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The Paleo Diet And Gout

By Loren Cordain, Ph.D., Professor Emeritus, Founder of The Paleo Diet
November 12, 2009
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I have a question regarding the paleo diet and gout - what is the effect of The Paleo Diet® on seniors with respect to gout? I've heard that protein in one's diet can have an adverse effect.

Dr. Cordain's Response:

Gout is considered as part of a metabolic syndrome and insulin resistance is at the root of gout. Along these lines, gout was rare among pre-agricultural populations (Hunter-gatherers). Serum uric acid levels depend on the amount entering the blood and the amount leaving the blood.

The amount of uric acid entering the blood depends on the amount of it produced by the liver (1/3 from the diet and 2/3 from the body turn-over of cells) and the amount of uric acid leaving the blood depends on the kidneys' excretion capacity. The metabolic syndrome and insulin resistance induce kidney underexcretion of uric acid. On the other hand, when the kidney is
faced with high protein purine-containing foods, serum uric acid levels decrease because the kidney increases uric acid excretion (this is an evolutionary trade-off).

So, the real problem is increased liver production of uric acid and kidney uric acid underexcretion. High glycemic load foods (as found in the typical western diet and not in The Paleo Diet) and subsequent hyperinsulinemia halt the kidneys' capacity to excrete uric acid. Regarding liver production of uric acid: fructose, and particularly High Fructose Corn Syrup (HFCS), decreases inorganic phosphate in the liver and this increases the production
of uric acid from purines.

The Paleo Diet helps to fight gout as is based on low glycemic load foods, high protein and no HCFS foods.

Cordially,

Loren Cordain, Ph.D., Professor Emeritus

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