[Hinews] SEOUL, South Korea — Gout, a painful and often debilitating form of arthritis traditionally associated with older men, is now rapidly increasing among younger South Koreans—particularly men in their 20s, 30s, and 40s. Driven by changing dietary patterns, the condition—which most commonly affects the big toe but can also involve the ankles and knees—has become a growing public health concern.

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. In 2023, men accounted for 93% of gout cases—totaling 496,290 patients. The most dramatic increases were among younger men: cases rose by 167% among those in their 20s, 109% in their 30s, and 83% in their 40s compared to a decade earlier. 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. Yoo-geun Kim, an orthopedic surgeon at Bupyeong Himchan Hospital. These painful episodes, known as “gout flares,” often occur at night or in the early morning and can be severe enough to require emergency room visits.

Gout cases in South Korea rose by 73% between 2014 and 2023, with young men in their 20s to 40s leading the increase—largely due to dietary shifts toward fast food, alcohol, and purine-rich foods. The condition causes severe joint pain and requires long-term management. (Image: ClipartKorea)
Gout cases in South Korea rose by 73% between 2014 and 2023, with young men in their 20s to 40s leading the increase—largely due to dietary shifts toward fast food, alcohol, and purine-rich foods. The condition causes severe joint pain and requires long-term management. (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—such as organ meats, mackerel, beer, fruit juices, and processed foods containing high-fructose corn syrup—can raise 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. Even lean protein sources such as chicken breast and protein supplements, often favored by fitness enthusiasts, can contribute to elevated uric acid levels when consumed in excess, 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, which refers to symptom-free periods between attacks, 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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