Cranberry juice and UTIs:
maybe Grandma was right.

 Author/s: Beth Fontenot Issue: Sept-Oct, 1998

 Generations of women have regarded drinking cranberry juice as a simple preventive or
 treatment for urinary tract infections (UTIs). Is this just another dubious folk remedy, or has
 science shown that this bit of medical folklore has some merit?

 Cranberry Science

 About 75 years ago scientists determined that eating large amounts of cranberries could
 cause urine to become more acid. They speculated that this could prevent or treat recurrent
 UTIs since bacteria favor an alkaline medium for growth. Subsequently, commercial cranberry
 juice cocktails became a popular "cure" for women suffering from recurrent UTIs, and
 anecdotal evidence seemed to support the notion. It was years later that scientists found
 that the increase in urine acidity after drinking cranberry juice was small and transient, but
 this finding did not seem to sway those who believed in the benefits of the beverage.

 More recent studies have suggested that cranberry juice's alleged effectiveness against
 bacteria is not in its ability to acidify the urine, but in its ability to prevent bacteria from
 sticking to the lining of the urinary tract where they can multiply and cause infection. Two
 anti-adhesion factors have been isolated from cranberry juice, fructose and another
 polymeric compound of unknown nature. Several fruit juices have been tested, but only
 cranberry and blueberry juice contain the latter inhibitor.

 Recently a randomized, doubleblind, placebo-controlled study of 153 elderly women was
 undertaken to determine whether the regular consumption of cranberry juice did indeed have
 an effect on the incidence of UTIs (Journal of the American Medical Association
 271:751-754, 1994). This population was chosen because the condition is particularly
 prevalent in older women. The researchers found that women given 10 ounces of cranberry
 juice every day for 6 months were half as likely to develop a urinary tract infection as
 women who consumed a placebo beverage. The study also suggested that cranberry juice
 reduced preexisting bacteria in the urinary tract as well as the occurrence of new bacteria,
 and that the effects were unrelated to the acidity of the women's urine. The researchers
 concluded that prevalent beliefs about the effects of cranberry juice on the urinary tract
 may have microbiologic justification.

 Pop a Pill Instead?

 Cranberry pills and capsules are sold in health-food stores and pharmacies. One brand is
 marketed as a convenient way to get the benefits of cranberry juice "without the
 unnecessary, and nutritionally harmful, calories." The pills are purported not only to prevent
 or treat UTIs, but also to treat kidney stones and act as a "urine deodorizer" for those
 troubled by urinary incontinence.

 A Good Housekeeping Institute study of cranberry pills, however, found that they vary
 greatly in the amount of cranberry concentrate they contain, in the number of pills
 recommended per day, and in their price. The manufacturers base their claims about the pills'
 effectiveness against UTIs on studies using cranberry juice. But there is no scientific
 evidence that cranberry pills are effective. Nor is there evidence that cranberry pills prevent
 kidney stones or "deodorize" the urine.
Jerry Avorn, MD, of Brigham and Women's Hospital and Harvard Medical School, was a
 researcher in the JAMA study. He doubts the effectiveness of cranberry pills or capsules.
 Avorn told the Good Housekeeping Institute, "We don't know if the active component in
 cranberries survives the extraction process, or, if it does, if it's present in an amount that
 would help."

 The Bottom Line

 So is cranberry juice effective against urinary tract infections? The answer seems to be
 probably. NF Editorial Board member Varro Tyler, PhD, a top expert on the medicinal use of
 plants, says that an "appropriate cranberry product" does seem to be useful in the
 prevention and treatment of UTIs. He thinks that consuming about 3 ounces daily of
 cranberry juice cocktail (which is about 33% cranberry juice) may work as a preventive,
 while 12 to 32 ounces daily may be useful as treatment for a UTI. He cautions, however,
 that cranberry juice may be a useful addition to standard antibiotic therapy but should never
 be used in place of such therapy.

 More research is needed before we're certain of cranberry juice's anti-UTI effects in older
 women. And more studies will be necessary to determine if cranberry juice is effective at all
 in younger women. Another question that needs to be answered: Does cranberry juice taken
 along with antibiotics offer any benefit over either antibiotics or cranberry juice alone? In
 any case, it seems clear that for an otherwise healthy individual, drinking moderate amounts
 of cranberry juice can't do any harm and might even do some good.

 Beth Fontenot is a nutrition consultant and freelance nutrition writer in Lake Charles, LA,
 where she also serves on the adjunct faculty at McNeese State University.

 COPYRIGHT 1998 Prometheus Books, Inc.