[Hinews] SEOUL, South Korea — Gout, a crippling form of arthritis traditionally linked to older men, is surging among younger South Koreans, particularly men in their 20s, 30s, and 40s. Fueled by shifting dietary habits, this painful condition—most often striking the big toe but also affecting ankles and knees—has emerged as a pressing public health issue.

South Korea’s Health Insurance Review and Assessment Service reports a 73 percent rise in gout diagnoses over the past decade, from 308,728 cases in 2014 to 535,100 in 2023. Men accounted for 93 percent of cases in 2023, totaling 496,290 patients. The sharpest increases were among younger men: gout cases among those in their 20s soared by 167 percent, in their 30s by 109 percent, and in their 40s by 83 percent compared to a decade ago. By 2023, men in these age groups made up nearly half of all gout patients.

“Gout results from elevated serum uric acid levels, leading to urate crystal deposits in joint cartilage, tendons, and surrounding tissues, causing intense pain,” said Dr. Kim Yoo-geun, an orthopedic surgeon at Bupyeong Himchan Hospital. The severe pain, often termed a “gout flare,” typically strikes at night or early morning, frequently driving patients to emergency rooms.

Gout cases in South Korea have surged 73% from 2014 to 2023, with young men in their 20s, 30s, and 40s driving the increase due to dietary shifts toward purine-rich foods like fast food and alcohol. The condition, marked by severe joint pain, requires lifelong management through medication and lifestyle changes.(Image : Clipartkorea)
Gout cases in South Korea have surged 73% from 2014 to 2023, with young men in their 20s, 30s, and 40s driving the increase due to dietary shifts toward purine-rich foods like fast food and alcohol. The condition, marked by severe joint pain, requires lifelong management through medication and lifestyle changes.(Image : Clipartkorea)


Dietary Shifts Fuel Gout’s Rise
Gout develops when purines, compounds found in certain foods, break down into uric acid, a waste product normally excreted through urine. When uric acid accumulates, it forms urate crystals that trigger inflammation in joints and tendons, causing excruciating pain—so severe that gout is sometimes called “the disease that hurts when the wind blows.” In chronic cases, urate deposits, known as tophi, can lead to joint deformities.

Hyperuricemia, defined as serum uric acid levels above 6.0 mg/dL, is a precursor to gout. Purine-rich foods, including processed products with high-fructose corn syrup, fruit juices, organ meats, mackerel, and beer, elevate uric acid levels. While some uric acid is naturally cleared, excessive levels can overwhelm this process, leading to hyperuricemia, which often goes undetected due to its asymptomatic nature.

The alarming rise in gout among younger South Koreans is largely driven by changing eating habits. Heavy alcohol consumption, frequent reliance on delivery foods, fast food, and purine-rich processed products, coupled with sedentary lifestyles, contribute to the trend. Prolonged inactivity slows metabolism, increasing obesity risk, which impairs uric acid excretion and worsens hyperuricemia. Patients with kidney dysfunction, obesity, or metabolic syndrome face a two- to fourfold higher risk of gout. High-protein diets, including protein supplements and lean meats like chicken breast, popular among fitness enthusiasts, can also raise uric acid levels, potentially triggering gout flares, especially when paired with intense exercise.

Lifelong Management Essential

Gout progresses through distinct stages, starting with asymptomatic hyperuricemia, where elevated uric acid levels go unnoticed, often detected only through routine blood tests. It can advance to acute gouty arthritis, marked by painful flares. Without treatment, it may evolve into interval gout, with symptom-free periods, and, in severe cases, chronic tophaceous gout, where urate deposits accumulate throughout the body.

The initial gout attack is typically followed by another within six months to two years, with recurrent episodes worsening if untreated. Treatment for acute gouty arthritis involves anti-inflammatory medications to relieve pain and urate-lowering therapies to address the root cause. The first metatarsophalangeal joint (big toe) is most commonly affected, with symptoms including burning sensations, needle-like pain, and swelling. Pain often intensifies at night, may subside within hours, or persist for weeks. Chronic gout can lead to joint deformities and tophus formation.

Prevention and management rely heavily on lifestyle changes. Reducing purine-rich foods is critical, while incorporating low-purine options like whole grains, seaweed, low-fat dairy, black coffee, apples, and bananas can help. Drinking at least two liters of water daily aids uric acid excretion, and 500 mg of daily vitamin C may also lower uric acid levels. Gout requires lifelong management, so maintaining dietary discipline and medication adherence is essential, even when uric acid levels normalize. Keeping acute treatment medications on hand for potential flares is also recommended.

“The goal is to maintain stable serum uric acid levels through adequate hydration and long-term prevention,” Dr. Kim said. “Alongside consistent medication, avoiding purine-rich foods and alcohol is critical.”

As gout increasingly afflicts younger South Koreans, health experts urge heightened awareness and proactive lifestyle changes to curb this growing epidemic through early intervention and sustained management.

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