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Drop Acid: The Surprising New Science of Uric Acid―The Key to Losing Weight, Controlling Blood Sugar, and Achieving Extraordinary Health
THE NEW YORK TIMES BESTSELLER
Unlock the secret to extraordinary health by reducing high uric acid levels—the hidden risk you didn't know you had—by the author of Grain Brain and Brain Wash.
What do obesity, insulin resistance, diabetes, fatty liver disease, hypertension, cardiovascular disease, stroke, neurological disorders, and premature death have in common? All can be stoked by high uric acid levels.
Our most respected scientific literature is bursting with evidence that elevated uric acid levels lie at the root of many pervasive health conditions, but mainstream medicine for the most part remains unaware of this connection. This is especially alarming because a large number of Americans don’t know they are suffering from increased levels, putting them at risk for developing or exacerbating potentially life-threatening illnesses.
Offering an engaging blend of science and practical advice, Drop Acid exposes the deadly truth about uric acid and teaches invaluable strategies to manage its levels, including how to:
Reduce fructose and foods high in “purines” through simple dietary edits
Lower uric acid levels through natural hacks like consuming tart cherries, vitamin C, quercetin, and coffee
Identify common pharmaceuticals that threaten to increase uric acid
Implement lifestyle interventions, like restorative sleep and exercise
Easily test your uric acid levels at home—a test routinely performed in your doctor’s office during regular check-ups but typically ignored
Featuring the groundbreaking “LUV” (Lower Uric Values) diet, 35 delicious recipes, self-assessment quizzes, and a 21-day program for dropping levels, Drop Acid empowers readers with the information they need to address this hidden danger and live longer, leaner, and healthier lives.
Unlock the secret to extraordinary health by reducing high uric acid levels—the hidden risk you didn't know you had—by the author of Grain Brain and Brain Wash.
What do obesity, insulin resistance, diabetes, fatty liver disease, hypertension, cardiovascular disease, stroke, neurological disorders, and premature death have in common? All can be stoked by high uric acid levels.
Our most respected scientific literature is bursting with evidence that elevated uric acid levels lie at the root of many pervasive health conditions, but mainstream medicine for the most part remains unaware of this connection. This is especially alarming because a large number of Americans don’t know they are suffering from increased levels, putting them at risk for developing or exacerbating potentially life-threatening illnesses.
Offering an engaging blend of science and practical advice, Drop Acid exposes the deadly truth about uric acid and teaches invaluable strategies to manage its levels, including how to:
Reduce fructose and foods high in “purines” through simple dietary edits
Lower uric acid levels through natural hacks like consuming tart cherries, vitamin C, quercetin, and coffee
Identify common pharmaceuticals that threaten to increase uric acid
Implement lifestyle interventions, like restorative sleep and exercise
Easily test your uric acid levels at home—a test routinely performed in your doctor’s office during regular check-ups but typically ignored
Featuring the groundbreaking “LUV” (Lower Uric Values) diet, 35 delicious recipes, self-assessment quizzes, and a 21-day program for dropping levels, Drop Acid empowers readers with the information they need to address this hidden danger and live longer, leaner, and healthier lives.
336 pages, Hardcover
First published February 15, 2022
932 people are currently reading
3321 people want to read
About the author
David Perlmutter
222 books499 followersDr. Perlmutter is a Board-Certified Neurologist and four-time New York Times bestselling author. He serves on the Board of Directors and is a Fellow of the American College of Nutrition.
Dr. Perlmutter received his M.D. degree from the University of Miami School of Medicine where he was awarded the Leonard G. Rowntree Research Award. He serves as a member of the Editorial Board for the Journal of Alzheimer’s Disease and has published extensively in peer-reviewed scientific journals including Archives of Neurology, Neurosurgery, and The Journal of Applied Nutrition. In addition, he is a frequent lecturer at symposia sponsored by institutions such as the World Bank and IMF, Columbia University, Scripps Institute, New York University, and Harvard University, and serves as an Associate Professor at the University of Miami Miller School of Medicine.
His books have been published in 34 languages and include the #1 New York Times bestseller Grain Brain, The Surprising Truth About Wheat, Carbs and Sugar, with over 1 million copies in print. Other New York Times bestsellers include Brain Maker, The Grain Brain Cookbook, and The Grain Brain Whole Life Plan. He is the editor of the upcoming collection The Microbiome and the Brain that will be authored by top experts in the field and will be published in late 2019 by CRC Press. He has been interviewed on many nationally syndicated television programs including 20/20, Larry King Live, CNN, Fox News, Fox and Friends, The Today Show, Oprah, The Dr. Oz Show and The CBS Early Show.
Dr. Perlmutter is also the recipient of numerous awards, including: the Linus Pauling Award for his innovative approaches to neurological disorders; the National Nutritional Foods Association Clinician of the Year Award, the Humanitarian of the Year Award from the American College of Nutrition, and most recently the 2019 Global Leadership Award from the Integrative Healthcare Symposium.
Dr. Perlmutter received his M.D. degree from the University of Miami School of Medicine where he was awarded the Leonard G. Rowntree Research Award. He serves as a member of the Editorial Board for the Journal of Alzheimer’s Disease and has published extensively in peer-reviewed scientific journals including Archives of Neurology, Neurosurgery, and The Journal of Applied Nutrition. In addition, he is a frequent lecturer at symposia sponsored by institutions such as the World Bank and IMF, Columbia University, Scripps Institute, New York University, and Harvard University, and serves as an Associate Professor at the University of Miami Miller School of Medicine.
His books have been published in 34 languages and include the #1 New York Times bestseller Grain Brain, The Surprising Truth About Wheat, Carbs and Sugar, with over 1 million copies in print. Other New York Times bestsellers include Brain Maker, The Grain Brain Cookbook, and The Grain Brain Whole Life Plan. He is the editor of the upcoming collection The Microbiome and the Brain that will be authored by top experts in the field and will be published in late 2019 by CRC Press. He has been interviewed on many nationally syndicated television programs including 20/20, Larry King Live, CNN, Fox News, Fox and Friends, The Today Show, Oprah, The Dr. Oz Show and The CBS Early Show.
Dr. Perlmutter is also the recipient of numerous awards, including: the Linus Pauling Award for his innovative approaches to neurological disorders; the National Nutritional Foods Association Clinician of the Year Award, the Humanitarian of the Year Award from the American College of Nutrition, and most recently the 2019 Global Leadership Award from the Integrative Healthcare Symposium.
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Displaying 1 - 30 of 157 reviews
January 28, 2022
Drop Acid by David Perlmutter is a fascinating look into the effects of diet, specifically excess uric acid has on the human body. The book is full of scientific references but, it is told in a conversational tone that is easy to understand.
The book is told in two parts. The first part gives you all the scientific data that supports the role uric acid plays in human metabolism. The second part is all about how to lower uric acid using the author’s LUV (Lower Uric Values) diet and gives the reader a three-week diet plan as well as outlying the foods to avoid, and the foods that help lower uric acid levels.
I found this book gives the reader a good scientific background of the role of uric acid, told in a way that most readers can understand. And the book gives a good solid way for readers to lower uric acid levels using diet and supplements.
This review is based on the book and the way it is laid out and told. I did not try the LUV diet, so I cannot give a first-hand account of how it works.
I recommend this book to anyone who wants to try to understand the effects of uric acid on the body. I received a complimentary copy of this book. The opinions expressed in this review are completely my own.
The book is told in two parts. The first part gives you all the scientific data that supports the role uric acid plays in human metabolism. The second part is all about how to lower uric acid using the author’s LUV (Lower Uric Values) diet and gives the reader a three-week diet plan as well as outlying the foods to avoid, and the foods that help lower uric acid levels.
I found this book gives the reader a good scientific background of the role of uric acid, told in a way that most readers can understand. And the book gives a good solid way for readers to lower uric acid levels using diet and supplements.
This review is based on the book and the way it is laid out and told. I did not try the LUV diet, so I cannot give a first-hand account of how it works.
I recommend this book to anyone who wants to try to understand the effects of uric acid on the body. I received a complimentary copy of this book. The opinions expressed in this review are completely my own.
May 27, 2022
Sensationalist. Contains some useful info, and I definitely think the subject bears further discussion, but the author lost me when he tried to attribute all mental illness and forms of neurodiversity to excessive sugar consumption. Clearly he is a dog with a bone when it comes to HFCS, and I think he is barking up some incorrect trees in his zeal.
January 30, 2022
An informative and clearly written book on how we are inadvertently and lethally overburdening our metabolism with uric acid by our overconsumption of certain foods. Perlmutter covered many of the same issues in his previous books, Grain Brain and Brain Wash although the focus on this guide is slightly different. It's an easy book to read and it's good to be aware of the foods and habits that lead to an overload of uric acid and how slight modifications can make a huge difference in long term health. Half the book is recipes and sample meals, and this will appeal to many readers. He's also included a hefty list of his own references, which I very much appreciate.
There is no such thing as a magic pill but the suggestions in this book are sound and sensible for anyone who is wanting to be proactive about long term health, both physical and mental.
#netgalley
There is no such thing as a magic pill but the suggestions in this book are sound and sensible for anyone who is wanting to be proactive about long term health, both physical and mental.
#netgalley
Read
October 4, 2022Learn about the dangers of uric acid and how to optimize your levels through diet and lifestyle changes.
If you selected this book hoping to find a treatise on the benefits (or drawbacks) of psychedelics, you might be disappointed. The acid you’re going to learn about here isn’t LSD, and it’s not going to open your mind to the wonders of the universe.
The acid in question also isn’t illegal. And yet, research is increasingly connecting it to many modern health problems, such as metabolic syndrome and obesity, diabetes, dementia, and cardiovascular disease.
So it’s time to introduce you to our special guest: uric acid.
As you’ll soon learn, uric acid isn’t something we consume; it’s made in our bodies. But certain foods, drinks, and even lifestyle habits influence how much of it our system produces.
In Part One of this book, you’ll learn about the main suspect: where uric acid comes from, what it does, and why many of us seem to be getting way too much of it these days. In Part Two, you’ll learn about the nutritional accomplices – those foods and drinks that can really push your UA levels over the top. And in Part Three, you’ll get the solution: how to prepare a three-week meal plan following the author’s LUV diet – that’s L-U-V for Lower Uric Values – to help you minimize uric acid-causing foods and maximize acid-dropping foods. Finally, as a treat at the end, you’ll get a day’s worth of the many recipes listed in the book to try at home. Let’s go drop acid!
---
Part One: The Suspect
Key takeaway: High uric acid levels are linked to many of today’s leading causes of premature death.
What do Leonardo da Vinci, Queen Anne of Britain, and Henry VIII all have in common? Many things, probably. But for now there’s only one commonality that concerns us – gout. That’s right, they all had gout, a form of arthritis that induces throbbing joints and excruciating inflammation, and is otherwise known as “that thing that causes your big toe to swell up and become super painful.”
Gout is often regarded as a malady of the past, like rickets or consumption. And that’s not totally inaccurate: it used to be more common. But that doesn’t mean gout isn’t still with us.
Over the last century, cases of gout have continued to rise. Between the 1960s and 1990s in the United States, the number of patients with gout doubled. Today, almost 10 million people in the US have gout.
Just like kidney stones, the main marker of those with gout is chronically elevated uric-acid levels. Here’s the rub: until very recently, these two ailments were the only reason most doctors paid attention to their patients’ UA levels. The reference range – often under 7 milligrams per deciliter – is mostly derived from UA’s connection to gout. But anything higher than 5.5 is what the author calls a “high normal,” and comes with a host of other dangers. According to a study over an eight-year period by the American College of Rheumatology, high uric-acid levels are to blame for 16 percent of all-cause mortality – that just means death from any cause. And for cardiovascular diseases such as stroke or coronary heart disease? That jumps to 39 percent.
There may be no immediate symptoms. But chronically elevated levels of uric acid can cause major problems. These often play out over a longer period, culminating in all sorts of diseases based on inflammation, from Alzheimer’s to nonalcoholic fatty liver disease and other disorders linked to obesity and metabolic syndrome, as well as sexual dysfunction in men.
Uric acid is made in our body. And there are two main sources that cause this process to happen.
The first is fructose. Along with its turbo-charged sibling, high-fructose corn syrup, fructose has become the cheapest ingredient in recent decades. In concentrated form, it’s added to nearly everything, from (as you’d expect) sodas and desserts to (as you might not expect) breads, sauces, and yogurts.
The second is something called purines. They’re a class of chemicals present in nearly all living cells – including the human body. Purines are necessary for healthy physiology, but elevated levels can be harmful. You can find them in many foods, from seafood and meat to beer and some vegetables.
When you ingest purines or fructose, the body naturally breaks them down in the liver, the intestines, and the inner cellular lining of blood vessels. As a result, voilà. Uric acid is born.
It can then trigger fat production. Even for those who are not obese, excessive uric acid can cause fat to build up within the liver.
---
Key takeaway: Human bodies have not yet adapted to the modern Western diet.
Think back tens of thousands of years ago to the time when your distant ancestors were still hunters and gatherers. There were no pizzas or burgers; no sodas or Twinkies. And no agriculture. They ate what they could find. Nuts, fruits, meat when they could get their hands on it. When agriculture first started developing around 12,000 years ago, things took a very, very slow turn toward fructose. But in evolutionary terms, the period from then till now is just the blink of an eye. For the collective human genome to make any real changes through evolution, between 40,000 and 70,000 years have to elapse. In other words, though we haven’t changed much since then, our environment has.
In pre-agricultural times, humans who were predisposed to save fat had an advantage. According to the thrifty-gene hypothesis, which was first put forward in 1962 by James Neel, a geneticist at the University of Michigan, it paid off to be able to put on more fat during times when food was plentiful. It was a way to prepare for times when food was scarce. It’s plausible, then, that we evolved the ability to create uric acid and add fat for similar reasons. It was advantageous.
These days, while food security is still an issue in some parts of the world, calories are becoming ever more abundant and cheap, partially thanks to the ever-rising amount of fructose in our foods. And foods and beverages that cause the most uric-acid production – such as highly processed cereal grains, all forms of refined sugars and vegetable oils, and alcohol – make up over 72 percent of the total energy consumed by people in the United States today. In this environment, the ability to create uric acid and add fat is definitely disadvantageous.
High-fructose corn syrup, which is a combination of 55 percent fructose and 42 percent glucose, came on the scene in the 1950s and gained popularity in the 1970s when cane and beet sugar was more expensive and corn was cheap. Even though fructose does naturally occur in fruit and honey, it takes real dedication to consume the same amount of fructose from some fresh blueberries as you can from the concentrated added sugar in sweetened drinks, sauces, and breads, among other places.
Next up, you’ll learn how to spot uric acid-causing foods, which is the first step toward avoiding them all together.
---
Part Two: The Accomplices
Key takeaway: To cut down on uric acid-causing foods, first learn where to spot them.
Joanna was in her late forties and had struggled with various health issues over the years. High blood pressure, diabetes, gaining 60 pounds seemingly overnight: she just couldn’t catch a break. All that her doctors would tell her was the vague “eat well and exercise.” For her fiftieth birthday, she decided to treat herself to a comprehensive medical spa, where on-site physicians would help her create a tailor-made plan to optimize her health. Her goal was to do this without the help of pharmaceuticals.
During her stay at the medical spa, one doctor looked over Joanna’s profile and diagnosed her with metabolic syndrome on the spot. She had all five main characteristics associated with the disorder: in addition to her high blood pressure and blood sugar, she also had excess body fat around the waist, high triglyceride levels in her blood, and abnormal cholesterol levels. The doctor’s next question left her stumped: “How much fructose do you consume?” he had asked. She had absolutely no idea what it was or how much she normally took in. Nor how it was related to uric acid, or how the latter was helping along fructose’s damaging effects.
It soon became clear: while she generally ate healthy food, she had a weakness for sugary drinks. In recent decades, there have been heated debates – and expensive lawsuits – about whether fructose is healthier than sucrose, or table sugar. Big Corn and Big Sugar both went to bat, trying to prove in court that they were, in fact, the healthier sweetener. The science, however, has shown both to have a similar effect on blood-sugar levels. And, predictably, it’s not a good one. Over time, Joanna was able to find the culprits, cut out sodas and other sources of fructose, and get her weight under control, all while improving her other health conditions.
Unprocessed food only contains small amounts of fructose. And in fruits and vegetables such as broccoli, artichokes, and asparagus, the fructose is offset by fiber and other nutrients, which slow the absorption of the sugar into the bloodstream. Drinking fruit juice or soft drinks, on the other hand, is essentially an express train to fructose town. Once in your system, fructose is quick to disable the parts of your metabolism that say when you’re feeling full, and can lead to mindless eating. Under the persistent influence of fructose, the body believes that it’s starving, so it goes into fat storage mode, thanks to elevated uric-acid values. Since insulin cannot work properly, the body is set on a course of long-term inflammation.
So let’s identify the sources of fructose and purines, in addition to the lifestyle habits that can contribute to high uric acid.
We’ve already mentioned the usual suspects with added sugar. Check the labels on anything you buy that isn’t a whole food – you’d be surprised where fructose, sucrose, or other sweeteners have snuck in.
But also be careful to limit consumption of red meats like beef, lamb, and pork, as well as oily fish such as sardines and anchovies. Avoid organ meats such as liver and kidney. All of these tend to have higher purine content. Certain vegetables also have high purine content, but, as with berries, it’s difficult to get an overdose on purines by just eating peas or spinach. Some whole foods high in purines can even protect your body from an increase in uric acid.
Try to eliminate gluten in all forms, refined carbohydrates, added sugars, and MSG. Most artificial sweeteners, such as those in diet sodas, can also raise uric-acid levels, even though they don’t tend to impact blood sugar in the short term. Too much salt has been linked to cognitive decline and an increase in obesity, insulin resistance, and metabolic syndrome. The average American eats ten grams of salt a day or more, while medical experts advise to eat less than half of that. In the place of these acid-raisers, eat mainly plant-based meals with whole fruits and vegetables, nuts and seeds, extra virgin olive oil, and organic eggs. Make sure to incorporate “acid-dropping” foods and drinks such as tart cherries, broccoli, sprouts, and coffee.
Alcohol in its various forms also raises UA levels. Unfortunately, beer causes the greatest increase, even more than liquor. Luckily, moderate wine consumption is associated with a decrease in uric acid levels in women. In men, it caused neither an increase nor a decrease.
Take a moment to check out your medicine cabinet as well. Are you taking aspirin, niacin, or testosterone supplements? What about diuretics? These can also raise uric-acid levels.
And, finally, sleep and exercise. According to a 2019 study, there is a strong inverse correlation between how long you sleep and how high your uric-acid levels are. Getting enough sleep was associated with lower levels, suggesting that sleep plays a role in regulating the rises and falls in uric acid. It would make sense, since most gout attacks also occur during the night. A 2017 study suggested that prediabetic adults getting less than six hours of sleep had a 44 percent greater chance of developing diabetes; the risk for those getting less than five hours of shuteye was 68 percent. In your fight against uric acid, the Z’s are your friend.
---
Part Three: The Solution
Key takeaway: By committing to the LUV diet for three weeks, you can get a taste of the healthful benefits of dropping acid.
At this point, you’ve heard some of the science about the dangers of elevated uric acid. Perhaps you’ve even approached your doctor or gone through your past bloodwork to check where your levels stand. The good news is that, just like with blood glucose monitors, home uric-acid test kits are affordable and accessible. If you’re ready to embark on a three-week journey to lower your uric-acid levels through diet and lifestyle changes, read on.
The LUV diet – again, that’s Lower Uric Values – is designed to do just what it says: lower your uric-acid levels. Its goal is also to help you get in the habit and routine that promotes low uric acid, so that once you get it down, you can keep it down.
Check with your doctor before starting any of this, especially if there are any preexisting health issues you need to watch out for. If you have test kits for both uric acid and blood glucose, test yourself before the first day, too, to have a baseline and track your progress.
The author recommends doing a 24-hour fast before the first day to start the week with a clean slate. It’s very simple: for 24 hours, don’t eat any solid food or consume caffeine. Just drink lots of water.
In the first week, you’ll learn to follow a meal plan of acid-dropping dishes – though feel free to cook your own recipes as long as they don’t include any of the foods mentioned earlier that are verboten.
Of the following, you can eat as much as you want: healthful fats such as extra virgin olive oil, sesame oil, coconut or avocado oil, ghee and organic butter. Then there’s coconuts, olives, cheese, cottage cheese, nut butters, and nuts – especially walnuts. There are no limits on herbs and seasonings, as well as kimchi, whole fruits, and vegetables. Don’t forget leafy greens and legumes such as black beans, lentils, chickpeas, and kidney beans. If you really need an artificial sweetener other than a drizzle of natural honey, the author recommends allulose. According to some research, it does not have a negative effect on blood glucose levels.
The following recipes are just a sample day in the life of the LUV diet – the rest are listed in the book and on the author’s website, drperlmutter.com, and can be adapted for a ketogenic or vegetarian diet. On some days, consider skipping breakfast to add some time-restricted eating – also known as intermittent fasting – to your regimen.
But not today! Today’s breakfast is coconut pudding with one or two eggs, soft boiled or hard boiled. All you need is 16 ounces of either fresh or thawed frozen young Thai coconut flesh, a quarter cup of water, one tablespoon of allulose, and one teaspoon of vanilla extract. Blend these four ingredients together until smooth and creamy, then pop them in the refrigerator for one hour. In the meantime, for the topping, mix cashews, nigella seeds, and hemp hearts in a bowl. Scoop the coconut blend into a bowl, top with the nut mixture, and toss some berries on there if you have them.
Time flies, it’s already lunch time! Just the right weather for a chicken salad with broccoli-sprout pesto. Here’s how you make it. For the pesto, combine two cups of broccoli sprouts, two cups of baby spinach leaves, half a cup of chopped raw unsalted walnuts, one tablespoon of miso paste, half a teaspoon of salt, a quarter teaspoon of red pepper flakes, and three quarters of a cup of extra virgin olive oil in a food processor and blend until smooth. For the chicken, cook ten ounces of boneless skinless chicken breast and cut it into cubes. Combine it with a quarter cup of finely diced green bell pepper and a quarter cup of finely diced red onion. Bon appétit!
Dinner tonight is za’atar-crusted rack of lamb with arugula and a tart-cherry vinaigrette. Season one rack of baby lamb – about a pound – with sea salt and cover evenly with extra virgin olive oil. Rub three tablespoons of za’atar into the meat and cover with lemon slices. Place on a baking sheet and cook at 450 degrees for 15 minutes. Let it rest for 20 minutes before slicing it into chops. While the lamb’s cooking, make the vinaigrette: mix a quarter cup of fresh or thawed frozen tart cherries without the pits, two cardamom pods, one and a half tablespoons of both apple cider vinegar and dijon mustard, a quarter cup of olive oil, and salt and freshly ground black pepper to taste. To make the salad, take four cups of arugula or another leafy green and toss with salad dressing. Serve the salad onto two plates, top with the lamb chops, and garnish with pomegranate seeds and thinly sliced red onion.
There you have it! A gourmet day in the life of a not-so-average LUV dieter. Enjoy!
In the second and third weeks, you’ll continue with the meal plan and focus on optimizing your sleep schedule, making time for regular movement – whether it’s intense exercise or just getting up from your desk every hour. Week three is about looking at your rhythm, your life, and your goals.
Looking back over the first two weeks, what did you find most challenging? Did you frequently struggle to resist your favorite less-than-healthy foods? Or perhaps it was especially difficult to dedicate regular time to exercise? Hone in on your biggest weaknesses, and write down what specific things you can do to overcome them. Come up with a few nonnegotiable goals that you'll be able to stick to – such as completely avoiding sweetened drinks, or creating the right environment for yourself to get quality sleep by leaving smartphones and other devices outside of the bedroom.
Going forward, try to take some time each week to self-assess and plan. By being organized about meals, sleep, and movement, you’ll have that much more free time to devote to the other goals that are most important to you.
---
Uric acid is a big deal – and a big problem. The more processed foods we eat, with their added fructose and high purine content, the more we’re setting ourselves up for health issues down the road, from obesity and liver disease to ADHD and dementia. By adopting the LUV diet and changing what we eat, how we move, and how well we sleep, we can prevent some of these problems from emerging – or, in certain cases, reverse their course.
If you selected this book hoping to find a treatise on the benefits (or drawbacks) of psychedelics, you might be disappointed. The acid you’re going to learn about here isn’t LSD, and it’s not going to open your mind to the wonders of the universe.
The acid in question also isn’t illegal. And yet, research is increasingly connecting it to many modern health problems, such as metabolic syndrome and obesity, diabetes, dementia, and cardiovascular disease.
So it’s time to introduce you to our special guest: uric acid.
As you’ll soon learn, uric acid isn’t something we consume; it’s made in our bodies. But certain foods, drinks, and even lifestyle habits influence how much of it our system produces.
In Part One of this book, you’ll learn about the main suspect: where uric acid comes from, what it does, and why many of us seem to be getting way too much of it these days. In Part Two, you’ll learn about the nutritional accomplices – those foods and drinks that can really push your UA levels over the top. And in Part Three, you’ll get the solution: how to prepare a three-week meal plan following the author’s LUV diet – that’s L-U-V for Lower Uric Values – to help you minimize uric acid-causing foods and maximize acid-dropping foods. Finally, as a treat at the end, you’ll get a day’s worth of the many recipes listed in the book to try at home. Let’s go drop acid!
---
Part One: The Suspect
Key takeaway: High uric acid levels are linked to many of today’s leading causes of premature death.
What do Leonardo da Vinci, Queen Anne of Britain, and Henry VIII all have in common? Many things, probably. But for now there’s only one commonality that concerns us – gout. That’s right, they all had gout, a form of arthritis that induces throbbing joints and excruciating inflammation, and is otherwise known as “that thing that causes your big toe to swell up and become super painful.”
Gout is often regarded as a malady of the past, like rickets or consumption. And that’s not totally inaccurate: it used to be more common. But that doesn’t mean gout isn’t still with us.
Over the last century, cases of gout have continued to rise. Between the 1960s and 1990s in the United States, the number of patients with gout doubled. Today, almost 10 million people in the US have gout.
Just like kidney stones, the main marker of those with gout is chronically elevated uric-acid levels. Here’s the rub: until very recently, these two ailments were the only reason most doctors paid attention to their patients’ UA levels. The reference range – often under 7 milligrams per deciliter – is mostly derived from UA’s connection to gout. But anything higher than 5.5 is what the author calls a “high normal,” and comes with a host of other dangers. According to a study over an eight-year period by the American College of Rheumatology, high uric-acid levels are to blame for 16 percent of all-cause mortality – that just means death from any cause. And for cardiovascular diseases such as stroke or coronary heart disease? That jumps to 39 percent.
There may be no immediate symptoms. But chronically elevated levels of uric acid can cause major problems. These often play out over a longer period, culminating in all sorts of diseases based on inflammation, from Alzheimer’s to nonalcoholic fatty liver disease and other disorders linked to obesity and metabolic syndrome, as well as sexual dysfunction in men.
Uric acid is made in our body. And there are two main sources that cause this process to happen.
The first is fructose. Along with its turbo-charged sibling, high-fructose corn syrup, fructose has become the cheapest ingredient in recent decades. In concentrated form, it’s added to nearly everything, from (as you’d expect) sodas and desserts to (as you might not expect) breads, sauces, and yogurts.
The second is something called purines. They’re a class of chemicals present in nearly all living cells – including the human body. Purines are necessary for healthy physiology, but elevated levels can be harmful. You can find them in many foods, from seafood and meat to beer and some vegetables.
When you ingest purines or fructose, the body naturally breaks them down in the liver, the intestines, and the inner cellular lining of blood vessels. As a result, voilà. Uric acid is born.
It can then trigger fat production. Even for those who are not obese, excessive uric acid can cause fat to build up within the liver.
---
Key takeaway: Human bodies have not yet adapted to the modern Western diet.
Think back tens of thousands of years ago to the time when your distant ancestors were still hunters and gatherers. There were no pizzas or burgers; no sodas or Twinkies. And no agriculture. They ate what they could find. Nuts, fruits, meat when they could get their hands on it. When agriculture first started developing around 12,000 years ago, things took a very, very slow turn toward fructose. But in evolutionary terms, the period from then till now is just the blink of an eye. For the collective human genome to make any real changes through evolution, between 40,000 and 70,000 years have to elapse. In other words, though we haven’t changed much since then, our environment has.
In pre-agricultural times, humans who were predisposed to save fat had an advantage. According to the thrifty-gene hypothesis, which was first put forward in 1962 by James Neel, a geneticist at the University of Michigan, it paid off to be able to put on more fat during times when food was plentiful. It was a way to prepare for times when food was scarce. It’s plausible, then, that we evolved the ability to create uric acid and add fat for similar reasons. It was advantageous.
These days, while food security is still an issue in some parts of the world, calories are becoming ever more abundant and cheap, partially thanks to the ever-rising amount of fructose in our foods. And foods and beverages that cause the most uric-acid production – such as highly processed cereal grains, all forms of refined sugars and vegetable oils, and alcohol – make up over 72 percent of the total energy consumed by people in the United States today. In this environment, the ability to create uric acid and add fat is definitely disadvantageous.
High-fructose corn syrup, which is a combination of 55 percent fructose and 42 percent glucose, came on the scene in the 1950s and gained popularity in the 1970s when cane and beet sugar was more expensive and corn was cheap. Even though fructose does naturally occur in fruit and honey, it takes real dedication to consume the same amount of fructose from some fresh blueberries as you can from the concentrated added sugar in sweetened drinks, sauces, and breads, among other places.
Next up, you’ll learn how to spot uric acid-causing foods, which is the first step toward avoiding them all together.
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Part Two: The Accomplices
Key takeaway: To cut down on uric acid-causing foods, first learn where to spot them.
Joanna was in her late forties and had struggled with various health issues over the years. High blood pressure, diabetes, gaining 60 pounds seemingly overnight: she just couldn’t catch a break. All that her doctors would tell her was the vague “eat well and exercise.” For her fiftieth birthday, she decided to treat herself to a comprehensive medical spa, where on-site physicians would help her create a tailor-made plan to optimize her health. Her goal was to do this without the help of pharmaceuticals.
During her stay at the medical spa, one doctor looked over Joanna’s profile and diagnosed her with metabolic syndrome on the spot. She had all five main characteristics associated with the disorder: in addition to her high blood pressure and blood sugar, she also had excess body fat around the waist, high triglyceride levels in her blood, and abnormal cholesterol levels. The doctor’s next question left her stumped: “How much fructose do you consume?” he had asked. She had absolutely no idea what it was or how much she normally took in. Nor how it was related to uric acid, or how the latter was helping along fructose’s damaging effects.
It soon became clear: while she generally ate healthy food, she had a weakness for sugary drinks. In recent decades, there have been heated debates – and expensive lawsuits – about whether fructose is healthier than sucrose, or table sugar. Big Corn and Big Sugar both went to bat, trying to prove in court that they were, in fact, the healthier sweetener. The science, however, has shown both to have a similar effect on blood-sugar levels. And, predictably, it’s not a good one. Over time, Joanna was able to find the culprits, cut out sodas and other sources of fructose, and get her weight under control, all while improving her other health conditions.
Unprocessed food only contains small amounts of fructose. And in fruits and vegetables such as broccoli, artichokes, and asparagus, the fructose is offset by fiber and other nutrients, which slow the absorption of the sugar into the bloodstream. Drinking fruit juice or soft drinks, on the other hand, is essentially an express train to fructose town. Once in your system, fructose is quick to disable the parts of your metabolism that say when you’re feeling full, and can lead to mindless eating. Under the persistent influence of fructose, the body believes that it’s starving, so it goes into fat storage mode, thanks to elevated uric-acid values. Since insulin cannot work properly, the body is set on a course of long-term inflammation.
So let’s identify the sources of fructose and purines, in addition to the lifestyle habits that can contribute to high uric acid.
We’ve already mentioned the usual suspects with added sugar. Check the labels on anything you buy that isn’t a whole food – you’d be surprised where fructose, sucrose, or other sweeteners have snuck in.
But also be careful to limit consumption of red meats like beef, lamb, and pork, as well as oily fish such as sardines and anchovies. Avoid organ meats such as liver and kidney. All of these tend to have higher purine content. Certain vegetables also have high purine content, but, as with berries, it’s difficult to get an overdose on purines by just eating peas or spinach. Some whole foods high in purines can even protect your body from an increase in uric acid.
Try to eliminate gluten in all forms, refined carbohydrates, added sugars, and MSG. Most artificial sweeteners, such as those in diet sodas, can also raise uric-acid levels, even though they don’t tend to impact blood sugar in the short term. Too much salt has been linked to cognitive decline and an increase in obesity, insulin resistance, and metabolic syndrome. The average American eats ten grams of salt a day or more, while medical experts advise to eat less than half of that. In the place of these acid-raisers, eat mainly plant-based meals with whole fruits and vegetables, nuts and seeds, extra virgin olive oil, and organic eggs. Make sure to incorporate “acid-dropping” foods and drinks such as tart cherries, broccoli, sprouts, and coffee.
Alcohol in its various forms also raises UA levels. Unfortunately, beer causes the greatest increase, even more than liquor. Luckily, moderate wine consumption is associated with a decrease in uric acid levels in women. In men, it caused neither an increase nor a decrease.
Take a moment to check out your medicine cabinet as well. Are you taking aspirin, niacin, or testosterone supplements? What about diuretics? These can also raise uric-acid levels.
And, finally, sleep and exercise. According to a 2019 study, there is a strong inverse correlation between how long you sleep and how high your uric-acid levels are. Getting enough sleep was associated with lower levels, suggesting that sleep plays a role in regulating the rises and falls in uric acid. It would make sense, since most gout attacks also occur during the night. A 2017 study suggested that prediabetic adults getting less than six hours of sleep had a 44 percent greater chance of developing diabetes; the risk for those getting less than five hours of shuteye was 68 percent. In your fight against uric acid, the Z’s are your friend.
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Part Three: The Solution
Key takeaway: By committing to the LUV diet for three weeks, you can get a taste of the healthful benefits of dropping acid.
At this point, you’ve heard some of the science about the dangers of elevated uric acid. Perhaps you’ve even approached your doctor or gone through your past bloodwork to check where your levels stand. The good news is that, just like with blood glucose monitors, home uric-acid test kits are affordable and accessible. If you’re ready to embark on a three-week journey to lower your uric-acid levels through diet and lifestyle changes, read on.
The LUV diet – again, that’s Lower Uric Values – is designed to do just what it says: lower your uric-acid levels. Its goal is also to help you get in the habit and routine that promotes low uric acid, so that once you get it down, you can keep it down.
Check with your doctor before starting any of this, especially if there are any preexisting health issues you need to watch out for. If you have test kits for both uric acid and blood glucose, test yourself before the first day, too, to have a baseline and track your progress.
The author recommends doing a 24-hour fast before the first day to start the week with a clean slate. It’s very simple: for 24 hours, don’t eat any solid food or consume caffeine. Just drink lots of water.
In the first week, you’ll learn to follow a meal plan of acid-dropping dishes – though feel free to cook your own recipes as long as they don’t include any of the foods mentioned earlier that are verboten.
Of the following, you can eat as much as you want: healthful fats such as extra virgin olive oil, sesame oil, coconut or avocado oil, ghee and organic butter. Then there’s coconuts, olives, cheese, cottage cheese, nut butters, and nuts – especially walnuts. There are no limits on herbs and seasonings, as well as kimchi, whole fruits, and vegetables. Don’t forget leafy greens and legumes such as black beans, lentils, chickpeas, and kidney beans. If you really need an artificial sweetener other than a drizzle of natural honey, the author recommends allulose. According to some research, it does not have a negative effect on blood glucose levels.
The following recipes are just a sample day in the life of the LUV diet – the rest are listed in the book and on the author’s website, drperlmutter.com, and can be adapted for a ketogenic or vegetarian diet. On some days, consider skipping breakfast to add some time-restricted eating – also known as intermittent fasting – to your regimen.
But not today! Today’s breakfast is coconut pudding with one or two eggs, soft boiled or hard boiled. All you need is 16 ounces of either fresh or thawed frozen young Thai coconut flesh, a quarter cup of water, one tablespoon of allulose, and one teaspoon of vanilla extract. Blend these four ingredients together until smooth and creamy, then pop them in the refrigerator for one hour. In the meantime, for the topping, mix cashews, nigella seeds, and hemp hearts in a bowl. Scoop the coconut blend into a bowl, top with the nut mixture, and toss some berries on there if you have them.
Time flies, it’s already lunch time! Just the right weather for a chicken salad with broccoli-sprout pesto. Here’s how you make it. For the pesto, combine two cups of broccoli sprouts, two cups of baby spinach leaves, half a cup of chopped raw unsalted walnuts, one tablespoon of miso paste, half a teaspoon of salt, a quarter teaspoon of red pepper flakes, and three quarters of a cup of extra virgin olive oil in a food processor and blend until smooth. For the chicken, cook ten ounces of boneless skinless chicken breast and cut it into cubes. Combine it with a quarter cup of finely diced green bell pepper and a quarter cup of finely diced red onion. Bon appétit!
Dinner tonight is za’atar-crusted rack of lamb with arugula and a tart-cherry vinaigrette. Season one rack of baby lamb – about a pound – with sea salt and cover evenly with extra virgin olive oil. Rub three tablespoons of za’atar into the meat and cover with lemon slices. Place on a baking sheet and cook at 450 degrees for 15 minutes. Let it rest for 20 minutes before slicing it into chops. While the lamb’s cooking, make the vinaigrette: mix a quarter cup of fresh or thawed frozen tart cherries without the pits, two cardamom pods, one and a half tablespoons of both apple cider vinegar and dijon mustard, a quarter cup of olive oil, and salt and freshly ground black pepper to taste. To make the salad, take four cups of arugula or another leafy green and toss with salad dressing. Serve the salad onto two plates, top with the lamb chops, and garnish with pomegranate seeds and thinly sliced red onion.
There you have it! A gourmet day in the life of a not-so-average LUV dieter. Enjoy!
In the second and third weeks, you’ll continue with the meal plan and focus on optimizing your sleep schedule, making time for regular movement – whether it’s intense exercise or just getting up from your desk every hour. Week three is about looking at your rhythm, your life, and your goals.
Looking back over the first two weeks, what did you find most challenging? Did you frequently struggle to resist your favorite less-than-healthy foods? Or perhaps it was especially difficult to dedicate regular time to exercise? Hone in on your biggest weaknesses, and write down what specific things you can do to overcome them. Come up with a few nonnegotiable goals that you'll be able to stick to – such as completely avoiding sweetened drinks, or creating the right environment for yourself to get quality sleep by leaving smartphones and other devices outside of the bedroom.
Going forward, try to take some time each week to self-assess and plan. By being organized about meals, sleep, and movement, you’ll have that much more free time to devote to the other goals that are most important to you.
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Uric acid is a big deal – and a big problem. The more processed foods we eat, with their added fructose and high purine content, the more we’re setting ourselves up for health issues down the road, from obesity and liver disease to ADHD and dementia. By adopting the LUV diet and changing what we eat, how we move, and how well we sleep, we can prevent some of these problems from emerging – or, in certain cases, reverse their course.
February 6, 2024
Catchy title, right? No, not LSD but uric acid levels. This is good book for those who are facing medical problems because of their high uric acids levels--gout, kidney stones, etc. That's usually the first sign that something is going wrong with how your body processes uric acid. Dr Perlmutter explains the science, what foods cause high uric acid levels and has created the LUV diet with recipes to change what you eat.
February 23, 2022
Scary stuff! A new way to monitor how horribly we treat our bodies! Just say no to high fructose corn syrup (HFCS)! The quirky name of the book drew me in and the material was presented in an organized fashion. The author did push his other books so you could gain more knowledge of how to treat your body better. Worth the read.
June 21, 2022
The topic is great, but the depth of explained chemistry and mechanics are a bit shallow. Finished reading this book, I feel like I was promised a lot, but the promise was not fulfilled in full. Will have to go for more reading on uric acid.
May 28, 2023
Absolutely loved an interview he gave on the Levels YouTube channel about uric acid so thought I'd give the book a go. I was left a bit disappointed.
The general gist is that uric acid is a mediator of fructose's harmful metabolic effects, and a good indicator of metabolic health. Which I totally buy, sounds reasonable, and it sure seems if you injected extra uric acid into yourself that you'd be doing harm.
But that's all the book had to communicate, which I had already grasped from the interview, this book could have been a paragraph. The book mostly goes as [STEP 1] Identify a study where health got worse as a result of the modern diet [STEP 2] Say "They didn't measure uric acid, but if they had, it would have been another bad marker"
Fascinating. I just didn't find the argument at all compelling or have any a-ha moment with this book. It never felt justified to me why this is the thing you'd write a book about. I'm glad we're doing more research into metabolic effects, and as I said I believe the author's thesis that it's harmful and a helpful marker, but there's just so little to say when it's activated by foods we already know are unhealthy and for the same reasons. I feel like there's nothing both *new* and actionable in this book.
He says he first looked into uric acid in *late 2020* - and I have tremendous respect for him disclosing that - but that immediately set off red flags. How do you both research and write a book on this in a year when you weren't even aware of it before?
You don't. Which is probably why the book felt like it had so little to say. An entire half of the book is references and a diet plan that basically says "be rich and have catered meals". I know this might be written for fitness heads but in my opinion, energy is limited and you have to pick your battles. Step 1 of your diet plan cannot be "just cut all wheat and bread and pasta and sugars, most meats, eat vegetables, but not even half of them because they're still bad, spend money on trackers, eat salmon but not too much..." etc. As someone who came from rural Midwestern poverty, that's just not actionable advice for me. It's great to identify what's harmful, but a gradual plan that focuses on building basic cooking skills, and making slightly healthier substitutions one day at a time would be far more effective. Running a marathon is a great way to lose weight, but if that's the one version of exercise you offer, everyone is going to drop out - so the advice is worthless.
There were also more "don't worry, trust me, I'll break it down for you, let's do it together, your new life starts today" sentences that don't communicate anything of value and fill space than I prefer (read: zero)
Compare this book to one of Dr. Jason Fung's "Code" series books that are so information dense chapter after chapter of bangers and the comparison is embarrassing.
They're both fantastic doctors, well educated, and agree on what needs to be done to fix our metabolic crisis. Dr. Perlmutter was an eloquent and engaging speaker in his interview that came off as intelligent and insightful, but the book? You can pass on this one.
The general gist is that uric acid is a mediator of fructose's harmful metabolic effects, and a good indicator of metabolic health. Which I totally buy, sounds reasonable, and it sure seems if you injected extra uric acid into yourself that you'd be doing harm.
But that's all the book had to communicate, which I had already grasped from the interview, this book could have been a paragraph. The book mostly goes as [STEP 1] Identify a study where health got worse as a result of the modern diet [STEP 2] Say "They didn't measure uric acid, but if they had, it would have been another bad marker"
Fascinating. I just didn't find the argument at all compelling or have any a-ha moment with this book. It never felt justified to me why this is the thing you'd write a book about. I'm glad we're doing more research into metabolic effects, and as I said I believe the author's thesis that it's harmful and a helpful marker, but there's just so little to say when it's activated by foods we already know are unhealthy and for the same reasons. I feel like there's nothing both *new* and actionable in this book.
He says he first looked into uric acid in *late 2020* - and I have tremendous respect for him disclosing that - but that immediately set off red flags. How do you both research and write a book on this in a year when you weren't even aware of it before?
You don't. Which is probably why the book felt like it had so little to say. An entire half of the book is references and a diet plan that basically says "be rich and have catered meals". I know this might be written for fitness heads but in my opinion, energy is limited and you have to pick your battles. Step 1 of your diet plan cannot be "just cut all wheat and bread and pasta and sugars, most meats, eat vegetables, but not even half of them because they're still bad, spend money on trackers, eat salmon but not too much..." etc. As someone who came from rural Midwestern poverty, that's just not actionable advice for me. It's great to identify what's harmful, but a gradual plan that focuses on building basic cooking skills, and making slightly healthier substitutions one day at a time would be far more effective. Running a marathon is a great way to lose weight, but if that's the one version of exercise you offer, everyone is going to drop out - so the advice is worthless.
There were also more "don't worry, trust me, I'll break it down for you, let's do it together, your new life starts today" sentences that don't communicate anything of value and fill space than I prefer (read: zero)
Compare this book to one of Dr. Jason Fung's "Code" series books that are so information dense chapter after chapter of bangers and the comparison is embarrassing.
They're both fantastic doctors, well educated, and agree on what needs to be done to fix our metabolic crisis. Dr. Perlmutter was an eloquent and engaging speaker in his interview that came off as intelligent and insightful, but the book? You can pass on this one.
March 27, 2022
Fascinating! It's very rare that I find a book on health that feels truly unique. But I'd really never considered uric acid at all except as it pertained to gout. I had no idea that there was so much evidence pertaining to uric acid and its relationship to metabolic syndrome, hypertension, high cholesterol, and really morbidity and mortality generally. I've started to test every one of my patients with relevant issues for uric acid, and even for those who have gout, I now know that the reference range is certainly not the ideal to shoot for. I may well end up adding uric acid to yearly screening labs for everybody--it seems that important.
February 24, 2022
This falls in the Nonfiction/Health genres. I've read quite a few books from these genres in the last few years and it is interesting to see them all grow and move as they focus on the new data that is coming forth. The importance of understanding insulin resistance has been getting a lot of press in recent years where as years ago, that wasn't a term you ever heard of.
This author takes that term and goes on to the next level of uric acid in our system and why we need to keep that in check by taking steps to lowering the overall value in our bodies. I liked the newness of this research. Definitely food for thought. But if I'm being honest, the first part of this was hard for me to get through. I contemplated not finishing it. Luckily though, the latter half, that included practical application, was a lot more interesting and it felt a lot more conversational rather than high school science class.
This author is also prone to handing out numerous plugs for his website, which always gets me rolling my eyes. So 3 or 4 stars. Three stars is how I felt, but the overall message of implementing healthy habits needs to heard and read by all...so I'll round up to 4.
This author takes that term and goes on to the next level of uric acid in our system and why we need to keep that in check by taking steps to lowering the overall value in our bodies. I liked the newness of this research. Definitely food for thought. But if I'm being honest, the first part of this was hard for me to get through. I contemplated not finishing it. Luckily though, the latter half, that included practical application, was a lot more interesting and it felt a lot more conversational rather than high school science class.
This author is also prone to handing out numerous plugs for his website, which always gets me rolling my eyes. So 3 or 4 stars. Three stars is how I felt, but the overall message of implementing healthy habits needs to heard and read by all...so I'll round up to 4.
December 15, 2024
I dislike the hype, but it’s surely true that a contemporary diet elevates uric acid and undermines health.
December 9, 2022
Very intresting discussion all about uric acid and the impact high levels of it have on the body.there are recipes to support the diet to use that ought to bring improvements .
March 21, 2022
The breakthrough, foundational science in 2022's Drop Acid: The Surprising New Science of Uric Acid---Learn the Secret to Controlling Blood Sugar, Losing Weight, and Achieving Incredible Health by David Perlmutter MD was fascinating and very helpful, but that was the first half of the book. In the second he outlined his LUV diet, a mostly plant-based diet that significantly lowers your uric acid, and offers forty recipes that were somewhat interesting, but mostly not plant-based.
I will try to summarize the science. It's very important for you to understand why elevated uric acid is such a health problem for the majority of us and I encourage you to read his first half.
For centuries elevated uric acid was considered only a medical problem that causes gout and kidney stones. That's because the medical industry chose to ignore the peer-reviewed findings of a doctor in 1892 who clearly showed that elevated uric acid drives the inflammatory signal in our bodies and will cause the metabolic syndrome behind all our chronic diseases, including Type 2 diabetes, obesity, heart disease, arthritis, cancer, and brain disorders that include depression, dementia and Alzheimer's.
Fortunately in this century the scientists have been busily studying elevated uric acid and their exciting findings are all over the leading medical journals. Perlmutter, a neurologist who has written three other popular books like The Grain Brain, gives us the current scientific findings, but explains that there is still more to learn.
Briefly, elevated uric acid diminishes the nitric oxide in our bodies and that starts all the problems because nitric oxide is extremely crucial to our entire health by oxygenating everything.
There are certain foods that support elimination of uric acid buildup in our livers, the latter which begins with processed fructose in junk drink and food, continues with purine-rich seafood and meats, and ends with alcohol and yeasty bread, I believe.
I was very disappointed in the second half when he said chicken eggs were just fine and a great source of protein, as was dairy milk (not skim milk). I wonder if further research will prove him wrong. Too much salt really stimulates uric acid also.
His forty recipes confused me because I saw white meats used and a fish. His few desserts made use of a sweetner I hadn't heard of, allulose, and he doesn't use honey in his recipes, but says a little bit is okay. Honey has a lot of fructose, but like with fruits its other immunity-strengthening properties renders the fructose harmless. But the science isn't there for honey approval.
Then there are five supplements that really drop uric acid, plus a couple prescribed drugs.
Good sleep on a regular basis will help keep uric acid levels low as will exercise and broccoli.
The science is fast and furious. I'm sure we'll learn much more about elevated uric acid that will eventually trickle down to your gastroenterologist, followed by other doctors, but why wait? I suggest you keep updated on the research.
I will try to summarize the science. It's very important for you to understand why elevated uric acid is such a health problem for the majority of us and I encourage you to read his first half.
For centuries elevated uric acid was considered only a medical problem that causes gout and kidney stones. That's because the medical industry chose to ignore the peer-reviewed findings of a doctor in 1892 who clearly showed that elevated uric acid drives the inflammatory signal in our bodies and will cause the metabolic syndrome behind all our chronic diseases, including Type 2 diabetes, obesity, heart disease, arthritis, cancer, and brain disorders that include depression, dementia and Alzheimer's.
Fortunately in this century the scientists have been busily studying elevated uric acid and their exciting findings are all over the leading medical journals. Perlmutter, a neurologist who has written three other popular books like The Grain Brain, gives us the current scientific findings, but explains that there is still more to learn.
Briefly, elevated uric acid diminishes the nitric oxide in our bodies and that starts all the problems because nitric oxide is extremely crucial to our entire health by oxygenating everything.
There are certain foods that support elimination of uric acid buildup in our livers, the latter which begins with processed fructose in junk drink and food, continues with purine-rich seafood and meats, and ends with alcohol and yeasty bread, I believe.
I was very disappointed in the second half when he said chicken eggs were just fine and a great source of protein, as was dairy milk (not skim milk). I wonder if further research will prove him wrong. Too much salt really stimulates uric acid also.
His forty recipes confused me because I saw white meats used and a fish. His few desserts made use of a sweetner I hadn't heard of, allulose, and he doesn't use honey in his recipes, but says a little bit is okay. Honey has a lot of fructose, but like with fruits its other immunity-strengthening properties renders the fructose harmless. But the science isn't there for honey approval.
Then there are five supplements that really drop uric acid, plus a couple prescribed drugs.
Good sleep on a regular basis will help keep uric acid levels low as will exercise and broccoli.
The science is fast and furious. I'm sure we'll learn much more about elevated uric acid that will eventually trickle down to your gastroenterologist, followed by other doctors, but why wait? I suggest you keep updated on the research.
February 23, 2022
Dr David Perlmutter has offered another thought-provoking , paradigm-changing book in his latest, “ Drop Acid”: The Surprising New Science of Uric Acid- The Key to Losing Weight, Controlling Blood Sugar, and Achieving Extraordinary Health.”
I have long admired Dr. Perlmutter, a neurologist, for his gentle humility and willingness to follow the science, even when it means course correcting what he recommends to his patients. He freely admits to, many years ago, following the now outdated recommendations of a low fat and higher carb diet. Eventually, he researched and changed his recommendations, leading to his ground breaking book “Grain Brain.” This latest book draws on cutting edge research to posit that elevated uric acid levels may be silently fueling biological processes that are resulting in elevated blood sugar and blood pressure, higher bad cholesterol,excess body fat, and systemic inflammation. These problems open the door to many chronic degenerative conditions that both lower our life span and weaken our health as we age.
According to Perlmutter, an estimated 21% of the population have elevated uric acid, unbeknownst to most of them, unless they have gout or kidney issues. He details the reason we evolved to have higher uric acid at times, and describes the lifestyle choices we make, specifically eating processed food with fructose, drinking purine rich alcohol( beer), and having too much purine rich meat, which elevate our uric acid levels.
He then offers information on how to test our levels and lower them, using food, sleep, exercise, time-restricted eating and supplements. As is typical of Perlmutter, his advice is practical, encouraging and hopeful.
He ends by comparing this new thinking about high uric acid to the change in thinking about smoking over 50 years ago. In the late 1960’s, years after the Surgeon General issued his report on the dangers of smoking, only one third of all doctors felt the case against smoking had been proven! He says he hopes it doesn’t take another half century for people to get the message about uric acid.
I’ll be re-reading this again and getting a home kit to test my own uric acid levels. A big thanks to Perlmutter for his continued commitment to provide dietary and lifestyle info to help us all live long and healthy lives.
I have long admired Dr. Perlmutter, a neurologist, for his gentle humility and willingness to follow the science, even when it means course correcting what he recommends to his patients. He freely admits to, many years ago, following the now outdated recommendations of a low fat and higher carb diet. Eventually, he researched and changed his recommendations, leading to his ground breaking book “Grain Brain.” This latest book draws on cutting edge research to posit that elevated uric acid levels may be silently fueling biological processes that are resulting in elevated blood sugar and blood pressure, higher bad cholesterol,excess body fat, and systemic inflammation. These problems open the door to many chronic degenerative conditions that both lower our life span and weaken our health as we age.
According to Perlmutter, an estimated 21% of the population have elevated uric acid, unbeknownst to most of them, unless they have gout or kidney issues. He details the reason we evolved to have higher uric acid at times, and describes the lifestyle choices we make, specifically eating processed food with fructose, drinking purine rich alcohol( beer), and having too much purine rich meat, which elevate our uric acid levels.
He then offers information on how to test our levels and lower them, using food, sleep, exercise, time-restricted eating and supplements. As is typical of Perlmutter, his advice is practical, encouraging and hopeful.
He ends by comparing this new thinking about high uric acid to the change in thinking about smoking over 50 years ago. In the late 1960’s, years after the Surgeon General issued his report on the dangers of smoking, only one third of all doctors felt the case against smoking had been proven! He says he hopes it doesn’t take another half century for people to get the message about uric acid.
I’ll be re-reading this again and getting a home kit to test my own uric acid levels. A big thanks to Perlmutter for his continued commitment to provide dietary and lifestyle info to help us all live long and healthy lives.
March 24, 2025
Great book with so much information, I’m actually kind of sad I listened to it instead of read it, since I didn’t usually have anything with me to take notes while I listened. Definitely lots of good info
April 30, 2022
Another eye opener from a great source; Dr. David Perlmutter. I highly respect this authors philosophy on “food is medicine” and the way he delegates recommendations.
Becoming more aware of Uric Acid and other non-essential but detrimental anti-nutrients I’ve been consuming is where I would place the value I gained from this read.
I appreciate a book that encourages me to a point where I make a lasting change in my life and this book has done just that.
Key Takeaway for me is going to be changing the alcohol I drink and balancing my acid intake throughout my meals.
“Today we are starving for proper nourishment to support health. We are starving for more movement and refreshing sleep. And we are eager to usher in this revolution in our evolution. In the fifty-odd years since anti tobacco efforts began following the surgeon general's report, more than eight million American lives have been saved. How many millions of lives could have been saved since then had we known about uric acid's role in fomenting fires in the body?”
Becoming more aware of Uric Acid and other non-essential but detrimental anti-nutrients I’ve been consuming is where I would place the value I gained from this read.
I appreciate a book that encourages me to a point where I make a lasting change in my life and this book has done just that.
Key Takeaway for me is going to be changing the alcohol I drink and balancing my acid intake throughout my meals.
“Today we are starving for proper nourishment to support health. We are starving for more movement and refreshing sleep. And we are eager to usher in this revolution in our evolution. In the fifty-odd years since anti tobacco efforts began following the surgeon general's report, more than eight million American lives have been saved. How many millions of lives could have been saved since then had we known about uric acid's role in fomenting fires in the body?”
July 9, 2022
A family member has high uric acid levels and their doctor recommended this book so I thought I’d educate myself and read it.
The science behind it all seems pretty reasonable and similar to what I read in The Obesity Code and/or some of the intermittent fasting books I’ve read. Pretty much, fructose is the devil and causes lots of metabolic problems including raising uric acid levels.
The second half of the book outlines a diet and other lifestyle changes one should make to lower uric acid levels. I don’t think the average person would have the willpower to make all of the changes. As well, the diet is pretty restrictive and while there are lots of recipes included very few contained ingredients that are all easily found or aren’t expensive.
The science behind it all seems pretty reasonable and similar to what I read in The Obesity Code and/or some of the intermittent fasting books I’ve read. Pretty much, fructose is the devil and causes lots of metabolic problems including raising uric acid levels.
The second half of the book outlines a diet and other lifestyle changes one should make to lower uric acid levels. I don’t think the average person would have the willpower to make all of the changes. As well, the diet is pretty restrictive and while there are lots of recipes included very few contained ingredients that are all easily found or aren’t expensive.
March 13, 2022
Read this for my husband more than for myself. That's probably why I zoned out during the "what to eat" portions. It could help me cook for him, but it was similar to things I already do. It's more about not being able to force others to change even when they fully know they should and what changes they should make. Oh well, useful information for any human nonetheless.
March 22, 2024
This book has some very good information on ways to improve health now and to avoid issues in later life as well. The research was presented well, though a little too science-y for me. It is evident that Dr. Perlmutter is knowledgeable and intelligent, not just someone with a theory and nothing to back it up. I listened to the audiobook, but I will more than likely be purchasing the print book as well. I’d like to have it on hand for future reference.
February 24, 2023
I was surprised by this book and how it revealed the surprising new science of uric acid. I didn’t know that uric acid played such a key role in our lives and how it affects our weight, blood sugar, and overall health. The author explains how uric acid is a byproduct of metabolism that can cause inflammation, oxidative stress, and chronic diseases if it accumulates too much in our bodies. He also offers practical advice on how to lower uric acid levels through diet, lifestyle, and supplements. I learned a lot from this book and I highly recommend it to anyone who wants to improve their health and well-being.
April 26, 2025
This book had really good info and I plan to follow some of the tips. I have already changed a few things around in my daily cooking and the way I look at nutrition labels.
As the wife of someone that suffers from gout I have made my husband make changes in his supplements. Next step is to get him off of most meds.
As the wife of someone that suffers from gout I have made my husband make changes in his supplements. Next step is to get him off of most meds.
August 12, 2025
I read Drop Acid after my uric acid came in slightly above average. It’s clear, and informative. The book focused on understanding how lifestyle impact uric acid, but I think there’s another important factor - genetics. The book did not mention it, but for people who are already taking care of their sleep, exercise, and nutrition, uric acid levels might still be high due to genetic factors.
January 28, 2024
So there I was, laid up in bed for 3 days with a bloody horrible gout flare-up, when this title turned up in the Audible sale.
I’ve spent much of this bed-bound weekend listening to this book whilst taking lots of notes, and now I feel more confident about how to get a grip of my uric acid levels and why it matters to do so, not just for pain and mobility, but for heart health and preventing cognitive decline.
Looks like I’m going to have to make some lifestyle changes - but at least now I know which ones will work. Anything is better than more of this level of pain 🤬
I’ve spent much of this bed-bound weekend listening to this book whilst taking lots of notes, and now I feel more confident about how to get a grip of my uric acid levels and why it matters to do so, not just for pain and mobility, but for heart health and preventing cognitive decline.
Looks like I’m going to have to make some lifestyle changes - but at least now I know which ones will work. Anything is better than more of this level of pain 🤬
October 12, 2022
The first part went over my head, but I'm surprised about how much I learned from the scientific portion. The second part was great because he laid out a plan on how to drop uric acid.
January 20, 2025
Great information on uric acid but some of the food recommendations are not for everyone and especially I didn’t agree with “everyone” could benefit from coffee! Overall, great info!
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June 11, 2025Túm lại là ăn ít thôi các chế ạ, nhất là HFCS, đồ ngọt, thức ăn nhiều purine. Nhưng về cơ bản thì ăn ít thôi, ngày ăn 1-2 bữa thôi. Mà thời bây giờ thì đúng, càng ăn ít càng tự do =)) Dành thêm thời gian vận động, đều đặn quan trọng hơn cường độ nữa nha.
Vấn đề của các quyển nonfic mình đọc là quá dài dòng. Nhiều đoạn cứ cố viết dài ra phát mệt mà chả hiểu để làm gì. Nhưng mình cũng tự hỏi ngược lại là nếu không bôi ra như thế, mà rút gọn lại thành các gạch đầu dòng thì ai đọc, ai tin? Thế nên là anh em mình cứ thế thôi hẹ hẹ.
Vấn đề của các quyển nonfic mình đọc là quá dài dòng. Nhiều đoạn cứ cố viết dài ra phát mệt mà chả hiểu để làm gì. Nhưng mình cũng tự hỏi ngược lại là nếu không bôi ra như thế, mà rút gọn lại thành các gạch đầu dòng thì ai đọc, ai tin? Thế nên là anh em mình cứ thế thôi hẹ hẹ.
February 5, 2023
This is a good general health book, but he does not really connect uric acid as the cause of anything, though it’s obviously related / correlated to a lot of negative health outcomes (but that conclusion not new). The book is actually disappointing and frustrating from that perspective, and it’s very hard not to conclude that he’s simply looking for an angle to distinguish himself from numerous authors (i.e., sell more books!) that have already written similar books on glucose and insulin as the causes of metabolic problems. I followed up the reading by checking out his website, where he suggests that a 2016 study identifies uric acid as ‘the’ cause of a lot of health issues, but in fact the study concludes that now is NOT the time to focus on lowering uric acid but is instead the time to do more research.
I’m not a doctor so maybe just missing something, but he should be making a clear and compelling argument that non-doctors can easily understand. He did not.
That said, there is still a lot of good information in here on diets and lifestyle generally. He also has a decent amount of recommendations for lowering uric acid, but until I’m further convinced that it really matters other than being correlated with a lot of negative health outcomes, I won’t be following those specific recommendations.
I’m not a doctor so maybe just missing something, but he should be making a clear and compelling argument that non-doctors can easily understand. He did not.
That said, there is still a lot of good information in here on diets and lifestyle generally. He also has a decent amount of recommendations for lowering uric acid, but until I’m further convinced that it really matters other than being correlated with a lot of negative health outcomes, I won’t be following those specific recommendations.
February 2, 2024
Is there good information in this book? You betcha. Will you hear the same thing over and over? Definitely. The intro chapters are Repeat City. The last chapters on HOW to lower uric acid are decidedly short (but aren’t as repetitious...so win?) and somewhat incomplete (so...maybe not a win?).
For example, he says to go ahead and eat all the beans! But not peanuts because they’re legumes. ...But, beans are ALSO legumes...so...wait...what? To add to my confusion, not once does he mention his fantastic beans in his one-week meal plan. I don't get it. Just tell me if beans are on or off the table, man! He needs a better editor.
BTW, the tips to lower uric acid are basically: live a healthy lifestyle. Whole foods, exercise, sleep...you know the drill. And remember, don't drink soda.
So really, his aim was to alert the masses to the importance of tracking uric acid, which I appreciate. I just wish he had a better editor that could have reined him in a little bit to make his message clearer.
For example, he says to go ahead and eat all the beans! But not peanuts because they’re legumes. ...But, beans are ALSO legumes...so...wait...what? To add to my confusion, not once does he mention his fantastic beans in his one-week meal plan. I don't get it. Just tell me if beans are on or off the table, man! He needs a better editor.
BTW, the tips to lower uric acid are basically: live a healthy lifestyle. Whole foods, exercise, sleep...you know the drill. And remember, don't drink soda.
So really, his aim was to alert the masses to the importance of tracking uric acid, which I appreciate. I just wish he had a better editor that could have reined him in a little bit to make his message clearer.
February 27, 2022
This is an important book and one that is fairly easy to consume. If you are familiar with the work of Richard Johnson from CU Boulder then this book doesn't add anything you don't already know. But of course the book will reach a much bigger audience because Perlmutter is well known.
The writing can be a little verbose and repetitive. In fact it feels like the material should be a few chapters in another book or a pamphlet. I also found that there was a degree of over-simplification that (paradoxically) may make the messaging hard to follow without already having familiarity with Richard Johnson's science writings.
Anyway, if you are one of the millions of Americans struggling with metabolic disease, weight, hypertension or hypercholesterolemia this book is worth a read. It will likely be surprising to most that uric acid isn't just related to gout and kidney stones.
The writing can be a little verbose and repetitive. In fact it feels like the material should be a few chapters in another book or a pamphlet. I also found that there was a degree of over-simplification that (paradoxically) may make the messaging hard to follow without already having familiarity with Richard Johnson's science writings.
Anyway, if you are one of the millions of Americans struggling with metabolic disease, weight, hypertension or hypercholesterolemia this book is worth a read. It will likely be surprising to most that uric acid isn't just related to gout and kidney stones.
November 22, 2022
One of the very best health and wellness books I've ever read.
A quick one-liner could summarize this book:
But, the author provides so much more beyond that core message that we all have heard at least one time before, either conclusively or bits and pieces of the message in its entirety.
Some personal highlights:
- "Survival of the Fattest"
- Evolutionary mismatch with our current environment. The abundance of abundance is the greatest plague to humankind.
- "Sugar is alcohol without the buzz"
If you want to live a longer life without obesity, illness, and other preventable conditions, this book will get the wheels spinning in your head on how you can approach reasonable change towards a happier, healthier, better you.
A quick one-liner could summarize this book:
But, the author provides so much more beyond that core message that we all have heard at least one time before, either conclusively or bits and pieces of the message in its entirety.
Some personal highlights:
- "Survival of the Fattest"
- Evolutionary mismatch with our current environment. The abundance of abundance is the greatest plague to humankind.
- "Sugar is alcohol without the buzz"
If you want to live a longer life without obesity, illness, and other preventable conditions, this book will get the wheels spinning in your head on how you can approach reasonable change towards a happier, healthier, better you.
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