You’ve probably heard that moderate alcohol consumption doesn’t harm your health and may even be beneficial. However, it is becoming increasingly clear that even small amounts of alcohol can be harmful to your health.
A recent large-scale study of UK Biobank participants has revealed new findings about the relationship between alcohol consumption and gout risk.1 Surprisingly, even light to moderate consumption of several alcoholic beverages was associated with an increased risk of gout. The study, which followed more than 401,128 participants for an average of 12.7 years, found that the type of alcohol chosen mattered in this case.
While beer and spirits were most strongly associated with gout risk, white wine and champagne were also not immune to gout risk. Even red wine, which is often touted for its health benefits, has been shown to slightly increase the risk of gout in men. This challenges the long-held belief that wine, especially red wine, may be a safer choice for people concerned about gout and other health risks.
Takeout? Regardless of your preferred beverage type, drinking even small amounts of alcohol may have a greater impact on your risk of gout than previously thought.
Men and Women: Different Drinks, Different Risks
Gender affects how alcohol affects your risk of gout. The study found some interesting differences between men and women when it comes to drinking and gout. In men, current drinking was associated with a 69% higher risk of developing gout compared to never drinking alcohol.2 Women, on the other hand, do not have a significantly increased risk just because they are current drinkers.
However, frequent drinking (more than five times a week) increased the risk for both men and women. That is, a 105% increase for men and a 34% increase for women.3 One possible explanation for this difference lies in beverage preference.
The men in the study consumed significantly more beer or cider than the women. Women consumed an average of 4.2 pints per week compared to just 0.4 pints per week. Given that beer shows the strongest association with gout risk, this drinking pattern may partially explain why men have a higher overall risk from alcohol consumption.
The truth about pints causing gout
If you’re a beer lover, you might want to think twice before drinking a pint. Studies have shown that consumption of beer or cider has the strongest association with gout risk of all alcoholic beverages. For both men and women, each additional beer per day increased the risk of gout by 60 to 62 percent.
This strong association may be due to the higher purine levels found in beer compared to other alcoholic beverages. Purines are compounds that, when broken down in the body, produce uric acid, the main culprit of gout.
Beer’s double entendre of alcohol and purines is especially problematic for people with gout or those at risk. So, if you’re concerned about gout, try reducing your beer consumption or finding healthy non-alcoholic alternatives.
If you’re worried about gout, you might think it’s safer to switch to wine or spirits. But research suggests it’s not that simple. Beer had the strongest association with gout risk, but other alcoholic beverages were not far behind. Consumption of champagne or white wine was associated with an increased risk of gout in both men and women.4
Distilled alcohol also showed a significant association, with a much stronger risk for women than for men. Red wine slightly increased the risk of gout in men but not in women. These findings challenge the notion that some types of alcohol are “safer” than others when it comes to gout risk.
The Carbohydrate Link: How Diet Affects Gout Risk
Alcohol consumption may increase your risk of developing gout, but not all carbohydrates are created equal when it comes to this condition. A large study looked at how different types of carbohydrates affected the likelihood of developing this painful form of arthritis.5 Total carbohydrate intake is associated with a reduced risk of gout, but the type and source of carbohydrates is very important.
For example, eating more naturally occurring sugars, starches, and fiber may lower your risk of gout. However, higher intakes of refined or free sugar, found in sweetened beverages and processed foods, have been shown to increase risk.
This reflects previous findings that alcohol and sugary drinks can increase blood uric acid levels. Takeout? When it comes to preventing gout, your overall carbohydrate intake is not as important as the specific types of carbohydrates you eat.
While dietary choices play a role in gout risk, genetic makeup is also a key factor. This study revealed insights into how these two factors interact. Participants who consumed higher amounts of total carbohydrates, non-lactoses, starches, and fiber and had a lower genetic risk for gout had the lowest risk of developing gout.
On the other hand, people who consumed high levels of free sugars and had a high genetic risk had the highest risk of gout.6 Researchers also made a surprising discovery about how diet and genetics work together to affect gout risk. In people who are genetically more prone to gout, eating more total carbohydrates or starches was associated with a lower risk of gout than expected.
Likewise, diets high in certain carbohydrates and having genes that generally increase gout risk worked together in unexpected ways. Diet offset some of the genetic risk. This means that if you have a family history of gout or know that you are genetically at higher risk, paying attention to the types of carbohydrates you eat may be especially helpful in lowering your chances of developing gout.
To understand how dietary carbohydrates affect gout risk, researchers looked at a variety of blood and urine biomarkers. They identified 11 biomarkers that mediate the relationship between carbohydrate intake and gout risk. Not surprisingly, serum uric acid (SUA) levels played the most important role. Both alcohol and certain carbohydrates can affect SUA levels, so this is consistent with alcohol’s effect on gout.
Two other notable mediators were cystatin C (CYS) and gamma-glutamyl transferase (GGT). Higher carbohydrate intake is associated with increased CYS levels, while certain carbohydrate-rich foods are associated with lower GGT levels. Both of these biomarkers have been associated with gout risk in previous studies.
These findings provide valuable insight into the biological mechanisms by which dietary choices, including carbohydrate and alcohol intake, influence the likelihood of developing gout.7 Although an increased risk of gout is only one consequence of a low-carb diet, it is important to get your carbohydrates from healthy sources, such as fruit, rather than processed foods or alcohol.
The Gut Microbiome: Your Hidden Ally Against Gout
Gut bacteria play an important role in managing uric acid levels, a major cause of gout. A recent study published in Cell Host & Microbe found that certain gut bacteria may lower the risk of gout by breaking down purines.8 However, alcohol consumption upsets this delicate balance. Drinking alcohol doesn’t just affect your liver. It also affects the complex ecosystem of the intestines.
Alcohol negatively impacts the gut microbiome and the gut-liver-brain axis, a two-way communication network that connects three important systems in the body. Effective at killing bacteria, alcohol’s antibacterial properties also kill beneficial gut bacteria indiscriminately.
For example, alcohol consumption can reduce Akkermansia muciniphila, a species of beneficial bacteria found naturally in the human gut.9 This in turn is associated with “dysregulation of microbial metabolite production, impaired intestinal permeability, induction of chronic inflammation and cytokine production.”10
Consuming alcoholic beverages, especially beer and spirits, puts more purines into your body. The body breaks down these purines into uric acid, potentially overwhelming the kidneys’ ability to filter and excrete them. Alcohol can also cause dehydration, making it more difficult for your body to flush out excess uric acid. But the story doesn’t end there.
Cellular host and microbiome studies have shown that certain gut bacteria break down purines in the gut before they can be absorbed into the bloodstream.11 Alcohol not only increases purine intake by damaging these beneficial bacteria, it also reduces the body’s natural defenses against uric acid buildup. This dual effect greatly increases your risk of developing gout, or, if you already have gout, of experiencing more frequent and severe gout attacks.
Health Risks of Alcohol Beyond Gout
Alcohol creates harmful compounds similar to excess omega-6 fats, such as linoleic acid (LA), found in vegetable and seed oils commonly found in processed foods. When metabolized, it turns into OXLAM, or oxidized linoleic acid metabolite. What all molecules agree on is that they are reactive aldehydes.
Alcohol turns into reactive aldehydes called acid aldehydes, and these reactive aldehydes wreak havoc throughout your body, damaging your mitochondria and accelerating aging at the cellular level. The negative effects of alcohol go far beyond the increased risk of gout. Alcohol consumption:
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Impairs mitochondrial function,12 accelerate aging |
Makes anxiety and depression worse |
It depletes important nutrients. |
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It affects hormones such as leptin and ghrelin. |
Dramatically increases cancer risk.13 |
Contributes to insulin resistance and metabolic disorders14 |
Drinking alcohol also affects the balance of hormones, especially testosterone and estrogen. Alcohol increases the conversion of testosterone to estrogen.15 This can have a variety of negative effects on both men and women. Estrogen is one of the main factors that increases cancer risk.
Alcohol also increases cancer risk through other mechanisms, including acetaldehyde toxicity, which can cause DNA damage, inflammation, leaky gut, and weakened immune function. Drinking alcohol also disrupts sleep. In other words, drinking alcohol can prevent you from getting a good night’s sleep.
The hard truth about alcohol and health
The evidence against alcohol consumption continues to grow. From increasing the risk of gout to disrupting the gut microbiome and accelerating cellular aging, the negative health effects of alcohol are widespread and serious. Despite persistent myths about “healthy moderation,” I don’t recommend drinking alcohol.
The scientific evidence is clear. The risks associated with consuming even small amounts of alcohol far outweigh the expected benefits. Even occasional drinks can trigger painful gout attacks, disrupt the delicate balance of gut microbes, and set the stage for a host of other health problems.
Whether your primary concern is preventing gout or you are simply committed to achieving and maintaining optimal health, eliminating alcohol from your lifestyle is an important step in the right direction.
Remember that your health is your most valuable asset. By making informed choices about what you put into your body, you can take control of your health and reduce your risk of chronic diseases like gout. The choice to abstain from alcohol may seem difficult in our alcohol-centric culture, but your body will thank you for it in the long run.
