Beer first, or wine? Order has no effect on hangovers, study finds

“One scotch, one bourbon, one beer.” There’s no mention of wine in this popular song written by Rudy Toombs and recorded by Amos Milburn in 1953. In the better-known 1966 John Lee Hooker version, the order is switched to “one bourbon, one scotch, one beer”.

It’s a familiar phenomenon wherever alcoholic beverages are consumed, and encapsulates a common belief among drinkers: the order in which different types of booze are consumed matters.

Such observations are surprisingly universal. The saying “Beer before wine and you’ll feel fine; wine before beer and you’ll feel queer”, has parallels in an English folk saying (“Grape or grain, but never the twain”), in German “(Wein auf Bier, das rat’ ich Dir – Bier auf Wein, das lass’ sein”) and in French (“Bière sur vin est venin, vin sur bière est belle manière”).

But there’s bad news at hand for any imbiber who hopes to find wisdom in these aphorisms.

In a study published in the American Journal of Clinical Nutrition, scientists at Witten/Herdecke University in Germany and the University of Cambridge in Britain evaluated whether there is any truth in the time-honoured sayings. Can one of the debilitating effects of consuming too much alcohol – the dreaded hangover – be mitigated by the order in which drinks are taken?

Sadly, the answer is an emphatic no. The study reveals that it doesn’t matter how you order your drinks. If you drink too much, you’re still likely to be ill.

The researchers, led by Kai Hensel from Cambridge, confirm they were “unable to confirm that the well-known folklore of drinking beer before wine purportedly results in a worse hangover than drinking wine before beer”.

They say this should rob “tactical drinkers” of the belief that they can reduce the after-effects of a heavy night out by careful ordering of beverages.

“Our findings suggest that ‘perceived drunkenness’ and ‘vomiting’ are useful predictors of misery in the morning after the night before,” they write.

The report cites a 2018 report by UK scientists Robyn Burton from Kings College London and Nick Sheron from the University of Southampton, published in the journal The Lancet, that “no level of alcohol consumption improves health”.

Hensel says: “Unpleasant as hangovers are, we should remember that they do have one important benefit, at least – they are a protective warning sign that will certainly have aided humans over the ages to change their future behaviour. In other words, they can help us learn from our mistakes.”

He adds the main reason for doing the study was the possibility that “a clear result in favour of one particular order could help to reduce hangovers and help many people have a better day after a long night out”.

“Unfortunately, we found that there was no way to avoid the inevitable hangover just by favouring one order over another,” he says.

Alcohol consumption is widespread and there are no effective remedies for its occasional consequence, the hangover. (The medical term for the condition, veisalgia, derives from the Norwegian kveis – uneasiness following debauchery – and the Greek algia, or pain.)

Instead, societies appear to rely on folk remedies such as “hair of the dog” and old sayings.

But such casual responses might mask a serious problem. In their report, the researchers note that excessive alcohol consumption is a significant “avoidable health risk around the world”.

“Acute alcohol-induced hangover constitutes a significant yet understudied global hazard, and a large burden to society,” they say.

“Specifically, acute hangover-associated symptoms bring risk to daily tasks such as driving or operating heavy machinery. Socio-economic costs arise from reduced productivity, impaired professional performance, workplace absenteeism, and academic underperformance.”

An extensive article published by prestigious US medical research centre the Mayo Clinic says hangover symptoms occur when higher than normal blood alcohol concentrations drop back to zero or near zero. Underlying causes include dehydration, immune response and disturbances to metabolism and hormones.

They are also likely to be influenced by ingredients other than the pure alcohol content. Colourings and flavourings have been suggested as making hangovers worse, prompting many a discussion about the relative merits of, for example, of bourbon versus vodka.

In the new study, the researchers used 90 volunteers, aged between 19 and 40, split into three groups. The first group consumed about two and a half pints of beer followed by four large glasses of wine. The second group consumed the same amounts of alcohol, but in reverse order. Subjects in the third consumed either only beer or wine.

A week later, participants in study groups one and two were switched to the opposite drinking order. Control group subjects who drank only beer the first time received only wine on the second study day, and vice versa. These changes provided comparison data and control factors.

Participants were asked about their wellbeing at regular intervals and requested to judge their perceived level of drunkenness on a scale between zero and 10 at the end of each study day. Before going to bed at the study site, all participants received an individualised amount of refrigerated drinking-water tailored to their body weight. All volunteers were kept under medical supervision overnight.

The following day, participants were asked about their hangover and given a score from zero to 56 according to the standard Acute Hangover Scale (which, yes, turns out to be an actual thing). Scores were based on factors including thirst, fatigue, headache, dizziness, nausea, stomach ache, increased heart rate and loss of appetite.

The researchers found that none of the three groups had a significantly different hangover score regardless of alcoholic drink order. Women tended to have slightly worse hangovers than men. While neither blood and urine tests, nor factors such as age, sex, body weight, drinking habits and hangover frequency helped to predict hangover intensity, vomiting and perceived drunkenness were associated with heavier hangover.

“Using white wine and lager beer, we didn’t find any truth in the idea that drinking beer before wine gives you a milder hangover than the other way around,” says first author Joran Kochling, from Witten/Herdecke University.

“The truth is that drinking too much of any alcoholic drink is likely to result in a hangover,” he says. “The only reliable way of predicting how miserable you’ll feel the next day is by how drunk you feel and whether you are sick. We should all pay attention to these red flags when drinking.”