This map displays the resurgence of a Victorian disease

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These areas have seen the largest increases in gout cases in four years (Picture: Metro Graphics)

A Victorian disease known as gout is making a significant comeback, with cases surging by 960% in a particular area of England.

Historically referred to as ‘the disease of kings’, gout is a type of arthritis typically associated with consuming rich foods and alcohol in excess.

Recently, the prevalence of gout has risen due to the increased availability of high-fat, high-sugar, and high-salt foods.

Data from NHS trusts in England, acquired through Freedom of Information requests, reveals a substantial surge in gout cases between 2019 and 2023, the latest accessible data.

Liverpool emerged as the most affected area by gout, recording 5,864 cases in 2023 – a staggering 960% rise from 2019.

Additionally, Dorset experienced a significant increase of 219% in gout cases over the same period, followed by South Warwickshire with a 121% increase.

Navin Khosla, a pharmacist at NowPatient, the online pharmacy responsible for the investigation, emphasized the significant impact of gout on patients.

He noted: ‘Gout typically manifests as sudden and severe joint pain, commonly starting in the big toe but can also affect other joints such as the feet, wrists, and ankles.

‘If individuals experience symptoms like sharp pain and swollen or red skin in the affected area, they can alleviate the pain by taking ibuprofen.’

Liverpool has not only witnessed a resurgence of gout but also a 447% spike in malnutrition cases over the past five years.

Malnutrition refers to inadequate nutrient intake, distinct from starvation. While gout is associated with obesity, individuals can be both overweight and malnourished, leading to a phenomenon known as the ‘hunger-obesity paradox’.

What is gout?

Gout is a type of arthritis characterized by sudden and severe joint pain.

It is caused by an excess of uric acid in the blood, leading to the formation of crystals around the joints and subsequent pain.

Commonly affecting men and having a familial tendency, gout risk factors include obesity, alcohol consumption, menopause, surgery or injury history, certain medications, and specific health conditions like high blood pressure.

Symptoms of gout typically include:

  • Sudden and intense joint pain, often in the big toe but can occur in other joints like the feet, ankles, hands, wrists, elbows, or knees
  • Swelling, redness, and warmth in the affected joint – redness might be less visible on darker skin tones

An untreated gout attack usually lasts one to two weeks, with potential for longer and more severe future attacks if untreated. Ignoring gout can result in lasting joint damage.

The resurgence of Victorian-era diseases like gout is partially attributed to the escalating cost of living crisis, compelling lower-income families to eliminate fresh produce like fruits and vegetables from their diets.

Rob Hotson, a registered nutritionist and Healthspan advisor, expressed concerns about poor diets, particularly in individuals heavily reliant on ultra-processed foods (UPF).

He elaborated: ‘Malnutrition, characterized by vitamin and mineral deficiencies, is plausible even in obese individuals with poor dietary quality.

‘UPFs are low in fiber, vitamins, and minerals yet high in calories, leading to weight gain.

‘Individuals with limited financial resources often opt for low-cost, calorie-dense, nutrient-poor foods like fast food, processed snacks, and sugary beverages.

‘This pattern underscores how individuals in countries such as the UK and US can be obese but still suffer health consequences due to poor nutritional intake.’

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