LAMB, Kirstie Louise (2022). Investigating dietary recommendations, particularly tart cherries, in gout and cardiovascular disease management. Doctoral, Sheffield Hallam University.
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Lamb_2023_PhD_InvestigatingDietaryRecommendations.pdf - Accepted Version
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Lamb_2023_PhD_InvestigatingDietaryRecommendations.pdf - Accepted Version
Available under License Creative Commons Attribution Non-commercial No Derivatives.
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Abstract
Gout is a painful form of inflammatory arthritis that affects approximately 3% of
adults in the United Kingdom (UK). It is associated with several comorbidities
including cardiovascular disease (CVD). Diet can contribute to the prevention and
management of gout and several evidence-based dietary guidelines for gout
have consequently been published. Nevertheless, gout patients may use
alternative sources for dietary recommendations, for example YouTube® videos.
One dietary recommendation that has received considerable attention in the
prevention and management of gout is the consumption of cherries, but evidence
supporting this is limited to observational research and studies without
appropriate controls. Therefore, over three studies, this thesis aimed to explore
the role of dietary modification in the prevention and management of gout and
CVD, with a particular focus on tart cherries.
In Study 1, the accuracy, reliability, quality, and understandability of dietary
information for gout provided on the YouTube® platform was assessed. This study
highlighted that dietary recommendations for gout on YouTube® often fail to align
with evidence-based guidelines in the UK, are inconsistent, and are not always
suitable for patients. Almost 30% of videos analysed included advice to consume
cherries. Study 2 compared the acute effects of tart cherry juice with a neutral
water control on uric acid levels, inflammation, and CVD risk markers in healthy
individuals. A single serving of juice was not found to exert any acute health
benefits. However, diurnal fluctuations in markers were detected. The effects of
12 months of daily tart cherry supplementation on gout flares, uric acid levels,
inflammation, and CVD risk in gout patients were evaluated in Study 3. Compared
with a placebo drink, long-term tart cherry supplementation did not present any
health-promoting benefits for gout or CVD. This study was limited by low sample
size. Nevertheless, long-term cherry juice supplementation was shown to be
feasible and accepted by individuals with gout.
Overall, this thesis is unable to support a direct role of tart cherry juice in the
prevention and management of gout and CVD, despite the prevalence of this
recommendation. However, it appears to be an appropriate alternative to drinks
that are known to exacerbate risk marker of gout and CVD. Placebo-controlled
studies with larger sample sizes are required to confirm these findings.
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