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Healthier Cranberry Juice

September 25, 2012 Written by JP    [Font too small?]

Last week a slew of studies were presented at the American Heart Association’s High Blood Pressure Research 2012 Scientific Sessions. Among them, was a trial funded by Ocean Spray Cranberries, Inc. – a leading manufacturer of cranberry juice. The details of the study reveal that the daily consumption of “low calorie” cranberry juice moderately reduces blood pressure (by about 3 mmHg diastolic and systolic) as compared to a placebo beverage. But, before you go out to the market to stock up on low-cal cranberry “cocktails”, consider the details that weren’t included in the mainstream press converge.

Reduced calorie cranberry juice is typically made by combining cranberry concentrate or juice with water and artificial sweeteners. The resulting product is undeniably lower in energy and pretty tasty. However, it also lacks the nutrients and phytochemicals which make cranberries a bonafide health food. Still, these dietetic drinks are heavily marketed to children, diabetics and those hoping to lose weight. Some nutritionists support their use because they’re lower in calories than sugar sweetened or undiluted juice. Manufacturers include them in their product lines because they boast a more robust profit margin – artificial sweeteners and water are cheaper than actual fruit juice.

The good reputation of cranberries has grown over the past several years. A handful of studies, including some using low calorie cranberry juice, have determined that this ruby red refresher is capable of supporting cardiovascular health in a variety of ways. Specifically, recent studies reveal that daily consumption of cranberry juice can: a) decrease cholesterol oxidation and lipid peroxidation while elevating overall antioxidant capacity; b) encourage healthier circulation by reducing “carotid femoral pulse wave velocity – a clinically relevant measure of arterial stiffness”; c) raise HDL (“good”) cholesterol. What’s more, a 2007 review carried out by the Jean Mayer USDA Human Nutrition Research Center on Aging points out that cranberries are a rich source of naturally occurring chemicals (anthocyanins, ellagic acid, flavonols, etc.) which are known to lower blood pressure and systemic inflammation.

If you’re concerned about cardiovascular health, there are a few details that bear discussion prior to adopting a regular cranberry juice routine. In the past, there were concerns expressed about potential interactions between cranberry juice and “blood thinning” medications such as Coumadin (warfarin). More recent investigations have ruled this out as a contraindication. In terms of which cranberries juice to use – I would suggest making your own homemade, low calorie cranberry juice instead of buying the premixed variety. The recipe I recommend is very simple and can be adjusted based on taste preferences. In our home, I generally combine equal parts 100% pure cranberry juice and purified water. I add several drops of liquid stevia to the mixture. The end result is a more natural product that provides higher levels of the therapeutic components found in fresh cranberries. I addition, based on personal blood sugar testing, this stevia-sweetened cranberry drink has virtually no impact on my fasting and post-meal blood sugar levels.

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

Click on the following links to learn more about the studies referenced in today’s column:

Study 1 – Low Calorie Cranberry Juice Lowers Blood Pressure in Healthy Adults (link)

Study 2 – Low-calorie Cranberry Juice Decreases Lipid Oxidation and Increases(link)

Study 3 – Plasma Matrix Metalloproteinase (MMP)-9 Levels Are Reduced (link)

Study 4 – Favorable Impact of Low-Calorie Cranberry Juice Consumption on (link)

Study 5 – Changes in Plasma Antioxidant Capacity and Oxidized Low-Density(link)

Study 6 – Effects of Cranberry Juice Consumption on Vascular Function (link)

Study 7 – Cranberries (Vaccinium Macrocarpon) and Cardiovascular Disease Risk (link)

Study 8 – Evidences of the Cardioprotective Potential of Fruits: The Case of (link)

Study 9 – Possible Interaction Between Warfarin and Cranberry Juice (link)

Study 10 – Effect of High-Dose Cranberry Juice on the Pharmacodynamics of (link)

Cranberry Juice May Improve Blood Pressure via Increased Nitric Oxide Levels

Source: J Am Coll Nutr. 2009 Dec;28(6):694-701. (link)


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Posted in Diet and Weight Loss, Heart Health, Nutrition

7 Comments & Updates to “Healthier Cranberry Juice”

  1. JP Says:

    Update: Cranberries may reduce the build up of harmful oral bacteria …

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4319342/

    Contemp Clin Dent. 2015 Jan-Mar;6(1):35-9.

    Comparative assessment of Cranberry and Chlorhexidine mouthwash on streptococcal colonization among dental students: A randomized parallel clinical trial.

    BACKGROUND: Chlorhexidine gluconate mouthwash has earned an eponym of the gold standard against oral infections, but with certain limitations. There is no effective alternative to Chlorhexidine. Cranberry is known to inhibit bacterial adhesion in various systemic infections and acts as a strong antioxidant. However, it is less explored for its dental use. Hence, there is a need to evaluate its effect against oral infections.

    AIM: The aim was to compare the efficacy of 0.2% Chlorhexidine mouthwash with 0.6% Cranberry mouthwash on Streptococcus mutans.

    MATERIALS AND METHODS: This was a double-blind, randomized parallel group clinical trial. Total sample of 50 subjects, aged 18-20 years, were randomly divided into two groups, Group A (25) and Group B (25) were given 10 mL of Chlorhexidine mouthwash and Cranberry mouthwash twice daily, respectively, for 14 days each. The plaque samples, which were taken from the subjects on 1(st) day and 14(th) day, were inoculated on blood agar plates and incubated at 37°C for 24-48 h. Number of streptococcal colony forming units were calculated using digital colony counter. The data were subjected to paired t-test and unpaired t-test at a 5% significance level.

    RESULTS: (1) Chlorhexidine mouthwash showed 69% reduction whereas Cranberry mouthwash showed 68% reduction in S. mutans count. (2) No significant difference was seen between Chlorhexidine and Cranberry mouthwash on streptococci.

    CONCLUSION: Cranberry mouthwash is equally effective as Chlorhexidine mouthwash with beneficial local and systemic effect. Hence, it can be used effectively as an alternative to Chlorhexidine mouthwash.

    Be well!

    JP

  2. JP Says:

    Update: Cranberry juice linked to lower systemic inflammation …

    http://www.nrjournal.com/article/S0271-5317%2814%2900265-6/abstract

    Nutr Res. 2015 Feb;35(2):118-26.

    Adult consumers of cranberry juice cocktail have lower C-reactive protein levels compared with nonconsumers.

    Flavonoids are important bioactive plant constituents found in abundance in berries, including cranberries. Cranberry beverages have been shown to beneficially impact urinary and cardiovascular health in clinical and observational studies, but their association with anthropometric outcomes is unknown. We examined the association between cranberry juice cocktail (CJC) consumption with flavonoid intake, and cardiometabolic and anthropometric outcomes among adults in the US data for adults (≥19 years, n = 10334) were drawn from cross-sectional National Health and Nutrition Examination Survey combined 2005-2008 survey. We hypothesized that CJC consumers will have lower anthropometric measures and healthier cardiometabolic profiles, including lower cholesterol and C-reactive protein (CRP). A CJC consumer (n = 330) was defined as anyone consuming CJC for 2 nonconsecutive 24-hour dietary recalls. We used multivariate linear regression models to examine differences in anthropometric and cardiometabolic outcomes comparing CJC consumers to nonconsumers controlling for important confounders. Consumers drank an average 404 mL (14 fl oz) of CJC for 2 days and did not have higher total energy intakes compared with nonconsumers (mean [SD], 2259 [79] vs 2112 [24], respectively). In fully adjusted models, adult CJC consumers had significantly lower levels of CRP (mean [SD], -0.13 [0.05]; P = .015), results that were strengthened after further adjustment for body mass index (mean [SD], -0.98 [0.04]; P = .027). Trends toward lower weights and lower levels of cholesterol did not reach statistical significance. Intake of cranberry polyphenols may play a role in promoting anti-inflammatory markers among CJC consumers, specifically lowering CRP levels.

    Be well!

    JP

  3. JP Says:

    Update 04/28/15:

    http://jn.nutrition.org/content/early/2015/04/22/jn.114.203190.abstract

    J Nutr. 2015 Apr 22. pii: jn203190.

    Cranberry Juice Consumption Lowers Markers of Cardiometabolic Risk, Including Blood Pressure and Circulating C-Reactive Protein, Triglyceride, and Glucose Concentrations in Adults.

    BACKGROUND: Cardiometabolic risk is the risk of cardiovascular disease (CVD), diabetes, or stroke, which are leading causes of mortality and morbidity worldwide.

    OBJECTIVE: The objective of this study was to determine the potential of low-calorie cranberry juice (LCCJ) to lower cardiometabolic risk.

    METHODS: A double-blind, placebo-controlled, parallel-arm study was conducted with controlled diets. Thirty women and 26 men (mean baseline characteristics: 50 y; weight, 79 kg; body mass index, 28 kg/m2) completed an 8-wk intervention with LCCJ or a flavor/color/energy-matched placebo beverage. Twice daily volunteers consumed 240 mL of LCCJ or the placebo beverage, containing 173 or 62 mg of phenolic compounds and 6.5 or 7.5 g of total sugar per a 240-mL serving, respectively.

    RESULTS: Fasting serum triglycerides (TGs) were lower after consuming LCCJ and demonstrated a treatment × baseline interaction such that the participants with higher baseline TG concentrations were more likely to experience a larger treatment effect (1.15 ± 0.04 mmol/L vs. 1.25 ± 0.04 mmol/L, respectively; P = 0.027). Serum C-reactive protein (CRP) was lower for individuals consuming LCCJ than for individuals consuming the placebo beverage [ln transformed values of 0.522 ± 0.115 ln(mg/L) vs. 0.997 ± 0.120 ln(mg/L), P = 0.0054, respectively, and equivalent to 1.69 mg/L vs. 2.71 mg/L back-transformed]. LCCJ lowered diastolic blood pressure (BP) compared with the placebo beverage (69.2 ± 0.8 mm Hg for LCCJ vs. 71.6 ± 0.8 mm Hg for placebo; P = 0.048). Fasting plasma glucose was lower (P = 0.03) in the LCCJ group (5.32 ± 0.03 mmol/L) than in the placebo group (5.42 ± 0.03 mmol/L), and LCCJ had a beneficial effect on homeostasis model assessment of insulin resistance for participants with high baseline values (P = 0.035).

    CONCLUSION: LCCJ can improve several risk factors of CVD in adults, including TGs, CRP, glucose, insulin resistance, and diastolic BP.

    Be well!

    JP

  4. JP Says:

    Update 07/09/15:

    http://link.springer.com/article/10.1007%2Fs00345-015-1611-7

    World J Urol. 2015 Jun 7.

    Cranberry fruit powder (Flowens™) improves lower urinary tract symptoms in men: a double-blind, randomized, placebo-controlled study.

    BACKGROUND: Lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia increase with age. To date, several medications are available to treat LUTS, including herbal remedies which offer less side effects but lack robust efficacy studies.

    METHODS: This 6-month, randomized, double-blind, placebo-controlled study aimed at evaluating the dose effect of 250 or 500 mg cranberry powder (Flowens™) on LUTS and uroflowmetry in men over the age of 45. A total of 124 volunteers with PSA levels <2.5 ng/mL and an international prostate symptoms score (IPSS) score ≥8 were recruited and randomized. The primary outcome measure was the IPSS, evaluated at 3 and 6 months. Secondary outcome measures included quality of life, bladder volume (Vol), maximum urinary flow rate (Q max), average urinary flow rate (Q ave), ultrasound-estimated post-void residual urine volume (PVR), serum prostate-specific antigen, selenium, interleukin 6, and C-reactive protein at 6 months.

    RESULTS: After 6 months, subjects in both Flowens™ groups had a lower IPSS (-3.1 and -4.1 in the 250- and 500-mg groups, p = 0.05 and p < 0.001, respectively) versus the placebo group (-1.5), and a dose-response effect was observed. There were significant differences in Q max, Q ave, PVR, and Vol in the Flowens™ 500-mg group versus baseline (p < 0.05). A dose-dependent effect on Vol was observed, as well as on PVR, for participants with a nonzero PVR. There was no effect on clinical chemistry or hematology markers. CONCLUSIONS: Flowens™ showed a clinically relevant, dose-dependent, and significant reduction in LUTS in men over 45. Be well! JP

  5. JP Says:

    Updated 10/27/15:

    http://www.ajog.org/article/S0002-9378%2815%2900355-5/fulltext

    Am J Obstet Gynecol. 2015 Aug;213(2):194.e1-8.

    Cranberry juice capsules and urinary tract infection after surgery: results of a randomized trial.

    OBJECTIVE: The risk of urinary tract infection (UTI) among women undergoing elective gynecological surgery during which a catheter is placed is high: 10-64% following catheter removal. We conducted the first randomized, double-blind, placebo-controlled trial of the therapeutic efficacy of cranberry juice capsules in preventing UTI after surgery.

    STUDY DESIGN: We recruited patients from a single hospital between August 2011 and January 2013. Eligible participants were undergoing elective gynecological surgery that did not involve a fistula repair or vaginal mesh removal. One hundred sixty patients were randomized and received 2 cranberry juice capsules 2 times a day, equivalent to 2 8 ounce servings of cranberry juice, for 6 weeks after surgery or matching placebo. The primary endpoint was the proportion of participants who experienced clinically diagnosed and treated UTI with or without positive urine culture. Kaplan-Meier plots and log rank tests compared the 2 treatment groups.

    RESULTS: The occurrence of UTI was significantly lower in the cranberry treatment group compared with the placebo group (15 of 80 [19%] vs 30 of 80 [38%]; odds ratio, 0.38; 95% confidence interval, 0.19-0.79; P = .008). After adjustment for known confounders, including the frequency of intermittent self-catheterization in the postoperative period, the protective effects of cranberry remained (odds ratio, 0.42; 95% confidence interval, 0.18-0.94). There were no treatment differences in the incidence of adverse events, including gastrointestinal upset (56% vs 61% for cranberry vs placebo).

    CONCLUSION: Among women undergoing elective benign gynecological surgery involving urinary catheterization, the use of cranberry extract capsules during the postoperative period reduced the rate of UTI by half.

    Be well!

    JP

  6. JP Says:

    Updated 06/01/16:

    http://www.ncbi.nlm.nih.gov/pubmed/27242317

    Mol Nutr Food Res. 2016 May 31.

    Cranberry (poly)phenol metabolites correlate with improvements in vascular function: A double-blind, randomized, controlled, dose-response, crossover study.

    SCOPE: Cranberries are rich in potentially bioactive (poly)phenols. The aim of this work was to investigate whether cranberry juice intake can improve vascular function in healthy men in a dose- and time-dependent manner, and to understand which of the circulating (poly)phenol metabolites correlate with vascular effects.

    METHODS AND RESULTS: A double-blind randomized controlled crossover trial was conducted in 10 healthy males. Flow-mediated dilation (FMD), blood pressure, pulse wave velocity and augmentation index were investigated at baseline, 1, 2, 4, 6, and 8h post-consumption of cranberry juices containing 409, 787, 1238, 1534, and 1910 mg of total cranberry (poly)phenols (TP), and a control drink. Plasma (poly)phenol metabolites were analyzed by UPLC-Q-TOF MS using authentic standards. We observed dose-dependent increases in FMD at 1, 2, 4, 6, and 8h with a peak at 4h and maximal effects with juice containing 1238 mg TP. A total of 60 metabolites were quantified in plasma after cranberry consumption. Twelve (poly)phenol metabolites significantly correlated with the increases in FMD, including ferulic and caffeic acid sulfates, quercetin-3-O-ß-D-glucuronide and a γ-valerolactone sulfate.

    CONCLUSION: (Poly)phenols in cranberry juice can improve vascular function in healthy males and this is linked to the presence of specific newly identified plasma metabolites.

    Be well!

    JP

  7. JP Says:

    Updated 06/16/17:

    https://www.ncbi.nlm.nih.gov/pubmed/28618237

    OMICS. 2017 Jun 15.

    Effect of Sweetened Dried Cranberry Consumption on Urinary Proteome and Fecal Microbiome in Healthy Human Subjects.

    The relationship among diet, human health, and disease is an area of growing interest in biomarker research. Previous studies suggest that the consumption of cranberries (Vaccinium macrocarpon) could beneficially influence urinary and digestive health. The present study sought to determine if daily consumption of sweetened dried cranberries (SDC) changes the urinary proteome and fecal microbiome, as determined in a prospective sample of 10 healthy individuals. Baseline urine and fecal samples were collected from the subjects in the fasted (8-12 h) state. The subjects then consumed one serving (42 g) of SDC daily with lunch for 2 weeks. Urine and fecal samples were collected again the day after 2 weeks of SDC consumption. Orbitrap Q-Exactive mass spectrometry of urinary proteins showed that consumption of SDC resulted in changes to 22 urinary proteins. Multiplex sequencing of 16S ribosomal RNA genes in fecal samples indicated changes in relative abundance of several bacterial taxonomic units after consumption of SDC. There was a shift in the Firmicutes:Bacteroidetes ratio, increases in commensal bacteria, and decreases or the absence of bacteria associated with negative health effects. A decrease in uromodulin in all subjects and an increase in Akkermansia bacteria in most subjects were observed and warrant further investigation. Future larger clinical studies with multiomics and multitissue sampling designs are required to determine the effects of SDC consumption on nutrition and health.

    Be well!

    JP

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