| |

Don't put that in your mouth...

I have been studying up on diet. I know it is a trendy obsession for the civilised among us but what you may put in your mouth may matter to what happens thereafter.

As you may know I've gone very low carbohydrate to combat the impact of Diabetes II . It works. Eating fewer and fewer carbs ensures you can control your blood sugars and look forward to a half normal life despite your in house hormonal inadequacies. You lose weight too.

It's seeming win win.

But in life -- as in physiology -- nothing is that easy.

Both my da and my ma suffered from gout so the high uric acid thing -- Hyperuricemia -- is something I seem to have inherited. I know that 27 years ago I had elevated uric acid levels but my first attack of gout only kicked in (my foot)-- ouch! -- 10 years ago on my birthday!

It ain't fun with gout about.

But first some background:
Recent surveys suggest that nearly 6 percent of all American men in their fifties suffer from gout, and over ten percent in their seventies. The proportion of women afflicted is considerably less at younger ages but still rises over 3 percent by age 60. Moreover, the prevalence of gout seems to have doubled over the last quarter century, coincident (perhaps not coincidentally) with the reported increase in obesity, and it may have increased five- or even six-fold since the 1950s, although a large portion of that increase may be due to the aging of the population.... The actual evidence, however, has always been less-than-compelling: Just as low cholesterol diets have only a trivial effect on serum cholesterol levels, for instance, and low-salt diets have a clinically insignificant effect on blood pressure, low-purine diets have a negligible effect on uric acid levels. A nearly vegetarian diet, for instance, is likely to drop serum uric acid levels by 10 to 15% percent compared to a typical American diet, but that’s rarely sufficient to return high uric acid levels to normality, and there is little evidence that such diets reliably reduce the incidence of gouty attacks in those afflicted. Thus, purine-free diets are no longer prescribed for the treatment of gout, as the gout specialist Irving Fox noted in 1984, “because of their ineffectiveness” and their “minor influence” on uric acid levels.Moreover, the incident of gout in vegetarians, or mostly vegetarians, has always been significant and “much higher than is generally assumed.” (One mid-century estimate, for instance, put the incidence of gout in India among “largely vegetarians and teetotalers” at 7%.) Finally, there’s the repeated observation that eating more protein increases the excretion of uric acid from the kidney and, by doing so, decreases the level of uric acid in the blood. This implies that the meat-gout hypothesis is at best debatable; the high protein content of meats should be beneficial, even if the purines are not. --Garry Taubes
The problem is that since I have altered my diet I am suffering from more attacks of gout than I deserve. What I thought was joint injury was probably gouty arthritis.

With gout attacks you can  also suffer fevers, chills, and extreme lethargy.Then there's the joint pain...and James Gillrays' cartoon (above left) is spot on about that.

My problem is that in the small print for the diet I pursue is a warning that you may get gout.

Voila! I get gout. But the complication is that there is a melange of complications that package Gout and Diabetes and Hypertension together so that if you have one you are on a short list for the other.

The tragedy is that if you address one illness you make more room for the other to happen.

There's no justice. It's a cruel world.

But hey! Persons with gout  are significantly less likely to develop Parkinson's disease. 

So I'm going to hold my course and hope for the best.

I started on Allopurinol and perhaps should have begun that drug years ago...but the conundrum of Hyperuricemia will still bear down upon me. Are  my recent gout attacks simply because I eat fewer grains; or because I shocked the system with a sudden diet change (my GP says that's a standard response)?

Bugger if I know.

The medical literature is very confusing but it is pretty much indicated that aside from familial tendency, lifestyle may rule the onset of gout -- even a  'good' lifestyle.

But...then what's so special about what you put in your mouth?
European physicians in World War I, for instance, reported a reduced incidence of gout in countries undergoing food shortages. In primitive populations eating traditional diets, gout was virtually unknown or at least went virtually unreported (with the conspicuous exception of Albert Schweitzer who says he saw it with surprising frequency.) The earliest documented cases reported in Asia and Africa were in the late 1940s. And even in the 1960s, hospital records from Kenya and Uganda suggested an incidence of gout lower than one in a thousand among the native Africans. Nonetheless, by the late 1970s, uric acid levels in Africa were increasing with westernization and urbanization, while the incidence of both hyperuricemia and gout among South Pacific islanders was reportedly sky-rocketing. By 1975, the New Zealand rheumatologist B.S. Rose, a colleague of Ian Prior’s, was describing the native populations of the South Pacific as “one large gouty family.” -- --Garry Taubes 
So I have to wonder what I am doing wrong...compared to what I 'traditionally ate'...

Notes

  • Meat Consumption: DOWN. I'm eating smaller portions less often but while I had steered away from preserved meats I'm eating more of those than I did before. My beef consumption is very small relative to other meats like chicken.
  • Fish Consumption: UP . I'm eating more fish when I can afford it and taking high dose omega fish oils.
  • Grain  Intake: CEASED I no longer eat grains nor potatoes, corm, legumes or bread, cakes and biscuits. That means that rice is off the menu too.
  • Egg Consumption: UP Not by much, as I hardly ate eggs previously.
  • Vegetable Consumption: UP MASSIVELY. I eat salad greens almost daily and a huge range of seasonally available/cheap vegetables aside from potatoes.
  • Fruit Consumption: UP. I consciously  eat certain fruits ( berries especially) on a daily basis. I don't east most other fruits (but I eat pawpaw and rockmelon).
  • Nuts: UP. I eat a lot of nuts, mainly almonds and peanuts (which are technically legumes).
  • Olives and Olive Oil: UP MASSIVELY. I have consciously increased my consumption,  and my cooking with , olive oil. I glug glug much more.  I now eat table olives almost on a daily basis. Olive oil is my largest fat source. 
  • Dairy Products: UP. I have consciously increased (Greek) yogurt and cheese consumption while beginning to use  cream.
  • Alcohol consumption: THE SAME. Average intake of around  400 ml per day of red wine more or less....
  • Protein Intake: UP ( I suspect). Despite the smaller portions and the meat free days, I'm probably consuming more protein on a day to day basis because of the dairy and egg increase. But then the proportion of protein has to be considered relative to  the collapse in carbohydrate consumption. As pie charts go the colours are changing shape.
  • Carbohydrate Intake: WAY WAY DOWN.
  • Conclusion...? Maybe I can reduce my meat consumption more to see if I can wing it. .

0 comments:

Post a Comment