DEAR DR. BLONZ: Is there any problem with eating fish, especially salmon, if you have gout? If so, does the problem also apply to fish-oil supplements? I also read that high doses of vitamin C are not recommended for gout patients. Can you shed any light on this? -- L.L., Seattle
DEAR L.L.: Gout is a form of arthritis (inflammation of the joints) that is brought about when there is an excess of uric acid in the blood, which gives rise to deposits of sharp crystals in and around joints. Usually, the first joint affected is the most remote one from the heart -- the big toe -- but gout can affect other joints, as well.
Uric acid is a normal metabolic intermediate that gets produced during the breakdown of certain compounds. Normal kidney function will eliminate uric acid. Gout can develop when the body produces too much, or when the kidneys, for some reason, are not able to do their job. Why this happens is not known, but it is thought there may be a genetic predisposition.
There are prescription medications to help with gout, but an important step is to cut down on foods known to give rise to uric acid during their metabolic breakdown. Purines are substances that turn into uric acid, so those at risk for gout are typically put on a low-purine diet. Some fish and shellfish are high in purine, including sardines, herring, anchovies, cod, trout, haddock, mussels and scallops. Salmon is considered moderate, not high, in purine. Fish oil does not contain purine.
To find out more, consult articles on gout at the Arthritis Foundation (tinyurl.com/nmzytqf) and the National Institutes of Health (tinyurl.com/3ulmzb).
DEAR DR. BLONZ: I recently took a loaf of bread out of the freezer, and it had mold on it. Of course I did not eat it, but was wondering how this could be possible. -- M.M., San Dimas, California
DEAR M.M.: Mold spores tend to be all over the place, and bread is not a sterile food. If your bread had already been opened when you froze it, it is likely a few mold spores were present. There could have also been some mold in the packaging that was used. You don't mention how long the bread was in the freezer, how it was defrosted or how much mold you found. There could have been a small amount of growth during the freezing process. Other factors could be a power outage during the loaf's life in the freezer, or if the loaf was near the freezer door and it was opened often.
Moisture in bread tends to move from the interior to the surface during the freezing process. This helps explain ice crystals that form in the package. During the defrosting process, any ice crystals present will create a high-moisture environment in the package as it returns to room temperature, which is an ideal situation for the mold to spring back to life.
It is difficult to say for sure what happened, but the key is whether this is an isolated incident or a regular occurrence with breads and other foods in your freezer. If it's the latter, you have some detective work to do.
Send questions to: "On Nutrition," Ed Blonz, c/o Universal Uclick, 1130 Walnut St., Kansas City, MO, 64106. Send email inquiries to firstname.lastname@example.org. Due to the volume of mail, personal replies cannot be provided.