Wine and gout: Wine is very popular, but is it safe when you have gout? Alcohol has long been recognized as a high risk factor for recurrent gout, but could wine be the exception?
Wine and Gout
Wine has been produced and drunk for millennia; in fact, wine storage vessels have been found dating back as far as 6,000 BC!
And it’s still being enjoyed around the world today, with an estimated 292.3 million hectoliters of wine being produced globally in 2018. Source.
The top three wine producers are Italy, France and Spain, but the biggest consumers are the USA, France, Italy, Germany and China, followed by the UK, Russia, Spain and Argentina.
So wine is hugely popular, but is drinking wine safe when you have gout?
Gout
Gout is a debilitating form of inflammatory arthritis, the root cause of which is higher-than-normal levels of uric acid in the bloodstream, a condition called hyperuricemia. Over time microscopic, needle-shaped crystals of monosodium urate (MSU) can form out of the uric acid and settle in the joints and connective tissue causing a very painful gout flare-up.
Uric acid is essentially a waste product, produced during the body’s metabolism process, and excreted from the body via the kidneys. But not all of it is excreted: some is retained in the bloodstream where it acts as a powerful antioxidant.
Higher-than-normal uric acid levels result from either the body producing too much uric acid (overproduction) or the kidneys not excreting acid quickly enough (under excretion), so that excess continues to build-up in the bloodstream.
So anyone with gout has to maintain their serum uric acid at healthy levels in order to prevent MSU crystal formation.
Alcohol & Gout Studies
It’s long been recognized that alcohol consumption is a high risk factor for gout. And this has been backed up by several studies looking at the effect of alcohol consumption on gout.
One 2004 study, using data from 14,809 participants in the USA, looked at the relationship between alcohol and uric acid.
The study authors concluded that:
These data suggest that the effect of individual alcoholic beverages on serum uric acid levels varies substantially: beer confers a larger increase than liquor, whereas moderate wine drinking does not increase serum uric acid levels.
This study suggests that although drinking beer and spirits is definitely linked to a higher risk of developing gout, moderate wine drinking may not increase the risk.
It should be noted, though, that this study only considered the impact of alcohol on incident gout, i.e., first time gout, not recurrent gout episodes. In other words, on the risk of someone having their first gout attack.
But what about patients who already have gout? How does, for example, moderate amounts of wine affect them?
Well, one recent study looked at just that: the effect of alcohol consumption (including wine) on recurrent gout. This 2006 study of 197 gout patients concluded that:
The present study found that alcohol intake, even a light-to-moderate amount, triggers recurrent gout attacks. This effect was likely to occur within 24 hours after its consumption. We suggest that subjects with established gout avoid drinking alcohol to lower their risk of recurrent gout attacks.
And, in terms of the effect of specific alcohol types on gout, they found that:
When the effect of specific alcoholic beverage (ie, beer, wine, or spirits) was assessed separately, the risk of recurrent gout attack increased as the number of drinks of each specific alcoholic beverage increased.
A more recent (2014) study of 724 participants with gout resulted in a similar conclusion:
Episodic alcohol consumption, regardless of type of alcoholic beverage, was associated with an increased risk of recurrent gout attacks, including potentially with moderate amounts. Individuals with gout should limit alcohol intake of all types to reduce the risk of recurrent gout attacks.
These last two studies, then, propose that any type of alcoholic beverage (wine included) increases the risk of recurrent gout.
So the message is…
If you don’t already have gout: avoiding beer and hard liquor will help to reduce your risk of getting gout, although drinking wine in moderation may be O.K.
Drinking in moderation, for otherwise healthy individuals, usually means no more than one 5 oz glass of wine per day. But it’s far safer to reduce this to just the occasional glass now and again, especially if you’re in a high risk group for gout.
But if you’ve already got gout: complete avoidance of all alcoholic drinks will reduce your risk of further gout flare-ups. At the very least, you should severely limit your intake.
Remember, if you already have gout, you need to keep your uric acid levels low in order to prevent future flare-ups.
Unfortunately, alcohol not only increases uric acid in the blood it also impedes uric acid excretion, leading to even more uric acid circulating in the bloodstream and an even greater risk of painful gout flare-ups.
So alcohol, even wine, really is a formidable trigger for recurrent gout and best avoided altogether.
