Paul Manafort Does Indeed Have Gout

It sure is tempting to read into this, but the disease is mainly genetic.

NEW YORK, NY - OCTOBER 13:  Boneless venison porterhouse made by chef Marc Forgione is served during the Marc Forgione and Jorge Espinoza dinner presented by Ferguson Bath, Kitchen & Lighting Gallery at Scarpetta on October 13, 2017 in New York City.  (Photo by Astrid Stawiarz/Getty Images for NYCWFF)
Probably not the cause of Paul Manafort’s gout.
Astrid Stawiarz/Getty Images

After much speculation, Paul Manafort’s lawyers have confirmed that poetic justice exists: He has gout. The revelation comes in a court filing from his lawyers responding to Robert Mueller’s accusation that Manafort lied to investigators (beyond the gout revelation, the filing seems like a legitimately big deal). The disclosure comes in a section about the hard time Manafort is having in solitary: “Mr. Manafort’s confinement have taken a toll on his physical and mental health,” his lawyers write. “As just one example, for several months Mr. Manafort has suffered from severe gout, at times confining him to a wheelchair.”

Could Manafort’s incarceration actually be exacerbating his gout? Possibly! Gout is a form of arthritis that affects joints, particularly the big toe, according to the Centers for Disease Control and Prevention. Though it’s not exactly a well-known side effect of solitary confinement, flares can be spurred by a lack of physical activity, which seems like a possible result of Manafort’s current situation. It’s unclear if Manafort’s gout initially reared its head in jail or predated his imprisonment. Risk for gout goes up with a diet rich in indulgent foods, according to the CDC—specifically, red meat, seafood, beer, liquor, and anything high in fructose. These foods contain purines, which break down into uric acid. Excess uric acid can collect in joints and cause pain, which is called gout. (Gout can’t be cured, but it can go into remission with the help of medications.)

Gout seems to be making a comeback in our cultural consciousness as an accompaniment to indulgence and status, Katy Schneider argued in the Cut last week. (Research suggests the uptick isn’t just anecdotal.) “[F]or literally hundreds of years it was considered a badge of nobility, a physical manifestation of wealth and success,” Schneider writes, citing its prominence in the movie The Favourite. It tracks, she suggests, that a man who’s spent millions dollars of laundered money on the likes of ostrich skin coats, ill-fitting suits, and antique rugs would come down with a disease to match his material consumption. Even before Manafort was spotted in a wheelchair with a bandaged foot prompting gout speculation, it was fitting to tack the word “gluttony” to his behaviors, as the Washington Post’s fashion critic did in August.

But Manafort’s gout is not necessarily caused by culinary gluttony. As the Guardian points out, citing a recent meta-analysis of nearly 17,000 people, eating “only lentils and muesli” doesn’t make you immune to the disease. The researchers found that eating foods that are associated with spurring gout did not have nearly much of an effect on uric acid levels as genetics. There but for the grace of a single nucleotide variation go we.