Where have the cranberry allegations come from?
In a recent statement by NICE, although they admit there is lots of research surrounding the use of Cranberry Juice for urinary tract infections, the conclusion from them is that there is not enough convincing evidence to recommend it for the treatment of this condition.
Their advice instead is to stick to plenty of fluids and take painkillers or antibiotics as necessary, although, they do aim to review the advice further, especially in terms of the use of antibiotics for this condition, over the coming weeks. This will be interesting, as with the threat of antibiotic resistance upon us, this definitely needs to be closely considered!
So, where does this leave us with the use of cranberry in the management of UTIs? Let’s take a closer look around the evidence around this.
What’s my take on the use of cranberry in light of the evidence?
A Cochrane Report1 reviewed a number of trials in this area, assessing the overall efficacy of cranberry to treat UTIs. It was concluded from this study that there wasn’t significant evidence to suggest that that cranberry was an effective enough treatment for UTIs.
However, this was assessing the use of cranberry for the treatment of UTIs. Could cranberry sit better for helping with prevention? We know that as the result of the structure of cranberries, bacteria may be more likely to stick to the cranberry (rather than your vulnerable urinary tract) and help flush them out of your system – in this way it may act as more of a suitable preventative measure, and there is some evidence to help back this theory up.
A clinical trial involving adults in the Netherlands found that after taking 500mg cranberry capsules twice daily for a year, participants had a 26% reduction in the incidence of UTIs compared to a control group2.
Even more pronounced, were the results of another clinical control trial set in Italy. This trial involved a smaller number of participants, but found that the use of cranberry was more protective than lifestyle advice alone for preventing the incidence of UTIs. Plus, up to one third of the participants had no incidence of infections (after previously suffering from recurrent infections) by the end of the trial3.
What are our thoughts on the best approach for treating UTIs going forward?
So, it seems that cranberry may be better placed for the prevention of UTIs rather than the treatment. This makes perfect sense; once the bacteria that contribute to UTIs become more established, they may become more stubborn, harder to shift, and we most likely need something more pronounced to help shift them!
Here I outline my advice for managing the different stages of UTIs:
The advice for protection
1 - Employ the lifestyle tips
Although some Cranberry Juice may be a helpful addition to the lifestyle advice3 when it comes to UTIs, there’s no denying that drinking plenty of plain, still water and refraining from excess sugar and caffeine are beneficial tactics to employ from home. Click the link to learn more!
2 - Include some cranberry
Whilst the jury is still out on using cranberry for the treatment of UTIs for prevention, the evidence certainly looks promising. Just be sure to opt for a good quality juice rather than one that is loaded full of sugar, or opting for a higher strength tablet may also be an option which means you don’t have to worry about the sugar content. Although NICE have implied that cranberry may not be a suitable treatment option for UTIs, research has suggested that cranberry may be just as effective as antibiotics in the prevention of UTIs1. With the threat of antibiotic resistance top of mind, this is really promising.
The advice for treatment
1 - Carefully consider the need for antibiotics
Whilst in some cases, antibiotics may be necessary, especially for more advanced infections (be sure to look out for warning signs such as blood in your urine or back pain), they perhaps shouldn’t always be the go-to. Read our blog in this topic for more information, ask your doctor for advice or look out for revised guidelines from NICE around this in the coming weeks.
2 - Employ some Uva-ursi
Uva-ursi is our licensed herbal remedy to help relieve the symptoms associated with cystitis. Combined with the herb echinacea, uva-ursi can help to get some of those minor urinary complaints such as a burning sensation when urinating or frequent urination under control.
1. Jepsom RG et al. Cranberries for treating urinary tract infections. Cochrane Database of Systematic Reviews 1998, Issue 4. Art. No.: CD001322. DOI: 10.1002/14651858.CD001322 Updated July 2010
2. Caljouw, MA et al. Effectiveness of cranberry capsules to prevent urinary tract infections in vulnerable older persons: a double-blind randomized placebo-controlled trial in long-term care facilities. J Am Geriar Soc. 2014, 62(1), p103-110
3. Ledda A, Bottari A, Luzzi R, et al. Cranberry supplementation in the prevention of non-severe lower urinary tract infections: a pilot study. Eur Rev Med Pharmacol Sci. 2015, 19(1), p77-80.