Gout, a form of arthritis once known as the "disease of kings" because it struck wealthy royals who ate rich meats and wine, is now increasingly showing up in young men, according to doctors and recent research.
The condition is caused by a buildup of uric acid in the blood. When levels get too high, the acid forms sharp, needle-like crystals that lodge in joints, most often the big toe, causing sudden pain, swelling and redness.
Cases among people aged 10 to 24 have risen more than 20 percent in recent decades, and the global burden of gout is projected to increase 70 percent by 2050, according to a 2024 study.
One theory points to the modern American diet and the growing popularity of the carnivore diet, an all-meat eating plan that has spread widely on social media under the hashtag #carnivorediet, drawing young men seeking weight loss and performance gains. Meat sales hit a record $112 billion in 2025, driven largely by Millennials and Gen Z.
Red meat is rich in purines, compounds that break down into uric acid. "I would call [the link between the carnivore diet and gout] a reasonable concern," said Dr Mike Daniels, a Maryland-based podiatrist. "Lately, it seems like I'm seeing more young men with gout, and I do think meat-heavy diets can be part of the story."
The body normally filters uric acid through the kidneys, but excess acid can also form crystals that cluster into kidney stones, causing pain, nausea and difficulty urinating. "There exists case-based evidence that has raised red flags about increased uric acid and kidney stone risk after switching to all-meat-eating diets," Daniels said.
Cases doubling worldwide
Gout cases have more than doubled globally since 1990, rising from roughly 22 million to 55.8 million in 2020, according to the 2024 study published in Lancet Rheumatology. The United States saw a sharper increase, with cases up 76.6 percent over that period.
Young men are more than four times as likely to have gout as young women, and the gap is widening. Global Burden of Disease data published in 2025 found that wealthier countries have the highest rates, with the United States and Canada topping the list. That study also found men with gout are more likely to have diets high in seafood, beef, pork and alcohol.
Meanwhile, American demand for meat kept climbing. The meat industry had a record year in 2025, reaching $111.9 billion in sales, with beef leading the way at $45 billion. Millennials and Gen Z drove much of the growth. Nearly 80 percent of shoppers now believe meat is part of a healthy diet, up sharply since 2020, and 45 percent say they are actively trying to prepare more meals with meat or poultry.
Online forums are filled with carnivore dieters describing gout flare-ups. One Reddit user wrote: "I did a few years ago, went full carnivore with frequent organ meats etc. Felt amazing for the first week and then had [the worst] gout attack I've ever had. Usually it attacks one joint, but this attack got both knees, both wrists and even the back of my neck. My rheumatologist suggested it was likely temporary, and if I kept going my body would sort it out, but I wasn't fully committed to long-term eating like this and decided to stop."
Another wrote on a separate forum: "Love carnivore, but my uric levels increase when on strict Carnivore. Knuckles, feet, ankles, shoulders, knees all hurt."
A third Reddit user wrote: "My dad started carnivore with me about two months ago, and he is getting debilitating gout attacks. We rushed him to the [doctor] now and he'll get meds." A fourth added: "Maybe it affects everyone differently but starting a carnivore diet is what got me diagnosed with gout."
What the studies show
A 2018 meta-analysis found that red meat consumption is linked to a 29 percent higher risk of gout, and patients diagnosed before age 40 have been shown to consume significantly more red meat than those who develop the condition later in life.
A 2022 study of 655 gout patients found that early-onset cases, those diagnosed before 40, had higher uric acid levels and were nearly three times more likely to be obese. They also ate more red meat: 44 percent consumed 101 to 200 grams daily, compared with 26 percent of later-onset patients.
Eating red meat occasionally, once or twice a week, is likely fine for most people, but daily consumption in large portions significantly increases risk, according to the reporting. "Anybody who has a strong family history of gout, chronic kidney disease (CKD), or poor renal function has a much greater baseline risk," said Dr Chad Larson, a California-based naturopathic doctor. "It is possible that for those individuals, implementing a meat-heavy diet without close monitoring via blood tests would rapidly exacerbate both the development of kidney stones and damage to joints prior to when symptoms occur."
Shifting federal guidance
Until January 2026, US dietary guidelines recommended replacing foods high in saturated fat, such as red meat, with plant-based foods, without setting a specific weekly limit on red meat. New 2025-2030 guidelines released by Health and Human Services Secretary Robert F Kennedy Jr have reversed that approach, placing red meat, cheese and other proteins at the top of a newly inverted food pyramid.
Kennedy said the shift "ends the war on saturated fats" and encourages Americans to prioritize protein-rich foods like red meat and full-fat dairy in every meal.
There is a widening gap between the policies of established medical groups such as the American Heart Association and the approach endorsed by Kennedy, who has long promoted red meat as a dietary staple. The American Heart Association has pushed back against the Trump administration's attempt to invert the food pyramid, emphasizing plant-based proteins instead.
Doctors say gout is preventable through diet and lifestyle changes, including reducing red meat, cutting back on alcohol and sugary drinks, and drinking plenty of water. "Diet and lifestyle changes are the first line of defense," Daniels said. "Gout doesn't have to be inevitable."
