By Dr. Mercola
Painful, stiff and inflamed joints are a few of the characteristic symptoms of gout, which is a type of arthritis that is typically, but not always, located on your great toe.
When an attack occurs, the pain can be debilitating, with sufferers often describing it as being burned by a flame or skewered with a hot poker.
Gout symptoms usually go away within three to 10 days, and the next attack may not occur for months, or even years, if at all. However, oftentimes gout becomes a lifelong problem, with attacks occurring with increasing frequency and severity. In time, this can permanently damage your joints and surrounding areas.
Needless to say, preventing gout attacks is essential to maintaining your quality of life – which is why new research showing cherries might do the trick is worth shouting from the rooftops.
10-12 Cherries a Day Can Reduce Gout Attack Risk
In a study of over 600 people with gout, those who ate a ½-cup serving of cherries a day, the equivalent of about 10 or 12 cherries, or consumed cherry extract, had a 35 percent lower risk of a subsequent gout attack.1 Those who ate more cherries, up to three servings in two days, had an even lower, 50 percent reduction in risk.
It might seem strange that cherries would lower your risk of gout, as this condition is often associated with sugar, fructose and fruit juice consumption. But you only need to eat a small amount of cherries to get the benefit, meaning the sugar contribution is small. Plus, they contain powerful compounds like anthocyanins and bioflavonoids, which are known to fight inflammation. They may also be beneficial because of their impact on your uric acid levels.
Gout occurs when the metabolic processes that control the amount of uric acid in your blood fail to do their job effectively. The stiffness and swelling are a result of excess uric-acid-forming crystals in your joints, and the pain associated with this condition disease is caused by your body's inflammatory response to the crystals. Past studies have found:
- Eating two servings of cherries after an overnight fast lead to a 15 percent reduction in uric acid, and lower nitric oxide and C-reactive protein levels (which are associated with inflammatory diseases like gout.)2 The researchers noted the study supports "the reputed anti-gout efficacy of cherries" as well as "evidence that compounds in cherries may inhibit inflammatory pathways."
- Consuming tart cherry juice daily for four weeks may lower your levels of uric acid3
Fructose and Uric Acid: If You Have Gout, You Need to Know The Connection
Drinking just one soda or 6-ounce glass of orange juice a day has been linked to a significant increase in gout – 74 percent and 41 percent, respectively – compared to drinking these only rarely.4 We believe the primary culprit is fructose, which typically generates uric acid within minutes of ingestion. You probably already know that fructose is a sugar, but you may not realize is that it's distinctly different from other sugars as it's metabolized through very specific pathways that differ from those of glucose, for example, and through its distinct metabolic action, uric acid is generated.
For those of you who maintain that "a sugar is a sugar is a sugar," fructose -- and fructose ALONE -- drives up uric acid. And elevated uric acid levels are not only a factor in gout, they're a factor in many other health conditions, including hypertension, insulin resistance/diabetes, obesity and kidney disease. Not coincidentally, may of these conditions, like diabetes and hypertension, also increase your risk of gout (as does the use of thiazide diuretics, which are commonly used to treat hypertension).
The connection between fructose consumption and increased uric acid is so reliable that a uric acid level taken from your blood can actually be used as a marker for fructose toxicity. I now recommend that a uric acid level be a routine part of your blood screening. According to the latest research, the safest range for uric acid is between 3 and 5.5 milligrams per deciliter, and there appears to be a steady relationship between uric acid levels and blood pressure and cardiovascular risk, even down to the range of 3 to 4 mg/dl. As you probably know, two-thirds of the U.S. population is overweight, and most of these people likely have uric acid levels in excess of 5.5. Some may even be closer to 10 or higher (this may explain why being overweight also increases your risk of gout). Dr. Richard Johnson, professor of medicine at the University of Colorado, suggests that the ideal uric acid level is probably around:
- 4 mg/dl for men
- 3.5 mg/dl for women
You can find out more about how uric acid in your blood can cause not only gout but also wreak havoc on your blood pressure, insulin production and even kidney function in the interview with Dr. Johnson below.
What are the Top Tips for Preventing and Managing Gout?
Be careful not to overdo it on cherries. I know from personal experience because they are my favorite fruit and I could easily eat a pound of them in one sitting. They key is moderation, as large amounts of fructose on a regular basis are not a good strategy for health. Fortunately, they have a relatively short harvest season and are not a temptation for too long.
According to Dr. Johnson's research, a quarter of the U.S. population consumes a whopping 134 grams of fructose a day. This is a staggering amount of fructose when you consider the fact that you need to restrict your fructose intake to below 25 grams a day in order to maintain good health.
If you have gout, this is extremely important, and you must take into account the fructose you consume from fruit. For instance, if you eat cherries for their therapeutic value, 10 sweet cherries or 1 cup of sour cherries contain about 4 grams of fructose. The fructose level of other fruits are listed in the graphic below.
So if you had no other sources of fructose 25 cherries would put you at 10 grams of fructose. You would need to eat more than 60 cherries to put you over the limit. My guess is that if you only did this occasionally and did not have insulin resistance this would likely not be a problem. However, you would activate your fat switch and put on some storage fat. But that is ok as you have the metabolism designed to burn it, especially if you are not consuming cherries every day.
Limiting fructose in your diet is one of the most important parts of managing and preventing gout attacks, and you can find a simple guide for doing so using my nutrition plan. You'll want to be sure to cut out soda, fruit drinks and other sweetened beverages, as these types of drinks are a primary source of excessive fructose. Instead, drink plenty of pure water, as the fluids will help to remove uric acid from your body.
Alcohol in general, and beer specifically, may also raise the levels of uric acid in your blood, so this should also be limited or avoided.