HealthDay News — Eating cherries or cherry extract is associated with a significantly lower risk of gout attacks, and this effect is intensified when cherry intake is combined with the urate-lowering medication allopurinol, data from a large observational study show.
Among 633 patients who experienced a gout attack in the previous year, those who consumed cherries over a two-day period had a 35% reduced risk for a recurrent attack (OR=0.65; 95% CI: 0.50 to 0.85), Yuqing Zhang, ScD, of Boston University School of Medicine, and colleagues reported in Arthritis & Rheumatism.
And those who consumed cherries along with allopurinol experienced an even greater benefit — a 75% lower risk for recurrent gout (OR=0.25; 95% CI: 0.15 to 0.42) — compared to those who consumed neither.
“Should our findings be confirmed by randomized clinical trials, cherry products could provide a novel nonpharmacologic preventive option against gout attacks,” the researchers wrote.
Although previous smaller studies have shown uric acid reduction among those who consume cherries or cherry extract, the FDA prohibits manufacturers from claiming that cherry products are beneficial for those with gout in the absence of more carefully designed studies.
So Zhang and colleagues conducted a one-year, prospective, case-crossover study, among 633 U.S. adults with physician-diagnosed gout. In addition to information on gout attacks, the researchers collected data on socioeconomic status, medical history and medications.
Participants were asked about risk factors including alcohol use, consumption of purine-rich foods, physical activity, infections, anti-gout treatments and alternative remedies in the two days preceding an acute gout attack. The researchers also assessed gout risk factors and cherry consumption at four two-day periods when no gout symptoms were present during the same year, so patients could serve as their own controls.
A total of 1,247 gout attacks, most of which involved a lower extremity, occurred during the one year follow-up period. Patients reported using a range of medications including colchicine, nonsteroidal anti-inflammatory drugs and corticosteroids.
Overall, 35% of patients reported eating cherries, 2% used cherry extracts and 5% consumed both. One serving of cherries was defined as one half cup, or 10 to 12 cherries.
Among patients who consumed cherry extract, risk reduction was 45% (OR 0.55, 95% CI 0.30 to 0.98), the researchers found.
Those who ate cherries experienced a diminishing risk with increasing servings of cherries during the two-day hazard period period (P for trend <0.001), with the odds ratio for a gout attack going down with each serving:
- 1 serving, OR 0.98 (95% CI 0.65 to 1.48)
- 2 servings, OR 0.52 (95% CI 0.34 to 0.79)
- 3 servings, OR 0.39 (95% CI 0.20 to 0.77)
However, increasing intake to more than four servings did not result in additional benefit.
The relationship between cherry consumption and gout reduction was observed in both men (OR 0.68, 95% CI 0.51 to 0.91) and women (OR 0.48, 95% CI 0.27 to 0.83), as well as obese (OR 0.57, 95% CI 0.40 to 0.80) and normal weight (OR 0.72, 95% CI 0.49 to 1.04) participants.
Despite the benefits observed in this study, Allan C. Gelber, MD, of Johns Hopkins University, and Daniel H. Solomon, MD, of Harvard Medical School in Boston, warned in an accompanying editorial that patients with gout should not be advised to avoid conventional medications.
“We would not advocate on the basis of the current findings that those who suffer from gout attacks abandon standard therapies and opt for cherry extract products as an alternative,” they wrote.
They called for more rigorous randomized controlled clinical trials to support the efficacy of cherries and cherry extract before they can be widely recommended as alternative treatments.