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Among older women residing in nursing homes, administration of cranberry capsules compared with placebo resulted in no significant difference in presence of bacteriuria plus pyuria (presence of bacteria and white blood cells in the urine, a sign of urinary tract infection [UTI]), or in the number of episodes of UTIs over 1 year, according to a study published online by JAMA. The study is being released to coincide with its presentation at IDWeek 2016.
Urinary tract infection is the most commonly diagnosed infection among nursing home residents. Bacteriuria is prevalent in 25 percent to 50 percent of women living in nursing homes, and pyuria is present in 90 percent of those with bacteriuria. Cranberry capsules are an understudied, nonantimicrobial prevention strategy used in this population. Manisha Juthani-Mehta, M.D., of the Yale School of Medicine, New Haven, Conn., and colleagues randomly assigned 185 women (average age, 86 years; with or without bacteriuria plus pyuria at study entry) residing in nursing homes to two oral cranberry capsules, each capsule containing 36 mg of the active ingredient proanthocyanidin (i.e., 72 mg total, equivalent to 20 ounces of cranberry juice) or placebo administered once a day.
Another folk remedy bites the dust?
(Score: 5, Insightful) by HiThere on Sunday October 30 2016, @06:56PM
It often happens that something works, but doesn't work for the reasons supposed. Cranberry juice concentrate capsules aren't at all equivalent to cranberry juice.
One guess as to how it might actually work is that it flushes the bacteria out because of a higher volume of urine. If that were the case, then cranberry juice concentrate wouldn't be expected to work.
And this wasn't even cranberry juice. This was some particular extract from cranberry juice. So, no, it doesn't even indicate that "the folk remedy doesn't work". It does indicate that one particular hypothesis of why it might work is wrong. To study whether it works or not you need to compare those drinking cranberry juice with those that aren't. This was not done.
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(Score: 2) by HiThere on Sunday October 30 2016, @06:58PM
"Was not done" is too severe. The accurate statement is "There's no indication in the summary that this was done.".
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(Score: 1) by Ethanol-fueled on Sunday October 30 2016, @07:19PM
Still, that's kind of like trying to prove that vaping Marijuana causes lung-cancer by having your test subjects smoke joints.
(Score: 4, Informative) by AthanasiusKircher on Sunday October 30 2016, @10:43PM
Yes, it wasn't done in this study. See the linked Cochrane review in my previous post, or see the JAMA editorial [jamanetwork.com] which accompanied this article for details of other studies which did use actual cranberry juice.
For a brief history, originally cranberry juice was hypothesized to help based on its ability to lower urine pH. But studies showed that the effect was too small to even theoretically affect UTIs unless people drank WAY more cranberry juice than was reasonable. Thus, they started looking into more targeted possible causes for effects, hence capsules that concentrate the substances that some people have hypothesized are the "active" ones that help with UTIs. (In the present case, the capsules contained more of the hypothesized "active" ingredient than would be reasonable for most people to consume, equivalent to drinking ~20 ounces of pure cranberry juice each day... and not that sweet "cocktail" that only contains maybe 1/4 cranberry juice.)
Another reason for the capsules is that cranberry juice studies apparently tend to have a very high non-compliance rate -- i.e., a lot of people just don't like drinking it all the time, and they simply stop. This obviously creates potential data issues.
Bottom line: they've tried giving people the juice. They've tried the capsules. They've tried both on female college students, old women, pretty much all common subpopulations. Most studies show no significant results at all, and the few that did tend to have methodological problems which mostly have disappeared in subsequent better studies. The JAMA editorial mentions one remaining subpopulation which still has a statistically significant positive effect -- women with recent gynecological surgery. However, the study that showed the effect had various methodological problems, so the effect still needs confirmation.
(Score: 0) by Anonymous Coward on Sunday October 30 2016, @08:18PM
One guess as to how it might actually work is that it flushes the bacteria out because of a higher volume of urine. If that were the case, then cranberry juice concentrate wouldn't be expected to work.
Which means that cranberry juice itself still does nothing. Unless you're going to claim that urine created from ingesting cranberry juice is magically different than urine created simply by drinking water.
(Score: 0, Troll) by Francis on Sunday October 30 2016, @09:49PM
Not necessarily. It might mean that the active ingredient in the pill isn't making its way into the small intestine when it's taken as a pill.
That wouldn't be the first time changing the delivery mechanism changed the efficacy. That's a problem that comes up fairly often when generic medications are put into different pill shrouds than the name brand you sometimes get slightly different reactions from patients.
A better way to conduct the experiment would probably be to take the ingredient they're looking at and dissolve it into water at roughly the expected concentration of cranberry juice. That way, it's more likely to behave like the real thing. If that works, then they can consider testing it in pill form. But as it is, they don't necessarily know if the ingredient didn't work or if it didn't get delivered appropriately.
(Score: 0) by Anonymous Coward on Monday October 31 2016, @04:02AM
Reading comprehension much? The person I quoted was claiming the benefit had to do with increased urine to flush out bacteria. What does the small intestine have to do with the bladder and urine?
(Score: -1, Troll) by Anonymous Coward on Monday October 31 2016, @04:08AM
If you're going to mod me a troll, you could at least read my post before doing so. I think it's pretty fucking obvious what the connection between my post and the ones I'm responding to is.
(Score: 2) by HiThere on Monday October 31 2016, @06:07PM
Well, the urologist was reported as claiming that cranberry juice resulted in urine that contained substances which interfered with the adhesion of the bacteria to the walls of the urethra. I don't know what he based that on. Perhaps he (she?) just wanted to have some answer to give.
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