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Milestones in cranberry health research
Since 1984, many studies have indicated that cranberries may have
a number of health benefits, the foremost being its “anti-adhesion”
effect on certain bacteria. Ocean Spray Cranberry Juice Cocktail
contains natural cranberry compounds called proanthocyanidins, which
are the compounds believed responsible for the anti-stick mechanism
that helps maintain urinary tract health. In other words proanthocyanidins
“disable” certain harmful bacteria in the body, so the
“bugs don’t stick.”
The first scientific findings on cranberry were related to urinary
tract health. Emerging science suggests that cranberries may also
be helpful protectors of our health in other areas of the body.
While this research is still in the early stages, it is exciting
to consider the cranberry’s importance as a promising tool
to help fight bacteria naturally.
May 1984 – Journal of Urology
While trying to account for cranberry juice’s unique urinary
tract health benefits, Youngstown State University researchers demonstrate
that the benefits may be related to the cranberry’s ability
to inhibit bacteria from adhering to the walls of the urinary tract.
The researchers found that 15 ounces of cranberry juice cocktail
significantly inhibited the E. coli bacteria, which cause
80 to 90 percent of UTIs, from adhering to urinary tract cells.
- Sobota AE. Inhibition of bacterial adherence
by cranberry juice: potential use for the treatment of urinary tract
infections. The Journal of Urology 1984; 131: 1013-1016.
May 1991 – The New England Journal of Medicine
Tel Aviv University researchers also describe the anti-E. coli
adherence property of cranberry juice and attempt to identify the
specific components in cranberries that cause this beneficial effect.
They conclude that a compound in cranberries of an “unknown
nature” prevents certain E. coli from adhering to
the bladder’s lining. Orange, pineapple, mango, guava and
grapefruit juices did not possess this anti-adhesion property.
- Ofek I, Goldhar J, Zafriri D, Lis H, Adar R,
Sharon N. Anti-Escherichia coli adhesion activity of cranberry
and blueberry juices. New England Journal of Medicine 1991;
324: 1599.
March 1994 – Journal of the American Medical
Association
Harvard Medical School researchers conduct the first well-controlled,
large-scale clinical trial to demonstrate that drinking cranberry
juice cocktail regularly, significantly reduced the presence of
bacteria in the urine. The researchers found that the effect was
not because of more acidic urine (the urine of the cranberry juice
drinkers was no more acidic than those drinking a non-cranberry
placebo drink) and speculated that there was something specific
in cranberry that prevented bacteria from adhering to the urinary
tract. This research was conducted with 153 women, average age of
78, using 10 ounces of Ocean Spray Cranberry Juice Cocktail, which
contained 27 percent cranberry juice.
- Avorn J, Monane M, Gurwitz JH, Glynn RJ, Choodnovskiy
I, Lipsitz LA. Reduction of bacteriuria and pyuria after ingestion
of cranberry juice. Journal of the American Medical Association
1994; 271: 751-754.
1997 – Journal of Family Practice
In a small, double-blind clinical trial, researchers from Weber
State University found that sexually active women between the ages
of 18 and 45 who daily consume a cranberry dietary supplement (from
spray-dried cranberry juice) for six months had a significantly
lower risk of UTIs than women taking a placebo.
- Walker EB, Barney DP, Mickerlsen JN, Walton
RJ, Mickelsen RAJr. Cranberry concentrate: UTI prophylaxis. The
Journal of Family Practice 1997; 45: 167-168.
October 1998 - The New England Journal of Medicine
Rutgers-led scientists identify the active components in cranberries
responsible for maintaining urinary tract health as proanthocyanidins
or condensed tannins. The researchers concluded that the cranberry
Vaccinium proanthocyanidins in cranberry juice are responsible
for promoting urinary tract health.
- Howell AB, Vorsa N, Marderosian AD, Foo LY.
Inhibition of the adherence of p-fimbriated Escherichia coli to
uroepithelial-cell surfaces by proanthocyanidin extracts from cranberries.
The New England Journal of Medicine 1998; 339: 1085.
April 2001 – Federation of American Societies
for Experimental Biology
Research led by Rutgers University researchers presented at Experimental
Biology 2001 confirms that cranberry Vaccinium proanthocyanidins
are absorbed in the body. This suggests that once cranberry proanthocyanidins
are absorbed into the bloodstream they become available to other
sites throughout the body and may function as anti-adhesion agents
and/or antioxidants. For the first time, in vivo research
helps confirm the role of cranberry compounds as the active compounds
responsible for anti-adhesion of certain E. coli bacteria
in the urinary tract. An animal model was used to perform this research.
- Howell AB, Leahy M, Kurowska E, Guthrie N. In
vivo evidence that cranberry proanthocyanidins inhibit adherence
of p-fimbriated E. coli bacteria to uroepithelial cells.
Federation of American Societies for Experimental Biology Journal
2001; 15: A284.
June 2001 – British Medical Journal
Research from the University of Oulu, Finland, found that regular
consumption of a cranberry juice beverage reduced the recurrence
of UTIs by about half, in women studied. One hundred and fifty women
who have had at least one UTI in their lifetime with the median
age of 30 were used in this study. This adds to the body of research
supporting cranberry's preventative role with these infections.
- Kontiokari T, Sundqvist K, Nuutinen M, Pokka
T, Koskela M, Uhari M. Randomised trial of cranberry-lingonberry
juice and Lactobacillus GG drink for the prevention of
urinary tract infections in women. British Medical Journal
2001; 322: 1571-1575.
April 2002 - Federation of American Societies for Experimental
Biology
Researchers from the Rutgers and the University of Wisconsin investigated
the anti-adhesion effects of cranberry juice cocktail versus other
foods that contain proanthocyanidins (PACs). In this human study,
they found that only consumption of cranberry juice cocktail resulted
in urine with microbial anti-adhesion activity. Grape and apple
juices, green tea and chocolate were also tested and did not produce
this anti-adhesion activity. The researchers found that cranberry
proanthocyanidins contained a unique structural feature that may
account for this unique microbial anti-adhesion property.
- Howell AB, Reed J, Winterbottom R, Krueger C.
Bacterial anti-adhesion activity of cranberry vs. other foods. Federation
of American Societies for Experimental Biology 2002.
June 2002 – The Canadian Journal of Urology
A University of British Columbia urologist found use of cranberry
juice and tablets with increased fluid intake are more effective
than fluids alone in preventing UTIs in women studied. Forty percent
fewer women experienced UTIs when receiving cranberry products vs.
placebo, and on average had half the number of UTIs. Antibiotic
use was less in the cranberry groups vs. placebo. The researcher
recommended that cranberry products be offered as an option in the
management of recurrent UTIs.
- June 2002 - Stothers L. A randomized trial to
evaluate effectiveness and cost effectiveness of naturopathic cranberry
products as prophylaxis against urinary tract infection in women.
The Canadian Journal of Urology 2002; 9: 1558-1562.
June 2002 – Journal of the American Medical Association
Findings by researchers suggest that regular consumption of cranberry
juice cocktail may offer protection against certain antibiotic resistant
bacteria that cause urinary tract infections (UTIs). This latest
research, conducted jointly between Rutgers and The University of
Michigan, suggests that regular consumption of cranberry juice cocktail
could reduce the potential for development of UTIs, thus decreasing
the rate of antibiotic resistance.
- Howell AB, Foxman B. Cranberry juice and adhesion
of antibiotic-resistant uropathogens. Journal of the American
Medical Association 2002; 287.
March 2003 - American Journal of Clinical Nutrition
Research from the University of Oulu, Finland, found frequent consumption
of fresh berry juices to be associated with lowered risk for recurrence
of UTIs. Dietary habits seem to be an important risk factor for
UTI recurrences in women, and dietary guidance could be a first
step towards prevention.
- Kontiokari T, Laitinen J, Jarvi L, Pokka T,
Sundqvist K, Uhari M. Dietary factors protecting women from urinary
tract infection. American Journal of Clinical Nutrition
2003; 77: 600-604.
January 2004 - Cochrane Database Systematic Reviews
- Urinary Tract Health
The Cochrane Collaboration published a research review, concluding
that there is some evidence that cranberry juice may decrease the
number of symptomatic UTIs in women. The Cochrane Collaboration
is a non-profit organization based in the UK whose mission is to
help people make well informed decisions about healthcare by developing
systematic reviews of the effects of healthcare interventions.
RESEARCH REFERENCES:
CLINICAL RESEARCH
- Avorn J, Monane M, Gurwitz JH, Glynn RJ,
Choodnovskiy I, Lipsitz LA. Reduction of bacteriuria and pyuria
after ingestion of cranberry juice. Journal of the American
Medical Association 1994; 271: 751-754.
- Walker EB, Barney DP, Mickerlsen JN, Walton RJ, Mickelsen RAJr.
Cranberry concentrate: UTI prophylaxis. The Journal of Family
Practice 1997; 45: 167-168.
- Kontiokari T, Sundqvist K, Nuutinen M, Pokka T, Koskela M, Uhari
M. Randomised trial of cranberry-lingonberry juice and Lactobacillus
GG drink for the prevention of urinary tract infections in women.
British Medical Journal 2001; 322: 1571-1575.
- Stothers L. A randomized trial to evaluate effectiveness and cost
effectiveness of naturopathic cranberry products as prophylaxis
against urinary tract infection in women. The Canadian Journal
of Urology 2002; 9: 1558-1562.
MECHANISTIC RESEARCH
- Sobota AE. Inhibition of bacterial adherence
by cranberry juice: potential use for the treatment of urinary tract
infections. The Journal of Urology 1984; 131: 1013-1016.
-Ofek I, Goldhar J, Zafriri D, Lis H, Adar R, Sharon N. Anti-Escherichia
coli adhesion activity of cranberry and blueberry juices. New
England Journal of Medicine 1991; 324: 1599.
- Howell AB, Vorsa N, Marderosian AD, Foo LY. Inhibition of the
adherence of p-fimbriated Escherichia coli to uroepithelial-cell
surfaces by proanthocyanidin extracts from cranberries. The
New England Journal of Medicine 1998; 339: 1085.
- Howell AB, Leahy M, Kurowska E, Guthrie N. In vivo evidence that
cranberry proanthocyanidins inhibit adherence of p-fimbriated E.
coli bacteria to uroepithelial cells. Federation of American
Societies for Experimental Biology Journal 2001; 15: A284.
- Howell AB, Reed J, Winterbottom R, Krueger C. April 2002 - Bacterial
anti-adhesion activity of cranberry vs. other foods. Federation
of American Societies for Experimental Biology 2002.
EPIDEMIOLOGICAL RESEARCH
- Foxman B, Geiger AM, Palin K, Gillespie
B, Koopman JS. First-time urinary tract infection and sexual behavior.
Epidemiology 1995; 6: 162-168.
- Dignam RR, Ahmed M, Kelly KG, Denman SJ, Zayon M, Kleban M.The
effect of cranberry juice on urinary tract infection rates in a
long-term care facility. Annals of Long-Term Care 1998;
6: 163-167.
- Kontiokari T, Laitinen J, Jarvi L, Pokka T, Sundqvist K, Uhari
M. Dietary factors protecting women from urinary tract infection.
American Journal of Clinical Nutrition 2003; 77: 600-604.
ANTIBIOTIC RESISTANCE OF ESCHERICHIA COLI
- Manges AR, Johnson JR, Foxman B, O'Bryan
TT, Fullerton KE, Riley LW. Widespread distribution of urinary tract
infections caused by a multidrug-resistant Escherichia coli
clonal group. The New England Journal of Medicine 2001;
345: 1007-1013.
- Stamm WE. An epidemic of urinary tract infections. The New
England Journal of Medicine 2001; 345: 1055-1057.
- Howell AB, Foxman B. Cranberry juice and adhesion of antibiotic-resistant
uropathogens. Journal of the American Medical Association
2002; 287.
Cranberry Research Reviews:
- Henig YS, Leahy MM. Cranberry juice and
urinary-tract health: Science supports folklore. Nutrition
2000; 16: 684-687.
- FC, Fagelman E. Cranberry juice and urinary tract infections:
what is the evidence? Urology 2001; 57: 407-413.
-Leahy M, Roderick R, Brilliant K. The cranberry - promising health
benefits, old and new. Nutrition Today 2001; 36: 254-265.
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