As the rate of obese adults in America rises, so does the number of people being diagnosed with the painful form of arthritis known as gout, according to a recent article published in Reuters Health.

This comes as no surprise, really. The reason obesity is linked to many degenerative diseases is because excess fat causes metabolic aberrations. Gout is a classic example of this. People who have gout are unable to properly metabolize a substance called uric acid. Uric acid builds up in the bloodstream and is eventually deposited in the joints causing inflammation and extreme pain.

Uric acid is formed by the breakdown of purines. Purines can be found in the body and also in certain foods. The cause of gout is not actually the ingestion of these foods, but rather the inability to efficiently eliminate uric acid from the blood.

Although the exact metabolic defect is not known in the majority of gout sufferers, gout is one of the most controllable metabolic diseases. The good news is that by changing your diet you can experience instant relief and prevent painful gout attacks in the future. There are 10 dietary strategies that have been shown to be very effective in controlling gout:

1. Avoid all high (and most medium) purine proteins. Consuming purines greatly increases uric acid levels. High purine foods include organ meat, meats, shellfish, yeast, herring, sardines, mackerel, and anchovies. Foods with moderate levels of purines include dried legumes, spinach, asparagus, fish, poultry, and mushrooms.

2. Avoid nightshade foods. Nightshade foods contain substances called alkaloids that have many physiological effects. In people with gout, alkaloids exacerbate inflammation caused by elevated uric acid. Examples of nightshade foods include potatoes, tomatoes, peppers, and eggplant.

3. Avoid fructose and other sugars. Sugars such as honey, maple syrup, and corn syrup rapidly increase uric acid. In gout sufferers this effect is exaggerated. Fruit juice and sugar sweetened soft drinks should be eliminated.

4. Eliminate alcohol. Alcohol increases uric acid production by accelerating purine breakdown. It also reduces uric acid excretion by increasing lactate production which impairs kidney function. Moreover the breakdown products of alcohol are toxic. Metabolism of these toxic compounds takes priority over uric acid disposal. Not all alcoholic beverages contribute to gout to the same extent. Beer has been shown to carry the highest risk because it contains purines.

5. Include potassium bicarbonate. In normal metabolism there is a post-meal alkaline surge that keeps uric acid from building up. Potassium bicarbonate raises pH, thereby stimulating this normal physiologic mechanism. Taking potassium bicarbonate is a simple way to raise pH and prevent gout attacks.

6. Drink unsweetened cherry juice. Cherries contain compounds that reduce inflammation. Eating 1/2 pound of cherries or drinking 6 ounces of cherry juice is an effective strategy for lowering uric acid levels and preventing gout attacks.

7. Drink plenty of water. Dehydration is a trigger for gout attacks. Adequate fluid intake keeps the urine diluted and promotes the excretion of uric acid. Pure water is the single best fluid for hydration. Be sure to consume at least .5 ounces per pound of body weight to maintain hydration.

8. Lose weight. Being overweight is a major risk factor for gout. Excess weight increases uric acid because there is more tissue available for turnover and breakdown. Weight reduction has been shown to significantly reduce serum uric acid levels. An effective weight loss plan includes proper nutrition and regular exercise.

9. Eat right for your metabolic type. The one-size-fits-all diet just doesn’t exist. One man’s food really is another man’s poison. Eating in a way that is right for your metabolic type is fundamental because it balances biochemistry, improves metabolic efficiency, and restores the fundamental homeostatic controls that govern metabolic processes. Building health starts with eating the right foods for you.

10. Work with a nutritionist. Because the diet therapy for gout involves many food restrictions and includes determining your metabolic type, it is important to work with a qualified nutritionist. A nutritionist will also determine proper supplementation based on nutrient deficiencies and your unique needs. Making dietary changes can be a challenging process and requires support. A nutritionist will guide you through the process of changing your diet and provide you with all the resources you need to be successful.

The author is the director of nutrition and health coach at Santa Monica-based LifeSpan Medicine, and a nutrition expert. She can be contacted at NKuhl@lifespanmedicine.com. For more information visit www.Lifespanmedicine.com.

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