Q My gout is acting up again. Is there anything new in diets for gout? — R.K., Greenville

A Thanks for your note. It sounds like you have been bothered by gout for awhile. I get questions almost weekly from people who have just had their first attack. I asked Jenny Laut, a third-year medical student, to tell us about gout, and here is what Jenny has to say.

Gout is a condition in which uric acid is deposited in the body's joints. More importantly, for the people who suffer from gout, it can be incredibly painful. If you have had a flare-up, you know it often comes on suddenly and leaves a hot, red, swollen, very tender joint, so doing what you can to prevent a flare-up is important. Your family doctor can give you medicines to both treat and prevent an attack. There are also things that you can do to help ensure you remain pain-free.

Gout occurs in people who have abnormally high levels of uric acid. Your body may make too much, or it may have trouble getting rid of uric acid. The uric acid forms crystals in your joints that the immune system recognizes as something foreign. Your immune system then attacks the crystals, causing pain and swelling, most often in the base of the big toe. The medicines work by decreasing the amount of uric acid in the body.

You can try to accomplish the same goal as the medicine by following a diet that can reduce uric-acid levels by as much as 15 percent-20 percent. Some foods are naturally high in purine, which gets turned into uric acid in the body. The recommendations are to limit the amount of these foods you eat. They include organ meats like liver, kidneys, sweetbreads and brains; sardines and anchovies; broth and gravy; oily fish like mackerel, herring, carp and trout; game meat like duck, rabbit, venison, and pheasant. Making sure you drink enough water to stay hydrated will also help flush the uric acid out of your body. Limit alcohol intake, especially beer. Men that are healthy can usually tolerate two drinks, women, one drink. A drink is defined as 12 ounces of beer, or 6 ounces of wine or 11\u20442 ounces of spirits. If you are overweight, losing a few pounds can help, too. Eat smaller portions and be physically active to try and lose 1-2 pounds per week. Take note that fasting can actually bring on an attack. For this reason, it's also a good idea not to skip meals. Eating low-fat dairy products has been shown to be protective against an attack by some researchers.

Gout can be considered a chronic condition and you need to take responsibility for your own health. You can do this by recognizing symptoms of gout and seeking medical care, by following your doctor's recommendations and taking medications as prescribed, and by avoiding foods and alcohol that could aggravate an attack. Hopefully you and your doctor working together can prevent the gout and prevent the pain.

Q I have been diagnosed with diverticulosis. I looked on the Web and found one site that said I had to avoid seeds and another place that said seeds were OK to eat. What do you think? — F.G.M., Ayden

A A couple of years ago I ran a column about dietary fiber and diverticulosis. Dr. Tom Ruffolo, a local gastroenterologist, said the advice to avoid seeds was an "old wives' tale" that is continually perpetuated, even by some misinformed physicians. Web sites can also perpetuate misinformation. Seeds have not been shown to cause obstruction of the diverticula or cause infection. So, the best advice is to eat the foods you tolerate well.

Professor Kathy Kolasa, a registered dietitian and Ph.D., works with the Family Medicine Center, Brody School of Medicine at ECU. Contact her at kolasaka@ecu.edu, or C/O The Daily Reflector, P.O. Box 1967, Greenville, NC 27835.