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By Mayo Clinic Staff Gout is a painful form of arthritis that occurs when high levels of uric acid in the blood cause crystals to form and accumulate in and around a joint.
Uric acid is produced when the body breaks down a chemical called purine. Purine occurs naturally in your body, but it's also found in certain foods. Uric acid is eliminated from the body in urine. A gout diet may help decrease uric acid levels in the blood.
A gout diet isn't a cure. But it may lower the risk of recurring gout attacks and slow the progression of joint damage. People with gout who follow a gout diet generally still need medication to manage pain and to lower levels of uric acid.
Gout diet goals A gout diet is designed to help you: Achieve a healthy weight and good eating habits Avoid some, but not all, foods with purines Include some foods that can control uric acid levels A good rule of thumb is to eat moderate portions of healthy foods.
Diet details The general principles of a gout diet follow typical healthy-diet recommendations: Weight loss. Being overweight increases the risk of developing gout, and losing weight lowers the risk of gout. Research suggests that reducing the number of calories and losing weight — even without a purine-restricted diet — lower uric acid levels and reduce the number of gout attacks. Losing weight also lessens the overall stress on joints.
Complex carbs. Eat more fruits, vegetables and whole grains, which provide complex carbohydrates. Avoid foods and beverages with high-fructose corn syrup, and limit consumption of naturally sweet fruit juices. Stay well-hydrated by drinking water. Cut back on saturated fats from red meat, fatty poultry and high-fat dairy products. Focus on lean meat and poultry, low-fat dairy and lentils as sources of protein.
Recommendations for specific foods or supplements include: Organ and glandular meats. Avoid meats such as liver, kidney and sweetbreads, which have high purine levels and contribute to high blood levels of uric acid.
Red meat. Big problem. Without going too far afield, let me point out that I believe this problem in languaging has a lot to do with the difficulty in drawing conclusions from studies of meat eaters or vegetarians. Its possible to be a vegetarian just eating Twinkies and white rice, and its possible to be a vegetarian eating nothing but vegetables, whole grains, fruits, and eggs. Similarly, meat eaters can refer to people who dine exclusively on ballpark hot dogs and have never met a vegetable they didnt hate, or it can refer to small tribes of huntergatherers who dine on pasture-fed wild gamewhen they can catch itand tons of wild fresh vegetables, fruits, and nuts.
See where Im going with this? I think, in America, weve made a huge mistake by trying to define the perfect diet in terms of protein, carbs, and fats. Endless diet and weight loss books are written trying to come up with the perfect formulathis many carbs, this much fat, this percentage of proteinwhen in fact the actual quality of the food we eat is probably way more important for our health than the proportions of fat, carbs, and protein.
Which brings us to this book. Given the mandate to choose the healthiest foods on the planet, I had to make a lot of decisions. Some were easy, slam-dunks, nobrainers. Think vegetables.
There are no bad ones. Unless you count French fries. Some, because of the language issue discussed above, required very careful exposition. Milk, for example, is a great food in its raw, organic state; but in my opinion, in its typical homogenized, pasteurized form, its a nightmare.
So when you read the entries, Id like you to pay particular attention to those qualifications. Youll probably be very surprised at some of the foods that made the cut, and even more surprised at some of the ones that didnt. See, for example, the entry on soy foods. That is, if you can find it. Its pretty short. At one point, it was suggested that I rate the foods in each category. I didnt do it. Because foods are like friends: They provide different things. You can have a friend whos absolutely great for going to basketball games with but with whom you wouldnt think of sharing your innermost feelings about your marriage.
Some foods provide great fats like omega-3s, but no calcium. Others provide a cornucopia of vitamins and min- erals, but no protein. No food provides everything. Rating them would involve making a decision about which essential vitamins, minerals, and macronutrients are more important, and thats impossible. You need them all. However, I did put stars on the foods I thought were exceptional in terms of nutritional value. That said, there are some key factors to be aware of when reading this book.
Four, to be exact. Having a passing acquaintance with them will enrich your understanding of the things that make foods healthy. And Id like to go over them here, so that when I reference them in the sections on food, you know what Im talking about. The first is the omega-3 fats, the presence of which almost always guarantees a food makes the list. The second is fiber. The third is antioxidants. And the fourth is the glycemic index.
Lets go over them one by one. A Short Primer on Fat: The Omega-3s Fats come in many different forms, and the different forms have varying effects on your health. Most people are aware that there are saturated fatswhich theyve been told to avoidand have heard vaguely of monounsaturated fats like those in olive oil and polyunsaturated fats like those in vegetable oils, nuts, and fish. Much as Id love to, I dont have the space here to go into a primer on fats, but Id like to give you a few bullet points before going into a little more detail about one specific class of polyunsaturated fats called the omega-3s.
Here are the take-home points: Saturated fat is not always bad. Some forms of saturated fatfor example, the kind in coconutare very healthy.
While you dont want to overdo it, you also dont need to avoid saturated fat like its poison. Its not. Trans fat, however, is. Metabolic poison, that is. Its found in cookies, crackers, baked goods and snacks, doughnuts, French fries, and most margarines. Regardless of what the label says, if it says partially hydrogenated oil in the ingredients, its got trans fat. Dont eat trans fats. The one single exception is the trans fat CLA, or conjugated linoleic acid, which is found naturally in grassfed dairy and meat and is not man-made.
Monounsaturated fatfound in nuts and olive oilis good stuff and heart healthy. Polyunsaturated fats come in two flavors: omega-6s and omega-3s. While there are some health benefits to omega-6s, we get too many omega-6s and not enough omega-3s. There are three different omega-3 fats: One of them is found in flaxseed and is called ALA alpha-linolenic acid. Its considered an essential fatty acid because the body cant make it, so it has to be obtained from the diet more about this in the section on flaxseed and flaxseed oil; see page But the other two omega-3sDHA docosahexaenoic acid and EPA eicosapentaen- oic acid are found in fish like salmon the wild variety.
And these two may be of even more importance to the body than the first one. Although technically the body can make these two omega-3s from ALA the first, essential, one , it doesnt do a real good job of it. Thats why its such a good idea to obtain these incredibly important fats ready-made from fish like salmon. Theyre just so critically important to our health.
So what exactly do omega-3s do, and why do we need them in the first place? Lets start with the cell membranes. Omega-3s are incorporated into cells, making their membranes more fluid so they can communicate with one another. This means, for example, that feel-good neurotransmitters like serotonin and dopamine can get in and out of the cell more easily, translating to better mood.
In fact, omega-3s are currently being studied for their positive effect on depression. Theyre also being studied for their impact on behavior, feeling, and thinking. Nearly every study of behavior problemsfrom simple lack of concentration to actual aggressive behavior in prison inmateshas shown that people with these problems have low levels of omega-3 fats in their bloodstream. This doesnt mean that omega-3s will fix every behavior problem, but its certainly of more than academic interest that this correlation shows up so frequently.
On a side note, the omega-3s in fish have a significant effect on the developing brain of a human fetus. Since the babys brain is about 60 percent fat by weight, and since most of that fat is DHA the very omega-3 found in fish , taking fish oil or getting fat from healthy, wild fish is one of the absolute best things a pregnant woman can do for her developing baby.
Fish truly is brain food. The amount of omega-3 in a pregnant womans diet helps to determine her childs intelligence, fine-motor skills such as the ability to manipulate small objects and hand-eye coordination , and also propensity to antisocial behavior. Omega-3s are anti-inflammatory. Since inflammation is a critical component of virtually every degenerative disease from heart disease to diabetes to obesity to Alzheimers, and since inflammation itself has been dubbed The Silent Killer, anti-inflammatory foods and supplements are of critical importance to our health.
Omega-3s also support circulation. They transport oxygen from red blood cells to the tissues. They prevent blood cells from clumping together remember, blood clots can be a cause of heart attack and stroke. They act as a blood thinner, much like aspirin, only without the side effects. Its been estimated by Andrew Stoll, M. Omega-3s help lower blood pressure.
And theyre also very effective for diabetics in improving insulin and glucose metabolism. Fiber Fiberparticularly soluble fibercan also lower blood cholesterol levels and slow the absorption of sugar, which is hugely important both for people with diabetes and for people with any blood sugar challenges metabolic syndrome.
A high-fiber diet will probably reduce the risk of developing type 2 diabetes. Beans, raspberries, pure bran, oatmeal, prunes, avocado, raisins, and most green vegetables, for example, are high-fiber foods that cause less of a rise in blood sugar than foods like potatoes, or than almost any wheatbased food. And eating a high-fiber diet may also help with weight loss. High-fiber foods generally require more chewing time, giving your body extra time to register the fact that youre no longer hungry, so youre less likely to overeat.
A highfiber diet also tends to fill you up longer. And high-fiber diets tend to have more volume for fewer calories, which has been shown in research by Dr.
Barbara Rolls at Pennsylvania State University to be a boon to weight management. In my last book I suggested that the number-one supplement for weight loss is fiber! The glycemic index is a measure of how much a given food like fruit raises your blood sugar.
High-sugar foodsor foods that convert quickly to sugar in the bodyare considered high glycemic. Why do we care? Because raising blood sugar raises levels of a hormone called insulin, which, if raised high enough and long enough and frequently enough, contributes to diabetes, heart disease, and aging. Eating low glycemically is a strategy that is virtually guaranteed to contribute to health.
When I wax eloquent about a foods low glycemic impact, thats why. Unfortunately, the glycemic index is a very misleading measure because it doesnt take into account portion size. The glycemic load is the number thats more important. For now, the takehome point is this: Eat less sugar.
And eat fewer foods that convert quickly to sugar in the body read: almost all processed carbohydrates. If youre interested in learning more about thissomething I recommend highly that you dothere are many clear, well-written articles on the subject. Remember its the glycemic load you want to pay attention to.
Antioxidants: What Are They, Anyway? Throughout the book, I talk about compounds found in foods called antioxidants. Antioxidants are so important that Ive included a special section on them on the bonus CD included with this book. For now just let me say this: Oxidation is what happens when you leave a cut apple out in the air. When that happens in your bodyas it does every dayit can cause significant damage to your cells and organs.
Oxidationor oxidative stressis a factor in virtually every degenerative disease. Antioxidants help fight this process. Deficiencies of antioxidants are implicated in the early stages of heart disease, cancer, eye disease, and age-related declines in memory. When I tell you that a food is good because its loaded with antioxidants, now you know why. Cholesterol: Whats the Story?
I make no secret of my love for eggs. They got a star in this book for all the reasons that youll read about. I eat them almost every day and think they are one of natures perfect foods. And the last time I threw away the yolk and ate an egg white omelette was in Youll probably soon notice that Im very far from fanatic about recommending that you drain every last drop of saturated fat from your diet.
So inevitably, people ask me, What about cholesterol? Cholesterol just might be the most misunderstood molecule in the whole world. John Abramson, professor of medicine at Harvard University, says this: It is important to keep in mind that cholesterol is not a health risk in and of itself.
In fact, cholesterol is vital to many of the bodys essential functions. Cholesterol is the parent molecule of some of the bodys most important compounds, including the sex hormones and vitamin D. Its also an integral part of the cell membrane. What a lot of people dont realize is that the vast majority of cholesterol is made in your body, by the liver.
If you take in more from the diet, the liver makes less. If you take in less, the liver makes more. You need cholesterol. Without it, youd die. Doing justice to the whole cholesterol question in an introduction as short as this is a real challenge, but Id like you to have a few basic take-home points.
The first is that dietary cholesterollike the kind you find in egg yolkshas minimal impact on serum cholesterol the kind your doctor measures. Not only that, but the effect of eggs on heart disease cant be predicted by looking only at their cholesterol content. Eggs contain many other nutrients that are good for youprotein, some polyunsaturated fats, folic acid, and other B vitamins.
As Dr. Walter Willett, chairman of the department of nutrition at the Harvard School of Public Health and a professor of medicine at Harvard Medical School, has said, No research has ever shown that people who eat more eggs have more heart attacks than people who eat few eggs.
The second point has to do with the demonization of saturated fat in general. Yes, saturated fat raises cholesterol, but it raises both the good and the bad cholesterol. And though there may be a relationship between saturated fat and cholesterol, the relationship between saturated fat in the diet and heart disease or mortality is far less clear. In fact, an entire nexus of researchers, doctors, and statisticians led by the brilliant Swedish scientist Uffe Ravnskov, M. If the science doesnt scare you off, its worth a visit to get a second opinion.
Lowering cholesterol is big business. In , the two top-selling drugs on Forbes magazines list of pharmaceutical juggernauts were Lipitor and Zocor, both cholesterol-lowering statin drugs.
Its worth noting that many researchers believe that the good that statin drugs accomplish has much less to do with their ability to lower cholesterol than their ability to lower inflammation, which is indeed a definite risk for heart disease, as well as a component of Alzheimers, obesity, and diabetes. The foods in this book are filled with natural anti-inflammatories like the flavonoid quercetin, for example. Spices like turmeric are so incredibly healthy largely because they are anti-inflammatory.
Finally, in my opinion, weve been way too focused on lowering cholesterol and not focused enough on lowering heart disease and mortality. They are not the same thing. In the Lyon Diet Heart Study, people who had had a heart attack were either counseled to eat a Mediterranean-type diet fish, fruits, vegetables, whole grains, olive oil, nuts or given routine postheart attack advice watch your cholesterol, eat less saturated fat.
The people on the Mediterranean diet experienced 70 percent less heart disease than the group getting the standard advice, about three times the reduction in the risk of further heart disease achieved with statin drugs! Their overall risk of death was 45 percent lower than that of the group getting the conventional advice. Andget thistheir cholesterol levels didnt change much.
Though they had significantly less heart disease and less risk of dying, their cholesterol levels pretty much didnt budge. Though some studies have shown a reduction in heart disease with cholesterol-lowering medications, the amount of reduction pales when compared to whats achievable with lifestyle changes.
High-risk men in the WOSCOP study a statin drug study achieved about a 30 percent reduction in heart disease by going on drugs, but the women in the Nurses Health Study showed 31 percent reduction in heart disease just by eating fish once a week. As Harvards Dr. Abramson puts it, Most of our health is determined by how we live our lives.
What about Organic? One thing that became abundantly clear in researching this book was that it was really necessary to define terms like grass fed, organic, cage free, free range, and the like. Im purposely leaving out natural, as it is the most deceptive and dishonest term in food marketing and so overused as to become utterly meaningless.
Remember, poison ivy and gasoline are both natural, which doesnt mean I want to eat them. In the section on meat and poultry, I address the whole issue of grass fed and free range, since this is the category in which these terms apply.
But organic now is a label used on everything from fruits and vegetables to Captain Hickorys Chocolate Crunchy Cereal. What does it mean, anyway? Should we pay attention? And if so, why?
Despite the best efforts of the food industry to make us think our food just magically somehow appears in the supermarket aisle, our food actually comes from somewhere. And where it comes fromwhere and how it grows in the case of plants, and what it eats and how it was raised in the case of animalshas a lot to do with its quality. So lets start with a basic premise: The quality of the food we eat comes from the quality of the food our food eats.
This maxim even applies when were talking about fruits and vegetables.
Early studies showed that carrots grown in one section of the country did not have the same nutrient composition as carrots grown in another part of the country. The practice of studying this sort of thing was abandoned because it outraged farmers.
Grapefruit growers in one part of the country did not want data out there showing that grapefruits grown in another part of the country had more vitamin C. Agribusiness is dedicated to selling us the concept that carrots are carrots, beef is beef. Of course, thats demonstrably not true. Just for example: On a gram for gram basis, a California avocado has 77 percent more monounsaturated fat, 44 percent more potassium, and 21 percent more fiber than its Florida brethren.
It can even make a difference in its effect on blood sugar. If a fruit or vegetable is grown in soil depleted of minerals, that fruit or vegetable is going to be less nutritious than one thats grown in soil thats rich in nutrients. In fact, recent studies of fruits, vegetables, and wheat have indeed revealed a 5 to 35 percent decline in some key vitamins, minerals, and protein over the last half-century. If an apple is sprayed with a ton of chemicals or pesticides and then artificially treated to make it bigger, rounder, redder, more uniform, polished, and more appealing to the eye, it stands to reason that a chemical analysis of that apple is going to look a lot different than an analysis of an apple growing wild on a farm somewhere.
Now whether or not those measurable differences have any real impact on our health is a matter of huge debate. Agribusiness would like you to think that they dont. I suspect that they do.
The whole idea of the organic food movementthe spirit of the movement, if you willwas a desire to return to basics. It was fueled by a fervent wish to consume the healthy products of the small, sustainable farm where fruits and vegetables and cows and pigs and chickens and horses lived in an interdependent atmosphere of pastoral tranquility, where foodwhether animal or vegetablewas grown or raised the old-fashioned way.
The organic movement valued a time and place where animals were not fed growth hormones and steroids and antibiotics and where crops were left to fend off the elements with their own protective antioxidants and anthocyanins, rather than chemical pesticides and carcinogens, and where Roundup Ready, genetically modified plants GMOs were unknown. People who wanted organic food were voting both for their health and against a marketplace that was increasingly providing them with food products bearing less and less resemblance to anything that could once be considered real or whole foodstuff that grew out of the ground, fell from a tree, or was harvested from healthy animals grazing on pasture or wild fish from uncontam- inated waters.
Buying organic represented a return to naturaland presumably healthierfoods. At least that was the hope. So yes, I buy organic whenever possible. I just dont kid myself anymore that the label refers to something that came from a farm like the ones on which I collected eggs from the barnyard as a kid. You might need to join a food collective. Go to a farmers market.
Or, if you can, go to a local farm and buy your food there. See where it comes from.
Say hello to the people who grow and raise it. If youre lucky enough to be able to do that, youd be giving yourself a real gift. In Conclusion So after writing this book, youd think Id have a very definite opinion on what the best diet for human beings looks like, wouldnt you? Truth is, there is no perfect diet for humans. The only fact that could reasonably be called a universal truth when it comes to diet is this: The more plant foods, the better. People have lived and thrived on high-protein high-fat diets, on low-protein high-carb diets, on diets high in raw milk and cream, and even on diets high in animal blood the Masai.
And theyve done so without the ravages of degenerative diseases that are epidemic in modern lifeheart disease, diabetes, obesity, neurodegenerative diseases, osteoporosis, cancer. Heres what they havent done: thrived on food with bar codes. Nor, for that matter, have they thrived on food you could pick up in less than a minute at a drive-through. More than anything else, the take-home message of this book is: Eat real food.
Stuff your grandmother would have recognized as food. Stuff that usually doesnt come in a package. What you eat probably doesnt ultimately matter as much as how much processing its undergone. Real foodwhole food with minimal processingcontains a virtual pharmacy of nutrients, phytochemicals, enzymes, vitamins, minerals, antioxidants, anti-inflammatories, and healthful fats, and can keep you alive and thriving into your tenth decade.
And remember, how you eat is as important as what you eat. Mindfulness and consciousness in eatinglike in everything else in lifecontribute to health and well-being. Whether youre driving a car, building a relationship of love and support, or eating a meal, paying attention actually makes a difference.
Do it. Savor each momentand each morsel. And enjoy the journey. Which got me thinking. Not about what I eatsince I already know the answer to thatbut about what other experts who are conversant with the concepts in this book eat on a daily basis.
After all, all of them know what foods are good for you and whybut it might be interesting to see what they actually do. One time, when I was speaking at the worldrenowned Boulderfest annual conference on nutritional medicine, Robert Crayhonthe brilliant founder and organizer of Boulderfestasked each of the speakers to write down what we had for breakfast that morning, and also to list a typical days food.
The seminar attendees found it really interesting to read what the experts actually ate on a daily basis. Hence my ask the experts sections, peppered throughout the book.
Heres what I did: I went to my phone directory and started calling up some of the best people in the field and asking them if theyd submit a list of their top ten favorite healthy foods. The ones they actually ate, not just the ones they thought were the healthiest.
All were kind enough to say yes, and the results are sprinkled throughout this book. Many are authors of best-selling books on health, diet, and nutrition Ann Louise Gittleman, Elson Haas, Steve Sinatra, Mike and Mary Dan Eades, Shari Lieberman, Fred Pescatore, Dharma Singh Khalsa, Barry Sears, Oz Garcia ; some are well-known and highly respected docs with highprofile practices Mark Stengler, Andy Rubman ; one is practically a legend in the field of complementary medicine and a columnist for the Town- send Newsletter for Doctors and Patients Alan Gaby ; one is a nationally known expert on hypertension and metabolic syndrome and an acclaimed medical educator Mark Houston ; one is a wellknown academic researcher in the field of diet as well as a columnist for Mens Health Jeff Volek ; and one is an extraordinary nutritionist and media personality J.
Many fit into several categorieswriters as well as practitioners. All are, in my humble opinion, brilliant. I gave them all one mandate: Tell me your top ten healthy foods. Then I allowed them to interpret that instruction in any way they chose including extending the list to eleven or twelve.
I think youll find the results amusing and instructive. For those of you who are inclined toward statistics and graphs and like betting on the office pool for the Academy Awards, its amusing to notice which foods got the most votes and which were bypassed completely.
The clear winners were blueberries and other berries , spinach and kale , nuts especially almonds , broccoli, and wild salmon, with grass-fed beef a very close runner-up. There were some surprises coffee got mentioned twice , some new stars pomegranate and sea vegetables , and some notable absences not one person mentioned soynot as surprising as you might thinksee my essay on soy, page Anyway, I thought it was interesting, and I hope you do, too.
At first, I included my own list, but couldnt whittle it down from nineteenplus my editor figured that my opinions were all over the book anyway, so my personal list didnt make the cut. However if youre dying to know what I personally eat, Ill tell you: oatmeal, guava, raw certified organic milk, eggs, blueberries, spinach, sardines, kale, whey protein powder, free-range beef, apples, wild salmon, turmeric, nuts, coconut oil, avocado, green tea, fresh vegetable juice, and green drinks.
There, now you know. Read the entries and youll know why Iand so many of the expertslove those foods. I hope you will, too. Now, okay, maybe I need to clarify just a bit, since the most consumed vegetables in America include ketchup, iceberg lettuce, and French fries. Im talking about anything that has a leaf. Im talking about anything that makes a crunch when you bite it.
Im talking anything thats green, red, orange, or in rare cases white cauliflower and mushrooms. Get the point? Im definitely not talking French fries. So if the title of this book were the healthiest foods on the planet instead of the healthiest foods, probably every member of the vegetable family you can possibly think of would be listed which is decidedly not so with dairy, grains, or some other categories in this book.
Even corn and potatoes which wound up on no ones top ten list, Im happy to say. The thirty-six vegetables that made the A list here are those that I felt represented the absolute best nutritional bang for the buck in a crowded field in which most entries are already winners.
Arent Some Fattening? Vegetables Since were currently experiencing an obesity and diabetes epidemic in most of the Western world and even in some parts of the non-Western world , a reasonable question to ask would be this: Are some vegetables more fattening than others, and should they be avoided? Theres a lot of confusion about certain starchy vegetables that have a high glycemic index, vegetables that people following lower-carb eating plans have been told to avoid. The short answer is this: If youre a person for whom blood sugar management is a real issue, yes, some vegetables on this listsweet potatoes, for examplemight be worth limiting.
But in my opinion, the argument about vegetables and sugar is a tempest in a teapot. There are two real culprits in the obesity crisis: one, the fast-acting carbs and sugars in breads, cereals, pastas, desserts, cakes, rolls, crackers, and fast food; and two, the obscenely large portions of everything else.
Leigh Broadhurst, Ph. So of course, watch your sugar content. But most vegetables dont have that much, particularly compared to the real culprits in the American diet.
Potatoes and corn are exceptions.