Children Consuming Cranberry-Lingonberry Juice Shown to Have Different Gut and Urinary Microbiomes Compared to Placebo

by | Apr 5, 2023 | 2023, Bladder Health, Digestive Health, Fruits and Vegetables, Infant and Children's Health

Written by Taylor Woosley, Staff Writer. 6-month consumption of CLJ resulted in a different composition in the children’s gut and urinary microbiome. However, the diversity of the gut and urinary microbiome was not affected. 

child with healthy foodsUrinary tract infections (UTIs) are among the most common bacterial infections in children and up to 8% of children will experience at least one UTI between the ages of 1 month and 11 years1. The majority (91% to 96%) of UTI results from the ascent of bacteria from the periurethral area, migrating in a retrograde fashion via the urethra to reach the bladder and potentially the upper urinary tract2. Conventional treatments for UTI rely primarily on antibiotic therapy and do not include the preservation or restoration of the microbial community that exists in the host healthy state3.

Cranberry is abundant in nutritional components and many bioactive compounds, particularly proanthocyanins and flavanols4. Cranberry polyphenols act as antiadhesive agents in preventing/inhibiting the adherence of pathogens to uroepithelial cell receptors, which appears to be a major step in the pathogenesis of these infections5. Furthermore, lingonberries are a small reddish color berry that contain a significantly high anthocyanin content that have anti-inflammatory properties6.

Hakkola et al. conducted a randomized controlled trial to analyze the effects of cranberry-lingonberry juice on the gut and urinary microbiome in children. Primary outcomes consisted of comparing gut and urinary microbiomes in children who received cranberry-lingonberry juice (CLJ) for 6 months with those who received a placebo juice. Fecal samples were collected at 3, 6 and 12 months after entry and urine samples at 3 months. Secondary outcomes included the occurrence of UTI during the study. Study inclusion criteria consisted of being between the age of 1 to 16 years and having a confirmed UTI within 7 days of entry.

A parallel study design was used, and the participants were assigned to either the CLJ group or the placebo group (1:1) using a block randomization procedure with a block size of four. Upon entering the study, parents completed a questionnaire with information regarding background, clinical characteristics, and the child’s dietary habits. UTI episodes were treated with antibiotics, but parents were informed to not give their children any additional lingonberry or cranberry products during the trial.

The CLJ group received a juice containing 12.8% cranberry juice, 12.4% lingonberry juice, and 10 g/dL added sugars. Placebo received a juice containing natural cranberry flavor, red anthocyanin color, 5.5 g/L citric acid and 10 g/dL added sugars. The intervention lasted for 6 months with a daily dose of 5 mL/kg to a daily maximum of 300 mL. The QIAamp DNA stool kit was utilized to extract DNA from samples obtained at 3, 6, and 12 months. Comparisons of the microbiome composition regarding the relative abundance of the main bacterial phyla and the genus E.coli were performed to evaluate the pre-test hypothesis. The time to the first UTI recurrence was analyzed by the Kaplan-Meier method.

A total of 113 children were recruited for the trial, with 56 children in the CLJ group and 57 children in the placebo group. 184 fecal and urine samples were analyzed and there were 41 children who gave fecal or urine samples at 3 months and had >80% compliance. In total, 18 of these children were placed in the CLJ group and 23 in the placebo group. Significant findings of the study are as follows:

  • Regarding gut microbiome composition, Bacteroidetes was the most abundant phylum in the gut microbiome in both the CLJ and placebo groups, compromising 63% and 65% of the gut microbiome, respectively. However, the relative abundance of Actinobacteria in the CLJ group was higher than that in the placebo group (mean 0.28%, SD 0.97, p-value 0.02) at 3 months.
  • No significant differences were found between the two groups at any point regarding the mean relative abundance of coli in the urine samples.

Results of the study suggest that those in the 6-month consumption of a cranberry-lingonberry juice group had a different composition of their gut and urinary microbiome compared to the placebo group. However, the diversity of the gut and urinary microbiome was not affected. Study limitations include the small number of children with good compliance and sufficient fecal and urine samples.

Source: Hakkola, Mikael, Pekka Vehviläinen, Janita Muotka, Mysore V. Tejesvi, Tytti Pokka, Päivi Vähäsarja, Anna‐Maija Hanni et al. “Cranberry‐lingonberry juice affects the gut and urinary microbiome in children a randomized controlled trial.” APMIS (2023).

This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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Posted April 5, 2023.

Taylor Woosley studied biology at Purdue University before becoming a 2016 graduate of Columbia College Chicago with a major in Writing. She currently resides in Glen Ellyn, IL.

References:

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  2. Leung AKC, Wong AHC, Leung AAM, Hon KL. Urinary Tract Infection in Children. Recent Pat Inflamm Allergy Drug Discov. 2019;13(1):2-18. doi:10.2174/1872213×13666181228154940
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  5. González de Llano D, Moreno-Arribas MV, Bartolomé B. Cranberry Polyphenols and Prevention against Urinary Tract Infections: Relevant Considerations. Molecules. Aug 1 2020;25(15)doi:10.3390/molecules25153523
  6. Madduma Hewage S, Prashar S, O K, Siow YL. Lingonberry Improves Non-Alcoholic Fatty Liver Disease by Reducing Hepatic Lipid Accumulation, Oxidative Stress and Inflammatory Response. Antioxidants (Basel, Switzerland). Apr 6 2021;10(4)doi:10.3390/antiox10040565