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 Women taking the capsules had just as many UTIs and
infection-promoting factors in their urine as women taking inert
placebo pills, researchers conclude.
"I think it reinforces what many of the other studies have said so
far," said lead author Dr. Manisha Juthani-Mehta, of the Yale School
of Medicine in New Haven, Connecticut.
Previous studies on the use of cranberry products like juice and
capsules produced mixed results. A systematic look at that evidence
published in 2012 by the Cochrane Collaboration, an international
organization that evaluates and reviews medical research, concluded
"cranberry juice cannot currently be recommended for the prevention
of UTIs."
Originally, it was thought that eating or drinking cranberry
products increased the acidity of urine and prevented UTIs. There
was also speculation that a compound in cranberries known as
proanthocyanidin prevented bacteria from adhering to the bladder
wall.
For the new study, the researchers randomly assigned 185 women over
65 years old living in 21 nursing homes near Yale to take pills
every day. The participants received either two capsules containing
cranberry extracts including a total of 72 milligrams of
proanthocyanidin, the equivalent of a person drinking a 20-ounce
bottle of cranberry juice, or they got look-alike dummy pills.
At the start of the study, about a third of the women had positive
urine tests for bacteria and white blood cells, which doesn't mean
the women had UTIs but these are needed elements for an infection to
occur.
The researchers had a year of data on 147 women. The other women
either died, withdrew from the study or were discharged from the
nursing home.
Overall, there was no difference between women who took cranberry
pills or placebos in the proportion who had bacteria and white blood
cells in their urine at the end of the study period. Additionally,
there was no difference between the two groups in the share of women
who experienced symptomatic UTIs, died, were sent to hospitals or
used antibiotics.
The results were published in JAMA to coincide with their
presentation at the infectious disease conference known as IDWeek,
which is being held in New Orleans.
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"It is time to move on from cranberries," writes Dr. Lindsay Nicolle
in an editorial accompanying the new study.
"The continuing promotion of cranberry use to prevent recurrent UTI
in the popular press or online advice seems inconsistent with the
reality of repeated negative studies or positive studies compromised
by methodological shortcomings," writes Nicolle, of the University
of Manitoba in Winnipeg, Canada.
Juthani-Mehta told Reuters Health that there is probably little
downside to people eating or drinking cranberry products if they
like, but she wouldn't recommend those as a way to prevent UTIs -
especially among older adults who may be on a fixed income.
"Capsules can range from not a lot of money to $200 per month for a
30-day supply," she said.
For UTI prevention, Juthani-Mehta said there are a couple approaches
people - especially women - can take, including making sure they
stay hydrated.
"In terms of prevention, hydration is certainly important," she
said. "The other factor in post-menopausal women is topical estrogen
therapy among women who had recurrent UTIs. It has shown some
benefit."
"We may not have a study to say drinking water can prevent UTIs, but
that’s really what I recommend," she said.
SOURCE: http://bit.ly/2eKztGl and http://bit.ly/2eKABtx JAMA, online
October 27, 2016.
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