Liverpool has been dubbed “Britain’s gout capital” after cases of the “Victorian” disease rose by almost 1,000 per cent, new data reveals.
This painful type of arthritis was historically known as “the disease of kings” because it affected middle-aged men and was believed to be triggered by excessive consumption of rich foods and alcohol, such as port.
Monarchs, including King Henry VIII and Queen Victoria, suffered from it; However, it was relatively uncommon and was reserved for the wealthy who could afford such diets and live long enough to develop it.
In recent decades, due to the greater availability of foods rich in fat, sugar and salt, there has been an increase in cases that has worried doctors.
Data obtained through freedom of information laws found that Liverpool University Hospitals NHS Foundation Trust recorded 5,864 cases of gout in 2023: the most cases recorded by any NHS trust and a 960 per cent increase on figures recorded in 2019.
Data obtained through freedom of information laws found that Liverpool University Hospitals NHS Foundation Trust recorded 5,864 cases of gout in 2023.
For centuries, gout was known as the “disease of kings,” and monarchs such as King Henry VIII and Queen Victoria suffered from the disease.
When taken on a city-wide level, the figure equates to one in every 100 Liverpool residents currently suffering from gout.
University Hospitals Dorset NHS Foundation Trust was another area of significant gout growth with a 219 per cent rise in cases over the period, followed by South Warwickshire University NHS Foundation Trust, which saw a 121 per cent rise in cases.
Gout is an inflammatory reaction to urate crystals that form in and around the joints.
Urate is a byproduct of the body digesting a substance called purine, a chemical found in high levels in certain foods.
This includes red meat, offal such as liver and seafood with sauce, beer and sugary drinks are also potential sources.
Modern diets have increased people’s risk of developing this condition, which is also linked to being overweight, as well as a side effect of certain medications, such as those designed to combat high blood pressure.
Navin Khosla, a pharmacist at NowPatient, an online pharmacy that carried out the research, said the impact of gout on patients should be underestimated.
“The main symptoms of gout are sudden, severe attacks of pain, which usually start in the big toe, but can also occur in the feet, wrists, ankles and other joints of the body,” he said.
“Another sign of gout is when the skin over the painful area becomes swollen or red, so if you experience any of these symptoms, you can take ibuprofen to help relieve the pain.”
But gout is not the only Victorian-era health problem that has increased in Liverpool.
In an apparent paradox, malnutrition rates have also skyrocketed 447 percent in the last five years.
In 2019, Liverpool University Hospitals NHS Foundation Trust alone recorded 94 cases of malnutrition. But in 2023 this figure had increased to 514.
Malnutrition is not the same as hunger, but rather refers to people not getting the right amount of nutrients.
This can cause people to be underweight, but can lead to symptoms such as fatigue, weakness, and frequent illness.
It can be triggered by certain health conditions, but is also linked to poverty.
University Hospitals Dorset NHS Foundation Trust also had high growth in malnutrition with 180 cases (361 per cent growth), followed by Ashford and St Peter’s Hospitals NHS Foundation Trust in Surrey with 86 cases (218 per cent growth).
Rob Hobson, registered nutritionist and Healthspan adviser, said gout is linked to obesity, which has been on the rise in the UK for years.
And he added that, contrary to popular belief, people can be overweight and malnourished.
“Malnutrition could mean vitamin and mineral deficiencies, which is perfectly plausible even if one is obese and the quality of one’s diet is poor.”
Hobson said bad diets were a particular concern for people following an ultra-processed foods (UPF) diet.
“UPFs are low in fiber, vitamins and minerals, but are energy dense and easy to consume in excess, leading to weight gain,” he said.
He said this is part of the trend that experts call “the hunger-obesity paradox.”
“Low-income individuals and families often have limited financial resources, which leads them to purchase cheap, high-calorie, nutrient-poor foods,” he said.
‘These foods, such as fast food, processed snacks and sugary drinks, are high in calories but low in essential nutrients.
“This represents how people in places like the UK and US may eat enough to be obese, but may suffer health problems because their diet is so nutritionally poor.”
Data suggests that cases of rickets, a bone development problem in children, are also increasing.
Rickets is caused by a lack of vitamin D or calcium, generated by exposure to sunlight and the consumption of dairy products respectively.
It causes sufferers to have soft, weak bones that can cause a variety of pain and deformities.
Children growing up on the smog-covered streets of Victorian Britain had little access to foods rich in vitamin D or calcium, leading to its reputation as a disease of the urban poor.
But now rates are going up again in some parts of the country.
East Kent Hospitals University NHS Foundation Trust had the biggest growth in cases with 586, a 380 per cent increase compared to the 122 it recorded in 2019.
Kettering General Hospital NHS Foundation Trust came second with a 138 per cent increase in cases to 1,678.
This was followed by South Tyneside and Sunderland NHS Foundation Trust, which recorded a 91 per cent increase in rickets in 2023, up to 1,679 cases.
Experts have been warning of the return of a surge in “Victorian” diseases that were reduced to isolated cases in the modern era.
This has been linked, in part, to the rising cost of living, which has led some families to eliminate fresh foods such as fruits and vegetables from their diet.