Gout And Alcohol

This gout and alcohol guideline explains the important facts about the way alcohol affects gout. More importantly, it explains how you can judge the effects of alcohol on your gout.

Alcohol is a major concern for some gout sufferers, yet they never get clear advice. It is time to forget outdated nonsense that alcohol causes gout, and time to work out the part that alcohol should play in your gout diet.

How Alcohol Affects Gout

Despite the strong opinions of some people, we have very little knowledge about how alcohol affects gout. There is quite a lot of published scientific data, but most of it is statistical analysis rather than medical facts.

Statistics have their place in suggesting possible links, but they do nothing for you as an individual. In fact, they can be dangerously misleading. There is an epidemic of “advice” triggered by a 12 year study of 47,150 men. The impressive numbers suggest impressive value, but a look at the details reveals medical nonsense. I believe this is dangerous, because it confuses the average gout sufferer. Anything that causes confusion is dangerous because it discourages gout sufferers from seeking, and complying with, proper treatment.

There is nothing fundamentally wrong with the 2004 study, as long as you wish to live your life by statistics. If you want medical treatment rather than math, focus on yourself, and ignore this study.

Why do I disapprove?

The study goes on (and on, and on) about relative risk (RR). They conclude that the relative risk of getting gout is twice as high (RR=1.96) if you consume 30 to 50 g alcohol per day, and two and a half times higher over 50g per day. Apart from the confusion of understanding what alcohol consumption in g per day actually is, I am also confused by this constant referral to relative risk.

What does this relative risk mean in actual terms?

The control group for comparison is men who abstain from alcohol. When the statistics are analyzed in such a way that abstainers have a risk factor of 1, then the alcohol consumers have a higher risk. Therefore, the results are not saying that if you stop alcohol, you will stop gout. This is the most common misinterpretation of the study findings. So, what truly matters is you as an individual. If you are considering stopping alcohol as a way to control gout, this study will not help you. As with all gout management choices, you have to test it yourself. Also, there is a much more misleading aspect to these results. I return to the real meaning of Relative Risk.

The abstainers have an absolute risk of gout every 94 years. Therefore, if you drink 30 to 50 g (3 or 4 glasses of wine) per day, you risk gout every 47 years.[1] I’ll drink to that.

So, the message of the study is that abstainers have a very small risk of gout. If you drink alcohol, your risk is higher. But higher than very small is still small.

As a gout sufferer, you have many more things to worry about. The dangers of excess iron in food, excess lead in the environment, excess prescribing of diuretics, are all much more significant than alcohol. Best not to worry too much about alcohol, but if you do wish to review alcohol consumption, then please do it the right way…

Alcohol In Your Diet For Gout

First, you must decide what type of gout sufferer you are. Are you simply suffering from gout, and reacting to it by random attempts to change your diet? Or are you a gout patient – a gout sufferer with a treatment plan?

If you are not sure, please start at the beginning of the Diet For Gout guidelines, then return here to learn how alcohol affects your gout. Alcohol is just one part of your gout diet, so you need to get the right approach to total diet, otherwise you will never know how alcohol affects your gout.

If you do not have a gout treatment plan, then you should focus on the part that alcohol plays in a healthy diet. For gout sufferers, it is important to eat a healthy balanced diet that meets national nutrition guidelines. Do not worry specifically about alcohol, or any other component of your diet, unless it forms an excessive part of that diet. The best you can hope for is that, if gout was due to bad eating or drinking habits, then stopping those bad habits might help your gout. However, you really need to get a treatment plan that matches your symptoms and diagnosis.

If you do have a treatment plan, then you should assess alcohol consumption in the light of that plan. The biggest problem is that excess alcohol consumption can cause you to forget to take gout medicine. Very few gout medicines lose there effectiveness with alcohol, but you should always check with your doctor or pharmacy about this, as it can be important for some meds.

Alcohol And Inflammation In Gout

I am unaware of any specific gout studies regarding alcohol and inflammation. If you see any, please share them in the gout forum. In general terms, alcohol can affect inflammation, and is therefore a concern to gout sufferers, but the situation is complicated.

Many studies have isolated genetic aspects to inflammation, and so it is impossible to generalize. You need to rely on personal experience to assess if alcohol is making your gout worse or not. I urge you to do this in conjunction with uric acid test results. I can provide individual help with this, so please explain your situation in the gout forum. One complication, is the differing effect of alcohol on inflammation at different levels. At least one study reports lower inflammation in moderate drinkers compared to abstainers and heavy drinkers. [2]

Which Alcohol For Gout

Gout And Alcohol: Next Steps

The role of alcohol in gout is often overplayed. Generally speaking, it is not significant when compared to other dietary factors. Your main focus should be on a healthy balanced diet.

On an individual basis, especially if your alcohol consumption is significant, there may be reasons to take action. Again, generally speaking, if you have an unhealthy alcohol consumption, it is more likely to impact your general health than to make gout worse. However, gout affects individuals differently, so you must speak to a health professional.

If you are not sure how to get professional advice, or if you do not understand that advice when you get it, please discuss your gout and your alcohol consumption in the gout forum.

I have not done a complete review of this gout and alcohol study, [1] but if you want more, please ask in the gout forum. My assessment of the small effect of alcohol from 3 or 4 glasses of wine is based on the authors explanation:

We used standard portions; a 12 oz (355 mL) bottle or can of beer, a 4 oz (118 mL) glass of wine, and a shot of spirits (44 mL). For each beverage, participants reported their usual average consumption in the preceding year, with nine response categories. We determined alcohol intake by multiplying the consumption of each beverage by its ethanol content (12·8 g for beer, 11·0 g for wine, and 14·0 g for spirits)

More Help for Gout And Alcohol

These guidelines explain some general principles about gout and alcohol. However, every gout sufferer is affected differently. You need to learn which principles apply to you, and how to manage gout and alcohol. You can join current alcohol and gout discussions. Or, you can ask your own questions about alcohol and gout.

Remember that alcohol is just one part of your gout diet. Alcohol must always be considered with respect to your total food and drink intake. You can learn about the importance of total food and drink intake in my gout diet guidelines.

Leave Gout And Alcohol to browse the Gout Diet guidelines.

Beer and Gout Update

I’ve flagged this article, for review. Are you are interested in more information about beer for gout sufferers? Please share your questions, opinions, and experiences at Possible Beer and Gout review.

Gout And Alcohol: References

  1. Published: Lancet. 2004 Apr 17;363(9417):1277-81. Title: Alcohol intake and risk of incident gout in men: a prospective study. Authors: Choi HK, Atkinson K, Karlson EW, Willett W, Curhan G.
  2. Published: Lancet. 2001 Mar 10;357(9258):763-7. Title: Effect of alcohol consumption on systemic markers of inflammation. Authors: Imhof A, Froehlich M, Brenner H, Boeing H, Pepys MB, Koenig W.

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