Chocolate Granola

Chocolate Granola © 2008

I have no idea how many of you have flown off to Paris, found a lover, or been seduced by lemon cakes and baguettes as a result of my reckless suggestion that you visit Molly Wizenberg’s blog, Orangette (http://carbwars.blogspot.com/search?qOrangette). I can’t resist an occasional foray into her world, even though it makes me long to be young and perky and witty and full of joie de vivre, but mostly it makes me wish I still had the metabolism to eat like she does.

On my last visit to Orangette, I found the inspiration for something that I can actually eat rather than just envy, even in my advanced state of decrepitude. It needed quite a few changes, as carbs and calories and such have not yet intruded into her consciousness. (May she enjoy it as long as she can!) But her granola recipe has chocolate and so does mine, and that’s really all that matters.

CHOCOLATE GRANOLA
I used chopped Chocoperfection bars in testing this recipe. One and one-half bars make 1/2 cup of chocolate chunks.

1/4 cup of rolled oats

1/2 cup of unsweetened, flaked coconut

1/2 cup sliced almonds

1/4 cup of pumpkin seeds, or use part sesame or flax seeds

2 tablespoons of granular sugar substitute

- a pinch of salt
1 egg white

1/2 cup of chopped, sugar-free chocolate bars or chocolate chips*
1/4 cup of sugar-free dried cranberries

Preheat the oven to 300°F.

Combine oats, coconut, almonds, seeds, sweetener, and salt and stir until blended. Beat the egg white until thick and stir into the mixture until evenly coated. Spread granola in a shallow baking pan. Bake for 15 minutes, then stir and break apart any lumps. Continue to bake for an additional 15 to 20 minutes or until golden brown. Let cool completely. Stir in the chocolate and cranberries. Serve with cream and additional sweetener, if desired. Store in an airtight container. Makes about 2 1/2 cups.

Per serving of <1/3* cup: Total Carbs: 9.6 g, Fiber: 5.41 g, Net Carbs: 4.2g

*You may use the recipes in Carb Wars for sugar-free Dried Cranberries and Chocolate Chips or use purchased cranberries and sugar-free chocolate bars or chocolate chips.

*This is not a large serving at a little less than 1/3 cup, and the stuff is totally addictive. Eat it for breakfast when your insulin is more sensitive and then put it in an inconvenient place. (Coconut speeds up the metabolism, so that ought to help.)

Molly's blog: http://orangette.blogspot.com/

POTENTIAL DANGERS OF AGAVE

“Agave provokes bitter debate as a sweetener,” reads the headline in the March 23rd Chicago Tribune: www.chicagotribune.com/features/chi-0323deardorffmar23,1,7478086.story. The story raises questions about the safely of the trendy, expensive, liquid sugar made from the Mexican agave cactus. Agave nectar is being marketed as a healthful, all-natural substitute for sucrose because it has a very low glycemic index and doesn’t raise insulin levels. However, the dangers of fructose are well known, and agave nectar is almost 100% fructose. As I wrote in this previous post, http://carbwars.blogspot.com/search?q=agave, fructose raises triglycerides, promotes belly fat, and contributes to fatty liver, obesity, diabetes, heart disease, hypertension, and metabolic syndrome. It increases the formation of glycation end-products, which speed up the aging process.

Although the juice of the agave cactus is about half glucose and half fructose as it comes from the plant, it is refined to remove the glucose. “ ‘It's almost all fructose, highly processed sugar with great marketing,’ said Dr. Ingrid Kohlstadt, fellow of the American College of Nutrition and associate faculty member at Johns Hopkins School of Public Health.”

But wait—there’s more. There have been reports that many of the products labeled as being from the blue agave plant really contain high-fructose syrup from corn and other varieties of agave because blue agave is expensive and in high demand for making tequila. Russ Bianchi, a food and beverage formulator, is quoted as saying, "Agave is really chemically refined hydrolyzed high-fructose inulin syrup and not from the blue agave plant, organic or raw as claimed."

Although the article includes quotes from some who endorse the use of agave “in moderation,” it also lists concerns about agave consumption, including the following:

- It can contain botulism spores and should not be given to babies.
- It should be avoided if you are pregnant, as some believe it can cause miscarriages.
- It can worsen acne and diabetes symptoms.
- It does not raise blood glucose levels, but it raises blood fructose, which is worse.
- Use only agave nectar that is organic and carries a USDA seal.

The author states that although the FDA does not see a need for action, it requests reports of adverse effects from agave.

Lotus Root

Raw Lotus Root © 2008

Lotus Root Chips © 2008

When I first started low-carb cooking, my son-in-law gave me a challenge. He said if I could find a good substitute for french fries, he would consider trying my diet. (He eventually did anyway.) I fried all sorts of things, animal and vegetable, with varying degrees of success. Several of the recipes in Carb Wars came from these experiments. One of the things I tried was lotus root, but I used the prepackaged slices from the Asian market and wasn't happy with them. When a local grocery started selling the fresh roots, I decided to give it another go. I made these yesterday for Easter dinner. Everyone liked them, even the kids.

Tip: Fresh lotus roots look like stiff links of fat, pale brown sausages. They break apart easily at the narrow joints. They can be stored in the refrigerator for up to two weeks.

LOTUS ROOT CHIPS
The chips have very little taste of their own, so you can spice them any way you like. They are more beautiful and exotic than potato chips and have fewer carbs in the bargain. They are sturdy enough to use for dips or like a cracker.

Peel the roots with a vegetable parer and cut into very thin, uniform rounds with a mandoline or a chef's knife. Drop the slices in a bowl of water with some lemon juice added to prevent discoloration. Dry well on paper toweling before frying.

Heat oil in a deep fryer set on high (375 degrees). Deep fry in batches for 2 to 3 minutes or until golden brown. Drain on paper towels and sprinkle with coarse salt and freshly ground pepper. Alternately, toss with chili powder, smoked paprika, or other spices. Store chips in airtight container.

Eight slices of raw lotus root weigh about an ounce, which comes out to 0.37 Net Carbs per chip.

Easter Menus

Easter is early this year—are you ready? Here are two menus, one for a spring brunch and one for a scrumptious Easter dinner. There’s still time, but you’d better get hopp’n!

EASTER SUNDAY BRUNCH
Waffles Benedict (Waffles, ham and poached eggs with Hollandaise Sauce)
Fruit and Nut Compote
*
Devonshire Cream with fresh strawberries for dipping
Shortbread Cookies

EASTER DINNER

Snow Peas stuffed with Herb Cheese
*
Pan Grilled Duck Breasts with Brown Sauce

Rhubarb Ginger Chutney

Cheese Polenta

Sautéed Asparagus
*

Heavenly Pie

Items in bold are from Carb Wars; Sugar is the New Fat.

WE NEED A HERO, Part 3

There are many theories about what causes fibromyalgia /chronic fatigue. There is a doctor who thinks it is caused by a deficiency of vitamin D and one who thinks it is caused by too much vitamin D. There is one who thinks it is caused by a thyroid deficiency and some who think it is triggered by infection. Some suggest that it is just an over-sensitivity to pain signals in the brain. Others blame flouride, inflammatory foods or toxins in the environment or stress hormones or lack of deep sleep. There may be merit in these theories, and they are not all mutually exclusive.


Most of the conventional treatments for FMS/CF just deal with symptoms, and not very effectively at that. They have no effect on the cause and no possibility of correcting the problem or preventing its progression. Dr. St. Amand has dedicated his career to the study and treatment of this misunderstood disease. He believes that all the symptoms of FMS result from one genetic defect which, if untreated, eventually leads to osteoarthritis.

I don’t pretend to be an expert; I just plan to see what works for me and report on my experience.

Dr. St. Amand's guaifenesin protocol has three main parts:

1. You must discover your correct dose. You start low and increase the amount in timed increments until it starts to work. When you start to feel dramatically worse, you know you have reached the proper dosage to start reversal. Dr. St. Amand’s warns that the treatment is not easy. Some liken it to having a bad case of the flu. The time it takes to get through the reversal process depends on how long you have had the condition. It may take as long as two months for every year that you have had symptoms. That works out to a formidable 22 months for me, but I’m hoping that since that estimate is a worse case scenario, it won’t really take that long. Good days are supposed to be interspersed with the bad ones until the bad days diminish and disappear.

2. Another important part of the system is that you must avoid any topical substance that contains salicylates. We are most familiar with salicylates in aspirin, but all plants contain them. Salicylates preferentially bind to the same receptors as guaifenesin and block its absorption, so all products that list plant oils, gels, or extracts (except for wheat, oats, rice, soy, and corn) must be eliminated. There is no problem with eating salicylate-containing plants; it is only products that will stay in contact with the skin that block quaifenesin. It is better to be safe and eliminate them all than to risk negating the treatment. Herbal supplements must also be avoided, since they are taken in greater quantities than what is naturally found in food. Rather than learn all the chemical names and scrutinize every label, I just bought the minimum daily necessities from a store that specializes in salicylate-free products. It may actually save me a lot of money in the long run since I stopped using some expensive cosmetics, lotions, and creams and replaced them with much simpler products.

Some critics of the protocol say that it is too difficult to follow and that no one could possibly do it correctly. I’m baffled by this complaint—how could anyone believe eliminating some toiletries and giving up herbal supplements could be worse than living with fibromyalgia and chronic fatigue? I can only think that perhaps fibro fog has addled their brains and affected their judgment.

3. The third layer of the protocol is diet, although this part does not apply to everyone, only to those who have hypoglycemia (estimated to be 40%). Dr. St. Amand tells his patients that if they have hypoglycemia, they must deal with it or they will not get better. He has two diets; both are low carb, one strict and one liberal. In my opinion, reducing sugar and starch is something we all need to do anyway and it is not really difficult. You just have to decide to do it and make the effort to find good food that you enjoy so you don’t feel deprived. I’ve been eating a diet similar to the strict one for eight years and it has become second nature.

If, as some allege, it is the low-carb diet that is responsible for Dr. St. Amand’s success—I’ve been there; done that. It changed my life for the better, and I will never go back to my old sugar-junkie habits—but I still have FMS. I've also tried a lot of other things; some of you probably have as well. If I were susceptible to the placebo effect, surely some of them would have worked.

I started the guaifenesin protocol about 6 weeks ago. I progressed from a dose of 600 mgs per day to 1200 and then increased up to 1800 with no results. I will stay at 1800 for two months and then go up to 2400 if nothing changes. It is a strange situation to be hoping to wake up in misery in order to know that the system is going to work. I’m not looking forward to being more tired or in more pain, but if there is a chance that this will work, there is no way I’m not going to try it. The choice is to do nothing and continue to suffer or to suffer with a purpose and with the hope of getting better. That is an easy decision.

R. Paul St. Amand, M.D., is a graduate of Tufts University School of Medicine. He has been on the teaching staff at the Los Angeles Harbor/UCLA Hospital, Department of Endocrinology for over fifty years. He is currently an assistant clinical professor at the UCLA School of Medicine.

Claudia Craig Marek, M.A., is a medical researcher tutored, trained, and taught on the job as Dr. St. Amand's assistant. She has co-written three books with Dr. St. Amand and one of her own.

Dr. St. Amand's and Claudia Marek's books are available from the Fibromyalgia Treatment Center at http://www.fibromyalgiatreatment.com/ or from Amazon.com at the links below:

What Your Doctor May Not Tell You About Fibromyalgia : The Revolutionary Treatment That Can Reverse the Disease

What Your Doctor May Not Tell You About Pediatric Fibromyalgia: The Program that Helps Boost Your Child's Energy Level

What Your Doctor May Not Tell You About Fibromyalgia Fatigue: The Powerful Program That Helps You Boost Your Energy and Reclaim Your Life

The First Year: Fibromyalgia: An Essential Guide for the Newly Diagnosed (First Year, The)

Note: A reader asked me to mention the social networking site that he has started for fibromyalgia sufferers and their families. Check it out at: http://fibromyalgia.ning.com/

DON'T BANISH THE BUNNY

Don’t banish the Easter Bunny, just have him hop over to fill your baskets with sugar-free treats.

* To make Chocolate Peanut Butter Easter Eggs, shape my Peanut Butter Balls into ovals before dipping in chocolate.

* Roll Chocolate Dipped Strawberries in pastel tinted coconut after dipping. Link to recipe: http://www.carbwarscookbook.com/choc_dipped.html

* Make individual Sponge Cakes in egg-shaped cupcake pans. Frost and decorate with Confectioner’s Icing.

(Recipes in bold are from Carb Wars; Sugar is the New Fat.)

* Chocoperfection and Livin’ La Vida Low Carb chocolate bars are perfect for Easter, all dressed up in their red and pink foil-lined wrappers. Available from http://www.lowcarbspecialties.com/.

* You can order a whole, ready-made basket of sugar-free goodies from the Low Carb Connoisseur at http://www.low-carb.com/. The assortment includes solid milk-chocolate rabbits and eggs, marshmallow rabbits and eggs, and sugar-free jelly beans.

* And don’t forget to include the original Easter treat, real colored eggs, which are always low carb!

Happy Easter!

http://www.carbwars.blogspot.com/

WE NEED A HERO, Part 2

I was diagnosed with fibromyalgia about ten years ago. In looking back, I realize that many traits that didn’t seem to be related were all part of one syndrome. When I was in high school, I would have to lie down to rest after walking home from school. I was the only one who went back to my room to brush my teeth after lunch in college, and yet I was the one who needed frequent dental work. Wool was intolerably scratchy, and the tags on my clothes would raise welts on the back of my neck so I cut them out. Even with heated socks, my feel would go numb in 15 minutes in the snow. My husband called me “the princess,” because he was sure I would be able to detect a pea under 20 mattresses like the heroine of the fairytale.

The pain started with tendonitis and bursitis, first in one joint and then another. Sometimes I couldn’t turn my head to look behind me when driving, and I couldn't lift my arms to more than shoulder height. Like most FMS sufferers, I went from doctor to doctor, and all repeated the same tests with the same lack of results. I was told to exercise, get massages, try acupuncture, take up yoga, get psychotherapy, and I was sent to a pain-management clinic. Even when I went to a doctor whose specialty was fibromyalgia, the first question he asked was about what traumatic event I had experienced at the time I started to have symptoms. (He didn’t ask if there had been some traumatic event, but what it was.) I seldom get more than a few hours of sleep and usually wake up more exhausted than when I went to bed. As bad as all this sounds, I actually got off light compared to what others have described. I’ve managed to function reasonably well with the help of some supplements and a low-carb diet. As long as the pain kept moving from one body part to another, I accepted it as a nuisance, but not a “real” problem. Besides, there didn’t seem to be any alternative.

FMS/CF symptoms:
In addition to pain and fatigue, FMS patients report brittle nails, poor hair quality and hair loss, periodontal disease, frequent bladder infections, irritable bowel syndrome, genital pain, and sensitivity to light, noise, and odors. They have a narrow comfort range in temperature, and hot flashes and night sweats disrupt sleep. Rashes, acne, eczema, rosacea, and seborrhea are common. They can’t tolerate synthetic fabrics and some can wear only cotton. Many wear their underwear, socks, and pajamas inside out so the seams won’t hurt. They experience dizziness, frequent headaches, memory lapses, and mental confusion. They have allergy-like symptoms of the throat, nose, and eyes. Weight gain and carb cravings are common. According to a 2007 survey, the average female patient weighs 180 pounds and is 5’4” tall. Several of Dr. Kervokian’s suicide clients were said to have been suffering from FMS.

It was through an e-mail from a reader that I learned that there is a treatment that holds promise. Dr. R. Paul St. Amand is an endocrinologist in Los Angeles who has devoted more than 40 years to the treatment of fibromyalgia. He and his assistant, Claudia Marek, have written three books together and she has written a fourth that describe a protocol using a common, over-the-counter medication to reverse the disease. Dr. St. Amand’s protocol has been used by thousands of people, but you are not likely to learn about it except by word of mouth or through an Internet search.

Dr. St. Amand believes that FMS is caused by a genetic defect that results in an accumulation of phosphate in the cells that interferes with energy production. Since it involves every cell, the condition affects all parts of the body, and all the varied symptoms can be explained by this one defect. He has discovered that guaifenesin, usually used as an expectorant, can purge the excess phosphates and reverse the symptoms of the disease. The medication is a weak unricosuric agent, meaning that it causes the kidneys to eliminate uric acid. He contends that it also acts to remove phosphates. You can read about Dr. St. Amand's protocol on the Fibromyalgia Treatment Website at: http://www.fibromyalgiatreatment.com/. An explaination of his hypothesis about how guaifenesin works is available at: Use of Uricosugic Agents in Fibromyalgia.

Although this protocol has not been endorsed by mainstream medicine and is actively disputed by some, he claims that his system works for 95% of the people who follow it. (A placebo effect could account for only a 30% positive response, so that eliminates that argument.)

To be continued: We Need a Hero, Part 3

WE NEED A HERO

It’s official. Fibromyalgia is real. How do I know? Because I just saw an ad for a drug to treat it. Lyrica (pregabalin) is now allowed to claim that it may help patients with fibromyalgia (FMS). When The New York Times ran the story on January 14, 2008, the headline was: “Drug Approved. Is Disease Real?” In clinical trials Lyrica has been shown to reduce pain by about 2 points on a scale of 10, compared to 1 point for a placebo. It has significant side effects, including weight gain, dizziness, and sleeplessness, problems that are already associated with fibromyalgia. Nevertheless, Pfizer spent $46 million dollars advertising the drug in the first nine months of 2007. Other drugs that have been prescribed for fibromyalgia and chronic fatigue include antidepressants, narcotics, sedatives, anti-anxiety drugs, drugs designed to control epileptic seizures, amphetamines, muscle relaxants, Botox®, and even a drug used for chemotherapy.

Fibromyalgia is a condition characterized by widespread pain in joints and fibrous tissues without the outward signs of inflammation (redness, heat, and swelling) that are usually present in rheumatic conditions. Insomnia, irritable bladder and irritable bowel syndrome, restless legs, dysmenorrhea, cold sensitivity, Reynaud’s phenomenon, hypoglycemia, tinnitus (ringing ears), headaches, and eczema, as well as mental confusion and the inability to concentrate (called fibro fog) frequently accompany the chronic pain and fatigue that characterize the condition. FMS sufferers also exhibit tender points all over their bodies—these are lumps of swollen or knotted tissue that are extremely painful to the touch. Pain medications, even powerful narcotics, offer little relief. Although the lumps can be felt, and brain scans have shown that the pain is real, there is no test to confirm fibromyalgia. It is the default diagnosis after everything else has been ruled out. It is estimated that 10 million adults in America suffer from the disorder.

Many health practitioners do not consider FMS to be a real disease but believe that these patients are hypochondriacs and whiners who are suffering from stress, anxiety, depression, mental illness, or just laziness. They are often told to suck it up and quit complaining by people who have no idea how it feels to suffer from chronic, relentless pain and debilitating fatigue. This attitude comes in part from the fact that fibromyalgia is often accompanied by so many other nebulous conditions, and 85 percent of sufferers are middle-aged women. (The same complaints that are labeled fibromyalgia in a woman are likely to be diagnosed as chronic fatigue in a man; it is the same disease. It may be called one or the other depending on whether pain or fatigue is the predominate symptom.)

Dr. Frederick Wolfe, who was the lead author of the 1990 paper that first defined fibromyalgia, has changed his mind. He now says, ''Some of us in those days thought that we had actually identified a disease, which this clearly is not…To make people ill, to give them an illness, was the wrong thing.” Dr. George Ehrlich, a rheumatologist at the University of Pennsylvania, observed that most people ''manage to get through life with some vicissitudes, but we adapt.…People with fibromyalgia do not adapt.'' I think I see part of the problem; who wouldn’t be depressed, stressed, and anxious with doctors like these?

We need a hero. Dr. Richard Bernstein has been a champion for those with diabetes, working tirelessly to educate and heal patients while being ignored by mainstream medicine. Dr. Robert Atkins and Dr. Michael Eades continued to tell the truth about what constitutes a healthful diet while being marginalized and ridiculed by a misguided health establishment. Gary Taubes risked his own credibility and career to expose the lack of science that serves as the basis for much of modern medical practice. Fibromyalgia/chronic fatigue syndrome desperately needs such a hero. I think I have found one.

To be continued: We Need a Hero, Part 2

Irish Musings

We think of corned beef and cabbage as a traditional Irish dish, but it is actually Irish/American. According to Bridgett Haggerty of the Irish Cultures and Customs website, cows were generally used for milk in Ireland and were too valuable to eat. Pork was cheaper, so a side of bacon was cooked with cabbage for Easter. The Irish in New York substituted corned beef for bacon, borrowing from their Jewish neighbors, and it has come to be associated with St. Patrick’s Day. She says that Irish pubs now serve corned beef and cabbage on St. Patrick’s Day, but it is to please the tourists. Another bit of trivia—did you know that the national color of Ireland is blue?

Here’s a verse from a poem by Frances Shilliday:

Good Grief—Not Beef!

This custom the Yanks have invented,
Is an error they've never repented,
But bacon's the stuff
That all Irishmen scoff,
With fried cabbage it is supplemented.
©Frances Shilliday 2004

LOW CARB CORNED BEEF AND CABBAGE

I don’t usually think about corned beef and cabbage until I see the seasonal specials in the stores in mid-March. It makes an easy, tasty, one-dish meal; I don’t know why I don’t make it more often. (Try my walnut trick to keep the cooking odors from permeating the house and to make the rutabagas taste more like potatoes.)

1 corned beef brisket, spice packet included, about 4 pounds
1 head of green cabbage, cut into wedges
3 or 4 small rutabagas, peeled and cut into chunks (about 4 cups)
2 whole walnuts in the shell

Put the corned beef and the contents of the spice packet into a large pot and cover with cold water; bring to a boil and then lower the heat and simmer for 2 and 1/2 to 3 hours or until almost tender. Add rutabagas and walnuts and simmer for 30 minutes. Add the cabbage and simmer for an additional 30 minutes or until the meat and vegetables are fork tender. Discard the walnuts. Slice the corned beef across the grain and surround with the vegetables. Serve with prepared mustard.

Servings: about 8
Total Carbs per Serving: 8.6 g, Fiber: 3.3 g, Net Carb: 5.3 g

Note: Corned beef was cured with dry spices in Anglo-Saxon times to preserve it. Corned refers to the large grains of coarse salt used in the rub. The Oxford English Dictionary gives the meaning of the word corn as a "small, hard particle, a grain, as of sand or salt." Corned beef is now brined or pickled in liquid.

AN IRISH OMEN

My brother has done a bit of research on our family history; as far as I know, he hasn’t uncovered any Irish connections, but I suspect that somewhere in my gene pool there was an Irish grandma, spouting Gaelic proverbs, which I sometimes find myself repeating even now. When I was a girl, I used to whistle when I was concentrating or when I was nervous. My mother would tell me, “A whistling girl and a crowing hen always come to no good end.” I’ve come across several variations on this aphorism in Irish anthologies. When I see the beginnings of those little pucker lines on my lips, the kind that only smokers are supposed to get, I wonder if this could be my comeuppance for breaking the no-whistling rule for proper young ladies.

"Diabetes Health" Article About "Carb Wars"

Following is a link to an article by Patrick Totty, titled, "Carb Wars: Sugar Is The New Fat Provides Delicious Recipes For People Living With Diabetes," that appeared on Diabetes Health on March 9th: http://www.diabeteshealth.com/read/2008/03/09/5670.html

Do artificial sweeteners cause weight gain?

This is interesting. Several recent studies have linked artificial sweeteners with weight gain, which I find baffling and counter to my own experience. The rationale used to explain the phenomenon is that just the sensation of a sweet taste provokes an insulin surge in anticipation of sugar just as a ringing bell associated with feeding caused Pavlov's dogs to salivate. The insulin then promotes fat storage.

A new study from Purdue University seems to confirm that using artificial sweeteners makes it harder, not easier to lose weight. (Here's a link to the article, "Low Cal Sweeteners Tied to Weight Gain": http://www.smh.com.au/cgi-bin/common/popupPrintArticle.pl?path=/articles/2008/02/24/1203788130770.html)

The scientists fed yogurt, sweetened with either saccharin or glucose, to rats and discovered that the ones who got the saccharin went on to eat more and gain more weight and body fat than the ones who were given real sugar. The researchers speculated that the sweet-tasting foods prompted the body to prepare for a lot of calories, but when the extra calories failed to follow, the body was confused, which may have led to eating more calories or expending less energy than normal.

Herein may lie the explanation for why those of us who are on low-carb diets don't react like the rats in the study. If the expectation of calories is the causative factor, and the calories don't materialize, the rats over-eat. But what would happen if the sweet taste were accompanied by plenty of calories from fat and protein but not from carbs? Would you have happy, satisfied rats consuming lots of calories that can't be stored as fat?

I'm not a scientist, so I'm clearly out of my comfort zone here, but I'd be interested in hearing from some of you who are perhaps better qualified than I am as to what you make of this study.

Gout and Metabolic Syndrome

I did a little research on gout for a friend who had been given the standard advice for treating this painful condition: eat a low-fat diet, cut out red meat, seafood, fish, beans, and other purine-rich foods, and take medication. Purines can be broken down into urate, which can crystallise out to cause pain in the joints, so a reduction in purine-containing foods is standard advice, in spite of the fact that most uric acid is made in the body and does not come from the diet.

Although much of what I found when I Googled the subject repeated the conventional litany, many of the studies and articles also said that gout is part of the metabolic syndrome and is related to insulin resistance, obesity, and high levels of fats in the blood (all of which are caused by sugar, not fat, in the diet). Here is a sample from Nature Clinical Practice Rheumatology (2007), titled: High prevalence of metabolic syndrome in patients with gout or SLE

"Studies have indicated an increased prevalence of metabolic syndrome in patients with gout or systemic lupus erythematosus (SLE), and two independent quantitative studies have now confirmed these findings." Source: Nature Clinical Practice Rheumatology (2007) 3, 250-251.

One thing that seems to be unanimous is that alcohol is a risk factor and that beer is the worst offender. Beer, often called "liquid bread," is high in both alcohol and carbohydrates so that fits the hypothesis that gout is just another manifestation of the metabolic syndrome.

Here are two recent articles about sugar and fructose that may be on the right track:

1. This article says soft drinks, fruit, and fruit juices increase the risk of gout--
http://www.medicalnewstoday.com/articles/96164.php --"Link Found Between Gout In Men And Sugar In Soft Drinks" (notice how they have to get in the caveat that they're not telling anyone not to eat fruit or drink fruit juice--no matter what the science shows!)


2. This article says fructose and soft drinks are worse than alcohol for causing gout--
http://www.medicalnewstoday.com/articles/96073.php --"Pop Goes The Question Of Gout"

I also found two articles on Dr. Briffa's blog that are from a couple of years ago, but they are well worth reading. If you go to his blog at http://www.drbriffa.com/ and search for "gout" you will find them.

Here's a quote from Dr. Briffa:
"Excesses of insulin have been shown to raise uric acid levels, and there is evidence that eating less carbs is effective in tempering uric acid levels in the system. In one study, a 16-week long carb-restricted diet significantly reduced uric acid levels. Other side-benefits of a lower carb diet were reduced blood fat levels and satisfying weight loss to boot. Those keen to restore health to the system in the New Year might consider a diet lower in foodstuffs likely to boost uric acid levels such as alcohol, refined sugar and starches that tend to cause considerable insulin induction (such as bread, potatoes, rice, pasta and breakfast cereals).. In practice, such a diet is often effective in neutralising the effects of uric acid in the system."