UTIs – Help Is On The Way!

Urinary tract infections (UTIs) are common but can lead to serious complications including kidney infections. UTI infections are more common in women. Younger women tend to have obvious genitourinary symptoms such as localized pain or difficulty urinating. Older women can present with less obvious symptoms such as back pain, chills, or constipation. ⅓ of all nursing home infections are UTIs (Rowe & Juthani-Mehta, 2013). 

UTIs are usually caused by Escherichia coli bacteria. Conventional treatment usually involves antibiotics. Because antibiotics are disruptive to the gut microbiome, it is important to avoid getting a UTI in the first place.

Dietary Suggestions to Lower the Risk of UTIs

Proper hydration is crucial and can be a problem for older individuals as they begin to lose the sensation of thirst as a part of the aging process. 

Most people know that cranberry juice is helpful in the prevention of UTIs.  Cranberry juice contains plant compounds called proanthocyanidins that prevent the adhesion of E. coli bacteria to the urinary tract. The problem with cranberry juice is that it usually contains a lot of sugar. That is why using chewable tablets or powders may be preferable (Howell et al., 2010).

Researchers have identified other dietary interventions that help lower the risk of a UTI. These include berry juices and fermented milk products (Kontijokar et al., 2003)

In general, following a low-sugar diet rich in a variety of plants should help promote healthy gut and vaginal flora and keep the pathogens at bay.  

Probiotics to Prevent UTIs

Certain strains of probiotics are effective for fighting UTIs, especially strains found in fermented milk products. Specific strains within the lactobacilli family are especially helpful, especially certain rhamnosus and reuteri strains. Quality probiotic products designed for UTI prevention can be quite helpful (Falagas et al., 2006). 

D-Mannose to the Rescue!

While antibiotics remain the standard of care for UTIs, there is growing concern about antibiotic-resistant infections. In cases of uncomplicated UTIs, D-mannose can often be as effective as antibiotics. Alternative treatments are needed because once a woman has an initial UTI and is treated with antibiotics, in 20-30% of cases the infection returns in 4-6 months (Wadenlehner et al., 2022). 

D-mannose is a monosaccharide available in supplement form and is not known to raise blood sugar.

My Favorite Tea for UTIs

Hibiscus tea confers many of the same benefits as cranberries in preventing UTIs (Milandri et al., 2019). 

I often recommend hibiscus tea to clients because it has other health benefits as well, including helping with high blood pressure. 

Consider making a glass container of hibiscus tea and storing it in the refrigerator. Unlike cranberry juice, it requires no sweeteners. Drinking tea also helps support hydration. 

Common Supplement That May Increase the Risk of UTIs!

For a variety of reasons, older women are especially vulnerable to UTIs, especially if they live in a nursing home. The fact that their symptoms are often confusing and non-specific, means they may go longer without a diagnosis and treatment (Rowe & Juthani-Mehta, 2013). 

30% of postmenopausal women develop osteopenia or osteoporosis and many take take calcium and vitamin D supplements. However, research suggests that taking too much calcium may increase the risk of UTIs (Apicella & Sobota 1990). Antacids like Tums are high in calcium carbonate and should be used sparingly.  If you are postmenopausal and prone to UTIs, remember that a calcium supplement is not meant to replace calcium in the diet. 

Dietary calcium will not increase the risk of UTIs. Use a free app to calculate a calcium dietary baseline prior to supplementing with calcium — especially if UTIs are a concern. 

Disclaimer 

The included information is not meant to or should not be used to replace or substitute medical treatment, recommendations, or the advice of your physician or health care provider. The information contained within is strictly for educational purposes and is based on evidence-based nutrition. If you believe you have a medical problem or condition, please contact your physician or healthcare provider. 

References 

Apicella, L. L., & Sobota, A. E. (1990). Increased risk of urinary tract infection associated with the use of calcium supplements. Urological research, 18(3), 213–217. https://doi.org/10.1007/BF00295850

Falagas, M. E., Betsi, G. I., Tokas, T., & Athanasiou, S. (2006). Probiotics for preventing recurrent urinary tract infections in women: a review of the evidence from microbiological and clinical studies. Drugs, 66(9), 1253–1261. https://doi.org/10.2165/00003495-200666090-00007

Howell, A. B., Botto, H., Combescure, C., Blanc-Potard, A. B., Gausa, L., Matsumoto, T., Tenke, P., Sotto, A., & Lavigne, J. P. (2010). Dosage effect on uropathogenic Escherichia coli anti-adhesion activity in urine following consumption of cranberry powder standardized for proanthocyanidin content: a multicentric randomized double-blind study. BMC infectious diseases, 10, 94. https://doi.org/10.1186/1471-2334-10-94

Kontiokari, T., Laitinen, J., Järvi, L., Pokka, T., Sundqvist, K., & Uhari, M. (2003). Dietary factors protecting women from urinary tract infection. The American journal of clinical nutrition, 77(3), 600–604. https://doi.org/10.1093/ajcn/77.3.600

Milandri, R., Maltagliati, M., Bocchialini, T., Del Prete, C., Bianchi, G., Rocco, B. M., & Micali, S. (2019). Effectiveness of D-mannose, Hibiscus sabdariffa and Lactobacillus plantarum therapy in prevention of infectious events following urodynamic study. Urologia, 86(3), 122–125. https://doi.org/10.1177/0391560318798291

Rowe, T. A., & Juthani-Mehta, M. (2013). Urinary tract infection in older adults. Aging health, 9(5), 10.2217/ahe.13.38. https://doi.org/10.2217/ahe.13.38

Wagenlehner, F., Lorenz, H., Ewald, O., & Gerke, P. (2022). Why d-Mannose May Be as Efficient as Antibiotics in the Treatment of Acute Uncomplicated Lower Urinary Tract Infections-Preliminary Considerations and Conclusions from a Non-Interventional Study. Antibiotics (Basel, Switzerland), 11(3), 314. https://doi.org/10.3390/antibiotics11030314