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SUFU 2022: D-Mannose Intake in the Diet of Women with Recurrent Urinary Tract Infections May Affect Urinary ph and Contribute to its Preventive Effectiveness

(UroToday.com) D-mannose is a bioactive monosaccharide frequently recommended by clinicians to prevent recurrent urinary tract infections (rUTIs) in women. It is unknown if this protective effect against RUTIs results from urinary pH changes. This study analyzed the effect of D-mannose on urinary pH.  This study reported on a review of the urine pH and D-mannose content of foods and beverages reported in the 3-day diet records of women with rUTIs not taking D-mannose supplements.


Three groups were identified:

  • Group 1 - those with persistently low pH <6
  • Group 2 -persistently high pH always >6
  • Group 3 - variable pH
Foods that do and do not contain D-mannose, as identified by HU and colleagues (2016) were compared for nutrient composition.

Total D-mannose consumed (naturally and with other vitamin and mineral supplements) between groups was compared using a mixed model analysis, with a compound symmetric covariance structure to account for meals from the same patient. The overall distribution of weight of foods containing D-mannose was visualized using box and whisker plots.

Over the study period (2019-2021), 32 women (median age 72yrs, 8% White) supplied urine pH and diet data. D-mannose foods had significant differences in nutrients (higher in D-mannose: calcium, iron, riboflavin, and niacin; lower in D-mannose: sugar, potassium, and water; all p < 0.05) compared to foods not containing D-mannose. A significant difference was found in the amount of D-mannose foods consumed for those women with a variable pH at dinner (p = 0.033).

Authors concluded that although D-mannose can be found naturally in foods and supplements but found a significant difference among women with variable urinary pH. This may be an ideal group for improved D-mannose supplementation.

Presented by: Juliann Chavez, Private Practice,1 Jacqueline Chavez, Department of Urology,2 Ethan Fan, Depart. of Urology,2 Alana Christie, Simmons Comprehensive Cancer C,2 Philippe Zimmern,3

  1. Healthy Lifestyles, Healthy Futures
  2. University of Texas Southwestern Medical Center
  3. UT Southwestern Medical Center

Written by: Diane K. Newman, DNP, ANP-BC, FAAN, Adjunct Professor of Urology in Surgery, Perelman School of Medicine, University of Pennsylvania and Co-Director of the Penn Center for Continence and Pelvic Health at the 2022 Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (SUFU) Winter Meeting, February 22 - 26, 2022

References:

  1. Chavez JA, Chavez JM, Kuprasertkul A, Carroll TF, Fuentes JL, Christie AL, Alhalabi F, Zimmern PE. Prospective Evaluation of Daily and Weekly Urine pH Variations Along With Diet Intake in Postmenopausal Women With Recurrent Urinary Tract Infections. Female Pelvic Med Reconstr Surg. 2021 Feb 1;27(2):e352-e359. doi: 10.1097/SPV.0000000000000931.PMID: 33009261
  2. Hu, X., Shi, Y., Zhang, P et al d-Mannose: Properties, Production, and Applications: An Overview. Compr Rev Food Sci Food Saf. 2016; 15(4): 773-785.