Flesh & Fructose

Flesh & Fructose
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Meat and sugar increase uric acid levels, which are associated with increased risk of gout, hypertension (high blood pressure), obesity, prediabetes, diabetes, kidney disease and cardiovascular disease.

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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

In modern times, we want to keep our uric acid levels as low as possible. How are we going to do that?

Well, there are two main things that raise your uric acid levels: purines and fructose, which means mostly meat and sugar. Everything from bacon and brains, to fish, poultry, shrimp, and veal, and then, both sugar and high fructose corn syrup are both about half fructose—which leads to uric acid production in the body. 

That explains why a spoonful of sugar helps the blood pressure go up, along with the risk of gout in men, and the risk of gout in women. And the risk of hypertension, obesity, prediabetes, diabetes, kidney disease, and cardiovascular disease. 

We went from eating about four pounds of added sugars a year to now about 100 pounds per person. That’s like third-pound of sugar a day. This could be playing a role in the dramatic rise in chronic disease over the last century, as argued in this award-winning recent paper, “The Evolution of Obesity: Insights from the mid-Miocine.”

Please consider volunteering to help out on the site.

Images thanks to Caro Wallis and revedavion.com via flickr, and Stephan Guyenet.

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

In modern times, we want to keep our uric acid levels as low as possible. How are we going to do that?

Well, there are two main things that raise your uric acid levels: purines and fructose, which means mostly meat and sugar. Everything from bacon and brains, to fish, poultry, shrimp, and veal, and then, both sugar and high fructose corn syrup are both about half fructose—which leads to uric acid production in the body. 

That explains why a spoonful of sugar helps the blood pressure go up, along with the risk of gout in men, and the risk of gout in women. And the risk of hypertension, obesity, prediabetes, diabetes, kidney disease, and cardiovascular disease. 

We went from eating about four pounds of added sugars a year to now about 100 pounds per person. That’s like third-pound of sugar a day. This could be playing a role in the dramatic rise in chronic disease over the last century, as argued in this award-winning recent paper, “The Evolution of Obesity: Insights from the mid-Miocine.”

Please consider volunteering to help out on the site.

Images thanks to Caro Wallis and revedavion.com via flickr, and Stephan Guyenet.

Doctor's Note

What does the Miocene Era have to do with anything? Make sure you see the “prequel” to this video Miocene Meteorites and Uric Acid. No surprise that the meat and sugar industries both got upset with the latest round of dietary guidance from the federal government. See Dietary Guidelines: Pushback From the Sugar, Salt and Meat Industries and Dietary Guidelines: Corporate Guidance. Is the sugar in fruit juice as bad as the sugar in the sugar bowl? The title of the next video of the day kind of gives it away: Apple Juice May Be Worse Than Sugar Water.

For more context, please check out my associated blog post:  Uric Acid From Meat and Sugar.

If you haven’t yet, you can subscribe to my videos for free by clicking here.

96 responses to “Flesh & Fructose

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    1. John Smith: I’m not speaking as an expert here, but I have a thought for you. As you know, too much of anything, even water, is bad. The question is, what is too much? I have a hard time believing that the average person would eat too much whole fruit in a day. My guess is that you would have to really try hard to do so. The vast majority of people in America do not eat enough fruit. So, it seems like that is not a worry we need to have.

      Also, I agree with Veganrunner making a distinction between sugar, juice, and whole berries.

          1. Those things just don’t seem to have much nutrition, to me. Very sweet, not much potassium, or fiber or anything else? If someone wants to jump on in defense of bananas, fine, I might learn something. They sure aren’t local, for that matter, to me.

            1. Kim Churchman: My understanding is that the greenish bananas have a type of fiber that is especially healthy and sought after. (I don’t remember the type off the top of my head.) And other people consider bananas ideal for other reasons. I won’t say bananas are a perfect fruit, but I would not put them down either. Seems like bananas can be a part of a healthy diet to me.

              Of course, if bananas don’t appeal to you, no reason to eat them!

    2. No. Somebody missed the part about added sugars. Fruit is far too nutritious for it to really be detrimental to your health- even in large quantities. It’s most likely a bad idea to eat truckloads of refined sugars, but please don’t stop eating fruit. To tell a person to stop eating fruit is akin to telling someone to stop eating vegetables- fruit is a health-promoting food. A balanced plant-based diet includes fruit and the fructose within it.

      1. Right. Fruit’s fructose is mediated by everything else that comes with it if you eat a piece of fruit whole. That’s why HFCS is nasty for you – nothing to slow it down. Whole fruit rocks!

      2. What to eat needs to be considered in the context of an individual’s health issues. If you have high uric acid levels and are subject to gout attacks, then I think it wise to limit fruit high in fructose (with a goal of taking in no more than 15-25 mg of fructose per day, according to some accounts).

              1. On a strict WFPB diet, about 18 months. I have been a vegetarian of one form or another for over 40 years but the quality of my diet has varied substantially over the years. From about 1985 the only animal protein I ate has been from fish and dairy but as mentioned, gave that up fairly recently. For the last ~ 7 years I have been careful not to eat processed food, added sugars, etc.

  1. The relationship between fructose intake and gout isn’t all that clear according to a study by D. David Wang et.al.(J Nutr. 2012 May; 142(5): 916–923). Although there are limitations to the study, isocaloric fructose consumption was not associated with an increase in uric acid whereas a hypercaloric fructose intake was. This is In contrast to the NHANES III study and Health Professional follow-up study which showed a correlation between fructose consumption and increased uric acid levels. According to Wang’s study, it appears that there may be a threshold at which fructose consumption has an effect on uric acid levels in addition to its metabolic effects since the isocaloric trials mean fructose dose was 93.4g/day and the hypercaloric trial was 215 g/d. The mean dietary intake of fructose is estimated to be 49 g/day (in the US) which may or may not affect uric acid levels.(Bernadette P. Marriott, Nancy Cole and Ellen Lee, National Estimates of Dietary Fructose Intake Increased from 1977 to 2004 in the United States, Journal of Nutrition June 2009 vol. 139 no. 6 1228S-1235S)
    Meat has long been associated with gout but with purine-rich vegetables the results are less clear. (PLoS One. 2012; 7(6): e38123). Vegetarian diets has shown a decrease in plasma urate levels. Interestingly, dairy products has shown to reduce uric acid levels.

    1. Right but vegans had the highest levels of uric acid, perhaps (one study speculated) because they avoid dairy, which is effective in lowering uric acid levels.

      1. You are giving one study that ‘speculated’ as if it is a source? Pick up a text book and read! Meat is the highest contributor of gout, Uric acid is produced in the body through the breakdown of purines – PURINES are specific chemical compounds that are found in certain foods such as meat, poultry and seafood. Don’t make up shit to support a uneducated attack against fruit intake and your unhealthy relationship to casein, if you have gout you are a meat eater that is out of control !!

        1. For reference, I tracked down the article I mentioned, and also found that Jack Norris took the study seriously enough that he interviewed one of the authors and provided his analysis:

          Serum uric acid concentrations in meat eaters, fish eaters, vegetarians and vegans: a cross-sectional analysis in the EPIC-Oxford cohort.
          http://www.ncbi.nlm.nih.gov/pubmed/23418557

          http://jacknorrisrd.com/higher-uric-acid-levels-in-vegans/

          Let me go through your points (as best as I could discern them).

          [1] With regard to the “speculation” in that study that dairy intake might account for the observed lower uric levels in the non-vegan groups, it is widely known, and commonly accepted, by those who actually know something about the topic that dairy products lower uric acid levels. In fact, rph1978 mentioned this fact.
          Here’s a quote from the study :

          “The higher uric acid concentrations among vegans might be due to their lack of consumption of dairy products, which are thought to lower uric acid concentrations [11]. Also, the low calcium content of the
          vegan diet might contribute to higher uric acid concentrations.”

          [2] “Meat is the highest contributor of gout” – I agree that animal flesh is the primary *exogenous*
          contributor to high uric acid levels, hence increases gout risk. In fact, I had already agreed with you on this: in response to your comment to me under the “bananababe thread” (“It would also ‘be wise’ to hold back on meat consumption “), I replied: “Right, that’s key”.

          [3] “Don’t make up shit to support a uneducated attack against fruit intake and your unhealthy relationship to casein, if you have gout you are a meat eater that is out of control !!”

          My concern was not with fruit per se but with *fructose* intake and by implication, the possibly significant role of only *fructose-rich* fruit intake on uric acid levels (at least in people predisposed to high uric acid levels and gout). That’s why I used the word “fructose” in my comments. I happen to eat quite a lot of fruit but since I have recently become concerned about non-meat dietary sources of uric acid, I limit my intake
          of fructose-rich fruit (I do not consume sugary drinks or foods with significant added sugars of any kind).
          Perhaps you wrongly think that fructose, or at least fructose from fruit, cannot raise uric acid levels or contribute to gout risk. But fructose metabolism does produce uric acid, and it appears fructose-rich fruit
          can play a role in increased risk of gout:

          Soft drinks, fructose consumption, and the risk of gout in men: prospective cohort study
          http://www.ncbi.nlm.nih.gov/pubmed/18244959

          “Other major contributors to fructose intake such as total fruit juice or **fructose rich fruits (apples and oranges)** were also associated with a higher risk of gout (P values for trend <0.05).”

          A prescription for lifestyle change in patients with hyperuricemia and gout
          Curr Opin Rheumatol. 2010 Mar;22(2):165-72. doi: 10.1097/BOR.0b013e328335ef38.

          where it is stated that: "Dairy products, vegetables, nuts, legumes, fruits (**less sugary ones**), and whole grains are healthy choices for the comorbidities of gout and may also help prevent gout by reducing insulin resistance.”

          I would be relieved to find out that the only significant threat to those in my group (vegans predisposed to gout or just high or even high normal uric acid levels) is from sugary drinks, high fructose corn syrup, etc.
          But it still seems reasonable to say for such vegans, that there is an issue (as in “an issue to be resolved”) regarding safe intake of fructose-rich fruit. I am not alone in this view. Whatever the right answer might be, many experts on the topic recommend limiting fructose intake from fruit.

          [4] “your unhealthy relationship to casein”: No matter what my relationship to casein might be, it is irrelevant. Casein does not raise uric acid level; in fact, it lowers it:

          Milk- and soy-protein ingestion: acute effect on serum uric acid concentration
          http://www.ncbi.nlm.nih.gov/pubmed/2000819

          [5] “, if you have gout you are a meat eater that is out of control !!” – This implies that non-meaters do not get gout. That’s ridiculous. I am a vegan counterexample as are some others who have commented on this topic. (Not only am I a vegan but I have not eaten meat in approximately 45 years.)

          1. @dj–Are you suggesting we only eat sweet potatoes and rice ( starch) instead? Or just no apples? Did you see the latest video thesis on “how much fruit is too much?” I think the majority of people will do great on more fruit. Are there exceptions? Probably.

            1. No, not at all. I do not have a strong opinion on what kind of WFPB diet a particular individual should eat as I think it important to consider individual circumstances. I happen to eat a diet with a large emphasis on vegetables, legumes, nuts, seeds, whole grains and what I think is a reasonable amount of fruit. I do not consume that much starch.

              I agree completely that the majority of people will do fine on more fruit, including fructose-rich ones. But if one is in the minority (vegan, high uric acid level) and susceptible to gout, then one might consider limiting fruit very high in fructose, especially dried fruit. But I have to admit I have no idea how effective this strategy might be. Since having a gout attack last year and finding my uric acid level to be in the high normal range (yes, one can have a gout attack with supposedly normal levels), I have been seeking effective natural methods for lowering my level e.g. drinking coffee, eating lots of cherries, and reading some of the literature made me think restricting fructose-rich fruit (dried fruit, in particular) might help.

              I did watch the video. It was quite interesting, and if I did not have higher than optimal uric acid levels, I would eat whatever fruit I wanted freely. (Note though that the studies in the video did not discuss uric acid levels, most likely because that is only a concern for a small minority of people like me.)

              1. Apparently the more “alkaline” the diet the better the “body” is at removing excess uric acid, as revealed in the “purple cabbage pH urine test” video. I’m sure you already know that! best of luck DJ!

          2. Yup, I’m a (non-drinking) vegan and have had a couple of gout flares recently (to the surprise of my doc) – these were the first signs I’ve ever had of gout. My uric acid levels turn out to be in the high “normal” range. I’m still trying to parse all the info. in your message but:

            “Other major contributors to fructose intake such as total fruit juice or **fructose rich fruits (apples and oranges)** were also associated with a higher risk of gout (P values for trend <0.05).”

            looked interesting as it seems that it might have been right around the time that I started putting oranges in my morning protein shake that my first flare occurred…

            1. I’m also a nondrinking vegan. I’ve had two very short-lived attacks in the last 4 years. The first time my doctor claimed I did not have gout b/c my uric acid level was “normal” but gout was confirmed by joint aspiration the last time. About a week after my 2nd attack last Sept., my uric acid level was 6.4. I was told that was normal and the doctor only recommended I go on a low purine diet, which as a vegan, was not very helpful (since plant purines seem not to be a problem). In the intervening time I have not eaten any dried fruit (I regulary eat berries, cherries, unripe bananas, and no more than one orange per day plus occasionally eat other fruit), started taking 2 TBL of tart cherry concentrate, drinking 4 cups of (decafe) coffee and taking a 500mg vitamin C supplement daily. Each of these has been shown in one study or another to lower uric acid levels, but individually the amount might not be ‘clinically significant’, so I was aiming for a cumulative effect. My last reading about 2 weeks ago was only 5.2, which is, as I understand it, around the ‘mainenance level’ aimed for when one takes medication. Since I exercise a lot, I also pay attention to keeping well hydrated (one theory was that my attack was the result of dehydration since I had been on a long hike in hot weather a day or two before the attack, but I was never convinced since I always drink water on hikes). Since I only have one data point post my dietary changes, I cannot be sure they are the reason for the drop but I am hopeful they are. If I can maintain the current level, I would assume I won’t experience another attack.

              1. Thanks for the detailed info. – my uric acid level was 6.7 when tested after my first attack. My primary doc wasn’t too concerned about that level but another doc thought that was high for someone worrying about gout flares (and which you seem to confirm). I drink quite a bit of tea, but I assume it’s not the caffeine in coffee that is contributing to the uric acid level reductions, so I guess tea probably isn’t a substitute for coffee in this respect – maybe I’ll have to think about drinking coffee again (though I’ve really enjoyed restricting myself to tea). At the moment I’m only taking 100mg of C a day so that looks like a potential avenue. And given the studies you cite it sounds like some experimenting with types and amount of fruit could be useful, though it’s a little hard to treat oneself as an experimental subject re. isolating what is the most useful. I.e. as an individual I’m a terrible scientist in that if I can prevent any further gout flares, I’m not interested in experimenting with what in particular led to that result !

                In any case thanks again for the information.

          3. You are suggesting that once you find an article you like, you read more in depth to prove it’s point. That’s not how it works, with science they do things tens of hundreds of times if they are doing good research. So now that you found. How do we know these weren’t junk food vegans? And other “meat” eating people who are more plants than the vegans? There are not enough specifics or control groups in this study to prove anything without many other studies to back it up. sorry.

            1. >>>You are suggesting that once you find an article you like, you read more in depth to prove it’s point. That’s not how it works, with science they do things tens of hundreds of times if they are doing good research.

              This sort of silly response is not worth more of a response than this one.

        2. My worst ever attack of gout followed excessive consumption of fruit smoothies, reinforcing the scientific fact that fructose consumption causes gout.

  2. I am sensing a heated discussion here. Coacervate there is a big difference between an 8 oz serving of cola (30,000 mg) and a cup of frozen unsweetened strawberries (12,500 mg). We all are aware that drinking orange juice probably isn’t the best choice.

    Rph1978 has very interesting info in his post from one study cited. (93 grams/day isocaloric)

    That’s a heck of a lot of berries!

  3. So what’s an endurance athlete to do? I understand strenuous exercise
    increases uric acid levels. I need some kind of carbohydrates on rides
    over 2 hours. Currently I use home-made sports drink consisting of
    water with about 1/2 tablespoon of sugar per 8 oz. plus a dash of salt
    and a dash of crystal lite powder for flavor (I use it mainly because it
    galls me to pay $$$$ for any of the “xxx-ade” products). But now it
    sounds as if my sugar drink plus hard riding is just asking for trouble.

    I assume honey is not much better; my home-made energy gel is mostly honey and black strap molasses.

    Is
    there something I can ingest as a sports drink/gel that will provide
    enough carbohydrates and electrolytes for 5-6 hours of cycling without
    also increasing uric acid — without paying through the nose?

    Many thanks!

    1. Combi: Very interesting question.

      I don’t know the answer to your question, but you may want to check out Dr. Greger’s videos on erythritol (sp?). Perhaps erythritol would not have the same effect as sugar????? I don’t know. Just guessing.

      1. Thanks, everyone, for your replies. Sorry I don’t have time to respond individually. You’ve all given me good things to think about. I’ll have to experiment with my home-made recipes to try and eliminate fructose and increase magnesium and potassium.

    2. Strenuous exercise increases lactic acid levels in the body which hinders uric acid excretion. You might want to consider adding magnesium and potassium to buffer the excess lactic acid.

    3. Hi Combi,

      I assume you eat on those long rides? My husband is also a cyclist and he takes a sandwich and fruit. Also coconut water but that isn’t cost effective if that is your main concern. The sport drinks are so full of crap. Plain old water and eating should do the trick. Hibiscus tea is nice. Or green tea.

    4. Combi – look up Brendan Brazier. I have one of his books – Thrive Fitness, and there are some whole food sports drink recipes. It is well worth a read. He uses things like dates, coconut water, lemon / lime juice, green tea and coconut oil to make sports drinks which give sustained energy. He also has some recipes for some energy gels for mid-race nutrition.

      Dates are relatively low in fructose. They have a lot of sugar, but if your an athlete this is not a problem.

      https://www.facebook.com/brendanbrazier/posts/167993430017241

      The wood alcohols would not be a good choice. (Xylitol etc) They are good for sweetening, but do not get digested much, so are not a very good energy source! They can also cause digestive problems in excess.

    5. The night before your ride, but some dates and whatever dried fruit you have, raisins will work, goji berries are fantastic. I like 4-5 dates and a handful of goji berries (blend the goji berries in a coffee grinder first to get them into a powder) in 32 oz of water. Let it soak in the blender overnight in the fridge. Then in the morning just blend it and there is your sports drink. Awesome whole food nutrition.

  4. what about those 801010 folks, who eat crazy amounts of ‘sugar’? surely they’d be dropping dead with the rate they consume fruits, no? I too am interested in this as I have lots of fruit!

  5. My uric acid is pretty high, about 7, for the last 6 years! went vegan 1.5 year ago, 80/10/10 a year ago, and it’s still high. Could I have some genetic disorder, or does anyone has some explanation?

    1. Our levels of uric acid are a factor of our genetics and what we eat. By avoiding meat you will tend to reduce your uric acid. It would be interesting to see how your uric acid changed after changing your diet. The next step would be to lower fructose consumption if your goal is to lower your uric acid level. Clearly avoiding table sugar(half fructose), checking labels to avoid high fructose corn syrup( 55% or more fructose depending on the type of HFCS used) and limiting fruit consumption would be things you could try. By focusing on starch consumption which are long chains of glucose molecules you will also minimize fructose. You might find Dr. John McDougall’s book, The Starch Solution of interest. You can go to his website and view his free lecture, The Starch Solution for an introduction. A level of 7 is outside “normal” limits but may be normal for you and may not cause you long term problems. That is a clinical decision based on you and your physician working together.

  6. I have a friend with gout and I have been unsuccessful at steering him to a vegan diet. He relies on chicken. Is there a vegan diet for gout?

    1. I have gout. When I turned from meat to vegetarian to vegan to raw vegan, the incidents of gout attacks decreased. By habit I still avoid certain plant foods but there is no doubt I am consuming more of them these days and not suffering a gout attack. The point is that you should not be thinking in terms of a vegan diet for gout, just make sure you consume a wide variety of whole plants, preferable organic and raw and you should be just fine. Your body will adjust and produce less uric acid and dispose of it more efficiently, so no or fewer gout attacks. I hope this helps and please check my blog. http://lwghpd.blogspot.com.au/

    2. Go to http://www.gout-aware.com To find some interesting things about gout. There is no GOUT diet per se. Some things that we need to stay away from are: BEEF, LAMB, SHELLFISH, ORGAN MEATS, SPINACH, BEANS, AND YEAST (in breads and in many other processed foods these days–even soups, and beer). Eating the right caloric diet for your body size (see a R.D.) helps to keep protein intake in line. Most foods have purines, except for fruits and veggies, which are low to none. Intake of at least 2 liters of water/day is essential to flush your system and dehydration makes gout worse. Fat burning exercises increase blood uric acid because I found out, excess uric acid is stored in fat and when you burn fat, it releases the acid back into the blood system. GOUT is complicated and if you have a bout of it, so very painful! :(

      1. are lentils bad for gout? I Just read that they are awesome for helping to control sugar in your body. I made a cup of dried lentils this past week and ate them with rice.

  7. Thank you Dr. Greger. I have been subscribing for a while now, since shortly after becoming vegan. I am a vegan living in a social soup of enthusiastically, decidedly non-vegans: aka chefs and restaurant owners. I own a restaurant with my husband, and it was our foray into the industry that opened my eyes and changed my life and world view. I was put in an interesting, perhaps unusual position, and my decision was to remain in my marriage and business. The reasons I remain relatively sane are that I understand much of why things are the way they are, and I know- even though many food industry people do not wish to think about it- if the people finally accepted and embraced the plant based diet, they would still need restaurants galore; that part would probably remain the same! So my restaurant has in-house made vegan hot dogs, vegetable sides and animal-free baked beans that are to die for (or not). Yes my business markets vast quantities of meat and is poised to expand. Alot. The way I look at it is that more people be choosing our place over something else, and they will be exposed to the vegan option. Also, the majority of the food enthusiasts I associate with are brave and loving people who are thoughtful and accommodating, and I have had wonderful experiences with the most staunch ‘church of meat’ types. I believe that they are faced with certain facts and new findings every day and can only deny or try and circumvent them for so long. And I believe, even if other restaurant people don’t, that we can make positive changes, and evolve with any food revolution without missing a beat. Yes I live on a high wire tightrope in a way, but I can see alot from here. Thanks!

    1. Bless you, for introducing “meatless” alternatives in your restaurant. I wish every restaurant owner would have the courage to do just as you have done. My wife and I are plant eaters and find it very difficult to dine out due to the limited plant-based options offered in our local restaurants.

    1. Uric Acid is a metabolic product manufactured by your body. It is from the breakdown of purines which are part of nucleic acids in your body and are high in meat products. It is also produced as one of several metabolic byproducts of fructose by the liver. So Uric Acid is not in the food per se but we produce based on the food we consume. So foods that are high in purines (meat especially organ meats) and fructose (table sugar, fruits, some vegetables) that are high in fructose will tend to elevate uric acid.

  8. There are basically two reasons for having high serum uric acid – excessive production and inadequate excretion. Excessive production can be the result of diet, or cell destruction due to chemotherapy for cancer.

    Some people are genetically under-excretors of uric acid and may be predisposed to gout. They are usually treated with medication, either to increase the excretion of uric acid or designed to interrupt the metabolic pathway which ends in uric acid – not very soluble – at an earlier stage, where the metabolite can be more easily excreted.

  9. May be chiming in a bit late, but after a recent attack of gout and a visit to my Naturopath a couple of weeks later.. he told me about the dangers of fructose. Consequently, I eliminated most of it from my diet and it showed in the results of a blood test about 1.5 months later.

    I went from being at a level of somewhere between 7.5 and 8 down to 6.2. It fell quite rapidly. The main concessions I made were: No more energy drinks, barely any soft drinks, my fruit intake consisted of berries and apples now which were all cooked (helps eliminate fructose), and I kept away from fruit juices that had any label of sugar on them.

    I eliminated alcohol for the most part; red meat no more than once a week, but I still continued to eat steamed chicken.

    I do think purines in food may play a roll (all be it a small one), but I’m completely convinced fructose is major contributer to uric acid levels.

  10. Hello Dr. Greger,
    I have a question about recommended diet for gout:
    My father is 63 years old and diagnosed with Gout. Doctors advised him to stop
    consuming meat, and I wanted to know if you think he should avoid dairy also? And what about legumes?

    Thanks

    1. To play devil’s advocate, higher uric acid levels are protective for multiple sclerosis, which very rarely overlaps with gout. In other words, we might not all want rock bottom uric acid levels.

  11. I’ve been on a very low fat vegan diet for about a year. Prior to this diet, I was eating lean meats and low fat dairy along with fruits/veggies. I consistently would have gout like symptoms and found that lima beans were a trigger. So much so that I stopped eating them. After being on the vlf vegan for a few months I tried limas again and found that I had no gout like symptoms. For me, there is a correlation between eating meat/fat and the effect of purine rich foods such as limas. For me, more evidence of the benefits of the vlf vegan choice I’ve made.

  12. 80% of my diet is Fructose from fruit such as bananas. I am an athlete and a high carb diet is essential for good performance. If I am not getting my carbs from Fructose in fruit where should I be getting them from? Thanks for the videos they are great.

  13. Most medical advice we’ve read as to how to prevent gout type problems has to do with avoiding foods that contain purines. Along with organ meats, shell fish, sugar and alcohol they normally list beans, legumes, lentils, nuts, and mushrooms. Are all purines created equal? Or is this just an assumption and in fact there is a difference between plant and animal purines?

  14. This is a very misleading video that should have elaborated upon. This basically makes one think that if they are eating a considerable amount of whole fruits on a daily basis that they are doing their body a disservice.

    1. Unless they are an endurance athlete or an avid crossfitter eating considerable amounts of fruits daily is extremely harmful. Sugar is sugar.

  15. RE: MEAT AND SUGAR VIDEO. I suffer from Gout. Three months ago I eliminated meat and dairy from my diet. I do eat fish, the odd egg, tea and coffee without sugar. I do eat three, low sugar, tea cookies a day. Otherwise everything else is plant based. (I make my own whole wheat bread and ad wheat germ, flax seed meal and quinoa flour to it.) After about 10 days on this diet I got very tired and it took a couple of weeks for me to get back to feeling normal. I also lost weight though I didn’t start the diet for that purpose. During the first 6 weeks I had no gout symptoms until I veered off the road and baked and ate a white cake covered with sugar icing and drank four glasses of wine over a period of two days. The gout reappeared on the third day and the symptoms took about a week to go away. I remained on the diet for another month with no gout symptoms until two days ago when I baked and ate another white cake smothered with sugar icing over anther two day period. It could be coincidence. It is hard to link sugar directly to maladies in one person’s diet. To test the effectiveness suddenly adding sugar, I have ate pancakes (made from flour and wheat germ which puffs them up so eggs and baking powder are needed) and blueberries. I smothered then with real maple syrup with no ill effects. I presume the sugar in maple syrup turns into fructose and so should have caused a spurt in uric acid and gout. Perhaps I got the symptoms from the cake because I ate it through the day over a period of two days whereas with the maple syrup I ate approx. two tablespoons and no sugar thereafter?
    I will continue on the diet sans the white iced cake and if I have no gout symptoms at all over 6 months I will consider my self, if not cured, then at least, in remission.

    1. As long as you eat more alkaline forming foods as opposed to acidic, you should be fine. From what you posted I can see that the whole grains kept it present while the red wine flipped your body back into acidic.

      You also have to understand that uric acid levels rise and fall throughout the day. The triggers in some people can be different; it could be meat, dairy, wine, fruit, sugar, or simply just stubbing your toe. The sure fire way to fix it is fixing your gut and liver. Sugar is linked mainly to raising uric acid levels whether your liver is functioning well or not. If the liver isn’t healthy, many other foods can cause the uric acid to go up. Best thing to do is eliminate sugar completely and grains and let your gut and liver heal. Add eggs in to help remove the fat from the liver (and prevent it).

      If another gout attack ensues, what has helped people is squeezing a half lemon into a glass then dumping a half to full tsp of baking soda in it, and let it fizzle up and recede. Then put some water in it and drink it. Do this first thing in the morning and before you go to bed and you should notice the attack subsides much quicker.

  16. I’m an ultra endurance athlete who eats 90% of my calories from fruit. For me, it doesn’t seem that a diet high in fructose from fruit causes any negative health or performance detriments. I only see amazing results.

    1. Congratulations on enjoying your personal success. Gotta stick with studies of a range of people to give general advice though. Some people like you might find an ideal eating what you eat, but it can’t be recommended to the general population.

    2. your an endurance athlete, you can handle it. Having an average person or a couch potato follow that diet plan and their liver will be screaming bloody murder at them.

  17. I adopted the raw Fruitarian diet supplemented with raw greens and occasional steamed rice or baked potato slices about 6 yrs ago and had gout in my left big toe. Gout symptoms left within a few weeks of beginning the transition. I also run up on average 85 miles per week barefoot on and off road and another 40-45 in Luna running sandals.

      1. Contrary to the fear of… “You name it” “Eat Clean in moderation” and “Eat a balanced diet” what ever that is. The reality of human design has proven to be fruit centered diet crowned with a few greens and colorful veggies. Everyone wants to dance around fruit as the main stay of a healthy menu due to all the fear of sugar not realizing that all primates seek a primarily fruit centered diet supplemented with a few hopefully tender, young greens and shoots. Humans are the only confused species when it comes to what their native foods are. Put a toddler in a play pen with a baby bunny rabbit and a piece of ripe honeydew and watch it choose its native food. Everything from there is confusion pushed down based on false assumptions.

    1. Gout is also largely based on whether your body is acidic or not. If your eating more alkaline forming foods (which you are), its next to impossible for gout to form.. that doesn’t mean your out of the woods though. Your problem is your still eating piles of sugar from fruit which can elevate your uric acid levels at any given time, so if you step off the wagon at all or do something else to trigger it like trauma, your back with that giant red toe again.

  18. John, Whole fruit is good, taking out the sugar and eating just that is bad…. remember our bodies get their premium energy during the Krebs cycle from fructose, we need it.

    1. David is right, fructose is not need in any function what so ever. In fact, our brains are the only thing that require a bit of glucose and they can manufacture that from proteins or fat.

  19. Meat doesn’t increase uric acid levels, sugar and your liver’s inability to break down foods does. If your liver is having difficult breaking down foods, it’s because of sugar.

    If your having liver difficulties, meat, sugar, and anything with a high purine content will raise them. In a normally functioning liver, meat has little effect on uric acid. Sugar/fructose on the other hand, has a big effect on uric acid.

  20. John Smith – No, I’m a barefoot ultra distance runner who logs 85-150 miles per week year round for decades and thrive on a Fruitarian centered diet with zero animal DNA. I should also mention that I’ve logged over 800,000 human powered miles so far in my 59 laps around the sun including a 23 yr career in bicycle road racing. You can eat all the fruit you want or need and not get fatty liver. A good resource for you would the book “The 80-10-10 Diet” Google it…

    1. I know what you’re talking about on the 80-10-10, that was my first attempt at a healthier, high-performance life. Eventually I let myself eat junk again in order to get off nicotine. THEN I couldn’t restart the 80-10-10. For me it just became laborious hauling in and peeling and eating ALL that much fruit. And me with only marginal fruit markets less than 30 minutes away. I kept buying bananas and letting them rot, eventually I gave up restarting fruitarian style (with weekends off).

      Now with WFPB (also weekends my option) I don’t have to pack in so many cubic feet of food to not be hungry. And then I discovered good dates. But even with good dates to pack in more calories as an 80-10-10’er, I’m much happier with the grains, starches, nuts, and seeds as well as plenty of fruits, berries, and greens than I ever was with 32oz smoothies every morning and hungry again by 9 or 10am.

      I had no complications with whatever a high-fruit diet might complicate. Got skinny as hell.

  21. Does this set the verdict on green smoothies?

    Do smoothies have high fructose and therefore cause high uric acid such as blended apples?

    Would appreciate the Doc’s view on this or wether someone can shed some light.

  22. Hello shiftpolitics!

    I think it may have. Check this other videos about the downsides of green smoothies:

    https://nutritionfacts.org/video/the-downside-of-green-smoothies/

    https://nutritionfacts.org/video/green-smoothies-what-does-the-science-say/ here’s also explained why it’s different to eat a whole apple than a blended apple on a smoothie. This one it’s interesting because it mentions the effect of differents fruits on blood sugar.

    Also check: https://nutritionfacts.org/video/are-green-smoothies-bad-for-you/

    And this study also explains why we shouldn’t take too many green smoothies: https://www.ajkd.org/article/S0272-6386(17)30863-6/abstract

    Hope it helps

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