Suppression of Helicobacter pylori infection by daily cranberry intake: A double‐blind, randomized, placebo‐controlled trial

Abstract

Background and aim: Dietary strategies that contribute to reducing incidence of Helicobacter pylori infection without negative side effects are highly desirable owing to worldwide bacterial prevalence and carcinogenesis potential. The aim of this study was to determine dosage effect of daily cranberry consumption on H. pylori suppression over time in infected adults to assess the potential of this complementary management strategy in a region with high gastric cancer risk and high prevalence of H. pylori infection. Methods: This double-blind, randomized, placebo-controlled trial on 522 H. pylori-positive adults evaluated dose-response effects of proanthocyanidin-standardized cranberry juice, cranberry powder, or their placebos on suppression of H. pylori at 2 and 8 weeks by 13 C-urea breath testing and eradication at 45 days post-intervention. Results: H. pylori-negative rates in placebo, low-proanthocyanidin, mediumproanthocyanidin, and high-proanthocyanidin cranberry juice groups at week 2 were 13.24%, 7.58%, 1.49%, and 13.85% and at week 8 were 7.35%, 7.58%, 4.48%, and 20.00%, respectively. Consumption of high-proanthocyanidin juice twice daily (44 mg proanthocyanidin/240-mL serving) for 8 weeks resulted in decreased H. pylori infection rate by 20% as compared with other dosages and placebo (P < 0.05). Percentage of H. pylori-negative participants increased from 2 to 8 weeks in subjects who consumed 44 mg proanthocyanidin/day juice once or twice daily, showing a statistically significant positive trend over time. Encapsulated cranberry powder doses were not significantly effective at either time point. Overall trial compliance was 94.25%. Cranberry juice and powder were well-tolerated. Conclusions: Twice-daily consumption of proanthocyanidin-standardized cranberry juice may help potentiate suppression of H. pylori infection. Trial registration: ChiCTR1800017522, per WHO ICTRP.

Review of Functional and Pharmacological Activities of Berries

“…Extracts of cranberry inhibit the adhesion of uropathogenic Escherichia coli ( E. coli ), as well as the interference of H. pylori to the human gastric mucosa [ 123 , 124 ]. Daily consumption of cranberry juice has been found to fight against H. pylori infections and has shown significant bacterial suppression in clinical trials [ 125 ]. Animal studies show that berry components such as epicatechin, chlorogenic acid and quercetin effectively counteract nonsteroidal anti-inflammatory drugs mediated damage and H. pylori infection.…”

Clinical evidence supporting cranberry as a complementary approach to Helicobacter pylori management

“…Cranberry fruit and fruit extracts have a broad array of bioactivities that may contribute to the mechanisms of action in H. pylori suppression, including anti‐adhesion, anti‐inflammatory, and anti‐bacterial (Howell, 2020). Daily cranberry juice consumption has been studied as a complementary dietary approach to managing H. pylori infections and has exhibited significant bacterial suppression in clinical trials, three of which examined the effects of daily consumption of various intake levels of cranberry juice over different time periods (Gotteland et al., 2008; Li et al., 2020; Zhang et al., 2005).…”

“…Although consumption of the cranberry juices used in these two clinical trials resulted in significant suppression of H. pylori in the test cohorts, the uncharacterized juices were administered at single dosages once per day making it difficult to determine the most effective intake regimen for consumers to implement as part of a complementary H. pylori management strategy. A recent well‐designed RCT was conducted in Linqu County (Li et al., 2020), the same rural Chinese province as the 2005 study (Zhang et al., 2005). It focused on using investigational products standardized to different PAC levels, frequency of intake and different cranberry product forms (juice vs. encapsulated powder) that could potentially enhance bacterial suppression in this susceptible population with high stomach cancer rates.…”

“…It focused on using investigational products standardized to different PAC levels, frequency of intake and different cranberry product forms (juice vs. encapsulated powder) that could potentially enhance bacterial suppression in this susceptible population with high stomach cancer rates. In this trial, 522 H. pylori ‐positive adults consumed either once‐ or twice‐daily cranberry juice or encapsulated cranberry extract powder standardized for PAC content or their placebos and were evaluated for effects on suppression of H. pylori after 2 and 8 weeks, and eradication at 45 days postintervention as measured by UBT (Li et al., 2020). Cranberry juice concentrate (50° Brix) was formulated into low PAC (23 mg/240 mL) and high PAC (44 mg/240/mL) juice drinks containing cranberry juice (17.5% or 35%, respectively), beet sugar, and water.…”

“…Daily cranberry juice consumption has been studied as a complementary dietary approach to managing H. pylori infections and has exhibited significant bacterial suppression in clinical trials, three of which examined the effects of daily consumption Food Frontiers. 2020;1:329-331. wileyonlinelibrary.com/journal/fft2 329 HOWELL of various intake levels of cranberry juice over different time periods (Gotteland et al, 2008;Li et al, 2020;Zhang et al, 2005).…”