Dr. Ron’s Research Review – October 23, 2013

© 2013

This week’s research review focuses on cherries for gout.

Tart cherry juice has been shown to inhibit hepatic xanthine oxidase/dehydrogenase activity and lower the serum uric acid levels of hyperuricemic rats. (Haidari, Mohammad Shahi et al. 2009)

A recent study of 633 individuals with gout showed that cherry intake over a 2-day period was associated with a 35% lower risk of gout attacks compared with no intake (multivariate OR 0.65, 95% CI 0.50-0.85). Cherry extract intake showed a similar inverse association (multivariate OR 0.55, 95% CI 0.30-0.98).  (Zhang, Neogi et al. 2012)

One study found that women that consumed two servings (280 g) of cherries after an overnight fast had decreased plasma urate. The decrease in plasma urate after cherry consumption supports the reputed anti-gout efficacy of cherries. (Jacob, Spinozzi et al. 2003)

Dr. Ron


Articles

Consumption of cherries lowers plasma urate in healthy women

         (Jacob, Spinozzi et al. 2003) Download

To assess the physiologic effects of cherry consumption, we measured plasma urate, antioxidant and inflammatory markers in 10 healthy women who consumed Bing sweet cherries. The women, age 22-40 y, consumed two servings (280 g) of cherries after an overnight fast. Blood and urine samples were taken before the cherry dose, and at 1.5, 3 and 5 h postdose. Plasma urate decreased 5 h postdose, mean +/- SEM = 183 +/- 15 micro mol/L compared with predose baseline of 214 +/- 13 micro mol/L (P < 0.05). Urinary urate increased postdose, with peak excretion of 350 +/- 33 micro mol/mmol creatinine 3 h postdose compared with 202 +/- 13 at baseline (P < 0.01). Plasma C-reactive protein (CRP) and nitric oxide (NO) concentrations had decreased marginally 3 h postdose (P < 0.1), whereas plasma albumin and tumor necrosis factor-alpha were unchanged. The vitamin C content of the cherries was solely as dehydroascorbic acid, but postdose increases in plasma ascorbic acid indicated that dehydroascorbic acid in fruits is bioavailable as vitamin C. The decrease in plasma urate after cherry consumption supports the reputed anti-gout efficacy of cherries. The trend toward decreased inflammatory indices (CRP and NO) adds to the in vitro evidence that compounds in cherries may inhibit inflammatory pathways.

Cherry consumption and decreased risk of recurrent gout attacks

         (Zhang, Neogi et al. 2012) Download

OBJECTIVE: To study the relationship between cherry intake and the risk of recurrent gout attacks among individuals with gout. METHODS: We conducted a case-crossover study to examine the associations of a set of putative risk factors with recurrent gout attacks. Individuals with gout were prospectively recruited and followed up online for 1 year. Participants were asked to provide the following information regarding gout attacks: the onset date of the gout attack, symptoms and signs, medications (including antigout medications), and exposure to potential risk factors (including daily intake of cherries and cherry extract) during the 2-day period prior to the gout attack. We assessed the same exposure information over 2-day control periods. We estimated the risk of recurrent gout attacks related to cherry intake using conditional logistic regression. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated. RESULTS: Our study included 633 individuals with gout. Cherry intake over a 2-day period was associated with a 35% lower risk of gout attacks compared with no intake (multivariate OR 0.65 [95% CI 0.50-0.85]). Cherry extract intake showed a similar inverse association (multivariate OR 0.55 [95% CI 0.30-0.98]). The effect of cherry intake persisted across subgroups stratified by sex, obesity status, purine intake, alcohol use, diuretic use, and use of antigout medications. When cherry intake was combined with allopurinol use, the risk of gout attacks was 75% lower than during periods without either exposure (OR 0.25 [95% CI 0.15-0.42]). CONCLUSION: These findings suggest that cherry intake is associated with a lower risk of gout attacks.

References

Haidari, F., Jr., M. Mohammad Shahi, et al. (2009). "Inhibitory Effects of Tart Cherry (Prunus cerasus) Juice on Xanthine Oxidoreductase Activity and its Hypouricemic and Antioxidant Effects on Rats." Malays J Nutr 15(1): 53-64. [PMID: 22691805]

Jacob, R. A., G. M. Spinozzi, et al. (2003). "Consumption of cherries lowers plasma urate in healthy women." J Nutr 133(6): 1826-9. [PMID: 12771324]

Zhang, Y., T. Neogi, et al. (2012). "Cherry consumption and decreased risk of recurrent gout attacks." Arthritis Rheum 64(12): 4004-11. [PMID: 23023818]