Cranberry juice with high proanthocyanidin content may reduce incidence of Helicobacter pylori infection

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A recent study published in the Journal of Gastroenterology and Hepatology¹ found that Helicobacter pylori infection significantly declined when subjects consumed a cranberry juice standardized to high proanthocyanidin (PAC) content. In the double-blind, randomized, placebo-controlled study, 522 H. pylori-positive subjects consumed either a placebo, a 240 ml bottle of low-PAC cranberry juice with 23 mg of PAC once daily, a medium-PAC cranberry juice containing 44 mg of PAC once daily, or two 240 ml bottles of cranberry juice containing 44 mg of PAC daily for eight weeks. In another arm of the study, subjects consumed either one or two 280 mg capsules of cranberry powders containing 36 mg of PAC per capsule, or two placebo capsules, daily for eight weeks.

The study’s primary outcome was the H. pylori-negative rate in each group at two and eight weeks. Intention-to-treat analysis of all 294 subjects in the cranberry juice arm showed that among subjects consuming the juice, negative rates at two weeks were 13.7% for the placebo group, 6.67% for the low-PAC group, 1.37% for the medium-PAC group, and 12.16% for the high-PAC group. Negative rates for the high-PAC group were significantly higher than the medium-PAC group, but there were no statistical differences between placebo, low-PAC, and high-PAC group. After eight weeks, negative rates were 6.85% for the placebo group, 6.67 for the low-PAC group, 4.11% for the medium-PAC group, and 17.57% for the high-PAC group. The high-PAC group had significantly higher negative rates than all the other groups. Subjects taking the encapsulated cranberry powder saw no statistically significant differences between groups. Researchers attributed this to potentially sub-efficacious doses and dissolution issues.

Forty-five days post-intervention, 23 subjects across all groups that remained H. pylori-negative at both two and eight weeks were tested to determine eradication rates. Results showed that 75% of the subjects who received active treatment in the juice arm of the study and 66.7% of the subjects who received active treatment in the encapsulated powder arm remained H. pylori-negative. Compare this to 50% and 60% in the placebo juice and powder groups, respectively. However, because of the limited sample size, statistical analysis could not be performed.

"The study findings reveal that cranberry juice may be a useful aid in H. pylori management in adults in a high-risk region of China with an endemic infection rate of over 50%, and has potential to be a key area for future research," said lead researcher Kai-Feng Pan, MD, PhD, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Cancer Epidemiology, of Peking University Cancer Hospital & Institute. "While not alternatives to antibiotics, effective complementary strategies, like cranberry, that can contribute to managing H. pylori infections without negative side effects are highly desirable."

Reference

1. Le ZX et al. “Suppression of Helicobacter pylori infection by daily cranberry intake: A double‐blind, randomized, placebo‐controlled trial.” Journal of Gastroenterology and Hepatology, vol. 36, no. 4 (2021): 927-935