But that’s not stopping Ocean Spray.
Of course the head scientist for Ocean Spray has never had a urinary tract infection. With all that cranberry nectar at her disposal, Christina Khoo, the head of research science at the newly launched Ocean Spray Cranberry Health Institute, should have the most sparkly-clean urinary tract in the world.
But that’s not the case for a majority of women. In fact, when Khoo conducted a study in 2016 on cranberry juice’s effectiveness at preventing recurrent UTIs, some of the women she studied got three UTIs in a six-month period. That study, led by Ocean Spray researchers and supplied with Ocean Spray products, is now part of a petition Ocean Spray has filed with the FDA asking permission to market some of its cranberry products as preventing UTIs.
If approved, the petition would allow the company to make the official claim that “by consuming one serving of cranberry products each day, like one 8 ounce glass of this Ocean Spray® cranberry juice cocktail, healthy women who have had a urinary tract infection may reduce their risk of recurrent UTI.”
UTIs and cranberry juice are practically inextricable for women these days. “People hear about cranberry from their mothers and grandmothers, and what we do is try and provide the science to substantiate those statements,” Khoo says. Lots of scientists have been trying to do that for a long time, actually, some more successfully than others.
But lately, things aren’t looking so great for the cranberry. Both a 2012 review of cranberry-UTI literature and a 2016 study out of Yale found no statistically significant reason to believe cranberries prevent infection.
If the cranberry thing were true, it’d be a saving grace for the roughly half of all women who get a UTI in their lifetime, and probably also for Ocean Spray’s profits. The company owns the vast majority of cranberry bogs in the country. Arguably too many cranberry bogs — cranberry growers are harvesting more berries than Ocean Spray can possibly squeeze into bottles.
FDA approval of Ocean Spray’s petition to market itself as helping prevent one of the most frequent infections in the world would be the best thing to happen to cranberries since Carrie Bradshaw ordered her first cosmopolitan.
The idea that cranberries may help infections is older than this country. The fruit, one of a few that are native to North America, was used by Native Americans for all sorts of reasons. “They would take cranberries and grind them up and put the paste on wounds,” says Amy Howell, a scientist with Rutgers University’s Marucci Center for Blueberry and Cranberry Research. (She’s also a regular speaker at things like the annual Berry Health Benefits Symposium, where the country’s berry experts meet to “present research that will attract media and consumer attention to berries as a superfruit.”) Howell says that Native Americans believed the berry had antibacterial properties that could prevent infection.
Early colonists to New England were the first to cultivate cranberries, which they sweetened with honey to make them more edible (now, most cranberry juice cocktails on the market, including Ocean Spray’s, contain comparable amounts of sugar to soda). Official cranberry research started in the late 1800s, when scientists first observed that consuming cranberries increased the amount of acid in urine. A study published in the Journal of Urology in 1984 was the first to suggest that drinking cranberry juice could prevent or even treat UTIs.
In 1998, Howell’s research team isolated a molecular compound in cranberries that they believed prevented E. coli bacteria (the most common cause of UTIs) from attaching to cells in the urinary tract. The New England Journal of Medicine later issued a correction, disclosing that Howell’s research was “supported in part by a grant from Ocean Spray Cranberries, Inc.”
That same year, a network of independent scientists and medical experts around the world published its first review of studies on cranberries and UTIs. Their consensus: We need more evidence.
Scientists tried. There were more clinical trials. Variations on the cranberry’s powers emerged, like that only pure, unsweetened cranberry juice works (Howell says this will “rip the enamel right off your teeth”). But as Betsy Foxman, the director of the Center for Molecular and Clinical Epidemiology of Infectious Diseases at the University of Michigan, explains, most of these clinical trials had problems. The first is that very few people wanted to drink the daily eight ounces of cranberry juice hypothesized to help prevent UTIs. Another was that most of these studies were too small to prove anything.
A third problem is that a lot of studies that suggest cranberry helps prevent UTIs are actually inconclusive on that point. Like the largest study on cranberries and UTIs to date, which was funded by Ocean Spray and published in 2016. Researchers, Khoo among them, found that drinking cranberry juice prevented symptoms of UTIs compared to a placebo group that drank fake cranberry juice. But when other researchers compared actual, culture-confirmed UTIs, there was no significant difference between women who drank cranberry juice and women who didn’t.
Kellyanne Dignan, the director of corporate communications for Ocean Spray, had a total cranberry nightmare on her hands in late 2016, when a team of scientists from Yale published the findings of their own cranberry study. Focused on older women in nursing homes (a population particularly plagued with UTIs), the study found no relationship between taking concentrated cranberry supplements and preventing UTIs.
Headlines declared the cranberry myth busted. The New Yorker listed the study as one of the most notable medical findings of 2016. Lindsay Nicolle, chair of the Biomedical Research Ethics Board at the University of Manitoba, wrote a scorching editorial that accompanied the research and said it was officially time to move on from cranberries as a UTI solution. It was a cranberry coup.
“I got a lot of calls when that happened, and I said we stand by our products and any claims we make about them,” Dignan says. “Part of the reason why we research so extensively is if we are making health claims, we want to make sure we have the science to back them up.”
At the time, Ocean Spray technically wasn’t making any health claims. The new FDA petition, filed less than a year later, is what would allow the company to do so, though Dignan clarified that not every bottle with a “blue Ocean Spray logo” would carry the promise of health benefits. Several cranberry trials led by Howell and Khoo are listed among the studies Ocean Spray presents as proof that cranberries prevent recurrent UTIs. The Yale study is not mentioned on the petition.
Despite the Yale study and Nicolle’s decisive op-ed, Foxman isn’t quite ready to give up on the bitter little berry. “I’m still curious whether cranberry might do something for urinary symptoms,” she says. A study she led in 2015 (funded by the National Institute of Health, not Ocean Spray) found that taking cranberry supplements every day helped women with short-term catheters prevent clinical UTIs. She’s waiting for someone to repeat her study and show the same result.
The FDA will give a final decision on the Ocean Spray petition later in the fall. Within a few weeks of filing, the petition was downgraded from an “authorized health claim” to a “qualified” one, which some interpret as a sign that things aren’t looking good for Ocean Spray.
Foxman can’t predict the verdict, but she has her own feelings. “Cranberry juice is juice — it’s high in vitamin-C, it’s supposed to be slightly diuretic so it makes you urinate more frequently, which is a good thing if you have a tendency toward urinary tract infections,” she says. “If you tolerate it, and it helps you, do it.”
What Ocean Spray and the rest of the cranberry believers need now is what Khoo, a beacon of urinary health, has experienced her whole life: A stroke of good luck.