Maori gout evidence suggests lesser link to lush lifestyle

Discoveries of early Maori skeletal remains show tell-tale signs of the condition even though early settlers did not recognise the disease among Maori as being gout. Instead, they often referred to it as Maori rheumatism, a term to describe general inflammatory joint diseases.

Gout is caused when uric acid in the blood crystallises in the joints, causing them to become inflamed. Sufferers are advised to avoid consuming too much red meat, seafood and beer.

Archaeological evidence​

"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​," said Anna Gosling of 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​."

Her paper was recently published in the journal Rheumatology. Recent data shows that 7.7% of Maori and 8.6% of Pacific Islanders living in New Zealand suffer from gout, compared to 2.3% of New Zealand Europeans.

Gosling says gout had long been perceived as a disease of the aristocracy – a disease of affluence and lush lifestyles.

Genetic predisposition​

"The Europeans, who were reporting on the presence of certain diseases among the Maori, may not have recognised the disease as being gout because Maori were not living lifestyles of luxury and excess as seen in the upper echelons of European society at the time​.

“This may be the basis for the high rate of ‘rheumatism’ being reported by such observers​," she said.

This study and the skeletal evidence shows that genetic factors play a significant role and are likely to have meant that Maori had suffered from gout well before first European contact.

"While lifestyle, particularly diet, can contribute to the likelihood of developing gout, there is also a genetic component, which seems particularly strong among Maori and Pacific Islanders​.

"This is something which both the clinicians, who treat gout, and the sufferers of gout, should be aware of. There is a precedent which dates back hundreds, possibly thousands of years [across the Pacific], for Maori and other Pacific peoples suffering gout​.

“Given the importance of ancestry among Māori and Pacific communities, gout is not just a result of how the patient is living, and an awareness of this may hopefully help promote the message that effective modern drugs are available to prevent gout​," Gosling added.