Is Milk Lowering Uric Acid a Good Thing or a Bad Thing?

Parkinson’s disease, the second most common neurodegenerative disorder after Alzheimer’s, is characterized by a slowness of movement, rigidity, tremor, and stooping posture, all of which worsen over time. Non-movement symptoms such as cognitive impairment and sleep, smell, and mood disturbances occur as the disease spreads to other areas of the brain. The cause of Parkinson’s is perhaps “one of the important questions posed by the neurobiology [science] of aging.” For example, why is the consumption of dairy products associated with increased risk of Parkinson’s? Perhaps because they contribute to our exposure to pesticides and other neurotoxins like dieldrin, which continues to be found in the autopsied brains of Parkinson’s victims. Even though dieldrin was banned decades ago, it lingers in the environment and we “continue to be exposed to the pesticide through contaminated dairy and meats…”

The cause of Parkinson’s “is unlikely to be due to milk compounds such as calcium, vitamin D, total fat, or total protein as these compounds are not associated with [the disease] when derived from other sources.” However, it could be lactose, the milk sugar, perhaps accounting for the increased associated risk of death and bone fractures, as well as Parkinson’s. Earlier onset of Huntington’s disease has also been identified. There is, however, a third possibility.

As I discuss in my video Parkinson’s Disease and the Uric Acid Sweet Spot, milk lowers uric acid levels, and uric acid may be protective against Huntington’s and also slow the decline caused by Parkinson’s. More importantly, it may lower the risk of getting Parkinson’s in the first place. Why? Perhaps because uric acid is an important antioxidant in the brain, something we’ve known for more than 30 years. We can demonstrate uric acid’s importance directly on human nerve cells in a petri dish. When the pesticide rotenone is added, oxidative stress goes up. Add the pro-oxidant homocysteine, and it goes up even more. But, when uric acid is added, it completely suppresses the oxidative stress caused by the pesticide.

Drinking milk, however, has a uric acid-lowering effect. In the paper making this assertion, a study they cited was “A cute effect of milk on serum urate concentrations,” but that was just a cute typothey meant Acute effect. Indeed, drink cow’s milk, and, within hours, uric acid levels drop 10 percent. Drink soymilk, and, within hours, they go up 10 percent. Now, for gout, a painful arthritic disease caused by too much uric acid, the uric acid-lowering effect of dairy is a good thing—but uric acid is “a double-edged sword.”

If our uric acid levels are too high, we can get gout, but, if they’re too low, it may increase our risk of neurodegenerative diseases, such as Alzheimer’s, Huntington’s, Parkinson’s, and multiple sclerosis.

Incidence rates of gouty arthritis over five years indicate that if our uric acid is over 10.0 mg/dl, we have a 30 percent chance of suffering an attack of gout within the next 5 years. However, at levels under 7.0 mg/dl, our risk is less than 1 percent, so it might make sense to have levels as high as possible without going over 7.0 to protect the brain without risking our joints. But having excessive uric acid in the blood puts more than just our joints in jeopardy. Yes, having levels that are too low may increase our risk of MS, Parkinson’s, Alzheimer’s, and even cancer, but having levels that are too high may increase our risk of gout, kidney disease, and heart disease.

In fact, having a uric acid level over 7.0 mg/dl isn’t only associated with an increased risk of gout, but also an increased risk of dying from all causes. However, having a low uric acid level may also shorten our lifespan by increasing mortality. High uric acid levels are associated with increased risk of death from heart disease, but low uric acid levels are associated with increased risk of fatal stroke. So, keeping uric acid at optimum levels, the sweet spot between 5.0 and 7.0 mg/dl, may protect the brain in more ways than one.

If we measure the uric acid levels in patients with Parkinson’s, they come in around 4.6 mg/dl, which may help explain why dairy consumption may increase risk for Parkinson’s since milk pushes down uric acid levels. Dairy intake may also explain the differences in uric acid levels among meat-eaters, vegetarians, and vegans. In the graph in my video, you can see that vegan men have significantly higher uric acid levels at 5.7 mg/dl than vegetarians, presumably because vegans don’t drink milk, and those who both eat meat and consume milk fall between the vegans and vegetarians.

For more on Parkinson’s see:

Uric acid as an antioxidant? I’ve touched on that before in Miocene Meteorites and Uric Acid.

If uric acid levels are too high consider cutting down on Flesh and Fructose and eating cherries. (See Gout Treatment with a Cherry on Top and Treating Gout with Cherry Juice for more information.) Also, check out Preventing Gout Attacks with Diet.

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Concerns About Bone Broth

There are toxicological issues associated with production and processing of meat, such as the presence of various toxic contaminants—from dioxins and PCBs to cooked meat carcinogens. Carcinogenesis, the development of cancer, may be the main concern, but there are a number of other toxic responses connected with the consumption of meat products. Lead, for example, can be toxic to the nerves, gastrointestinal tract, bone marrow, and kidneys.

Where is lead found in the food supply? In general terms, the highest levels of lead, as well as arsenic and mercury, are found in fish. Sardines have the most arsenic, but tuna may have sardines beat when it comes to mercury and lead.

The problem is that “fish-consumption advisories related to human health protection do not consider the fish by-products fed to farmed animals,” like farmed fish. If some tilapia are fed tuna by-products, they could bioaccumulate heavy metals and pass them onto us when we eat them. Researchers found the highest levels in frozen sole fillets, averaging above the legal limit for lead.

Lead exposure has been shown to have adverse effects on nearly every organ system in the body. Symptoms of chronic exposure range from memory loss and constipation to impotence and depression. These symptoms present after pretty hefty exposure, though. However, we now know that “[b]lood lead levels in the range currently considered acceptable are associated with increased prevalence of gout and hyperuricemia” (elevated levels of uric acid in the blood). According to the Centers for Disease Control and the World Health Organization, a blood lead level needs to be less than 25 micrograms per deciliter to be “non-elevated.” You’d assume that at values under 25, there’d be no relationship with health outcomes, but even throughout this “acceptable” range, lower lead means lower uric acid levels and lower gout risk. So, even blood lead levels 20 times below the acceptable level can be associated with increased prevalence of gout. “These data suggest that there is no such thing as a ‘safe’ level of exposure to lead.” 

Once lead gets into the body, it tends to stay in the body. It builds up in the bones such that it may take 30 years just to get rid of half. The best strategy? Don’t get exposed in the first place.

If lead builds up in bones, though, what about boiling bones for broth? As I discuss in my video Lead Contamination in Bone Broth, we know bones sequester lead, which can then leach from the bones. So, researchers suggested that “the bones of farmyard animals will sequester lead, some of which will then be released into broth during its preparation.” Who eats bone broth? Bone broth consumption is encouraged by many advocates of the paleo diet. Online, you can learn all about purported “benefits” of bone broth, but what they don’t tend to mention is the theoretical risk of lead contamination—or at least it was theoretical until now. Broth made from chicken bones was to have markedly high lead concentrations, up to a ten-fold increase in lead. Researchers concluded, “In view of the dangers of lead consumption to the human body, we recommend that doctors and nutritionists take the risk of lead contamination into consideration when advising patients about bone broth diets.”

But what if you only use bones from organic, free-range chickens? They did use only bones from organic, free-range chickens.

For more on the paleo diet, see:

Other products contaminated with lead include Ayurvedic supplements, protein powders, wild animals shot with lead ammunition, dairy products, and tea from China:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Plant vs. Animal Food Purines for Preventing Gout

More than 2,000 years ago, “Hippocrates described gout as a disease of kings primarily because it was the wealthy who could afford the ‘rich’ foods, which seemed to precipitate gouty attacks.” Today, however, we can all eat like kings and acquire some diseases of royalty ourselves. That’s why I produced my video Preventing Gout Attacks with Diet.

Gout is caused by needle-sharp crystals of uric acid in our joints. Uric acid comes from the breakdown of purines, which are the breakdown product of genetic material—DNA, the foundation of all life. So, “there is no such thing as a purine-free diet, but foods do vary in their purine content.” It was long thought that people with gout just needed to stay away from all high-purine foods, whether from animals, like organ meats, or plants, like beans, but this strategy proved ineffective. Yes, all uric acid comes from the breakdown of purines, so limiting meat makes sense, but plant sources “have largely been exonerated.”

“The association of gout with alcohol intake and increased dietary purine consumption had been known since ancient times, but there were no prospective trial data” to back it up until fairly recently. The Harvard Health Professionals Follow-Up Study, which followed about 50,000 men for a dozen years, found that alcohol intake was “strongly associated with an increased risk of gout.” In terms of food, they found “an increased risk of gout with higher meat consumption or seafood consumption,” but not with higher consumption of purine-rich plant foods. Perhaps this is because the purines in plants are less bioavailable? So, though it had been suggested that gout sufferers should moderate purine-rich animal and plant foods, their “results suggest that this type of dietary restriction may be applicable to purines of animal origin but not to purine-rich vegetables.”

Although it was not surprising that meat, including seafood, had significant associations with the incidence of gout, this lack of effect of purine-rich plant foods was new. There don’t appear to be any long-term studies showing purine-rich plant foods increase risk, though there are still some guidelines continuing to disseminate those outdated recommendations.

Not only has the intake of purine-rich plants not been associated with high uric acid levels, but the vegetables gout sufferers are specifically told to stay away from—mushrooms, peas, beans, lentils, and cauliflower—were actually found to be protective. This may be because foods rich in fiber, folate, and vitamin C appear to protect against uric acid buildup and gout. “Fiber,” for example, “has been recognized as having a potential role in binding uric acid in the gut for excretion.”

Lack of association between purine-rich vegetables and urate could be due to the co-packaging of these “beneficial plant components (such as vitamin C, dietary fiber or some phytochemicals), which may have masked an effect of purine on [uric acid]. Vegetable intake, regardless of purine content, may also be protective as it may increase [uric acid] excretion.”

By changing the pH of our urine, we can change uric acid clearance. Eating an alkaline diet, which was a vegetarian diet in the case of the study I profile in my video, was found “effective for removing uric acid from the body.” Those eating the alkaline diet excreted significantly more uric acid than those eating the acidic diet. As such, uric acid levels in the blood of those eating the acid-forming diet rose within days.

So, one would assume uric acid levels are lower in vegetarians, and, indeed, those eating vegetarian diets long-term were found to have significantly lower levels in their blood. To prove cause and effect, though, you need to do an interventional trial, where you take people, change their diets, and see what happens. Researchers took ten guys to study the build-up of uric acid in their kidneys, kept them on a standard Western diet for five days, and measured their relative supersaturation for uric acid. Then, they tried a vegetarian diet for five days. The result? Within days, the intake of the vegetarian diet led to a 93 percent decline in the risk of uric acid crystallization.

You can do it the other way, too: Take a bunch of people with gout, feed them a big meal of meat, and see if you can trigger an attack. Seven patients were put in a hospital, “stabilized on a low-purine diet and then challenged with a meat-laden dinner.” In response, their uric acid levels shot up, and they started getting gout attacks. Then they added alcohol, and their uric acid levels shot up even further. In all, the researchers were able to trigger gout attacks in six out of the seven patients with just single meals.

Now, some meats have less purines than others. For those who aren’t squeamish, inches-long superworms, for example, have particularly low purine levels.

Not all animal foods increase gout risk, though. Low-fat dairy products were found to be protective. Given that, we would predict vegans to be at a disadvantage, which is indeed what was found, though all groups tested—meat eaters, fish eaters, vegetarians, and vegans—were within the normal range of around 3.5 to 7.

Should gout patients add milk to their diets? Well, although drinking the equivalent of ten cups of skim milk at a time appears to have an acute lowering effect on uric acid levels, in the long term over months, at the equivalent of two cups a day, there was not a statistically significant lowering effect. Gout patients were given skim milk powder for three months, and it did not appear to help. Though soymilk has also been associated with a lower risk of uric acid buildup, there are no interventional trials to back that up.

The bottom line is that we now have good research on how to reduce risk of gout “without the use of drug treatments through modification of diet.” That’s important, because allopurinol is the “drug of choice.” It’s considered generally safe, but what does it mean when doctors talk about a relatively safe drug? Well, about “2% of patients develop hypersensitivity reactions, which can sometimes be severe and fatal with a mortality rate of ~20%”—and that’s the safe drug. The other leading drug, colchicine, has “no clear-cut distinction between nontoxic, toxic, and lethal doses.”

A better choice is through diet, and these videos show you how sweet that diet choice can be:

And, for alkalinizing your urine, see How to Treat Kidney Stones with Diet and Testing Your Diet with Pee and Purple Cabbage.

Uric acid is double-edged sword, as both high and low levels are associated with increased mortality. If our uric acid levels are too high, we can get gout; if they’re too low, it may increase our risk of neurodegenerative diseases such as Alzheimer’s and Parkinson’s. This is presumed to be because uric acid acts as a powerful brain antioxidant. See my videos Miocene Meteorites and Uric Acid and Parkinson’s Disease and the Uric Acid Sweet Spot for more on this.

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations: