honey is one of the more accessible sweeteners out there. If youre looking for something that has a milder taste, opt for the acacia honey or clover honey.
Brown rice syrup has a nutty flavor to it so choose wisely which dishes to add itin.
Agave has a neutral flavor compared to honey so it makes for a great sweetener for sweet dishes.
Another good alternative to honey is golden syrup. This sweetener has a buttery flavor to it so pick the right dish to add it into as well.
How has sugar impacted your gout symptoms? And what do you do to minimize high fructose corn syrup in your diet? Share your thoughts in the comments below.
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How Does Too Much Sugar Affect Your Body
Chances are you already know that eating too much sugar isnât good for you. Yet youâre probably still overdoing it. Americans average about 270 calories of sugar each day, thatâs about 17 teaspoons a day, compared to the recommended limits of about 12 teaspoon per day or 200 calories.
Sugary drinks, candy, baked goods, and sweetened dairy are the main sources of added sugar. But even savory foods, like breads, tomato sauce, and protein bars, can have sugar, making it all too easy to end up with a surplus of the sweet stuff. To complicate it further, added sugars can be hard to spot on nutrition labels since they can be listed under a number of names, such as corn syrup, agave nectar, palm sugar, cane juice, or sucrose.
No matter what itâs called, sugar is sugar, and in excess, it can negatively affect your body in many ways. Hereâs a closer look at how sugar can mess with your health, from head to toe.
Look Forward Not Back
Give your taste buds time to adjust. Sugar is a big part of the modern American diet, and your body has become used to the taste, feeling, and consequences of a sugary snack.
It can be difficult to adapt to your new healthier diet, but if you stick with it, soon youll notice the natural sweetness in certain foods, and youll be able to satisfy your sweet tooth while you boost your health with wholesome ingredients.
Attitude and commitment are important parts of any healthy lifestyle change. Stay focused on your goal, appreciate every small gain you make, and keep your health and wellbeing firmly at the top of your priority list.
Realize that sugar is a drug, and cutting it out wont be a walk in the park, but your life will be a lot more comfortable and fulfilling once you reduce your gout risk by limiting your sugar intake.
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Medications That Can Trigger Gout
Some medications can trigger gout symptoms. This includes common pain medications. Even small amounts of these drugs can impact gout. Your doctor may recommend changing these medications if you notice more gout symptoms.
Aspirin or acetylsalicylic acid raises uric acid in your blood. Even low doses of aspirin can trigger gout. Research shows that this effect of aspirin is more common in women than in men.
Diuretics or water pills help to treat conditions such as high blood pressure and edema or swelling in the legs. These medications work by getting rid of excess water and salt from the body. However, they can also cause a side effect of too much uric acid in the body, triggering gout. Diuretic drugs include:
- chlorothiazide
The Cause Of Gout Is More Than Just Diet
While diet is critical, dont overlook other important factors that affect gout. These include family history, sleep apnoea, and lack of physical exercise to name a few.
Further discussion of best treatment for gout is outside the scope of this article. But there are foods thought to be protective namely dairy, cherries, and coffee, in decreasing order of evidence.
And as much as I prefer focusing on what you should eat to prevent health scares, there are just so many clear trigger foods for gout.
Its important to deal with these factors first and foremost.
About Joe Leech, Dietitian
Joe Leech is a university-qualified dietitian from Australia.
He graduated with a Bachelor’s degree in exercise science, followed by a Master’s degree in Nutrition and Dietetics in 2011.
Learn more about him on the About page.
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Temporarily Paralyzed Vocal Cords
Concentrated beet juice has been known to cause temporary paralysis of vocal cords. This is caused by tightened vocal cords which could cause a temporary change in your voice to a hoarse one, difficulty swallowing or coughing.
Although this effect is temporary and causes no harm, it can be very alarming. It is considered an allergic reaction to beets. To avoid it, make a point to mix your beets with other fruits and vegetables when making your juice.
Where Can I Get Advice About My Diet
An accredited practising dietitian can provide you with personalised advice to give you the confidence to eat in a way that is best for you. APDs are university-qualified experts in nutrition and dietetics and are committed to the Dietitians Association of Australias Code of Professional Conduct, continuing professional development and providing quality services.
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Sugar Consumption Increases In Shakespearean England
Sugarcane was originally grown in India in the Ganges River Valley, where it was harvested as early as 500 BC. Nevertheless, sugar remained largely unknown to Europe until the Middle Ages, when some of the earliest reports came from the Crusaders fighting in the Holy Lands. By approximately 1000 AD, however, sugar was entering Europe from Egypt and Ceylon primarily via the port of Venice .
At first sugar was so expensive that it was available only in small amounts and was primarily used as a medicine. For those who were rich, however, sugar became a special, sought-after food. Many kings loved sugar. For example, court records showed that King Edward I of England ordered 1877 pounds of sugar in 1287 and 6258 pounds of sugar in 1288 . Saint Thomas Aquinas of Italy declared that sugar, while being a medicine, could be eaten during the fast . Aquinas went on to become extremely fat himself.
The only other country that was importing sugar to the same extent was Holland, due largely to the formation of the Dutch East Indies Company in 1602. The Dutch brought sugar to Amsterdam from the East Indies. One of the major sources was Java, where the number of sugar mills increased from 20 in 1650 to 130 in 1710.
The Evil High Fructose Corn Syrup
What about high fructose corn syrup? Unlike sucrose and table sugar, which is a 50-50 split of fructose and glucose, high fructose corn syrup contains these sugars in a mix dominated by fructose. In a study conducted by Michael Goran at the University of Southern Californias Keck School of Medicine, in Los Angeles, collected 23 different samples of canned, bottled and fountain sugar sweetened beverages. What they discovered was that all of the soft drinks are 58% fructose or above and the three most popular soft drinks which are Coca-Cola, Pepsi and Sprite contained 65% fructose!
The corn syrup industry insiders are a bunch of liars because they claim that the amount of extra fructose is small at about a 55 fructose and 45 glucose split. Food and beverage manufacturers began switching their sweeteners from sucrose to corn syrup in the 1970s when they discovered that high fructose corn syrup was not only far cheaper to make, its about 20 percent sweeter than conventional table sugar that has sucrose.
Due to its chemical form HFCS is more metabolically risky to you. The fructose and the glucose are not bound together in HFCS, as they are in table sugar, so your body doesnt have to break it down. Therefore, the fructose is absorbed immediately, going straight to your liver. Glucose is the form of energy you were designed to run on.
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Aspirin And Diuretics Significantly Increase Gout Risk
Not exactly foods to avoid with gout, but the ingestion of some common medications sharply raise the risk of a gout attack.
Specifically, low doses of aspirin, which one in three middle-aged Americans takes regularly to help prevent heart disease .
The emphasis is on low doses because aspirin has a dual effect on uric acid levels. Very high doses above 3,000 mg promotes excretion of uric acid , whereas low doses prevent excretion .
In a study of 49 elderly patients, just 75 mg of aspirin per day increased blood uric acid levels by 6% within one week. A daily dose of 150 mg kept levels high during the second week, before coming down with 300 mg doses in the third week .
Considering the typical dose for heart disease prevention is 81-325 mg per day, it is no real surprise this dosage is associated with a doubling in gout risk. In fact, even the use of a low-dose aspirin for two consecutive days increases risk of recurrent gout attacks .
Another type of medication known to trigger gout is diuretics. They are typically used to treat high blood pressure and oedema, and if feasible should be discontinued in gout sufferers.
Im by no means recommending you cease your medications if you have gout, but its important to understand the pharmaceutical triggers. First speak with your doctor and closely monitor uric acid levels before making any changes.
And if you need a temporary painkiller, choose paracetamol or ibuprofen. No aspirin.
Does Fruit Cause Gout Too
Researchers have also linked fruit juice and certain types of fruit, such as apples and oranges, with gout risk. In one study, men who drank two glasses or more of fruit juice a day were nearly twice as likely to get gout as those who drank less than a glass daily.
Yet that doesnt mean you should abandon fruit in your diet. I think its probably a question of quantity, Simkin says. Fruit is high in nutrition you just dont want to overdo it. Its especially important to watch your portion size when it comes to fruit juice, which is more concentrated in fructoseespecially if youre already at risk for gout because of your weight or other factors.
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Fructose And Gout: Whats The Link
Most of us know how sugar affects our waistline. Too much of the sweet stuff contributes to obesity, and with it, diseases like diabetes and heart disease. Overdoing it on one type of sugar in particularthe high fructose corn syrup found in sodas and processed foodscan also set off painful gout. Considering that the average American eats 22 to 30 teaspoons of sugar daily, gout is yet another health risk worth noting.
Fructose is a natural sugar found in fruit and honey. High fructose corn syrup is a man-made sweetener produced from corn. Its composed of 55 percent fructose and 45 percent glucose. Why is this type of sugar harder on your joints than other forms, like glucose? Fructose is metabolized differently from glucose, explains Peter Simkin, MD, emeritus professor of medicine in the University of Washington School of Medicine division of Rheumatology.
As the body breaks down fructose, chemical compounds called purines are released. The breakdown of purines produces uric acidthe substance that forms painful crystals in the joints and causes gout. Within minutes after you drink high fructose corn syrup-sweetened soda, your uric acid levels rise.
Most Important Foods And Food Ingredients To Avoid
As this article is focused on artificial sweeteners, this list is going to be made up of products and items that are found to aggravate gout or inflammation the most.
Most of these are going to contain either fructose or sucrose in them, which I will explain at the end of this list.
There are other foods that impact gout, but for sweeteners, always look out for high fructose corn syrup on the nutritional facts and ingredients label of your food.
This will include things such as:
- Regular sodas like Pepsi
- Store-bought fruit juice
- Most candies or pastries maybe you can find a good at-home recipe to try to get your sweet tooth fix
- Popsicles
- Canned fruits or soups they tend to use high fructose corn syrup as a preservative in fruits and occasionally in soups
- Certain condiments like ketchup or mayonnaise
This list could honestly be endless. This is primarily due to the high fructose corn syrup most companies put into their foods as a cheaper alternative to sugar. Reading the labels and nutritional facts are the best way to help you determine if it is a good food to eat or not.
Be wary of foods high in sugar or if the label includes a word like fructose or sucrose in it. These are two types of sugars that are used in most processed foods and you are likely to come across.
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