Study: Cherries Lower Gout Attack Risk

Gout patients who eat cherries may lower their risk of gout attacks, new findings suggest.

In a study of 633 gout patients, researchers led by Yuqing Zhang, DSc, of Boston University, found that any consumption of cherries in the previous two days lowered the risk of a gout attack by 35% compared with not eating cherries, after adjusting for potential confounding factors, according to a report in Arthritis & Rheumatism. The researchers adjusted for purine intake and use of alcohol, diuretics, allopurinol, colchicines, and non-steroidal anti-inflammatory drugs.

The investigators also observed that the greater cherry consumption generally was associated with increased risk reduction. Compared with non-consumption, eating one, two, three, or four or more servings of cherries in the previous two days was associated with a 2%, 48%, 61%, and 38% decreased risk, respectively. The researchers defined a serving of cherries as one half cup of the fruit (about 10-12 cherries).

Dr. Zhang's team looked separately at consumption of cherry extract. Compared with non-consumption, consumption of any amount of extract in the previous two days was associated with a 45% decreased risk of gout attacks.

Furthermore, the study showed that cherry intake combined with allopurinol use decreased the risk of gout attacks by 75% compared with not eating cherries and taking allopurinol.

The researchers concluded that that if their findings are confirmed by randomized clinical trials, “cherry products could provide a novel non-pharmacological preventive option against gout attacks.”

Small experimental studies in healthy human subjects and animals have shown that cherry consumption reduces serum uric acid levels, the authors noted. Other studies have demonstrated that cherry products contain high levels of anthocyanins that possess anti-inflammatory and antioxidant properties.

Dr. Zhang and his colleagues said that to the best of their knowledge, no previous study has assessed whether cherry consumption decreases the risk of gout attacks.

To be included in the study, patients had to report gout diagnosed by a physician and have suffered a gout attack within the past 12 months. Each gout sufferer served as his or her own control.

“The results of this study are in general good news,” said gout specialist Anthony J. Bleyer, MD, Professor of Internal Medicine-Nephrology at Wake Forest School of Medicine in Winston-Salem, N.C. “Many patients desire natural remedies for their ailments, and physicians are trying to shift their patients' dietary intake to healthy foods such as fruits. While still not definitively proven, why not eat a few cherries and potentially decrease the risk of gout? If cherry pie decreases the risk of gout, this will be even better news.”

A previous study by Robert A. Jacob, MD, and colleagues (J Nutr 2003;133:1826-1829) found that healthy women who consumed cherries experienced a decrease in plasma urate concentrations, which Dr. Bleyer said suggests an effect of cherries on the renal tubular transport of urate. “While increased urate excretion may have contributed to a decreased risk of gout in the current study, another possibility is that cherries or cherry juice extract have an anti-inflammatory effect that decreases gout attacks,” Dr. Bleyer told Renal & Urology News

The new study will likely lead to additional studies that will more definitively prove the value of cherries in preventing gout, Dr. Bleyer said.

“But what should we do now with these findings? Fortunately, cherries are in general considered to be a healthy food choice,” he observed.

“For our patients with kidney disease, we are frequently concerned with potassium intake.  Cherries are reported to have a moderate amount of potassium, with about 10 cherries containing between 150 and 250 mg. They are also seasonal and expensive when consumed out of season, making their use likely sporadic. Cherry extract is more of a problem, as these products are largely unregulated, and whether all extracts provide benefit has not been determined.  In addition, patients with chronic kidney disease will have to pay attention to the potassium content of these extracts.”

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