Bad news for gout sufferers who enjoy drinking the fruit of the vine - new research finds that all types of alcohol, even previously exempt wine, can bring on attacks of the painful condition.
"I don't want to sound too dogmatic and say, 'You must stop drinking,'" lead author Dr Tuhina Neogi told Reuters Health. But, the Boston University rheumatologist said, "based on this study, I would counsel patients that any type of alcohol may trigger an attack."
"It's not just beer or hard liquor that can trigger attacks, but also wine," she said.
Gout is a potentially debilitating form of arthritis that afflicts more than 8 million American adults, and the number is rising, Neogi's team writes in The American Journal of Medicine.
The so-called disease of kings causes joints to swell and redden. It most often strikes overweight men's big toes but also claims feet, ankles, knees, hands and wrists. A link between intoxicating beverages and gout has been suspected since ancient times.
A 2004 landmark study of more than 47,000 men found that drinking beer and hard liquor - but not wine - increased the risk of developing gout.
Neither has wine been shown in other studies to bring on attacks in people who already have gout, the way beer and liquor have.
Nonetheless, Neogi said, some of her patients report "they can't even sniff wine without having a gout attack."
To investigate the effects of all types of alcohol on the short-term risk of a gout flare-up, Neogi and her team examined survey responses from 724 adults with gout, 78 percent of them men, from across the United States between 2003 and 2012.
Study participants completed questionnaires every few months about their gout attacks, medications, exercise, alcohol use and diet.
The more alcohol they drank, Neogi's team found, the greater their risk of having a gout attack within 24 hours.
A five-ounce glass of wine, a 12-ounce beer or up to 1.5 ounces of liquor were considered one drink.
The researchers compared the study participants to themselves on days when they had no alcohol.
When participants had a single drink, the risk of gout attack didn't change much. But with one to two drinks in a 24-hour period, the risk of a gout attack rose by 36 percent. With two to four drinks, the risk rose by 50 percent.
Wine was one of the worst triggers, at least for men. Regularly drinking a glass or two of wine hiked the