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Diseases

Gout—the disease of kings that is making a comeback at our tables?

Sources: 8 · Article: 11 382 characters

Hubert Czerniak describes gout as the buildup of uric acid, most often in the big toe.

  • Hubert Czerniak says crystals form especially when someone often drinks alcohol.
  • Michał Tombak lists pumpkin and pumpkin juice as recommended for gout.

What the authors write

Hubert Czerniak

Gout develops when uric acid builds up in the body.

„It develops when uric acid starts to build up, most often in the big toe—in which case it is called podagra. It can also occur in other parts of the body: gonagra, meaning in the knees, or chiragra, meaning in the thumb. It crystallizes, and this happens especially when we drink alcohol too often.”Powstaje ona, gdy kwas moczowy zaczyna się odkładać, najczęściej w paluchu – wtedy nazywa się to podagra. Ewentualnie w innych częściach naszego organizmu – gonagra, czyli w kolanach czy hiragra, czyli w kciuku. Krystalizuje się, a do tego dochodzi, szczególnie gdy zbyt często sięgamy po alkohol.
Hubert Czerniak

The buildup of uric acid most often affects the big toe; in that case, the disease is called podagra.

„It develops when uric acid starts to build up, most often in the big toe—in which case it is called podagra. It can also occur in other parts of the body: gonagra, meaning in the knees, or chiragra, meaning in the thumb. It crystallizes, and this happens especially when we drink alcohol too often.”Powstaje ona, gdy kwas moczowy zaczyna się odkładać, najczęściej w paluchu – wtedy nazywa się to podagra. Ewentualnie w innych częściach naszego organizmu – gonagra, czyli w kolanach czy hiragra, czyli w kciuku. Krystalizuje się, a do tego dochodzi, szczególnie gdy zbyt często sięgamy po alkohol.
Hubert Czerniak

Frequent alcohol consumption promotes crystallization.

„It crystallizes, and this happens especially when we drink alcohol too often. What about young people who come in with severe pain? Are they also diagnosed with rheumatoid arthritis? Young people usually have reactive arthritis. If they catch a bacterial infection, reactive arthritis can develop even several years later. To find out whether this is the case, IgG antibodies should be tested, not IgM.”Krystalizuje się, a do tego dochodzi, szczególnie gdy zbyt często sięgamy po alkohol. A młodzi ludzie, gdy przychodzą z silnym bólem? Czy u nich diagnozą również jest RZS? Młodzi mają zwykle zapalenie odczynowe, czyli jeśli złapią infekcję bakteryjną, to nawet po kilku latach może dojść do odczynowego zapalenia stawów i aby się przekonać czy tak jest, należy zbadać przeciwciała IgG, a nie IgM.
Michał Tombak

Eating pumpkin is listed as recommended for gout.

„Eating pumpkin is especially recommended for: • kidney and bladder conditions, • diabetes, • gout, • musculoskeletal conditions, • diseases of the circulatory system and heart muscle, • anemia and anorexia, thanks to its high iron content. It is also highly recommended during breaks between chemotherapy treatments.”Spożywanie dyni szczególnie zalecane jest przy: • schorzeniach nerek i pęcherza moczowego,• cukrzycy,• dnie moczanowej,• chorobach narządów ruchu,• chorobach układu krążenia i mięśnia sercowego,• anemii i anoreksji, dzięki znacznej zawartości żelaza.Bardzo wskazana jest też w przerwach pomiędzy zabiegami chemioterapii.
Michał Tombak

Pumpkin juice is listed as recommended for gout.

„Drinking pumpkin juice is especially recommended for: • liver conditions (fatty liver), gallbladder and bile duct conditions (gallstones), • kidney and bladder conditions (gravel), • diabetes and insulin resistance, • gout, • musculoskeletal conditions (osteoarthritis, etc.), • heart muscle and circulatory system diseases (atherosclerosis), • excess weight, • menopause (hormonal disorders).”Spożywanie soku z dyni szczególnie zalecane jest przy: • schorzeniach wątroby (stłuszczenie), woreczka i dróg żółciowych (kamica), • schorzeniach nerek i pęcherza moczowego (piasek),• cukrzycy, insulinooporności,• dnie moczanowej,• chorobach narządów ruchu (artrozy itp.),• chorobach mięśnia sercowego i układu krążenia (miażdżyca),• nadwadze,• okresie menopauzy (zaburzenia hormonalne).

Research from PubMed · Europe PMC

We selected 4 studies with the best, positive results. This is a selection, not a full review of all research.

Total number of studies on this topic in PubMed: 987.

The review found that red meat, seafood, alcohol, and fructose are associated with a higher risk of gout, while dairy and soy are associated with a lower risk.

Aim of the study: To evaluate the associations between dietary factors and the risk of gout and hyperuricemia.

Results: The meta-analysis revealed several dietary associations with gout risk: red meat: OR 1.29 (95% CI 1.16–1.44); seafood: OR 1.31 (95% CI 1.01–1.68); alcohol: OR 2.58 (95% CI 1.81–3.66); fructose: OR 2.14 (95% CI 1.65–2.78); dairy products: OR 0.56 (95% CI 0.44–0.70); soy foods: OR 0.85 (95% CI 0.76–0.96); high-purine vegetables: OR 0.86 (95% CI 0.75–0.98); coffee: OR 0.47 (95% CI 0.37–0.59). Dietary associations with hyperuricemia risk were: red meat: OR 1.24 (95% CI 1.04–1.48); seafood: OR 1.47 (95% CI 1.16–1.86); alcohol: OR 2.06 (95% CI 1.60–2.67); fructose: OR 1.85 (95% CI 1.66–2.07); dairy products: OR 0.50 (95% CI 0.37–0.66); soy foods: OR 0.70 (95% CI 0.56–0.88); high-purine vegetable intake: OR 1.10 (95% CI 0.88–1.39), P=0.39; coffee: OR 0.76 in men (95% CI 0.55–1.06), OR 1.58 in women (95% CI 1.16–2.16). The risk of hyperuricemia and gout is positively correlated with the intake of red meat, seafood, alcohol, or fructose, and negatively correlated with dairy products or soy foods.

Money for the studynot stated
Do the authors have ties to companies?not stated
Did a manufacturer help with the study?unknown
Type of studycombined analysis of many studies (meta-analysis)

“Not stated” does not mean nobody paid — the database does not always record it.

In a 42-day study, a low-purine, calorie-restricted diet lowered uric acid levels and improved selected body composition measures in people with gout.

Aim of the study: Background/Objectives: Nutritional therapy has emerged as a promising therapeutic strategy for managing chronic metabolic diseases. This study aims to evaluate the effectiveness of a low-purine, energy-restricted, balanced diet (LPEB diet) in improving gout and related metabolic risk factors.

Results: Meanwhile, fractional excretion of uric acid (FEUA) increased significantly more in the intervention group than in the control group, by 0.87% (p = 0.003), while daily purine intake decreased significantly by 262 mg (p = 0.001) in the intervention group. In addition, notable improvements in body composition were observed in the intervention group. Specifically, body mass index (BMI) decreased by 0.50 kg/m2 (p < 0.001) and visceral fat area (VFA) was reduced by 12.1 cm2 (p < 0.001), with significant differences between groups confirmed for both indicators. Conclusions: This study shows that an LPEB diet not only effectively reduces sUA levels by increasing FEUA, but also significantly reduces central adiposity and related metabolic risk factors in patients with gout.

Money for the studygovernment, public institutions · National Natural Science Foundation of China
Do the authors have ties to companies?no — the authors say so
Did a manufacturer help with the study?NO
Type of studystudy with random allocation to groups (RCT)
Participants90

“Not stated” does not mean nobody paid — the database does not always record it.

In a study of men, higher dairy intake was associated with a lower incidence of gout, while higher meat and seafood intake was associated with a higher incidence.

Aim of the study: Various purine-rich foods and high protein intake have long been thought to be risk factors for gout. Similarly, metabolic studies have raised the possibility that dairy products may help protect against gout. We prospectively investigated the association between these dietary factors and new cases of gout.

Results: During the 12 years of the study, we documented 730 confirmed new cases of gout. The multivariate relative risk of gout among men in the highest quintile of meat intake, compared with those in the lowest quintile, was 1.41 (95 percent confidence interval, 1.07 to 1.86; P for trend = 0.02). The corresponding relative risk associated with seafood intake was 1.51 (95 percent confidence interval, 1.17 to 1.95; P for trend = 0.02). In contrast, gout incidence decreased as dairy intake increased; the multivariate relative risk among men in the highest quintile, compared with those in the lowest quintile, was 0.56 (95 percent confidence interval, 0.42 to 0.74; P for trend <0.001). Intake of purine-rich vegetables and total protein intake were not associated with an increased risk of gout.

Money for the studygovernment, public institutions · NCI NIH HHS, NIDDK NIH HHS
Do the authors have ties to companies?not stated
Did a manufacturer help with the study?unknown
Type of studyobservation of people
Participants47 150

“Not stated” does not mean nobody paid — the database does not always record it.

In two cohort studies, higher intakes of certain lignans and some whole-grain products were associated with a lower risk of gout.

Aim of the study: Multiple plant-based dietary patterns are inversely associated with gout, although the individual components driving this association remain unclear. Dietary lignans, a major group of phytoestrogens abundant in plant foods, are metabolized by gut microbiota and may influence gout risk. We examined the associations between dietary lignan intake, certain lignan-rich whole-grain foods, and new cases of gout.

Results: Higher intakes of matairesinol (hazard ratio [HR] comparing extreme quintiles, 0.78; 95% confidence interval [CI], 0.69–0.90; P trend = 0.002) and secoisolariciresinol (HR, 0.78; 95% CI, 0.68–0.89; P trend = 0.002) were both associated with lower gout risk, whereas pinoresinol and lariciresinol were not associated with gout. We found inverse associations between gout and whole-grain cold breakfast cereals (HR for those consuming ≥1 serving per day, 0.62; 95% CI, 0.53–0.73), cooked oatmeal/oat bran (HR for those consuming ≥2 servings per week, 0.78; 95% CI, 0.70–0.86), and bran added to food (HR for those consuming ≥2 servings per week, 0.84; 95% CI, 0.74–0.95), but not dark breads or other cooked breakfast cereals. Higher intakes of matairesinol and secoisolariciresinol, as well as whole-grain cold breakfast cereals, oatmeal, and added bran, were each significantly associated with lower gout risk.

Money for the studygovernment, public institutions · NIH HHS, CIHR
Do the authors have ties to companies?not stated
Did a manufacturer help with the study?unknown
Type of studyobservation of people
Participants122 680

“Not stated” does not mean nobody paid — the database does not always record it.

Perspectives and opinion materials

The content below presents the authors’ opinions, interpretations and hypotheses. It is not treated as equal to scientific studies and systematic reviews.

Orthomolecular Medicine News Service Opinion material
„The study could not determine the nature of this type of correlation because it lacked a detailed study of each patient's diet and a chemical analysis of each stone that could have offered a clue about the likely cause. So this was a poorly designed study that did not determine what kind of stone formed or what caused the stones. These are serious flaws. Drawing conclusions from such a study can hardly be a good example of “evidence-based medicine.” Different Types of Kidney Stones (Renal Calculi) There is a considerable variety of kidney stones. Here are five well-known ones: 1.”The study could not determine the nature of this type of correlation, because it lacked a detailed study of each patient's diet and a chemical analysis of each stone to provide a hint about the probable cause. So we have a poorly designed study that did not determine what kind of stone was formed, or what caused the stones that were formed. These are serious flaws. Drawing conclusions from such a study can hardly be a good example of "evidence based medicine." Different Types of Kidney Stones (Renal Calculi) There is a considerable variety of kidney stones. Here are five well-known ones: 1.
Orthomolecular Medicine News Service Opinion material
„Although the urate ion in blood plasma is a strong antioxidant, at high levels it can crystallize and cause kidney stones or gout in the joints. Although uric acid kidney stones are not the most common, they and several other types of kidney stones can be managed by eating an excellent diet and drinking enough water [1,2]. What about oxalate? Another product of metabolism is oxalate.”Although the urate ion in blood plasma is a strong antioxidant, at high levels it can crystallize and cause kidney stones or gout in joints. Although uric acid kidney stones are not the most common, they and several other types of kidney stone can be managed by eating an excellent diet with adequate water intake [1,2] What about oxalate? Another product of metabolism is oxalate.

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