Cranberry and UTIs – What is the Real Deal?

Cranberry and UTIs – What is the Real Deal?

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

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 ⊕⊕⊕⊝).

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 Evidence Statements, Comments and References, click here.

Do you know the answers to these questions?

Are there significant differences in the growth patterns of infants, birth to one year of age, who consume human milk versus formula?

Which tools should be used to monitor infant growth, and when/how should they be used?

How should child growth be discussed with parents/caregivers?

To find out, click on each practice question above or for a condensed version, see the Pediatrics/Paediatrics - Child Growth Summary of Recommendations and Evidence.

Looking for more information? See the Pediatrics/Paediatrics - Child Growth and Growth Faltering Toolkit, which provides an overview of the Pediatrics/Paediatrics - Child Growth and the Pediatrics/Paediatrics Growth Faltering Knowledge Pathways that includes key nutrition issues; nutrition assessment, monitoring and evaluation; diagnosis; intervention; and professional and client resources.

Food-Related Media Literacy Programs – Do They Work?

Can food-related media literacy programs improve nutritional knowledge and dietary behaviours of children, adolescents and families?

Limited evidence from evaluation studies suggests that food-related media literacy programs improve nutritional knowledge and dietary behaviours of children, adolescents and families in the short-term, but the long-term impacts are not known.

A series of studies investigating the effects of a six-week family-based media literacy program found that the program decreased youth’s susceptibility to food marketing, increased families’ discussions about food-related media messages, improved the home food environment, increased youth's vegetable and fruit intake and improved parents’ management of media in the home (beyond limiting screen time). Results may be limited by the small sample size, short study duration with lack of long-term follow up, non-randomization of study participants, use of self-reported measures and low participation rates by male parents.

A small 2020 study (n=36 healthy children aged 10.5±1.5 years) investigating the impacts of a brief media literacy intervention on children’s food decision-making behaviours found that the media literacy program had no impact on the type or amount of food children consumed, although it did reduce the relative importance of taste in food decisions, children’s perception of unhealthy foods as tasting good and the perceived influence of advertising on food preferences. Results may be limited by the small sample size, short study duration, the lack of participant demographic information provided by the study authors and that some of the language in the media literacy program may promote a problematic relationship with food (e.g. describing foods as “good” or “bad”).

Grade of Evidence C

See Additional Content: What are the key elements in planning and implementing school nutrition interventions?

To see the full practice question, including the Evidence and References, click here. 

How do I… Customize and Send PEN^® Client Handouts?  

The PEN Client Handouts are one of the most popular features of the PEN System, but did you know that you can customize the handouts and email them directly to your clients from the PEN System? You can add your organization/company logo to the handout, add a personalized note to your client and/or remove the additional resources section. 

The customize and share features on the PEN System are not available with site licenses, but if you have an individual account with your Dietetic Association, read the steps below to become a PEN Client Handout aficionado!

How do I customize the “Distributed by” box in PEN Client Handouts?

*Skip to Step 4 if your logo is already uploaded or if you do not want your logo included.

Step 1: Click on ‘My Profile’.

Step 2: Under “My Handout Distribution Preferences”, click on “Upload New Photo” and find the logo you want to add. If desired, add a distribution message.  

Step 3: Click “SAVE & UPDATE” at the bottom right-hand side of the page.

Step 4: Navigate to the PEN client handout you wish to customize.

Step 5: Click on “Customize and Share this Resource” phrase or the  icon.    

Step 6: On the Share this Resource pop-up page, make sure that the “Include” bubble corresponding with “Distributed By” is checked.

Step 7: Text in the “Distributed By” box can be added or edited. The “Distributed By” box will not accept images.

Step 8: Click "PDF PREVIEW" to view this content on the last page of the handout. Make sure the “Include” bubble is checked if you want your logo displayed.

Step 9: A hard copy of the handout including your “Distributed By” information can be printed from the PDF preview, or click SEND to e-mail a copy to your client or yourself.

How do I customize the editable "Notes" feature in PEN Client Handouts?

Step 1: Access a PEN handout from the Search, or the Related Tools and Resources section within a Knowledge Pathway, or from the PEN Client Handout Collection.

Step 2: Click on “Customize and Share this Resource” phrase or the  icon.

Step 3: A Customize and Share this Resource pop-up window will appear that will allow you to enter a message in the “Notes” section (up to six lines of text). Make sure that the ‘Include’ bubble corresponding with the “Notes” section has been checked.

Step 4: Once you have entered the information, you can click ‘PDF Preview’ to check that the information is correct, and then you can click "Send". If you want to provide a hard copy to your client, you can e-mail the handout to yourself, and then print.

How do I suppress the Additional Resources, Notes and/or Distributed By section from displaying in a Handout?

Step 1: Access a PEN Handout using the Search, or the Related Tools and Resources section within a Knowledge Pathway, or from the PEN Handout Collection.

Step 2: Click on the ‘Customize and Share this Resource’ phrase or the  icon.  

Step 3: A Customize and Share this Resource pop-up window will appear. To exclude any of the “Additional Resources”, “Notes” or “Distributed By” sections, make sure that the corresponding bubbles are cleared of check marks.

You can click the PDF PREVIEW button to view the handout and print a hard copy, or click the SEND button to e-mail a copy to your client or yourself.

How do I send a PEN^® Handout to a client via email?

Step 1: Click on “Customize and Share this Resource” phrase or the  icon

Step 2: Fill in your e-mail address, your client’s e-mail address, the message you wish to send to your client to accompany the handout and press Send.