Urinary Tract Infection (UTI) Prevention Diet
Dietary advice for UTI prevention is scarce despite a direct link between urine composition and what we eat and drink. Taking into consideration the most common causes of UTI, we outline here specific dietary recommendations that are most relevant for its prevention.
General dietary guidelines
A well-balanced, nutrient-packed diet is diverse, rich in vegetables, fruits, and whole grains, and low in red meat, sweets, and processed food.
Diets that emphasize such healthy, nourishing foods - the Mediterranean diet or DASH (Dietary Approaches to Stop Hypertension) - are very effective in reducing the risk of common ailments, such as diabetes and cardiovascular disease. Adopting a healthy eating philosophy will definitely have a positive effect on your overall well-being and give you the best chance of fighting off any disease.
A healthy lifestyle for a healthy immune system
UTIs occur when our immune system and defense mechanisms fail to ward off the harmful bacteria. While we do not know the exact ways in which our habits (what we eat, how we exercise, how we cope with stress) affect the functioning of our immune system, it is clear that a healthy lifestyle substantially boosts our immunity and minimizes the likelihood of an infection.
Malnutrition is widely accepted as the most common cause of immunodeficiency. Research suggests that both macronutrients (proteins, carbohydrates, fats) and micronutrients (vitamins A, C, D, E, B6, folate, iron, selenium, zinc, copper) are necessary for the well functioning of the immune system. With a few exceptions, all nutrients needed for a strong immune system can be obtained in a varied, plant-rich diet.
It is yet to be determined exactly which nutrients are needed to fight off specific infections. Current research suggests that, among the micronutrients, it is vitamins A and D that may play an especially important role in UTI prevention.
Vitamin A is a group of molecules that includes provitamin A (found in fruits and vegetables), preformed vitamin A (found in animal sources), as well as several active forms of the vitamin found in the body. Once called “the anti-infective vitamin”, vitamin A is vital for the proper functioning of the mucosal immune system. In the bladder, this immune system helps provide an effective protective barrier against the attachment of pathogens to the cells lining the urinary tract.
Rich sources of vitamin A are: sweet potatoes, dark leafy greens (spinach, kale, collard greens, Swiss chard), carrots, liver, apricots, cantaloupe, eggs, cheese, yogurt. Vitamin A is soluble in fat. For best bioavailability, foods rich in vitamin A should be consumed alongside the healthy fats such as olive oil or avocado.
Vitamin D is a group of molecules that are essential for bone development and health. Vigorous research is currently exploring the role vitamin D plays in the immune system, as well as its relation to diseases such as cancer, diabetes, and cardiovascular disease. Several clinical studies investigated the relationship between vitamin D levels and urinary tract infections. One study showed that the women who had experienced recurrent urinary tract infections had significantly lower levels of Vitamin D than the women with no history of recurrent UTIs. In another study, Vitamin D supplementation increased the bladder’s antibacterial response to the most common uropathogen, Escherichia coli (E. coli). In a most recent clinical trial vitamin D supplementation significantly reduced the incidence of UTIs in men. Together, these studies suggest the significance of vitamin D for the prevention of urinary tract infections.
Vitamin D deficiency is a global health problem. People with dark skin, elderly, and overweight people are at especially high risk for vitamin D deficiency. When exposed to the sun, our bodies synthesize vitamin D. While sensible sun exposure remains the most efficient source of it, many factors, such as sunlight intensity, geographical location, and time of the year, affect the amount of vitamin D that is produced.
Meeting the recommended intake of vitamin D through diet is also not an easy task, as only few foods are naturally abundant in it. These include oily fish, such as salmon, mackerel and tuna, and fish oil, such as cod liver oil. Some foods, for example, dairy products and cereals, are fortified with vitamin D.
If you are prone to recurrent UTIs, check your vitamin D levels. In case of deficiency, discuss supplementation with your doctor.
For a strong immune system, make sure that in addition to eating healthy you get enough sleep and exercise.
Fiber for constipation relief
The incidence of urinary tract infection is higher in people with chronic constipation. The waste that remains in the rectum for a prolonged time can affect the emptying of the bladder, which is an important step in removing bacteria from the urinary tract.
High fiber diets have a number of health benefits, including constipation relief. Enrich your diet with whole foods that are abundant in fiber: legumes (beans, lentils, peas), fruits (raspberries, apples, pears), vegetables (artichokes, corn, broccoli), grains (barley, bran, oatmeal, popcorn) and nuts (almonds, pistachios, pecans). Fiber is most effective in the presence of water. Stay well hydrated throughout the day.
Physical inactivity is one of the major factors contributing to constipation. Current recommendation for physical activity is 30 minutes of moderately intense exercise, 5 times a week. However, if you are presently inactive, doing any form of exercise (walking, dancing, gardening) for as little as 15 minutes will do wonders for your overall health.
Power-hydrate with food!
People with UTIs are commonly advised to drink plenty of water to help wash out bacteria from the bladder. Although this recommendation does not have a firm scientific backing, being well hydrated is unlikely to do you any harm. On the contrary, water is vital to good health! Water carries essential nutrients to cells and removes waste from the body. It regulates body temperature, lubricates joints, and moistens eyes, nose, and mouth.
In order to stay well hydrated, in addition to drinking fluids throughout the day make sure that your diet includes food with high water content. Many vegetables and fruits are rich in water: watermelon, cucumbers, spinach, tomatoes, celery, cabbage, strawberries, etc. The inclusion of these foods in your diet will not only help ensure proper hydration, but will also provide a multitude of nutrients: antioxidants, vitamins, and fiber.
Regulate urine pH
The body’s acid-base balance is a tightly controlled process that keeps blood pH within a very narrow range, 7.35-7.45. As part of this balancing process, excess acids and bases are excreted in the urine. This is why urine can have a relatively broad range of pH values, from acidic (pH~4.5) through neutral (pH=7) to alkaline (pH~8). It is widely thought that acidic urine restricts bacterial growth. However, a recent study found that urine with pH closer to neutral is actually best at limiting the growth of pathogens. It is important to
note that the acidity of urine is not the only factor contributing to bladder’s effective antibacterial response. The same study found that dietary factors, such as the presence of aromatic molecules (similar to those abundant in cranberries) work in unison with urine pH in mounting a strong antibacterial reaction.
Unlike blood’s pH, the pH of urine can be adjusted with diet. Our meals are often rather complex, consisting of a multitude of ingredients prepared in a variety of ways. For this reason, it is hard to predict with high accuracy the effect of a particular food item on urine’s pH. However, it is very useful to know what type of food leads to acidification or alkalization of urine. Vegetables, fruits and fruit juices, make the urine more alkaline. Dairy, grains and meat are urine-acidifying foods.
Give yourself the best chance to fight off infections: enrich your diet with lots of fruits and vegetables!
Keep your blood glucose levels under control
Urinary tract infections are more common in patients with diabetes than in the general population. One of the reasons for such prevalence is hyperglycemia (high blood glucose levels), which occurs in diabetes.
Urine normally contains little or no glucose, as kidneys efficiently filter it back into the bloodstream. When glucose reaches levels that cannot be filtered by kidneys, it leaks into the urine. Glucose in urine (glycosuria) serves as food to the harmful bacteria and leads to their overgrowth.
To deprive bacteria of excess food, make sure you control your blood sugar.
Fight the bad bacteria with the good
Many strains of E. coli, the most common pathogen causing UTIs, are part of the normal gut microflora. Some research suggests that certain bacteria that are also present in the normal gut flora, such as Lactobacili (most commonly found in fermented dairy products), may provide protection against UTIs. Lactobacilli seem to be able to compete with the harmful bacteria and prevent their attachment to the cells lining the urinary tract. A Finish study found a significant reduction in recurrent UTIs in women who consumed fermented dairy (yogurt, buttermilk, cheese) more than three times a week. However, probiotic supplements did not provide the same kind of protection against recurrent UTIs. Other fermented foods, such as kimchi, sauerkraut, kombucha, are another good source of various beneficial bacteria. Antibiotics, the standard therapy for UTIs,
destroy both good and bad bacteria. To replenish the good bacteria and restore the normal gut flora, make sure you intensify the intake of fermented foods during and following an antibiotic therapy.
Do not forget the berries!
Cranberries have been used in UTI prevention for a long time. Studies show that this preventive effect comes from a particular type of molecule abundant in cranberries: the A-type proanthocyanidins. In varying amounts, these molecules are also found in other berries from the same Vaccinium family - blueberries and lingonberries. Eating berries frequently may be an easy and delicious way to lower your risk of a UTI.
Last updated: November 27, 2016