Beer gut me into this

Scientists find a connection between beer and gout but wine drinkers are in the clear

By Charles Rowe

Gout � the downside to living large � has afflicted the wealthy for thousands of years. This 'disease of kings' was first described by Hippocrates in the 5th century BC. Of course, in keeping with the times, gout has since ceased to discriminate and affects people from all social classes. The buildup of uric acid that inflames joints has been coupled with the gluttonous consumption of meat and alcohol almost since the disease was first discovered. Amazingly, given the antiquity of this linkage, the booze connection has been largely anecdotal, with little hard evidence of the effect of alcohol on the incidence of gout.

The first article to document the booze/gout link and to assess the risk of gout according to the type of alcohol consumed was published in the April 17 issue of The Lancet. The study, headed by Dr Hyon Choi of the rheumatology unit of the Massachusetts General Hospital, Harvard Medical School, shows that a moderate amount of wine poses no risk of gout, whereas beer drinkers may be setting themselves up for a worse pain than the morning-after hangover.

"It's well known that alcohol can raise levels of uric acid in the blood, but its role in actually increasing the risk of gout had never been confirmed," said Dr Choi in a news release accompanying the paper.

Between 1986 and 1998, over 47,000 initially gout-free men filled out questionnaires twice a year over the course of four years as part of the Health Professionals Follow-up Study on dietary factors and various diseases. The drinking habits of the 730 men who were subsequently diagnosed with gout were examined.

Those who guzzled more than two 350ml cans or bottles of beer each day had a 2.5 times greater risk of developing gout than nondrinkers, while downing two shots of liquor daily upped the risk of gout by 1.6 times as compared to abstinence. On the other hand, there's good news for wine aficionados as drinkers who stuck to two or less glasses of wine per day were no more in danger of gout than teatotallers.

The researchers concluded that the historic assumption that booze and gout are connected is right on the button. However, "while there had been some suggestion that beer might have a greater contribution to risk, we were surprised to see such a strong difference," Dr Choi commented in the Harvard University news release. "It certainly suggests that individuals with gout should try to limit or even cut their beer consumption, whereas wine may be allowed, given other health benefits associated with moderate alcohol consumption."

Choi also proposed that some as-yet unknown but nonalcoholic component in beer and spirits may be a major player in spurring attacks of gout. But what exactly is the nasty stuff dwelling in that frosty mug of brew, or the good news protective factor in a glass of red wine? That remains to be determined. But for now, dedicated tipplers who want to avoid a painful big toe may want to switch from a sudsy brown buddy to a warm red Merlot or a crisp white Chardonnay. Santé!