Gout — not just for rich old men

Philip J. Goscienski, M.D.

August 2012

Known for centuries as arthritis of the affluent, modern day gout dips into every socioeconomic group. In about half of cases the patient awakens at night with severe pain, swelling and redness in the first joint of a big toe. Sometimes other joints or even multiple joints are affected. Ordinary pain-relievers may not help much and prescription drugs are usually needed for patients whose symptoms persist.

Egyptian physicians described the disease more than 4,000 years ago. The incidence of gout has doubled in only the past few decades and it now occurs in about 2 percent of the U.S. population. Perhaps that's because dietary overindulgence and obesity, which were markers for the disease in times past, are now so prevalent in our society.

There is a clear association between gout and metabolic syndrome, which includes abdominal obesity, high blood pressure, abnormal blood sugar patterns and high lipid levels (cholesterol and other fat-like substances). Metabolic syndrome is linked to heart disease, stroke and diabetes, all of which have skyrocketed in the last half-century and that are due to lifestyle factors. One of these dietary factors seems to stand out: soft drinks.

The chemical culprit in most cases of gout is uric acid, which the body produces in the course of metabolizing certain high-protein foods such as meats and seafood as well as alcohol- and fructose-containing beverages. The consumption of fructose, which makes up about half of ordinary table sugar, contributes to the sweetening — and fattening — of America. Our high intake of sugar is astounding, nearly 150 pounds per person per year. Soft drinks account for much of the intake, especially among young persons. There is a direct correlation between soft drink consumption and uric acid levels in the blood. Those who swish down four soft drinks per day have uric acid levels that are almost twice as high as those who take in less than one sugared drink daily.

This overindulgence in fructose-containing food and drink messes up what is actually a benefit of uric acid. Of all the antioxidant chemicals that the body produces, uric acid is one of the most important. Many millennia ago humans lost the ability to break down uric acid and it may have contributed to our survival. In addition to being a potent antioxidant uric acid supports blood pressure. What benefited us in the past has come back to haunt us — in a very painful way.

Philip J. Goscienski, M.D. is the author of Health Secrets of the Stone Age, Better Life Publishers 2005. Contact him at drphil@stoneagedoc.com.