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When we look for gout food to avoid, we tend to look for low purine foods. There is some merit in this, but unless you only eat shellfish, gravy, liver, kidney, and the like, it is much more important to look at pH balance. Do it right, and not only will it help your gout, but you will become generally healthier.

I describe how alkalizing your body can help gout by making uric acid more soluble in the Prevention Section. Taking baking soda (sodium bicarbonate) works for many gout sufferers. Unfortunately, it can raise blood pressure. As about 40% of gout sufferers also have hypertension, an alternative is useful.

This is where increasing your pH level through food comes in. There is a lot of information about alkalizing diets and acid-alkaline balance. Much of this is confusing and sometimes contradictory.

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Gout Food To Avoid foods acid-base balance table tables PRAL potential renal acid load

Potential Renal Acid Load (PRAL) is a calculated value of certain nutrients in food that have the most significant indication of changing acidity or alkalinity of the body.

PRAL is a precise calculation from 5 nutrient values in food, but it is not an exact measure. It is a shortcut measure to assess the affect of foods on the pH of the body.

Potential renal acid load experiments show that PRAL is a reliable approximation of the pH effect of foods. It is calculated from:

PRAL =
0.49 Protein + 0.037 Phosphorus
- 0.021 Potassium - 0.026 Magnesium - 0.013 Calcium

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Potential Renal Acid Load Calculation PRAL acid-base balance nutrition info

Vitamin D status is positively correlated with regulatory T cell function in patients with multiple sclerosis.\nSmolders J, Thewissen M, Peelen E, Menheere P, Cohen Tervaert JW, Damoiseaux J, Hupperts R.\nPLoS One. 2009 Aug 13;4(8):e6635.\nPMID: 19675671

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2009 August study research epidemiological humans patients vitamin_D status 25ohd Tregs T-regs multiple sclerosis MS multiple_sclerosis RRMS T-helper cells nutrition Th1-Th2 Th1 Th2 balance T-regulatory medline

Fruit and vegetables: the unexpected natural answer to the question of osteoporosis prevention?
Lanham-New SA.
Am J Clin Nutr. 2006 Jun;83(6):1254-5.
PMID: 16762933

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2006 June ajcn Lanham-New medline nutrition fruit vegetables food diet foods bone health mineral content osteoporosis acid_alkaline acid_base acid-base balance alkaline study phytochemicals phytoestrogens vitamin_K

Origins and evolution of the Western diet: health implications for the 21st century.
Cordain L, Eaton SB, Sebastian A, Mann N, Lindeberg S, Watkins BA, O'Keefe JH, Brand-Miller J.
Am J Clin Nutr. 2005 Feb;81(2):341-54. Review.
PMID: 15699220

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2005 February ajcn diet health nutrition paleolithic preagricultural glycemic glycemic_load fatty acid macronutrient acid_base acid-base acid_alkaline balance potassium fiber hunter-gatherers evolution food foods disease study Cordain Sebastian review

Positive effects of vegetable and fruit consumption and calcium intake on bone mineral accrual in boys during growth from childhood to adolescence: the University of Saskatchewan Pediatric Bone Mineral Accrual Study.
Vatanparast H, Baxter-Jones A, Faulkner RA, Bailey DA, Whiting SJ.
Am J Clin Nutr. 2005 Sep;82(3):700-6.
PMID: 16155286

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2005 September ajcn medline nutrition fruit vegetables foods calcium intake bone mineral osteoporosis health acid_alkaline acid_base acid-base balance content study research

Various selected vegetables, fruits, mushrooms and red wine residue inhibit bone resorption in rats.
Mühlbauer RC, Lozano A, Reinli A, Wetli H.
J Nutr. 2003 Nov;133(11):3592-7.
PMID: 14608079

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2003 November jn nutrition fruit vegetables diet wine red bone resorption acid acid_alkaline acid_base acid-base balance osteoporosis study research red_wine medline

Calcium, protein, and fruit and vegetables as dietary determinants of bone health.
New SA, Millward DJ.
Am J Clin Nutr. 2003 May;77(5):1340-1; author reply 1341.
PMID: 12716695

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2003 May New letter reply nutrition fruit vegetables calcium bone health acid_alkaline acid_base acid-base balance osteoporosis study research

Low dietary potassium intakes and high dietary estimates of net endogenous acid production are associated with low bone mineral density in premenopausal women and increased markers of bone resorption in postmenopausal women.
Macdonald HM, New SA, Fraser WD, Campbell MK, Reid DM.
Am J Clin Nutr. 2005 Apr;81(4):923-33.
PMID: 15817873

www.ajcn.org/...923 - Preview

2005 April ajcn nutrition potassium fruit vegetables dietary intake bone resorption mineral density BMD acid acid_alkaline acid_base acid-base balance osteoporosis menopause study research

The acid-base hypothesis: diet and bone in the Framingham Osteoporosis Study.
Tucker KL, Hannan MT, Kiel DP.
Eur J Nutr. 2001 Oct;40(5):231-7.
PMID: 11842948

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2001 October ejn nutrition diet bone health osteoporosis acid_alkaline acid_base acid-base balance study research Framingham medline

Welch AA, Bingham SA, Reeve J, Khaw KT. More acidic dietary acid-base load is associated with reduced calcaneal broadband ultrasound attenuation in women but not in men: results from the EPIC-Norfolk cohort study.
Am J Clin Nutr. 2007 Apr;85(4):1134-41.

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2007 April ajcn acid acid-base acid_base acidosis alkaline base balance load EPIC diet dietary bone medline nutrition study research osteoporosis fracture risk potential renal PRAL

Dawson-Hughes B.
Interaction of dietary calcium and protein in bone health in humans.
J Nutr. 2003 Mar;133(3):852S-854S. Review.
PMID: 12612168

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2003 March jn study review protein calcium interaction bone mineral density fractures BMD acid-base acid_base acidosis balance osteoporosis health nutrition diet medline

Sebastian A, Harris ST, Ottaway JH, Todd KM, Morris RC Jr.
Improved mineral balance and skeletal metabolism in postmenopausal women treated with potassium bicarbonate.
N Engl J Med. 1994 Jun 23;330(25):1776-81.
PMID: 8190153 [PubMed - indexed for MEDL

content.nejm.org/...1776 - Preview

1994 June Mineral NEJM skeletal Metabolism Potassium Bicarbonate acid acid-base acid_base acidosis alkaline base balance bone bmd osteoporosis supplementation supplements study research nutrition medline dietary Sebastian

Estimation of the net acid load of the diet of ancestral preagricultural Homo sapiens and their hominid ancestors.
Sebastian A, Frassetto LA, Sellmeyer DE, Merriam RL, Morris RC Jr.
Am J Clin Nutr. 2002 Dec;76(6):1308-16.
PMID: 12450898

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2002 December ajcn Sebastian Frassetto health diet paleolithic preagricultural net acid load acid-base alkaline balance nutrition study research bone osteoporosis evolution medline

The balance of bone health: tipping the scales in favor of potassium-rich, bicarbonate-rich foods.
Lanham-New SA.
J Nutr. 2008 Jan;138(1):172S-177S. Review.
PMID: 18156420

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2008 January jn study review humans Lanham-New bone health potassium potassium-rich bicarbonate bicarbonate-rich foods acid-base balance diet osteoporosis prevention nutrition fruit vegetables medline

Dietary influences on bone mass and bone metabolism: further evidence of a positive link between fruit and vegetable consumption and bone health?
New SA, Robins SP, Campbell MK, Martin JC, Garton MJ, Bolton-Smith C, Grubb DA, Lee SJ, Reid DM.
Am J Clin Nutr. 2000 Jan;71(1):142-51.
PMID: 10617959

Conclusion: The BMD results confirm our previous work (but at peripheral bone mass sites), and our findings associating bone resorption with dietary factors provide further evidence of a positive link between fruit and vegetable consumption and bone health.

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2000 January ajcn study research epidemiological cross-sectional humaans women bone mass turnover potassium magnesium vitamin_C beta-carotene fruit vegetables acid-base balance nutrtion medline New BMD osteoporosis alcohol

Fruit and vegetable consumption and bone mineral density: the Northern Ireland Young Hearts Project.
McGartland CP, Robson PJ, Murray LJ, Cran GW, Savage MJ, Watkins DC, Rooney MM, Boreham CA.
Am J Clin Nutr. 2004 Oct;80(4):1019-23.
PMID: 15447914

Conclusion: High intakes of fruit may be important for bone health in girls. It is possible that fruit’s alkaline-forming properties mediate the body’s acid-base balance. However, intervention studies are required to confirm the findings of this observational study.

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2004 October ajcn study research epidemiological humans adolescents young boys girls fruit vegetables BMD bone health dietary intake acid-base balance osteporosis nutrition medline

Urine pH is an indicator of dietary acid-base load, fruit and vegetables and meat intakes: results from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk population study.
Welch AA, Mulligan A, Bingham SA, Khaw KT.
Br J Nutr. 2008 Jun;99(6):1335-43. Epub 2007 Nov 28.
PMID: 18042305

In conclusion, a more alkaline diet, higher fruit and vegetable and lower meat intake were related to more alkaline urine with a magnitude similar to intervention studies. As urine pH relates to dietary acid-base load its use to monitor change in consumption of fruit and vegetables, in individuals, warrants further investigation.

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2008 June bjn urine pH indicator dietary acid–base load balance fruit vegetables meat intake nutrition medline bone

Amount and type of protein influences bone health.
Heaney RP, Layman DK.
Am J Clin Nutr. 2008 May;87(5):1567S-1570S. Review.
PMID: 18469289

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2008 May ajcn study review humans Heaney amount type protein bone health acid-base balance diet nutrition medline osteopenia sarcopenia calcium fruit vegetables osteoporosis

Bushinsky DA, Krieger NS, Geisser DI, Grossman EB, Coe FL.
Effects of pH on bone calcium and proton fluxes in vitro.
Am J Physiol. 1983 Aug;245(2):F204-9.
PMID: 6881337 [PubMed - indexed for MEDLINE]

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1983 bone calcium pH fluxes flux acid acid-base balance acidosis base osteoporosis medline study research alkaline alkali influx efflux in_vitro