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reference
Vidlar A, Vostalova J, Ulrichova J, et al. The effectiveness of dried cranberries (Vaccinium Macrocarpon) in men with lower urinary tract symptoms.Br J Nutr.2010;104(8):1181-1189.
design
Participants were randomly divided into two groups: control group (n 21; mean age 64.0 (SD 5.4) years) and cranberry (n 21; mean age 62.0 (SD 5.4) years). In the cranberry group, three capsules (1500 mg CFP per day) were taken daily at approximately equal intervals throughout the day for 6 months. They were instructed not to consume foods rich in phenols, especially anthocyanin-containing fruits, and not to make any other dietary or lifestyle changes during the study. The control group received the same instructions as the cranberry group, but no cranberry supplement. Physical examination, International Prostate Symptom Score (IPSS), quality of life (QoL), five-point version of the International Index of Erectile Function (IIEF-5), basic clinical chemistry parameters, hematology, Se, testosterone, PSA (free and total), C-reactive protein (CRP), antioxidant status, transrectal Ultrasound prostate volume, urinary flow rate, ultrasound estimated postvoid residual urine volume at baseline and at 3 and 6 months, and ex vivo urinary antiadherence activity were determined in all subjects.
Participant
42 men from the Czech Republic
Evaluated study parameters
42 men aged 45 to 70 years (mean age 63 (SD 5.5) years) participated in this study. All subjects participating in the study had lower urinary tract symptoms (LUTS), elevated PSA and/or BHP (BPH). Further inclusion criteria were histological findings of acute or chronic nonbacterial prostatitis, normal urinary sediment and negative bacterial culture in the urine. The diagnosis was asymptomatic inflammatory prostatitis category IV according to the National Institutes of Health classification system. Exclusion criteria included avoiding dietary supplements such as Se, vitamins E and D, lycopene or herbal products with possible effects on prostate health, a diet rich in isoflavones, antibiotics, anti-inflammatory drugs, alpha-blockers or 5-alpha-reductase inhibitors. In addition, people with food allergies, chronic liver or kidney disease, gastrointestinal or metabolic disorders, or other chronic health problems such as diabetes were excluded from the study. All exclusion criteria were identified in the interview.
Key findings
- Die tägliche Dosis Cranberry-Fruchtpulver (CFP) enthielt 223 mg organische Säuren, 1,65 mg Anthocyane, 29,5 mg kondensierte Tannine und insgesamt 52 mg Phenole.
- Patienten, die 6 Monate lang Cranberry erhielten, hatten einen statistisch signifikant niedrigeren IPSS- und QoL-Score als die Kontrollpersonen.
- Ein niedrigerer IPSS-Score spiegelte eine Verbesserung der irritativen und obstruktiven Symptome wider.
- Alle Parameter des Wasserlassens, der durchschnittlichen Harnflussrate, der Entleerung der Prostatablase und des Restharnvolumens nach der Entleerung waren bei mindestens 70 % der Teilnehmer der Cranberry-Gruppe signifikant verbessert.
- In der Kontrollgruppe veränderten sich die getesteten Parameter nicht, mit Ausnahme des Restharnvolumens nach der Entleerung, bei dem eine statistisch signifikante Verschlechterung festgestellt wurde.
- Die hämatologischen Werte blieben unverändert, mit Ausnahme eines signifikanten Anstiegs der Erythrozyten in der Cranberry-Gruppe, der jedoch innerhalb physiologischer Grenzen lag.
- Der Gesamt-PSA sank bei etwa 80 % der Patienten in der Cranberry-Gruppe.
- Obwohl die Veränderungen der Werte mehrerer „Sicherheits“-Marker statistisch signifikant unterschiedlich waren, lag die Schwankung nach 6 Monaten für beide Gruppen innerhalb normaler physiologischer Grenzen.
- Zusammenfassend lässt sich sagen, dass sich die Cranberry-Gruppe im Vergleich zur Kontrollgruppe stabilisierte, und dies könnte auch für die Marker für oxidativen Stress gelten. Darüber hinaus zeigte diese Studie, dass Preiselbeeren das LUTS verbessern können, unabhängig von der benignen Prostatahyperplasie oder dem C-reaktiven Proteinspiegel.
- Unterschiede in der Urinhaftung Ex-vivo in beiden Gruppen waren nicht signifikant unterschiedlich.
- Es wurden keine unerwünschten Ereignisse registriert.
Effects on practice
Naturopaths and herbalists have been using cranberry extracts for urinary tract disorders for decades. Today, patients demand herbal diuretics, antimicrobial and antiadherent agents, renal protectants, and herbs for their LUTS or BPH, although these may be met with reservations by their urologists. Cranberry fruit and juice are known for their ability to inhibit the binding of pathogenic E. coli strains and other microbes to the bladder epithelium.1As male baby boomers age, the prevalence of LUTS due to an enlarged prostate will certainly increase. LUTS refers to a complex of irritative and obstructive voiding symptoms that are common in both aging women and men. Prostate enlargement and BPH primarily affect older men. The incidence of LUTS associated with BPH increases dramatically with age. The current conventional treatments for BPH, 5-alpha-reductase inhibitors, cause hormonal changes that are associated with unpleasant sexual side effects, particularly erectile dysfunction and decreased libido.2Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), which accounts for 90% to 95% of all prostatitis cases, is a clinical condition defined as urologic pain or discomfort in the pelvic area associated with LUTS and/or sexual dysfunction. Duration of at least 3 of the last 6 months. Symptoms of CP/CPPS can impact quality of life and affect physical and psychological functioning. Natural treatments can be of great help to this group of patients, as conventional therapies have little chance of success.3
The results of the Cranberry/LUTS study in men are convincing, but inconclusive due to the small number of subjects recruited. Although a larger trial is needed, the use of concentrated cranberry powder at a dosage of approximately 500 mg three times daily may be safe and sufficient for any man suffering from LUTS, regardless of whether the symptoms are due to CP/CPPS or BPH. Two other natural ingredients that may work well in treating BPH and CP/CPPS are rye pollen extract and beta-sitosterol.4,5,6Rye pollen extract was used in combination with betasitosterol, saw palmetto, and vitamin E in a study that showed favorable results for men with BPH/LUTS.7It would be advisable to use cranberry powder (Vaccinium Macrocarpo), betasitosterol, rye pollen extract, vitamin E and saw palmetto in men with LUTS of any prostate origin.