Gout is an inflammatory arthritis characterized by sudden, severe attacks of pain, swelling, and redness, often affecting the big toe. This condition results from the accumulation of microscopic, needle-shaped crystals within the joint space. These crystals form due to an abnormally high concentration of uric acid in the blood, known as hyperuricemia. The belief that consuming cherries can help manage gout symptoms has been popular for decades. This article investigates the scientific basis for this claim, examining the biological mechanisms and summarizing the clinical evidence.
Understanding Gout and Uric Acid Formation
Uric acid is a natural byproduct of the body’s metabolism, specifically the breakdown of compounds called purines. Purines are found in all human cells and in many foods, such as red meat, some seafood, and alcohol. The process begins when purines are degraded into hypoxanthine, which is then converted into xanthine, and finally into uric acid. This two-step conversion is catalyzed by the enzyme xanthine oxidase.
The resulting uric acid normally circulates in the bloodstream and is primarily excreted by the kidneys. When the body produces too much uric acid or the kidneys excrete too little, blood levels rise, leading to hyperuricemia. At elevated concentrations, the uric acid converts into monosodium urate crystals. These crystals deposit in the joints, tendons, and surrounding tissues, triggering a powerful inflammatory response that causes a gout flare.
Bioactive Compounds Responsible for Cherry Benefits
The therapeutic properties attributed to cherries, particularly the tart varieties, stem from their rich content of specialized plant compounds. The most widely studied of these compounds are anthocyanins, which are part of the flavonoid family of polyphenols. These pigments are responsible for the deep red and purple color of the fruit. Tart cherries contain higher concentrations of these compounds compared to sweet cherries, like Bing.
Anthocyanins and other polyphenols, such as quercetin and vitamin C, function as potent antioxidants and anti-inflammatory agents. Their chemical structures allow them to neutralize unstable molecules within the body that contribute to oxidative stress. This general property forms the basis for their purported health benefits, including those related to joint health.
Clinical Evidence and Physiological Effects
Research indicates that cherry consumption can affect the progression and severity of gout through two primary physiological pathways.
Uric Acid Reduction
One mechanism involves lowering the concentration of uric acid circulating in the blood. Cherry compounds are believed to interfere with the enzyme xanthine oxidase, inhibiting the final step of uric acid production. Other components may enhance the renal excretion of uric acid, allowing the body to eliminate the compound more efficiently. Multiple human studies have demonstrated a positive correlation between cherry intake and reduced risk of gout attacks.
In one large study, participants who consumed cherries or cherry extract over a two-day period experienced a 35% reduction in the risk of recurrent gout attacks. When cherry consumption was combined with the standard gout medication allopurinol, the risk of flares dropped by 75%. This suggests cherries act as a complementary therapy rather than a replacement for prescribed treatments.
Anti-Inflammatory Effects
The second physiological effect is a reduction in inflammation, which helps mitigate the symptoms of a flare. The anthocyanins in cherries have been shown to reduce markers of inflammation, such as C-reactive protein (CRP) and certain interleukins. This anti-inflammatory action can lessen the severity and duration of a flare, even if the individual’s serum uric acid levels are not drastically altered. Consuming two servings of fresh cherries has been shown to reduce blood uric acid by 15% and decrease inflammatory markers within hours in healthy subjects.
Practical Application and Consumption Guidelines
Cherries can be incorporated into a gout management plan in several forms, each with varying concentrations of the beneficial compounds. Tart cherries, such as the Montmorency variety, are generally the focus of research due to their higher antioxidant content. While whole fresh or frozen cherries are beneficial, a concentrated form is often used to achieve therapeutic levels of bioactive compounds.
Tart cherry juice concentrate is a common choice, as one ounce of concentrate is equivalent to approximately 90 whole cherries. Studies have shown positive effects from drinking eight ounces of diluted tart cherry juice concentrate daily. A general guideline for prevention or management suggests consuming about one-half cup of fresh cherries or one cup of unsweetened tart cherry juice per day.
It is important to be cautious of the sugar content in cherry products, especially juice concentrates, as excessive sugar intake can worsen gout. When selecting a product, look for 100% unsweetened juice or extracts without added sugars. Cherries should be viewed as a dietary supplement to a comprehensive treatment plan, not as a standalone cure. Any changes to a gout regimen, particularly replacing prescribed medications, must always be discussed with a healthcare professional.