Gout is an excruciatingly painful inflammatory disease of the joints. It is caused by an increased blood level of uric acid, which, when crystallized, can produce inflammation in the joints and surrounding tissues. Gout has been linked to major medical conditions such as heart attack, diabetes, and premature death. For years, gout has been thought to affect mostly men. Legends of kings suffering from podagra (a gout attack in the big toe) after eating meat and drinking alcohol led to gout being called "the disease of kings." However, over the last several decades, the frequency of gout has almost doubled, including in women. The November 24, 2010, issue of JAMA includes an article showing that this phenomenon among women might be related to an increased intake of fructose (a fruit sugar) because of increased consumption of fructose-rich beverages.