American Herbal Pharmacopoeia ® and Therapeutic Compendium Cranberry Fruit Vaccinium macrocarpon Aiton Standards of Analysis, Quality Control, and Therapeutics Editors Roy Upton RH DipAyu American Herbal Pharmacopoeia® Scotts Valley, CA Thomas Brendler PlantaPhile Collingswood, NJ Research Associates Marta V Correll MS LAc American Herbal Pharmacopoeia® Scotts Valley, CA Michael Mazur Maryland University of Integrative Medicine Laurel, MD Diana Swisher MA American Herbal Pharmacopoeia® Scotts Valley, CA Lynette Casper BS Planetary Herbals Scotts Valley, CA To Dr Boxin Ou, whose many scientific accomplishments have enriched the world of medicinal plant research, this monograph is lovingly dedicated. Authors Tony Chang PhD Traditional Medicinals Dwight McKee MD ICT Laboratories (International Sebastopol, CA Aptos, CA History Chemistry Testing) Paul Milbury PhD Milford, MA International Status David Winston Herbalist (AHG) Tufts University Josef Brinckmann Boston, MA Herbalist and Alchemist Therapeutics Traditional Medicinals Broadway, NJ Pharmacokinetics Sebastopol, CA Elan Sudberg Roy Upton RH DipAyu Ronald Prior PhD Alkemist Labs American Herbal Pharmacopoeia® University of Arkansas Costa Mesa, CA Scotts Valley, CA Fayetteville, AR Reviewers Nancy Turner PhD Urinary Tract Health Wendy Applequist PhD University of Victoria Botanical Identification Amy Howell PhD Missouri Botanical Garden British Columbia, Canada Alison Graff PhD Rutgers University St. Louis, MO John Wilson ® American Herbal Pharmacopoeia Chatsworth, NJ Jegdish Babu PhD Cranberry Institute Scotts Valley, CA Christina Khoo PhD University of Tennessee Carver, MA Memphis, TN Macroscopic Identification, Ocean Spray Cranberries Inc Commercial Sources and Lakeville, MA Boxin OuPhD Final Reviewers Handling Affects on Helicobacter pylori ICT Laboratories Josef Brinckmann Thomas Brendler Milford, MA Michael J Andrews Jr MD FACS Traditional Medicinals PlantaPhile Paula Brown PhD Division of Urologic Surgery Sebastopol, CA Collingswood, NJ British Columbia Institute of Duke University School of Medicine Technology Durham, NC Roy Upton RH DipAyu Cranberry and Oral Health American Herbal Pharmacopoeia® Daniel Grenier PhD Burnaby, British Columbia, Canada Jeffrey Blumberg PhD Scotts Valley, CA Université Laval Michael Chan DipIT BTech BS Tufts University Québec, Canada British Columbia Institute of Boston, MA Microscopic Identification Cranberry Polyphenols: Affects on Technology David Cunningham PhD Prof Dr Reinhard Länger Cardiovascular Risk Factors Burnaby, British Columbia, Canada Ocean Spray Cranberries Inc AGES PharmMed Christina Khoo PhD Jed Colquhoun PhD Lakeville, MA Vienna, Austria Ocean Spray Cranberries Inc University of Wisconsin Gunter Haesaerts Lakeville, MA Madison, WI Pharmatoka Constituents Rueil-Malmaison, France Christian G Krueger PhD Michael Falk PhD Mary Hardy MD Jess D Reed PhD Life Sciences Research University of California at Los Ann E Hagerman PhD Complete Phytochemical Organization Inc Angeles Department of Chemistry & Solutions LLC Bethesda, MD Los Angeles, CA Biochemistry Cambridge, WI Anticancer Properties of Cranberry Kristine Heitmann PhD (candidate) Miami University Catherine C Neto PhD University of Bergen Oxford, OH Analytical University of Massachusetts Bergen, Norway Amy Howell PhD High Performance Thin Layer Dartmouth Terry Humfeld Rutgers University Chromatography (HPTLC) North Dartmouth, MA Cranberry Institute Chatsworth, NJ Eike Reich PhD Antiviral Effects Carver, MA Diane L McKay PhD FACN CAMAG-Laboratory Doris D’Souza PhD Tufts University Muttenz, Switzerland Wilhelmina Kalt PhD University of Tennessee-Knoxville Agriculture and Agrifoods Canada Boston, MA High Performance Liquid Knoxville, TN Kentville, Nova Scotia, Canada Devon A Mihesuah PhD Chromatography (HPLC) Karl Kingsley PhD MPH University of Kansas Paula Brown PhD Traditional Western Herbal Lawrence, KS Ronan Yu PhD Medicine Supplement University of Nevada-Las Vegas Las Vegas, NV Aviva Romm MD British Columbia Institute of Aviva Jill Romm MD ® Technology American Herbal Pharmacopoeia® Richard Ko PhD PharmD American Herbal Pharmacopoeia Burnaby, British Columbia, Canada West Stockbridge, MA Herbal Synergy West Stockbridge, MA 4-(Dimethylamino)cinnamaldehyde Roy Upton Pinole, CA Alison Turner PhD (DMAC) Method American Herbal Pharmacopoeia® Tom Lochner Executive Director Marlboro College Ronald Prior PhD Scotts Valley, MA Wisconsin State Cranberry Growers Marlboro, VT University of Arkansas Association (WSCGA) Fayetteville, AR Safety Wisconsin Rapids, WI Zoe Gardner PhD (candidate) ISBN: 1-929425-36-8 ISSN: 1538-0297 © 2016 American Herbal Pharmacopoeia® Medical Disclaimer Design & Composition PO Box 66809, Scotts Valley, CA 95067 USA The information contained in this monograph rep- Fani Nicheva All rights reserved. No part of this monograph may be resents a synthesis of the authoritative scientific and Santa Cruz, CA reproduced, stored in a retrieval system, or transmitted traditional data. All efforts have been made to ensure in any form or by any means without written permission the accuracy of the information and findings presented. Cover Photograph of the American Herbal Pharmacopoeia®. Those seeking to utilize botanicals as part of a health © 2016 Vaccinium macrocarpon care program should do so under the guidance of a quali- courtesy of Thomas Brendler, ® The American Herbal Pharmacopoeia is a nonprofit fied health care professional. PlantaPhile, Collingswood, NJ. corporation 501(c)(3). To purchase monographs or AHP-Verified botanical reference materials, contact the Statement of Nonendorsement American Herbal Pharmacopoeia® • PO Box 66809 • Reporting on the use of proprietary products reflects Scotts Valley, CA 95067 • USA • (831) 461-6318 or visit studies conducted with these and is not meant to be a our website at www.herbal-ahp.org. product endorsement. American Herbal Pharmacopoeia® • Cranberry Fruit • 2016 Table Of Contents Safety Profile | 68 Side Effects Contraindications Nomenclature Precautions Botanical Nomenclature Interactions Botanical Family Pregnancy, Mutagenicity, and Reproductive Toxicity Pharmaceutical Nomenclature Lactation Pharmacopoeial Definition Carcinogenicity Common Names Influence on Driving Overdose Treatment of Overdose History | 2 Toxicology Nomenclatural History Classification of the American Herbal Products Association Native American Use Early History of European Immigrants Use of Cranberry by Eclectic Physicians Medical and Popular Uses of Cranberry in the 19th and Traditional Western Herbal Medicine Early 20th Century Supplement | 77 Recent History of Cranberry Use and Stud Traditional Use of Cranberry for Urinary Tract Health Other Uses of Cranberry by Traditional Practitioners Identification | 5 Botanical Identification International Status | 78 Macroscopic Identification Microscopic Identification References | 80 Commercial Sources and Handling | 10 American Herbal Pharmacopoeia® Cultivation PO Box 66809 Irrigation Scotts Valley, CA 95067 US Collection Tel: 1-831-461-6318 Handling and Processing FAX: 1-831-475-6219 Drying Email: [email protected] Storage Website: www.herbal-ahp.org Qualitative Differentiation Adulterants Sustainability Preparations Constituents | 21 Macro Constituents Anthocyanins Proanthocyanidins (PACs) Flavonols Organic Acids Volatile Oils Sugars and Complex Carbohydrates Vitamins Seed Oil Analytical | 26 High Performance Thin Layer Chromatography (HPTLC) for the Identification of Cranberry Fruit and Detection of the Anthocyanin Cyanidin-3-O-glucoside and the Flavonoid Hyperoside High Performance Liquid Chromatography (HPLC) for the Quantitation of Anthocyanins in Freeze-Dried Cranberry Powder, Cranberry Juice, Cranberry Cocktail, and Cranberry Extract Powder 4-(dimethylamino)cinnamaldehyde (DMAC) for Quantification of Soluble Proanthocyanidins (PACs) in Cranberry Juice Concentrate Therapeutics | 35 Pharmacokinetics Urinary Tract Infections Affects of Cranberry on Helicobacter pylori Affects of Cranberry on Gut Health Cranberry and Oral Health Cranberry Polyphenols: Affects on Cardiovascular Risk Factors Anticancer Properties of Cranberry Antiviral Effects Other Effects American Herbal Pharmacopoeia® • Cranberry Fruit • 2016 1 NOMENCLATURE has two origins; the first a botanical reference regarding the stamens that resemble the beak of a crane; the sec- Botanical Nomenclature ond, due to the reported fondness of marsh cranes for the berry. Regardless of which is true, writings of the middle Vaccinium macrocarpon Aiton 1600s variably use the names cranberry, cramberry, and Botanical Family craneberry. Ericaceae Native American Use Pharmacopoeial Nomenclature Native Americans living in northern regions commonly con- sumed various species of Vaccinium, including Vaccinium Fructus macrocarponii macrocarpon, V. oxycoccos, and V. vitis-idaea (also known Pharmacopoeial Definition as mountain cranberry or lingonberry) for their tart flavor and nutritive value. According to the oral history of the Cranberry fruit consists of the fresh or dried whole, crushed, Wampanoag of Cape Cod, Massachusetts, the originat- or powdered mature fruits of Vaccinium macrocarpon Aiton ing location of the first colonial Thanksgiving, cranberries conforming to the methods of identification and standards (sasumuneash or ibimi) were cooked in stews. The name provided. ibimi refers to the bitter or sour taste of the fruits (Whitman- Salkin 2013). The Ojibwa, Iroquois, Huron, Mi’kmaq Common Names (Micmac), Anticosti, Anishinaabe (Chippewa,