Gout, a disease often associated with rich men and rich foods, is making a comeback. As the American population becomes older and heavier, instances of the disease are rising.

Gout is actually a very painful form of arthritis, affecting the big toe and other joints, and is sometimes called the disease of kings.

But, ordinary Americans are suffering too - an estimated 2 to 6 million of them, and it's not just men

 either, although women are three to four times less likely to have gout (possibly due to the protective properties of estrogen).

So, what causes gout:

Gout is caused by the buildup of a chemical called uric acid in the blood. Uric acid is formed by the breakdown of purines, which are components of DNA, RNA and some other important molecules in the body.

Your chance of getting gout is influenced by a number of factors. Being overweight and drinking alcohol are indeed two of them. But, a family history of gout, kidney problems, and even eating red meat and seafood can all be factors too.

Even so, the rise in instances of gout is yet another reason to encourage Americans to keep their weight to a healthy level, and to eat and drink moderately.

BUPA has a fact sheet on gout, if you want to find out more.