Category Archives: Nutrition

I’ll take my gin without raisins, please.

Did you read my recent post on use of cherries as a gout treatment? Let’s continue the theme of wacky food treatments with the good old “gin-soaked raisins” treatment. Just do an internet search and you’ll find many sites that discuss this. Apparently you’re supposed to soak golden raisins in good gin (one post debated good gin vs cheap gin, though I know some people who’d say any gin is good gin) and eat 9 a day. No one knows why this helps with arthritis pain. There are no scholarly articles. I could not find any discussion on the science behind it. I don’t think that 9 gin-soaked raisins a day is enough to give you much of an alcohol effect, but I guess that depends on how plumped up they get. I wonder what one’s blood alcohol level would be after eating these raisins. I’m not recommending this. I just wanted to see if I could find out a little more info regarding something patients continually ask me about. It’s right up there with the idea that putting a bar of soap under your sheets will help with night time leg cramps. I don’t really feel like commenting on that one. Have you used the gin raisins? Have patients asked you about it? What do you think?

Gout: A bowl of cherries?

Did you know that I write a health blog for the Worcester Telegram and Gazette? The latest one was about patients asking me about cherry juice as a gout treatment. Keep in mind these are short, general purpose blog entries for the newspaper site.  Here is a reprint:

Maybe it is because the grocery stores are fully stocked with beautiful cherries this time of year, but several patients in the last few weeks have come in touting the merits of cherries as a gout treatment. Yes, I’d heard this before and no, I didn’t really know why. Some patients eat cherries, some drink the juice and some take special cherry juice extract pills they purchase through a vitamin store. My first reaction to the patient who claimed eating a pound of cherries a day cured his gout was, “wow, you must spend a lot of time in the bathroom!” But I digress . . .

Why cherries? I searched good old google and found mainly advertisements or websites trying to sell juice or extracts. I turned to google scholar and to PubMed, which is an internet database of the US National Library of Medicine and National Institutes of Health, or a site where you can search for what we call “scholarly articles” or scientific research printed in medical journals. I did find some articles talking more specifically about the chemicals in cherries. Some of them were sports-medicine related and discussed cherry juice for post-workout recovery following intense exercise, like marathons. There is an article loaded with very “science-y” words in a journal called Plant Foods for Human Nutrition called “Improved antioxidant and Anti-Inflammatory Potential in Mice Consuming Sour Cherry Juice.” I wonder how well the mice liked the cherry juice?? (According to the article the food pellets incorporated the juice). An article in the Journal of Nutrition was titled “Consumption of Bing Sweet Cherries Lowers Circulating Concentrations of Inflammation Markers in Healthy Men and Women.”

I did skim a few more articles and overall it seems there are some anti-inflammatory chemicals in cherries that may have a benefit in inflammatory conditions, like gout. Bottom line? If your gout isn’t that bad and you find eating cherries or drinking juice daily prevents attacks, great! If you feel cherries can prevent a gout attack when you feel one coming on, also great! Remember that cherries and especially juices have calories and sugar. Overdoing it can lead to weight gain or high blood sugars for diabetics. Also, we’re talking tart cherries, bing cherries or dark sweet cherries. Stay away from the bright red ones in the jar! Remember that uncontrolled gout can lead to a chronic and deforming arthritis, so be sure to discuss your condition and what you’re doing for it with your doctor. It is possible your condition may require a prescription gout medication.

Other ways to “go bananas”

[picapp align=”left” wrap=”false” link=”term=banana&iid=240843″ src=”0237/c37280f8-8105-423c-873d-6d0eeaa2d116.jpg?adImageId=13066317&imageId=240843″ width=”234″ height=”312″ /]A patient recently complained to me that she had been encouraged to eat more bananas as a way to keep up her potassium intake. “But you know what,” she said, “I really don’t like bananas. Its hard to force myself to eat them.” She wasn’t allergic, just didn’t like bananas. We frequently encourage patients to eat bananas or drink OJ as ways to increase potassium. What if a patient doesn’t like one of these foods or perhaps is trying to lose weight or is diabetic? OJ can be pretty caloric or make blood sugars spike. Bananas, as well, are worth more than one coveted Weight Watchers Points®. I did a quick internet search with her to find out about other potassium-rich foods and we discovered that a cup of cantaloupe or honeydew melon has about as much potassium as a banana. A cup of papaya actually has more! She was pleased and is looking forward to eating more of these fruits. Keep in mind, though, that there can be an association between latex allergy and allergy to fruits like banana, kiwi, papaya, melon and avocado. Ask your doctor if you have any concerns.

Vitamin D

In Rheumatology we talk a lot with our patients about bone health, which is usually the setting of Calcium and Vitamin D discussions. However, lately Vitamin D has been quite the hot topic.If you are interested, you might want to read these two articles from the last week or so: here and here. There is a lot more information in the articles, but this quote in particular helps to answer a frequent question I get, “Can’t I get more Vitamin D from food?”

People’s vitamin D levels are influenced by whether they have light or dark skin, where they live, how much time they spend outdoors and by fish and milk consumption. To raise vitamin D without supplements, a person could increase sun exposure for 10 to 15 minutes a day. Eating more fish can help — a 3.5-ounce serving of wild fresh salmon has 600 to 1,000 I.U.’s of vitamin D — but it would take a quart of milk a day to get the recommended dose of vitamin D.

Fish Oil for RA

1Korea Trip 177My daily briefing email from the ACR (American College of Rheumatology) led with a story on fish oil in RA. More info can be found on the Health Day and UK Telegraph sites. The actual article was published in the journal Nature 461, 1287-1291 (29 October 2009). This site requires a paid registration to read the article, entitled “Resolvin D2 is a potent regulator of leukocytes and controls microbial sepsis.” Sounds fascinating, huh? Well, I could get the full article from the hospital library tomorrow but I think I’ll be OK with the Editor’s Summary on Nature’s site:

Resolvins, locally acting factors derived from omega-3 fatty acids, have been recognized as inflammation-resolving mediators. Experiments in a mouse abdominal sepsis model now show that resolvin D2 (RvD2) inhibits neutrophil trafficking to inflammatory sites and decreases leukocyte interactions with endothelial cells in a nitric oxide-dependent manner. RvD2’s cellular and molecular actions translated to a dramatic increased survival. This work points to RvD2 as a potent anti-inflammatory agent and suggests new therapeutic approaches that do not compromise host defences.

So, what does this mean? Fish oils may have a beneficial effect on inflammatory conditions, like RA. It appears that this happens because a substance in fish oils stops white blood cells from sticking to the walls of blood vessels. The article specifically talks about fish oil, but the vegetarians among us will be interested in other sources of omega-3 fatty acids, like flax seeds, walnuts and chia seeds. Many of my patients take these supplements and they are fairly well tolerated, aside from the occasional “fish belching” that some experience. Apparently taking the supplements with meals can decrease it, although a certain family member of mine unfortunately hasn’t found a tolerable brand yet! I should emphasize that the conclusions have been that these supplements may help symptoms of RA and may be part of a comprehensive treatment plan. Certainly no one is suggesting this as a treatment or in any way disease-modifying.

More Vitamin D

A reader recently asked about vitamin D related to RA (rheumatoid arthritis). This is interesting, and something we’re learning more and more about. Vitamin D sure is a hot topic in health news lately. One reason may be that the recommended daily intake was set long ago and actually may not be enough. Another reason may be all the sunscreen we wear, although this has been disputed. In terms of autoimmune illnesses, we do know that the cells of the immune system have vitamin D receptors. Some studies have suggested low vitamin D levels could cause a flare of autoimmune diseases, but other studies have not found this to be true. Either way, your doctor can talk with you about your specific requirements and check a vitamin D level if needed.

Yet another role for Vitamin D

One of my favorite discussions to have with patients is about osteoporosis, a condition that sometimes falls prey to being an orphan, or not having one single specialty wholly associated with its diagnosis and management. Primary care providers, Rheumatologists, Endrocrinologists and OB-Gyns all treat patients with low bone mass. One part of the equation is sufficient vitamin D. Indeed, it seems like every women’s magazine and TV news or talk show have had features on vitamin D and its proposed role in preventing cancer, improving musculoskeletal health and in my specialty, possible roles in regulating inflammatory conditions. Last week’s New York Times article discusses Vitamin D and athletic performance.