Gout and Alcohol

BrooklynDodger has been fielding some questions of bias, and concedes selective review of the literature on alcohol. After all, it must have some harmful effects. Seeing this title in Lancet, the Dodger figured it was a study of country squires, like Squire Western in Tom Jones. However, the study turned out to be from Boston.

The full abstract is below. The overall incidence of gout in these 47,000 men was 1.5%, which surprised the Dodger. The study covers 12 years, but even so the Dodger would think that someone he knew would have be diagnosed with Gout in that time, but no. Gout increased with beer, spirits, but not with wine consumption. This is one of the first studies to confirm the general assumption that wine is not as bad for you as other types of sauce. [BrooklynDodger usually objects to calling a non significant increase no effect, as was done for wine in this paper, but as a bibulophile choses not to object in this case.

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The Lancet Volume 363, Issue 9417 , 17 April 2004, Pages 1277-1281

Alcohol intake and risk of incident gout in men: a prospective study

DrHyon K Choi MDa, d, , , Karen Atkinson MDa, Elizabeth W Karlson MDb, Walter Willett MDc, e and Gary Curhan MDc, d

aRheumatology Unit, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
bDivision of Rheumatology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
cChanning Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
dDepartment of Epidemiology, Harvard School of Public Health, Boston, MA, USA
eDepartment of Nutrition, Harvard School of Public Health, Boston, MA, USA

Available online 20 April 2004.

Summary

Background
The association between alcohol consumption and risk of gout has been suspected since ancient times, but has not been prospectively confirmed. Additionally, potential differences in risk of gout posed by different alcoholic beverages have not been assessed.

Methods
Over 12 years (1986–98) we used biennial questionnaires to investigate the relation between alcohol consumption and risk of incident gout in 47 150 male participants with no history of gout at baseline. We used a supplementary questionnaire to ascertain whether reported cases of gout met the American College of Rheumatology survey gout criteria.

Findings
We documented 730 confirmed incident cases of gout. Compared with men who did not drink alcohol, the multivariate relative risk (RR) of gout was 1·32 (95% CI 0·99–1·75) for alcohol consumption 10·0–14·9 g/day, 1·49 (1·14–1·94) for 15·0–29·9 g/day, 1·96 (1·48–2·60) for 30·0–49·9 g/day, and 2·53 (1·73–3·70) for ≥50 g/day (p for trend <0·0001).>Beer consumption showed the strongest independent association with the risk of gout (multivariate RR per 12-oz serving per day 1.49; 95% CI 1.32-1.70). Consumption of spirits was also significantly associated with gout (multivariate RR per drink or shot per day 1.15; 95% CI 1.04-1.28); however, wine consumption was not (multivariate RR per 4-oz serving per day 1.04; 95% CI 0.88-1.22).

INTERPRETATION: Alcohol intake is strongly associated with an increased risk of gout. This risk varies substantially according to type of alcoholic beverage: beer confers a larger risk than spirits, whereas moderate wine drinking does not increase the risk.