HEALTH

A grow­ing co­hort of peo­ple in their 20s and 30s are now af­flicted by gout, finds Luke Mintz. In a gen­er­a­tion that’s shun­ning ev­ery­thing from meat to cig­a­rettes, is ge­net­ics or life­style to blame?

Friday - - CONTENTS -

It’s the dis­ease that’s no longer con­fined to glut­tonous me­dieval kings – gout is now af­flict­ing health-con­scious mil­len­ni­als.

Harry Tyn­dall as­sumed he’d frac­tured a bone when he stepped out of bed one morn­ing and wasn’t able to walk on his right foot. Hob­bling along to a phys­io­ther­apy clinic near his home, the oth­er­wise healthy 28-year-old turned out to be wrong; af­ter one look at his foot, the clin­i­cian told him he was suf­fer­ing from gout – a se­vere form of in­flam­ma­tory arthri­tis, which causes limbs to swell up in size. Harry, who was work­ing as head of sales for a courier firm at the time, was a keen fan of foot­ball and trav­el­ling, try­ing to visit a new coun­try each year. The prospect of a dis­ease that would scup­per his abil­ity to walk long dis­tances seemed ter­ri­fy­ing.

‘I hon­estly thought I’d been shot back into the Tu­dor era,’ he said. ‘Not for one sec­ond did I ever think I had gout, be­cause I knew it was for peo­ple dou­ble my age.’

Harry is not alone. Men­tion gout to most peo­ple, and their minds will jump to a few well-worn stereo­types: glut­tonous me­dieval kings who have in­dulged in too much al­co­hol, or florid golf club man­agers with a weak­ness for rare steaks.

Rarely do we imag­ine health-con­scious mil­len­ni­als who are, as we are fre­quently re­minded, ab­stain­ing from meat and al­co­hol at higher rates than any gen­er­a­tion be­fore them. But gout may well be on the rise among this very group, as a grow­ing con­sump­tion of sugar and fatty foods leaves them vul­ner­a­ble to the con­di­tion, which can cause im­mensely painful at­tacks of arthri­tis.

A UK study ex­am­in­ing 15 years of pa­tient data found that gout di­ag­noses rose by 64 per cent be­tween 1997 and 2012, with one in 40 peo­ple now suf­fer­ing from the con­di­tion. Although most pa­tients are still aged over 60, hos­pi­tal ap­point­ments for those in their 20s and 30s com­plain­ing of gout symp­toms have in­creased by 30 per cent since 2012, says the re­port.

Mil­len­ni­als are the most ab­stemious gen­er­a­tion alive, re­cent fig­ures sug­gest, with those born be­tween 1980 and 2000 shun­ning ev­ery­thing from meat to cig­a­rettes to al­co­hol.

Mean­while, the rau­cous pre-wed­ding cel­e­bra­tions for so long favoured by brides-to-be are out, now deemed deeply ‘un­cool’, as ‘healthy hen par­ties’ soar in pop­u­lar­ity. Yet gout ap­pears to be pro­lif­er­at­ing. Trig­gered by a build-up of uric acid in the blood, which goes on to crys­tallise in bone joints, it usu­ally af­fects the joint at the bot­tom of the big toe, lead­ing to the enor­mous swelling that plagues many suf­fer­ers.

The wors­en­ing obe­sity epi­demic is be­lieved to be at the heart of the is­sue, ac­cord­ing to Prof Alan Sil­man, the med­i­cal di­rec­tor of Arthri­tis Re­search UK. Prof Sil­man points par­tic­u­lar blame at fizzy drinks, and there is al­most cer­tainly a ge­netic fac­tor as well, with around one in 10 pa­tients in­her­it­ing the con­di­tion from their par­ents, ac­cord­ing to the UK Gout So­ci­ety.

How­ever, ex­perts do not yet agree on how much of the con­di­tion is down to ge­net­ics and how much to life­style.

An at­tack of gout, Prof Sil­man says, is ‘prob­a­bly the most painful form of se­vere arthri­tis there is’. Many of his pa­tients say their be­sieged joint be­comes so ten­der they can’t even sleep un­der a bed­sheet.

In­deed, it was the pain that Harry re­mem­bers most vividly. The big toes in both of his feet swelled up enor­mously, which made walk­ing some­thing of a ‘ma­jor hob­bling process’. He re­mem­bers be­ing ‘on his hands and knees’ in agony. But what Harry has found even more dif­fi­cult than the pain is the to­tal change in diet he’s been forced to un­der­take. ‘This year in par­tic­u­lar has been quite frus­trat­ing,’ he says. ‘I’ve had gout come up three or four times, and I don’t re­ally know what from. So for the last four or five weeks I’ve ac­tu­ally cut out most dairy [in­clud­ing] ice cream, yo­gurt, milk, choco­late and cheese.’

He says he hasn’t touched red meat or red wine for twoand-a-half years – though he con­cedes that a par­tic­u­larly po­tent sweet tooth used to see him drink whole tubs of ice cream af­ter melt­ing them in the mi­crowave. Need­less to say, then, these changes have pre­sented their share of chal­lenges.

Harry’s diet trans­for­ma­tion did give him one added ben­e­fit, though – an idea for his next busi­ness ven­ture. Un­able to have any of his beloved dairy or choco­late, he found him­self buy­ing pot af­ter pot of hum­mus.

He has also had to sus­tain a fair amount of (mostly) wellinten­tioned ban­ter from friends and fam­ily for be­ing struck down by an ill­ness many thought was con­signed to cen­turies past. His work col­leagues be­gan to call him Henry VIII when they found out about his gout di­ag­no­sis, a nick­name shared by his girl­friend’s fam­ily, who warned her not to ‘lose her head over him’.

Though he is san­guine about their barbs – ‘you’ve got to learn to laugh about it’, Harry says with a chuckle – it is this em­bar­rass­ment that can be dif­fi­cult to over­come for many suf­fer­ers, ac­cord­ing to Lynsey Con­way, of the UK Gout So­ci­ety.

Harry has also had to sus­tain a fair amount of (mostly) wellinten­tioned ban­ter from friends and fam­ily for be­ing struck down by an ill­ness many thought was con­signed to cen­turies past

‘Peo­ple laugh be­cause they think it’s funny, but it’s ac­tu­ally ex­cru­ci­at­ingly painful,’ she says.

She thinks much greater pub­lic un­der­stand­ing is needed, call­ing for a na­tional aware­ness cam­paign to teach peo­ple that gout is ‘linked to se­ri­ous health con­di­tions’ and is ‘not just a life­style dis­ease’. Harry is now be­ing treated, and his con­di­tion is im­prov­ing. He takes al­lop­uri­nol pills each day, which re­duces the lev­els of uric acid in his blood. His acid lev­els have al­ready dropped from 5.4 to 4.4 mg/dL, and his doc­tor hopes even­tu­ally to get them be­low 3.5.

Harry will be cross­ing his fin­gers as he awaits the re­sults of his lat­est blood test, but he hasn’t let his po­ten­tially in­hibit­ing con­di­tion hold him back. He was able to walk up the aisle at his wed­ding last year, and his wife, Saman­tha, a ra­di­ol­o­gist, sup­ports his ef­fort to fend off gout by adopt­ing his diet re­stric­tions when­ever they eat to­gether in restau­rants – no to steak, yes to ve­gan pasta.

Harry now wants to warn more peo­ple – par­tic­u­larly those of his own age – about the dan­gers of gout, which he is frus­trated re­main poorly un­der­stood. ‘I think young peo­ple just don’t re­ally un­der­stand or ap­pre­ci­ate what we’re putting into our bod­ies,’ he says, adding that he hopes his cau­tion­ary tale may go some way to chang­ing things.

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