The article, by journalist Dani Blum, ran in The New York Times on Sept. 26 under the headline ”Pills and Powders Aim to Replace Cranberry Juice as Go-To Prevention for U.T.I.s.” It examined the trend in the market toward cranberry-based products in the market in either capsule or sachet form to replace cranberry juice, which in many cases is laden with sugar.
Article repeats tired criticisms of supplements
The article notes there is some limited evidence that these products, when properly formulated, do work to reduce the incidence of UTIs, but goes on to say that, “the studies had small numbers of participants.”
Blum quoted Dr. Erin Higgins, an OB-GYN at Cleveland Clinic, as saying, “It could be that you’re just making expensive pee.” It’s a quote of unclear provenance that has been parroted by medical professionals skeptical of any sort of supplementation for well more than a decade.
Amy Howell, PhD, of the Mariucci Center for Blueberry & Cranberry Research at Rutgers University in New Jersey, is one of the world’s foremost experts on the health effects of cranberries on UTIs. Howell, who has spent almost three decades studying berry ingredients, said the author erred by using physicians as the primary sources.
Few doctors have expertise in supplement research
Relatively few physicians really understand the role some nutrients can play in health and most have a bias against studies that don’t match the multi-center, multi-phase, billion-dollar pharmaceutical model. It’s apparent to anyone who has taken a moment to reflect on the economics of dietary supplements that such a model can’t be supported by an industry featuring modestly priced products based on unpatentable ingredients.
“They talked to physicians rather than to the researchers who really know what’s going on,” Howell told NutraIngredients-USA.
Thee first thing to understand Howell said, is that a cranberry supplement is a food product, and thus features a degree of homogeneity. Even carefully made cranberry products can’t match the rigid uniformity of a synthesized chemical product, which describes most drugs.
Further, she said, it’s important to note that there is a quality control issue when it comes to cranberry supplements. Very inexpensive cranberry capsules often are filled with powders made from the mast left over from juice manufacture. In that case, most of the proanthocyanidins, the chemicals thought to confer most of the UTI benefit, are no longer present.
These powders contain mostly the dietary fiber fractions of the cranberry.
“People are paying basically for a product that ends up being a more expensive version of Metamucil. These powders are often made up of 90% dried pulp and then they add a couple of drops of dried juice back in there so they can claim it’s from ‘whole’ cranberry. These guys are selling a product that is cheaper but doesn’t work,” Howell said.
Howell: Properly formulated products have been proven to work
The NYT article does mention the quality control issue, but contains no information about what consumers should look for in a high quality supplement. Rather, the mention was included mostly as proof that most supplements aren’t what they claim to be and don’t work.
In a comment on the NTY article published on the newspaper’s web page, Howell said properly formulated products have been proven to work, something the article should have been more forthright in mentioning.
“Cranberry supplements can be very effective and there are well-designed clinical studies that demonstrate this. Some clinical trials on cranberry for UTI prevention have mixed results because inferior products were used or there were design flaws. Cheaper supplements often have high amounts of the insoluble fibrous pulp and less soluble juice extract (which is a lot more effective for preventing bacterial adhesion than the fiber). So the juice-based supplements with 36 mg of PAC taken daily have demonstrated the highest efficacy for recurrent UTI in the clinical setting,” she wrote.