Australasian Science: Australia's authority on science since 1938

Maori Gout Longstanding

By Stephen Luntz

The finding that gout was common in New Zealand prior to the arrival of Europeans has thrown into question many ideas about the painful disease.

Gout was once thought of as a disease of the European upper classes, and referred to as “a sign of a misspent youth”. The poor of Europe were spared, although they probably would have preferred access to the protein- and alcohol-rich diets that trigger it.

More recently an association has been found with sugary drinks, which reverse the behaviour of a gene that transports uric acid to the kidneys (AS, December 2013, p.14). However, there is also a genetic component, and the disease is substantially more common among Maori and Pacific Islanders than other ethnic groups.

“Most of the papers discussing gout in Maori talk about gout as if it is a disease primarily related to transitions to modern lifestyles and the adoption of a westernised diet, such as soft drinks, alcohol and highly processed foods,” says Anna Gosling, a PhD student in biological anthropology at the University of Otago.

“However, the archaeological evidence for gout found earlier at Wairau Bar, and then at another prehistoric site from Mangere, Auckland, contradicts this.” Gosling has backed these findings up with literature from the 19th century suggesting that gout was common among the Maori population then as well, although some of the Europeans reporting these cases referred to it under the broad category “rheumatism” because did they not expect to find the disease on this side of the world.

Ironically, Gosling’s work has been published in the journal Rheumatology.

The survival of genes that trigger urate reabsorption, leading to gout, in Maori and Pacific Islander populations represents something of a puzzle given the clear evolutionary disadvantage. There is evidence that seafood-rich diets can trigger the disease, suggesting it would have been particularly common in coastal areas. However, Gosling says “there is some evidence that urate has a protective role against some infectious diseases, including malaria”.

Gosling hopes awareness that gout is not simply a form of punishment for indulgent diets “may hopefully help promote the message that effective modern drugs are available to prevent gout”.