Cranberry harvesting requires you to wade into hip-high water.
Figuring out the berry’s health benefits, on the other hand, will have you wading into a raging debate.
A lot of good things have been said about cranberries: it’s anti-inflammatory, a cure for urinary tract infections, an antioxidant powerhouse.
Whether these are health myths or legitimate science, it’s clear that the fruit’s place in scientific literature is far from settled.
Now, Ocean Spray appears to be putting their money where their mouth is with a pledge of $10 million over the next five years to study the berry as well as to launch other health-related initiatives.
The company will also open their Ocean Spray Cranberry Health Institute, in tandem, next year.
Christina Khoo, PhD, director of Global Health Science and Nutrition Policy at Ocean Spray, says their focus is on cranberry’s potential antimicrobial benefits and its role in helping to combat antimicrobial resistance.
“In communicating and talking to researchers as well as people that are having issues with [urinary tract infections], we realized the importance of the effect of maintaining urinary tract health to this issue of antibiotic resistance,” Khoo told Healthline. “We can’t help but see all the news and announcements about antibody resistance and what a serious issue it is.”
“We feel like we need to help accelerate the activity on our cranberry health research and focus on getting an alternative to antibiotics,” she added.
The scientific debate
Khoo is exuberant about the company’s financial pledge.
However, research on whether or not cranberries really have the kind of potential that is being touted — by a cranberry company no less — has invited a fair amount of skepticism.
Cranberries have attained an almost mythical level of healthfulness from use as a primitive antibiotic to use now to prevent urinary tract infections (UTIs).
While many swear by the fruit’s goodness, it has proven significantly harder to demonstrate on paper.
Dr. David Ginsberg, an associate professor of clinical urology at the University of Southern California (USC), told Healthline, “I don’t think that we’ve solved the issue. The quality of the studies isn't great, so it’s not clear-cut whether or not this is helpful in a large placebo-controlled trial or not.”
He does add, however, that in his practice, “We have patients that are on lots of cranberry juice.”
A lot of attention has been paid to one particular compound present in cranberries known as A-type proanthocyanidin, commonly called PAC.
Researchers have praised PAC for its ability to stop the bacteria E. coli from attaching to tissue in the urinary tract.
According to Ginsberg, the science surrounding PAC is sound but that doesn’t mean cranberries are the right way to get it into your system.
“What’s not necessarily accepted is that if you drink more cranberry juice, does it have an impact on UTIs,” he says.
Despite contradictory evidence, cranberries have proven to be a fruitful area of exploration for researchers.
Two 2012 meta-analyses of studies on the ability of cranberries (and derivatives such as juice and concentrates) to prevent urinary tract infections came to different conclusions.
Authors of one publication wrote, “Our findings indicate that cranberry-containing products are associated with protective effects against UTIs.”
The other, a well-cited meta-analysis by Cochrane, concluded, “Cranberry juice does not appear to have a significant benefit in preventing UTIs and may be unacceptable to consume in the long term.”
Since then, research on cranberries has gotten significantly more contentious.
A study funded by Ocean Spray and published in the American Journal of Clinical Nutrition in 2016 was billed as a “landmark” by the company.
It concluded that “cranberries can be a nutritional approach to reducing symptomatic [urinary tract infections].”
The research also appeared to meet the gold standard of research. It was a randomized, double-blind, placebo-controlled trial involving nearly 400 women.
But, it didn’t take long for the study to be rebuked.
A lengthy editorial published by Vox Media called out Ocean Spray’s involvement in the study — from funding it to writing portions of the manuscript — as well as the design of the study itself.
An independent researcher in the Vox article called it “smoke and mirrors.”
Despite Vox’s dismissiveness, others have been more measured both about that study and about industry funding in general.
A subsequent story by Slate called cranberries “less a hoax than a persistent mystery.”
Ginsberg says that “just because a drug company sponsors a study doesn’t mean that it’s bad, but you do have to make sure that it’s done appropriately.”
Meanwhile Khoo, who is listed as an author on the Ocean Spray study, is steadfast about its importance.
“We went into this trial with the utmost care with how the study should be run, based on the Cochrane 2012 review that suggested how a study should be conducted on cranberries,” she said.
“It’s unfortunate that there is the perception that, just because it’s funded by a company, that it’s not a good study,” she added.
A more recent meta-analysis in the Journal of Urology, this one published in 2017, supports the use of cranberries for UTIs.
Antibiotic resistance angle
With a new $10 million initiative, there is plenty of work to be done on the topic of cranberries, UTIs, and antimicrobial resistance — industry funded or not.
UTIs aren’t typically a serious health concern, but they’re common. As reported in 2015, 150 to 250 million people a year are affected by them globally, most of them women.
Almost half of all women will get at least one UTI during their lifetime.
More problematic than UTI frequency, however, is that the bacteria that most frequently causes UTIs, E. coli, is becoming resistant to antibiotics.
Last year, a new superbug was discovered by the Walter Reed National Military Medical Center in Maryland.
The strand was an E. coli that was resistant to a serious antibiotic called colistin. It was discovered in a UTI of a female patient.
The bug was just the latest part of an ever-increasing rise in antibiotic resistant UTIs.
“We get recurring UTI patients who do get increasingly resistant bacteria over time as they get more and more antibiotics, absolutely. Thankfully it’s not incredibly common, but I wouldn’t say that it’s uncommon and rare either,” said Ginsberg.
Frequent and repetitive use of antibiotics to treat recurring UTIs fosters a greater risk of resistance — a topic which has been touched on at great length over the past two years by many news organizations.
Khoo stresses that finding an alternative way to treat UTIs and help to stop the growing trend of antibiotic resistance is paramount.
So, why not take a closer look at cranberries, she suggests.
“By setting up the Cranberry Health Institute, we hope to make people aware of this issue and to make people aware that UTI is a contributor to this issue. It is the second most common infection that results in antibiotic use and antibiotic resistance, and it only continues to build,” said Khoo.
Even for the skeptical, the promise of millions of dollars in funding to help research what is possibly one of the greatest dangers in the foreseeable future seems like a good thing.
According to Ginsberg, there are still a lot of questions about cranberries and UTIs that need to be answered.
However, he says the bottom line is this: do they help UTIs, and, if so, how can their use be implemented in medical care?
“Those are all issues that if someone wants to throw some money at this, and well-done studies are done, then that’s fantastic,” he says. “Why not?”