Dietary factors in Helicobacter pylori infection control: A review of in vitro and in vivo data, including case-controls.

Helicobacter pylori poses a major threat to human health, primarily due to its tumorigenic potential and ability to cause tissue damage. Because of its strong association with gastric cancer and mucosa-associated lymphoid tissue lymphoma, H. pylori is classified as a class I carcinogen. Its eradication has become a challenge due to increasing antibiotic resistance rates. This implies the need to investigate nutritional factors for their anti-H. pylori effects. This study aimed to encompass data regarding anti-inflammatory, antibacterial, anti-adhesive, anti-ulcer, anti-urease and anti-cancer properties of seven non-antibiotic agents against H. pylori. We assessed articles in English using Science Direct, Scopus and Google Scholar, focusing mostly on recent publications. There are data pointing to the strong anti-adhesive action of cranberry, green tea and Arthrospira (Spirulina) spp. The anti-ulcer effect of green tea, Nigella sativa and microalgae was demonstrated in rat models. Cranberry, microalgae, honey and curcumin inhibit the urease activity of H. pylori. Propolis, green tea and curcumin interfere with the nuclear factor kappa B signalling pathway, while the last two as well as Arthrospira spp. inhibit cyclooxygenase-2. There are in vivo clinical trials indicating that cranberry, Nigella sativa, broccoli and curcumin can improve the success of eradication regimens, while honey showed a preventive effect. Additional trials are needed to determine the precise dose regimens and whether the natural or encapsulated product is more effective. Potential side effects and drug-drug interactions should be taken into account.