This post is in response to one of my readers, who confesses to being a ‘bit gouty’ and needing to lay off the fruit. Gout, once upon a time the illness of the upper classes has now become classless. I have at least three friends who regularly get gout attacks, and they’re not at all posh (one’s even Australian, that’s how not-posh she is).
What is gout? It’s a form of arthritis, basically, that tends to attack the joints of the big toe. One of the main differences between gout and other forms of arthritis is that gout pains can come on suddenly and agonisingly, in response to the consumption of certain foods or drinks.
How is it caused? Well the verdict seems clear – gout is caused by excess uric acid in the blood. Uric acid can crystallise in the joints, causing swelling, inflammation and mucho agony.
The cause of excess uric acid hasn’t had such a clear verdict, though, and a brief look around the internetz may lead you to believe that the culprit – as if there could be just one cause – is red meat. What a surprise, the demonisation of nature’s only true superfood continues. Now it’s true that red meat (and especially offal) contains substances called purines, and that purines break down into uric acid.
There the reductionist theory has to end, though, since most unprocessed food contains purines, and eliminating purines from your diet would mean restricting yourself to, say, pizza, doughnuts and fizzy drinks. And if you had a tendency to gout, you’d probably suffer even more. People who eat large amounts of meat don’t necessarily get gout, either, especially if you look at traditional cultures that subsist on animal products, where gout is unknown.
Alcohol is a strong candidate for causing gout, especially beer, since the presence of alcohol inhibits the body’s capacity to remove uric acid via the kidneys, and increases purine breakdown (into the nasty uric acid) as well. Beer happens to contain purines too.
Fructose is also a very strong candidate, since, like alcohol, it needs an enzyme called ATP to break it down, and in doing so produces lots of uric acid. As usual, meat has got the bad rap because there have been studies associating it with gout, when for example fructose wasn’t taken into account in the studies. Or carbs in general.
So if you eliminate fructose completely from your diet for a while (I don’t know, let’s say the next 40-50 years), remembering that it is found in table sugar and many, many processed foods, as well as fruit, things could change. Remember this centuries-old poem:
No fruit down the spout. Processed food out. No sugar, no doubt. You’re in with a shout. Of ditching the gout.