Cranberry juice is the liquid

juice Juice is a drink made from the extraction or Cold-pressed juice, pressing of the natural liquid contained in fruit and vegetables. It can also refer to liquids that are flavored with concentrate or other biological food sources, such as meat ...

of the

cranberry Cranberries are a group of evergreen dwarf shrubs or trailing vines in the subgenus ''Oxycoccus'' of the genus ''Vaccinium''. Cranberries are low, creeping shrubs or vines up to long and in height; they have slender stems that are not th ...

a fruit recognized for its bright red color,

tart A tart is a baked dish consisting of a filling over a pastry base with an open top not covered with pastry. The pastry is usually shortcrust pastry; the filling may be sweet or savoury, though modern tarts are usually fruit-based, sometimes with ...

taste, and versatility for product manufacturing. Major cranberry products include cranberry juice, dried cranberry, cranberry sauce, frozen cranberry, cranberry powder, and

dietary supplement A dietary supplement is a manufactured product intended to supplement a person's diet by taking a pill (pharmacy), pill, capsule (pharmacy), capsule, tablet (pharmacy), tablet, powder, or liquid. A supplement can provide nutrients eithe ...

s containing cranberry

extract An extract (essence) is a substance made by extracting a part of a raw material, often by using a solvent such as ethanol, oil or water. Extracts may be sold as tinctures or absolutes or dried and powdered. The aromatic principles of ma ...

s. The term "cranberry juice

cocktail A cocktail is a mixed drink, usually alcoholic beverage, alcoholic. Most commonly, a cocktail is a combination of one or more liquor, spirits mixed with other ingredients, such as juices, flavored syrups, tonic water, Shrub (drink), shrubs, and ...

" or "cranberry juice blend" refers to products that contain about 28% cranberry juice, with the remainder either from other fruit juice concentrates (typically grape, apple or pear), water, and

added sugar Added sugars or free sugars are sugar carbohydrates (caloric sweeteners) added to food and beverages at some point before their consumption. These include added carbohydrates ( monosaccharides and disaccharides), and more broadly, sugars nat ...

to improve

palatability Palatability (or palatableness) is the hedonic reward (which is pleasure of taste in this case) provided by foods or drinks that are agreeable to the "palate", which often varies relative to the homeostatic satisfaction of nutritional and/or wa ...

. Low-calorie cranberry juice products use non-caloric sweeteners. Despite a long-held reputation for providing

antibacterial An antibiotic is a type of antimicrobial substance active against bacteria. It is the most important type of antibacterial agent for fighting bacterial infections, and antibiotic medications are widely used in the treatment and prevention ...

activity against

urinary tract infection A urinary tract infection (UTI) is an infection that affects a part of the urinary tract. Lower urinary tract infections may involve the bladder (cystitis) or urethra (urethritis) while upper urinary tract infections affect the kidney (pyel ...

s (UTIs), cranberry juice has no proven effects on UTIs due to uncertainty about the quality of research, as determined by a

Cochrane review Cochrane is a British international charitable organisation formed to synthesize medical research findings to facilitate evidence-based choices about health interventions involving health professionals, patients and policy makers. It includes ...

of completed

clinical research Clinical research is a branch of medical research that involves people and aims to determine the effectiveness (efficacy) and safety of medications, devices, diagnostic products, and treatment regimens intended for improving human health. The ...

. A scientific panel for the

European Food Safety Authority The European Food Safety Authority (EFSA) is the agency of the European Union (EU) that provides independent scientific advice and communicates on existing and emerging risks associated with the food chain. EFSA was established in February 2002 ...

concluded a cause-and-effect relationship could not be established between cranberry consumption and risk of UTIs.

Nutrition and composition

Cranberry juice is 86% water, 11%

carbohydrate A carbohydrate () is a biomolecule composed of carbon (C), hydrogen (H), and oxygen (O) atoms. The typical hydrogen-to-oxygen atomic ratio is 2:1, analogous to that of water, and is represented by the empirical formula (where ''m'' and ''n'' ...

s, and less than 1%

fat In nutrition science, nutrition, biology, and chemistry, fat usually means any ester of fatty acids, or a mixture of such chemical compound, compounds, most commonly those that occur in living beings or in food. The term often refers specif ...

protein Proteins are large biomolecules and macromolecules that comprise one or more long chains of amino acid residue (biochemistry), residues. Proteins perform a vast array of functions within organisms, including Enzyme catalysis, catalysing metab ...

(table). A cup of standard ( fortified) cranberry juice, amounting to 248 grams or 8 ounces, provides 107

calorie The calorie is a unit of energy that originated from the caloric theory of heat. The large calorie, food calorie, dietary calorie, kilocalorie, or kilogram calorie is defined as the amount of heat needed to raise the temperature of one liter o ...

s and contains

vitamin C Vitamin C (also known as ascorbic acid and ascorbate) is a water-soluble vitamin found in citrus and other fruits, berries and vegetables. It is also a generic prescription medication and in some countries is sold as a non-prescription di ...

as an ingredient to preserve freshness, with other

micronutrient Micronutrients are essential chemicals required by organisms in small quantities to perform various biogeochemical processes and regulate physiological functions of cells and organs. By enabling these processes, micronutrients support the heal ...

s that may be added during manufacturing. Other than vitamin C and

folate Folate, also known as vitamin B9 and folacin, is one of the B vitamins. Manufactured folic acid, which is converted into folate by the body, is used as a dietary supplement and in food fortification as it is more stable during processing and ...

having more than 10% of the

Daily Value In the U.S. and Canada, the Reference Daily Intake (RDI) is used in nutrition labeling on food and dietary supplement products to indicate the daily intake level of a nutrient that is considered to be sufficient to meet the requirements of 97� ...

, a typical serving of cranberry juice provides no micronutrients in significant content (table). One half

cup A cup is an open-top vessel (container) used to hold liquids for drinking, typically with a flattened hemispherical shape, and often with a capacity of about . Cups may be made of pottery (including porcelain), glass, metal, wood, stone, pol ...

of cranberry juice provides 60

s, 20% of the

for vitamin C, and counts as one-half of a fruit serving toward the United States MyPlate daily nutrition guide.

Effect on health

Cranberry juice is an acidic drink with a pH of about 2.6. Some cranberry juice products contain large amounts of sugar used in manufacturing to make the drink more palatable, but their consumption may increase the risk of

hyperglycemia Hyperglycemia is a condition where unusually high amount of glucose is present in blood. It is defined as blood glucose level exceeding 6.9 mmol/L (125 mg/dL) after fasting for 8 hours or 10 mmol/L (180 mg/dL) 2 hours after eating. Blood gluc ...

and reduced control of blood glucose in people with

diabetes Diabetes mellitus, commonly known as diabetes, is a group of common endocrine diseases characterized by sustained high blood sugar levels. Diabetes is due to either the pancreas not producing enough of the hormone insulin, or the cells of th ...

or glucose intolerance.

Cranberry juice and urinary tract infection

In 2008, there was tentative evidence that long-term use of cranberry juice might help prevent symptomatic urinary tract infections (UTIs), but this finding was refuted in 2012 with a conclusion that "14 further studies suggest that cranberry juice is less effective than previously indicated," and "cranberry juice cannot currently be recommended for the prevention of UTIs." The

reviewed the evidence and concluded a cause and effect relationship has not been established between the consumption of cranberry products and reducing the risk of UTIs. One

systematic review A systematic review is a scholarly synthesis of the evidence on a clearly presented topic using critical methods to identify, define and assess research on the topic. A systematic review extracts and interprets data from published studies on ...

in 2017 showed that cranberry products significantly reduced the incidence of UTIs, indicating that cranberry products may be effective particularly for individuals with recurrent infections. When the quality of

meta-analyses Meta-analysis is a method of synthesis of quantitative data from multiple independent studies addressing a common research question. An important part of this method involves computing a combined effect size across all of the studies. As such, th ...

on the efficacy of cranberry products for preventing or treating UTIs was examined, large variation was evident, resulting from inconsistencies in

methods. A further systematic review published in 2023 concluded there is evidence that consuming cranberry products is effective for reducing the risk of UTIs in women with recurrent UTIs, in children, and in people susceptible to UTIs following clinical interventions; in this same review, there was little evidence of effect in elderly people, those with urination disorders, or pregnant women. In September 2017, Ocean Spray, a major cranberry juice manufacturer, submitted a health claim petition to the FDA. According to the FDA's February 2018 response letter, the company had "requested that FDA authorize a health claim for the relationship between the consumption of cranberry juice products and a reduced risk of recurrent urinary tract infection in healthy women." The FDA stated that they would consider the petition for a "qualified health claim." This type of health claim label does not require "significant scientific agreement" as the FDA's label with a higher standard, the "authorized health claim," does. Rather, "qualified health claims" only require that the claim be "supported by some scientific evidence." These types of health claims also ''do not'' need to "meet the significant scientific agreement standard" and must be accompanied by a disclaimer stating that there is insufficient evidence of the product affecting a disease, such as UTI. Further FDA guidance in 2019 notified cranberry juice manufacturers that added sugars necessary for making the juice appealing to consumers had to be declared on the nutrition facts panel of product labels, and the amount of sugar used would be reviewed by the FDA under its "enforcement discretion". In October 2018, the

National Institute for Health and Care Excellence The National Institute for Health and Care Excellence (NICE) is an executive non-departmental public body of the Department of Health and Social Care (United Kingdom), Department of Health and Social Care. As the national health technolog ...

's recommendation for self-care for lower UTIs in people aged 16 and over states that "no evidence was found on cranberry products or urine alkalinising agents to treat lower UTI".

Dental health

Cranberry juice has a level of acidity (pH 2.6) that may erode

tooth enamel Tooth enamel is one of the four major Tissue (biology), tissues that make up the tooth in humans and many animals, including some species of fish. It makes up the normally visible part of the tooth, covering the Crown (tooth), crown. The other ...

Manufacturing and processing

Manufacturing

Cranberries are a kind of tart red berry produced by various plant species, but it is the large-fruited, or "American cranberry" ('' Vaccinium macrocarpon''), that is farmed for commercial production. Currently, the main cranberry farming Canadian provinces are

British Columbia British Columbia is the westernmost Provinces and territories of Canada, province of Canada. Situated in the Pacific Northwest between the Pacific Ocean and the Rocky Mountains, the province has a diverse geography, with rugged landscapes that ...

, Québec,

New Brunswick New Brunswick is a Provinces and Territories of Canada, province of Canada, bordering Quebec to the north, Nova Scotia to the east, the Gulf of Saint Lawrence to the northeast, the Bay of Fundy to the southeast, and the U.S. state of Maine to ...

Nova Scotia Nova Scotia is a Provinces and territories of Canada, province of Canada, located on its east coast. It is one of the three Maritime Canada, Maritime provinces and Population of Canada by province and territory, most populous province in Atlan ...

and

Prince Edward Island Prince Edward Island is an island Provinces and territories of Canada, province of Canada. While it is the smallest province by land area and population, it is the most densely populated. The island has several nicknames: "Garden of the Gulf", ...

. However, the lower temperatures present in the Eastern provinces require the use of irrigation and flooding to prevent frost damage and moisture loss. Wet harvesting is the common harvesting method used for cranberries that are to become cranberry juice. A paddled machine called a water reel harvester is used to separate the ripe cranberries from the vines, then collected through a large suction pipe and transported by truck to a processing plant. At the processing plant, the cranberries go through a sequence of fruit crushing, mash maceration, mash heating, juice pressing, and pasteurization to produce a cranberry concentrate that is separated from pulp. To prepare a cranberry juice/cocktail product, cranberry juice concentrate is reconstituted with varying amounts of water, specified by the solicitation, contract, or purchase order.

Sterilization

Traditionally, cranberry juice is commercially sterilized though thermal processing to eliminate any pathogenic or spoilage-causing microorganisms and spores. The prepared cranberry juice product is heat treated by high temperature-short time (HTST) or ultra-high temperature (UHT) techniques and packaged into aseptic, hermetically sealed containers. During thermal processing, the cranberry juice receives a heat treatment time equivalent to
5-log pathogen reduction
Often, the bacterium ''

Clostridium botulinum ''Clostridium botulinum'' is a Gram-positive bacteria, gram-positive, Bacillus (shape), rod-shaped, Anaerobic organism, anaerobic, endospore, spore-forming, Motility, motile bacterium with the ability to produce botulinum toxin, which is a neurot ...

'' is given special attention during thermal processing techniques of food. However, ''C. botulinum'' does not grow and produce toxins below a pH of 4.6 and cranberry juice is classified as a high-acid food with a pH of 2.3 to 2.9.

Improved sterilization

In 2017, new methods of cranberry juice processing included high pressure processing (HHP) and pulsed electric field (PEF) technology. HHP treatment involves applying pressure (80,000 psi or 550 MPa) to cranberry juice for 1 to 9 minutes to eliminate any harmful bacteria, moulds and viruses. The resulting raw cranberry juice, without thermal processing, is classified as a novel food item by Health Canada. PEF treatment involves generating a high-intensity electric field inducing a flux of electric current to flow through the food product to eliminate harmful microorganisms. PEF treated cranberry juice does not alter the flavor, color, or aroma profile of the cranberries used, unlike the traditional thermally processed method.

Tartness

Naturally, cranberries are low in sugar content and have a tart taste. As a result, unsweetened cranberry juice is generally considered unpalatable by consumers. To make the juice more palatable to consumers, the tart flavor can be made less acidic by blending with other fruit juices or the addition of sugar or

sugar substitute A sugar substitute or artificial sweetener, is a food additive that provides a sweetness like that of sugar while containing significantly less food energy than sugar-based sweeteners, making it a zero-calorie () or low-calorie sweetener. Arti ...

s. The tartness of cranberry juice derives from its mixed content of

polyphenol Polyphenols () are a large family of naturally occurring phenols. They are abundant in plants and structurally diverse. Polyphenols include phenolic acids, flavonoids, tannic acid, and ellagitannin, some of which have been used historically as ...

s, including

flavonoid Flavonoids (or bioflavonoids; from the Latin word ''flavus'', meaning yellow, their color in nature) are a class of polyphenolic secondary metabolites found in plants, and thus commonly consumed in the diets of humans. Chemically, flavonoids ...

proanthocyanidin Proanthocyanidins are a class of polyphenols found in many plants, such as cranberry, blueberry, and grape seeds. Chemically, they are oligomeric flavonoids. Many are oligomers of catechin and epicatechin and their gallic acid esters. More complex ...

anthocyanin Anthocyanins (), also called anthocyans, are solubility, water-soluble vacuole, vacuolar pigments that, depending on their pH, may appear red, purple, blue, or black. In 1835, the German pharmacist Ludwig Clamor Marquart named a chemical compou ...

s, phenolic acids, and

ellagitannin image:Castalagin.svg, 130px, Castalagin is a representative ellagitannin, characterized by coupled gallic acid substituents The ellagitannins are a diverse class of hydrolyzable tannins, a type of polyphenol formed primarily from the oxidative link ...

Packaging

All cranberry juice products are required to be packed in aseptic, hermetically sealed containers (plastic bottles, cans, cartons) in accordance with good manufacturing practices of their country. The typical container size used are 11.5 or 64 fluid ounce, and each must be filled with the product by at least 90 percent. Cranberry juice products should also not be packaged more than 90 days prior to their delivery, unless specified in the order. Ocean Spray and Fruit d'Or cranberry juice products have a frozen shelf life of 24 months and 36 months, respectively.

Regulations

Labeling

In 2020, the US

Food and Drug Administration The United States Food and Drug Administration (FDA or US FDA) is a List of United States federal agencies, federal agency of the United States Department of Health and Human Services, Department of Health and Human Services. The FDA is respo ...

(FDA) announced that a qualified health claim would be allowed on cranberry juice product labels for reduced risk of recurrent urinary tract infection in healthy women consuming per day of a fruit juice product containing at least 27% cranberry juice. An example of the label claim provided by the FDA was: "Consuming one serving (8 oz) each day of a cranberry juice beverage may help reduce the risk of recurrent urinary tract infection (UTI) in healthy women. FDA has concluded that the scientific evidence supporting this claim is limited and inconsistent." Cranberry juice container labels have the following information printed: product name and code, nutrition facts table, lot/drum number, date of packaging, brix, acidity, net weight, manufacturer name, manufacturer address and country of origin. According to Canada's composition claims, a "no preservatives" claim can be added to cranberry juice products if it only contains naturally-occurring constituents that provide a preservative function such as benzoates.

United States

For many US markets, cranberry juice from concentrate is a blended mixture of cranberry juice or cranberry juice concentrate, water, sweeteners, and

(as ascorbic acid). The cranberry juice or concentrate in the mixture must be produced from clean, sound, mature, well-colored, and washed, fresh or frozen cranberries (''Vaccinium macrocarpon''). One or more of the following sweetening ingredients may be added:

sucrose Sucrose, a disaccharide, is a sugar composed of glucose and fructose subunits. It is produced naturally in plants and is the main constituent of white sugar. It has the molecular formula . For human consumption, sucrose is extracted and refined ...

, liquid sugar, invert sugar syrup, or high-fructose corn syrup (40% or greater). The use of food additives (color, flavours, or acids) into cranberry juice depends on the percentage of cranberry juice or concentrate by volume. Cranberry juice mixtures with 25% or 27% contain none of the mentioned additives, except for ascorbic acid. Cranberry juice mixtures with 22% contain no added color or flavors, but citric acid may be added. Cranberry juice mixtures with 20% may contain color, flavors, and citric acid. The finished cranberry juice from concentrate product should yield a minimum of one part cranberry juice concentrate to three parts water with a minimum brix level of 12°. Additionally, each cranberry juice product should be fortified with vitamin C, with each serving size delivering not less than 100% of the current US Reference Daily Intake. The minimum titratable acidity of the cranberry juice product must be 1.67% wt/wt, measured as

citric acid Citric acid is an organic compound with the formula . It is a Transparency and translucency, colorless Weak acid, weak organic acid. It occurs naturally in Citrus, citrus fruits. In biochemistry, it is an intermediate in the citric acid cycle, ...

Canada

For Canadian markets, cranberry juice is regulated as a processed product under fruit juices. Cranberry juice must be made from sound, clean, and ripe cranberries. One or more of the following dry sweetening ingredients may be added:

sugar Sugar is the generic name for sweet-tasting, soluble carbohydrates, many of which are used in food. Simple sugars, also called monosaccharides, include glucose Glucose is a sugar with the Chemical formula#Molecular formula, molecul ...

, invert sugar, and

dextrose Glucose is a sugar with the molecular formula , which is often abbreviated as Glc. It is overall the most abundant monosaccharide, a subcategory of carbohydrates. It is mainly made by plants and most algae during photosynthesis from water an ...

. According to the Canadian Food Inspection Agency (CFIA), the common name of this product may appear as "cranberry juice drink/cooler" if at least 25% of the named juice is contained within the net quantity of the product. In Canada, cranberries are graded into two categories: Canada No. 1 and Canada Domestic. The cranberries of Canada No. 1 grade are required to be fairly clean; be uniform in size; and free from any damage and/or defect that affects the appearance, edibility, or shipment quality. The cranberries of Canada Domestic grade are required to be reasonably clean; and be free from any damage and/or defect that seriously affects the appearance, edibility, or shipment quality. Furthermore, all grades must be properly packaged; be sound; have a minimum surface area of 65% coloured red; and be free of insects and insect larvae.

Interaction with blood thinners

Cranberry juice may interfere with coumarins used as blood thinners, such as

warfarin Warfarin, sold under the brand name Coumadin among others. It is used as an anticoagulant, anticoagulant medication. It is commonly used to prevent deep vein thrombosis and pulmonary embolism, and to protect against stroke in people who ha ...

, causing an unstable INR. The British National Formulary (BNF) and the Food and Drug Administration (FDA) both advise avoiding concomitant use.

Market

Commercially cultivated in the United States and Canada, cranberries are harvested in the

autumn Autumn, also known as fall (especially in US & Canada), is one of the four temperate seasons on Earth. Outside the tropics, autumn marks the transition from summer to winter, in September (Northern Hemisphere) or March ( Southern Hemisphe ...

for manufacturing of juice and other products. A

barrel A barrel or cask is a hollow cylindrical container with a bulging center, longer than it is wide. They are traditionally made of wooden stave (wood), staves and bound by wooden or metal hoops. The word vat is often used for large containers ...

of US cranberries weighing cost US$57.60 in 2017, but the price fell to $22.30 per barrel in 2019 due to international trade wars with the United States, causing the market to shift to more purchases from Canada. Including cranberries used for juice production, Americans consume some 400 million pounds (180 million kg) of cranberries per year. About 95% of the annual US cranberry harvest is used to make juice or juice blends.

Wisconsin Wisconsin ( ) is a U.S. state, state in the Great Lakes region, Great Lakes region of the Upper Midwest of the United States. It borders Minnesota to the west, Iowa to the southwest, Illinois to the south, Lake Michigan to the east, Michig ...

was the leading producer of cranberries in the United States in 2017. Cranberries and juice concentrate exported from the United States were the objects of imposed

tariff A tariff or import tax is a duty (tax), duty imposed by a national Government, government, customs territory, or supranational union on imports of goods and is paid by the importer. Exceptionally, an export tax may be levied on exports of goods ...

s during trade wars with the

European Union The European Union (EU) is a supranational union, supranational political union, political and economic union of Member state of the European Union, member states that are Geography of the European Union, located primarily in Europe. The u ...

China China, officially the People's Republic of China (PRC), is a country in East Asia. With population of China, a population exceeding 1.4 billion, it is the list of countries by population (United Nations), second-most populous country after ...

Mexico Mexico, officially the United Mexican States, is a country in North America. It is the northernmost country in Latin America, and borders the United States to the north, and Guatemala and Belize to the southeast; while having maritime boundar ...

, and

Canada Canada is a country in North America. Its Provinces and territories of Canada, ten provinces and three territories extend from the Atlantic Ocean to the Pacific Ocean and northward into the Arctic Ocean, making it the world's List of coun ...

over the period 2017–19.

References

{{Fruit juice Fruit juice

Juice Juice is a drink made from the extraction or Cold-pressed juice, pressing of the natural liquid contained in fruit and vegetables. It can also refer to liquids that are flavored with concentrate or other biological food sources, such as meat ...

Thanksgiving food