The bout of excruciating agony centred around your big toe, has arisen because the body has accumulated too much uric acid. Unable to pee it out, it has been squirreled away , in the form of uric acid crystals – apparently a good place to horde these crystals is your big toe “joint”. Go figure.
But have the health gurus got it wrong ?
Purine chemistry is not just about meat and spinach
On the whole, meat consumption has decreased in the last few decades, thanks to the “SATURATED FAT KILLS” rally cry. Alcohol kills too, but this vice seems to be able to persist.
All things being equal, gout should be a disappearing disease or at the very least, the incidence should be a stable statistic.
Far from it, the levels of gout have steadily ticked up, in fact, it has gone from being a problem of rich old men, to a problem of the rich and poor, male and female.
Something doesn’t add up.
Uncovering the real culprit ?
In an attempt to explain why hyperuricemia (high uric levels) is waxing, not waning, researchers followed 46 000 men, aged 40 years and over for 12 years.
At the start of the study – none of the participants had experienced a gout attack.
The men were given a once over, every two years. The once over included a weigh in, a run down of what meds they were taking, as well as their current medical conditions. In addition to checking in on their state of health, the men were required to complete a comprehensive food and beverage questionnaire.
NOTE : This kind of questioning is always a little iffy, because many people can’t remember what they ate for breakfast, never mind what they’ve been eating for the last two years on a regular basis, but it does help pinpoint potential “danger” foods.
Gout comes to those who….
During the study, 755 men suffered a gout attack.
When the researchers crunched the numbers – the red flag for these unlucky souls was in their drinking habits.
But, it wasn’t alcohol which was tipping the balance towards gout, it was sugar sweetened cold drinks and fruit juice.
Sugar sweetened cold drinks are sweetened with high fructose corn syrup. Fruit juice is sweetened with fructose.
The chemical in the middle of the problem appears to be, FRUCTOSE.
Fructose becomes “a purine”
At first glance, the chemistry doesn’t make sense because fructose is not a purine.
But, when scientists have unpacked the metabolism of fructose, it manages to feed itself into the pathway that ends up making, uric acid. This “uric acid”, is the uric acid in the so-called purine pathway and the substance that is sky high in the gout sufferer.
If you’re curious about the chemistry – here is the biochemical pathway courtesy of Bulletin of the NYU Hospital for Joint Diseases (2008) 66(3):231-9
Fructose is the big toe tormentor
Fructose is already connected with big belly problems, having been implicated in leptin resistance and the resulting metabolic syndrome aka. obesity.
A growing body of research suggests this sweet little molecule, is also tormenting big toes.
A teaspoonful of “sugar” is probably okay, but a ladel full isn’t – cutting down on your “sugar” consumption is going to bring health benefits.Sugary soft drinks linked to increased risk of gout in men – press release on EurekAlert (a service of AAAS).
Interested in learning more about the chemistry behind those aches and pains ?
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