'Kings' disease' all too common

University of Otago gout and obesity researcher Associate Prof Tony Merriman says our love affair with sugary fizzy drinks is adding to New Zealand's obesity epidemic. Photo by Linda Robertson.
University of Otago gout and obesity researcher Associate Prof Tony Merriman says our love affair with sugary fizzy drinks is adding to New Zealand's obesity epidemic. Photo by Linda Robertson.
University of Otago biochemist Associate Prof Tony Merriman is among the leaders of an international research project involving gout genetics. He was also the co-author of a major study, recently published in The Lancet, which highlighted the disturbingly rapid growth of obesity in this country. And he recently gained $5 million from the Health Research Council to continue his gout-related research for another five years.

University of Otago biochemist Associate Prof Tony Merriman is keen to shatter some popular myths about gout and New Zealand's obesity epidemic.

Gout was once known as ''the disease of kings''.

Another popular image of gout, from 19th century England, is that of a red-faced squire, with an overfondness for drinking port.

Prof Merriman points out that although those images linger, they have been left far behind by today's realities.

The mass production of food and sugary drinks means many more people - not just a social elite - can now eat and drink ''like a king''.

He points out that gout - a damaging form of arthritis - is ''very prevalent'' in New Zealand.

More than 100,000 New Zealanders have it, including 3% of Europeans, 6% of Maori, and 8% of Pacific people.

''If it is not treated then it can be very debilitating.''

Lack of treatment was quite common, through a combination of reasons, including the ''social stigma of gout''.

Untreated gout could lead to time off work, pain and permanent disability because of large build-ups of uric acid.

Consumption of alcohol, fructose-sweetened drinks, meat and seafood have been suggested as dietary contributors to gout.

Prof Merriman and Dr Lisa Te Morenga, also of Otago University, are part of a recently formed group called ''Fizz'', which is waging war on sugary drinks and junk food.

Prof Merriman was also the lead author of a study last year which showed that consuming sugary drinks reversed the benefits of a gene variant, SLCA9, which usually helped transport uric acid out of the bloodstream and facilitated its excretion through the kidney.

''A fundamental cause of gout is increased uric acid levels, and we know a relatively decent amount about the genes and environmental factors that cause increased uric acid levels,'' Prof Merriman says.

''However, we know very little about why only some people with increased uric acid levels get gout.''

These are the issues Prof Merriman is helping to address in an international genetic research project which has just been supported by a $5 million programme grant from the Health Research Council.

He was ''very relieved'' to gain the funding, ''a recognition of the importance of gout in New Zealand'', and meant the momentum built up in recent years in gout research could be maintained and ''very talented people in my research group retained''.

He is also ''very excited'' about an imminent genome-wide scan for gout genes, also involving other researchers overseas.

And one of his broader, long-term goals is to ''research the genetic causes of increased weight in New Zealand''.

He hopes this research information ''may go some way to dispelling general myths around obesity'' - and may dispel the belief that somehow obesity was ''the fault of the individual''.

He also hopes that future research findings, further highlighting the importance of genetic elements in weight gain, will help turn around ''ingrained prejudices that lead to stigma''.

In turn, this stigma was ''a barrier to bringing in the sort of environment changes needed to address obesity, and the associated serious conditions such as kidney and heart disease, gout and diabetes''.

He urges more awareness of the strong genetic contributing factors to obesity and more action to improve the obesity-producing environment.

The latter includes the wide availability of sugary drinks at much lower prices than more healthy products like milk.

Prof Merriman says he initially became interested, in the early 1990s, in the ''genetic and environmental causes of common diseases'' because of a strong family connection.

His wife, Marilyn, has type 1 diabetes, a largely congenital condition.

''That's really what got me started in the whole field,'' he said.

And that was the subject he subsequently studied in his postdoctoral work at Oxford University, after his Otago studies.

''When I returned to New Zealand in 1998, I turned to rheumatoid arthritis, an autoimmune disease with similarities to type 1 diabetes, and then to gout, largely because of the need for research into gout, both nationally and internationally.''

Prof Merriman was born in Gore and grew up in Pukerau, near Gore, also at Herbert, south of Oamaru, but mostly in Dunedin, where he attended King's High School.

If sparked by personal factors, his research is also driven on by a strong sense of curiosity, that he has also noticed among fellow scientists.

One of his favourite holiday spots in North Otago is the Waianakarua River.

''I just love walking up that river. You have a long stretch and then there's a question - what's round the next bend?''Science is very similar - you just want to find out.''