The prevalence of gout increases with age and up to 7% of men aged over 65 and 3% of women aged over 85 have gout. The risk of gout increases significantly with increasing serum uric acid levels. However, hyperuricaemia is far more common than gout implying that additional risk factors play a role in the development of the disease. Alcohol consumption, especially beer and to a lesser extent spirits, increases the risk of both incident and prevalent gout. Purine-rich foods such as red meat and seafood increase the risk of incident gout significantly, while dairy products and increasing coffee, but not tea, intake were found to be protective. A number of medications are well known to be associated with increased risk of gout. It is well established that gout is frequently associated with the metabolic syndrome which is characterised by hyperuricaemia, hyperlipidaemia, hypertension, diabetes and insulin resistance, and obesity. In addition, dehydration, increasing creatinine levels, and undergoing surgery are known to precipitate gouty flares. [With external links to the evidence base]