Editor’s Note: Each month, HerbalEGram highlights a conventional food and
briefly explores its history, traditional uses, nutritional profile, and modern
medicinal research. We also feature a nutritious recipe for an easy-to-prepare
dish with each article to encourage readers to experience the extensive
benefits of these whole foods. With this series, we hope our readers will gain
a new appreciation for the foods they see at the supermarket and frequently
include in their diets. The American Botanical Council (ABC) would like to
acknowledge ABC Chief Science Officer Stefan Gafner, PhD, for his contributions
to this project.
By Hannah
Baumana and Jenny Perezb
a HerbalGram Associate Editor
b ABC Education
Coordinator
Overview
Known
for both their ornamental beauty and sweet and tart fruits, cherry (Prunus spp.) trees are among the 3,400
species that belong to the economically important rose (Rosaceae) family. This
botanical family also includes other fruit-bearing trees such as apples (Malus spp.) and pears (Pyrus spp.), as well as herbaceous perennials like
strawberries (Fragaria spp.) and brambles like blackberries (Rubus spp.) and raspberries (Rubus spp.).1
Cherry
fruits are produced by various trees and shrubs belonging to the subgenus Cerasus in the genus Prunus. (Cerasus is Latin for “cherry tree.”) The Prunus genus includes more than 430 known species, including
almonds (P. dulcis) and
pit-containing fruits such as plums (P. salicina),
apricots (P. armeniaca), and peaches
(P. persica).1 Species in
the subgenus Cerasus are
characterized by flowers that are arranged in small corymbs (not singly or in
raceme) and dark red fruits that are entirely smooth in appearance or have a
subtle groove along one side. The leaves of cherry trees are simple, typically
lanceolate, and unlobed with serrated margins, and their flowers are typically
white to pink with five petals and five sepals. The fruits are botanically
known as drupes: fleshy fruits surrounding a single stony seed. Of the 150
known species of cherries, the two most commonly grown commercially are the
wild or sweet cherry (P. avium) and
the sour cherry (P. cerasus).1
The
sour cherry is a hybrid between the sweet cherry and P. fruticosa, a wild cherry species.2
Sour
cherry trees are half the size of sweet cherry trees and grow to about 16 feet
tall.3 Cultivated sour cherry trees are thought to have ancient origins
from Armenia and areas near the western Caspian Sea.1 Throughout
Europe, the pits of wild cherry species have been uncovered in settlements that
date back to the Bronze Age (around 3200 BCE). Records indicate that by 800
BCE, cherry trees were being cultivated in Turkey.1 By 300 BCE, sour
cherry trees were being cultivated in Greece and spread throughout Europe
thereafter by the Romans.1,2
Sweet
cherry is derived from cultivars of a wild cherry native to temperate Europe
and Western Asia.1,2 Sweet cherry trees are large and can reach a
height of 36 feet. The tree’s white flowers appear in clusters of up to five.2
Unlike the sour cherry, sweet cherry requires cross-pollination for fruit
production, and therefore requires the planting of two or more cherry trees.2
The fruits of P. avium are firm,
heart-shaped to almost globular, and vary in color from yellow to red to
crimson-black. Unlike sour cherries, sweet cherries have a high sugar and low
acid content.1,3
Historical and Commercial Uses
The
cultivation of cherry trees became popular in the 16th century under King Henry
VIII of England. He and his gardener, Richard Harris, are commonly given credit
for improving cherry production by developing cultivars.1,4 The
“Kentish Red” cherry variety was one of two dozen cultivars developed by
Kentish growers by the mid-17th century and the first sour cherry variety
planted in Massachusetts when European colonists arrived in the Americas.1
Today, there are more than 1,000 cherry cultivars: approximately 900 sweet and
300 sour.4
Aside
from their fruits, various species of cherry trees have been grown for their
ornamental value (such as Japanese cherry [P.
serrulata], which is frequently depicted in Japanese art) and for fine
furniture and wood construction (such as black cherry [P. serotina]).1
Black
cherry bark traditionally was used by Native American, including the Cherokee,
Delaware, Iroquois, and Ojibwa, as a remedy for coughs and colds.5 Black
cherry bark contains prunasin, a cyanogenic glycoside that suppresses the cough
reflex.6 Western and European herbalists continue to use wild cherry
bark in small amounts as a cough suppressant and for lung support. The Cherokee
and Iroquois also used black cherry bark to treat diarrhea and “toxic” blood
conditions that were thought to contribute to rheumatoid arthritis, gout, and
allergic reactions.5
In Ayurveda
and traditional Chinese medicine, cherries are considered to be astringent and “blood-building,”
and the fruits are used to remove excess body acids and reduce blood
stagnation. In these systems of medicine, daily cherry consumption is indicated
for easing the pain and inflammation associated with gout, arthritis, and
rheumatism.7-9
ABC
Chief Science Officer Stefan Gafner recalled a non-therapeutic use of cherry
pits from his youth: “When I was young, cherry pit pillows were quite commonly
used in rural areas of Switzerland,” Gafner wrote (email, August 15, 2018). “We
used them mainly to protect our buttocks from overheating while sitting on the
wood stove.” Cherry pit pillows have been used as cold or hot compresses because
they have a natural inner air chamber surrounded by a heat-conducting outer
layer, which enables heat to be released slowly over time.
Phytochemicals and Constituents
Cherries
are considered a nutrient-dense, low-calorie fruit and provide important
nutrients such as beta-carotene, vitamins C and E, potassium, magnesium,
folate, iron, and fiber.9-11 A one-cup serving of pitted cherries
contains about 10.8 g of vitamin C, 3 g of fiber, and 342 mg of potassium.11
Cherry
fruit contains significant amounts of polyphenols and flavonoids, including
anthocyanins, hydroxycinnamic acid, and quercetin.10 When consuming
the whole fruit, there appears to be a synergy between the antioxidant effects
of vitamin C, carotenoids, and anthocyanins, and this is thought to contribute
to their health-promoting effects.9
Anthocyanins
are phenolic compounds that make up the largest group of water-soluble plant
pigments and give orange, red, and blue colors to vegetables, flowers, and
fruits.12,13 A dark fruit is indicative of a high anthocyanin
content.14 Sweet cherries have a higher anthocyanin content than
sour cherries, with cyanidin glycosides accounting for more than 90% of sweet
cherry’s total anthocyanin content.10,14 Cyanidin glycosides have
numerous health-promoting properties, including vasoprotection and inflammation
modulation, and they also provide anti-obesity and anti-diabetes benefits.15
Hydroxycinnamic
acid is an antioxidant substance that accounts for about 40% of the total
phenolic compounds present in cherries.10 Hydroxycinnamates can
reduce oxidative stress in the body, inhibit low-density lipoprotein (LDL)
oxidation and tumor growth, and decrease the formation of nitrosamines and
other mutagenic compounds.
In
addition, cherries are also a good source of tryptophan, serotonin, and melatonin,
which play important roles in mood balance and cognition.16 In
humans, melatonin has been shown to support regular sleep cycles and circadian
rhythm, and improve immune system function, and slow processes associated with aging.17
Melatonin has potent antioxidant properties and can freely cross cell
membranes, mitigating free radical damage both inside and outside the cell,
thereby significantly reducing oxidative stress.1,10,16-17 Melatonin
can increase plasma levels of interleukin 1β (IL-1β)
and tumor necrosis factor α (TNF α), both of which promote
non rapid-eye-movement (REM) sleep. Sour cherries have a higher level of
melatonin than sweet cherries.
Modern Research and Potential Health
Benefits
Long
considered a “superfruit,” cherry is associated with several health benefits. Research
on cherry’s bioactive compounds suggests that this fruit has the potential to prevent
cardiovascular disease, diabetes, and other chronic inflammatory diseases.
Oxidative
stress and inflammation are among the primary causes of chronic inflammatory
diseases, such as diabetes, heart disease, and arthritis.16 Cherry
consumption has been associated with reductions in oxidative stress,
inflammation, glucose modulation, and inhibition of uric acid production.10
Polyphenols, melatonin, carotenoids, and vitamins E and C all contribute to
cherry’s antioxidant and anti-inflammatory properties.16
Inflammation
A
2018 meta-analysis of clinical studies that assessed the benefits of cherry
fruit consumption found that sweet or tart cherry consumption was correlated with
reductions in oxidative stress and inflammation.16 In most human
studies, the daily dose of cherries ranged from 45 to 270 cherries (an
anthocyanin equivalent of 55-720 mg/day) and were served as either a single
dose or split into two or three doses, and the duration of studies ranged from
five hours to three months.16 Eleven of 16 clinical studies that
investigated the effects of cherry or cherry product consumption showed significant
decreases in inflammatory markers, including plasma C-reactive protein (CRP)
levels, TNF α, interleukin 6 (IL-6), interleukin 8
(IL-8), and nitric oxide (NO).16
The
cyanidin content in cherries has the ability to inhibit cyclooxygenase (COX)
enzymes, which perpetuate the inflammatory response.10 Many over-the-counter
(OTC) pain medications work by inhibiting COX-1 and COX-2 enzymes. When
compared to ibuprofen and the nonsteroidal anti-inflammatory drug naproxen, anthocyanins
derived from cherries were able to inhibit COX-1 and COX-2 inflammatory
cascades just as effectively as the OTC pain relievers.13 Of all
fruits tested for inflammation modulation, the anthocyanins derived from
raspberries and sweet cherries had the strongest inhibitory effects on COX-1 and
COX-2.13
Additionally,
cherry’s flavonoids have been shown to reduce oxidative stress and β-amyloid
plaque formation (a process believed to contribute to Alzheimer’s disease).10
Cherry’s phenolic compounds have a potential role in protecting neuronal cells
and thus neurological function as well.10
Cardiovascular Disease
Cardiovascular
disease is responsible for one in four deaths in the United States, killing
approximately 610,000 people annually.18 Diets rich in colorful, flavonoid-rich
fruits and vegetables are correlated strongly with a lower incidence of
cardiovascular disease. Additionally, fruits such as cherries that are high in
potassium have been shown to support cardiovascular health and can help reduce
risk of hypertension and stroke. Since 2006, Kelley et al. have evaluated the
effects of cherry anthocyanin compounds on heart health in multiple human
studies. Results indicate that individuals with cherry-enriched diets had reduced
triglycerides, total cholesterol, fasting glucose, and insulin levels, as well
as elevated high-density lipoprotein (HDL) levels and antioxidant capacity of
the blood.9
In
human studies that examined the effects of cherry consumption on blood
pressure, the greatest reductions in both systolic blood pressure (SBP) and diastolic
blood pressure (DBP) occurred when the doses were higher and less frequent.16
For example, with a 300 mL dose of cherry juice, both SBP and DBP decreased within
two hours, and blood pressure returned to baseline at six hours. However, when
doses were divided into three 100-mL increments at 0, 1, and 2 hours, there was
no decrease in either SBP or DBP at two or six hours. The reduction in blood
pressure was determined to be caused by a peak increase of circulating
anthocyanin metabolites in the blood.18
Elevated
CRP level is associated with and an increased risk of heart disease. In a 2006
clinical trial, healthy men and women who supplemented their diets for four
weeks with a daily dose of 280 g fresh cherries (equivalent to 45 fresh pitted cherries)
experienced a reduction in NO, a key regulator of vascular integrity, and a 24%
reduction in CRP levels. The authors noted that these changes may be associated
with a significant reduction in the risk of atherosclerosis.18,19
Exercise-Induced
Muscle Damage and Recovery
The
tart Montmorency cherry cultivar has been investigated in human studies for its ability to improve
muscle soreness and overall recovery from strenuous exercise.20 In a
clinical trial, athletes were able to more rapidly recover their strength when
consuming cherry juice post-marathon when compared to placebo. All
exercise-related studies evaluated by Kelley et al. used a tart cherry juice
concentrate that delivered a dose equivalent to approximately 50 to 270
cherries daily.16 Researchers concluded that the high concentrations
of anthocyanins in Montmorency tart cherries are responsible for reducing
post-exercise inflammatory and oxidative stress responses thereby protecting
athletes from decreased muscle function following strenuous exercise.21
For athletes who are required to perform in back-to-back competitions,
consuming tart cherry juice post-strenuous exercise may help maintain strength and stamina.
Diabetes
Oxidative
stress causes numerous complications in diabetic patients.
Antioxidants, such as quercetin and anthocyanins present in cherries, have the
potential to modulate these symptoms.10 Studies have shown that
anthocyanins play a role in reducing insulin resistance and glucose intolerance
as well as improve insulin secretion in response to varying glucose loads. Results
from human, animal, and in vitro studies
suggest that anthocyanins can decrease blood glucose by slowing glucose production
from complex carbohydrates, and this in turn reduces hepatic glucose output, decreases
glucagon production by pancreatic α cells, and increases
hepatic glucose uptake and insulin production by pancreatic β
cells.16
The
most commonly used method for monitoring the effectiveness of diabetes
treatments is to measure hemoglobin A1c (HbA1c) plasma values.12 In
human studies, the consumption of cherries and cherry products resulted in decreased HbA1c, very-low-density lipoprotein (VLDL), and triglyceride levels in
both diabetic and obese patients.16 A 2008 study of diabetic women
given 40 mL of tart cherry juice daily for six weeks demonstrated a significant
reduction in HbA1c and lowered fasting blood glucose (FBG) levels by 8%, though
FBG reduction was not statistically significant.16 Additionally,
when a 600 mg dose of anthocyanins was given daily to diabetic patients for two
months, the treatment appeared to prevent damage to blood vessels and
capillaries, as well as the abnormal protein production associated with retinopathy,
a serious complication of diabetes.9
The
glycemic index is used by the American Diabetes Association as a guide for
selecting fruits and vegetables that are metabolized more slowly, thus
preventing problematic fluctuations in blood glucose levels.22 Foods
with a low glycemic index release glucose slowly and steadily and, when
consumed regularly, help promote weight loss. Studies have shown that cherries
have a glycemic index of 22, which is fairly low for a fruit.10
Arthritis, Gout, and Associated Risk
Factors
One
of the earliest known human studies to explore the health benefits of cherry fruit
was conducted in 1950 on patients with gout.16 Results indicated that cherry
consumption helped reduce symptoms of arthritis and restore plasma uric acid
(UA) levels, and at least four of the patients reported greater mobility in the
joints of both fingers and toes. Subsequent studies by Jacob, et al. found that
cherry fruit consumption reduced blood levels of inflammatory and oxidative
stress markers. The plasma UA levels were significantly reduced at five hours post-consumption,
but not at 1.5 or three hours, when compared to baseline.23
In a 2003
pilot study designed to assess plasma urate levels before and after consuming
an anthocyanin-rich food, 10 healthy women ate a single 280-gram dose of pitted
sweet cherries and blood samples were collected at 1.5, three, and five hours
post-consumption. Five hours after consuming cherries, there was a significant
mean reduction in plasma urate levels, demonstrating a prolonged anti-inflammatory
effect that was not shown with grape (Vitis
vinifera, Vitaceae), strawberry (Fragaria
x ananassa, Rosaceae), or
kiwifruit (Actinidia deliciosa,
Actinidiaceae). 10,23
A crossover
study on 633 gout patients given fresh cherries or cherry
extract over a two-day period was correlated with a 35% lower risk of gout attacks
compared to those who consumed no cherries at all.17 When cherry
consumption was combined with allopurinol (Zyloprim; Prometheus Labs, Inc., San
Diego, California), a pharmaceutical medication used to reduce UA levels, there
was a 75% reduction in risk of gout attacks. Furthermore, participants who used
allopurinol and did not consume cherries experienced 792 hazard periods, a two-day
period of time prior to a recurrent gout attack, as opposed to 45 hazard
periods experienced by those who combined cherry consumption with allopurinol.17
Sleep, Mood, and Cognitive Function
A 2012
clinical trial was the first to report evidence that supplementation with tart
cherry juice may improve quality of sleep by increasing exogenous melatonin
available to the body.24 In a randomized, double-blind,
placebo-controlled crossover study, 20 healthy individuals consumed either
placebo or 30 mL tart Montmorency cherry juice diluted in 200 mL water twice
daily (within 30 minutes of waking and 30 minutes before the evening meal) for seven
days. Each 30 mL serving of tart cherry juice contained
90-100 tart cherries. The concentration of melatonin in the tart cherry juice
was equivalent to a dose of approximately 42.6 µg per serving or approximately 85.2
µg daily.24 Upon completion of the study, results indicated an
increase in circulating blood levels of melatonin, and participants reported
modest improvements in sleep time and quality of sleep.24,25 Studies
on melatonin supplementation for disturbed sleep patterns and insomnia indicate
that 0.5-5 mg is required daily.
Sweet
cherry consumption also has been studied for improving both quality and
quantity of sleep. Within three days of beginning the study, noticeable
effects on sleep were detected when patients consumed 141 g or 25 cherries
daily while the sleep enhancing effects of tart cherry consumption (240 mL tart
cherry juice or approximately 100 cherries daily) were not detectable until day
five. Studies using sweet cherries also reported improved mood, lowered anxiety,
and decreased urinary cortisol.16 These findings indicate that
cherry fruit or juice may be a natural sleep aid for those
suffering from chronic or situational insomnia.
Consumer Considerations
Fruits
and vegetables that have thin skins are prone to the potential accumulation of
pesticide residues. Cherries, with their thin, anthocyanin-loaded skin, are
listed among the 12 fruits and vegetables that have the highest pesticide
residues, according to the 2018 Shopper’s Guide to
Pesticides in Produce published by the consumer advocacy organization known
as the Environmental Working Group (EWG).26 According to its annually gathered data, conventionally grown cherries had an average of five
detectable pesticides. Additionally, 30% of cherry samples tested contained
iprodione, a carcinogenic pesticide that is banned in Europe.26 Due
to the cumulative nature of fat-soluble pesticide residues within the body,
purchasing and consuming organically grown cherries is strongly recommended
whenever possible.
The
levels of anthocyanins and phenolic compounds in cherries vary depending on
the cultivar, cultivation methods, ripening stages, harvest time, and
post-harvest handling and storage conditions.14 Depending on the
type of cherry cultivar, fresh sweet cherries can be stored in the refrigerator
for two to four weeks.14 After six months of freezer storage, more
than 75% of Bing cherry anthocyanins were lost. For canned cherry fruit, all
analyzed cultivars showed a 21-24% decrease in anthocyanin concentrations when processed
with heat, high acid, and sugar concentrations; however, about 50% of anthocyanins
and polyphenols were leached from the fruits into the syrup and were nonetheless
retained within the can.10 Despite the seasonal availability of
fresh cherries, modern processing techniques do not cause a significant loss in
total anthocyanins and phenols, allowing for year-round accessibility to the
benefits of cherries.27
Nutrient Profile11
Macronutrient Profile: (Per 1 cup pitted
cherries [approx. 154 g])
97 calories
1.63 g
protein
25 g carbohydrate
0.3 g
fat
Secondary Metabolites: (Per 1 cup pitted
cherries [approx. 154 g])
Very good source of:
Vitamin
C: 10.8 mg (12% DV)
Dietary
Fiber: 3.2 g (10.7% DV)
Good source of:
Potassium:
342 mg (7.3% DV)
Also provides:
Manganese:
0.11 mg (4.8% DV)
Vitamin
B6: 0.08 mg (4.7% DV)
Magnesium:
17 mg (4% DV)
Riboflavin:
0.05 mg (3.8% DV)
Thiamin:
0.04 mg (3.3% DV)
Iron:
0.55 mg (3.1% DV)
Vitamin
K: 3.2 mcg (2.7% DV)
Phosphorus:
32 mg (2.6% DV)
Vitamin
A: 99 IU (2% DV)
Calcium:
20 mg (1.5% DV)
Folate:
6 mcg (1.5% DV)
Niacin:
0.24 mg (1.5% DV)
Zinc:
0.11 mg (1.1% DV)
Provides trace amounts:
Vitamin
E: 0.11 mg (0.7% DV)
DV =
Daily Value as established by the US Food and Drug Administration, based on a
2,000-calorie diet.
Recipe: Cherry
Balsamic Shrub
Courtesy of Emily
Han28
Ingredients:
- 2
cups pitted sweet cherries
- 1
cup balsamic vinegar
- 1
cup white wine vinegar
- 1
vanilla bean, split
- 2
cups turbinado sugar
Directions:
- Place
the cherries in a bowl and lightly crush them using a potato masher or a
fork. Transfer the cherries and their juices to a sterilized quart jar.
- Pour
both vinegars into the jar with the cherries and add the vanilla bean, making
sure that the cherries and vanilla are completely submerged.
- Cover
the jar with a nonreactive lid and store in a cool, dark place for one week,
shaking daily and ensuring that the fruit stays submerged.
- Strain
mixture through a fine mesh strainer and discard the solids. Combine vinegar
mixture with sugar. Cover and refrigerate for another week, shaking daily to
help dissolve sugar. Store in the refrigerator for up to a year.
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Image credits (top to bottom): Sour cherry fruit on the tree. ©2018 Steven Foster.
Illustration of cherry by Carl Axel Magnus Lindman from Bilder ur Nordens Flora, 1901. Sour cherry fruit. ©2018 Steven Foster.
Cherry tree in bloom. Image courtesy of Benjamin Gimmel. Sour cherry fruit. ©2018 Steven Foster. References
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RA, Spinozzi GM, Simon VA, et al. Consumption of cherries lowers plasma urate
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Dirty Dozen. Environmental Working Group website. Available at: http://www.ewg.org/foodnews/dirty-dozen.php
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