Skip to main content Accessibility help
×
Home
Hostname: page-component-768ffcd9cc-727vs Total loading time: 1.341 Render date: 2022-12-02T09:48:37.375Z Has data issue: true Feature Flags: { "useRatesEcommerce": false } hasContentIssue true

The effectiveness of dried cranberries (Vaccinium macrocarpon) in men with lower urinary tract symptoms

Published online by Cambridge University Press:  31 August 2010

Ales Vidlar
Affiliation:
Department of Urology, University Hospital, Olomouc, Czech Republic
Jitka Vostalova*
Affiliation:
Department of Medical Chemistry and Biochemistry, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic
Jitka Ulrichova
Affiliation:
Department of Medical Chemistry and Biochemistry, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic
Vladimir Student
Affiliation:
Department of Urology, University Hospital, Olomouc, Czech Republic
David Stejskal
Affiliation:
Department of Laboratory Medicine, Central Moravian Hospital, Prostejov Hospital, Prostejov, Czech Republic
Richard Reichenbach
Affiliation:
WALMARK a.s., Trinec-Oldrichovice, Czech Republic
Jana Vrbkova
Affiliation:
Department of Mathematical Analysis and Applications of Mathematics, Faculty of Science, Palacky University, Olomouc, Czech Republic
Filip Ruzicka
Affiliation:
Department of Microbiology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
Vilim Simanek
Affiliation:
Department of Urology, University Hospital, Olomouc, Czech Republic
*
*Corresponding author: Dr Jitka Vostalova, fax +420 585 632 302, email psotova@tunw.upol.cz
Rights & Permissions[Opens in a new window]

Abstract

Lower urinary tract symptoms (LUTS) are a common condition in older men. The objective of the present study was to evaluate the efficacy and tolerability of cranberry (Vaccinium macrocarpon) powder in men at risk of prostate disease with LUTS, elevated prostate-specific antigen (PSA), negative prostate biopsy and clinically confirmed chronic non-bacterial prostatitis. Forty-two participants received either 1500 mg of the dried powdered cranberries per d for 6 months (cranberry group; n 21) or no cranberry treatment (control group; n 21). Physical examination, International Prostate Symptom Score, quality of life (QoL), five-item version of the International Index of Erectile Function (IIEF-5), basic clinical chemistry parameters, haematology, Se, testosterone, PSA (free and total), C-reactive protein (CRP), antioxidant status, transrectal ultrasound prostate volume, urinary flow rate, ultrasound-estimated post-void residual urine volume at baseline, and at 3 and 6 months, and urine ex vivo anti-adherence activity were determined in all subjects. In contrast to the control group, patients in the cranberry group had statistically significant improvement in International Prostate Symptom Score, QoL, urination parameters including voiding parameters (rate of urine flow, average flow, total volume and post-void residual urine volume), and lower total PSA level on day 180 of the study. There was no influence on blood testosterone or serum CRP levels. There was no statistically significant improvement in the control group. The results of the present trial are the first firm evidence that cranberries may ameliorate LUTS, independent of benign prostatic hyperplasia or C-reactive protein level.

Type
Full Papers
Copyright
Copyright © The Authors 2010

Prostate diseases are a major health concern for the male population throughout the Western world. Benign prostatic hyperplasia (BHP) and chronic prostatitis (CP), two of the most common medical conditions affecting older men (aged over 40 years), are associated with lower urinary tract symptoms (LUTS) which can have a negative impact on the quality of life (QoL). LUTS are divided into irritative and obstructive symptoms. The former include frequency, urgency and nocturia. The latter consist of slow urine stream and incomplete bladder emptying. Recently, a significant association between the serum levels of C-reactive protein (CRP) and irritative LUTS in both men and women was found(Reference Kupelian, McVary and Barry1, Reference Nickel, Roehrborn and O'Leary2). On the other hand, CRP levels were not significantly associated with obstructive LUTS, or prostate-specific antigen (PSA) levels(Reference St Sauver, Sarma and Jacobson3). Untreated BHP and CP can lead to a number of medical complications, such as acute urinary retention, gross haematuria, repeated urinary tract infections, obstructive uropathy and cystolithiasis. The current standard of preventive care for men at risk of BHP and/or CP is treatment with α-adrenergic receptor blockers, 5-α-reductase inhibitors or antibiotics(Reference Chapple4). In recent years, there has been increasing interest in dietary supplements in the prevention of prostate diseases(Reference Klein5Reference Wong, Lau and Leung8). The proposed active components of these preparations include Se, vitamin E, vitamin D, lycopene, plant oils, n-3 fatty acids, phytosterols, terpenoids, lectins, polysaccharides, flavonolignans, flavonols and isoflavones. Some important dietary supplements for prostate health are complex extracts from green tea leaf (Camellia sinensis), saw palmetto berry (Serenoa repens), milk thistle seed (Silybum marianum), pumpkin seed (Cucurbita pepo) and stinging nettle root (Urtica dioica). Cranberry (Vaccinium macrocarpon) is a source of organic and phenolic acids, flavonoids, flavonoid glycosides, anthocyanins, proanthocyanidins and triterpenoids of the ursane type with beneficial effects on the urinary tract(Reference Neto9, Reference Guay10). Cranberry preparations are used as natural treatments for urinary tract infections, may reduce the ability of Helicobacter pylori to cause gastrointestinal ulcers and display anti-plaque activity(Reference Howell11Reference Yamanaka, Kimizuka and Kato13). The medicinal effectiveness and safety of intact cranberry fruits, juice and extracts have been critically evaluated recently(Reference Jepson and Craig14). Among recently reported effects of cranberry are its anti-inflammatory action through reduced cyclo-oxygenase-2 expression, suppression of IκBα degradation in human colon cancer cells(Reference Narayansingh and Hurta15) and inhibition of the growth and proliferation of several types of tumour cells including prostate(Reference Neto, Amoroso and Liberty16). However, to date there has been no published clinical study assessing whether cranberry reduces LUTS in men at risk of developing prostate diseases.

The aim of the present study was to evaluate the effect on urinary tract function of a 6-month daily consumption of 1500 mg cranberry fruit powder (CFP) in men with LUTS based on the International Prostate Symptom Score (IPSS), elevated PSA, BHP and histopathologically confirmed non-bacterial CP.

Materials and methods

Cranberry fruit powder characterisation

CFP (lot 070306-B/07-0659 supplied by Decas Botanical Synergies, LLC, Carver, MA, USA), containing 14·85 % (w/w) organic acids, 15·5 % sugars, 0·11 % anthocyanins, 1·95 % condensed tannins, 3·49 % total phenolics, was used for the clinical part of the study. One gelatine capsule contained 500 mg CFP.

Study subjects and data collection

The study was conducted according to the guidelines laid down in the Declaration of Helsinki, and all procedures involving human subjects/patients were approved by the Ethics Committee of the University Hospital and Faculty of Medicine and Dentistry, Palacky University in Olomouc, Czech Republic. Written informed consent was obtained from all participants. A 6-month randomised controlled trial was conducted from October 2008 to November 2009 at the Department of Urology of the University Hospital.

Study subjects

We invited forty-two men, aged 45 to 70 years (mean age 63 (sd 5·5) years), to participate in the study. All subjects entering the study had LUTS, elevated PSA and/or BHP. Other inclusion criteria were histological findings of acute or chronic non-bacterial prostatitis, normal urinary sediment and negative bacterial cultivation of urine. The diagnosis was asymptomatic inflammatory prostatitis category IV according to the National Institute of Health classification system(Reference Krieger, Nyberg and Nickel17). Exclusion criteria were no supplements such as Se, vitamins E and D, lycopene or herbal products with possible effects on prostate health, a diet rich in isoflavones, antibiotics, anti-inflammatory drugs, α-blockers or 5α-reductase inhibitors, food allergies, chronic liver or kidney diseases, gastrointestinal or metabolic disorder or any other chronic health condition such as diabetes, all identified from interview. Participants were randomly divided into two groups: control (n 21; mean age 64·0 (sd 5·4) years) and cranberry (n 21; mean age 62·0 (sd 5·4) years). In the cranberry group, three capsules (1500 mg CFP per d) were taken at approximately equal intervals daily throughout the day for the 6-month period. The size of the daily dose was based on our double-blind study in young women(Reference Valentova, Stejskal and Bednar18). They were instructed not to consume food rich in phenolics, especially anthocyanin-containing fruits, and to make no other dietary or lifestyle changes during the study. The control group received the same instructions as the cranberry group but no cranberry supplementation.

Data collection

Each case report form included: (i) a detailed medical history; (ii) assessment of all concurrent medical drugs and therapies; (iii) digital rectal examination; (iv) dietary habits; (v) IPSS, QoL and the abridged five-item version of the International Index of Erectile Function (IIEF-5)(Reference Rosen, Cappelleri and Smith19); (vi) urinanalysis; (vii) uroflowmetry with post-voidal residual urine; (viii) kidney and bladder ultrasound; (ix) transrectal ultrasound prostate volume; (x) a complete blood laboratory analysis. The following data were also collected at baseline and at 3 and 6 months in all subjects: Se; testosterone; free PSA (PSAfree); total PSA (PSAtot); CRP; antioxidant status; urine ex vivo anti-adherence activity.

Lower urinary tract symptoms

All participants completed the IPSS including each of the seven areas (feeling of incomplete emptying, frequency, intermittency, urgency, weak stream, hesitancy and nocturia), QoL and five-item version of the International Index of Erectile Function (IIEF-5) questionnaires. Uroflowmetry data – maximal urinary flow rate (Qmax) and average urinary flow rate (Qave) – were measured using the FlowMic (Medkonsult, Olomouc, Czech Republic). Prostate bladder voiding volume (V) and post-void residual urine volume (RV) were assessed using the BK Medical Viking 2400 (BK Medical World Headquarters, Herlev, Denmark) with abdominal probe 3–7 MHz. V and RV were calculated using the formula for a prolate ellipsoid (width × length × height × 0·523). Histopathological examination of prostate tissue was done using ultrasound-guided prostate biopsy (BK Medical Viking 2400, transrectal probe 5–12 MHz; BK Medical World Headquarters) in all subjects.

Clinical biochemistry and haematology

Basic biochemical and haematological parameters were determined in all samples: Na, K, chlorides, total cholesterol, LDL, HDL, TAG, apoA, apoB, CRP, alkaline phosphatase, alanine aminotransferase, aspartate aminotransferase, γ-glutamyl transpeptidase, lactate dehydrogenase, urea, creatinine, and testosterone were quantified in serum using a Hitachi Modular Evo P Analyzer (Hitachi, Tokyo, Japan). PSA (PSAtot and PSAfree) in serum was determined using an Architect type LEIA Analyzer (Abbott Laboratories, Abbott Park, IL, USA). Analysis of selected parameters, i.e. total antioxidant capacity and total thiol (SH) groups in plasma, lipid peroxidation products such as malondialdehyde in plasma and erythrocytes, advanced oxidation protein products in serum, glutathione, glutathione peroxidase, catalase, glutathione reductase, glutathione transferase, and superoxide dismutase in erythrocytes was carried out as described by Psotova et al. (Reference Psotova, Vecera and Zdarilova20). Se in plasma was determined by atomic absorption spectrometry using the AA6300 instrument (Shimadzu, Kyoto, Japan). Hb, packed cell volume, erythrocytes, thrombocytes and leucocytes were measured in Na2EDTA blood.

Urinanalysis

Urine samples were collected from a midstream clean catch and analysed by the IQ200 Automated Urinanalysis System (IRIS International, Inc., Chatsworth, CA, USA).

Anti-adherence activity of urine

Four biofilm-positive micro-organisms were used: Escherichia coli FB42, Enterococcus faecalis FB16 and Candida parapsilosis BC 12 (clinical strain; Collection of the Department of Microbiology, Faculty of Medicine, Masaryk University, Brno, Czech Republic) and Staphylococcus epidermidis CCM 7221 from the Czech Collection of Micro-organisms (CCM; Faculty of Sciences, Masaryk University, Brno, Czech Republic). The bacteria were stored in cryotubes at − 76°C. The biofilm formation was detected using a modification of the adherence assay(Reference Christensen, Simpson and Younger21). The experiment was repeated three times.

Statistical analysis

The data were analysed using the non-parametric Wilcoxon two-tailed tests (paired-samples and independent-samples) to test the statistical significance of differences in all parameters on days 0, 90 and 180. The level of significance was 5 %. Values are presented as 1st quartile, median and 3rd quartile or mean value and standard deviation. Box and empirical cumulative distribution plots were used as graphic illustration of significant differences in progression over 3 and 6 months between the groups.

Results

At baseline both groups had similar clinical and demographic characteristics except for significant differences in BMI and Qmax values (Table 1). The daily dose of CFP contained 223 mg organic acids, 1·65 mg anthocyanins, 29·5 mg condensed tannins and 52 mg total phenols. Patients who received cranberry for 6 months had a statistically significant lower IPSS and QoL score than controls. A lower IPSS score reflected improvement in the irritative and obstructive symptoms (Table 2). All parameters of urination (Qmax, average urinary flow rate (Qave), prostate bladder voiding and post-void residual urine volumes) were significantly improved in at least 70 % of participants of the cranberry group (Fig. 1); in the control group, the tested parameters did not change with the exception of post-void residual urine volume where a statistically significant deterioration was found (Table 3). Haematology values were unchanged with the exception of a significant increase in erythrocytes in the cranberry group, which, however, was within physiological limits (Table 4). PSAtot decreased in approximately 80 % of patients in the cranberry group while, in contrast, the PSAfree:PSAtot ratio mostly increased (Table 4; Fig. 2). Although changes in the values of several ‘safety’ markers were statistically significantly different, after 6 months for both groups, the fluctuation was within normal physiological limits. From this point of view, the cranberry group compared with the control group stabilised and this might be true for oxidative stress markers as well (Table 5). Differences in urine adherence ex vivo in both groups were not significantly different. No adverse events were recorded.

Table 1 Baseline demographics and clinical characteristics

(Mean values and standard deviations)

QoL, quality of life questionnaire; IPSS, International Prostate Symptom Score; PSAtot, total prostate-specific antigen; PSAfree, free prostate-specific antigen; Qmax, maximal urinary flow rate.

* Mean value was significantly different from that of the control group (P < 0·05).

Table 2 International Prostate Symptom Score (IPSS), quality of life (QoL) score and International Index of Erectile Function (IIEF-5) in control and cranberry groups

(Mean values and standard deviations)

* Mean value was significantly different from that of the control group (P < 0·05).

Fig. 1 Effect of cranberry (Vaccinium macrocarpon) on uroflowmetry parameters of maximal urinary flow rate (Qmax; a), average urinary flow rate (Qave; b), prostate bladder voiding volume (V; c) and post-void residual urine volume (RV; d) during 6 months of treatment. (), Cranberry group; (□), control group. The box-and-whisker graphs show the median as the middle line. The box extends from the 25th to the 75th percentile and the whiskers extend from the lowest value to the highest. ○, Outside values. * Median was significantly different from that of the control group (P < 0·05).

Table 3 Values of uroflowmetry in control and cranberry groups

(First quartiles, medians and third quartiles)

Qmax, maximal urinary flow rate; Qave, average urinary flow rate; V, prostate bladder voiding volume; RV, post-void residual urine volume.

* Median was significantly different from that at day 0 (P < 0·05).

Table 4 Markers of haematology and clinical chemistry in control and cranberry groups

(First quartiles, medians and third quartiles)

ALT, alanine aminotransferase; AST, aspartate aminotransferase; ALP, alkaline phosphatase; GMT, γ-glutamyl transpeptidase; LD, lactate dehydrogenase; CRP, C-reactive protein; PSAtot, total prostate-specific antigen; PSAfree, free prostate-specific antigen; TST, testosterone.

* Median was significantly different from that at day 0 (P < 0·05).

Fig. 2 Effect of cranberry (Vaccinium macrocarpon) on free prostate-specific antigen:total prostate-specific antigen ratio after 90 and 180 d of consumption. The values are expressed as difference values based on day 90 and day 0 (a) and day 180 and day 0 (b) of study. (—), Cranberry group; , control group. * P < 0·05 v. control. The numbers near to the lines correspond with the number of each participant.

Table 5 Markers of oxidative stress in control and cranberry groups

(First quartiles, medians and third quartiles)

PMDA, plasma malondialdehyde; SHGtot, total thiol groups; AOPP, advanced oxidation protein products; TAC, total antioxidant capacity; MDA, malondialdehyde; GSH, glutathione; SOD, superoxide dismutase, GPX, glutathione peroxidase; CAT, catalase; GST, glutathione transferase; GSR, glutathione reductase.

* Median was significantly different from that at day 0 (P < 0·05).

Discussion

Plant extracts for urinary tract disorders have long been used in traditional medicine. Today, botanical diuretics, antimicrobials and anti-adherence agents, renal protectives and herbs for patients with LUTS or BHP are requested by patients, even though accepted only with reservation by urologists(Reference Yarnell22, Reference Dedhia and McVary23). Cranberry fruit and juice are noted for their ability to inhibit the binding of pathogenic E. coli strains and other microbes to the bladder epithelium. This effect has been attributed to proanthocyanidins (condensed tannins), even if a more simple explanation might be the direct antibacterial action of hippuric acid(Reference Jepson and Craig14). Cranberry prophylaxis is also recommended to women with recurrent urinary tract infection. In a recent publication, for example, the antibiotic Trimethoprim was shown to have minimal advantage over cranberry extract in the prevention of recurrent urinary tract infections in women and had side effects(Reference McMurdo, Argo and Phillips24). LUTS refer to a complex of irritative and obstructive voiding symptoms that are common in both ageing women and men. Prostate enlargement and BPH affect primarily older men. The incidence of LUTS associated with BPH increases dramatically with advancing age(Reference Nickel and Roehrborn25). Unfortunately, no trials have yet been published assessing the effect of cranberry components on men with indicated LUTS and/or increased PSA levels. Recently published results have demonstrated that CP might be linked to a higher prostate cancer risk(Reference Vasto, Carruba and Candore26). The present study was focused on men with diagnosed LUTS, increased PSA level, and histologically confirmed non-bacterial prostatitis. We selected cranberry whole fruit powder in preference to cranberry extract for the present study. Our previous work had shown equivalent efficacy between CFP and two different cranberry extracts(Reference Palikova, Vostalova and Zdarilova27). The daily dose of 1500 mg dried cranberries was based on our double-blind study in young women(Reference Valentova, Stejskal and Bednar18). This dose elicited urine anti-adherence activity but had no adverse effects. In participants taking cranberry for 6 months there was, in addition to a marked improvement in all urodynamic parameters (Fig. 1), a statistically significant decrease in the IPSS score, and an increase in the quality of life evaluated by the QoL questionnaire (Table 2). Taking cranberry affected the value of PSA (Table 4). In the cranberry group, both a decrease in the PSA value and an increase in the PSAfree:PSAtot ratio (Fig. 2) without affecting CRP or testosterone levels were recorded. The use of selective 5-α-reductase inhibitors has often been linked to hormone changes associated with unpleasant sexual side effects, in particular, erectile dysfunction and decreased libido(Reference Tindall and Rittmaster28, Reference Giuliano29). The treatment approach in patients with elevated PSA and histologically confirmed prostatitis is rather complicated and may involve long-term antibiotics with the expectation of lowering the PSA level. The decrease in PSA in the cranberry group demonstrates that prophylaxis by cranberry may be as effective as antibiotic treatment but without the risk of antimicrobial resistance and a minimum of adverse effects. The diuretic effects of cranberries may also have contributed to the reduction in LUTS in the cranberry group(Reference Duke, Bogenschutz-Godwin and DuCellier30). Cranberries contain several structurally different groups of compounds that modulate various cellular pathways in man including the urinary tract and the prostate. However, phenolics, as phenolic acids, anthocyanins and proanthocyanidins, that are metabolised mainly to hippuric acid, are assumed to be the active components. The synergistic effects of cranberry constituents may improve their bioactivity. Use of the whole berries may be more beneficial than single components and with minimal adverse effects.

Conclusions

Our trial is the first to evaluate cranberry in the treatment of LUTS specifically in men with BHP, elevated PSA levels and non-bacterial prostatitis. The present results show that dried cranberries improve prostate health very effectively both in men with elevated PSA in histologically proven prostatitis and for improving voiding dysfunction. In the cranberry group, no associations were found between dried powdered berry consumption and CRP levels. Unlike currently used medication for prostatitis and LUTS, cranberry has no adverse effects. Our findings may assist men suffering from LUTS, and also their clinicians, to decide on a treatment that is both inexpensive and natural, like cranberry. The limitations of the present study include the relatively small number of men. Given the probability that some responses on the IPSS and QoL questionnaires in the cranberry group may have been secondary to a placebo effect, there is a need to control for this in future clinical trials.

Acknowledgements

The present study was supported by the Ministry of Education, Youth and Sport of the Czech Republic (grant no. MSM 6198959216).

The original authors and their contributions were as follows: A. V. was involved in the development of the protocol; V. Student and D. S. participated in the clinical observation of the subjects; J. Vrbkova carried out the statistical analysis; F. R. performed the microbial anti-adherent assay; R. R. performed the cranberry analysis; V. Simanek. and J. U. analysed the clinical chemistry data; J. Vostalova was responsible for the management of the study, and was the principal investigator and guarantor.

There is no conflict of interest.

References

1 Kupelian, V, McVary, KT, Barry, MJ, et al. (2009) Association of C-reactive protein and lower urinary tract symptoms in men and women: results from Boston Area community health survey. J Urol 73, 950957.CrossRefGoogle ScholarPubMed
2 Nickel, JC, Roehrborn, CG, O'Leary, MP, et al. (2008) The relationship between prostate inflammation and lower urinary tract symptoms: examination of baseline data from the REDUCE trial. Eur Urol 54, 13791384.CrossRefGoogle ScholarPubMed
3 St Sauver, JL, Sarma, AV, Jacobson, DJ, et al. (2009) Associations between C-reactive protein and benign prostatic hyperplasia/lower urinary tract symptom outcomes in a population-based cohort. Am J Epidemiol 169, 12811290.CrossRefGoogle Scholar
4 Chapple, CR (2004) Pharmacological therapy of benign prostatic hyperplasia/lower urinary tract symptoms: an overview for the practicing clinician. BJU Int 94, 738744.CrossRefGoogle Scholar
5 Klein, EA (2005) Can prostate cancer be prevented? Nat Clin Pract Urol 2, 2431.CrossRefGoogle ScholarPubMed
6 Thomasset, SC, Berry, DP, Garcea, G, et al. (2006) Dietary polyphenolic phytochemicals – promising cancer chemopreventive agents in humans? A review of their clinical properties. Int J Cancer 120, 451458.CrossRefGoogle ScholarPubMed
7 Van Patten, CL, de Boer, JG & Tomlinson Guns, ES (2008) Diet and dietary supplements intervention trials for the prevention of prostate recurrence: a review of randomized controlled trial evidence. J Urol 180, 23142322.CrossRefGoogle ScholarPubMed
8 Wong, SY, Lau, WW, Leung, PC, et al. (2007) The association between isoflavone and lower urinary tract symptoms in elderly men. Br J Nutr 98, 12371342.CrossRefGoogle ScholarPubMed
9 Neto, CC (2007) Cranberry and blueberry: evidence for protective effects against cancer and vascular diseases. Mol Nutr Food Res 51, 652664.CrossRefGoogle ScholarPubMed
10 Guay, DR (2009) Cranberry and urinary tract infections. Drugs 69, 775807.CrossRefGoogle ScholarPubMed
11 Howell, AB (2007) Bioactive compounds in cranberries and their role in prevention of urinary tract infections. Mol Nutr Food Res 51, 732737.CrossRefGoogle ScholarPubMed
12 Shmuely, H, Yahav, J, Samra, Z, et al. (2007) Effect of cranberry juice on eradication of Helicobacter pylori in patients treated with antibiotics and a proton pump inhibitor. Mol Nutr Food Res 51, 746751.CrossRefGoogle Scholar
13 Yamanaka, A, Kimizuka, R, Kato, T, et al. (2004) Inhibitory effects of cranberry juice on attachment of oral streptococci and biofilm formation. Oral Microbiol Immunol 19, 150154.CrossRefGoogle ScholarPubMed
14 Jepson, RG & Craig, JC (2008) Cranberries for preventing urinary tract infections. Cochrane Database Systemic Reviews, issue 1, CD001321. http://mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD001321/frame.html.Google Scholar
15 Narayansingh, R & Hurta, RAR (2008) Cranberry extract and quercetin modulate the expression of cyclooxygenase-2 (COX-2) and IκBα in human colon cancer cells. J Sci Food Agric 89, 542547.CrossRefGoogle Scholar
16 Neto, CC, Amoroso, JW & Liberty, AM (2008) Anticancer activities of cranberry phytochemicals: an update. Mol Nutr Food Res 52, S18S27.Google ScholarPubMed
17 Krieger, JN, Nyberg, LJ & Nickel, JC (1999) NIH consensus definition and classification of prostatitis. JAMA 282, 236237.CrossRefGoogle ScholarPubMed
18 Valentova, K, Stejskal, D, Bednar, P, et al. (2007) Biosafety, antioxidant status, and metabolites in urine after consumption of dried cranberry juice in healthy women: a pilot double-blind placebo-controlled trial. J Agric Food Chem 55, 32173224.CrossRefGoogle ScholarPubMed
19 Rosen, RC, Cappelleri, JC, Smith, MD, et al. (1999) Development and evaluation of an abridged, 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction. Int J Impot Res 11, 319326.CrossRefGoogle ScholarPubMed
20 Psotova, J, Vecera, R, Zdarilova, A, et al. (2006) Safety assessment of sanguiritrin, alkaloid fraction of Macleaya cordata, in rats. Vet Med – Czech 51, 145155.Google Scholar
21 Christensen, GD, Simpson, WA, Younger, JJ, et al. (1985) Adherence of coagulase-negative staphylococci to plastic tissue-culture plates – a quantitative model for the adherence of staphylococci to medical devices. J Clin Microbiol 22, 9961006.Google ScholarPubMed
22 Yarnell, E (2002) Botanical medicines for urinary tract. World J Urol 20, 285293.Google ScholarPubMed
23 Dedhia, RC & McVary, KT (2008) Phytotherapy for lower urinary tract symptoms secondary to benign prostatic hyperplasia. J Urol 179, 21192125.CrossRefGoogle ScholarPubMed
24 McMurdo, MET, Argo, I, Phillips, G, et al. (2009) Cranberry or trimethoprim for the prevention of recurrent urinary tract infections? A randomized controlled trial in older women. J Antimicrob Chemother 63, 389395.CrossRefGoogle ScholarPubMed
25 Nickel, JC & Roehrborn, CG (2000) New dimensions in the pharmacologic treatment of benign prostatic hyperplasia. http://cme.medscape.com/viewarticle/416422 (accessed 15 October 2009).Google Scholar
26 Vasto, S, Carruba, G, Candore, G, et al. (2008) Inflammation and prostate cancer. Future Oncol 4, 637645.CrossRefGoogle ScholarPubMed
27 Palikova, I, Vostalova, J, Zdarilova, A, et al. (2010) Long-term effects of three commercial cranberry products on the antioxidative status in rats: a pilot study. J Agric Food Chem 58, 16721678.CrossRefGoogle ScholarPubMed
28 Tindall, DJ & Rittmaster, RS (2008) The rationale for inhibiting 5-α-reductase isoenzymes in the prevention and treatment of prostate cancer. J Urol 179, 12351242.CrossRefGoogle ScholarPubMed
29 Giuliano, F (2006) Impact of medical treatments for benign prostatic hyperplasia on sexual function. BJU Int 97, 3438, discussion 44–45.CrossRefGoogle ScholarPubMed
30 Duke, JA, Bogenschutz-Godwin, MJ, DuCellier, J, et al. (2002) Handbook of Medicinal Herbs. Boca Raton, FL: CRC Press.CrossRefGoogle Scholar
Figure 0

Table 1 Baseline demographics and clinical characteristics(Mean values and standard deviations)

Figure 1

Table 2 International Prostate Symptom Score (IPSS), quality of life (QoL) score and International Index of Erectile Function (IIEF-5) in control and cranberry groups(Mean values and standard deviations)

Figure 2

Fig. 1 Effect of cranberry (Vaccinium macrocarpon) on uroflowmetry parameters of maximal urinary flow rate (Qmax; a), average urinary flow rate (Qave; b), prostate bladder voiding volume (V; c) and post-void residual urine volume (RV; d) during 6 months of treatment. (), Cranberry group; (□), control group. The box-and-whisker graphs show the median as the middle line. The box extends from the 25th to the 75th percentile and the whiskers extend from the lowest value to the highest. ○, Outside values. * Median was significantly different from that of the control group (P < 0·05).

Figure 3

Table 3 Values of uroflowmetry in control and cranberry groups(First quartiles, medians and third quartiles)

Figure 4

Table 4 Markers of haematology and clinical chemistry in control and cranberry groups(First quartiles, medians and third quartiles)

Figure 5

Fig. 2 Effect of cranberry (Vaccinium macrocarpon) on free prostate-specific antigen:total prostate-specific antigen ratio after 90 and 180 d of consumption. The values are expressed as difference values based on day 90 and day 0 (a) and day 180 and day 0 (b) of study. (—), Cranberry group; , control group. * P < 0·05 v. control. The numbers near to the lines correspond with the number of each participant.

Figure 6

Table 5 Markers of oxidative stress in control and cranberry groups(First quartiles, medians and third quartiles)

You have Access
37
Cited by

Save article to Kindle

To save this article to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

The effectiveness of dried cranberries (Vaccinium macrocarpon) in men with lower urinary tract symptoms
Available formats
×

Save article to Dropbox

To save this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about saving content to Dropbox.

The effectiveness of dried cranberries (Vaccinium macrocarpon) in men with lower urinary tract symptoms
Available formats
×

Save article to Google Drive

To save this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about saving content to Google Drive.

The effectiveness of dried cranberries (Vaccinium macrocarpon) in men with lower urinary tract symptoms
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *