Living with rheumatic diseases is easier if you maintain a proper height-to-weight ratio, or body mass index (pdf*). With few exceptions, however, people with rheumatic diseases require no special diet. Some general guidelines to follow include:

• Limit alcohol consumption.
• Control your weight. Excess weight puts added stress on joints in your back, hips, knees and feet - places where arthritis pain is commonly felt. Excess weight also can make joint surgery more difficult and risky.
• Eat a healthy diet. Eating a diet high in vegetables, whole grains and fruits helps you maintain a proper weight and good health.

Gout is one rheumatic disease that does require a special approach to diet.

Gout is caused by high blood levels of uric acid, a waste formed from the breakdown of purines. These chemical compounds help make up RNA and DNA and are used to form the compounds of uric acids. They are found naturally in our bodies, as well as in all meats, fish and poultry. Organ meats (e.g., liver, brains, kidney and sweetbreads), anchovies, herring and mackerel contain extraordinarily high levels of purines.

If your body produces too much or eliminates too little uric acid, it builds up forming needlelike crystals in a joint or the surrounding tissue, which can then cause pain, inflammation and swelling.

A similar condition, called false gout (pseudogout), is caused by crystals made of calcium pyrophosphate dihydrate. These are usually felt in the large joints like the knees, wrists and ankles.

People with gout should avoid:

• Consuming too much alcohol (especially beer), generally meaning more than two drinks a day for men and one for women
• Weighing 30 pounds or more above their ideal weight
• Having untreated high blood pressure, diabetes, high blood fat levels (hyperlipidemia) and narrowing of the arteries (arteriosclerosis)
• Eating too much animal protein because these foods contain purines
• Drugs that interfere with the proper elimination of uric acid in the body, including aspirin and diuretics (water pills)