Gout may be historically known as the disease of kings – or certainly those wealthy enough to afford rich food and drink. But new research has shown that the number of people with gout is growing. It occurs in about 4 percent of American adults. This translates to about 8 million individuals – 6 million men and 2 million women.

Men in their 40s and 50s are most likely to develop gout. But by age 60, gout affects men and women roughly equally. After age 80 more women than men have gout. 

High uric acid levels (hyperuricemia), which can lead to gout, occur for one of two reasons: the body produces too much uric acid or the body is not efficient at excreting uric acid in the urine. For more than 90 percent of people with gout, the cause is the latter. There are certain inborn errors of metabolism that can cause hyperuricemia, but these genetic disorders account for a very small fraction of people with gout.

Risk factors for gout include:

Genes: If family members have gout, you’re more likely to develop it.

Other health conditions: High cholesterol, high blood pressure, diabetes and heart disease may raise your risk.

Medications: Diuretic medications, or “water pills” taken for high blood pressure can raise uric acid levels; so can some drugs that suppress the immune system taken by rheumatoid arthritis and psoriasis patients, as well as transplant recipients.

Gender and age: Gout is more common in men than women until around age 60. Experts believe natural estrogen protects women up to that point.

Diet: Eating red meat and shellfish increases your risk.

Alcohol: For most people, more than two liquor drinks or two beers a day can increase the risk of gout.

Sodas: The fructose in sweet sodas has recently been shown to increase gout risk.

Obesity: Obese people are at a higher risk for gout, and they tend to develop it at a younger age than people of normal weight.

Bypass surgery: Those who have undergone gastric bypass surgery also have an increased risk.