Cranberry Juice and Other Functional Foods in Urinary Tract Infections in Women: A Review of Actual Evidence and Main Challenges
- Pp. 183-211 (29)Rebeca Monroy-Torres and Ana Karen Medina-Jiménez
An urinary tract infection (UTI) is defined as the presence of signs and symptoms caused by a pathogenic external agent, which can be of viral or bacterial origin, and the most common bacterial agent is E. coli. An UTI can affect upper or lower urinary tract. Signs and symptoms could include, but are not limited to: dysuria, urinary urgency and frequency, sensation of bladder fullness, lower abdominal discomfort, suprapubic tenderness, flank pain, costovertebral angle tenderness, bloody urine, fevers, chills, and malaise. UTIs are the most common infections seen in medical practice in women of reproductive age and adults in general. Most UTI are caused by enterobacteriaceae such as Escherichia Coli, which is a gram-negative bacterium present in 80% of these infections. The presence of fimbriae in some strains determines its ability to colonize the urethra and migrate to the bladder. The antibiotic resistant genes of this bacterium have resulted in the need to search for alternatives to antibiotic therapy, which has become less effective due to misuse and abuse, and it is now a major worldwide problem. Several nutrients have been associated with better urinary health, mainly vitamin C, probiotics and flavonoids. Some studies have shown that frequent consumption of yogurt with probiotics and fruit juices rich in vitamin C decrease the recurrence of UTI in women. Vitamin C and flavonoids are considered non-enzymatic antioxidants that slow down the production of free radicals and oxidation, thus strengthening the immune system. The flavonoids in cranberries have a deleterious effect on E. Coli fimbriae, causing the bacteria to lose its grip. Diet and nutritional status, especially regarding the consumption of certain antioxidants, have a particularly strong relationship with urinary function and health. These findings may lead to defining programs for nutritional and dietary monitoring which could improve health and nutritional prognosis for women and their newborns, as well as prevent obstetric complications from Urinary Tract Infection. The primary objective of this review is to analyze the most conclusive evidence about the effectiveness of these options and to integrate other alternatives in future treatment that can fight against antimicrobial resistance and impact on morbidity, mortality and health cost.