TikTok and gout would appear to be unlikely bedfellows. Yet, they appear together in the title of a study: Gout, TikTok and Misleading Information: A Content Analysis, just published in the journal Rheumatology Advances in Practice.
The University of Auckland researchers concluded that TikTok videos about gout are commonly misleading, inconsistent or inaccurate.
Gout is one of a group of joint disorders that occur when crystals build up in joints and soft tissues. It develops when uric acid levels rise in the bloodstream, before infiltrating the joints where uric acid solidifies, forming needle-like crystals that inflame the joints, making them incredibly sore. Many people who experience gout describe it as one of the worst pains they have ever felt. It most commonly affects the big toe and it can make even the lightest touch to the joint unbearable.
Such is the level of pain with gout that it is traditionally illustrated as a sharp-toothed demon sinking its fangs into a human foot. Satirist James Gillray pilloried gout as a scourge of the 18th-century gluttonous diet. And gout was a particular problem for the British royal family of that era so the illness came to be associated with the aristocracy and an overly rich diet.
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Gout typically occurs in acute attacks, before settling with treatment and becoming dormant. A diagnosis of gout is based around the classic symptoms: excruciating pain, swelling in and around the affected joint and redness. Microscopic examination of the fluid taken from the swollen joint may show crystals and blood tests will usually show raised uric acid levels.
An estimated 41 million people worldwide suffer from gout, with physicians diagnosing about seven million new cases a year. But there are persistent gaps in awareness and understanding about gout among patients and the public. Although medical guidelines recommend long-term urate-lowering therapy for effective gout management, gout remains poorly controlled.
[ Diet ‘may be less important than genes’ in causing goutOpens in new window ]
Some 98 per cent of people aged 12 years or older use social media, and those with health conditions are more likely to share health information on the platforms. TikTok, with 1.2 billion users, is influential in shaping public beliefs, perceptions, and behaviours. A survey of 1,172 women aged 18-29 found that about 70 per cent intentionally sought health information on TikTok.
In the most recent survey, researchers searched the term “gout” on the TikTok discover page and collected the first 200 videos they found. The investigation revealed that people with gout or close family members were the most prevalent video presenters, followed by health professionals and members of the public. The main purpose of videos was to provide health advice, share personal gout stories or to sell products.
Interestingly, diet and lifestyle were the most common risk factors for gout covered in the TikTok videos. When it came to gout management, the focus was primarily on dietary advice. But only seven of the TikTok videos discussed medications as a management approach, primarily recommending pain relief options such as steroids and non-steroidal anti-inflammatory drugs. And the researchers found that only two TikTok videos mentioned long-term urate-lowering therapy for effective gout management, even though this is the standard, proven treatment.
By focusing solely on lifestyle and dietary risk factors the content portrayed gout as a personal choice, rather than a disease that is also caused by underlying factors such as kidney disease and genetics.
Meanwhile, a 2023 survey conducted by Dublin City University found that 57 per cent of Gen-Z and Millennial TikTok users are influenced by, or regularly adopt, nutrition trends from the platform. The same research also found that only 2 per cent of the analysed nutrition content on TikTok proved to be accurate when compared to public health guidelines.
But please don’t let all this talk about gout put you off having an indulgent Christmas.
We all deserve a slice of dietary hedonism at this time of year.
