Review The role of cherries in exercise and health P. G. Bell 1 , M. P. McHugh 2 , E. Stevenson 1 , G. Howatson 1,3 1 Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK, 2 Nicholas Institute of Sports Medicine andAthletic Trauma, Lenox Hill Hospital, New York, New York, USA, 3 Water Research Group, School of Environmental Sciences and Development, Northwest University, Potchefstroom, South Africa Corresponding author: Glyn Howatson, PhD, Faculty of Health and Life Sciences, Northumbria University, Northumberland Building, Newcastle upon Tyne NE18ST, UK. Tel: +44 (0)191 243 7018, Fax: +44 (0)191 227 4713, E-mail: glyn.howatson@northumbria.ac.uk Accepted for publication 26 April 2013 Recently, cherries and cherry products have received growing attention within the literature with regard to their application in both exercise and clinical paradigms. Reported to be high in anti-inflammatory and anti- oxidative capacity, cherries and their constituents are proposed to provide a similar but natural alternative akin to over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) or analgesics. Within exercise para- digms, concern has been raised with regard to the use of products, which inhibit such inflammatory or oxidative actions, because of the possibility of the blunting of physiological training adaptations. Despite this, numer- ous scenarios exist both within exercise and clinical populations where a goal of optimal recovery time is more important than physiological adaptation. This review critically evaluates and discusses the use of cher- ries as a supplementation strategy to enhance recovery of muscle function, inhibit exercise-induced inflammation, oxidative stress, and pain primarily; furthermore, the potential application of cherries to clinical populations is discussed. Research into supplementation with “functional foods” in health and exercise science has gained momentum in recent years. Beetroot juice (Bailey et al., 2009, 2010; Ferreira & Behnke, 2010; Vanhatalo et al., 2010; Lansley et al., 2011a,b), purple sweet potatoes (Chang et al., 2007, 2010), blueberries (Sanchez-Moreno et al., 2008; McAnulty et al., 2011), pomegranate juice (Trombold et al., 2010, 2011), green tea (Eichenberger et al., 2010; Jowko et al., 2011), lychee extract (Nishizawa et al., 2011; Kang et al., 2012), and cherries (Connolly et al., 2006; Ducharme et al., 2009; Howatson et al., 2010, 2011a, b; Kuehl et al., 2010; Bowtell et al., 2011) have received varying degrees of attention in rela- tion to their purported applications. The last of these, cherries, have provided several avenues for research because of the high levels of bioactive compounds present within them and have been compared favorably with other functional foods. More specifically, both sweet and tart cherries contribute to dietary fiber intake and contain high levels of antioxidants such as melato- nin, carotenoids, hydroxycinnamates, and several fla- vonoid groups including anthocyanins, as well as the flavonol quercetin (McCune et al., 2011). Bioavailability of these potent phytochemicals has been shown to differ depending upon food source and dose (Manach et al., 2005). Reports suggest that quercetin metabolites have a slow elimination rate, with half-lives ranging from 11 to 28 h reported, and as a result, plasma accumulation may be possible with multiple doses (Manach et al., 2005). Conversely, anthocyanins are rapidly absorbed with poor efficiency and are quickly eliminated (Manach et al., 2005). Although it has been suggested that anthocyanins may be efficiently absorbed into the gastrointestinal tract tissue efficiently, with the subsequent transport into the circulation being the point at which overall dose effi- ciency decreases (Wallace, 2011).Additionally, the food matrix and gut microflora may also play a significant role in the metabolism, absorption, and subsequent bio- availability of anthocyanins (Manach et al., 2005; Wallace, 2011). A detailed review has recently been pro- vided by McCune et al. (2011) outlining specific nutri- tional properties of cherries. Such antioxidants have been demonstrated to be: (a) proficient in the reduction of cell damaging oxidative stress (Wang et al., 1997, 1998, 1999; Boyle et al., 2000; Bitsch et al., 2004; de Boer et al., 2005; Traustadottir et al., 2009); (b) high in anti-inflammatory capacity (Howatson et al., 2010; Kelley et al., 2006; Seeram et al., 2001); and (c) inhibit uric acid production (Jacob et al., 2003), which, although is a powerful antioxidant, is also implicated in the development of gouty arthritis (Schlesinger & Schlesinger, 2012; Zhang et al., 2012; Kelley et al., 2013). Resultantly, cherries have been implicated in their use as a natural nutritional supplement Scand J Med Sci Sports 2013: ••: ••–•• doi: 10.1111/sms.12085 © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd 1