Since 1984, many studies have indicated that cranberries may have a number of health benefits, the foremost being its "anti-adhesion" effect on certain bacteria. Ocean Spray Cranberry Juice Cocktail contains natural cranberry compounds called proanthocyanidins, which are the compounds believed responsible for the anti-stick mechanism that helps maintain urinary tract health. In other words proanthocyanidins "disable" certain harmful bacteria in the body, so the "bugs don't stick."

The first scientific findings on cranberry were related to urinary tract health. Emerging science suggests that cranberries may also be helpful protectors of our health in other areas of the body. While this research is still in the early stages, it is exciting to consider the cranberry's importance as a promising tool to help fight bacteria naturally.

May 1984 - Journal of Urology
While trying to account for cranberry juice's unique urinary tract health benefits, Youngstown State University researchers demonstrate that the benefits may be related to the cranberry's ability to inhibit bacteria from adhering to the walls of the urinary tract. The researchers found that 15 ounces of cranberry juice cocktail significantly inhibited the E. coli bacteria, which cause 80 to 90 percent of UTIs, from adhering to urinary tract cells.

- Sobota AE. Inhibition of bacterial adherence by cranberry juice: potential use for the treatment of urinary tract infections. The Journal of Urology 1984; 131: 1013-1016.

May 1991 - The New England Journal of Medicine
Tel Aviv University researchers also describe the anti-E. coli adherence property of cranberry juice and attempt to identify the specific components in cranberries that cause this beneficial effect. They conclude that a compound in cranberries of an "unknown nature" prevents certain E. coli from adhering to the bladder's lining. Orange, pineapple, mango, guava and grapefruit juices did not possess this anti-adhesion property.

- Ofek I, Goldhar J, Zafriri D, Lis H, Adar R, Sharon N. Anti-Escherichia coli adhesion activity of cranberry and blueberry juices. New England Journal of Medicine 1991; 324: 1599.

March 1994 - Journal of the American Medical Association
Harvard Medical School researchers conduct the first well-controlled, large-scale clinical trial to demonstrate that drinking cranberry juice cocktail regularly, significantly reduced the presence of bacteria in the urine. The researchers found that the effect was not because of more acidic urine (the urine of the cranberry juice drinkers was no more acidic than those drinking a non-cranberry placebo drink) and speculated that there was something specific in cranberry that prevented bacteria from adhering to the urinary tract. This research was conducted with 153 women, average age of 78, using 10 ounces of Ocean Spray Cranberry Juice Cocktail, which contained 27 percent cranberry juice.

- Avorn J, Monane M, Gurwitz JH, Glynn RJ, Choodnovskiy I, Lipsitz LA. Reduction of bacteriuria and pyuria after ingestion of cranberry juice. Journal of the American Medical Association 1994; 271: 751-754.

1997 - Journal of Family Practice
In a small, double-blind clinical trial, researchers from Weber State University found that sexually active women between the ages of 18 and 45 who daily consume a cranberry dietary supplement (from spray-dried cranberry juice) for six months had a significantly lower risk of UTIs than women taking a placebo.

- Walker EB, Barney DP, Mickerlsen JN, Walton RJ, Mickelsen RAJr. Cranberry concentrate: UTI prophylaxis. The Journal of Family Practice 1997; 45: 167-168.

October 1998 - The New England Journal of Medicine
Rutgers-led scientists identify the active components in cranberries responsible for maintaining urinary tract health as proanthocyanidins or condensed tannins. The researchers concluded that the cranberry Vaccinium proanthocyanidins in cranberry juice are responsible for promoting urinary tract health.

- Howell AB, Vorsa N, Marderosian AD, Foo LY. Inhibition of the adherence of p-fimbriated Escherichia coli to uroepithelial-cell surfaces by proanthocyanidin extracts from cranberries. The New England Journal of Medicine 1998; 339: 1085.

April 2001 - Federation of American Societies for Experimental Biology
Research led by Rutgers University researchers presented at Experimental Biology 2001 confirms that cranberry Vaccinium proanthocyanidins are absorbed in the body. This suggests that once cranberry proanthocyanidins are absorbed into the bloodstream they become available to other sites throughout the body and may function as anti-adhesion agents and/or antioxidants. For the first time, in vivo research helps confirm the role of cranberry compounds as the active compounds responsible for anti-adhesion of certain E. coli bacteria in the urinary tract. An animal model was used to perform this research.

- Howell AB, Leahy M, Kurowska E, Guthrie N. In vivo evidence that cranberry proanthocyanidins inhibit adherence of p-fimbriated E. coli bacteria to uroepithelial cells. Federation of American Societies for Experimental Biology Journal 2001; 15: A284.

June 2001 - British Medical Journal
Research from the University of Oulu, Finland, found that regular consumption of a cranberry juice beverage reduced the recurrence of UTIs by about half, in women studied. One hundred and fifty women who have had at least one UTI in their lifetime with the median age of 30 were used in this study. This adds to the body of research supporting cranberry's preventative role with these infections.

- Kontiokari T, Sundqvist K, Nuutinen M, Pokka T, Koskela M, Uhari M. Randomised trial of cranberry-lingonberry juice and Lactobacillus GG drink for the prevention of urinary tract infections in women. British Medical Journal 2001; 322: 1571-1575.

April 2002 - Federation of American Societies for Experimental Biology
Researchers from the Rutgers and the University of Wisconsin investigated the anti-adhesion effects of cranberry juice cocktail versus other foods that contain proanthocyanidins (PACs). In this human study, they found that only consumption of cranberry juice cocktail resulted in urine with microbial anti-adhesion activity. Grape and apple juices, green tea and chocolate were also tested and did not produce this anti-adhesion activity. The researchers found that cranberry proanthocyanidins contained a unique structural feature that may account for this unique microbial anti-adhesion property.

- Howell AB, Reed J, Winterbottom R, Krueger C. Bacterial anti-adhesion activity of cranberry vs. other foods. Federation of American Societies for Experimental Biology 2002.

June 2002 - The Canadian Journal of Urology
A University of British Columbia urologist found use of cranberry juice and tablets with increased fluid intake are more effective than fluids alone in preventing UTIs in women studied. Forty percent fewer women experienced UTIs when receiving cranberry products vs. placebo, and on average had half the number of UTIs. Antibiotic use was less in the cranberry groups vs. placebo. The researcher recommended that cranberry products be offered as an option in the management of recurrent UTIs.

- June 2002 - Stothers L. A randomized trial to evaluate effectiveness and cost effectiveness of naturopathic cranberry products as prophylaxis against urinary tract infection in women. The Canadian Journal of Urology 2002; 9: 1558-1562.

June 2002 - Journal of the American Medical Association
Findings by researchers suggest that regular consumption of cranberry juice cocktail may offer protection against certain antibiotic resistant bacteria that cause urinary tract infections (UTIs). This latest research, conducted jointly between Rutgers and The University of Michigan, suggests that regular consumption of cranberry juice cocktail could reduce the potential for development of UTIs, thus decreasing the rate of antibiotic resistance.

- Howell AB, Foxman B. Cranberry juice and adhesion of antibiotic-resistant uropathogens. Journal of the American Medical Association 2002; 287.

March 2003 - American Journal of Clinical Nutrition
Research from the University of Oulu, Finland, found frequent consumption of fresh berry juices to be associated with lowered risk for recurrence of UTIs. Dietary habits seem to be an important risk factor for UTI recurrences in women, and dietary guidance could be a first step towards prevention.

- Kontiokari T, Laitinen J, Jarvi L, Pokka T, Sundqvist K, Uhari M. Dietary factors protecting women from urinary tract infection. American Journal of Clinical Nutrition 2003; 77: 600-604.

January 2004 - Cochrane Database Systematic Reviews - Urinary Tract Health
The Cochrane Collaboration published a research review, concluding that there is some evidence that cranberry juice may decrease the number of symptomatic UTIs in women. The Cochrane Collaboration is a non-profit organization based in the UK whose mission is to help people make well informed decisions about healthcare by developing systematic reviews of the effects of healthcare interventions.

RESEARCH REFERENCES:

CLINICAL RESEARCH
- Avorn J, Monane M, Gurwitz JH, Glynn RJ, Choodnovskiy I, Lipsitz LA. Reduction of bacteriuria and pyuria after ingestion of cranberry juice. Journal of the American Medical Association 1994; 271: 751-754.
- Walker EB, Barney DP, Mickerlsen JN, Walton RJ, Mickelsen RAJr. Cranberry concentrate: UTI prophylaxis. The Journal of Family Practice 1997; 45: 167-168.
- Kontiokari T, Sundqvist K, Nuutinen M, Pokka T, Koskela M, Uhari M. Randomised trial of cranberry-lingonberry juice and Lactobacillus GG drink for the prevention of urinary tract infections in women. British Medical Journal 2001; 322: 1571-1575.
- Stothers L. A randomized trial to evaluate effectiveness and cost effectiveness of naturopathic cranberry products as prophylaxis against urinary tract infection in women. The Canadian Journal of Urology 2002; 9: 1558-1562.

MECHANISTIC RESEARCH
- Sobota AE. Inhibition of bacterial adherence by cranberry juice: potential use for the treatment of urinary tract infections. The Journal of Urology 1984; 131: 1013-1016.
-Ofek I, Goldhar J, Zafriri D, Lis H, Adar R, Sharon N. Anti-Escherichia coli adhesion activity of cranberry and blueberry juices. New England Journal of Medicine 1991; 324: 1599.
- Howell AB, Vorsa N, Marderosian AD, Foo LY. Inhibition of the adherence of p-fimbriated Escherichia coli to uroepithelial-cell surfaces by proanthocyanidin extracts from cranberries. The New England Journal of Medicine 1998; 339: 1085.
- Howell AB, Leahy M, Kurowska E, Guthrie N. In vivo evidence that cranberry proanthocyanidins inhibit adherence of p-fimbriated E. coli bacteria to uroepithelial cells. Federation of American Societies for Experimental Biology Journal 2001; 15: A284.
- Howell AB, Reed J, Winterbottom R, Krueger C. April 2002 - Bacterial anti-adhesion activity of cranberry vs. other foods. Federation of American Societies for Experimental Biology 2002.

EPIDEMIOLOGICAL RESEARCH
- Foxman B, Geiger AM, Palin K, Gillespie B, Koopman JS. First-time urinary tract infection and sexual behavior. Epidemiology 1995; 6: 162-168.
- Dignam RR, Ahmed M, Kelly KG, Denman SJ, Zayon M, Kleban M.The effect of cranberry juice on urinary tract infection rates in a long-term care facility. Annals of Long-Term Care 1998; 6: 163-167.
- Kontiokari T, Laitinen J, Jarvi L, Pokka T, Sundqvist K, Uhari M. Dietary factors protecting women from urinary tract infection. American Journal of Clinical Nutrition 2003; 77: 600-604.

ANTIBIOTIC RESISTANCE OF ESCHERICHIA COLI
- Manges AR, Johnson JR, Foxman B, O'Bryan TT, Fullerton KE, Riley LW. Widespread distribution of urinary tract infections caused by a multidrug-resistant Escherichia coli clonal group. The New England Journal of Medicine 2001; 345: 1007-1013.
- Stamm WE. An epidemic of urinary tract infections. The New England Journal of Medicine 2001; 345: 1055-1057.
- Howell AB, Foxman B. Cranberry juice and adhesion of antibiotic-resistant uropathogens. Journal of the American Medical Association 2002; 287.

Cranberry Research Reviews:
- Henig YS, Leahy MM. Cranberry juice and urinary-tract health: Science supports folklore. Nutrition 2000; 16: 684-687.
- FC, Fagelman E. Cranberry juice and urinary tract infections: what is the evidence? Urology 2001; 57: 407-413.
-Leahy M, Roderick R, Brilliant K. The cranberry - promising health benefits, old and new. Nutrition Today 2001; 36: 254-265.