Piña Colada

A piña colada is a tropical cocktail made from rum, pineapple juice, and coconut cream or coconut milk. For people with gout, this drink combines two of the most problematic components: alcohol and fructose. Rum is a distilled spirit, and alcohol consumption — particularly spirits — is associated with increased uric acid production and reduced excretion, significantly raising the risk of an acute gout flare .

Pineapple juice is naturally rich in fructose, a sugar that promotes uric acid synthesis in the liver. When fructose is metabolized, it depletes cellular ATP and drives the production of purine breakdown products, directly increasing serum urate levels . The added simple syrups commonly used in bar versions only worsen the sugar load, which can also contribute to insulin resistance — a condition linked to higher uric acid levels.

Coconut cream is not a major purine source, and its fat content does not directly raise uric acid. However, the overall calorie density of this drink can promote weight gain, and excess body weight is a well-established risk factor for gout.

For those managing gout, the safest choice is to avoid piña coladas entirely. If you do indulge occasionally, keep portions small, choose a version with minimal added sugar, and ensure you are well hydrated with water before and after. It is also wise to avoid pairing it with other gout triggers, such as shellfish or organ meats, on the same occasion.