A new study published in the journal Cell Reports suggests that a ketogenic (high fat, low carb) diet may be helpful in treating the symptoms of gout.
Gout is a form of inflammatory arthritis that results from an imbalance in the production and secretion of uric acid. Uric acid, a normal byproduct of metabolic processes, is typically dissolved in the blood and then excreted from the body through the urine.
However, when the body is unable to properly break down uric acid, blood levels rise, and the excess is deposited in bodily tissues. The “needle-like” uric acid crystals irritate the area where they are deposited, triggering inflammation, swelling, and severe pain. When uric acid accumulates around the joints it is known as “tophi,” and can manifest as jelly like lumps under the skin. When uric acid crystals collect in the kidneys, it can result in kidney stones.
The Role Of Ketosis
Recent research out of the laboratory of Vishwa Deep Dixit, professor of comparative medicine and immunobiology at Yale School of Medicine in New Haven, CT, suggests that symptoms of gout may be managed with a ketogenic diet.
Ketogenic diets are typically implemented for weight loss, or to treat childhood epilepsy. The diet involves a significant reduction of carbohydrate intake favoring moderate protein and high fat foods. This starves the central nervous system of glucose and prompts the liver to metabolise fats producing fatty acids and ketone bodies. This is referred to as the physiologic state of ketosis.
The new study focuses on one of these ketone bodies in particular called beta-hydroxybutyrate, or BHB. The researchers suggest that BHB may be responsible for the noticeable effect of ketosis on the symptoms of gout.
BHB, Inflammation, and Gout
Episodes of immune cell activation caused by gout are referred to as “flares” and are mediated by a protein complex called the NLRP3 inflammasome.
Using rodents, the research team refined a new model of gout flares by injecting uric acid into the rat’s knees and tracking markers of inflammation. Dixit and his team also examined human subjects, conducted statistical analysis, and repeated the experiments at least twice.
What the researchers discovered is that a ketogenic diet caused production of ketone bodies resulting in elevated levels of BHB. The BHB served to inhibit the NLRP3 inflammasome thus lowering inflammation and alleviating the symptoms of gout without any noticeable negative side effects.
Although they admit more research is needed, the researchers concluded:
“Collectively, our studies show that BHB, a known alternate metabolic fuel, is also an anti-inflammatory molecule that may serve as a treatment for gout.”
This is wonderful news for the more than 8 million people who are affected by gout in the United States and are looking for a natural treatment of symptoms. A ketogenic diet includes macro nutrient ratios of about 75% fat, 20% protein, and 5% carbs. Balance out the high fat content of this diet by including lots of low glycemic and non starchy vegetables like leafy greens, sprouts, and herbs.
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