Evolutionary perspective on the etiology of hyperuricemia and gout (continued)

Abstract

From an evolutionary perspective, contemporary diets have greatly changed from the Paleolithic diets to which our core metabolism and physiology have adapted during the long evolutionary development of homo sapiens. The difference between contemporary diets and Paleolithic diets may account for some current lifestyle-related diseases. The main difference in the diet composition is the introduction of fat-rich and sugar-rich foods replacing plant-based dietary materials. Consequently, energy-rich and nutrient-rich diets can induce a derangement of cellular function, leading to endoplasmic reticulum stress (ER stress). Under ER stress, metabolic and immune responses may induce insulin resistance through the complex intracellular signaling systems, resulting in the accumulation of uric acid. Given these considerations, we propose a dietary intervention to reduce hyperuricemia. An increased intake of plant-based foods such as vegetables and fruits for the purpose of urine alkalization, can reduce the intake of sugar-based and lipid-rich foods, thereby suppressing the de novo production of uric acid, and reducing insulin resistance caused by ER stress.