Daniel Lavelle is mentions that gout was historically called “the rich man’s disease” (At 35, I found out I had gout. Imagine having to give up everything you like to eat and drink, 29 November). It was also known as “the disease of kings”, but we now know that its main similarity with royalty is a predilection for certain genes. Lavelle’s article was enjoyable, but perpetuates the misconception that gout is fundamentally a lifestyle disease. This misconception can lead to shame and stigma for some patients.
Research has relatively recently confirmed that the association between diet and gout is far weaker than previously thought. The underlying driver of gout is uric acid crystals in the joints. There is evidence that diet accounts for no more than 1% of the variation in uric acid levels between people. In contrast, genetics has a tremendously greater impact on the risk of developing gout than any other risk factor. Moreover, well-meaning dietary rules can be burdensome and confusing.
