Dietary approaches for raised uric acid and gout

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The dietary excesses of the festive season are well known to have the capacity to swell our vital statistics, but can leave their mark deeper within the body too. A glut of food and drink can, for instance, boost levels of uric acid – the blood component elevated levels of which can precipitate an attack of gout. However, research shows that raised uric acid levels may jeopardise the health of not just our joints: a recent study published in the Annals of Internal Medicine found that middle-aged men with the highest uric acid levels, compared to those with lower levels, were two and a half times more likely to die from cardiovascular conditions such as heart attack and stroke. The evidence suggests that uric acid has a pretty corrosive effect on health.

It is not known for sure whether uric acid actually has the capacity to increase risk of heart disease, or is just a ‘marker’ for increased risk. However, uric acid is known to induce changes in the body’s biochemistry and physiology that would be expected to heighten heart disease risk including impaired blood vessel function (known as ‘endothelial dysfunction’) and increased clotting tendency in the blood. Also, some evidence suggests that drug-induced lowering of uric acid helps to reduce the risk of heart attacks and stroke. This sort of evidence suggests that uric acid is a bona fide risk factor for cardiovascular disease.

Uric acid is a breakdown product of dietary elements known as purines found in foods such as meat, seafood, fish, beans and lentils. As a result, those with raised levels of uric acid are often advised to cut back on purine-rich foods. However, about two-thirds of purines in the body do not come from the diet, but are made naturally in the body. This fact helps to explain why low-purine diets are generally ineffective for moderating uric acid levels in the blood.

Clues about more effective dietary strategies come from the observation that raised uric acid levels often go hand-in-hand with a condition known a metabolic syndrome – itself characterised by features such as an excess of weight around the middle of the body, high blood pressure, and raised levels of blood fats such as cholesterol and triglyceride. Another common feature of metabolic syndrome is raised levels of the insulin – the hormone secreted in response to carbohydrate-rich foods including Yuletide favourites such as port and Christmas pud.

Excesses of insulin have been shown to raise uric acid levels, and there is evidence that eating less carb is effective in tempering uric acid levels in the system. In one study, a 16-week long carb-restricted diet significantly reduced uric acid levels. Other side-benefits of a lower carb diet were reduced blood fat levels and satisfying weight loss to boot. Those keen to restore health to the system in the New Year might consider a diet lower in foodstuffs likely to boost uric acid levels such as alcohol, refined sugar and starches that tend to cause considerable insulin induction (such as bread, potatoes, rice, pasta and breakfast cereals).. In practice, such a diet is often effective in neutralising the effects of uric acid in the system.

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