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Gout and rickets on the rise: Public health expert warns of rise in Tudor-era diseases

Malnutrition, rickets and other manifestations of extreme poor diet are becoming apparent in parts of Britain, warn experts

Malnutrition and diseases such as rickets and gout are on the rise due to poor diet, a leading public health expert has warned.

John Middleton, the vice president at the Faculty of Public Health which represents doctors and public health workers, said it will call for changes to national food policy, such as introducing sugar tax, to address problems caused by poor diet and poverty.

“Malnutrition, rickets and other manifestations of extreme poor diet are becoming apparent. GPs are reporting rickets anecdotally in Manchester, the East End of London, Birmingham and the West Midlands. It is a condition we believed should have died out,” he wrote in The Observer.

In May the association sent an open letter to the Prime Minister, David Cameron, published in the Lancet medical journal, highlighting the increase in the use of food banks, and said that high food and energy prices were causes contributing to poor diet choices and ill-health.

We look at the reasons why joint diseases such as gout are on the increase and what the symptoms are.

What is it?

Gout is a form of inflammatory arthritis and is incredibly painful.  Jane Tadman, a spokeswoman from Arthritis Research UK, told the Independent that gout causes excruciating pain, “it can be too painful to even rest a bed sheet on,” she said.

Didn’t Henry VIII have gout?

Yes he did. Historically, gout was a curse of the wealthy – a result of eating too much game meat and drinking red wine. Now, there are a variety of contributing factors to developing gout, including eating rich food, but it is more likely to be on the increase as result of obesity and poor diet.

Tadman said: “There is a genetic factor sometimes in the cause of gout but dietary choices are also a factor too, obesity is on the rise and so is gout it seems. Things like too much beer, red wine and oily fish can contribute. In the past it used to be a disease associated with the well-off aristocracy, but that is not true now, it is more associated with poor diet. “

What are the symptoms?

Symptoms are described as painful, red, hot and swollen joints. Skin over the joint can appear shiny and sometimes peeling. Attacks of gout often start at night and develop over a few hours. Gout often affects the big toe but can occur in the rest of the foot, ankles, knees, elbows, wrists and fingers.

What causes the inflammation?

Gout is caused by having too much uric acid in the blood which is not effectively flushed by the kidneys and so can lead to the build-up of sodium urate crystals that form around joints. The crystals cause damage to the joint cartilage and the nearby bone, sharp crystals can come in to contact with the soft lining around joints making it inflamed, according to the NHS and Arthritis Research UK.

How can I treat it?

Gout can be managed by drug called allopurinol taken regularly, Tadman says. During a gout attack, the NHS advises sufferers to rest, raise the limb and keeping the affected joint cool.