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6 May 2011

Does Soda Cause Gout?

Sugary sodas have recently been implicated in everything from obesity to high blood pressure. But if you’re worried about gout, it may be especially important to steer clear of the sweet stuff.

Ongoing research has examined the relationship between rising soft drink consumption and an increase in gout. Consider this: The number of people with gout back in the 1970s was 20 per 100,000. By the mid-1990s, that number had more than doubled to 45.9 per 100,000. Likewise, soda consumption among adults rose by 61 percent from 1977 to 1997.

This link between soda intake and gout makes sense since the "source of almost all of the sweetness in sugary drinks comes from fructose — and fructose elevates uric acid levels, [leading to] gout," explains Hyon Choi, MD, DrPH, clinical associate professor of medicine in the rheumatology section at Boston University School of Medicine. Dr. Choi also points out that fructose is used to make high-fructose corn syrup, a substance commonly used to sweeten many foods and beverages besides soda.

Soda and Gout: The Link

Uric acid is usually filtered by the kidneys and excreted from your body in your urine. Gout occurs when uric acid builds up in the blood, causing uric acid crystals to form in one or more joints and leading to intense pain and swelling. There are a number of factors that can cause elevated uric acid levels, including heavy fructose consumption.

Choi's research has shown that study participants who consumed two or more servings of sugar- or fructose-sweetened soda each day had an 85 percent increased risk of developing gout, compared with participants who consumed less than one serving of sugary soda per month. Even sugary fruit juice, such as orange juice, raises the risk.

If diet soda is your vice, you may not have to worry as much about developing gout. "With diet soda, we did not find the association," Choi says.

Choi and his colleagues did find a slight increase in gout risk with consuming high-fructose fruits, such as apples and oranges. However, Choi emphasizes, artificially added fructose found in soda is linked to a higher risk of gout than naturally occurring sources of fructose like fruit.

Soda and Gout: What This Means for You

Traditionally, gout prevention strategies have focused on limiting protein-rich foods and alcohol, which can encourage uric acid accumulation in the body. This new research, however, suggests that cutting back on soda consumption may be just as important in preventing future gout attacks.

Also keep in mind that in the United States, the biggest single source of calories is soda sweetened with sugar or fructose. This means that beyond reducing your risk of developing gout, avoiding the empty calories in soda may also help you shed excess weight and keep your blood sugar levels in check. So instead of reaching for another soda or sugar-sweetened drink at your next meal, opt for water instead — your joints will thank you.

3 May 2011

Chiropractic Management of Pain in a Young Scoliosis Patient

By Nancy Martin-Molina, DC, QME, MBA
Case History
The patient is a 14-year-old girl with a recent diagnosis of scoliosis received on medical referral.

She reports her actual pain onset started at menarche around 11-12 years of age, worsening in the past 6-9 months, during which time she underwent a growth spurt.  Written parental consent is obtained and an initial evaluation is provided with radiographic spinal record review performed. She hand-carried her medical radiograph report, dated six months prior.
The patient's complaint on pain drawing is neck / mid-back / low back / midline; the pain level was rated as a 6-7/10; severe on a scale of 1-10 with 10 being severe pain with moderate interference in activities of daily living. The quality of the pain is as follows: aches at suboccipital to upper dorsal, stabbing intrascapular, aches low back. Provocative: daily ADL. Palliative: nothing; mother has tried administering Tylenol. Source: oral history and pain.
Evaluation & Findings

Scoliosis Prevalence Increases With Age