At university, almost 40 years ago now, we were taught gout was a deficiency in purine metabolism, well not so much taught as referred to the current scientific papers on the subject.. Specifically an inherited disorder which affects an enzyme (Hypoxanthine-guanine phosphoribosyltransferase). I think the main problem is that it’s probably expressed to different degrees in different individuals, which will dictate tolerance to certain foods, frequency and severity of attack.
I was also told that food high in purines needed to be avoided…but depending on the level of expression of the gene (and how big a defect there is in the metabolism), I would imagine even foods relatively low in purines will cause a problem. I think the whole Port thing is a bit of a red herring (and herring isn’t good for gout) and the main problem is Alcohol in general.
P.S. At the time I don’t think it was medically realised to be a defect in purine metabolism, and was thought to be an autoimmune condition, similar to arthritis. This was because it took about 10-20 years for the papers to get into the text books.
