Do Cherries Really Work in Gout?
Jonathan Kay, MD
May 03, 2013
Hello. I am Jonathan Kay, Professor of Medicine and Director of Clinical Research in the Division of Rheumatology at the University of Massachusetts Medical School and UMass Memorial Medical Center, both in Worcester, Massachusetts.
In the 1931 musical Scandals, Ethel Merman sang a song that began, "Life is just a bowl of cherries." It turns out that gout might also be just a bowl of cherries. Gout is a very prevalent condition, affecting more than 8 million individuals in the United States, and is a very common reason for patients to present to the rheumatologist.
Recently, many patients have come in saying that they take cherry extract or eat cherries to prevent an attack of gout. Is there any scientific basis for this?
In December 2012, Zhang and colleagues from Boston University Medical Center published a very interesting paper inArthritis and Rheumatism. In this case/control study, patients with gout were enrolled in an Internet-based registry. Investigators picked a 2-day period just before an attack of gout and compared that period with the 2 preceding days and the 2 subsequent days as control periods unrelated to an attack of gout.
The investigators validated the diagnosis of gout in more than 550 patients by looking at medical records authorized by the patients for review, and found that this group of patients had more than 1250 attacks of gout. The investigators looked at various self-reported dietary items, including cherries and other unrelated foods. They found that the intake of cherries before an attack of gout reduced the likelihood of experiencing an acute attack of gout by one third compared with the intake of unrelated foods.
This interesting finding suggests that there may be some basis to the ingestion of cherry extract or cherries to reduce attacks of gout. What might be the scientific basis for this? Cherry extract blocks the tubular reabsorption of urate and increases urate excretion in the urine. Cherry juice may also block xanthine oxidase and reduce the production of uric acid.
Cherry extract has a synergistic effect with allopurinol. Moreover, cherries contain anthocyanins, which are somewhat anti-inflammatory. Thus, there may actually be a reason why patients are making the right decision by ingesting cherries. Future controlled clinical trials of cherry extract should help to confirm or disprove this very interesting epidemiologic observation.
Thank you very much for your attention, and I look forward to seeing you on Medscape.
Zhang Y, Neogi T, Chen C, Chaisson C, Hunter DJ, Choi HK. Cherry consumption and decreased risk of recurrent gout attacks. Arthritis Rheum. 2012;64:4004-4011. Abstract