Uric Acid’s Extensive Health Impact (And How To Lower It)

This is Dr. David Perlmutter. He’s a medical doctor, and a Fellow of the American College of Nutrition. He’s a member of the Editorial Board for the Journal of Alzheimer’s Disease, and has been widely published in many other peer-reviewed journals.

What does he want us to know?

He wants us to know about the health risks of uric acid (not something popularly talked about so much!), and how to reduce it.

First: what is it? Uric acid is a substance we make in our own body. However, unlike most substances we make in our body, we have negligible use for it—it’s largely a waste product, usually excreted in urine.

However, if we get too much, it can build up (and crystallize), becoming such things as kidney stones, or causing painful inflammation if it shows up in the joints, as in gout.

More seriously (unpleasant as kidney stones and gout may be), this inflammation can have a knock-on effect triggering (or worsening) other inflammatory conditions, ranging from non-alcoholic fatty liver disease, to arthritis, to dementia, and even heart problems. See for example:

• David Perlmutter | Uric Acid and Cognitive Decline
• American Heart Association | Uric acid linked to later risk for irregular heart rhythm
• World Journal of Gastroenterology | The role of uric acid in non-alcoholic steatohepatitis development

How can we reduce our uric acid levels?

Uric acid is produced when we metabolize purine nucleotides, which are found in many kinds of food. We can therefore reduce our uric acid levels by reducing our purine intake, as well as things that mess up our liver’s ability to detoxify things. Offsetting the values for confounding variables (such as fiber content, or phytochemicals that mitigate the harm), the worst offenders include…

Liver-debilitating things:

• Alcohol (especially beer)
• High-fructose corn syrup (and other fructose-containing things that aren’t actual fruit)
• Other refined sugars
• Wheat / white flour products (this is why beer is worse than wine, for example; it’s a double-vector hit)

Purine-rich things:

• Red meats and game
• Organ meats
• Oily fish, and seafood (great for some things; not great for this)

Some beans and legumes are also high in purines, but much like real fruit has a neutral or positive effect on blood sugar health despite its fructose content, the beans and legumes that are high in purines, also contain phytochemicals that help lower uric acid levels, so have a beneficial effect.

Eggs (consumed in moderation) and tart cherries have a uric-acid lowering effect.

Water is important for all aspects of health, and doubly important for this.

Hydrate well!

Lifestyle matters beyond diet

The main key here is metabolic health, so Dr. Perlmutter advises the uncontroversial lifestyle choices of moderate exercise and good sleep, as well as (more critically) intermittent fasting. We wrote previously on other things that can benefit liver health:

How To Unfatty A Fatty Liver

…in this case, that means the liver gets a break to recuperate (something it’s very good at, but does need to get a chance to do), which means that while you’re not giving it something new to do, it can quickly catch up on any backlog, and then tackle any new things fresh, next time you start eating.

Want to know more about this from Dr. Perlmutter?

You might like his article:

An Integrated Plan for Lowering Uric Acid ← more than we had room for here; he also talks about extra things to include in your diet/supplementation regime for beneficial effects!

And/or his book:

Drop Acid: The Surprising New Science of Uric Acid―The Key to Losing Weight, Controlling Blood Sugar, and Achieving Extraordinary Health

…on which much of today’s main feature was based.

Take care!

The Best Brains Bar Nun?

This is Dr. David Snowdon. He’s an epidemiologist, and one of the world’s foremost experts on Alzheimer’s disease. He was also, most famously, the lead researcher of what has become known as “The Nun Study”.

We recently reviewed his book about this study:

Aging with Grace: What the Nun Study Teaches Us About Leading Longer, Healthier, and More Meaningful Lives – by Dr. David Snowdon

…which we definitely encourage you to check out, but we’ll do our best to summarize its key points today!

Reassurance up-front: no, you don’t have to become a nun

The Nun Study

In 1991, a large number (678) of nuns were recruited for what was to be (and until now, remains) the largest study of its kind into the impact of a wide variety of factors on aging, and in particular, Alzheimer’s disease.

Why it was so important: because the nuns were all from the same Order, had the same occupation (it’s a teaching Order), with very similar lifestyles, schedules, socioeconomic status, general background, access to healthcare, similar diets, same relationship status (celibate), same sex (female), and many other factors also similar, this meant that most of the confounding variables that confound other studies were already controlled-for here.

Enrollment in the study also required consenting to donating one’s brain for study post-mortem—and of those who have since died, indeed 98% of them have been donated (the other 2%, we presume, may have run into technical administrative issues with the donation process, due to the circumstances of death and/or delays in processing the donation).

How the study was undertaken

We don’t have enough space to describe the entire methodology here, but the gist of it is:

• Genetic testing for relevant genetic factors
• Data gathered about lives so far, including not just medical records but also autobiographies that the nuns wrote when they took their vows (at ages 19–21)
• Extensive ongoing personal interviews about habits, life choices, and attitudes
• Yearly evaluations including memory tests and physical function tests
• Brain donation upon death

What they found

Technically, The Nun Study is still ongoing. Of the original 678 nuns (aged 75–106), three are still alive (based on the latest report, at least).

However, lots of results have already been gained, including…

Genes

A year into the study, in 1992, the “apolipoprotein E” (APOE) gene was established as a likely causative factor in Alzheimer’s disease. This is probably not new to our readers in 2024, but there are interesting things being learned even now, for example:

The Alzheimer’s Gene That Varies By Race & Sex

…but watch out! Because also:

Alzheimer’s Sex Differences May Not Be What They Appear

Words

Based on the autobiographies written by the nuns in their youth upon taking their vows, there were two factors that were later correlated with not getting dementia:

• Longer sentences
• Positive outlook
• “Idea density”

That latter item means the relative linguistic density of ideas and complexity thereof, and the fluency and vivacity with which they were expressed (this was not a wishy-washy assessment; there was a hard-science analysis to determine numbers).

Want to spruce up yours? You might like to check out:

Reading, Better: Reading As A Cognitive Exercise

…for specific, evidence-based ways to tweak your reading to fight cognitive decline.

Food

While the dietary habits of the nuns were fairly homogenous, those who favored eating more and cooked greens, beans, and tomatoes, lived longer and with healthier brains.

See also: Brain Food? The Eyes Have It!

Other aspects of brain health & mental health

The study also found that nuns who avoided stroke and depression, were also less likely to get dementia.

For tending to these, check out:

• Two Things You Can Do To Improve Stroke Survival Chances
• Depression, And The Mental Health First-Aid That You’ll Hopefully Never Need
• Behavioral Activation Against Depression & Anxiety

Community & Faith

Obviously, in this matter the nuns were quite a homogenous group, scoring heavily in community and faith. What’s relevant here is the difference between the nuns, and other epidemiological studies in other groups (invariably not scoring so highly).

Community & faith are considered, separately and together, to be protective factors against dementia.

Faith may be something that “you have it or you don’t” (we’re a health science newsletter, not a theological publication, but for the interested, philosopher John Stuart Mill’s 1859 essay “On Liberty“ makes a good argument for it not being something one can choose, prompting him to argue for religious tolerance, on the grounds that religious coercion is a futile effort precisely because a person cannot choose to dis/believe something)

…but community can definitely be chosen, nurtured, and grown. We’ve written about this a bit before:

• How To Beat Loneliness & Isolation
• Make Social Media Work For Your Mental Health

You might also like to check out this great book on the topic:

Purpose: Design A Community And Change Your Life – by Gina Bianchini

Want more?

We gave a ground-up primer on avoiding Alzheimer’s and other dementias; check it out:

How To Reduce Your Alzheimer’s Risk

Take care!