I seem to keep hearing of people getting gout on both LC and Paleo diets. Of course some might seize upon this fact, and claim it as "proof" that we are not adapted to a very high purine/meat diet. (I think most paleo folks already know to avoid excess fructose which also causes gout) But the fact is that gout has been found in other animals besides humans, such as crocodiles and T-Rex skeletons. So if even a pure carnivore acting 100% within it's evolutionary niche can get gout, then perhaps no surprise some humans do as well, when eating lots of meat and seafoods high in purines?
asked byMystery_Man_X (806)
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on August 23, 2012
at 07:51 PM
Dietary purine makes up a very minor rise in serum urate (http://www.jrheum.org/content/29/7/1350.full.pdf).
The diet is not to blame. Lack of exercise, and lack of vitamin C are typically the primary causes.
Where could humans possibly get get vitamin c? fresh herbs, dark leafy greens, cruciferous vegetables, citrus fruits, and berries are all very paleo. I know a lot of people on LC atkins style that get gout and blame the diet. The real reason is they dropped cereals that had been "fortified" with vitamin C, and didn't replace it with anything. simply eating a salad or some straw berries would have done the trick.
on September 27, 2012
at 10:51 PM
Where are you getting the idea that "lots of people" are getting gout on Paleo? I know at least one person who has "cured" themselves of gout with a Paleo diet. (I use "cured" because you never know when it'll come back...but he hasn't had a single attack since starting.)
The literature is very clear: gout is a problem of underexcretion of urate, not overproduction of urate.
Bonifacio ??lvarez-Lario and Jes??s Macarr??n-Vicente
Rheumatology (2010) 49 (11): 2010-2015.
"Uric acid (UA) is the end product of purine metabolism in humans due to the loss of uricase activity by various mutations of its gene during the Miocene epoch, which led to humans having higher UA levels than other mammals. Furthermore, 90% of UA filtered by the kidneys is reabsorbed, instead of being excreted. These facts suggest that evolution and physiology have not treated UA as a harmful waste product, but as something beneficial that has to be kept."
Pathogenesis of Gout
Ann Int Med October 4, 2005 vol. 143 no. 7 499-516
"Hyperuricemia results from the overproduction of urate (10%), from underexcretion of urate (90%), or often a combination of the two.
What causes the body to hold onto urate? The primary culprits are alcohol...and fructose. (There is also a role of systemic inflammation...as UA is an antioxidant, the body seems to want to hold into it in response to oxidative stress, including exercise. Therefore: exercise + energy bars/GU/drinks/Gatorade = gout problems.)
Reducing purine intake addresses the 10% issue of overproduction, not the 90% issue of underexcretion.