We recently read The Art and Science of Low Carbohydrate Performance by Jeff Volek and Stephen Phinney and it gave us a new insight into how bread and other carbohydrates cause gout attacks and make us short of breath.
Eating carbohydrates causes glucose (blood sugar) levels to rise and the body to produce insulin to store any excess glucose as glycogen in the liver. When the insulin level goes down, the stored glycogen is broken down into glucose for energy. The process of glycogen breaking down produces CO2 which is released through breathing. Exercise uses the stored glycogen faster and increases the concentration of CO2 in the blood making it more acidic. The increased acidity can cause Uric acid in the blood to start precipitating out into the needle like crystals that cause gout. Exercise causes rapid breathing to rid of the body of CO2 and can make you breathless.
However, there is a form of fuel other than glucose. If there is no glucose available, the liver will convert fat to ketones for energy. Ketones are burned differently and produce much less CO2 than glycogen so you can exercise more before you are out of breath. There are other benefits to ketogenic energy including better efficiency of the muscles, like the heart. The average person can only store about 2000 calories as glycogen and although it can be quickly converted to energy, once it is gone the muscles and brain stop functioning. We have seen this happen to Ironman athletes in Kona. When the body is using ketones for fuel, it can convert up to 40,000 calories a day, 20 times more than from glucogen.
We have been on the ketogenic diet for almost 6 months. After the adaption period, we are feeling more energetic than ever. We love not being hungry all the time and have made great progress on our weight loss. The best part is no gout attacks, even though it has been very hot and humid this year and we have been exercising more.