Which are More Anti-Inflammatory: Sweet Cherries or Tart Cherries?

Anti-inflammatory life is a bowl full of cherries

Haggis, the national dish of Scotland, is a savory pudding of heart, liver, lungs, and oatmeal traditionally stuffed inside of a stomach. When that stomach goes into our own stomach, our digestive enzymes and stomach acid have no problem digesting it away. How do our bodies digest the stomach lining of a sheep on our plate without digesting our own stomach linings? It’s meat and we’re meat.  So, why don’t we digest our own stomach every time we eat?

Partly because we have an enzyme called cyclooxygenase (COX) that protects the lining of our stomach. There are two types, COX-1 and COX-2. COX-1 is thought to be the primary protector of our stomach, whereas COX-2 is an enzyme responsible for pain and inflammation. In fact, anti-inflammatory drugs like ibuprofen and naproxen work by inhibiting the COX-2 enzyme. But these are non-selective drugs; so, in addition to inhibiting COX-2 they also inhibit COX-1, which is trying to protect our stomach linings. Thus, although drugs like ibuprofen are great at relieving pain and inflammation, they kill thousands every year due to ulcerations through the stomach wall that result in life-threatening bleeding and perforation.

What are the risks on an individual level? On average, one in about 1,200 people who take this class of drugs for at least two months will die as a result. To put this into perspective, we can compare the death rate from anti-inflammatory drug side-effects to the risks associated with some well-known events. For example, it may be safer to go bungee jumping a few hundred times.

What we need is a selective COX-2 inhibitor, inhibiting the pain and inflammation of COX-2 without inhibiting the stomach protection of COX-1. We thought we got it with Vioxx, a blockbuster drug that brought in billions in profits before it started killing tens of thousands of peoples. Internal emails reveal how the drug manufacturer responded to the revelation that they were killing people:  They drew up a list of doctors who were trying to warn people to “neutralize” them. If that didn’t work, they tried to discredit them (You can see the emails in the video, Anti-inflammatory Life Is a Bowl of Cherries).

We’re left then with two options: death from internal bleeding from one type of drug or death from side effects from another type of drug. If only there was some sort of natural COX-2 inhibitor. There is: cherries, which unlike ibuprofen suppress COX-2 more than COX-1.

In videos I did on insomnia and reducing muscle soreness (See Tart Cherries for Insomnia and Reducing Muscle Soreness with Berries), I talked about the benefits of sour cherries, the types of cherries used in baking. But sweet cherries, the kind you eat fresh, seem to be the MVP for COX-2 inhibition. Tart cherries had less of an effect. Regular red sweet cherries (Bing sweet cherries) were shown to have a greater anti-inflammatory activity than tart cherries. This makes sense since we think it may be the anthocyanin phytonutrients, and there are much more in sweet red cherries than in tart, and nearly none in yellow Rainer cherries.

Because fresh cherries have limited availability, what about other cherry products? In terms of anthocyanin phytonutrients, fresh is best, but frozen would appear to be the second-best choice.

Here are two ways I incorporate cherries into my diet:

Other studies in which anti-inflammatory drugs were compared to natural dietary remedies include: Turmeric Curcumin and Osteoarthritis and Turmeric Curcumin and Rheumatoid Arthritis.

Anti-inflammatory activity in a test tube is one thing, but can cherries actually be used clinically to treat inflammatory diseases? See Gout Treatment with a Cherry on Top.

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death, More Than an Apple a Day, From Table to Able, and Food as Medicine.

Image Credit: Valdemar Fishmen / Flickr

  • Leslie

    Dr., you recently did a piece on the detrimental role of sulfur on cancer, health, etc., sulfur from eggs, meats and such. Do you think there is reason to be concerned about the large amount of sulfur that are sprayed on organic grape crops? This is legal, and widely used in the organic farming industry for grapes.

    Is this harmful, long term, for the consumer of lots of organic grapes? Is it even “natural”? Sometimes natural and organic farming methods seem somewhat dangerous to me. And in light of you recent post on this sulfur topic…

    • Joseph Gonzales R.D.

      There may be, as he does present videos on organic foods and pesticides. I think the amount of spraying done on organic crops is negligible and would not pose a risk.

  • charles grashow

    I absolutely LOVE certain fruits in my smoothies! Cherries, blueberries, pineapple – all anti-angiogenesis foods

    Dietary sources of naturally occurring antiangiogenic sunstances

    Can we eat to starve cancer?

    • LG King

      Charles, Thanks for that…good video!

  • Sv

    Oh this is great! I learned about cherries n muscle soreness from a body builder…I had auditioned for my college dance team (rass a forme of Indian dance that is very intense) n had to go through several rounds…I was pretty unfit to start off so my body was extremely sore I couldn’t even walk up a flight of stairs or move too much….the competitive body builder who was in my class noticed n suggested cherries…two glasses of cherry juice later I was as good as new!! But he talked about how this wouldn’t work if I drank it every time I had muscle soreness? Something about my body n muscles getting used to the effects? Would this be true?

    • Joseph Gonzales R.D.

      Gosh, I am just not sure if the body would get “used” to it, but I do know other fruits and even beta-glucan fiber and spices like turmeric may also help athletic performance. We have so many videos on food like peppermint, beets, etc that may help. The link I added will take you to them all. Keep up the training!

  • Cathy Katin-Grazzini

    So, according to the research reported in “Cherries and health: a review”, sweet cherries inhibit both COX-2 and COX-1, although according to Dr. Greger, less for COX-1 than 2. I can’t access the data in the study, but wonder if one wants to use cherries therapeutically to reduce inflammation/pain, is there a safe daily limit one should be aware of?

    • David Johnson

      Good question! I take 2 TBL of tart cherry concentrate each night (equivalent to about 80 cherries) and have been assuming that’s safe.

    • Joseph Gonzales R.D.

      Hard to give an exact amount because this was a cell study looking at COX activity. I don’t think there is a limit to how many cherries one can eat. Dr. Greger has this video showing tons of fruits appears fine so I assume large amounts are safe.

      • monika

        Thank you Dr. Gonzales.

      • Cathy Katin-Grazzini

        Thanks! Yes, it was only cherries unusual (as far as I know) propensity to suppress COX 1 activity that prompted me to ask.

  • monika

    Thanks, Dr. Greger, for this info! I mistakenly thought the sour cherries were the best for gout and inflammation.

    • David Johnson

      Me too, I take 2 TBL per day (at night) of concentrated tart cherry with decafe coffee and take vitamin C to reduce my uric acid level. My uric acid level is now normal at 5.2; it had been high normal 6.4 when I had a gout attack and started this regimen, but I don’t really know what has caused the drop.

      Now I am left wondering if this amount could adversely affect my stomach but sinceI have not experienced any problems in over 6 months, I’d guess not.

    • Joseph Gonzales R.D.

      They still may be better for insomnia! I guess both types have their role :-)

  • Tikiri

    Thanks for this. Next time I’m not well, I will go bungee jumping. It gives that natural “drug,” adrenaline and the rush is incredible, unforgettable. And if my family asks, I will say Dr’s orders. :)

  • Johanna Martin

    Thank you for posting this, Dr. Greger!

  • Guest

    If it’s the anthocyanins that relieve inflammation and pain, then cherries are only average compared to many other fruits and vegetables. Cherries only have 350- 400 mg of anthocyanins per 100 g, while choke berries have 2,147; elderberries: 1,993; purple corn: 1642; red grape: 888; black raspberries: 845; eggplant:750; wild blueberries: 705; blackcurrants: 533; cultivated blueberries: 529; Marion blackberries:433; red raspberry 365 blackberries: 353; acai berries: 320; oranges: 200; concord grape 192; cranberries 133; red radish:116; red cabbage 113; black plum: 82; Strawberry: 69; red onion:39.

    • Wegan

      Thank you. I threw up every time I put elderberries in my smoothie or ate them wild. Then I learned they are toxic unless they are cooked.

  • Melinda

    I take it that dried Bing cherries are also beneficial?

  • Maryse

    A new plum has been developed accidentally by the CSIRO here in Australia. Meant to be high in anthocyanins.
    Here’s the link http://www.abc.net.au/landline/content/2015/s4180101.htm