Cranberry

Cranberry

(Vaccinium Macrocarpon)

Mike Darnofall and Stewart Eckard

General Description

Small evergreen shrub (botanical family, Ericacea) that grows in mountains, forests and damp bogs from Alaska to Tennessee
Requires wet, boggy, acidic Soil (pH{ 4-5.5)
Pink or purple flowers bloom from late spring to late summer and produce bright red berries in the fall.
Berries have a distinct, tart flavor and are a low-calorie source of vitamins, minerals, and fiber.
Most commercial production of cranberries is in New England and Wisconsin.
- dry harvesting (fresh produce)
- wet harvesting (juice, sauce)

Chemical Composition

Fructose and other sugars
Organic acids (benzoic acid in cranberry is converted to hippuric acid (N-benzoylglycine) in the urine.)
Proanthocyanidin complexes similar to those found in pine bark, grape seed.
A high molecular weight glycoprotein that blocks bacterial adhesion to body tissues.

History and Folk Use

Europeans learned how to use cranberry as a food, dye, medicine from Native Americans.
Pilgrims supposedly dined on cranberry dishes at the first Thanksgiving in 1621.
Cranberry sauce became a national tradition when General U.S. Grant ordered it served to Union troops during the siege of Petersburg in 1864.
Use by New England sailors to prevent scurvy.
German researches discovered hippuric acid in urine of cranberry eaters in 1840. Thought to acidify urine and prevent UT'
Cranberry fell out of favor in the 1960s because researchers showed that it couldn't increase urine acidity enough to prevent illness.
Current theory focuses on cranberry's ability to prevent bacteria from attaching to urinary tract walls.

Pharmacology

Anti-adhesion
- Prevents bacteria (E coli, Klebsiella, etc.) from adhering to urinary tract tissue
- Helps urinary tract to "flush" bacteria

Increased Acidity?
- Reduces urine odor
- May prevent some types of kidney stones (decreased urinary calcium with increased acidity)

Proanthocyanidin Related?
- Increase intracellular vitamin C level
- Decrease capillary permeability/fragility
- Anti-free radical activity
- Inhibit destruction of collagen

Clinical Uses of Cranberry

Toxicity

Drug-Disease Interactions

Large doses (> 1.5 L juice/day) can increase elimination of basic drugs.
Most common type of kidney stone (calcium oxalate) tends to occur in acid urine.

Dosage

Clinical Studies

Reduction of Ammoniacal Urinary Odors by the Sustained Feeding of Cranberry Juice

2 groups- 110 males, 110 females- most but not all were incontinent
All cleaning/sanitizing materials used to deodorize the wards were removed 1 week before the project
3 oz Cranberry Juice/day, increased by 1 oz/week until total of 6 oz/d
Urine sampled from 5 patients for pH
Air samples collected in 0. lN solution of Sulfuric acid
Measurements for determination of Ammonia
Reports from institution personnel
Results:
- Chemical measurements failed to reveal significant changes after patients received CJ
- Subjective questioning of the employees did seem to show improvement in the amount of urinary odors among the patients, particularly in the female ward

Reduction of Bacteriuria and Pyuria after Ingestion of Cranberry Juice

Randomized, Double Blind, Placebo Controlled
153 elderly women(mean age 78~5)-8l8 urine samples
Drank 300ml/d of either CJ or specially prepared synthetic placebo drink indistinguishable in taste, appearance, and Vitamin C
Baseline urine sample + 6 clean voided samples at 1 month intervals
- Tested for bacteriuria and WBC's

Could not consume any cranberry products other than those distributed during study
Results:
- Bacteriuria with Pyuria
  - placebo=28.1%
  - sample=15.0%
  - Adjusted Odds Ratio =0.42(95% CI, 0.23-0.76; p=0.004)
  - Difference not present in ~ month, but most striking between ~ and 2nd and then remaining fairly stable

Subjects on CJ were fare more likely to make transition from contaminated to non-contaminated
No significant changes in acidity
- Placebo pH=5.5
- Sample pH=6.0

References

Avorn J., et al: Reduction of Bacteriuria and Pyuria After Ingestion of Cranberry Juice. JAMA 271, 751-754, 1994

Castleman, M~, The Healing Herbs, Rodale Press, Emmaus, PA. 1991; pp 141-142

Dugan, C., Cardaciotto, P.S., [Cranberry and Incontinence], Journal of Psychiatric Nursing 8: 467, 1966.

Light I., et al: Urinary Ionized Calcium in Urolithiasis. Effect of Cranberry Juice. Urology 1, 67-70, 1973.

Sobota A. E.: Inhibition of Bacterial Adherence By Cranberry Juice:... J Urol. 131, 1013-1016, 1984.