Bad news for gout
sufferers who enjoy drinking the fruit of the vine – new research finds
that all types of alcohol, even previously exempt wine, can bring on attacks of
the painful condition.
"I don't want to sound too dogmatic and say, 'You must stop
drinking,'" lead author Dr Tuhina Neogi told Reuters Health. But, the
Boston University rheumatologist said, "based on this study, I would
counsel patients that any type of alcohol may trigger an
attack. It's not just beer
or hard liquor that can trigger attacks, but also wine,"
Gout is a potentially debilitating form of arthritis that
afflicts more than 8 million American adults, and the number is rising, Neogi's
team writes in The American Journal of Medicine.
The so-called disease of kings causes joints to swell and
redden. It most often strikes overweight men's big toes but also claims feet,
ankles, knees, hands and wrists. A link between intoxicating beverages and gout
has been suspected since ancient times.
A 2004 landmark study of more than 47 000 men found that
drinking beer and hard liquor – but not wine – increased the risk of developing
Neither has wine been shown in other studies to bring on
attacks in people who already have gout, the way beer and liquor have.
Nonetheless, Neogi said, some of her patients report
"they can't even sniff wine without having a gout attack." To
investigate the effects of all types of alcohol on the short-term risk of a
gout flare-up, Neogi and her team examined survey responses from 724 adults
with gout, 78% of them men, from across the United States between 2003 and
2012. Study participants completed questionnaires every few months about their
gout attacks, medications, exercise, alcohol use and diet.
The more alcohol they drank, Neogi's team found, the greater
their risk of having a gout attack within 24 hours.
A 0.15 litres glass of wine, a 0.35 litres beer or up to
0.04 litres of liquor were considered one drink. The researchers compared the
study participants to themselves on days when they had no alcohol.
When participants had a single drink, the risk of gout
attack didn't change much. But with one to two drinks in a 24-hour period, the
risk of a gout attack rose by 36%. With two to four drinks, the risk rose by
Wine was one of the worst triggers, at least for men.
Regularly drinking a glass or two of wine hiked the odds of recurrent attacks
by 138%, and drinking two to four servings of beer raised the risk by 75%.
"Moderate drinking", which is one drink for women
and two drinks for men, did not significantly raise women's risk, but there
were too few women in the study to estimate the effect, the researchers
note. "Our study results indicate that alcohol intake, regardless of type,
can increase the risk of gout attacks," Neogi said.
The effect of wine
"Additionally, increasing amounts of alcohol intake of
any type, even at moderate levels, can increase risk of gout attacks." Wine
may not have raised the risk of developing gout in past studies for a variety
of reasons, Neogi's team points out in their report. People who drink only wine
tend to have healthier diets and lifestyles, overall, than people who drink
only beer, for example. "They're making healthier
food choices, exercising
more and not smoking as much as beer and hard liquor drinkers," Neogi
That may have masked wine's effect on gout in the 2004
study. Dr Gary Curhan of Harvard Medical School, senior author of that study,
told Reuters Health in an e-mail. "I do think that doctors should advise
their patients with gout to minimise their alcohol intake." Because his
study controlled for diet, Curhan discounted the notion that wine drinkers'
healthier lifestyles explained differences between his and Neogi's results.
Though Curhan's study considered some food categories associated
with gout, such as meats and seafood, it failed to include other categories,
such as processed foods, or other lifestyle factors, like exercise and smoking,
Neogi said. "It just may be that without accounting for these other
factors, we can't see the true effects of wine," she added.
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