Background: Recurrent urinary tract infections (UTIs) are a common clinical problem among premenopausal women, often managed with prophylactic antibiotics that contribute to antimicrobial resistance. Cranberry extract, rich in proanthocyanidins, has emerged as a promising non-antibiotic alternative for UTI prevention, though existing evidence remains inconsistent due to variability in study designs and formulations. 

Objective: To evaluate the effectiveness of standardized cranberry extract supplementation in reducing recurrence rates of urinary tract infections in premenopausal women. 

Methods: This double-blind, randomized controlled trial was conducted over ten months in tertiary care hospitals in Lahore, Pakistan. A total of 160 premenopausal women with a history of recurrent UTIs were enrolled and randomly assigned to receive either 500 mg cranberry extract standardized to 36 mg PACs or placebo once daily for six months. Primary outcomes included the mean number of recurrent UTI episodes and time to first recurrence. Secondary outcomes assessed antibiotic use, adherence, and patient satisfaction. Data were analyzed using independent t-tests, Kaplan-Meier survival analysis, and chi-square tests, with significance set at p<0.05. 

Results: The cranberry group reported a significantly lower mean number of UTI episodes (0.6 vs. 1.2), longer time to first recurrence (142.3 vs. 97.6 days), and reduced antibiotic use (0.7 vs. 1.4 courses) compared to placebo. Recurrence occurred in 27.5% of the cranberry group versus 57.5% in placebo. Adherence exceeded 90% in both groups, with higher satisfaction in the cranberry arm. No serious adverse events were reported. Conclusion: Cranberry extract supplementation effectively reduced UTI recurrence and antibiotic dependence among premenopausal women. These findings support its role as a safe, non-antibiotic preventive strategy.

BACKGROUND: Cranberry (Vaccinium macrocarpon) is a small, red fruit that has been widely recognized for its potential health benefits. The cranberry is rich in antioxidant-rich bioactive chemicals and nutritious components like essential vitamins, minerals, and antioxidants; for example, vitamin C, vitamin E, magnesium, copper, potassium, anthocyanins, flavonoids, phenolic acid, etc. Cranberries are thought to offer a variety of health advantages because they are high in Polyphenols (PPs), which have significant antioxidant activity. 

OBJECTIVES: The objective of the current study was to evaluate the neuroprotective effect of cranberries on behavioural and neurochemical abnormalities induced by Quinolinic Acid (QA) treatment through Intracerebroventricular (ICV) injection in Wistar rats, as well as to identify the synaptic plasticity and cognition by modulating signaling cascades, such as the ERK and PI3K/AKT pathways, which offer an adjunct treatment to slow or enhance the effects of conventional treatment. 

MATERIAL AND METHODS: A total of thirty Wistar rats were randomly assigned to several experimental groups. QA (240 nM in normal saline) was administered via ICV. Thereafter, cranberry (0.5g/kg p.o.) with QA, and high-dose cranberry group (2g/kg p.o.) with QA were administered to the animals for 21 days. The dosage of QA and cranberries was chosen based on earlier experimental research. 

RESULT: The study found that cranberries significantly decrease cognitive deficits and motor impairments caused by Quinolinic Acid (QA) in rats. QA treatment affected cognitive function, as demonstrated by the Novel object recognition and the Morris water maze tests, and caused substantial disturbances in motor activity, as demonstrated by rotarod and footprint analyses. QA-treated rats also exhibited higher oxidative and nitrosative stress, lower Glutathione (GSH) levels, higher nitrite and lipid peroxidation, cholinergic dysfunction, and abnormalities in mitochondrial complexes I, II, and IV in the striatum and hippocampus regions. Cranberry (2 g/kg p.o.) significantly enhanced memory, learning, and motor coordination. Cranberry supplementation enhanced GSH levels, decreased MDA concentration, and improved mitochondrial function and cholinergic activity. According to a histological study, cranberries can protect against neuronal degeneration and inflammation. 

CONCLUSION: These findings indicate that cranberries may have neuroprotective properties, presumably through antioxidant, anti-inflammatory, and anti-excitotoxic processes that promote brain plasticity, neurogenesis, and neurotransmitter systems. This establishes the potential of cranberries as a prospective natural treatment for cognitive deficits and neurodegenerative illnesses, suggesting the need for additional research to understand the underlying mechanisms and human application better.

Large-fruited cranberry (Vaccinium macrocarpon Ait.) is a rich source of polyphenolic compounds, including anthocyanins, flavonols, and unique A-type proanthocyanidins, which exhibit strong antioxidant and health-promoting properties. Cranberry pomace, a by-product generated during juice and concentrate production, remains underutilized despite being abundant in dietary fiber and non-extractable polyphenols (NEPPs). In this study, cranberry pomace was characterized phytochemically and applied as a functional ingredient in biscuits at levels of 5%, 10%, and 15% substitution of wheat flour. Total polyphenol content (TPC) and antioxidant activity (ABTS•+, DPPH•) were significantly higher in pomace compared to whole fruit values reported in the literature, which can be attributed to the concentration of polymeric proanthocyanidins and flavonols in skins and seeds. Biscuits enriched with pomace exhibited a dose-dependent increase in TPC and antioxidant capacity, with the 15% variant showing up to 6-fold higher polyphenol content and over 30-fold higher ABTS•+ activity after in vitro digestion compared to control. Digestion also released NEPP bound to the fiber matrix, improving bioaccessibility. Moreover, extracts from digested biscuits reduced oxidative stress in Saccharomyces cerevisiae and inhibited COX-1, COX-2, and AChE activities, suggesting potential anti-inflammatory and neuroprotective effects. These findings highlight cranberry pomace as a sustainable, high-value ingredient for functional foods, aligning with circular economy strategies.

Background: Metabolic syndrome (MetS) and chronic kidney disease (CKD) share features such as inflammation and oxidative stress. Fruit- and vegetable-derived polyphenols may modulate these mechanisms. 

Background: To evaluate effects of fruit- and vegetable-based polyphenol interventions on metabolic and renal outcomes in adults with MetS or CKD/ESRD. 

Methods: We systematically reviewed randomized controlled trials comparing polyphenol-rich whole foods or supplements versus control. Data on lipids, blood pressure, glucose, endothelial function, estimated glomerular filtration rate (eGFR), albuminuria, and cardiovascular events were extracted and narratively synthesized. 

Results: Twenty-eight RCTs (n = 20-108) were included. In MetS, bergamot extract (six months) reduced LDL by 22% and triglycerides by 23% (p < 0.01). Grape powder (60 g/day for four weeks) lowered triglycerides and improved HDL function. Freeze-dried blueberry (45 g/day for six weeks) enhanced endothelial function (p < 0.05). Blood pressure reductions occurred with grape polyphenols; glycemic improvements were limited to polyphenol-rich diets and high-dose resveratrol. In CKD, fruit and vegetable diets (up to five years) slowed eGFR decline and increased plasma bicarbonate to levels comparable to sodium bicarbonate. Long-term interventions (five years) reported zero cardiovascular events versus six in controls (p < 0.01). Isolated supplements (e.g., cranberry, resveratrol) showed minimal effects on renal function. No serious adverse events were reported. 

Conclusion: Whole-food polyphenol interventions improve lipid profiles, endothelial function, and slow renal decline in MetS and CKD populations. Glycemic benefits are modest. Standardized, long-term RCTs are needed to refine dietary guidelines.

Purpose: Procyanidins have strong potential for antioxidation and decreasing hepatic fat accumulation thus preventing non-alcoholic fatty liver disease (NAFLD). Procyanidin A2 (PCA2), predominately found in cranberries, avocado, peanut red skins and litchi fruit pericarp, is poorly absorbed in the gastrointestinal tract. However, literatures about its metabolic profile by gut microbiota and effects on lipid metabolism are limited. Therefore, the metabolites of PCA2 by human intestinal microbiota as well as their antioxidant and hypolipidemic potential were investigated. 

Methods: PCA2 was incubated with human intestinal microbiota and the metabolites produced were characterized by UPLC-Q-TOF-MS. The antioxidant and hypolipidemic potential of PCA2 and its microbial metabolites (MPCA2) were evaluated and compared. 

Results: The metabolism of PCA2 resulted in the formation of 14 metabolites, and the highest antioxidant capacity values were reached after 6 h incubation. In addition, PCA2 and MPCA2 were effective in reducing oxidative stress and lipid accumulation induced by oleic acid (OA) in HepG2 cells. They significantly promoted the phosphorylation of AMP-activated protein kinase (AMPK) and thus stimulated hepatic lipolysis by up-regulating of the expression of carnitine palmitoyl transferase I (CPT-I) and suppressed hepatic lipogenesis by down-regulation of the expression of 3-hydroxy-3-methyl glutaryl coenzyme A reductase (HMG-CoA) reductase, fatty acid synthase (FAS) and sterol regulatory element binding proteins 1c (SREBP-1c).

Conclusion: Our results indicated that PCA2 and MPCA2 were effective to prevent OA-induced lipid accumulation and oxidative stress in HepG2 cells, implying that microbial metabolites may play a crucial role in the realization of human health effects of PCA2.

Following an application from Givaudan, submitted for authorisation of a health claim pursuant to Article 13(5) of Regulation (EC) No 1924/2006 via the Competent Authority of Italy, the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) was asked to deliver an opinion on the scientific substantiation of a health claim related to Pacran® and defence against bacterial pathogens in the lower urinary tract. The Panel considers that the food Pacran®, a powder obtained from cranberries, is sufficiently characterised. Defence against bacterial pathogens in the lower urinary tract is a beneficial physiological effect. The applicant identified two human intervention studies which investigated the effect of Pacran® on the incidence of urinary tract infections (UTI) as being pertinent to the claim. In weighing the evidence, the Panel took into account that one human intervention study showed a beneficial effect of Pacran® consumed daily at doses of 500 mg for 6 months on the incidence of symptomatic, culture-confirmed UTI in women with a history of recurrent UTI, whereas such an effect was not consistently observed in another study under similar conditions. The Panel also took into account that limited evidence has been provided for a mechanism by which Pacran® could exert the claimed effect. The Panel concludes that the evidence provided is insufficient to establish a cause and effect relationship between the consumption of Pacran® and the defence against bacterial pathogens in the lower urinary tract.

Urinary tract infections (UTIs) are among the most prevalent bacterial infections in women, with high recurrence rates and growing concerns over antimicrobial resistance. The need for alternative or adjunctive therapies has spurred interest in plant-based treatments, which offer antimicrobial, anti-inflammatory, antioxidant, and immune-modulatory benefits. This review summarizes the mechanisms of action, clinical efficacy, and therapeutic potential of various medicinal plants and natural compounds for preventing and treating UTIs in women. Notable candidates include cranberry, bearberry, pomegranate, green tea, and other phytochemicals with proven anti-adhesive and biofilm-disrupting properties. Evidence from clinical trials and meta-analyses supports the role of cranberry natural products and traditional herbal medicines (THMs) in reducing UTI recurrence, especially when combined with antibiotics. Notably, A-type proanthocyanidins in cranberry and arbutin in bearberry are key bioactive compounds that exhibit potent anti-adhesive and biofilm-disrupting properties, offering promising adjunctive strategies for preventing recurrent urinary tract infections. Additionally, emerging therapies, such as platelet-rich plasma (PRP), show promise in restoring bladder function and reducing infection in women with lower urinary tract dysfunction. Overall, plant-based strategies represent a valuable and well-tolerated complement to conventional therapies and warrant further investigation through high-quality clinical trials to validate their efficacy, safety, and role in personalized UTI management.

Background: Antioxidants and nitric oxide (NO) precursors may improve endurance exercise performance by reducing oxidative stress and increasing NO production. Almonds, dried grapes, and cranberries (AGC) are good sources of antioxidants and NO precursors. 

Objectives: To determine whether AGC consumption improved physiological responses and endurance cycling time-trial performance in response to training. 

Methods: After 1 wk of light training (LT), 96 male recreationally trained cyclists consumed 125 g of AGC or control (CON: isocaloric oat bar) daily during 2 wk of heavy training (HT) and a 2-wk taper (T). At the end of LT, HT, and T, endurance exercise performance (5-min cycling time-trial; 5CTT), NO bioavailability (plasma and urine nitrate and nitrite), oxidative stress [plasma F2-isoprostanes (F2-Isop)], muscle damage (creatine kinase) and subjective measures of wellbeing were assessed, as well as physiological responses during exercise at 70% maximal aerobic power output. 

Results: Compared to LT, 5CTT performance was impaired at HT (d = -0.27, P = 0.01) and improved at T (d = 0.79, P < 0.001), with no difference between treatments (P > 0.81). Compared with CON, during submaximal exercise at 70%, maximal aerobic power output AGC demonstrated higher oxygen consumption (HT: d = 0.46; T: d = 0.38, P < 0.001) and lower respiratory exchange ratio (HT: d = -0.61; T: d = -0.23, P < 0.032). At HT, urine F2-Isop was higher compared with LT (d = 0.21, P = 0.036), but plasma F2-Isop was lower (d = -0.22, P = 0.008), with no difference between treatments. At HT, AGC had higher subjective energy concentrations (d = 0.21, P = 0.02) and urinary nitrite (d = 0.23, P = 0.03) compared with CON and higher creatine kinase (d = 0.24, P = 0.02) and less fatigue (d = -0.20; P = 0.05) at T. 

Conclusion: Although not beneficial for 5CTT performance or exercise efficiency, AGC increases fat oxidation during exercise, NO bioavailability, and subjective energy concentrations, which may confer benefits for health and wellbeing..

Objectives: To evaluate the effects of polyphenol-containing products during pregnancy on preeclampsia-related maternal and neonatal outcomes. 

Design: Systematic review and meta-analysis. 

Setting: Nine databases and one trial registry, from inception to August 11th, 2023. 

Population/Sample: Randomised controlled trials where women received polyphenolic-containing products (as standardised extracts or dietary supplements) compared to placebo or standard care. 

Methods: All review stages were conducted by two independent reviewers. Random-effects meta-analysis with the Hartung-Knapp-Sidik-Jonkman method using a framework for studies with few events. Main Outcome Measures: Clinical outcomes combining the core outcome set for preeclampsia and WHO's priority outcomes. 

Results: Fourteen trials investigating six candidates were included. In women with preeclampsia, the addition of epigallocatechin gallate (EGCG) to nifedipine may reduce the time needed to achieve blood pressure control (mean difference (MD) = -14.10 min, 95% CI -18.46 to -9.74) and increase the time to the next hypertensive crisis (MD = 3.10 h, 95% CI 2.35 to 3.85) compared to nifedipine alone (1 trial, 349 women; low certainty). Similarly, the addition of resveratrol to nifedipine may reduce the time needed to achieve blood pressure control (MD = -15.50 min, 95% CI -19.83 to -11.17) and increase the time to the next hypertensive crisis (MD = 2.50 h, 95% CI 2.09 to 2.91) (1 trial, 349 women; low certainty). No differences were observed for other outcomes or candidates (Salvia miltiorrhiza, Bryophyllum pinnatum, raspberry and cranberry extracts). 

Conclusion: ECGC and resveratrol supplements have been investigated for potential effects in managing clinical signs and symptoms of preeclampsia; however, evidence on the clinical and adverse effects of polyphenols is limited and uncertain.

Recurrent urinary tract infection (rUTI) is a significant public health problem in women. General measures to prevent recurrence include behavioral changes and increased fluid intake, cranberry ingest, use of methenamine hippurate, antibiotic prophylaxis, D-mannose, probiotics, or vaccines. We conducted a literature review of the latest updates on preventing rUTI in December 2024. The search concluded with 27 articles that fulfilled our inclusion criteria. Our review demonstrated that behavioral changes such as correct genital hygiene, avoiding postponing micturition or defecation, urinating after sexual intercourse, and ingesting 1.5-2 L of water could prevent rUTI. The ingestion of cranberries reduces the risk of symptomatic, culture-verified urinary tract infections in women with rUTIs. Methenamine hippurate is an alternative to antibiotics to avoid rUTI. Estrogen reduces rUTI in women with hypoestrogenism. Limited evidence supports using D-mannose, probiotics, and vaccines to prevent rUTI. In conclusion, after successful treatment of the acute episode, preventative measures are needed to reduce rUTI frequency and morbidity according to each patient's characteristics and preferences