Uric acid is a product when purines break down in the body. Generally, the uric acid dissolves in blood and gets removed from the body through urine. So, when the body produces more uric acid, it is called hyperuricemia. It is known to be the second common metabolic disorder after diabetes globally and affecting all age groups. It is asymptomatic and often not tested clinically with overall blood or urine analysis. Though uric acid elevation does not cause immediate health disorders, it is found that if untreated for a long time it may lead to gout, cardiovascular morbidities, hypertension etc. So proper management of the hyperuricemia is a must.
Factors associated with hyperuricemia:
- Since uric acid is produced in purine metabolism, excess intake of purine rich foods can cause elevation. Some examples include sea foods especially fish, red meats and alcohol.
- Excess fructose intake from sodas and high fructose corn syrup.
- Medical conditions like psoriasis, tumor lysis, Paget’s disease etc. where cells break down and produce uric acid.
- When the excretion of uric acid is low in case of kidney diseases, hypothyroidism, down syndrome.
- Obesity, high BMI and high waist circumference are also known to cause disturbance in insulin metabolism thereby causing high uric acid concentration and decrease excretion.
The below image shows how BMI and high waist circumference increase the uric acid.
Picture from: de Oliveira, E. P., & Burini, R. C. (2012). High plasma uric acid concentration: causes and consequences. Diabetology & metabolic syndrome, 4, 12. https://doi.org/10.1186/1758-5996-4-12
Sometimes in situations such as chemotherapy or excessive exercises may increase the uric acid levels.
Consequences of hyperuricemia and diagnosis:
With increase of uric acid, one of the common medical conditions that arise is gout, wherein the uric acid gets accumulated and urate monohydrate crystals settle in the joints. Other conditions include hypertension, renal dysfunction and cardiac conditions. We can understand the amount of uric acid present through blood serum analysis and other clinical analysis like complete blood count, HbA1c etc., may be useful too.
Nutrition intervention:
The primary intervention will always be having a healthy and a balanced diet. Here are few of the specific interventions that are needed if one has elevated uric acid levels:
- Having a low purine diet will be helpful in the first place. Purine is predominantly present in seafoods, fishes, red meat and in alcohol. Seafoods and fish can be taken 1-2 times a month and red meat can be avoided or taken rarely. Avoiding alcohol completely will be better.
- Fructose rich foods may also have an impact, so reducing processed foods with High fructose corn syrup should be avoided.
- Having moderate protein, especially from vegetarian sources, is good. A plant-based diet with good inclusion of legumes, fruits, vegetables and whole grain will be helpful, not only for elevated uric acid but also reducing the incidence of other diseases associated with hyperuricemia.
- Though some fruits and vegetables might be high in purines, they are not directly associated with increasing uric acid levels.
- Maintaining a good weight is also very important. So, in cases of being overweight or obesity, reducing the weight through right nutrition and physical activity will be beneficial.
With ever increasing consumption of processed foods, non- vegetarian foods and alcohol the incidence of hyperuricemia is on the rise. So, it is important to watch your nutrition to avoid any complications and to lead a healthy life.
Image attribution- wayhomestudio on Freepik
Senior Dietitian
M.Sc FNS (AN)