Elsevier

Nutrition Research

Volume 34, Issue 5, May 2014, Pages 420-427
Nutrition Research

Consumption of cranberry beverage improved endogenous antioxidant status and protected against bacteria adhesion in healthy humans: a randomized controlled trial

https://doi.org/10.1016/j.nutres.2014.03.006Get rights and content

Abstract

Consumption of polyphenol-rich foods is associated with lower risk from many chronic diseases. We hypothesized that a single dose of cranberry beverage would improve indices of oxidative stress, inflammation, and urinary antibacterial adhesion activity in healthy humans. Six males and 6 females (18-35 years; body mass index, 19-25 kg/m2) consumed placebo, cranberry leaf extract beverage, or low-calorie cranberry juice cocktail (LCJC) once in a randomized, double-blind, placebo-controlled cross-over experimental design trial. The washout period between beverages was 1 week. Blood was collected 0, 2, 4, 8, and 24 hours after beverage consumption for measuring oxidative and inflammatory biomarkers. Urine was collected at 0, 0 to 3, 3 to 6, 6 to 9, 9 to 12, and 24 hours postintervention to assess antibacterial adhesion activity. Consumption of cranberry leaf extract beverage elevated (P < .05) blood glutathione peroxidase activity, whereas LCJC consumption increased (P < .05) glutathione concentrations and superoxide dismutase activity compared with placebo. Cranberry leaf extract beverage and LCJC consumption had no effect on the inflammatory biomarkers measured as compared with placebo. At 0 to 3 hours postconsumption, urine from participants who consumed cranberry beverages had higher (P < .05) ex vivo antiadhesion activity against P-fimbriated Escherichia coli compared with placebo. An acute dose of cranberry beverages improved biomarkers of antioxidant status and inhibition of bacterial adhesion in urine.

Introduction

Oxidative stress and inflammation are implicated in many chronic diseases, especially those with metabolic components such as cardiovascular disease. On the other hand, consumption of foods rich in phytochemicals lowers the risk for these diseases. Cranberries contain a unique fingerprint of polyphenolic compounds including flavanols, procyanidins, and anthocyanins [1]; these polyphenolics are relatively stable during juice processing with good retention of procyanidins and moderate retention of anthocyanins [2]. Bioavailability of cranberry polyphenolics has been demonstrated in both human plasma and urine. A total of 16 phenolic compounds, including myricetin, quercetin, resveratrol, benzoic, and phenolic acids, have been identified in human plasma 0.75 to 4.5 hours after cranberry juice consumption [3]. Maximal polyphenol excretion in the urine occurred 3 to 6 hours postconsumption [4], with approximately 5% of total anthocyanins from the juice excreted in the urine in intact form. However, little urinary excretion (0.8%) was observed in a similar study [5]. In spite of disagreement regarding the bioavailability of anthocyanins, it has been repeatedly shown that consuming cranberry increases blood antioxidant capacity and exerts antioxidant effects in preventing damage to lipids, DNA, and proteins by scavenging reactive oxygen species (ROS).

Proper pro-oxidant:antioxidant balance is necessary to maintain antioxidant defenses. Increases in ROS results in oxidation of polyunsaturated fatty acids, causing vascular damage [6]. Polyphenol antioxidants have been shown to prevent this damage; anthocyanin-rich berry extracts inhibited tumor necrosis factor α (TNF-α)–induced vascular endothelial growth factor production in hydrogen peroxide–stressed human keratinocytes in vitro [7] and decreased the toxic effects of CCl4 by inhibiting nitric oxide (NO) production and TNF-α release in rats [8]. Nitric oxide production was also inhibited by cranberry extract in the mouse macrophage cell line J774 after challenge with lipopolysaccharide [9]. Antioxidant effects of cranberries have also been demonstrated in vivo in rats, as the consumption of an anthocyanin-rich diet increased antioxidant capacity and decreased lipid and DNA damage [10]. In humans, a direct increase in plasma antioxidant capacity has been shown following consumption of a single dose of cranberry juice [11] as well as in longer intervention trials [12].

Cranberry consumption has long been associated with the prevention of urinary tract infection, with several theories proposed as potential mechanisms of action. Cranberry extract components have been shown to inhibit the adhesion of P-fimbriated Escherichia coli to uroepithelial cells (UECs) when assessed using a hemagglutination assay [13]. In addition, cranberry juice consumption has been shown to increase antiadhesion activity in human urine [14]. Cranberry antiadhesion activity has also been demonstrated in urine collected from volunteers following cranberry powder consumption [15]; the antiadhesion activity of urine collected from participants who consumed the cranberry powder increased dose dependently with increasing total proanthocyanidins (PAC) consumed.

Based on the above examples, polyphenol bioactive compounds in cranberry may ameliorate disease conditions due to their antioxidant, anti-inflammatory, and antiadhesive properties. Similar to cranberries, leaves from the cranberry vine contain classes of polyphenol compounds found in cranberry fruit and juice, including catechins, flavonoids, and PAC; however, negligible concentrations of anthocyanin flavonoids are present in the leaf [16]. No clinical studies are available on the possible health benefits of a cranberry leaf extract beverage; therefore, a cranberry leaf aqueous extract was used to make a beverage to compare to a traditional cranberry juice cocktail.

The objective of this study was to compare the effects of a single dose of cranberry juice cocktail and a novel cranberry leaf extract beverage on antioxidant status, oxidative damage, inflammation biomarkers, and urinary antibacterial adhesion activity in healthy adults using a randomized, double-blind, placebo-controlled cross-over experimental design. We hypothesized that a single dose of either cranberry beverage would improve indices of oxidative stress, inflammation, and urinary antibacterial adhesion activity in healthy humans.

Section snippets

Participants and study design

Healthy adults (n = 12) between 18 and 35 years (averaged 27.5 ± 1.3 years) and with body mass index (BMI) between 19 and 25 kg/m2 (averaged 23.7 ± 0.9 kg/m2) were recruited from Washington State University and the surrounding communities between August and September 2010. A medical questionnaire was administered before initiation of the study; the exclusion criteria included chronic diseases, infection, and the use of tobacco, anti-inflammatory drugs, and antioxidant supplements. The

Oxidative stress and inflammation biomarkers

Concentrations of GSH were similar among treatments during the initial 8 hours after beverage consumption; however, GSH concentration was higher (P < .05) at 24 hours in LCJC when compared with placebo (Fig. 1). There was no treatment difference in concentrations of GSSG (overall means ± SEM of 47.0 ± 3.8, 55.8 ± 3.7, and 52.8 ± 3.7 μmol/L for placebo, CLEB, and LCJC treatments, respectively) or GSH:GSSG ratio (overall means ± SEM of 62.5 ± 12.7, 40.8 ± 7.3, and 77 ± 31.1 for placebo, CLEB, and

Discussion

The antioxidative and anti-inflammatory effects of polyphenols from cranberry have been demonstrated in a number of models. Cranberry polyphenols have been shown to inhibit lipid and protein oxidation and increase radical-scavenging in a number of cell lines in vitro [23], [24]. Polyphenols were shown to reduce TNF-α–induced up-regulation of various inflammatory mediators in human microvascular endothelial cells [25]. Other studies have shown an inhibition of IL-1β, IL-6, TNF-α, and NO

Acknowledgment

Funding for this projection was received from Ocean Spray Cranberries Inc. The authors declare that they have no competing interests.

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