What are the dietary recommendations for someone with gout?

A low-purine diet has long been the mainstay of dietary therapy for gout. Foods with high purine levels should be omitted entirely. These include organ meats, yeast (brewer's and baker's), herring, sardines, mackerel, and anchovies.

Intake of foods with moderate levels of protein should be reduced to one serving every two to three days as well. These include dried legumes, spinach, asparagus, fish, poultry, and mushrooms. Low-purine foods may be eaten in smallamounts.

Alcohol increases uric acid production by accelerating purine breakdown. It also reduces uric acid excretion by increasing lactate production, which impairs kidney function. For many individuals, elimination of alcohol is all that is needed to reduce uric acid levels and prevent gouty arthritis.

Obesity is associated with an increased rate of gout. Weight reduction in obese individuals significantly reduces serum uric acid levels. High-fat and high-protein foods are usually foods that are high in purines.

High-fat animal foods also promote inflammation and should be avoided, regardless of purine content. High-proteinfoods that are not high in purines should be eaten only in small amounts to avoid taxing the kidneys, which are burdened with excreting excess uric acid. Liberal fluid intake keeps the urine diluted and promotes the excretion of uric acid.

Furthermore, dilution of the urine reduces the risk of kidney stones. Drink at least 48 ounces of water each day. Celery and cherries appear to be very effective in lowering uric acid levels and preventing attacks of gout.

Celery contains the compound 3-n-butylpthalide, while cherries are a rich source of flavonoids. Both of these compounds are beneficial in gout via several mechanisms, including the ability to inhibit the formation of uric acid by inhibiting the enzyme xanthine oxidase.

All refined carbohydrates and fried foods must be eliminated, and foods containing trans-fatty acids (margarine, shortening, and other synthetically hydrogenated vegetable oils) or oxidized fatty acids (fried oils) should be avoided, as these foods may aggravate acne. Consumption of milk and milk products should also be limited or eliminated due to their potential hormone content. Specific nutrients have been shown to exert a positive effect in treating acne.

They include zinc, vitamin A, selenium, vitamin E, and chromium (brewer's yeast). Zinc, in particular, is vitally important in the treatment of acne. Also important are dietary antioxidants, as male acne patients have significantly decreased levels of antioxidant enzymes.

This normalizes when vitamin E and selenium are supplemented in the diet. The widespread belief that chocolate per se causes or aggravates acne is apparently not true. In two studies, one conducted at the Pennsylvania School of Medicine and the other at the U.S. Naval Academy, eating chocolate did not produce any significant changes in the acne conditions of study participants.

Nonetheless, we recommend that individuals with acne choose dark chocolate since it is has the highest levels of anti-inflammatory phenols and that they avoid sweet chocolate products (too much sugar!) and those that contain trans-fatty acids. Milk chocolate should also be avoided due to the high hormone content of most commercially available milk.

Coffee, as well as less obvious caffeine sources such as soft drinks, chocolate, coffee-flavored ice cream, hot cocoa, and tea must all be eliminated in people who suffer from insomnia. Even small amounts of caffeine such as those found in decaffeinated coffee or chocolate may be enough to cause insomnia in some people. Alcohol must also be eliminated in people with regular insomnia.

Alcohol causes the release of adrenaline and disrupts the production of serotonin (an important brain chemical that initiates sleep). Although not considered stimulants, sugar and refined carbohydrates can interfere with sleep. Eating a diet high in sugar and refined carbohydrates and eating irregularly can cause a reaction in the body that triggers the fight-or-flight response, causing wakefulness.

Other food compounds that can act as stimulants include some food colorings. Adverse food reactions such as food sensitivities and allergies can also cause insomnia.In sleep maintenance insomnia, we at the Hunger Free Forever program have found nocturnal hypoglycemia (low nighttime blood glucose level) to be a major factor. When there is a drop in the blood glucose level, it causes the release of hormones that regulate glucose levels, such as adrenaline, Cortisol, glucagon, and growth hormone.

These compounds stimulate the brain. They are a natural signal that it is time to eat.

A high-protein diet is associated with increased excretion of calcium in the urine and increased risk of osteoporosis, too. In contrast, a vegetarian diet is associated with a lower risk of osteoporosis. A diet high in salt or acid ash also causes calcium removal from bones and increases calcium loss in the urine.

Therefore, we recommend avoiding salt and eating an alkaline-based diet. Basically, an alkaline diet is one that focuses on vegetables, fruit, nuts, and legumes while avoiding overconsumption of meat and dairy products. Soft drinks containing phosphates (phosphoric acid) are definitely linked to osteoporosis because they lead to lower calcium levels and higher phosphate levels in the blood.

When phosphate levels are high and calcium levels are low, calcium is pulled out of the bones. The phosphate content of soft drinks, such as Coca-Cola and Pepsi, is very high, and they contain virtually no calcium. Refined sugar intake also increases the loss of calcium from the bone.

Regular consumption of refined sugar increases loss of calcium from the blood through the urine. A deficiency in trace minerals can also predispose to osteoporosis. Green leafy vegetables from the cabbage family, including broccoli, Brussels sprouts, kale, collards, and mustard greens, as well as green tea, offer significant protection against osteoporosis.

These foods are rich sources of a broad range of vitamins and minerals that are important to maintaining healthy bones, including calcium, vitamin K1, and boron. In addition, soy foods, such as tofu, soy milk, roasted soybeans and soy extract powders, may be beneficial in preventing osteoporosis. Alfalfa is another isoflavone- and vitamin K-rich food that can be included in the diet.

While numerous clinical studies have demonstrated that calcium supplementation can help prevent bone loss, the data are inconclusive in regard to any link between a high dietary calcium intake from milk and prevention of osteoporosis and bone fractures. In fact, women who drank two or more glasses of milk per day had an increased relative risk of 45 percent for hip fracture compared to women consuming one glass or less per week. In other words, the more milk a woman consumed, the more likely she was to experience a hip fracture.

This negative effect may turn out to be due to the vitamin A added to milk (at higher levels, vitamin A-but not beta-carotene-may interfere with bone formation).

Don't eat solid foods. During the acute phase of diarrhea, no solid foods should be consumed. Instead, the focus should be on liquid.

Replace water and electrolytes by consuming herbal teas, vegetable broths, fruit juices, and electrolyte replacement drinks. An old naturopathic remedy is to sip a drink made of equal parts of sauerkraut and tomato juice. Avoid dairy products.

Acute intestinal illnesses, such as viral or bacterial intestinal infections, frequently injure the cells that line the small intestine. This results in a temporary deficiency of lactase, the enzyme responsible for digesting the milk sugar (lactose) in dairy products. Avoid dairy products (with the possible exception of live-cultured yogurt) while experiencing diarrhea.

Avoid food allergens. Food allergy is one of the most common causes of chronic diarrhea. The ingestion of an allergenic food can result in the release of histamine and other allergenic compounds from white blood cells, known as mast cells, that reside in the lining of the intestines.

These allergenic compounds can produce a powerful laxative effect. During the chronic phase, to help solidify stools, pectin-rich fruits and vegetables, such as pears, apples, grapefruit, carrots, potatoes, and beets may offer some benefit. Also, fresh blueberries have a long historical use in treating diarrhea because of their tannins, which firm up a loose stool.

Carob has been used medicinally as a treatment for diarrhea for centuries, and recent clinical studies have confirmed its clinical effectiveness, particularly for treating infants with diarrhea. Add 1 to 2 teaspoon of carob to applesauce or other food, two to three times daily. Mango has been shown to afford protection against as well as eliminate Giardia, a parasite that can be encountered while traveling.

Vegetable broths and dilute fruit and vegetable juices should be consumed to maintain electrolyte levels.

Elimination of food allergy is the primary goal in dealing with eczema. Although any food or food additive can trigger eczema, eggs, fish, milk, peanuts, soy, and wheat appear to be the most common food allergens. In one study, eggs, milk, and peanuts accounted for roughly 81 percent of all cases of childhood eczema.

Patients with eczema also appear to have an essential fatty acid deficiency. This results in decreased synthesis of the anti-inflammatory prostaglandins. As a result, there is a relative increase in the prostaglandins that promote inflammation.

Increasing the dietary intake of the omega-3 essential fatty acids, either by eating more fatty fish (e.g., mackerel, herring, and salmon) or through consuming flaxseed oil or fish oil supplements, can be of benefit. However, if fish allergy is suspected, a molecularly distilled fish oil product should be used.

In general, all simple, processed, and concentrated carbohydrates and high-glycemic load foods must be avoided. When these refined carbohydrates are eaten, blood sugar levels rise quickly, producing a strain on blood sugar control. Eating foods high in simple sugars in any form-sucrose, honey, or maple syrup-can lead to hypoglycemia.

Caffeine significantly worsens the effect. Avoid alcohol, as its consumption severely stresses blood sugar control and is often a contributing factor to hypoglycemia. Alcohol induces reactive hypoglycemia by interfering with normal glucose utilization and increasing the secretion of insulin.

The resultant drop in blood sugar produces a craving for food, particularly food that will quickly elevate blood sugar levels, as well as a craving for more alcohol. The increased sugar consumption aggravates the reactive hypoglycemia, particularly in the presence of more alcohol.

A deficiency of any single nutrient can alter brain function and lead to depression, anxiety, and other mental disorders, especially deficiencies of vitamin B12, folic acid, other B vitamins, and omega-3 fatty acids. Alcohol utilizes many of these nutrients in its metabolism, and drinking alcohol regularly replaces calories one would otherwise get from food. In this case, nutrients are just not adequately consumed, and those that are consumed are often needed to rid the body of the alcohol.

In the case of hypothyroidism, inadequate iodine intake can be a cause. Since the brain requires a constant supply of blood sugar to function properly, hypoglycemia must be avoided. Symptoms of hypoglycemia can range from mild to severe and include depression, anxiety, irritability, and other psychological disturbances; fatigue; headache; blurred vision; excessive sweating; mental confusion; incoherent speech; bizarre behavior; and convulsions.

Several studies have shown hypoglycemia to be very common in depressed individuals. Simply eliminating refined carbohydrates and caffeine (which can aggravate hypoglycemia) from the diet is sometimes all that is needed for effective therapy in patients whose depression results from reactive hypoglycemia. Food allergy is also a significant factor in some people suffering from depression.

Eliminating offending foods can bring about tremendous relief.

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A low-fiber diet high in refined foods contributes greatly to the development of hemorrhoids. Individuals who consume a low-fiber diet tend to strain more during bowel movements, since their smaller, harder stools are more difficult to pass. This straining raises the pressure in the abdomen, which obstructs venous blood flow, increases pelvic congestion, and may significantly weaken the veins, causing hemorrhoids to form.

A high-fiber diet is perhaps the most important component in the prevention of hemorrhoids. A diet rich in vegetables, fruits, legumes, and whole grains promotes peristalsis, the normal rhythmic contractions of the intestines. Furthermore, many fiber components attract water to form gelatinous masses that keep the feces soft, bulky, and easy to pass.

The net effect of a high-fiber diet is significantly less straining during defecation; therefore, a significantly lower risk of developing hemorrhoids is achieved. The diet should also contain liberal amounts of flavonoid-rich foods, such as bilberries, blackberries, blueberries, cherries, buckwheat, and citrus fruits to strengthen vein structures.