Gout

Just to make life more interesting (difficult), my family member is now having gout flare ups.  :(

He had gout a year or two ago.  We cut meat out of his diet and, ta da!, no more gout.  But now he needs the protein for the liver diet, so we put the meat back in.  Two months later ... gout.

In case anyone can use the info, here are other possible causes and contributing factors:

• dehydration and/or diuretic usage
• fructose, which is found in fruits and anything with high fructose corn syrup, and is also a metabolic by-product of sucrose (table sugar)
• eating too much meat and/or seafood
• sleep apnea (maybe?)

These may (or may not) help:

• low fat dairy
• vegetable-based protein in beans, tofu, etc.
• coffee
• reducing sugar & fructose consumption
• drink more liquids!  multiple liters!

This is incredibly frustrating.  I need to feed him protein, but now I am having to cut back meat.  He needs the diuretic to help with ascites and therefore appetite, but it is very likely contributing to the attacks.  He drinks four Ensure Plus a day, but the sugar in those may be contributing to the attacks.  It just makes me want to scream in frustration.

Baking Powder substitute

I like cooking baked goods, which takes a lot of baking powder.  Do you know what's in baking powder?  Two separate sodium salts, for a total of 95 mg per 1/8 teaspoon, i.e. 760 mg per teaspoon.

Then I discovered there are substitutes for baking powder, and baking soda as well, that use calcium salts in place of sodium.  Get them at Ener-G Foods.

So far I have had very good luck when I use half regular and half substitute.  (Just keep in mind you have to double the amount when using the substitute.  For example, if the original recipe called for 1 tsp baking powder, I might use 1/2 tsp regular baking powder and 1/2 tsp x 2 = 1 tsp baking powder substitute.)  I am now getting brave and trying recipes with only substitute ... we'll see how it goes.

Essential Tips & Tricks

It's hard to eat when your liver is sick and you don't feel hungry. And if you're low on energy, it's even harder to find the time or inspiration to eat right. Plus it's just confusing and hard to find information on what you should do.

Here are simple tips and ways to stock your pantry that I've found make it easier.

RULE #1: Calories in a serving of a food should be more than the mg (milligrams) of sodium in the same food.

The typical recommendation is a 2,000 calorie diet with fewer that 2,000 mg of sodium per day. Keeping exact track of both of those is time consuming and stressful, so if everything you buy conforms to this rule, you only have to think actively about calories.

RULE #2: Drink things with calories in them.

If you have ascites, the fluid buildup compresses your stomach, giving you a full feeling and less room for food.  However, liquids can pass more easily through a compressed stomach and so are a good alternative for getting calories.  As a bonus, your kidneys need plenty of liquid to flush waste products and "toxins" out of your system.

And since liquids are so good for you, make them count toward your daily calorie limit. Better yet, have them count toward your protein limit too!

For example:

• EnsurePlus or Boost
• Milk
• Blender smoothies made with protein powder and/or frozen yogurt
• Pre-made smoothie juice drinks from Odwalla, Naked, or similar brands

You can also drink juice, but it won't contribute to your protein intake.

RULE #3: Frequent snacking is your friend.

Small, frequent meals and snacks are friendlier toward a smaller stomach.  If it helps, set food timers for 5-7 times a day to remind yourself to eat something or drink a smoothie.

COROLLARY to #3: A great many traditional snack foods (salted nuts, chips) actually comply with the calories/sodium ratio rule!  Look for "low sodium" options and check the labels.  Nuts are especially good because they pack in a lot of protein.

RULE #4: Purge your cupboard, then restock with healthy things you'll enjoy eating.

Many things in the average pantry or fridge are very high in sodium.  Get rid of them.  That way you won't be tempted to eat them.

The following are some of the worst high-sodium culprits.  Get rid of them.

• Canned soup, reduced sodium or otherwise
• Canned beans and vegetables and tomato products, unless no or reduced sodium
• Lunch meat, bacon, ham, sausage, hot dogs ... basically any form of cured or prepackaged meat.
• Sauces and condiments like catsup, BBQ sauce, mustard, etc.
• Frozen meals.
• In fact, just about any pre-packaged or canned item.

And then stock up on healthy food you enjoy.  Even if oatmeal is good for you, if you hate it there's no reason to have it in your cupboards. And even though eggs are a bit high in cholesterol, if they taste good and you'll eat them, then by all means please eat a lot!  (Eggs are also high in protein and balanced in calories/sodium, so they're a very good choice for a liver diet.)

RULE #5: Limit or eliminate eating out.

Restaurants tend to make their dishes using lots of canned foods (especially canned tomato products and beans), which are in turn very high in sodium.  They also tend to add lots of salt and sauces to food to make it tasty.

Even so, you can eat out ... but it won't be easy.  Only big chains typically have sodium and calorie content listed on their menus or websites.  Avoid fast food.  When ordering, always ask for no salt, or reduced salt if no salt can't be done.

If you're able, try cooking your own meals.  This is one place to start looking for low sodium recipes: lowsodiumcooking.com



Those are the five basic guidelines I can think of at the moment.  I hope they can help.