Urinary tract infections (UTIs) are among the most prevalent bacterial infections in women, with high recurrence rates and growing concerns over antimicrobial resistance. The need for alternative or adjunctive therapies has spurred interest in plant-based treatments, which offer antimicrobial, anti-inflammatory, antioxidant, and immune-modulatory benefits. This review summarizes the mechanisms of action, clinical efficacy, and therapeutic potential of various medicinal plants and natural compounds for preventing and treating UTIs in women. Notable candidates include cranberry, bearberry, pomegranate, green tea, and other phytochemicals with proven anti-adhesive and biofilm-disrupting properties. Evidence from clinical trials and meta-analyses supports the role of cranberry natural products and traditional herbal medicines (THMs) in reducing UTI recurrence, especially when combined with antibiotics. Notably, A-type proanthocyanidins in cranberry and arbutin in bearberry are key bioactive compounds that exhibit potent anti-adhesive and biofilm-disrupting properties, offering promising adjunctive strategies for preventing recurrent urinary tract infections. Additionally, emerging therapies, such as platelet-rich plasma (PRP), show promise in restoring bladder function and reducing infection in women with lower urinary tract dysfunction. Overall, plant-based strategies represent a valuable and well-tolerated complement to conventional therapies and warrant further investigation through high-quality clinical trials to validate their efficacy, safety, and role in personalized UTI management.

Background: Antioxidants and nitric oxide (NO) precursors may improve endurance exercise performance by reducing oxidative stress and increasing NO production. Almonds, dried grapes, and cranberries (AGC) are good sources of antioxidants and NO precursors. 

Objectives: To determine whether AGC consumption improved physiological responses and endurance cycling time-trial performance in response to training. 

Methods: After 1 wk of light training (LT), 96 male recreationally trained cyclists consumed 125 g of AGC or control (CON: isocaloric oat bar) daily during 2 wk of heavy training (HT) and a 2-wk taper (T). At the end of LT, HT, and T, endurance exercise performance (5-min cycling time-trial; 5CTT), NO bioavailability (plasma and urine nitrate and nitrite), oxidative stress [plasma F2-isoprostanes (F2-Isop)], muscle damage (creatine kinase) and subjective measures of wellbeing were assessed, as well as physiological responses during exercise at 70% maximal aerobic power output. 

Results: Compared to LT, 5CTT performance was impaired at HT (d = -0.27, P = 0.01) and improved at T (d = 0.79, P < 0.001), with no difference between treatments (P > 0.81). Compared with CON, during submaximal exercise at 70%, maximal aerobic power output AGC demonstrated higher oxygen consumption (HT: d = 0.46; T: d = 0.38, P < 0.001) and lower respiratory exchange ratio (HT: d = -0.61; T: d = -0.23, P < 0.032). At HT, urine F2-Isop was higher compared with LT (d = 0.21, P = 0.036), but plasma F2-Isop was lower (d = -0.22, P = 0.008), with no difference between treatments. At HT, AGC had higher subjective energy concentrations (d = 0.21, P = 0.02) and urinary nitrite (d = 0.23, P = 0.03) compared with CON and higher creatine kinase (d = 0.24, P = 0.02) and less fatigue (d = -0.20; P = 0.05) at T. 

Conclusion: Although not beneficial for 5CTT performance or exercise efficiency, AGC increases fat oxidation during exercise, NO bioavailability, and subjective energy concentrations, which may confer benefits for health and wellbeing..

Objectives: To evaluate the effects of polyphenol-containing products during pregnancy on preeclampsia-related maternal and neonatal outcomes. 

Design: Systematic review and meta-analysis. 

Setting: Nine databases and one trial registry, from inception to August 11th, 2023. 

Population/Sample: Randomised controlled trials where women received polyphenolic-containing products (as standardised extracts or dietary supplements) compared to placebo or standard care. 

Methods: All review stages were conducted by two independent reviewers. Random-effects meta-analysis with the Hartung-Knapp-Sidik-Jonkman method using a framework for studies with few events. Main Outcome Measures: Clinical outcomes combining the core outcome set for preeclampsia and WHO's priority outcomes. 

Results: Fourteen trials investigating six candidates were included. In women with preeclampsia, the addition of epigallocatechin gallate (EGCG) to nifedipine may reduce the time needed to achieve blood pressure control (mean difference (MD) = -14.10 min, 95% CI -18.46 to -9.74) and increase the time to the next hypertensive crisis (MD = 3.10 h, 95% CI 2.35 to 3.85) compared to nifedipine alone (1 trial, 349 women; low certainty). Similarly, the addition of resveratrol to nifedipine may reduce the time needed to achieve blood pressure control (MD = -15.50 min, 95% CI -19.83 to -11.17) and increase the time to the next hypertensive crisis (MD = 2.50 h, 95% CI 2.09 to 2.91) (1 trial, 349 women; low certainty). No differences were observed for other outcomes or candidates (Salvia miltiorrhiza, Bryophyllum pinnatum, raspberry and cranberry extracts). 

Conclusion: ECGC and resveratrol supplements have been investigated for potential effects in managing clinical signs and symptoms of preeclampsia; however, evidence on the clinical and adverse effects of polyphenols is limited and uncertain.

Recurrent urinary tract infection (rUTI) is a significant public health problem in women. General measures to prevent recurrence include behavioral changes and increased fluid intake, cranberry ingest, use of methenamine hippurate, antibiotic prophylaxis, D-mannose, probiotics, or vaccines. We conducted a literature review of the latest updates on preventing rUTI in December 2024. The search concluded with 27 articles that fulfilled our inclusion criteria. Our review demonstrated that behavioral changes such as correct genital hygiene, avoiding postponing micturition or defecation, urinating after sexual intercourse, and ingesting 1.5-2 L of water could prevent rUTI. The ingestion of cranberries reduces the risk of symptomatic, culture-verified urinary tract infections in women with rUTIs. Methenamine hippurate is an alternative to antibiotics to avoid rUTI. Estrogen reduces rUTI in women with hypoestrogenism. Limited evidence supports using D-mannose, probiotics, and vaccines to prevent rUTI. In conclusion, after successful treatment of the acute episode, preventative measures are needed to reduce rUTI frequency and morbidity according to each patient's characteristics and preferences

Cranberries are well known for their antioxidative, anti-inflammatory, antimicrobial, and anti-biofilm formation properties. Many studies indicate their potential for cancer prevention, blood sugar regulation, gastrointestinal and cardiovascular health, and antiviral properties. Such wide therapeutic potential for human health has made cranberries favourable for dietary formulations. Considering how prone patients are to accept treatment via nature's pharmacy instead of the conventional one, cranberries in the form of juice, tablets, capsules, or extracts are often prescribed alongside antibiotic therapy for urinary tract infection (UTI) treatment. This review paper aims to provide a better understanding of the limitations of the usage of berry dietary formulations for health improvement. The healing potential of cranberries is limited due to the bioaccessibility of their ingredients and their pharmacokinetic properties. Although rich with pharmacologically active substances, including anthocyanins, proanthocyanidins, vitamin C, vitamins (B1, B2, B3, B5, B6, B9), and organic acids, their potential is limited due to low absorption and distribution, extensive metabolism, and elimination. The variability in gene expression affecting the biosynthesis of anthocyanins and proanthocyanidins within the Vaccinium berries results in diminished concentrations of active ingredients within the plant material itself. Also, the results from the clinical trials are inconsistently standardized. This paper offers a comprehensive analysis of the available data and presents a clear direction for future research.

Introduction: Cranberry (Vaccinium macrocarpon) and Vitamin D have both demonstrated significant potential in combating microbial infections, particularly in the oral environment. Cranberry is known for its bioactive compounds, such as proanthocyanidins, flavonoids and organic acids, which exhibit antibacterial properties, while Vitamin D plays a crucial role in bone metabolism and immune response. This study aims to evaluate the antimicrobial efficacy of dental implants coated with cranberry extract and Vitamin D to inhibit bacterial biofilm formation and improve osseointegration. 

Materials and Methods: Titanium dental implants were coated with a cranberry hydrogel solution containing Vitamin D. The process involved surface preparation, dip coating and curing of the implants. Sub-gingival plaque samples were collected from patients with peri-implantitis for microbial analysis. In vitro biofilm formation was assessed on both coated and uncoated implants, followed by a colony reduction ability assessment where biofilm from the implant surfaces was dislodged and cultured to quantify bacterial colony-forming units (CFUs). 

Results: The results indicated a significant reduction in bacterial colonies in the test group (coated implants) compared to the control group (uncoated implants). The cranberry/Vitamin D coating effectively inhibited the growth of black-pigmented microbes. The test group showed a notable decrease in CFU count, confirming the antimicrobial properties of the coating. 

Conclusion: Cranberry and Vitamin D-coated dental implants exhibit significant antimicrobial activity, reducing bacterial colonisation and promoting better clinical outcomes in terms of infection control and bone healing. The use of natural bioactive compounds on implant surfaces represents a viable option to enhance the success rate of dental implants. However, further clinical trials are needed to validate long-term efficacy.

Background: High prevalence of urinary tract infections (UTI), including cystitis, and concern for antimicrobial resistance justify safe and effective nonantibiotic therapies for prevention of recurrent UTI (rUTI). Objectives: This study investigated the effect of a whole cranberry fruit powder supplement on incidence of culture-confirmed UTI (primary outcome) in females with rUTI history.

Methods: This multicenter, 6-mo, randomized, placebo-controlled, double-blind study enrolled 150 healthy females [18-65 y, body mass index (BMI) >17.5 and <35 kg/m2] with rUTI defined as >=3 UTIs in the last year or <=2 UTIs in the last 6 mo, excluding those with >5 UTIs in the last 6 mo. Participants consumed either 1 capsule of 500 mg/d of whole cranberry powder (Pacran) or placebo. Culture-confirmed UTIs (>108cfu/L) were assessed throughout the intervention period at unscheduled clinic visits whenever participants experienced UTI symptoms and at baseline, 3- and 6-mo clinic visits. Symptomatic suspected UTIs were defined as participant-reported UTI-associated symptoms at unscheduled visits. 

Results: Whole cranberry powder capsules reduced culture-confirmed UTI risk compared with placebo by 52% (adjusted relative risk [RR]: 0.48; 95% confidence interval [CI]: 0.26, 0.87; P = 0.01); reduced Escherichia coli UTIs (RR: 0.49; 95% CI: 0.24, 1.01; P = 0.05); reduced incidence of UTI with urinary frequency and urgency symptomatology (RR: 0.29; 95% CI:0.13, 0.63; P < 0.01); delayed time to first UTI episode (adjusted hazard ratio [HR]: 0.36; 95% CI: 0.18, 0.74; P = 0.01); and reduced the mean total number of UTIs per participant (adjusted incidence rate ratio IRR: 0.41; 95% CI: 0.21, 0.79; P = 0.01). Significant differences between groups in incidence of symptomatic suspected UTIs and culture-confirmed dysuria were not observed. Exploratory scores for UTI-related female sexual matters, assessed in a subset of sexually active, consenting females, did not differ significantly between groups. No safety concerns were reported. 

Conclusion: This study shows that whole cranberry powder capsules do not impact safety markers and reduce the incidence of culture-confirmed UTI and several other UTI-related outcomes in healthy females with rUTI history. This trial was registered at clinicaltrials.gov asNCT03042273.

The diameter, length, and shape of bacteria are maintained with such high fidelity that these parameters are classically used as metrics in the distinction of bacterial species. Increasing evidence indicates that bacteria transiently shift their shapes into distinctive morphologies in response to environmental changes. Elongation of bacterial length into a filamentous shape provides unique survival advantages for many bacterial species. Analysis of 42 clinical isolates of uropathogenic Escherichia coli (UPEC) revealed that filamentation to host-derived antimicrobials is a conserved phenotype. Therefore, we hypothesize that filamentation represents a conserved mechanism of pathogenic bacterial persistence that can be targeted for narrow-spectrum, anti-virulence therapies. We demonstrate that cranberries prevent SulA-mediated filamentation of UPEC. Furthermore, we identify multiple fractions of cranberries that retain anti-filamentation properties. These studies provide mechanistic insight into the clinical efficacy of cranberry for patients with recurrent urinary tract infections. Inhibition of filamentation represents a novel approach to promote bacterial pathogen susceptibility to immune and antibiotic-mediated clearance to attenuate disease.

Background High prevalence of urinary tract infections (UTI), including cystitis, and concern for antimicrobial resistance justify safe and effective nonantibiotic therapies for prevention of recurrent UTI (rUTI). 

Objectives This study investigated the effect of a whole cranberry fruit powder supplement on incidence of culture-confirmed UTI (primary outcome) in females with rUTI history. 

Methods This multicenter, 6-mo, randomized, placebo-controlled, double-blind study enrolled 150 healthy females [18–65 y, body mass index (BMI) >17.5 and <35 kg/m2] with rUTI defined as ≥3 UTIs in the last year or ≤2 UTIs in the last 6 mo, excluding those with >5 UTIs in the last 6 mo. Participants consumed either 1 capsule of 500 mg/d of whole cranberry powder (Pacran) or placebo. Culture-confirmed UTIs (>108cfu/L) were assessed throughout the intervention period at unscheduled clinic visits whenever participants experienced UTI symptoms and at baseline, 3- and 6-mo clinic visits. Symptomatic suspected UTIs were defined as participant-reported UTI-associated symptoms at unscheduled visits. 

Results Whole cranberry powder capsules reduced culture-confirmed UTI risk compared with placebo by 52% (adjusted relative risk [RR]: 0.48; 95% confidence interval [CI]: 0.26, 0.87; P = 0.01); reduced Escherichia coli UTIs (RR: 0.49; 95% CI: 0.24, 1.01; P = 0.05); reduced incidence of UTI with urinary frequency and urgency symptomatology (RR: 0.29; 95% CI:0.13, 0.63; P < 0.01); delayed time to first UTI episode (adjusted hazard ratio [HR]: 0.36; 95% CI: 0.18, 0.74; P = 0.01); and reduced the mean total number of UTIs per participant (adjusted incidence rate ratio IRR: 0.41; 95% CI: 0.21, 0.79; P = 0.01). Significant differences between groups in incidence of symptomatic suspected UTIs and culture-confirmed dysuria were not observed. Exploratory scores for UTI-related female sexual matters, assessed in a subset of sexually active, consenting females, did not differ significantly between groups. No safety concerns were reported. 

Conclusion This study shows that whole cranberry powder capsules do not impact safety markers and reduce the incidence of culture-confirmed UTI and several other UTI-related outcomes in healthy females with rUTI history.

Background: Previous studies have explored the relationship between breakfast cereal consumption and mortality risk, but these studies reported inconsistent findings and did not distinguish between consumers of different breakfast cereal types. This prospective cohort study aims to elucidate the dose-response relationship between specific breakfast cereal types and mortality risk. 

Methods: A total of 186,168 participants aged 40 to 69 years from UK Biobank that completed at least one online 24-hour dietary recall questionnaire and reported information on breakfast cereal consumption were included. Self-reported types and amounts of dietary breakfast cereal intake, and mortality from CVD (cardiovascular disease), cancer, and all causes were estimated. Cox regression analyses were employed to illustrate the correlation between the daily intake of different breakfast cereal types and mortality risk. 

Results: During a median follow-up of 13.4 years, 9402 deaths were recorded (including 5073 cancer deaths and 1687 CVD deaths). The intake of muesli was significantly correlated with reduced all-cause mortality, with the HRs (hazard ratios) (95% CIs) being 0.89 (0.83-0.95) (> 0-0.5 bowls/d) and 0.85 (0.79-0.92) (> 0.5-1 bowls/d), respectively. Bran cereal consumption also exhibited inverse correlations with all-cause mortality, showing an HR of 0.88 (95% CI: 0.81-0.95) (> 0-0.5 bowls/d) and 0.88 (95% CI: 0.80-0.98) (> 0.5-1 bowls/d). Moderate intake of porridge (> 0.5-1 bowls/day) was correlated with a reduced risk of all-cause mortality, with an HR (95% CI) of 0.89 (0.84-0.96). Furthermore, moderate consumption of muesli and bran cereal correlated with reduced mortality risks related to CVD and cancer, while plain cereal intake was correlated with increased CVD-specific mortality risk, and sweetened cereal consumption was correlated with elevated cancer-specific mortality risk. Additionally, participants who reported adding dried fruit to their breakfast cereals exhibited significantly lower risks of all-cause mortality and cause-specific mortality, and those who added milk to their breakfast cereals had a reduced risk of all-cause mortality. 

Conclusions: The findings support the moderate intake of several breakfast cereal types, including porridge, bran cereal, and muesli, as part of a healthy diet, while oat crunch and sweetened cereal consumption should be reduced to lower premature mortality risk.