Twice-daily Montmorency tart cherry juice supplementation may provide clinical benefits for patients with mild to moderate ulcerative colitis, suggest findings from a recent UK-based randomized controlled trial.
Researchers from the University of Central Lancashire and University of Hertfordshire conducted the 6-week parallel-group study, and revealed significant improvements in quality-of-life scores and reductions in disease activity markers among participants consuming tart cherry juice compared with placebo. Results were published in the February 2025 issue of the journal Life.
The trial's primary outcome, assessed using the Inflammatory Bowel Disease Quality of Life Questionnaire (IBDQ), showed statistically significant improvements in the tart cherry group compared to placebo. This improvement exceeded the 16-point threshold considered clinically meaningful.
"Given the profoundly negative effects of ulcerative colitis (UC) on health-related quality of life and its fiscal implications for global health care systems, this trial indicates that twice-daily tart cherry supplementation can improve IBD-related quality of life as well as the severity of symptoms and therefore may be important in the management of UC," the authors stated.
Simple Clinical Colitis Activity Index (SCCAI) scores also showed significant improvements in the tart cherry group vs the placebo group.
Notably, fecal calprotectin—a gold standard biomarker for intestinal inflammation—showed significantly greater reductions in the tart cherry group compared to placebo.
Study Background, Design, and Administration
UC treatments often involve pharmaceuticals with significant side effects. The authors noted that while 5-aminosalicylic acid shows efficacy among patients with mild to moderate disease, adherence rates typically range between only 40% and 50%, and side effects can include hepatitis, pancreatitis, nephritis or nephrotoxicity, and pulmonary dysfunction.
The researchers enrolled 37 participants with mild-to-moderate UC, defined as a Mayo Clinic Score between 3 and 10. Of these, 35 completed the study (18 in the tart cherry group and 17 in the placebo group). Patients were randomized to receive either 60 mL of Montmorency tart cherry concentrate or placebo daily, consumed in two 30 mL servings diluted with water.
The tart cherry supplement contained approximately 9.117 mg/mL of anthocyanins and 6.63 total phenolics/mL (expressed as gallic acid equivalents). Compliance was high (95.8% in the tart cherry group), and the blinding strategy was effective, with no statistically significant differences in loss to follow-up or adverse events between groups.
Potential Mechanisms and Considerations
The authors suggest Montmorency tart cherry supplementation may mediate reductions in intestinal inflammation and promote histologic healing. "These benefits may also be attributed to gut microbiota–derived metabolites produced in response to tart cherry supplementation," they noted. "Polyphenols in tart cherries are metabolized by gut bacteria into bioactive compounds with anti-inflammatory and antioxidant properties."
However, despite these proposed mechanisms, the study found no significant differences in gut microbiota alpha diversity (P = .46) or beta diversity (P = .32) between the groups.
Dietary analyses revealed a statistically significant increase in sugar intake in the tart cherry group compared to the placebo group. This observation deserves consideration, emphasized investigators, as previous research has demonstrated connections between IBD and diabetes as well as associations between sugar intake and IBD risk and symptom exacerbation.
The researchers acknowledged several limitations of the study, including the small sample size and lack of stratification for participants' current medical therapy, which may have influenced the variability in responses to tart cherry supplementation. Additionally, the study relied on self-reported disease activity rather than clinician-verified assessments, which could introduce variability in patient classification.
This study represents the first randomized placebo-controlled trial examining Montmorency tart cherry supplementation in patients with UC, providing preliminary evidence for its potential as a complementary therapeutic approach.
