ESCANABA — Despite spending more on healthcare than any other country in the world, we have the worst outcomes. Over 25% of Americans suffer from two or more chronic diseases, twice that of such countries as Great Britain and the Netherlands. The prevalence of heart disease is higher than in the other developed countries. Life expectancy is shorter by two years, five years shorter than Switzerland.

Obviously, these numbers are the result of numerous factors, diet to environment, genetics to politics. But the first item is often implicated as being of particular concern. Is it possible our diet is driving the 21st century epidemic of our ‘modern’ diseases, the chronic diseases of lifestyle? We’re talking about the usual suspects, heart disease, stroke, diabetes, obesity.

Abundant research has demonstrated an association between uric acid levels and many pervasive health problems. As discussed in last week’s edition, a gout attack is a very painful result of high levels of uric acid, aka hyperuricemia. But there are concerning questions on this issue. What is the connection between this commonplace product of food metabolism and overall metabolic health? Which foods lead to higher amounts? Multiple studies indicate high uric acid lies at the root of many of our major diseases.

The attitude of conventional medicine on the topic of hyperuricemia is tepid at best. If you don’t have any gout attacks, little heed is given. No advice dispensed, nary a prescription written. Uric acid is typically considered harmless, inert, simply a waste product from the breakdown of various foodstuffs. Without the stimulus of a gout attack, treatment is not offered to lower one’s levels.

As to the incidence of hyperuricemia, how common it is, the data is clear. One out of every five Americans has abnormally high amounts of uric acid in their blood and tissues. What is driving these levels? The easy response would be diet and there seems to be an especially guilty party. The cheapest ingredient in our foods is sugar, and not just any, but fructose, the form of sugar found in fresh fruits.

Fructose is metabolized differently than table sugar and does not directly raise blood sugar (glucose). But refined, highly processed fructose is being added to every imaginable food product on the market, from salad dressings to sauces, baked goods to beverages. Unfortunately, fructose is the only carbohydrate that generates uric acid during its metabolism. Circulating uric acid levels increase within minutes of consuming a fructose-rich meal and remain elevated for some time.

Substantial evidence has accumulated demonstrating a direct relationship between the epidemic of obesity, diabetes, fatty liver disease and the increase in fructose consumption. Will we learn that these chronic diseases of our modern world are not fueled simply by increased overall sugar ingestion but, instead, it’s the flood of ultra-processed fructose in our diet?

Numerous studies have demonstrated approximately 20% of adults in this country have hyperuricemia. Most are kept ignorant of the fact….unless they have a gout attack. And only 50% of those with this recurrent joint problem are treated for their hyperuricemia, versus simply addressing the symptoms of the attack. Certainly, relieving pain is a noble ambition but if the cause isn’t treated, significant damage can be done beyond the occasional stiff, sore, big toe joint.

Testing for uric acid levels is a common component of many routine blood tests. But drugs are not always necessary to reduce and control one’s levels, with dietary changes, as well as supplementation, being of benefit in the effort to normalize uric acid. One particularly helpful substance is quercetin, which functions to improve the gut microbiome. It is found in grapes, onions, kale, and many other fresh foods.

Over 10% of the calories consumed by the average American in a day are from fructose. But no one knew for certain the consequences of introducing into our diet this substance never before consumed by humans, and in such quantities. Some would say it has been a grand experiment and we have been the guinea pigs.

Although conventional medicine has not recognized the severity of the condition, the tide is slowly turning on the dangers of chronically high levels of uric acid in the body. According to a landmark paper published by the American College of Rheumatology, high uric acid is responsible for 16% of the deaths from all causes. Knowledge is power and knowing your uric acid levels is an excellent first step on the path to health. The optimal amounts that should be found in the human bloodstream have been well defined. Here’s hoping yours are perfect.

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Dr. Conway McLean is a physician practicing foot and ankle medicine in the Upper Peninsula, with offices in Escanaba, Marquette, and L’Anse. McLean has lectured internationally on wound care and surgery, being board certified in surgery, orthotic therapy and wound care. His articles on health and wellness appear in multiple local and national publications. Dr. McLean welcomes subject requests for future articles at drcmclean@outlook.com.