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Are cherries really the miracle cure for gout?
03/10/2021 OxiPur
It has long been said that eating cherries has a positive effect on gout, and you can find countless online forums and blogs in which cherries are advertised as a real miracle cure against the disease. But what is the evidence?
Cherries are an interesting food for gout sufferers for a number of reasons. Their high citric acid content facilitates the excretion of uric acid. Cherries also contain vitamin C, which in high concentration, circa 500 mg, has a positive effect on the disease. However, it should be noted that the typical vitamin C amount found in a portion of cherries is less than 10 mg and far too low to actually make any significant impact on its own [1].
The most intriguing ingredient found in cherries that apparently makes them so effective against gout are anthocyanins. These are found in their highest concentration in sour cherries, but they are also present in other foods (see Table 1).
▲Table 1: Maximum anthocyanin content of selected foods [2]
Anthocyanins are plant-based dyes that imbue food with a dark red, purple or blue color. They belong to the class of compounds known as flavonoids, which are secondary plant metabolites that have a positive effect on human health.
Anthocyanins have antioxidant properties and can thus render harmful free radicals in the body ineffective. They also function as an anti-inflammatory by generating Cyclooxygenase (COX) to inhibit the activity of key enzymes that accelerate inflammation. In that respect, anthocyanins have a similar effect to many known painkillers (e.g. ibuprofen and diclofenac) that are often used as the first-line treatment for gout [3].
Regular consumption of cherries could therefore partially neutralize the side effects of the inflammation caused by uric acid crystals in the tendons and joints [1].
The conclusion we could potentially draw is that by consuming cherries, without long-term medication, it is possible to reduce the risk of a severe gout attack. According to one study, a positive effect was observed by eating as few as six cherries per day [3].
Those largely positive results have so far only been noted in very small studies and online surveys. Unfortunately, these studies often involve an insufficient randomization of participants, meaning results are often distorted and drawing absolute conclusions is very difficult [4].
Many websites and forums carry extremely positive accounts regarding the effectiveness of cherry extracts, but interestingly, these are nowhere to be found among general guidelines for actually treating gout. The data is still too insufficient [5]. On the contrary, you often get the impression that these embellished endorsements only serve to entice gout sufferers desperate for some relief into buying extremely expensive dietary supplements containing cherry extracts. User reviews of such supplements also often contain these exact kinds of exaggerated promises [6].
The use of these supplements is not without controversy. As noted above, antioxidants are beneficial in neutralizing free radicals harmful to the body, but they also neutralize useful radicals that play an important role in the creation of new cells. For this reason, consumers need to be careful when taking high-dose antioxidants, as they can have a negative effect on a person’s health under certain circumstances [7].
We have already seen the first individual cases of chronic kidney diseases, which may have occurred due to the consumption of highly concentrated cherry extracts. Patients who are already taking several medications (a common combination is diuretic medication, ACE inhibitors, and painkillers) appear to be at particular risk [3]. Added caution is required here, and dietary supplements should not be taken without consulting a physician.
Cherries – and sour cherries in particular – are a healthy snack, and if consumed regularly, could help keep gout manageable and possibly prevent flare-ups of the disease. However, whether they – and especially expensive cherry extracts – constitute some kind of miracle cure to bring gout under control is very doubtful. The studies that have been done are simply too lacking in reliable data to make such a claim. Nevertheless, there is much to be said for regularly consuming sour cherries, pickled cherries, or cherry juice (the latter in moderation, since it can quickly lead to excess sugar consumption). These all contain moderate amounts of anthocyanins, among other useful substances, and can be safely consumed.
Advertisements for cherries may display all kinds of claims and promises, and not just for Montmorency cherries, to take one example. The lesson here is: do not be fooled. Other blue, purple, or dark red foods, such as blackberries, blueberries, and eggplants, also contain an abundance of anthocyanins than can help combat gout.
We should also be very skeptical of considering dietary supplements as some sort of miraculous defence against gout. Unfortunately, falling victim to this misplaced belief often means that the manufacturer will reap most of the benefits, not you. A holistic approach is needed when it comes to treating gout with an improved diet. By all means, take supplements once you have consulted a doctor, but without also correcting long-term eating habits, no magic supplement bullet will help.
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References:
[1] Y. Zhang et al., Cherry consumption and decreased risk of recurrent gout attacks, Arthritis & Rheumatism 64:12 (2012), 4004–4011
[2] J. Fleschhut, Untersuchungen zum Metabolismus, zur Bioverfügbarkeit und zur antioxidativen Wirkung von Anthocyanen, Dissertation (2004), Tabellen 1.2 und 1.3., http://nbn-resolving.de/urn:nbn:de:swb:90-26403
[3] M. Matout et al., A case of acute kidney injury secondary to black cherry concentrate in a patient with chronic kidney disease secondary to type 2 diabetes mellitus, CEN Case Reports 8 (2019), 212–215
[4] Pei-En Chen et al., Effectiveness of Cherries in Reducing Uric Acid and Gout: A Systematic Review, Evidence-Based Complementary and Alternative Medicine (2019), 1–7
[5] https://www.klartext-nahrungsergaenzung.de/faq/projekt-klartext-nem/sauerkirsche-zur-harnsaeuresenkung-33117 (abgerufen 09/2020)
[6] https://www.klartext-nahrungsergaenzung.de/wissen/projekt-klartext-nem/fakerezensionen-in-onlineshops-nahrungsergaenzungen-sind-betroffen-51329
[7] https://www.verbraucherzentrale.de/wissen/lebensmittel/nahrungsergaenzungsmittel/antioxidantien-helfer-gegen-freie-radikale-10575 (abgerufen 09/2020)
What makes cherries so special for gout sufferers?
Cherries are an interesting food for gout sufferers for a number of reasons. Their high citric acid content facilitates the excretion of uric acid. Cherries also contain vitamin C, which in high concentration, circa 500 mg, has a positive effect on the disease. However, it should be noted that the typical vitamin C amount found in a portion of cherries is less than 10 mg and far too low to actually make any significant impact on its own [1].
The most intriguing ingredient found in cherries that apparently makes them so effective against gout are anthocyanins. These are found in their highest concentration in sour cherries, but they are also present in other foods (see Table 1).
| Food | Maximum anthocyanin content [mg/100 g] |
|---|---|
| Elderberries | 1005 |
| Eggplants | 750 |
| Blueberries | 515 |
| Cherries | 450 |
| Black currants | 400 |
| Blackberries | 326 |
| Blood oranges | 200 |
| Strawberries | 50 |
| Red onions | 25 |
| Red currants | 20 |
Do anthocyanins lower the risk of gout?
Anthocyanins are plant-based dyes that imbue food with a dark red, purple or blue color. They belong to the class of compounds known as flavonoids, which are secondary plant metabolites that have a positive effect on human health.
Anthocyanins have antioxidant properties and can thus render harmful free radicals in the body ineffective. They also function as an anti-inflammatory by generating Cyclooxygenase (COX) to inhibit the activity of key enzymes that accelerate inflammation. In that respect, anthocyanins have a similar effect to many known painkillers (e.g. ibuprofen and diclofenac) that are often used as the first-line treatment for gout [3].
Regular consumption of cherries could therefore partially neutralize the side effects of the inflammation caused by uric acid crystals in the tendons and joints [1].
The conclusion we could potentially draw is that by consuming cherries, without long-term medication, it is possible to reduce the risk of a severe gout attack. According to one study, a positive effect was observed by eating as few as six cherries per day [3].
It sounds too good to be true. What’s the catch?
Those largely positive results have so far only been noted in very small studies and online surveys. Unfortunately, these studies often involve an insufficient randomization of participants, meaning results are often distorted and drawing absolute conclusions is very difficult [4].
Many websites and forums carry extremely positive accounts regarding the effectiveness of cherry extracts, but interestingly, these are nowhere to be found among general guidelines for actually treating gout. The data is still too insufficient [5]. On the contrary, you often get the impression that these embellished endorsements only serve to entice gout sufferers desperate for some relief into buying extremely expensive dietary supplements containing cherry extracts. User reviews of such supplements also often contain these exact kinds of exaggerated promises [6].
Possible side effects of cherry extracts
The use of these supplements is not without controversy. As noted above, antioxidants are beneficial in neutralizing free radicals harmful to the body, but they also neutralize useful radicals that play an important role in the creation of new cells. For this reason, consumers need to be careful when taking high-dose antioxidants, as they can have a negative effect on a person’s health under certain circumstances [7].
We have already seen the first individual cases of chronic kidney diseases, which may have occurred due to the consumption of highly concentrated cherry extracts. Patients who are already taking several medications (a common combination is diuretic medication, ACE inhibitors, and painkillers) appear to be at particular risk [3]. Added caution is required here, and dietary supplements should not be taken without consulting a physician.
Conclusion
Cherries – and sour cherries in particular – are a healthy snack, and if consumed regularly, could help keep gout manageable and possibly prevent flare-ups of the disease. However, whether they – and especially expensive cherry extracts – constitute some kind of miracle cure to bring gout under control is very doubtful. The studies that have been done are simply too lacking in reliable data to make such a claim. Nevertheless, there is much to be said for regularly consuming sour cherries, pickled cherries, or cherry juice (the latter in moderation, since it can quickly lead to excess sugar consumption). These all contain moderate amounts of anthocyanins, among other useful substances, and can be safely consumed.
Advertisements for cherries may display all kinds of claims and promises, and not just for Montmorency cherries, to take one example. The lesson here is: do not be fooled. Other blue, purple, or dark red foods, such as blackberries, blueberries, and eggplants, also contain an abundance of anthocyanins than can help combat gout.
We should also be very skeptical of considering dietary supplements as some sort of miraculous defence against gout. Unfortunately, falling victim to this misplaced belief often means that the manufacturer will reap most of the benefits, not you. A holistic approach is needed when it comes to treating gout with an improved diet. By all means, take supplements once you have consulted a doctor, but without also correcting long-term eating habits, no magic supplement bullet will help.
Why do we care so much about this topic?
We have been developing our "OxiPur" app about gout and oxalates for many years and are happy to share our knowledge with you. Check it out:
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References:
[1] Y. Zhang et al., Cherry consumption and decreased risk of recurrent gout attacks, Arthritis & Rheumatism 64:12 (2012), 4004–4011
[2] J. Fleschhut, Untersuchungen zum Metabolismus, zur Bioverfügbarkeit und zur antioxidativen Wirkung von Anthocyanen, Dissertation (2004), Tabellen 1.2 und 1.3., http://nbn-resolving.de/urn:nbn:de:swb:90-26403
[3] M. Matout et al., A case of acute kidney injury secondary to black cherry concentrate in a patient with chronic kidney disease secondary to type 2 diabetes mellitus, CEN Case Reports 8 (2019), 212–215
[4] Pei-En Chen et al., Effectiveness of Cherries in Reducing Uric Acid and Gout: A Systematic Review, Evidence-Based Complementary and Alternative Medicine (2019), 1–7
[5] https://www.klartext-nahrungsergaenzung.de/faq/projekt-klartext-nem/sauerkirsche-zur-harnsaeuresenkung-33117 (abgerufen 09/2020)
[6] https://www.klartext-nahrungsergaenzung.de/wissen/projekt-klartext-nem/fakerezensionen-in-onlineshops-nahrungsergaenzungen-sind-betroffen-51329
[7] https://www.verbraucherzentrale.de/wissen/lebensmittel/nahrungsergaenzungsmittel/antioxidantien-helfer-gegen-freie-radikale-10575 (abgerufen 09/2020)