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Britain’s Growing Struggle With Gout

Posted on Mar 21, 2014 by Ailee Slater ()  | Tags: gout, gout in Britain, U.K. health, lifestyle disease, obesity, alcohol use and gout, purine, uric acid, NSAIDs

An unhealthy lifestyle can lead to plenty of diseases: diabetes, high blood pressure, cancer of the liver and more. Eating large amounts of rich food and drinking too much alcohol can also increase the risk of developing another, lesser known disease: gout. In fact, during the past decade and a half, cases of gout have risen by 64 percent in the United Kingdom, and all signs point to the prevalence of this disease increasing. 

Most people know gout as an old fashioned disease; an affliction common before the 20th century that primarily affected nobility and those with access to a good amount of food and drink. Indeed, a diet high in sodium and sugar can cause more uric acid to enter the blood stream, leading to an inflammation of the joints – gout. The disease is best known for affecting a sufferer’s big toe, causing pain and difficulty walking. Gout is also associated with an increased risk of diabetes and cardiovascular disease. 

So why, in the 21st century, are cases of gout growing? Most medical experts agree that higher rates of obesity and poor lifestyle choices are leading to more instances of gout. Research from the Clinical Practice Research Datalink of Britain has shown that from 1997 to 2012, cases of gout increased by 64 percent in the U.K., rising approximately 4 percent every year. The journal Annals of the Rheumatic Diseases has reported that one in 40 British citizens is suffering from gout, and if diet and exercise habits across the nation do not improve, the problem of gout is likely to worsen. 

Health care advocates are especially worried about rising rates of alcohol use in the United Kingdom. The British group Alcohol Concern has reported that from 1980 to 2009 alcohol consumption in the U.K. has risen around 9 percent – whereas other European countries have seen a 9 percent decrease in alcohol use. Alcohol Concern also reports that many British citizens are drinking above recommended amounts: approximately 34 percent of men and 28 percent of women exceed the maximum weekly recommended number of alcoholic drinks. 

A 2004 study published in The Lancer found a definite link between alcohol use and gout. Researchers from the Massachusetts General Hospital observed nearly 50,000 men over 12 years, recording rates of beer, liquor and wine consumption. Of the test subjects, 730 developed gout during the course of the study, and researchers saw that those who drank more than two beers per day were 2.5 times more likely to have gout by the end of the study. Drinking spirits appeared to raise the risk of gout, but by less: those who drank more than two units of spirits per day were 1.6 times more likely to develop gout, and those who drank an equal amount of wine showed no increased risk for gout. 

Diet is also a key risk factor in who does and doesn’t get gout. When levels of uric acid in the blood are too high, acid crystals can form around a joint and cause the inflammation known as gout. And what causes high levels of uric acid? Alcohol and meat, including poultry and fish. Meats are high in the compound purine; when the body digests purine and breaks it down, uric acid is produced. Too much saturated fat can also lead to gout, as this type of fat limits the body’s ability to flush uric acid. High fructose corn syrup has also been shown to increase uric acid levels. 

Gout is painful, but not untreatable. Many patients take non-steroidal anti-inflammatory drugs (NSAIDs) to ease the joint swelling and increase mobility and comfort. However, some patients are reluctant to take NSAIDs due to the drugs’ reputation for harming the kidneys and leading to an increased risk of some vascular diseases. These side effects are very rare, but still – preventing gout is better than treating its symptoms, and doctors will recommend diet and lifestyle changes to their patients along with a course of medication.­­ And, because gout is a recurring illness, preventative treatment is all the more important. 

Unfortunately, suffers of gout may face more than just sore joints and tough lifestyle changes: they may face mockery. In a personal essay for BBC News, journalist Richard Warry talks about his personal experience being diagnosed with gout, and then putting up with weeks of medical jokes from his friends and colleagues. Warry says that gout’s 19th century, Dickensian image makes the disease seem laughable in the modern era – at least until you’ve experienced the painful condition for yourself. Gout may sound like a disease of the indulgent upper class of years gone by, but plenty of risk factors exist in modernity too, and family metabolic history can also influence gout. 

If recent research is any indication, gout won’t be a laughing matter for very long as more and more people are diagnosed with the condition. Preventative education about gout could go a long way toward ensuring that 21st century Britons are aware of the symptoms of gout, know how to decrease their chances of getting it, and realize that gout is not an illness of the past. 


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