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  • Kaelyn Turner

Good, grief Charlie Brown.

Shoooooo it's election night and I got my wine sippin' through a swirly straw. I started writing this blog a WEEK ago and I've been so busy I am just now finishing it. Not proud of that, I'm gonna do better!! Anyway............ Aside from the election day/night/week/year drama......

I heard on the radio that none of the Charlie Brown holiday special shows are going to be played on cable this year. Not the Great Pumpkin, not the Thanksgiving Special, no Charlie Brown Christmas. Sigh. I have the best memories of Snoopy and Chuck. Every time I stayed

the weekend at my grandparents house, my grandfather would sit me on his knee on Sunday morning, as I was served coffee-milk, and he would read me "the funnies" out the actual

newspaper - like the paper that left ink on your fingers. Of course, my favorite was Snoop and Chuck.

Ah, nostalgia - a dying joy in 2020.

Yes, I'm aware of the controversy regarding the Thanksgiving Charlie Brown. This ain't that kinda blog. Speaking of Thanksgiving, cranberries.....yeah.... Cranberries..... are totally a "thing" for Thanksgiving dinner (and holiday food in general), right? I guess. I don't eat pie (the jelly looking texture of it makes me gag), and I don't think any of my family dinners have ever included cranberry sauce? I dunno. I've never pondered it until now.

Do y'all do a lot of cranberry stuff for holidays? I'd take 'em like this LOL

Did you know cranberries have drama too?! Why does everything have drama? I'm tired.

I would bet every female that reads this blog has either heard, read, been told, or been advised by a medical professional that "drinking cranberry juice will help (or even cure?!) your urinary tract infection."

Yes. We did bounce from Election night... to Charlie Brown... to a trigger topic... to Thanksgiving cranberry food items... to urinary tract infections... If you're new here, this is normal...

So. That's our topic for today. Does cranberry juice cure urinary tract infections?

As a patient - should you be drinking cranberry juice or taking cranberry based supplements if you start feeling symptoms of a UTI (burning when you pee, difficulty peeing, feeling like you constantly have to pee and every time you try nothing comes out, bladder spasms)?

As a provider, should you be telling patients to drink cranberry juice when you diagnose them with a UTI - or perhaps recommending a certain supplement, in addition to or other than antibiotics? Let's find out!

I could make this the shortest blog ever:

"Pure cranberry juice, cranberry extract, or cranberry supplements may help prevent repeated UTIs in women, but the benefit is small. It helps about as much as taking antibiotics to prevent another UTI. 1 ... No single concentration of cranberry juice, extract, or supplement has been studied, so it's hard to know which product to choose... to prevent UTIs, it's better to drink pure, unsweetened cranberry juice (rather than cranberry juice cocktail). Drinking cranberry juice cocktail doesn't seem to prevent UTIs better than drinking any other fruit juice... There is no proof that cranberry can cure a UTI. Cranberry is not well tested as a UTI treatment."

The end.

LOLLL If you know me even a little, you know that's a lie! I alwayss got more to say.

A UTI is an infection that occurs anywhere in the urinary tract. Infections can happen in the kidneys (where urine is created), the ureters (where urine travels from the kidneys), the bladder (where urine is stored) and the urethra (where urine leaves the body). These infections are all usually caused by bacteria. 2

The key player in this is definitely not your gas station Ocean Spray 2 for $3. No offense Ocean Spray, you are delicious with lime and tequila. Or champagne.

Just not delicious for UTIs.

The key player: It's "A-type proanthocyanidins (PACs)". Don't even ask me to pronounce.

The PACs found in cranberries have a different structure than those found in other fruits and vegetables which are associated with their anti-adhesion properties. Cranberry PACs help prevent the adhesion of certain harmful bacteria, including E. coli associated with urinary tract infections, onto cell walls. 3

Translation: Scientists figured out that this little teeny chemical compound that can be extracted from cranberries, is built in such a way that it can block some bacteria from sticking to the walls of your bladder. An E. Coli infection is the most common UTI...E. Coli is prominent in our digestive poops...and... a lot of people get UTIs because of E. Coli.....

Wipe front to back! Wipe ya kids front to back. Tell ya wife to wipe front to back. #WipingFrontToBackMatters

"Among the generally healthy population, the risk of having an uncomplicated UTI is ∼50 times higher in adult women than in adult men". Women have different anatomy compared to men... different outlets are in closer proximity... if you pick up what I'm putting down. 6

Proanthocyanidins (PACs) are in the flavanol family – a class of polyphenols. 3

"Polyphenols are micronutrients that we get through certain plant-based foods. They’re packed with antioxidants and potential health benefits." 4 Cocoa, berries, non berry fruits, beans, and other things are a good source of polyphenols. Beans are not an enemy BTW, but that's a topic for another blog. Y'all also - I am using way more direct quotes in this blog than I normally do - but the sites are stating these things so well, that I don't want to paraphrase.

Macronutrients are protein, carbohydrate, fat. Micronutrients are like.. sodium, magnesium, zinc, potassium, etc. Generally, most humans do not have a diet (meaning - the way they eat most of the time, their eating habits) that is nutrient-dense enough to provide adequate micronutrients. Which is why most people take a multivitamin, and most family/general doctors will recommend a multivitamin daily. Polyphenols are another micronutrient that humans get from "healthy" foods... again, that MOST people don't eat enough of...

but... not you... you're that unicorn...

Flavonoids are rich in antioxidant activity and can help your body ward off everyday toxins. 5 ...Anthocyanins are naturally produced pigments that give flowers their red, purple, and blue color. They’re predominantly found in the outer skin of berries and berry products like..... cranberries...
Flavanoids are found in many foods, and their main job is anti-oxidant activities - reducing inflammation, preventing infection from every-day germs, and reducing bad changes to your normal cells (changes that cause cancer). 5

So... this A-Type PAC that can be extracted from cranberries... You could assume that since this is the preventative or curative component of cranberries, that we'd want to consume a concentrated or clinically (medically) significant amount of it to specifically prevent or cure a UTI. "..Because women with recurrent UTIs are the group to whom most recommendations regarding cranberry consumption is directed, inclusion of other groups in the efficacy assessment could influence clinical practice quality..." 6

I'm going to close out this blog with two bottom-line summaries of everything I've read. You are more than welcomed to read them in their entirety, and that's why I include all my sources in the linked terms, numbers after paragraphs and at the very end in the source list. The science is very repetitive. These individual chemical compounds have yes, been isolated, and are shown to prevent binding of E. Coli to the bladder wall, thereby preventing infection. While E. Coli is certainly the most common infection (approximately 40% of all UTIs, that number also varies depending which study you read), but I can tell you, from clinical experience - there is NO way to know whether your UTI is even bacterial, or which bacteria is causing it. There are way too many healthcare providers out there that don't make the effort to CULTURE your urine. They treat you with the most common antibiotics that treat most infections and send you along your way. They tell you to drink cranberry juice because it's been "proven" to treat UTIs. This is inaccurate for MOST of the population. Most of the population is not having a chronic, recurrent UTI. Most of the population is having an uncomplicated, isolated UTI.

Another angle - pure cranberry concentrate is nasty LOL There are most definitely cranberry supplements you can buy, pills, powders, liquids.

But, when people are advised to "drink cranberry" for their UTI - they will go to the store and purchase cranberry cocktail or cranberry juice. If you have been around this blog for a while... you may know where I'm going with this....

How much SUGAR is in the cranberry juice you purchased and how many of them suckers are you throwing back the week you think you have a bladder infection? I searched far and wide for a legitimate source that proves my point that drinking excess sugar is bad for UTIs. I can find hundreds of blogs, urology clinic sites, women's health sites, blogs that confirm that intake of excess sugar will worsen symptoms and bacterial count for UTIs, but Google is just really not picking up what I'm putting down. There are tons of scientific sources that have massive amounts of evidence that high blood sugars, or spillage of sugar into your urine, and avoidance of dietary sugar/excess oral intake of sugar is an unquestionable cause of UTI - in diabetic patients.

My question is - why we gotta wait 'til we're fully diabetic to avoid intake of excess sugar?? There is one hypothesis on PubMed that strictly due to the diuretic effect of intake of sugary beverages coupled with the "increase in intake of fluids" compared to forced dehydration -intake of sugary beverages was superior to forced dehydration for clearly bacterial infection from the urinary tract.................................. DUH.

The bottom line for me - if I'm going to recommend cranberry to you, my patient with a burning urethra - I will never recommend or agree with you drinking sugary cranberry cocktail. You will unfortunately have to consume UNsweetened cranberry juice, or take concentrated cranberry supplements, or another thing called "D-Mannose" - if that's the route you want to take to fix your UTI. 8

Final thoughts:

"The isolation of the component(s) of cranberry with this activity has been a daunting task, considering the hundreds of compounds found in the fruit and its juice derivatives. Reasonable evidence suggests that the anthocyanidin/proanthocyanidin moieties are potent antiadhesion compounds. However, problems still exist with standardization of cranberry products, which makes it extremely difficult to compare products or extrapolate results. Unfortunately, most clinical trials have had design deficiencies and none have evaluated specific key cranberry-derived compounds considered likely to be active moieties (e.g. proanthocyanidins). In general, the preventive efficacy of cranberry has been variable and modest at best." 7

Key word: PREVENTIVE - not CURATIVE. Prevent. Not cure. Prevent, not treat.

Cochrane: Nursing students know what's up.

"Cranberry juice does not appear to have a significant benefit in preventing UTIs and may be unacceptable to consume in the long term. Cranberry products (such as tablets or capsules) were also ineffective (although had the same effect as taking antibiotics), possibly due to lack of potency of the 'active ingredient'." 9

What should you do?

Drink a ton of water, avoid caffeine and alcohol if you think you have a UTI, avoid highly sugary drinks, and go see somebody. Get your urine tested, not just in the office or clinic - make sure whoever tells you that you have a UTI actually sends your urine for a culture. They need to be sure they are giving you the correct antibiotic, if you even need one at all - and if you want to try cranberry products - stick to the cranberry concentrate pills, D-Mannose, or pure, unsweetened cranberry juice. Whole cranberries and blueberries are okay too, however, the amount of the necessary components is likely too low to make any difference in your symptoms and course of illness.

Prevention is always best! Drink plenty of water every day, pee when you need to, urinate after sex, wipe front to back, do not hold in your bowel movements, eat a healthy diet with plenty of fruits and vegetables, and be merry!

Cheers, America.



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