For the first time, scientists have documented the age-old belief that alcohol intake strongly increases the risk of developing gout, and that the risk is related to the type of alcoholic beverage consumed.
Drinking beer is more likely to lead to gout, but moderate wine consumption does not appear to raise the risk, according to a study reported in The Lancet this week.
People have long suspected a link between alcohol and gout. But the authors of the study, who are from Harvard-affiliated institutions, said it was the first to document the link systematically and to assess the risk according to the types of alcohol ingested.
The findings suggest that unidentified nonalcoholic components in beer and spirits may play an important role in precipitating the disease, a form of arthritis, said Dr. Hyon K. Choi of Massachusetts General Hospital in Boston, who led the study.
Gout can affect any joint, but it usually affects the big toe. Pain and inflammation result from deposits of uric acid crystals in a joint or tendon.
Gout tends to affect people older than 40 and often runs in families. It also tends to affect more men than women. About 3.4 million men and about 1.6 million women in the United States have the disease.
The participants in Choi's study were 47,150 male health professionals with no history of gout for 12 years. They answered a questionnaire when they entered the study in 1986 and every two years until 1998. Of the participants, 730 developed gout.
Choi's team quantified the amount of alcohol consumed based on dietary information the participants provided the researchers every four years.
Drinking two or more 12-ounce cans or bottles of beer a day increased the risk of gout 2.5 times compared with drinking no beer. Consuming two drinks each containing a shot of liquor increased the risk 1.6 times compared with consuming no liquor.
The study concluded that wine drinking did not appear to raise the risk, but experts said there were too few men in the study who drank a lot of wine to be sure that wine is a safer alternative.
Whether beer contains a factor that promotes gout or wine a protective factor, or both, is not known.
More research is needed to identify such possible factors and to determine whether changing the type of alcoholic beverage or reducing alcohol consumption would cut the incidence of gout, Choi's team said.
Last month, the team reported that among the same group of participants, consumption of meats and seafood, but not vegetables and overall protein, also increased the risk of gout. Dairy foods seemed to reduce the risk.