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Beer and cider significantly increase the risk of gout in both sexes, but men are more prone to it
Last reviewed: 02.07.2025
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A recent study published in JAMA Network Open assessed the association between total and specific alcohol consumption and the risk of developing gout in men and women.
Gout is the most common form of inflammatory arthritis and is caused by elevated serum uric acid levels. The prevalence of gout varies by geography and gender. In addition to genetic factors, lifestyle factors such as alcohol consumption, which is associated with elevated blood uric acid levels, also influence the development of hyperuricemia and gout.
Previous studies of this association have been limited by including mostly men or using cross-sectional or case-control designs. Additionally, existing studies have often used non-drinkers as controls, which may lead to problems of reverse causality, where existing health problems may cause a person to give up drinking, shifting them into the categories of “rare drinkers” or “non-drinkers,” which may bias the association between gout risk and alcohol consumption.
This study used sex-specific analyses to examine the association between long-term risk of developing gout and total and specific alcohol consumption.
The study included 401,128 participants from the UK Biobank database who were free of gout at study entry and aged between 37 and 73 years. Follow-up continued until 31 December 2021, with data analysis conducted from August 2023 to June 2024.
Data on total alcohol consumption and specific alcoholic beverages were obtained by questionnaire. The primary outcome was gout incidence, as assessed by hospital records.
The final study cohort included 179,828 men and 221,300 women, the majority of whom were of Asian or British Asian, Black or British Black and White ethnicity. Of men and women, 93.6% and 90.5% were current drinkers, 3.6% were former drinkers, and 2.9% and 5.9% had never drunk, respectively.
The study identified 6,561 and 2,078 cases of gout in men and women, respectively, over a median follow-up period of 12.7 years. In the main analysis, 4,096 and 1,182 cases were in women, respectively.
Among men, current drinkers had an increased risk of developing gout compared with never drinkers. Among women, this association was small and inverse in the main analysis.
Among current drinkers in men, the risk of gout increased with frequency of alcohol consumption. A positive association was observed among women only after controlling for body mass index (BMI) in a multivariate model.
Men consumed significantly more beer and cider than women. Beer or cider, white wine or champagne, and spirits were associated with a higher risk of gout in both sexes, with the strongest association seen with beer or cider for both sexes.
Among women, the association between gout and alcohol consumption was stronger than among men. A positive association was observed only among men who drank one glass of red wine daily; however, the association with fortified wine was not significant.
In an exploratory analysis, light to moderate consumption of certain alcoholic beverages was significantly associated with a lower risk of gout. In the main analysis, these associations did not persist when adjusting for the possibility of reverse causality.
The study found a positive association between increased risk of gout and consumption of several specific alcoholic beverages among men and women, allowing for the possibility of reverse causality. These sex differences may be due to differences in the types of alcohol consumed rather than biological differences.
Despite the careful approach, some limitations remained, such as potential imprecision of the data due to the self-reported nature of the study and the presence of residual confounding. Additional limitations included the assessment of alcohol consumption only at baseline and the relatively low consumption of fortified wine in the sample, which reduces the power of the estimates. The majority of participants were of European descent, which may limit the generalizability of the results.