Think alcohol-free beer is safe? Doctors warn it may still trigger gout

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A cold beer on a hot summer day may be a simple pleasure for many, but for others, it can trigger debilitating pain. With people in their 20s to 40s making up nearly half (48 percent) of all gout patients, young adults are increasingly being warned to take precautions.

Gout is an inflammatory joint disease caused by the buildup of uric acid crystals in cooler parts of the body, like the toes. When the body’s white blood cells recognize these crystals as foreign invaders, they trigger an immune response. The resulting inflammation irritates the nerves and leads to gout attacks, often felt as sudden pain in the big toe, ankle or knee.

“Gout used to be considered a typical middle-aged men’s disease, but due to modern lifestyle factors such as unbalanced diets and drinking alcohol before or after workouts, we’re seeing a noticeable rise among younger adults,” said Hwang Ji-won, a rheumatologist at Kyung Hee University Hospital.

Summer poses an even higher risk for gout flare-ups. Hot weather increases sweating, leading to rapid fluid loss and a rise in blood uric acid concentration. Drinking beer, which contains high levels of purines, compounds the problem. Not only does the breakdown of purines create more uric acid, but the liver’s breakdown of alcohol also produces lactic acid, which inhibits uric acid excretion. In fact, data from 2023 shows that the number of gout patients rose from 107,819 in February to 129,967 in August — a 20 percent increase.

Common bar foods in Korea like beef intestines and seafood such as shrimp or clams are high in purines and can raise uric acid levels. Fried and high-fat foods also burden the liver, increasing the risk of gout.

Even beers labeled “alcohol-free” are not entirely risk-free. “Some of these beverages still contain trace amounts of alcohol, and if they include fructose or artificial sweeteners, they can stimulate uric acid production,” Hwang said. Instead of relying solely on the “zero alcohol” label, it’s important to read the ingredient list carefully to check for components that affect purine levels or uric acid metabolism.

To prevent gout, health experts recommend eating low-purine foods such as vegetables, nuts and low-fat dairy products, while drinking plenty of water to help flush uric acid from the body through urine. “Gout is closely linked to metabolic conditions such as hypertension, high cholesterol, diabetes and abdominal obesity,” Hwang added. “It should be seen as a warning sign for broader systemic issues, but many delay treatment thinking it’s just ordinary arthritis.”

This article from the Hankook Ilbo, the sister publication of The Korea Times, is translated by a generative AI system and edited by The Korea Times.