Last week, media outlets were quick to pick up the story of a research study that showed cranberry extract isn’t as effective as antibiotics for the prevention of recurrent urinary tract infections (UTIs). The headlines were consistent: “Antibiotics beat cranberries,” “Don’t bet on cranberry,” and “Cranberries little help”. Unfortunately, what is lacking from many of the medical news reports is a critical review of the study’s methodology and thus the validity and applicability of its results. While a study comparing the efficacy of antibiotics and cranberry is a great idea, the cranberry extract studied contained the daily equivalent of merely 9.1 mg of proanthocyanidins, the key chemical constituent responsible for protecting against adherence of bacteria in the urinary tract. This dose falls far short of the 72 mg daily dose of proanthocyanidins currently accepted as the most effective based on recent clinical studies, a problem admitted by the study’s authors in discussing their results.
Even at such a low dose, cranberry showed great promise.
After 12 months of taking either trimethoprim-sulfamethoxazole (TMP-SMX, 480 mg once daily) or cranberry capsules (500 mg, containing 4.55 mg of proanthocyanidins, twice daily):
- the mean number of women experiencing at least 1 UTI was greater in the cranberry than the antibiotic group (4.0 vs 1.8; p=0.02)
- the proportion with at least 1 UTI was also greater in the cranberry group (78.2% vs 71.1%; p=0.03)
- median time to first UTI was 4 months in the cranberry group, vs. 8 months in the antibiotic group
- 86.3% of fecal and 90.5% of asymptomatic bacteriuria E coli isolates were TMP-SMX resistant vs. 23.7% and 28.1% in the cranberry group
- increased resistance rates for was other types of antibiotics were also found in the TMP-SMX group after 1 month
- antibiotic resistance did not increase in the cranberry group
As noted by Galen’s Watch, “As part of a total treatment that included other supplements that have shown benefit in preventing UTI’s such as probiotics and vitamin C the outcome could be quite different. A typical treatment plan could include dietary recommendations and herbs, among other things.” All is not lost for cranberry. At the correct dose, it remains an important part of a holistic approach to preventing UTIs.
- Beerepoot MAJ et al. Cranberries vs antibiotics to prevent urinary tract infections. A randomized double-blind noninferiority trial in premenopausal women. Arch Intern Med [serial on the internet]. 2011 [cited 2011 July 30];171(14):1270-1278. Available from: http://archinte.ama-assn.org/cgi/content/short/171/14/1270.
- Freeman DW. For urinary tract infection, antibiotics beat cranberries. CBS News [website]. 2011 July 26 [cited 2011 July 30]. Available from: http://www.cbsnews.com/8301-504763_162-20083454-10391704.html.
- Gardner A. Don’t bet on cranberry against UTIs. CNN [website]. 2011 July 25 [cited 2011 July 30]. Available from: http://www.cnn.com/2011/HEALTH/07/25/antibiotics.cranberry.upi.prevention/.
- Walsh N. Cranberries little help for bladder. MedPageToday [website]. 2011 July 25 [cited 2011 July 30]. Available from: http://www.medpagetoday.com/InfectiousDisease/GeneralInfectiousDisease/27725.
- Howell AB et al. Dosage effect on uropathogenic Escherichia coli anti-adhesion activity in urine following consumption of cranberry powder standardized for proanthocyanidin content: a multicentric randomized double blind study. BMC Infect Dis [serial on the internet]. 2010 [cited 2011 July 30];10:94. Available from: http://www.biomedcentral.com/1471-2334/10/94#B12.
- Way S. Antibiotics beat Cranberries for UTI’s? Not so fast… Galen’s Watch . 2011 July 26 [cited 2011 July 30]. Available from: http://camwatcher.typepad.com/cam_watcher/2011/07/antibiotics-beat-cranberries-for-utis-that-is-what-the-headlines-say-but.html.
This recipe has always been a hit in our house. The vegan version, pictured here, can be adapted for those who eat dairy to include a dollop of sour cream, crumbled queso fresco, or shredded cheese of any kind. I'm not a big supporter of "hiding" vegetables in food (I [...]
Knowing that there is virtually no sugar in my house, parents often ask me what I do with my kids at Hallowe’en. I confess to lying to my kids for the first couple of years. I told them that Hallowe’en was a holiday where people paraded up and down the street in costume and visited their neighbours. They were completely satisfied with my explanation. That is, until the other kids at school told them about the candy. Since then, we do go out trick or treating though we also employ several strategies for handling the vast amounts of high fructose corn syrup pouring into our house. […]
The days are getting colder out there, and cold and flu season has officially started. In fact, just last week I was home (and still trying to get some work done) with two kids sick with viral, croupy coughs. Thankfully, there are lots of great strategies for preventing colds and flus as well as naturopathic treatments that you can do at home to help shorten the course of an illness once you are sick. So why did my kids get sick and I didn’t? […]
This recipe, very slightly adapted from Vij’s: Elegant & Inspired Indian Cuisine, one of two excellent cookbooks courtesy of Vij’s restaurant in Vancouver, is a staple in our house. It is also a great way to incorporate tofu into your diet, as this recipe capitalizes on tofu’s ability to absorb other flavours. […]
Last spring, with the landscaping prowess of Small Spade Gardening, I transformed my front yard into a stunning display of medicinal plants indigenous to Ontario. Once everything was planned and planted, I realized I had forgotten to include one of my favourite native botanicals, jewelweed. A relative of the popular impatiens commonly found in annual flower beds, Impatiens capensis has a smaller more delicate flower on long succulent translucent stems. A couple of months later, as I was weeding and admiring the garden, I noticed my old friend jewelweed had found its place in my yard, filling in the spaces between the eastern hemlock bushes. Although it wasn’t the first time that I’ve invited a plant into my environment only to have it magically appear, it was still a welcome surprise. […]
The word neuroplasticity sounds like your brain on playdough. In a sense, it is. Neuroscience has documented how our brains are constantly changing and responding to our environments and lived experiences, changing both anatomically and physiologically. The mantra “neurons that fire together, wire together” has been used in educational and neuroscience circles since the 1990s but how does this relate to mindbody techniques such as meditation, visualizations, and affirmations in the context of general health? Conscious of it or not, we are constantly sending messages to ourselves, to our bodies. This internal dialogue may be related to physical sensations, feeling, moods, addictions, or ways of being in the world. The things we say to ourselves may be loving and self-affirming; or, they may be critical and hurtful. […]