Podcast: Play in new window | Download
Subscribe: Apple Podcasts | RSS
Dr. Patana is an MD, PhD trained in internal medicine and is a board-certified nephrologist who has a grave concern about excess fructose consumption, especially fructose addedto commonly eaten confectionery, processed and packaged foods, soft drinks and even the total fruit load in his home country of Thailand which has easy access to very cheap and abundant fruits.
Excess fructose consumption leads to almost all chronic diseases because fructose gets stored as fat and also gets metabolized into uric acid, creating hyperuricemia, a more acid state in the body, leading to a reversible cause of kidney disease, among other chronic diseases such as kidney failure, obesity, bone loss, hypertension, atherosclerosis, diabetes and fatty liver.
Dr. Patana was trained and has excelled as a nephrologist but realizing treating patients “by the book” for kidney disease did not prevent the disease in the first place, neither stop its progression, and most importantly keep people from needing dialysis which is the ultimate goal of a nephrologist.
Dr. Patana is a very busy practicing nephrologist in Thailand and is also Vice President of The American Academy of Anti-Aging Medicine in Thailand. He is the organizer of the 10th Annual Conference of Anti-Aging Medicine, Bangkok, Thailand (September 6-8, 2018) where this interview was conducted.
FRUCTOSE EXCESS AND “TOXICITY” LEADING TO HYPERURICEMIA
There is a significant concern in Thailand about “fructose toxicity” from the total fructose load leading to obesity, diabetes, fatty liver and chronic kidney disease from fructose-induced hyperuricemia.
Sources of added fructose added to the diet comes from many unnatural sources such as processed and confectionery foods (catsup, sweeteners, processed carbohydrates, canned foods, etc.) and the most significant source, high fructose sweetened soft drinks. But Dr. Patana also is concerned about excess fruit consumption in his country (above 2 kilograms daily) since fruit is so plentiful and very cheap, possibly the cheapest anywhere in the world. So the Thai people are getting a tremendous fructose load which is leading to hyperuricemia (excess uric acid production) which can lead to kidney disease as well as other chronic diseases such as obesity, bone loss, diabetes, fatty liver, arthritis/joint pain, hypertension, heart failure, atherosclerosis, etc..
THE PHYSIOLOGY OF TOO MUCH FRUCTOSE
The human species didn’t evolve eating such large amounts of fructose, especially daily almost on demand. Humans have the enzymes to digest fructose but not natural feedback mechanisms that help stop its consumption and metabolism. Fructose is converted fat in the liver and can lead to fatty liver (30% of Thai people have fatty liver) and is a contributor to hypertension and cirrhosis among other conditions. This metabolism of fructose is accelerated in Thailand because so much fruit is consumed (10-20 pieces per day at times), increased fruit juice consumption, fructose in processed foods has increased and their has been a dramatic increase in high fructose containing soft drinks.
KIDNEY DISEASE, URIC ACID AND FRUCTOSE CONSUMPTION
Fructose is metabolized to uric acid using ATP and when converted to AMP, leads to purines being release and elevated uric acid occurring. Elevated uric acid is related to more conditions besides gout such has endothelial dysfunction, insulin resistance and hypertension.
STOP OR REVERSE KIDNEY DISEASE BY REDUCING URIC ACID
One should eliminate all artificial fructose sources including fruit juices, soft drinks, condiments, processed carbohydrates and reduce even whole fruit which contains fructose to 2-3 whole fruits per day and try and consume low glycemic fruits such as berries.
LOWERING URIC ACID LEVELS BY DIET
Uric acid should be screened for in all basic chemistry profiles and done routinely in all patients. You may have to ask for uric acid’s inclusion in a “normal” chem profile. Trying to keep the uric acid level below 6.9 is optimal, maybe even 6 may be preferred. Seven or greater uric acid levels start to precipitate (become solid); above 8 is dangerous; and above 9 requires aggressive treatment. To keep the uric acid below 6.9 cut out all added fructose, limit whole fruit (2-3 pieces per day) and cut down on meat (cheeses and alcohol).
DRUGS TO LOWER URIC ACID
Dr. Patana uses an old and safe drug, allopurinol at 100 mg daily in most Thai patients with success and safety in reducing uric acid levels. If the patient is allergic to allopurinol he sometimes use the more expensive drug Febuxostat. But this is problematic for many Thai people due to cost.
NUTRACEUTICALS TO LOWER URIC ACID
Sodium bicarb powder can be taken at one teaspoon with lime squeezed on top and a natural sweetener stevia can be used. This dose can be given three time daily. Side effects include gas, bloating and flatulence. Dissolving this in water helps. In Thailand Sodamint tablets containing 300 mg of sodium bicarbonate which can be used and purchased cheaply (in stores not hospitals) at 200 Bhat ($6-7 US) for 1000 tablets. The problem with sodium bicarbonate tablets (Sodamint tablets) is that they are not dissolved in the water first before consumption and can cause a lot of GI distress sometimes causing GERD (“heart burn” ironically). Alka Seltzer Gold can be used (more expensive) at 2 tablets 2-3 times daily. Alka Seltzer Gold contains anhydrous citric acid 1000 mg and the antacids potassium bicarbonate 344 mg and sodium bicarbonate 1050 mg per tablet.
ALKALIZING THE BODY TO LOWER URIC ACID
Uric acid precipitates when the body is too acidic.
Reduce Foods That Increase Body Acidity – Sugar, meat and fat. NO PROCESSED FOODS WITH ADDED FRUCTOSE, ESPECIALLY SOFT DRINKS should be consumed.
Eat More Foods That Reduce Body Acidity – Vegetables and whole fruit (berries are best, 2-3 pieces per day). Citrus fruit actually alkalizes the body. Citric acid is metabolized to bicarbonate in the body and buffers the blood. Vinegar is alkaline because it contains acetic acid which gets converted to bicarbonate and buffers (alkalizes) the blood.
IS IT WORTH WHILE TRYING TO ACIDIFY THE URINE…NO!
The urine is always acidic. It is very difficult to really alkalize the urine. Bicarbonate probably won’t help and Dr. Patana doesn’t recommend trying to alkalize the urine. (Note: This comment is from an open minded urologist!)
ACIDIFICATION OF THE BODY CHEMISTRY – PLANT PROTEIN VS. ANIMAL PROTEIN
Plant protein is better, or less harmful, than animal protein with regards to acidification of the blood (it creates more alkalinity) which can lead to all the conditions mentioned above. But in Thailand, due to the extensive use of pesticides, many plant foods are contaminated and have their own health risks. Animal protein is rich in arachidonic acid which can lead to inflammation, in addition to being more acidic. Seafood has at least omega-3 fatty acids which are anti-inflammatory, but fish contamination is also a serious problem. So, Dr. Patana believes in moderate consumption of all three protein sources but states biochemically plant protein is more alkalizing and better for reducing kidney disease in principle.
OSTEOPOROSIS AND BODY ACIDITY
A major way the body buffers the blood to reduce acidity is by using bone (calcium, potassium, bicarbonate). So bone loss is caused by all the above that increase acidity and the risk to kidney disease. Milk consumption does not prevent bone loss but aggravates it because it creates more acidity. “More milk means weak bones.” Soft drinks, sugar (fructose), high meat diets all increase bone loss. Vegetarians generally have stronger bones according to Dr. Patana (he is not a vegetarian, though used to be) because they consume a more alkaline diet.
A NEPHROLOGIST’S PURPOSE – SAVE PATIENTS FROM KIDNEY DISEASE (I.E. DIALYSIS)
To Do This…
- Reduce uric acid by eliminating diuretics if possible
- REDUCE THE TOTAL FRUCTOSE LOAD IN THE DIET (all processed or added fructose) and limit fruit to 2-3 whole fruits per day preferably low glycemic fruits (berries, no juices or drinks) and eliminate foods that have added fructose
- Reduce hyperuricemia with 1) fructose reduction 2) alkalizing the diet with more vegetables, fruit, more plant proteins/less animal protein, dairy products and added sugar reduction or avoidance 3) use nutraceuticals like sodium bicarbonate (Sodamint, Alka Seltzer Gold) 4) use uric acid lowering medications like Allopurinol or Febuxostat.
Bottom line is high fructose intake increase uric acid in the blood which increases kidney disease.
__________
Dr. Teng-umnuay received his medical degree with first class honors from Chulalongkorn University, Thailand in 1986 and he is also board certified in Internal Medicine and Nephrology in 1990 and 1992. He then studied Molecular Cell Biology at the University of Florida and earned his PhD degree in 1998. He is on the faculty of the Anti-Aging and Regenerative Program of Dhurakij Pundit University. He is a columnist for FHM Magazine in Thailand, hosts a television show and also serves as a consulting physician for S Medical Clinic and Phyathai 2 Hospital, Thailand.
Assistant Professor Patana Teng-umnuay, MD, PhD, Director, Health Education & Academics (H.E.A.T.) Co. Ltd., Thailand. doctorpatana@yahoo.com, 147 Inthamara 33, Dindang, Dindang District, Bangkok 10400, Thailand, 66 61 401 0345, 66 02 261 6487, EXT. 102, a4mthailand@outlook.com, www.a4mthailand.com
__________
You may call Kirk Hamilton PA-C Monday thru Friday 8-9 a.m. PST at 916-489-4400 for brief medical questions at Health Associates Medical Group. (for information about Health Associates go to KwikerMedical.com)
Chronic Disease Reversal Programs (Heart Disease, Diabetes, Obesity, Alzheimer’s Disease, Living to 100)
HealthyLivingforBusyPeople.com
Kirk’s Staying Healthy Today Show You Tube
Kirk’s “Staying Healthy Today Show” Podcasts in iTunes
Kirk’s “Staying Healthy Today Radio” Podcasts in iTunes
Kirk’s “Sloppy Vegan Cooking Show” YouTube