hello everyone i'm dr david perlmutter you know in our efforts to keep uric acid uh under control the recommendations are of course be careful about the type of alcohol that you consume be on a diet that really limits your consumption of fructose and we've also talked about purines these breakdown products of dna and rna that can raise uric acid as well we find high levels of purines in certain foods like organ meats kidney and liver and certainly in small fish like anchovies and sardines but there are high levels of purines or there are some vegetables that are described as being high in purines and they have familiar names things like cauliflower broccoli bok choy and mushrooms for example have high levels of purines and you might find online for example in some of the forums related to gout that there are recommendations that that gout suffers that's a disease characterized by generally high levels of uric acid should avoid purine rich vegetables and uh gee that's taking a lot of seemingly good food off the table especially things like broccoli the cruciferous vegetables is that really a good idea let's take a look let's unpack that a little bit and see what the science tells us so again the question is should we consume high purine vegetables vegetables like broccoli i mean all these years we've been told gosh broccoli is a super food we want to increase available sulforaphane in the body any number of things that we were told is good about broccoli and it turns out that it's really valuable to look at this if if broccoli is high in purines and other vegetables are high in purines like artichokes leeks brussels sprouts mushrooms and spinach what does that tell us in terms of dishes like this which i have to admit looks really really good so are we to abandon high purine vegetables because of their uh propensity possibly because of the hyperions to increase uric acid does that stand the test of science and in fact it's been looked at quite extensively this is one study that is entitled the association of dietary intake of purine rich vegetables like broccoli like mushrooms sugar-sweetened beverages in dairy with plasma urate in a cross-sectional study and what these individuals who did the study looked at uh they had uh just over 2 000 participants about 44 female so the rest male and they gave them a food frequency questionnaire so that they could determine what they were eating and they also measured their plasma uric acid levels so what are you eating and what is your uric acid level and what do they find well they looked at both men and women and they stratified these individuals based upon in this case they did a lot of evaluation of these people but they looked at them in terms of their intake of what are called purine rich vegetables and correlated that or compare that to their uric acid levels now women in green men in blue what you see is moving from left to right looking at the the green bars the women that the higher levels of eating purine rich vegetables on the right side quartile number four these are the people these are the women who have the greatest level of purines from vegetables consumption look at their uric acid level it's in fact the lowest men have in general a higher uric acid level but nonetheless those men who ate the most of those purine rich vegetables that i just mentioned the broccoli the cauliflower the leeks the mushrooms etc these men had in fact the lowest uric acid level so what did we learn we learned that the findings of this study are in agreement with another study in which they evaluated uh 47 150 people and did not find an associate association between eating these vegetables and risk of gout which is a disease characterized in general by a high uric acid level further they stated our results reinforce concerns about the validity of recommendations to restrict intake of pure enriched vegetables such as asparagus cauliflower beans lentils and spinach in gout patients what they're saying is that their results would indicate that in fact gout patients should be eating these higher purine vegetables turns out they're good for you they're good for you according to their recommendation if you have gout and i am certainly going to indicate that they're good for you whether you had have gout or not but if your uric acid level is elevated these are good choices as it relates to the foods that we consume so what we've learned then is that though these vegetables seem to have higher levels of purines they don't tend to be associated with higher levels of uric acid and certainly they don't tend to be associated when they are consumed with higher risk for gout why might that be yeah they contain purines and purines are broken down to uric acid but they contain other things that help to lower uric acid things like a dietary fiber various bioflavonoids that can inhibit the enzyme that makes uric acid called xanthine oxidase maybe a little vitamin c that may aid in reducing or aiding in the excretion of uric acid and hence helping to keep the uric acid level lower than it otherwise would be so the the end of the day recommendation is that these are good vegetables for us like them or not they're good for you uh even if you're trying to gain control over an elevated uric acid good information hope you enjoyed it i enjoyed spending time with you and i'll be back soon i'm dr david perlmutter bye for now
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