Cranberry juice really can help with UTIs – and reduce reliance on antibiotics

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Cranberry juice has been used medicinally for centuries. Our new research indicates it should be a normal aspect of urinary tract infection (UTI) management today.

While some benefits of cranberry compounds for the prevention of UTIs have been suspected for some time, it hasn’t been clear whether the benefits from cranberry juice were simply from drinking more fluid, or something in the fruit itself.

For our study, published this week, we combined and collectively assessed 3,091 participants across more than 20 clinical trials.

Our analysis indicates that increasing liquids reduces the rate of UTIs compared with no treatment, but cranberry in liquid form is even better at reducing UTIs and antibiotic use.

Julie Falk/Flickr, CC BY-NC-ND

Are UTIs really that bad?

Urinary tract infections affect more than 50% of women and 20% of men in their lifetime.

Most commonly, UTIs are caused from the bug called Escherichia coli (E.coli). This bug lives harmlessly in our intestines, but can cause infection in the urinary tract. This is why, particularly for women, it is recommended people wipe from front to back after using the toilet.

An untreated UTI can move up to the kidneys and cause even more serious illness.

Even when not managing infection, many people are anxious about contracting a UTI. Sexually active women, pregnant women and older women may all be at increased risk.

Why cranberries?

To cause a UTI, the bacteria need to attach to the wall of the urinary bladder. Increasing fluids helps to flush out bacteria before it attaches (or makes its way up into the bladder).

Some beneficial compounds in cranberry, such as proanthocyanidins (also called condensed tannins), prevent the bacteria from attaching to the wall itself.

While there are treatments, over 90% of the bugs that cause UTIs exhibit some form of microbial resistance. This suggests that they are rapidly changing and some cases of UTI might be left untreatable.

massive lake with red cranberries floating on surface for harvesting
The juice of cranberries has long been thought to have infection-fighting properties. duckeesue/Shutterstock

What we found

Our analysis showed a 54% lower rate of UTIs from cranberry juice consumption compared to no treatment. This means that significantly fewer participants who regularly consumed cranberry juice (most commonly around 200 millilitres each day) reported having a UTI during the periods assessed in the studies we analysed.

Cranberry juice was also linked to a 49% lower rate of antibiotic use than placebo liquid and a 59% lower rate than no treatment, based on analysis of indirect and direct effects across six studies. The use of cranberry compounds, whether in drinks or tablet form, also reduced the prevalence of symptoms associated with UTIs.

While some studies we included presented conflicts of interest (such as receiving funding from cranberry companies), we took this “high risk of bias” into account when analysing the data.

woman sips from large glass of red juice
The study found extra hydration helped but not to the same extent as cranberry juice. Pixelshot/Shutterstock

So, when can cranberry juice help?

We found three main benefits of cranberry juice for UTIs.

1. Reduced rates of infections

Increasing fluids (for example, drinking more water) reduced the prevalence of UTIs, and taking cranberry compounds (such as tablets) was also beneficial. But the most benefits were identified from increasing fluids and taking cranberry compounds at the same time, such as with cranberry juice.

2. Reduced use of antibiotics

The data shows cranberry juice lowers the need to use antibiotics by 59%. This was identified as fewer participants in randomised cranberry juice groups required antibiotics.

Increasing fluid intake also helped reduce antibiotic use (by 25%). But this was not as useful as increasing fluids at the same time as using cranberry compounds.

Cranberry compounds alone (such as tablets without associated increases in fluid intake) did not affect antibiotic use.

3. Reducing symptoms

Taking cranberry compounds (in any form, liquid or tablet) reduced the symptoms of UTIs, as measured in the overall data, by more than five times.

Take home advice

While cranberry juice cannot treat a UTI, it can certainly be part of UTI management.

If you suspect that you have a UTI, see your GP as soon as possible.

Christian Moro, Associate Professor of Science & Medicine, Bond University and Charlotte Phelps, Senior Teaching Fellow, Medical Program, Bond University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Steps vs Cardio | Which is Best for Fat Loss, Health, & Performance?

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    “Move more”, they say; but does it matter how quickly?

    Use it or lose it

    For general performance:

    • More steps per day do offer slight aerobic benefits but do not significantly improve endurance.
    • Higher-intensity cardio (ideally, HIIT) is essential for improving aerobic fitness.
    • Training should match endurance goals (e.g. long-distance running vs team sports vs whatever it is that you care about for you).

    For general health:

    • Both cardio and step tracking reduce mortality risk and improve longevity.
    • 2–3 hours of cardio per week provides most health benefits, with diminishing returns after 8 hours per week.
    • 10,000+ steps/day is optimal, but 5,000+ steps/day still benefits health. And, not mentioned in this video, but really (per science) there seem to be diminishing returns after about 8,000 steps per day.

    Fun fact: the reason it’s 10,000 steps per day that everyone talks about as the default goal, is just because the Japanese person who popularized it noted that the kanji for 10,000 looks a bit like a walking person: 万

    For fat loss:

    • Both step tracking and cardio do help.
    • Step tracking better reflects total daily movement, while cardio burns calories in sessions—but if it’s not HIIT, there is likely to be a compensatory metabolic slump afterwards.
    • High-intensity cardio increases fatigue, which may impact resistance training and diet adherence.
    • Excessive endurance training can slightly inhibit muscle growth, but low-intensity steps have minimal interference.

    So for fat loss, it’s best to get those steps in, and throw in a few HIIT sessions per week, with adequate recovery time between them.

    For more on all of these things, enjoy:

    Click Here If The Embedded Video Doesn’t Load Automatically!

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    How To Do HIIT (Without Wrecking Your Body)

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  • What’s the difference between heat exhaustion and heat stroke? One’s a medical emergency

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    When British TV doctor Michael Mosley died last year in Greece after walking in extreme heat, local police said “heat exhaustion” was a contributing factor.

    Since than a coroner could not find a definitive cause of death but said this was most likely due to an un-identified medical reason or heat stroke.

    Heat exhaustion and heat stroke are two illnesses that relate to heat.

    So what’s the difference?

    Studio Nut/Shutterstock

    A spectrum of conditions

    Heat-related illnesses range from mild to severe. They’re caused by exposure to excessive heat, whether from hot conditions, physical exertion, or both. The most common ones include:

    • heat oedema: swelling of the hands, feet and ankles
    • heat cramps: painful, involuntary muscle spasms usually after exercise
    • heat syncope: fainting due to overheating
    • heat exhaustion: when the body loses water due to excessive sweating, leading to a rise in core body temperature (but still under 40°C). Symptoms include lethargy, weakness and dizziness, but there’s no change to consciousness or mental clarity
    • heat stroke: a medical emergency when the core body temperature is over 40°C. This can lead to serious problems related to the nervous system, such as confusion, seizures and unconsciousness including coma, leading to death.

    As you can see from the diagram below, some symptoms of heat stroke and heat exhaustion overlap. This makes it hard to recognise the difference, even for medical professionals.

    Heat exhaustion vs heat stroke venn diagram
    CC BY-SA

    How does this happen?

    The human body is an incredibly efficient and adaptable machine, equipped with several in-built mechanisms to keep our core temperature at an optimal 37°C.

    But in healthy people, regulation of body temperature begins to break down when it’s hotter than about 31°C with 100% humidity (think Darwin or Cairns) or about 38°C with 60% humidity (typical of other parts of Australia in summer).

    This is because humid air makes it harder for sweat to evaporate and take heat with it. Without that cooling effect, the body starts to overheat.

    Once the core temperature rises above 37°C, heat exhaustion can set in, which can cause intense thirst, weakness, nausea and dizziness.

    If the body heat continues to build and the core body temperature rises above 40°C, a much more severe heat stroke could begin. At this point, it’s a life-threatening emergency requiring immediate medical attention.

    At this temperature, our proteins start to denature (like an egg on a hotplate) and blood flow to the intestines stops. This makes the gut very leaky, allowing harmful substances such as endotoxins (toxic substances in some bacteria) and pathogens (disease causing microbes) to leak into the bloodstream.

    The liver can’t detoxify these fast enough, leading to the whole body becoming inflamed, organs failing, and in the worst-case scenario, death.

    Who’s most at risk?

    People doing strenuous exercise, especially if they’re not in great shape, are among those at risk of heat exhaustion or heat stroke. Others at risk include those exposed to high temperatures and humidity, particularly when wearing heavy clothing or protective gear.

    Outdoor workers such as farmers, firefighters and construction workers are at higher risk too. Certain health conditions, such as diabetes, heart disease, or lung conditions (such as COPD or chronic obstructive pulmonary disease), and people taking blood pressure medications, can also be more vulnerable.

    Adults over 65, infants and young children are especially sensitive to heat as they are less able to physically cope with fluctuations in heat and humidity.

    Firefighters holding hose, aimed at bushfire
    Firefighters are among those at risk of heat-related illness. structuresxx/Shutterstock

    How are these conditions managed?

    The risk of serious illness or death from heat-related conditions is very low if treatment starts early.

    For heat exhaustion, have the individual lie down in a cool, shady area, loosen or remove excess clothing, and cool them by fanning, moistening their skin, or immersing their hands and feet in cold water.

    As people with heat exhaustion almost always are dehydrated and have low electrolytes (certain minerals in the blood), they will usually need to drink fluids.

    However, emergency hospital care is essential for heat stroke. In hospital, health professionals will focus on stabilising the patient’s:

    • airway (ensure no obstructions, for instance, vomit)
    • breathing (look for signs of respiratory distress or oxygen deprivation)
    • circulation (check pulse, blood pressure and signs of shock).

    Meanwhile, they will use rapid-cooling techniques including immersing the whole body in cold water, or applying wet ice packs covering the whole body.

    Take home points

    Heat-related illnesses, such as heat stroke and heat exhaustion, are serious health conditions that can lead to severe illness, or even death.

    With climate change, heat-related illness will become more common and more severe. So recognising the early signs and responding promptly are crucial to prevent serious complications.

    Matthew Barton, Senior lecturer, School of Nursing and Midwifery, Griffith University and Michael Todorovic, Associate Professor of Medicine, Bond University

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Mediterranean Air Fryer Cookbook – by Naomi Lane

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    There are Mediterranean Diet cookbooks, and there are air fryer cookbooks. And then there are (a surprisingly large intersection of!) Mediterranean Diet air fryer cookbooks. We wanted to feature one of them in today’s newsletter… And as part of the selection process, looked through quite a stack of them, and honestly, were quite disappointed with many. This one, however, was one of the ones that stood out for its quality of both content and clarity, and after a more thorough reading, we now present it to you:

    Naomi Lane is a professional dietician, chef, recipe developer, and food writer… And it shows, on all counts.

    She covers what the Mediterranean diet is, and she covers far more than this reviewer knew it was even possible to know about the use of an air fryer. That alone would make the book a worthy purchase already.

    The bulk of the book is the promised 200 recipes. They cover assorted dietary requirements (gluten-free, dairy-free, etc) while keeping to the Mediterranean Diet.

    The recipes are super clear, just what you need to know, no reading through a nostalgic storytime first to find things. Also no pictures, which will be a plus for some readers and a minus for others. The recipes also come complete with nutritional information for each meal (including sodium), so you don’t have to do your own calculations!

    Bottom line: this is the Mediterranean Diet air fryer cook book. Get it, thank us later!

    Get your copy of “Mediterranean Air Fryer Cookbook” on Amazon today!

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  • California Becomes Latest State To Try Capping Health Care Spending

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    California’s Office of Health Care Affordability faces a herculean task in its plan to slow runaway health care spending.

    The goal of the agency, established in 2022, is to make care more affordable and accessible while improving health outcomes, especially for the most disadvantaged state residents. That will require a sustained wrestling match with a sprawling, often dysfunctional health system and powerful industry players who have lots of experience fighting one another and the state.

    Can the new agency get insurers, hospitals, and medical groups to collaborate on containing costs even as they jockey for position in the state’s $405 billion health care economy? Can the system be transformed so that financial rewards are tied more to providing quality care than to charging, often exorbitantly, for a seemingly limitless number of services and procedures?

    The jury is out, and it could be for many years.

    California is the ninth state — after Connecticut, Delaware, Massachusetts, Nevada, New Jersey, Oregon, Rhode Island, and Washington — to set annual health spending targets.

    Massachusetts, which started annual spending targets in 2013, was the first state to do so. It’s the only one old enough to have a substantial pre-pandemic track record, and its results are mixed: The annual health spending increases were below the target in three of the first five years and dropped beneath the national average. But more recently, health spending has greatly increased.

    In 2022, growth in health care expenditures exceeded Massachusetts’ target by a wide margin. The Health Policy Commission, the state agency established to oversee the spending control efforts, warned that “there are many alarming trends which, if unaddressed, will result in a health care system that is unaffordable.”

    Neighboring Rhode Island, despite a preexisting policy of limiting hospital price increases, exceeded its overall health care spending growth target in 2019, the year it took effect. In 2020 and 2021, spending was largely skewed by the pandemic. In 2022, the spending increase came in at half the state’s target rate. Connecticut and Delaware, by contrast, both overshot their 2022 targets.

    It’s all a work in progress, and California’s agency will, to some extent, be playing it by ear in the face of state policies and demographic realities that require more spending on health care.

    And it will inevitably face pushback from the industry as it confronts unreasonably high prices, unnecessary medical treatments, overuse of high-cost care, administrative waste, and the inflationary concentration of a growing number of hospitals in a small number of hands.

    “If you’re telling an industry we need to slow down spending growth, you’re telling them we need to slow down your revenue growth,” says Michael Bailit, president of Bailit Health, a Massachusetts-based consulting group, who has consulted for various states, including California. “And maybe that’s going to be heard as ‘we have to restrain your margins.’ These are very difficult conversations.”

    Some of California’s most significant health care sectors have voiced disagreement with the fledgling affordability agency, even as they avoid overtly opposing its goals.

    In April, when the affordability office was considering an annual per capita spending growth target of 3%, the California Hospital Association sent it a letter saying hospitals “stand ready to work with” the agency. But the proposed number was far too low, the association argued, because it failed to account for California’s aging population, new investments in Medi-Cal, and other cost pressures.

    The hospital group suggested a spending increase target averaging 5.3% over five years, 2025-29. That’s slightly higher than the 5.2% average annual increase in per capita health spending over the five years from 2015 to 2020.

    Five days after the hospital association sent its letter, the affordability board approved a slightly less aggressive target that starts at 3.5% in 2025 and drops to 3% by 2029. Carmela Coyle, the association’s chief executive, said in a statement that the board’s decision still failed to account for an aging population, the growing need for mental health and addiction treatment, and a labor shortage.

    The California Medical Association, which represents the state’s doctors, expressed similar concerns. The new phased-in target, it said, was “less unreasonable” than the original plan, but the group would “continue to advocate against an artificially low spending target that will have real-life negative impacts on patient access and quality of care.”

    But let’s give the state some credit here. The mission on which it is embarking is very ambitious, and it’s hard to argue with the motivation behind it: to interject some financial reason and provide relief for millions of Californians who forgo needed medical care or nix other important household expenses to afford it.

    Sushmita Morris, a 38-year-old Pasadena resident, was shocked by a bill she received for an outpatient procedure last July at the University of Southern California’s Keck Hospital, following a miscarriage. The procedure lasted all of 30 minutes, Morris says, and when she received a bill from the doctor for slightly over $700, she paid it. But then a bill from the hospital arrived, totaling nearly $9,000, and her share was over $4,600.

    Morris called the Keck billing office multiple times asking for an itemization of the charges but got nowhere. “I got a robotic answer, ‘You have a high-deductible plan,’” she says. “But I should still receive a bill within reason for what was done.” She has refused to pay that bill and expects to hear soon from a collection agency.

    The road to more affordable health care will be long and chock-full of big challenges and unforeseen events that could alter the landscape and require considerable flexibility.

    Some flexibility is built in. For one thing, the state cap on spending increases may not apply to health care institutions, industry segments, or geographic regions that can show their circumstances justify higher spending — for example, older, sicker patients or sharp increases in the cost of labor.

    For those that exceed the limit without such justification, the first step will be a performance improvement plan. If that doesn’t work, at some point — yet to be determined — the affordability office can levy financial penalties up to the full amount by which an organization exceeds the target. But that is unlikely to happen until at least 2030, given the time lag of data collection, followed by conversations with those who exceed the target, and potential improvement plans.

    In California, officials, consumer advocates, and health care experts say engagement among all the players, informed by robust and institution-specific data on cost trends, will yield greater transparency and, ultimately, accountability.

    Richard Kronick, a public health professor at the University of California-San Diego and a member of the affordability board, notes there is scant public data about cost trends at specific health care institutions. However, “we will know that in the future,” he says, “and I think that knowing it and having that information in the public will put some pressure on those organizations.”

    This article was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation. 

    KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

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  • How Does Fat Actually Leave The Body? Where Does It Go?

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    Fat loss is often misunderstood, with many believing it simply “vanishes” through exercise, is simply excreted in solid form in the bathroom, or materially disappears when converted for energy. However, the principle of conservation of mass plays out here, in that the mass in fat doesn’t disappear—it changes its arrangement:

    In and out

    Fat is composed of carbon, hydrogen, and oxygen atoms, with an example common form of fat in the body being C55H104O6. That’s a lot of Cs and Hs, and a few Os.

    When fat leaves the body, it has been primarily converted into carbon dioxide (CO2) and water (H2O).

    According to a 2014 study by the University of South Wales, 84% of the mass of fat exits the body as CO2 exhaled through breathing, while 16% leaves as water through sweat, urine, and other bodily fluids (all of which contain H2O).

    You’ll notice there are a lot more Os going out, proportionally, than we originally had in the C55H104O6. For this reason, the process requires oxygen intake; for every 10 kilograms of fat burned, by simple mathematics the body needs around 29 kilograms of oxygen.

    Physical activity plays a crucial role in fat loss. When the body exerts itself, it naturally switches to a higher oxygen metabolism necessary for fat breakdown. This effect is amplified during intermittent fasting, which boosts human growth hormone (HGH), a hormone that aids in fat metabolism.

    However, simply hyperventilating won’t work; exercise is essential to activate these processes—otherwise it’s just a case of oxygen in, oxygen out, without involving the body’s chemical energy reserves.

    Consequently, one of the best diet-and-exercise combinations for fat loss is intermittent fasting with high-intensity interval training.

    And, as for what to eat, this video says raw vegan, but honestly, that’s not scientific consensus. However, a diet rich in unprocessed (or minimally processed) fruits and vegetables definitely is where it’s at, with the plant-heavy Mediterranean diet generally scoring highest—which can be further improved by skipping the mammals to make it pesco-Mediterranean. Current scientific consensus does not give any extra benefits for also omitting moderate consumption of fish and fermented dairy products, so include those if you want, or skip those if you prefer.

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  • Is Marine Collagen Worth Taking?

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    Questions and Answers at 10almonds

    Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!

    This newsletter has been growing a lot lately, and so have the questions/requests, and we love that! In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

    As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

    So, no question/request too big or small

    I wanted to ask if you think marine collagen is decent to take. I’ve heard a lot of bad press about it

    We don’t know what you’ve heard, but generally speaking it’s been found to be very beneficial to bones, joints, and skin! We wrote about it quite recently on a “Research Review Monday”:

    See: We Are Such Stuff As Fish Are Made Of

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