Cranberry supplements are commonly used to prevent urinary tract infections (UTIs). However, their usefulness is uncertain in pregnant women. We aimed to comprehensively summarize the current knowledge on cranberry supplements' efficacy and acceptability during pregnancy in addition to the outcome's measurement methods and studies' feasibility. To achieve it, we searched PubMed, PMC, and Europe PMC databases plus screened citations followed by critical appraisal of included eligible English written primary studies that (1) focused on pregnant women supplemented with any cranberry supplements; (2) provided data on cranberry supplements' efficacy, acceptability, outcomes measurement methods, and studies' feasibility; (3) included human subjects; and (4) published worldwide. Two randomized clinical trials (RCTs) and one nested cohort study, including 1156 pregnant women in total, contributed to our analysis. A tendency toward UTI reduction was demonstrated, although the results' validity was impacted by significant juice-induced gastrointestinal intolerance (23%; 44 of 188 subjects). Changing the form of supplementation from cranberry juice to capsules reduced the issue, causing side effects in one of 49 subjects (2%). Nevertheless, both RCTs still experienced significant recruitment and retention problems, which were at 33% and 59% on average, respectively. Newly acquired safety data on 919 more subjects suggests no increased risks of all malformations, vaginal bleeding, and neonatal complications. Investigating cranberry capsules' efficacy as a non-antibacterial option for UTI prevention in pregnant women has become a feasible and important direction with the current advancement in understanding cranberry supplements' actions, recommended doses plus regimens, and their safety in the population. We reviewed the challenges and discovered knowledge gaps and the implementation strategies for future studies.

Background: Cranberries (particularly in the form of cranberry juice) have been used widely for several decades for the prevention and treatment of urinary tract infections (UTIs). The aim of this review is to assess the effectiveness of cranberries in treating such infections.

Objectives: To assess the effectiveness of cranberries for the treatment of UTIs.

Search methods: We searched the Cochrane Kidney and Transplant Register of Studies up to 1 August 2023 through contact with the Information Specialist using search terms relevant to this review. Studies in the Register are identified through searches of CENTRAL, MEDLINE, and EMBASE, conference proceedings, the International Clinical Trials Registry Portal (ICTRP) Search Portal and ClinicalTrials.gov.

Selection criteria: All randomised controlled trials (RCTs) or quasi-RCTs of cranberry juice or cranberry products for the treatment of UTIs. Studies of men, women or children were to be included.Data collection and analysisTitles and abstracts of studies that were potentially relevant to the review were screened and studies that were clearly ineligible were discarded. Further information was sought from the authors where papers contained insufficient information to make a decision about eligibility.Main resultsNo studies were found that fulfilled all of our inclusion criteria. Seven studies were excluded because they were the wrong study design, mixed interventions or did not report any relevant outcomes. One study is ongoing; however, its current status is unknown.

Authors' conclusions: After a thorough search, no RCTs which assessed the effectiveness of cranberry juice for the treatment of UTIs were found. Therefore, at the present time, there is no good quality evidence to suggest that it is effective for the treatment of UTIs. Well-designed parallel-group, double-blind studies comparing cranberry juice and other cranberry products versus placebo to assess the effectiveness of cranberry juice in treating UTIs are needed. Outcomes should include a reduction in symptoms, sterilisation of the urine, side effects and adherence to therapy. The dosage (amount and concentration) and duration of therapy should also be assessed. Consumers and clinicians will welcome the evidence from these studies.

PLAIN LANGUAGE SUMMARY: Still waiting for evidence about whether cranberries are useful for treating urinary tract infectionsCranberries contain a substance that can prevent bacteria from sticking to the walls of the bladder. This may help reduce bladder and other urinary tract infections (UTIs). Cranberries (usually as cranberry juice) have been used to try and treat UTIs, particularly in high-risk groups such as older people. Cranberries have few adverse effects. This review found no studies reporting the effects of cranberry juice or other cranberry products on the treatment of UTIs.

Mitophagy, a process that removes damaged mitochondria, plays a key role in healthy cellular homeostasis. Decreased mitophagy contributes to the aging process and induction of mitophagy has been identified as a novel anti-aging mechanism for a few polyphenols. Cranberries have numerous health benefits which have been ascribed to their rich polyphenol content. Cranberries and cranberry polyphenols may also have the ability to induce mitophagy. To evaluate this hypothesis, the mitophagy inducing abilities of cranberry extracts and a few abundant cranberry polyphenols were examined in normal human fibroblasts, monitoring via confocal microscopy and Western blots. A cranberry extract (polyphenol content 120-125 mg/g) induced mitophagy with a maximum effective concentration of similar to 4 mu g/mL. Cranberry polyphenol subfractions, flavonols (0.4 mu g/mL) and anthocyanins (5 mu g/mL), induced mitophagy at low concentrations, while proanthocyanidins required a significantly higher concentration (50 mu g/mL) to achieve efficacy. When tested separately, the most abundant cranberry flavonols, quercetin, myricetin and kaempferol each induced mitophagy in a dose-dependent manner but were less efficient than the flavonol subfraction. A mixture of quercetin, myricetin and kaempferol at their most effective concentrations induced mitophagy comparable to the flavonol subfraction. These results suggest cranberry polyphenols induce mitophagy with flavonols requiring the lowest concentration to effectively induce mitophagy due to complementary or synergistic effects, shedding new light on the bioactivity of cranberries.

Background: Beneficial effects of fish oil n-3 polyunsaturated fatty acids (PUFAs) have been reported in rheumatoid arthritis (RA) however, high doses of n-3 fatty acids have been associated with increased total and LDL cholesterol and impaired glucose metabolism. Cranberry products have been reported to improve markers of oxidative stress, inflammation, and the metabolic profile in patients with type 2 diabetes mellitus and with metabolic syndrome. We hypothesized that including low-energy cranberry juice on a regimen of fish oil supplementation could improve oxidative stress and attenuate the undesirable effects of fish oil in lipid and glucose metabolism in patients with RA. 

Methods: A 90-days randomized controlled trial was conducted. Patients (n = 70) were assigned to one of three groups: control (C); fish oil (FO) received 3 g of fish oil PUFAs supplementation/day; and fish oil and cranberry (FOCR) received 3 g of fish oil PUFAs and 500 mL of cranberry juice/day. 

Results: There was no difference in parameters between FO and the C. FOCR group showed decreased glucose (p = 0.0225), lipid (p = 0.0079), protein (p = 0.0063) oxidation, and Oxidative Stress Index (p = 0.0375) values compared to FO. FOCR reduced glucose values (p = 0.0104), triacylglycerol (p = 0.0065), protein oxidation (p = 0.0042) and Oxidative Stress Index (OSI) (p = 0.0053) compared to the C. Compared to baseline, FO group decreased triacylglycerol (p = 0.0374) and increased glucose (p 0.0001), whereas FOCR group decreased tri-acylglycerol (p = 0.0398) values. 

Conclusion: 500 mL/day of reduced-calorie cranberry juice in patients with RA using fish oil supplementation decreased lipid, protein oxidation and OSI. Turn on screen reader support To enable screen reader support, press Ctrl+Alt+Z To learn about keyboard shortcuts, press Ctrl+slash

BACKGROUND AND OBJECTIVE: With over 50% of women suffering from at least one episode of urinary tract infection (UTI) each year and an increasing prevalence of antimicrobial resistance, efforts need to be made to clearly identify the evidence supporting potential non-drug interventions. This study aims to compare the effects of cranberry juice, cranberry tablets, and increased liquids for the management of UTIs.

METHODS: PubMed, Embase, and Cochrane CENTRAL were searched for randomised controlled trials. The primary outcome was the number of UTIs, and the secondary outcomes were UTI symptoms and antimicrobial consumption. A risk of bias assessment was performed using the Cochrane risk of bias tool, and the certainty of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation.

KEY FINDINGS AND LIMITATIONS: A total of 20 trials (3091 participants) were included, with 18 studies highlighting a 54% lower rate of UTIs with cranberry juice consumption than no treatment and a 27% lower rate than placebo liquid. Cranberry juice also resulted in a 49% lower rate of antibiotic use than placebo liquid and a 59% lower rate than no treatment, based on a network meta-analysis of six studies. The use of cranberry compounds also reduced the prevalence of symptoms associated with UTIs.

CONCLUSIONS AND CLINICAL IMPLICATIONS: With moderate to low certainty, the evidence supports the use of cranberry juice for the prevention of UTIs. While increased liquids reduce the rate of UTIs compared with no treatment, cranberry in liquid form provides even better clinical outcomes in terms of reduction in UTIs and antibiotic use and should be considered for the management of UTIs.

PATIENT SUMMARY: With the increasing prevalence of antimicrobial-resistant UTIs, alternate non-drug treatment options for its management are required. Available evidence supports the use of cranberry compounds and increases in fluid intake for managing UTIs.

PURPOSE: Cranberries have the highest polyphenol and antioxidant capacity among fruits and vegetables and may protect against exercise-induced free radical production, consequently improving performance. This study aimed to investigate the effect of polyphenol-rich cranberry extract (CE) on time-trial performance and lactate response following exercise.

METHODS: A total of 14 trained runners were tested at i) baseline, ii) 2 h following an acute CE dose (0.7 g/kg of body mass), and iii) 4 weeks after daily supplement consumption (0.3 g/kg of body mass). At each time point, runners performed a 1500-m race followed by a 400-m race where the live vastus lateralis oxygenation changes were determined by near-infrared spectroscopy and blood lactate was measured at rest and 1 and 3 min after each trial. The Shapiro-Wilk test and repeated-measures analysis of variance were used to establish significance (P <0.05).

RESULTS: Cranberry supplementation over 28 d improved aerobic performance during the 1500-m time trial, whereas the acute dose had no effect. More specifically, muscle reoxygenation rates were significantly faster after 28 d compared to baseline (P = 0.04; eta = 0.29), and a trend towards slower deoxygenation rate was observed (P = 0.13; eta = 0.20). Chronic CE consumption also buffered the post-exercise lactate response for the 400-m race (P = 0.01; eta = 0.27), while no effects were seen for the longer race.

CONCLUSION: Our results suggest that cranberry supplementation may have ergogenic effects, as it improves physiological markers of performance during short- and long-distance running.

The mechanism by which cranberry-lingonberry juice (CLJ) prevents urinary tract infections (UTI) in children remains unknown. We hypothesized that it alters the composition of the gut or urinary microbiome. Altogether, 113 children with UTIs were randomly allocated to drink either CLJ or a placebo juice for 6 months. We collected urinary samples at 3 months and fecal samples at 3, 6 and 12 months and used next-generation sequencing of the bacterial 16S gene. The children who consumed CLJ had a lower abundance of Proteobacteria (p = 0.03) and a higher abundance of Firmicutes phylum (p = 0.04) in their urinary microbiome at 3 months than did those in the placebo group. The abundance of Escherichia coli in the urinary microbiome was 6% in the CLJ group and 13% in the placebo group (p = 0.42). In the gut microbiome the abundance of Actinobacteria at 3 and 12 months was higher in the children receiving CLJ. The diversity of the urinary and gut microbiome did not differ between the groups. The children drinking CLJ had a different urinary and gut microbiome from those receiving a placebo juice. A healthy urinary microbiome may be important in preventing UTIs in children.

Introduction: The main function of the urinary tract is to form an impermeable barrier against urinary solutes and bacteria. However, this barrier can be compromised by urinary tract infections, most commonly caused by uropathogenic Escherichia coli (UPEC). This can result in damage to the epithelial barrier, leading to decreased epithelial thickness, loss of tight junctions, loss of epithelial integrity, and apoptosis. Due to the rise in antimicrobial resistance, there is worldwide interest in exploring non-antibiotic agents as alternative therapy. 

Methods: Using the Madin-Darby canine kidney (MDCK) cell line, a widely accepted epithelial cell model for the urinary tract, and the UPEC strain UTI89, this paper aimed to investigate the impact of UPEC on cell integrity, permeability, and barrier functions, and determine whether cranberry, D-mannose and ibuprofen could counteract the effects induced by UPEC. Furthermore, the study examined the protective potential of these agents against UPEC-induced increase in reactive oxygen species (ROS) production and programmed death-ligand 1 (PD-L1) expression.

Results: The results demonstrated that UTI89 caused a marked reduction in cell viability and monolayer integrity. Cranberry (3 mg/mL) was protective against these changes. In addition, cranberry exhibited protective effects against UPEC-induced damage to cell barrier integrity, escalation of oxidative stress, and UPEC/TNF alpha-triggered PD-L1 expression. However, no effect was observed for D-mannose and ibuprofen in alleviating UPEC-induced cell damage and changes in ROS and PD-L1 levels.

Conclusion: Overall, cranberry, but not D-mannose or ibuprofen, has a protective influence against UPEC associated damage in urinary epithelial cells. Turn on screen reader support To enable screen reader support, press Ctrl+Alt+Z To learn about keyboard shortcuts, press Ctrl+slash

Urinary tract infections (UTI), which are among the most frequent cases of infectious diseases, mainly affect women. The most common treatment approach involves the use of antibiotics, although this solution is not always the most suitable, mainly because of the resistance that bacterial strains develop. Proanthocyanidins are a class of polyphenols, abundantly contained in cranberry extracts, which have shown beneficial effects in the treatment of urinary tract infections, due to their anti-adhesive properties toward bacteria, with respect to the membranes of the cells of the urothelium and intestine, thus reducing their virulence. In this work, we demonstrate via microscopy and scattering measurements how a mixture of cranberry and chondroitin sulfate can form a crosslinked structure with barrier properties. By using a design of experiment (DOE), we optimized the mass ratio to obtain a precipitate between cranberry extract and chondroitin sulfate in the presence of N-acetylcysteine and hyaluronic acid. By using transepithelial electrical resistance (TEER) chambers, we confirmed the barrier properties of the best mixture obtained with the DOE. Lastly, the antibiofilm action was investigated against five strains of Escherichia coli with different antibiotic sensitivity. The precipitate displayed a variable inhibitory effect in biofilm formation with major effects in UTI with an antibiotic resistance profile.

Background Astronauts undergo significant microgravity-induced bone loss during space missions, which has become one of the three major medical problems hindering human's long-term space flight. A risk-free and antiresorptive drug is urgently needed to prevent bone loss during space missions. D-mannose is a natural C-2 epimer of D-glucose and is abundant in cranberries. This study aimed to investigate the protective effects and potential mechanisms of D-mannose against bone loss under weightlessness. Methods The hind legs of tail-suspended (TS) rats were used to mimic weightlessness on Earth. Rats were administered D-mannose intragastrically. The osteoclastogenic and osteogenic capacity of D-mannose in vitro and in vivo was analyzed by micro-computed tomography, biomechanical assessment, bone histology, serum markers of bone metabolism, cell proliferation assay, quantitative polymerase chain reaction, and western blotting. RNA-seq transcriptomic analysis was performed to detect the underlying mechanisms of D-mannose in bone protection. Results The TS rats showed lower bone mineral density (BMD) and poorer bone morphological indices. D-mannose could improve BMD in TS rats. D-mannose inhibited osteoclast proliferation and fusion in vitro, without apparent effects on osteoblasts. RNA-seq transcriptomic analysis showed that D-mannose administration significantly inhibited the cell fusion molecule dendritic cell-specific transmembrane protein (DC-STAMP) and two indispensable transcription factors for osteoclast fusion (c-Fos and nuclear factor of activated T cells 1 [NFATc1]). Finally, TS rats tended to experience dysuria-related urinary tract infections (UTIs), which were suppressed by treatment with D-mannose. Conclusion D-mannose protected against bone loss and UTIs in rats under weightlessness. The bone protective effects of D-mannose were mediated by inhibiting osteoclast cell fusion. Our findings provide a potential strategy to protect against bone loss and UTIs during space missions.