Liverpool has been dubbed the ‘gout capital of Britain’ after cases of the ‘Victorian’ disease rose by almost 1,000 per cent, new data shows.
The painful type of arthritis was traditionally known as ‘the disease of kings’ because it affected middle-aged men and was thought to be caused by excessive consumption of rich foods and alcohol, such as port.
Royalty, including King Henry VIII and Queen Victoria, both suffered from it, but it was relatively uncommon and reserved for the wealthy who could afford such diets and live long enough to develop it.
In recent decades, due to the increased availability of foods high in fat, sugar and salt, there has been an increase in the number of cases of concern to medical professionals.
Data obtained through Freedom of Information laws showed 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 2019 figures.
Data obtained through Freedom of Information laws shows Liverpool University Hospitals NHS Foundation Trust recorded 5,864 cases of gout in 2023
For centuries, gout was known as the ‘disease of kings’, with monarchs such as King Henry the VIII and Queen Victoria both suffering from the disease
At a city-wide level, this equates to one in every hundred Liverpool residents now having gout.
University Hospitals Dorset NHS Foundation Trust was another area with big growth in gout, with a 219 per cent increase in cases over the period, followed by South Warwickshire University NHS Foundation Trust, where cases rose by 121 per cent.
Gout is an inflammatory response 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 concentrations in certain foods.
This includes red meat, offal such as liver and seafood, with gravy, beer and sugary drinks also being potential sources.
Modern diets have increased the risk of people developing the condition, which is also linked to being overweight, as well as a side effect of certain medications, such as those designed to tackle high blood pressure.
Navin Khosla, a pharmacist at NowPatient, an online pharmacy that conducted the study, said the impact of gout on patients should be underestimated.
“The main symptoms of gout are sudden and 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 indication of gout is when the skin over the area of pain becomes swollen or red, so if you experience any of these symptoms you can take ibuprofen to help ease the pain.’
But gout isn’t the only Victorian-era health problem Liverpool has seen a surge in.
In an apparent paradox, malnutrition rates have also increased by 447 percent in the past five years.
In 2019, Liverpool University Hospitals NHS Foundation Trust recorded just 94 cases of malnutrition. But by 2023 this had risen to 514.
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Malnutrition is not the same as starvation, but refers to people not getting the right amount of nutrients.
This can cause people to be underweight, but can also cause symptoms such as fatigue, weakness and frequent illnesses.
It can be caused by certain health conditions, but is also linked to poverty.
University Hospitals Dorset NHS Foundation Trust also had high malnutrition growth 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, a registered nutritionist and consultant for Healthspan, said gout is linked to obesity, which has been increasing in Britain for years.
And he added that, contrary to popular belief, people can be fat and malnourished.
‘Malnutrition can lead to vitamin and mineral deficiencies, which is entirely plausible even if you are obese and the quality of your diet is poor.’
Mr Hobson said poor eating habits are a particular concern for people on a diet of ultra-processed foods (UPFs).
“UPFs are low in fiber, vitamins and minerals, but any energy is dense and easy to overconsume, causing weight gain,” he said.
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He said this is part of the trend experts call “the hunger-obesity paradox.”
“Low-income individuals and families often have limited financial resources, leading them to purchase cheap, high-calorie and 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 shows how people in places like Britain and the US can eat enough to be obese, but develop health problems because their diet is so nutritionally poor.’
Data also suggests that the number of cases of rickets, a bone development problem in children, is increasing.
Rickets is caused by a deficiency of vitamin D or calcium, caused by exposure to sunlight and consuming dairy products, respectively.
It leaves patients with soft, weak bones that can cause a variety of pain and deformities.
Children growing up on the smog-covered streets of Victorian Britain had poor access to food rich in vitamin D or calcium, leading to the country’s reputation as a disease of the urban poor.
But now rates are rising again in certain parts of the country.
East Kent Hospitals University NHS Foundation Trust had the highest growth in cases at 586, an increase of 380 per cent from 122 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 to 1,679 cases in 2023.
Experts are warning of a rise in ‘Victorian’ diseases that have been reduced to isolated cases in modern times and are making a comeback.
This is partly linked to the changing cost of living, which is causing some families to eliminate fresh foods such as fruits and vegetables from their diets.