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Cranberries may help men with urinary tract symptoms

AniKowal — Mon, 15 Nov 2010 05:00:55 +0000

Cranberries have been used for hundreds of years for the treatment of bladder and kidney problems. Many women know that cranberries can help with the treatment and prevention of cystitis and other urinary tract infections (I have previously written about this here)

A new study (1) published in the British Journal of Nutrition has found that cranberries may also help men with lower urinary tract symptoms. Lower urinary tract symptoms are a common condition in older men. The study wanted to assess the usefulness of cranberry (powder) in men at risk of prostate disease with lower urinary tract symptoms. The study was preliminary and small, involving 42 men who received either 1500mg of dried cranberry powder daily for 2 months or no treatment at all (control group). Various measures were taken and it was found that in contrast to the control group, the men who were taking the cranberry powder has significant improvement in various measures including urination parameters such as rate of urine flow, average flow, total volume and post-void residual urine volume. The authors conclude that “The results of the present trial are the first firm evidence that cranberries may ameliorate LUTS [lower urinary tract symptoms]”

Another recent study (2) found “that daily consumption of concentrated cranberry juice can significantly prevent the recurrence of symptomatic UTIs [urinary tract infections] in children”.

Cranberries are fruits which contain various vitamins as well as numerous phytochemicals, bioactive plant chemicals, such as anthocyanins, flavonols, proanthocyanidins. It is the presence of these phytochemicals in cranberries that appears to be responsible for observations that cranberries may prevent many diseases and infections including cardiovascular diseases, various cancers, and infections involving the urinary tract, dental health, and Helicobacter pylori-induced stomach ulcers and cancers (3).

Urinary tract infections tend to involve bacteria. It was thought that cranberry worked against these infections by making the urine acidic and therefore causing the bladder not to be an environment where bacteria can colonise and multiply. Cranberry does acidify the urine and this is certainly one of its benefits. However, it has been shown more recently that cranberry actually provides major benefit through other means. It appears to prevent bacteria from adhering, or clinging, to the lining of the bladder and urinary tract. The specific agent within cranberries that seems to be useful here are pro-anthocyanidins, natural biologically active plant compounds. If bacteria cannot cling to the urinary tract they will be washed out of the body with the urine.

Traditionally urinary tract infections have been treated with antibiotics. These do certainly seem to be effective. The problem with treating recurrent bouts of UTI with antibiotics is that, over time, it can exacerbate the issue. The bacteria may become resistant to the antibiotics. Antibiotic use is also associated with increased risk of recurrent thrush infections in women, which can also lead to urinary tract infection. It is important to visit a doctor if you suspect you have a urinary tract infection. You might want to discuss the use of cranberry products with them. There have been a number of controlled clinical trials which have concluded that cranberry juice really is effective for preventing urinary tract infections however there are some trials which have not found benefit so evidence is not yet conclusive.
Many individuals would probably prefer not to take continued and repeat doses of antibiotics in order to prevent and treat the occurrence of cystitis or other urinary tract infections. Cranberry does seem like a viable alternative. If you want to try drinking cranberry juice for prevention then 2-3 250ml glasses a day are recommended, but be wary and check the label of the juice – many varieties are loaded with sugar and/or artificial sweetners and only contain 5% pure fruit!! Look for juices providing 100% pure fruit juice, these tend to be cranberry mixed with another juice (pure cranberry would be very bitter). Taking a cranberry supplement is another option, these are usually standardised to contain 10% pro-anthocyanidins and 800-1000mg a day is usually recommended (but check with your medical doctor first).

If you have received intensive antibiotic treatment in the past you may wish to take probiotic and/or a prebiotic supplement to help the body re-colonise with ’friendly’ beneficial bacteria.

(1)VidlarA et al. 2010. The effectiveness of dried cranberries (Vaccinium macrocarpon) in men with lower urinary tract symptoms. British Journal of Nutrition. 104: 1181-1189

(2) Ferrara P et al. 2009. Cranberry juice for the prevention of recurrent urinary tract infections: a randomized controlled trial in children. Scand J Urol Nephrol. 43(5):369-72.

(3)Côté J et al. 2010. Bioactive compounds in cranberries and their biological properties. Crit Rev Food Sci Nutr. 50(7):666-79.

Written by Ani Kowal

Probiotics for the prevention of cystitis

admin — Wed, 14 Jan 2009 08:13:33 +0000

On Monday I briefly mentioned the usefulness of probiotics (‘friendly bacteria’) in restoring the bacteria of the digestive system for women who have taken repeated courses of antibiotics for their cystitis or other urinary tract infections (UTI’s). However, probiotics may do more than just help positively rebalance gut bacteria after antibiotic use. Studies indicate that oral probiotic supplements and vaginal probiotic creams and suppositories may actually help prevent and treat the occurrence of UTIs.

You may be wondering how probiotics (taken orally or used vaginally) could be helpful in treating or preventing infections in the urinary system? As I mentioned on Monday, in women the bacteria responsible for urinary tract infections almost always come from the vagina or the rectum/anus and travel up through the urinary tract into the bladder where they can cause problems. In a healthy vagina the predominant bacteria present are ‘friendly’ non-harmful strains such as Lactobacilli (1), a healthy digestive system will also be dominated by a variety of different non-pathogenic bacteria. If the vagina and digestive system are mainly colonised with good bacteria these provide a barrier to the entry of pathogenic/harmful bacteria into the urinary tract and bladder (1). Studies now show that probiotic supplements or foods may be helpful in order to boost the number of good bacteria in the vagina and digestive system and therefore help to prevent urinary tract infections. Evidence also suggests that probiotics may also actively prevent the pathogenic bacteria from clinging or adhering to the urinary tract and multiplying (2).

One study (3) analysed the diet of over a hundred women, with an average age of 30, who suffered from recurrent UTI’s compared to over a hundred women who had not suffered from a UTI in over 5 years. Frequent consumption, more than three times a week, of milk products containing probiotics was associated with a significantly reduced risk of recurrent UTI’s. Studies (4,5) also indicate that vaginal suppositories of probiotic bacteria may be useful for the prevention of recurrent urinary tract infections.

Urine normally flows in one direction, down from the kidneys, through tubes called ureters, to the bladder. However there is a condition known as vesicoureteral reflux (VUR) where there is an abnormal flow of urine from the bladder back into the ureters. It is a condition most commonly diagnosed in childhood after a urinary tract infection has occurred. About one-third of children with a UTI are found to have VUR. VUR can lead to infection because urine that remains in the urinary tract provides a place for bacteria to grow. A study(6) in children with VUR compared the preventative effect of oral probiotics with antibiotics. The probiotic was shown to be as effective as the antibiotic in the prevention of recurrent UTIs.

The evidence for the use of probiotic supplements and vaginal suppositories in the treatment and prevention of UTI in women is still preliminary but ever growing. There is a lot of logic behind the rationale and in practice many women, especially those who have undergone repeat antibiotic treatment, find probiotics to be really helpful in preventing and treating cystitis and other urinary tract infections. Vaginal probiotic creams, suppositories and tablets are readily available, they usually contain lactobacillus acidophilus. Oral probiotics (and prebiotics) may be useful in order to help keep an overall balance of good bacteria in the vagina and digestive and system.

(1) Reid G & Bruce AW. 2006. Probiotics to prevent urinary tract infections: the rationale and evidence. World J Urol. 24:28-32
(2) Reid G. 2000. Probiotic Therapy and Functional Foods for Prevention of Urinary Tract Infections: State of the Art and Science. Curr Infect Dis Rep. 2:518-522
(3)Kontiokari T et al. 2003. Dietary factors protecting women from urinary tract infection. Am J Clin Nutr. 77:600-604
(4) Uehara S et al. 2006. A pilot study evaluating the safety and effectiveness of Lactobacillus vaginal suppositories in patients with recurrent urinary tract infection. Int J Antimicrob Agents. 28 Suppl 1:S30-S34
(5) Czaja CA et al. 2007. Phase I trial of a Lactobacillus crispatus vaginal suppository for prevention of recurrent urinary tract infection in women. Infect Dis Obstet Gynecol. 2007:35387
(6) Lee SJ et al. 2007. Probiotics prophylaxis in children with persistent primary vesicoureteral reflux. Pediatr Nephrol. 22:1315-1320

Written by Ani Kowal

Can the humble cranberry really be useful in the prevention of urinary tract infections?

admin — Mon, 12 Jan 2009 08:26:02 +0000

Many women seem to suffer with recurrent urinary tract infections (UTI), usually cystitis. This is a painful condition that occurs when the lining of the bladder becomes inflamed, making urination painful. I was shocked to learn that one in five women suffers from a UTI at least once per year. Some women suffer from recurrent attacks. If cystitis occurs treatment needs to be prompt and antibiotics may well be necessary, this is because recurring UTI’s may lead to kidney infections which can be serious. The key to UTI’s seems to be prevention.

Cystitis tends to occur as a result of a bacterial infection. Urine is normally free of bacteria when stored in the bladder but sometimes bacteria in the urinary tract can overwhelm the immune system and multiply, causing infection. Ignoring the urge to urinate can increase the likelihood of UTI since urine remains in the bladder for increased periods allowing bacteria to multiply. Personal hygiene is important since bacteria from the anal area may enter the urinary tract during sex or when wiping after a bowel movement (this is why women are always taught to wipe from front to back).

The problem with treating recurrent bouts of UTI with antibiotics is that, over time, it can exacerbate the issue. The bacteria may become resistant to the antibiotics. Antibiotic use is also associated with increased risk of recurrent thrush infections, which can also lead to UTI. Trying to prevent an infection in the first instance seems to be the answer.

Today I want to look at cranberry juice and cranberry supplements as a way of preventing UTI in women. Traditionally cranberry has been used by women to treat and prevent cystitis. It was thought that cranberry worked by making the urine acidic and therefore causing the bladder not to be an environment where bacteria can colonise and multiply. Cranberry does acidify the urine and this is certainly one of its benefits. However, it has been shown more recently that cranberry actually provides major benefit through other means. It appears to prevent bacteria from adhering, or clinging, to the lining of the bladder and urinary tract. The specific agent within cranberries that seems to be useful here are pro-anthocyanidins, natural biologically active plant compounds. If bacteria cannot cling to the urinary tract they will be washed out of the body with the urine.

Scientific research is beginning to accumulate for the usefulness of cranberry juice, supplements and other products in the treatment and prevention of UTI.

Recently a study tested the effectiveness of cranberry against an antibiotic called trimethoprin in the prevention of UTIs in women who suffered from recurrent attacks (1). 137 women were involved and they were given the antibiotic or 500mg cranberry extract per day for six months. It was found that the cranberry extract was as good as the antibiotic in preventing UTI. The antibiotic produced more side effects. The authors of the study note that cranberry extract is a cheap and useful alternative to antibiotics and as a natural product does not carry the risk of causing antibiotic resistance or further infections with thrush causing bacteria and yeasts.

Another very recent and well designed study(2) looked at the effectiveness of cranberry supplements for the prevention of UTIs in a particularly susceptible group of individuals (those with spinal cord injuries affecting the bladder). The study lasted six months and the participants received a cranberry extract supplement or a placebo (non active tablet). There was a reduction in the likelihood of UTI and UTI symptoms when taking the cranberry supplement and the frequency of UTI was reduced in the cranberry group compared to placebo. The authors of the study suggest that cranberry extract supplements should be seriously considered for the prevention of UTI.

In 2007(4) a study was conducted in women who were between the ages of 25 and 70 years old. These women had a history of suffering with a MINIMUM of 6 UTI in the proceeding year. The participants took one high-dose cranberry capsule twice daily for 12 weeks containing 200 mg of a concentrated cranberry extract standardized to 30% pro-anthocianidins. The participants were then followed up once per month for 4 months and then after 2 years. During the study none of the women suffered a UTI and two years later those who continued with a supplement continued to be free of UTI. The study was small and preliminary and needs further follow up with placebo-controlled trial but the results are very encouraging indeed.

Cranberry juice has also been widely tested and a review of the available evidence (3) suggests that cranberry juice may decrease the number of symptomatic UTIs over a 12-month period, particularly in women who suffer with recurrent UTIs.

Most women would probably prefer not to take continued and repeat doses of antibiotics in order to prevent the occurrence of cystitis or other urinary tract infections. Cranberry really does seem like a viable alternative. If you want to try drinking cranberry juice for prevention then 2-3 250ml glasses a day are recommended, but be wary and check the label of the juice – many varieties are loaded with sugar and/or artificial sweetners and only contain 5% pure fruit!! Look for juices providing 100% pure fruit juice, these tend to be cranberry mixed with another juice (pure cranberry would be very bitter). Taking a cranberry supplement is another option, these are usually standardised to contain 10% pro-anthocyanidins and 800-1000mg a day is usually recommended.

If you have received intensive antibiotic treatment in the past you may wish to take probiotic and/or a prebiotic supplement to help the body re-colonise with ’friendly’ beneficial bacteria.

(1)McMurdo ME et al. 2008. Cranberry or trimethoprim for the prevention of recurrent urinary tract infections? A randomized controlled trial in older women. J Antimicron Chemother. 28 November [Epub ahead of print]
(2) Hess MJ et al. 2008. Evaluation of cranberry tablets for the prevention of urinary tract infections in spinal cord injured patients with neurogenic bladder. Spinal Cord. 46(9):622-6.
(3) Jepson RG & Craig JC. 2007. A systematic review of the evidence for cranberries and blueberries in UTI prevention. Mol Nutr Food Res. 51(6):738-45.
(4) Bailey DT et al. 2007. Can a concentrated cranberry extract prevent recurrent urinary tract infections in women? A pilot study. Phytomedicine. 14(4):237-41

Written by Ani Kowal