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  • eNews - Cranberry Products And Urinary Tract Infections (UTIs)
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Cranberry Products And Urinary Tract Infections (UTIs)

PEN® eNews is a monthly e-newsletter shared with the global PEN Community and created to help dietitians position themselves as leaders in evidence-based nutrition practice. In addition, users of the PEN System will find articles on the new evidence, resources and features available and how to maximize one's use of PEN.


Cranberry Products And Urinary Tract Infections (UTIs)

The Question

Can the ingestion of cranberry products help to prevent or treat urinary tract infections (UTIs)?

The Recommendation

Preventing urinary tract infections
We suggest using cranberry products (e.g. capsules, tablets, powder, juice or extract) to reduce the risk of symptomatic urinary tract infections (UTIs) in:
  • women with recurrent UTIs (conditional recommendation, moderate quality evidence ⊕⊕⊕⊝)
  • children (conditional recommendation, moderate quality evidence ⊕⊕⊕⊝)
  • adults who are susceptible to a UTI due to medical or surgical intervention (conditional recommendation, low quality evidence ⊕⊕⊝⊝).

We suggest not using cranberry products to reduce the risk of symptomatic UTIs in:
  • older adults living in an institution (conditional recommendation, moderate quality evidence ⊕⊕⊕⊝)
  • pregnant women (conditional recommendation, moderate quality evidence ⊕⊕⊕⊝)
  • adults with bladder dysfunction (conditional recommendation, low quality evidence ⊕⊕⊝⊝).
Cranberry products may increase the risk of gastrointestinal side-effects (conditional recommendation, moderate quality evidence ⊕⊕⊕⊝).

Treating urinary tract infections
No recommendations can be made regarding cranberry products for the treatment of UTIs in adults or children due to a lack of studies. Grade D

The Remarks

The recommendation for women with recurrent UTIs, children and adults at risk of a UTI due to medical or surgical intervention (e.g. pelvic radiation, gynecological surgery) places a high value on the reduction of symptomatic UTIs through the use of cranberry products and considers that cranberry products may cause gastrointestinal side-effects. This recommendation applies to any kind of cranberry product. The active component of cranberries is proanthocyanidin, but the optimal dose is not known and cranberry products can vary significantly in the amount of proanthocyanidin they contain, with some containing none or very little (Williams et al., 2023).

The recommendation against the use of cranberry products to prevent UTIs in older adults living in an institution (e.g. long-term care home), pregnant women and adults with bladder dysfunction places a high value on evidence from RCTs that showed no benefit in these populations. Research on other client-important outcomes (e.g. health-related quality of life) and costs was not included. Personal preferences should be discussed with clients individually.

A subgroup analysis based on the social determinants of health was not conducted. Due to the costs associated with purchasing cranberry products and the need to store products, the intervention may be inaccessible to individuals with financial constraints and those experiencing homelessness. Determining the optimal dose of proanthocyanidin should be a priority for researchers (Williams et al., 2023).

To see the full practice question, including the Summary of Evidence, Evidence to Decision Summary and References, click here.


Looking for more content on urinary tract infections (UTIs)? Check out the Urology - Urinary Tract Infection Knowledge Pathway. 

  • Cranberry, 
  • Urinary Tract Infection 

Practice Guidance Toolkits - There for you!


Practice guidance toolkits make access to essential information on nutrition assessment, diagnosis, intervention, monitoring, associated tools and education materials based on nutrition-related conditions/diseases more 'up-front' and easier to retrieve. The toolkits present information in a format consistent with Nutrition Care Process Terminology (NCPT) with direct access to succinct information that dietitians use in their practice. The toolkits are a stand-alone tool used primarily for clinical knowledge pathways and also include the associated Summary of Recommendations and Evidence.  

To find them on the PEN home page, click on the Toolkits icon, which leads to all available toolkits.

They can also be found on the Knowledge Pathways Table of Contents page. Click on any of the icons under the Practice Guidance Toolkit column. Alternatively, within a knowledge pathway, click on the “Toolkit “ tab on the right-hand side of the page. The Toolkit tab will only display as an option if the knowledge pathway has a toolkit.


Helpful Features in the Toolkits  

  • Click on any of the items on the Table of Contents on the right-hand side of a toolkit to get quick, direct access to any section within the toolkit.  
  • Flags! Where information is specific to a particular country, you can see only your country’s information or view other’s information as well. Simply click the box at the top of the page for the country information that you would like to view, and it will be displayed (or alternatively unclick the box to hide it).

Below is a list of toolkits that have recently been added or updated: 

  • Wound Care and Pressure Injuries Practice Guidance Toolkit
  • Gastrointestinal System - Pancreatitis Practice Guidance Toolkit

  • PEN Features, 
  • PEN Uses, 
  • Tools 

PEN® Backgrounds – Ready for You When Needed


Backgrounds provide general information about a topic for new practitioners as well as for experienced health professionals.

Here are the new or newly updated backgrounds:

  • Probiotics Background
  • Food Safety - Pesticides/Herbicides Background

Backgrounds that are coming soon:

  • Chronic Kidney Disease
  • Irritable Bowel Syndrome
  • Cardiovascular disease
  • Cultural Humility

Want to know what else is new and updated? Bookmark these pages:
New Knowledge Pathway Content (Knowledge Pathways, Practice Questions, Summary of Recommendations and Evidence, Practice Guidance Toolkits, Backgrounds)
Tools and Resources.


  • PEN Features, 
  • PEN Uses 

PEN® Summary of Recommendations and Evidence: Where Evidence and Practice Guidance Meet


Short on time, but need a quick and comprehensive overview of the evidence on a topic area? The Summary of Recommendations and Evidence (SRE) is your new favourite tool. The SRE organizes all the questions in a knowledge pathway by topic. It is your one-stop shop to find the key practice points (including recommendations and graded evidence) for the topics covered in the knowledge pathway. The SRE replaces the Evidence Summary, which was a synthesis of just the evidence part of the key practice points, organized by evidence grade level. The SRE is a stand-alone tool and is mirrored in the Practice Guidance Toolkit, replacing the Key Findings and Recommendations section.

There are nearly 200 Knowledge Pathways in the PEN System, with over 150 Summaries of Recommendation and Evidence.

Here are the latest new or updated Summaries of Recommendations and Evidence:
  • Sports Nutrition Summary of Recommendations and Evidence
  • Nutrition Support - Enteral and Parenteral Summary of Recommendations and Evidence
  • Critical Illness Summary of Recommendations and Evidence

Note: PEN-specific terms used in this article are defined at this link: https://www.pennutrition.com/terminologyfeatures.aspx 

  • PEN Features, 
  • PEN Uses, 
  • Evidence Quality 
  

How Do I … access PEN® client handouts from the PEN® Handout Collection?

   


What are food sources of iodine? What are diet and cancer prevention basics? What are eating guidelines for food allergies and intolerances? Please take a look at our PEN® Client Handout Collections. The number of client handouts has grown over the years. Outlined below is how you can access the handouts.

The PEN® Handout Collections are available from the PEN home page:   
 
Individual handouts are also identified in relevant search results.

There are now seven handout categories available:

There is a + symbol next to some of the categories, that, when clicked, display subcategories and their related handouts. Click on each category to see the lists of PEN client handouts available.
 

Need handouts in a language other than English?
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  • Some have other language translations (Chinese, Hindi, Gujarati, Punjabi, Spanish, Tamil, Urdu and Vietnamese). 

Need handouts that have been adapted to cultural foods?
  • There are cultural adaptations to some handouts: African, Caribbean, Chinese, Gujarati, Hispanic, Latin, North and South Asia, North and South Indian, Pakistani, Sri Lankan. Some of these have also been translated, as in the example below: Heart Healthy Eating: Triglycerides – Adapted North Indian and Pakistani and translated into Gujarati, Hindi, Punjabi and Urdu. 

Here is an example in the Cardiovascular Disease subcategory under Disease Conditions:
 
 

You also have the option of seeing handout titles in French. At the top of each category under the title is English/Français option tab and when you click on Français you will see the handout titles in French.

 


Did you know you can share and customize handouts?
  • Add your customized nutrition advice to the Notes section by entering it from your computer under the ‘Additional Notes From Your Health Care Professional’, (See How do I…Customize Notes to Client Handouts) or you can write your comments in the Notes section of a printed copy.
  • Add your company logo in the Distribution By box 
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To learn how to complete these actions, you can:
  • go to the Help icon at the top of the PEN home page, 
  • go to Using PEN Power Tools and click on the various sections you need. 
  • Read the PEN eNews article: How do I… Customize Client Handouts .

As always, we welcome your feedback.

  • Customize PEN, 
  • PEN Features, 
  • PEN Uses 
PEN eNews
PEN: The Global Resource for Nutrition Practice  
July 2024  Volume 14 (7)


A Publication of the PEN® System Global Partners,
a collaborative partnership between International Dietetic Associations.
Learn more about PEN.
Copyright Dietitians of Canada . All Rights Reserved.
Articles in this issue
  • Cranberry Products And Urinary Tract Infections (UTIs)
  • Practice Guidance Toolkits - There For You!
  • PEN® Backgrounds – Ready For You When Needed
  • PEN® Summary Of Recommendations And Evidence: Where Evidence And Practice Guidance Meet
  • How Do I … access PEN client handouts from the PEN Handout Collection?
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