I know food is everything, but is there been anything that helped you going down in weight other the food habits?
That’s true, but the root cause of gout is carbs and fructose and alcohol. Lowering uric acid when gout is acute makes sense, but long term you want to get off the sugars and alcohols.
https://studyfinds.org/gout-genetic-fingerprint/
I don’t have access to the actual text of the study but gout is primarily genetic and not solely the result of diet or lifestyle.
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Quotes from the paper https://doi.org/10.1038/s41588-024-01921-5
Over recent decades, the incidence of gout has steadily increased, largely due to lifestyle factors such as diet, obesity, and metabolic conditions
The paper also indicates a global rise in gout going hand in hand with the rise in global metabolic dysfunction.
Having looked at the paper, it good, really good… but the genetic factors are for a population in the current metabolic context (high carb diets, poor metabolic health). Some people can tolerate the modern food landscape really well, and those people don’t get gout (hence this paper). But just because people’s genetics are intolerant of the current food landscape, doesn’t mean they HAVE to get gout… It can be avoided, by cutting out carbs, fructose, and alcohol. So even if you have a genetic sensitivity that leads to gout, you can simply not eat the foods necessary for the condition.
Here is the full paper: https://www.medrxiv.org/content/10.1101/2025.02.07.25321834v1.full.pdf
Right below that it says
Genetic factors play a crucial role in the development of gout, with several studies highlighting its strong hereditary component. Twin studies have demonstrated a strong genetic component in gout, with heritability estimates reaching 60% for uric acid kidney clearance, 87% for uric acid-to-creatinine ratios, and 28% to 31% for gout itself.
And also towards the end
While observational studies have often linked alcohol intake with gout, our MR analysis suggests that this association may be confounded by other factors or may not represent a direct causal relationship.
yeah, 100%. Not everybody gets gout, there is clearly a genetic profile that can develop gout… in the current metabolic context, and the modern diet.
People can’t control their genetics, they can control their metabolism, and their diet.
Fructose has uric acid as a byproduct of its metabolism [86]. Fructose induced hyperuricemia has a pathogenetic role in metabolic syndrome [78,87]. Higher insulin concentrations, associated with metabolic syndrome, reduce the renal excretion of uric acid [47,80,88]. Uric acid is an inhibitor of nitric oxide synthase, [78] which is the catalyst for nitric oxide, critical for circulatory and immune homeostasis.
Reducing circulating uric acid concentrations is one of the mechanistic components of improved blood pressure control that is observed with a reduction in fructose intake [89].
- Except from https://doi.org/10.1016/C2019-0-03604-7 section 7.3 Pathophysiology of gout
Here are the references
- 47 - https://doi.org/10.1016/j.semnephrol.2011.08.004
- 78 - https://doi.org/10.3899/jrheum.170806
- 80 - https://doi.org/10.1186/1758-5996-4-12
- 86 - https://doi.org/10.1152/physrev.00019.2009
- 87 - https://doi.org/10.1152/ajprenal.00140.2005
- 88 - https://doi.org/10.1001/jama.1991.03470210076036
- 89 - https://doi.org/10.1093/ajh/hpaa044
All of that is to say elevated uric acid is not the root of the problem, its a symptom of the core problem.
