Beer, But Not Wine, Raises Risk of Gout

Just one beer a day makes painful joint problem more likely

Alcohol has long been demonized as the gout sufferer's enemy. Doctors frequently tell people who experience this type of severe joint pain to avoid alcohol completely because it can boost levels of uric acid in the body, leading to a gout attack.

But now there's research to suggest that not all alcohol has the same deleterious effect.

"Individuals with gout or who are at a higher risk of gout should try to limit or even cut their beer consumption," study author Dr. Hyon Choi, a rheumatologist at Massachusetts General Hospital in Boston , told HealthDay .

Wine consumption, however, does not raise the risk of gout "and may even have other health benefits associated with moderate alcohol consumption," he added.

Gout, a painful form of arthritis, has been around since ancient times, according to the American College of Rheumatology. It is sometimes called "the disease of kings" because it was associated -- although falsely so -- with people's overindulgence in rich food and drink.

People afflicted with gout experience intense episodes of painful swelling in single joints, especially the big toe. It strikes suddenly and, over time, the attacks may become more frequent. Left untreated, it can be potentially disabling.

Gout occurs when excess uric acid, a normal waste product, builds up in the body, forming crystals that are deposited in the joints. When the body's immune system attacks these crystal deposits, the affected joints become tender and inflamed.

Certain foods, such as shellfish, as well as alcohol and certain medications, may increase uric acid levels.

The disease affects about 1 in 100 people, and as many as 7 percent of older men, according to the rheumatology group. It often runs in families and occurs more often in men than women. But postmenopausal women are also at risk, as well as people with kidney disease. Other risk factors associated with gout include obesity, hypertension, hyperlipidemia (excess lipids, or fats, in the blood) and diabetes.

Choi and colleagues monitored rates of gout onset in a group of 47,000 adult men over a 12-year period. Participants were regularly questioned about their daily consumption of various foods and drinks.

Beer had the strongest association with gout, the study found. The risk of the disease was about 30 percent greater in men who consumed one glass of beer a day compared with nondrinkers. Those who had two to four glasses of beer a day faced almost double the risk.

Likewise, the odds of gout were about 30 percent higher among men who drank one shot of liquor a day than among nondrinkers.

Yet wine had no effect on the likelihood of developing gout, a discovery that Choi described as surprising and possibly related to protective factors in wine. It could be that powerful antioxidants found in wine neutralize the detrimental effects of alcohol that boost the risk of gout, he told HealthDay .

Doctors often prescribe high doses of nonsteroidal anti-inflammatory drugs, such as naproxen and indomethacin, cox-2 inhibitors such as Celebrex, or steroids to relieve gout symptoms. For people who experience repeated gout attacks, medicines that can help normalize uric acid levels can be prescribed.

To prevent future attacks, gout sufferers might consider making certain lifestyle changes. Restricting foods high in purines -- a compound found in meats and certain types of seafood -- may help, the rheumatology group suggests.

And when it comes to alcohol, the advice may be changing.

"Before, what we thought was: 'Alcohol is alcohol is alcohol,'" Dr. Calvin R. Brown Jr., a rheumatologist at Rush University Medical Center in Chicago , told HealthDay . "But now, if a [gout] patient asks me if one form of alcohol is better, I'd say choose one or two glasses of wine per day."