Alcohol is also badly underestimated: in one study only about 43% of people with gout knew beer was a trigger (Harrold 2012). Checking a specific drink or cocktail? Run it through the Dish Decoder.
The ranking
Beer is the riskiest drink for gout. It carries the alcohol effect plus purines from brewer’s yeast, a double hit. Regular beer drinking is one of the strongest dietary risk factors for gout in the research.
Source: Choi et al. 2004, Lancet (beer the strongest of the three)
Hard liquor has little to no purine, but the alcohol itself still raises uric acid and slows how your kidneys clear it. More drinks mean more risk, and binge drinking can set off a flare on its own.
Source: Choi et al. 2004, Lancet (spirits raise risk despite little purine)Neogi et al. 2014, Am J Med (any alcohol, recurrent flares)
Wine shows the weakest link to developing gout in the first place. Once you have gout, it doesn’t come out safer: in a study of 724 people with gout, more than one to two glasses in a day carried higher flare odds than any other drink at that level. It grades D like the others.
Source: Choi et al. 2004, Lancet (wine, weakest link to new gout)Neogi et al. 2014, Am J Med (wine and recurrent flares)
Is any amount safe?
No amount is proven safe. In people who already have gout, flare odds rose with each step in drinks over the previous 24 hours, and every type raised them, wine included. During an active flare any alcohol can make it worse. The 2020 ACR guideline recommends limiting alcohol for everyone with gout.
How much is too much?
Two studies give the numbers, and they answer different questions. The first followed 724 people who already had gout through 1,434 flares. These are the flare odds in the 24 hours after drinking, compared with no alcohol:
| Drink | In 24 hours | Flare odds |
|---|---|---|
| Wine (5 oz glass) | More than 1 to 2 glasses | 2.38x |
| Beer (12 oz) | More than 2 to 4 beers | 1.75x |
| Beer (12 oz) | More than 4 to 6 beers | 2.60x |
| Liquor (1 to 1.5 oz shot) | More than 2 to 4 shots | 1.67x |
| Liquor (1 to 1.5 oz shot) | More than 6 shots | 2.79x |
Across all drinks, one or fewer showed no significant rise (1.13x), more than one to two reached 1.36x, and more than eight reached 3.13x. People taking allopurinol showed no rise with drinking in this study, which is covered on why do I still flare?
The second followed 47,150 men without gout for 12 years. It's why beer ranks worst for developing gout:
| Daily serving | Risk of new gout |
|---|---|
| Beer, per 12 oz a day | 1.49x |
| Spirits, per shot a day | 1.15x |
| Wine, per 4 oz glass a day | 1.04 (not significant)x |
By total alcohol, risk rose from 1.49x at 15 to 29.9 g of alcohol a day to 2.53x at 50 g or more. There's no threshold that fits everyone, so treat these as directions, not a budget to spend.
Evidence: Neogi et al. 2014, Am J MedChoi et al. 2004, Lancet
What about non-alcoholic beer?
Taking the alcohol out leaves the purines from the brew. We grade non-alcoholic beer C, against E for regular lager, because the alcohol trigger is gone and the purines aren't. The research is thin. In 4 people with gout, low and alcohol-free beers still held back urate excretion, and the authors called them unsuitable. In 14 healthy people, dealcoholized beer left plasma uric acid unchanged. A figure of "4.4%" for non-alcoholic beer circulates online with no study behind it that we could find.
Evidence: Eastmond et al. 1995, Br J RheumatolGhiselli et al. 2000, J Nutr Biochem
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Every alcoholic drink we rate
Each grade combines purine load per serving with alcohol as an independent trigger.
Sources
- 1. Source: Choi HK, et al. Alcohol intake and risk of incident gout in men. Lancet. 2004;363(9417):1277–1281.
- 2. Source: Neogi T, et al. Alcohol quantity and type on risk of recurrent gout attacks. Am J Med. 2014;127(4):311–318.
- 3. Source: Harrold LR, et al. Patients’ knowledge and beliefs concerning gout and its treatment: a population based study. BMC Musculoskelet Disord. 2012;13:180.
Values are per 100g unless a note says otherwise, rounded to three significant figures. Per-serving figures are calculated from the unrounded measurement, so recomputing from the rounded number can differ by a milligram or so. A single determination is normal in food composition tables, not a defect. The fructose figure is derived, not a label value: it counts free fructose plus half of sucrose, because sucrose is half fructose and the body treats both the same way. A sucrose-sweetened food therefore carries roughly twice this much total sugar.
Last reviewed August 11, 2026.
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