Once considered a condition that mainly affected middle-aged men who drank heavily and ate rich food, gout is now spreading rapidly among people in their 20s and 30s. Unhealthy lifestyle habits prevalent in that age group — from frequent delivery-food meals and heavy drinking to extreme weight-loss regimens such as intermittent fasting — can push uric acid levels higher and significantly raise the risk of gout.
Gout (disease code M10) occurs when uric acid accumulates excessively in the blood, forming crystals that deposit in the joints and trigger inflammation. The condition is notorious for excruciating pain — its Korean name literally means "even a passing breeze hurts." According to national health insurance review statistics, the number of gout patients in South Korea grew consistently from about 1.38 million in 2021 to about 1.49 million in 2025. Among them, patients in their 20s and 30s increased from about 331,000 to about 374,000 over the same period — a rise of 12.9 percent, well above the roughly 8 percent increase recorded for all age groups combined.
Lifestyle habits common among young adults are a major driver of the trend. Diets centered on fried foods and meat, along with frequent alcohol consumption, raise uric acid levels in the blood. Delivery food in particular tends to be high in purines, so eating it regularly can increase uric acid production in the body, while alcohol interferes with uric acid excretion and pushes blood levels higher. Obesity also heightens the risk of gout, and rapid weight loss is itself considered one of the triggers of gout attacks.
"People in their 20s and 30s whose daily routines are disrupted by dieting or work dinners tend to neglect uric acid management," said Lee So-yeon, a professor in the division of rheumatology at Gangdong Kyung Hee University Hospital. "Rather than thinking of gout as a condition you can manage simply by avoiding meat and alcohol, patients need to look at their overall diet and lifestyle patterns together."
Young adults who try high-protein diets or intermittent fasting to lose weight or reshape their bodies also need to exercise caution. Gout patients do not need to avoid protein altogether, but they should consider both the type and the amount they consume. Chicken breast contains fewer purines than red meat and is relatively safe, though excessive amounts can still affect uric acid levels. Protein supplements also warrant scrutiny — whey protein is generally a comparatively safe option, but checking the ingredient list of any product is advisable.
Intermittent fasting and severe caloric restriction also carry risks. Drastically cutting food intake or fasting for extended periods increases ketone bodies — metabolic byproducts of fat breakdown — which can impair the kidneys' ability to excrete uric acid and may trigger or worsen gout attacks. For those who are overweight, gradual weight loss through a balanced diet and regular exercise is far preferable to aggressive crash dieting, even though losing weight does help with uric acid management.
The growing "healthy pleasure" trend — seeking health and enjoyment at the same time — has driven more people toward zero-sugar drinks and non-alcoholic beer, but neither can be considered unconditionally safe from a gout-management standpoint. Zero-sugar beverages do reduce sugar intake compared with regular carbonated drinks, but they can raise uric acid levels through metabolic processes, so drinking them habitually in place of water is not recommended.
Non-alcoholic beer cannot be deemed safe simply because it contains little or no alcohol. The malt and barley used to brew it still retain their purine content even after the alcohol is removed. Rather than relying on "zero" or "non-alcoholic" labels alone, patients are better off checking the full ingredient and raw-material list of any product before consuming it.
Pain from an acute gout attack often subsides relatively quickly with anti-inflammatory painkillers, but that relief can be deceptive. Many patients — particularly busy young adults in their 20s and 30s who find it hard to visit a clinic regularly — assume they are cured once the pain disappears and stop taking their medication on their own. In reality, the uric acid crystals that have built up in the joints remain even after the pain is gone, setting the stage for repeated flare-ups and, eventually, chronic disease. Recurrent attacks can cause joint damage and deformity, and over the long term may lead to cardiovascular and kidney complications. Patients should continue taking prescribed medication consistently and not discontinue it on their own, even after the pain has resolved.
After a diagnosis of gouty arthritis, the key goal — even in the absence of pain — is to keep blood uric acid levels consistently below 6 milligrams per deciliter. Drug treatment with uric acid synthesis inhibitors or uricosuric agents should be combined with lifestyle improvements: weight management, regular exercise and adequate hydration. Cutting back on organ meats, alcohol and high-fructose corn syrup while maintaining a balanced diet is particularly helpful.
"Gout is a condition where long-term control of uric acid levels to prevent complications matters far more than short-term symptom relief," Lee said. "It is important to build habits of consistent medical care and self-management from a young age."
kty@heraldcorp.com
