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Cruciferous Vegetables Intake & Cancer Risk

Apr 19, 2020

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Highlights

Along with a variety of impressive health benefits, different studies have shown a beneficial impact of higher consumption of cruciferous vegetables such as broccoli, brussels sprouts, cabbage and cauliflower, in reducing the risk of different cancer types including gastric/stomach, lung, breast, colorectal, pancreatic and bladder cancers. Studies also indicate that consuming cruciferous vegetables such as broccoli in raw or steamed form helps to retain nutrients more and reap maximum health benefits, than consuming these veggies post cooking or boiling. However, even though taking these healthy vegetables is beneficial, consuming random dietary supplements of the bioactive constituents/nutrients present in these vegetables may not be always safe and may also interfere with the ongoing treatments. Hence, when it comes to cancer, it is essential to personalize nutrition to the specific cancer type and ongoing treatments, to get the benefits and stay safe.



What are Cruciferous Vegetables?

Cruciferous vegetables are a family of healthy veggies which falls under the Brassica family of plants. These are rich in a variety of nutrients and phytochemicals which synergistically contribute to different health benefits. Cruciferous vegetables are named so as their four-petal flowers resemble a cross or crucifer (one who carries a cross). 

Examples of Cruciferous Vegetables

Some examples of Cruciferous veggies include:

  • broccoli 
  • brussels sprouts
  • cabbage
  • cauliflower
  • kale
  • bok choy
  • horseradish
  • arugula
  • turnips
  • collard greens
  • radishes
  • watercress
  • wasabi
  • mustard 

Cruciferous vegetables, Key nutrients and benefits of veggies like broccoli consumed in raw or steamed form.

Nutritional Importance of Cruciferous Vegetables

Cruciferous vegetables are usually low in calories and are widely recognized for their profound nutritional benefits. Cruciferous veggies (such as steamed broccoli) are no less than any superfoods, as these are packed with several nutrients including:

  • Vitamins such as Vitamin C, Vitamin K, Vitamin E, Folic Acid
  • Isothiocyanates such as Sulforaphane (hydrolyzed products of glucosinolates which are sulfur-containing organic compounds)
  • Indole-3-carbinol (formed from glucosinolates)
  • Dietary Fibers
  • Flavonoids such as Genistein, Quercetin, Kaempferol
  • Carotenoids (converted to retinol (Vitamin A) in our body during digestion)
  • Minerals such as Selenium, Calcium and Potassium
  • Polyunsaturated fatty acids such as omega-3 fatty acids
  • Melatonin (a hormone that regulates sleep-wake cycles)

Health Benefits of Cruciferous Vegetables

Cruciferous vegetables have great anti-oxidant and anti-inflammatory properties and are one of the must eat foods recommended by all nutritionists due to their impressive health benefits. Following are some of the general health benefits of cruciferous vegetables:

  1. Reduces cholesterol
  2. Reduces inflammation
  3. Aids in detoxification
  4. Improves cardiovascular/ heart health
  5. Regulates blood sugar
  6. Aids in digestion
  7. Helps in weight loss
  8. Helps in maintaining estrogen balance

Due to their impressive health benefits, cruciferous vegetables were also extensively studied for their possible benefits in cancer prevention.

Top 10 Foods and Supplements to Avoid for Cancer

Go beyond same nutrition guidelines for everyone and make personalized decisions with confidence.

Studies on the association between High Intake of Cruciferous Veggies and Cancer Risk

Are Cruciferous Vegetables Good for Cancer? | Proven Personalized Diet Plan

In the last two decades, several observational studies were carried out to evaluate the association of cruciferous vegetables intake with the risk of different types of cancer. What do these studies say? Will adding cruciferous veggies to our diet reduce the risk of Cancer? Let’s glance through these studies and understand what the experts say! 

Reduced Risk of Stomach/Gastric Cancer

In a  clinical study conducted at Roswell Park Comprehensive Cancer Center in Buffalo, New York, the researchers analyzed questionnaire-based data from patients who were recruited between 1992 and 1998 as part of the Patient Epidemiology Data System (PEDS). This study included data from 292 stomach cancer patients and 1168 cancer-free patients with non-cancer diagnoses. 93% of the patients included for the study were Caucasian and were aged between 20 and 95 years.

The study found that high intake of total cruciferous vegetables, raw cruciferous vegetables, raw broccoli, raw cauliflower and Brussels sprouts was associated with 41%, 47%, 39%, 49% and 34% reduction in the risk of stomach cancer respectively. The researchers also found that high intake of total vegetables, cooked cruciferous, non-cruciferous vegetables, cooked Broccoli, cooked cabbage, raw cabbage, cooked cauliflower, greens and kale and sauerkraut had no significant association with the risk of stomach cancer.(Maia E. W. Morrison et al, Nutr Cancer.,2020)

Researchers from the Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine in China carried out a meta-analysis using literature search including studies till September 2012. Their meta-analysis evaluated the association between cruciferous vegetables and gastric cancer risk. The analysis used data from the Medline/Pubmed, Embase, and Web of Science databases which included a total of 22 articles including sixteen case-control and six prospective studies. The study found that high intake of cruciferous vegetables reduced the risk of gastric cancer in humans. The analysis also found that these results were consistent with North American, European, and Asian studies. (Wu QJ et al, Cancer Sci., 2013)

In short, the studies indicated that high intake of raw cruciferous vegetables may be associated with a low risk of stomach/gastric cancer. However, no significant association with risk of stomach cancer was found when these vegetables were cooked as opposed to when eaten raw.

Cruciferous Vegetables like Brussels Sprouts May Reduce Risk of Pancreatic Cancer

Researchers from the Second Affiliated Hospital & Yuying Children’s Hospital of Wenzhou Medical University in China carried out a meta-analysis using data from literature search done till March 2014. The meta-analysis was focused on evaluating the association between intake of cruciferous vegetable (such as broccoli, brussels sprouts etc) and pancreatic cancer risk. The analysis used data from PubMed, EMBASE, and Web of Science databases which included four cohort and five case-control studies. (Li LY et al, World J Surg Oncol. 2015)

The analysis concluded that a high intake of cruciferous vegetable (such as broccoli, brussels sprouts, etc) may reduce the risk of pancreatic cancer. However, due to the limited number of studies included in this meta-analysis, the researchers suggested more well-designed prospective studies to be carried out to confirm this inverse association between cruciferous vegetable (such as broccoli, brussels sprouts, etc) intake and pancreatic cancer risk. 

Reduced Risk of Breast Cancer

Researchers from the First Affiliated Hospital, School of Medicine, Zhejiang University in China carried out a meta-analysis using data from literature search in the Pubmed database including studies till November 2011. Their meta-analysis evaluated the association between cruciferous vegetables and breast cancer risk. The analysis included a total of 13 observational studies covering 11 case-control and 2 cohort studies. (Liu X and Lv K, Breast. 2013)

Meta-analysis of these studies indicated that a high consumption of cruciferous vegetables may be significantly associated with a reduced risk of breast cancer. However, due to the limited number of studies, the researchers suggested more well-designed prospective studies to be carried out to confirm the protective effect of cruciferous vegetables on breast cancer.

Reduced Risk of Colorectal Cancer 

Researchers from the Whiteley-Martin Research Centre, Sydney Medical School, Australia carried out a meta-analysis using data from literature search of electronic databases including studies till May 2013. Their meta-analysis evaluated the association between cruciferous vegetables and risk of colorectal neoplasms. The analysis used data from Medline/Pubmed, Embase, Web of Science, and Current Contents Connect which included a total of 33 articles. (Tse G and Eslick GD, Nutr Cancer. 2014)

The meta-analysis found that a higher intake of cruciferous vegetables may be significantly associated with a reduced risk of colon cancer. While assessing individual cruciferous vegetables, the researchers also found that Broccoli in particular exhibited protective benefits against colorectal  neoplasms. 

Reduced Risk of Bladder Cancer Risk

Researchers from the First Affiliated Hospital, College of Medicine, Zhejiang University in China carried out a meta-analysis using data from literature search in the Pubmed/Medline and Web of Science databases including studies published between 1979 and June 2009. Their meta-analysis evaluated the association between cruciferous vegetables and bladder cancer risk. The analysis included a total of 10 observational studies covering 5 case-control and 5 cohort studies. (Liu B et al, World J Urol., 2013)

Overall, the meta-analysis found a significantly decreased risk of bladder cancer with a high intake of cruciferous vegetables. These results were predominant in the case-control studies. However, no significant association was found between cruciferous vegetables intake and bladder cancer risk in the cohort studies. Hence, the researchers suggested more well-designed prospective studies to be carried out to confirm the protective effect of cruciferous vegetables on bladder cancer.

Association with Kidney Cancer Risk

In 2013, researchers from the First Affiliated Hospital, College of Medicine, Zhejiang University in China carried out a meta-analysis using data from literature search in the Pubmed database including studies published between 1996 and June 2012. Their meta-analysis evaluated the association between cruciferous vegetables and renal cell carcinoma (kidney cancer) risk. The analysis included a total of 10 observational studies covering 7 case-control and 3 cohort studies. (Liu B et al, Nutr Cancer. 2013)

Meta-analysis from the case-control studies indicated that a high intake of cruciferous vegetables may be associated with a moderate reduction in risk of renal cell carcinoma/kidney cancer. However, these benefits were not found in the cohort studies. Hence, more studies are required to establish a protective association between high cruciferous vegetables consumption and kidney cancer risk.

Reduced Risk of Lung Cancer

A large-scale population-based prospective study in Japan called the Japan Public Health Center (JPHC) Study, analyzed a 5 year follow-up questionnaire-based data, to evaluate the association between cruciferous vegetables intake and lung cancer risk in a population with a relatively high intake of cruciferous vegetables. The study included 82,330 participants including 38,663 men and 43,667 women who were aged between 45-74 years without a previous history of cancer. The analysis was further stratified by their smoking status. 

The analysis found that a higher intake of cruciferous vegetables may be significantly associated with a reduced risk of lung cancer among those men who were never smokers and those who were past smokers. However, the researchers found no association in men who were current smokers and women who were never smokers. (Mori N et al, J Nutr. 2017)

This study indicated that high intake of cruciferous vegetables may reduce the risk of lung cancer among men who were current nonsmokers. However, in a previous study, the analysis suggested that a diet rich in cruciferous vegetables may also reduce the risk of lung cancer among smokers. (Tang L et al, BMC Cancer. 2010) 

Based on the above studies, taking cruciferous vegetables seems to have some protective effects against lung cancer. However, more studies are required to establish this fact.

Association with Prostate Cancer Risk

Researchers from the First Affiliated Hospital, School of Medicine, Zhejiang University in China carried out a meta-analysis using data from literature search in the Pubmed database including studies till June 2011. Their meta-analysis evaluated the association between cruciferous vegetables and prostate cancer risk. The analysis included a total of 13 observational studies covering 6 case-control and 7 cohort studies. (Liu B et al, Int J Urol. 2012)

Overall, the meta-analysis found a significantly decreased risk of prostate cancer with a high intake of cruciferous vegetables. These results were predominant in the case-control studies. However, no significant association was found between cruciferous vegetables intake and prostate cancer risk in the cohort studies. Hence, the researchers suggested more well-designed prospective studies to be carried out to confirm the beneficial effect of cruciferous vegetables on prostate cancer.

In summary, the researchers mostly found that a higher intake of cruciferous vegetables may be significantly associated with a reduced risk of different cancer types, especially in the case-control studies, although more well-designed studies are suggested to confirm this protective association.

Nutrient Benefits in Raw, Steamed or Boiled Cruciferous Vegetables / Broccoli

Glucosinolates are phytonutrients and sulphur containing organic compounds present in cruciferous veggies which when hydrolyzed in our body forms health supporting nutrients like indole-3-carbinol and isothiocyanates such as sulforaphane. Most of the anti-cancer, anti-inflammatory, antioxidant and anti-estrogenic properties of these veggies may be attributed to sulforaphane and indole-3-carbinol nutrients. 

However, many of the studies indicate that boiling cruciferous vegetables can degrade the enzyme myrosinase which hydrolyses the glucosinate to its high nutrient, anti-cancer products, sulforaphane and indole-3-carbinol. Chopping or chewing raw broccoli releases myrosinase enzyme and helps in the formation of sulforaphane and indole-3-carbinol. Hence, eating raw or steamed broccoli helps to reap maximum health benefits from the nutrients rather than taking boiled vegetables.    

This is further supported by the studies conducted by the researchers at the University of Warwick in the United Kingdom. The researchers investigated the effect of cooking of cruciferous vegetables such as broccoli, brussel sprouts, cauliflower and green cabbage by boiling, steaming, microwave cooking and stir-fry on the glucosinolate content/nutrient content. Their study indicated serious impact of boiling on the retention of the important glucosinolate products within the cruciferous vegetables. The study found that the loss of total glucosinolate content after boiling for 30 minutes was 77% for broccoli, 58% for Brussel sprouts, 75% for cauliflower and 65% for green cabbage.  They also found that boiling of brassica vegetables for 5 minutes led to 20 – 30% loss and for 10 minutes led to 40 – 50% loss in glucosinolate nutrient content. 

The effects of other cooking methods on the nutrient content of cruciferous veggies were also investigated by the researchers including steaming for 0–20 min (eg steamed broccoli), microwave cooking for 0–3 min and stir-fry cooking for 0–5 min. They found that all these 3 methods didn’t lead to any significant loss of total glucosinolate contents over these cooking periods. 

Hence, taking raw or steamed broccoli and other cruciferous veggies will help retain the nutrients and obtain their maximum nutritional benefits. There are clear definite dietary/nutrient benefits for broccoli when taken in both its raw and steamed form and are recommended to be included as part of our daily diets. 

Conclusion

In short, most of the studies summarized in this blog suggest that high intake of raw or steamed cruciferous vegetables such as broccoli and brussels sprouts may be associated with a low risk of many cancers such as stomach cancer/gastric cancer, lung cancer, colorectal cancer, breast cancer, pancreatic cancer and so on. The researchers mostly found an inverse association between the cruciferous vegetables intake and cancer risk, especially in the case-control studies, although more well-designed studies are suggested to confirm this protective association. The chemo-preventive property as well as the antioxidant, anti-inflammatory, anti-cancer and anti-estrogenic properties of the cruciferous veggies may be attributed to their key active compounds/micronutrients, especially sulforaphane and indole-3-carbinol. The bottom line is, adding cruciferous vegetables such as broccoli and brussels sprouts to our daily diet in adequate amounts may help us reap great health benefits from nutrients including cancer prevention (breast cancer, pancreatic cancer etc), especially when consumed in their raw or steamed form.

“What should I eat?” is the most frequently asked question to cancer dieticians and physicians. The right answer depends upon cancer type, underlying genomics, current treatments, any allergies, lifestyle information, and factors like BMI.

The addon personalized nutrition plan keeps you safe from adverse nutrition interactions.

Get started NOW with answering questions on type of cancer, current treatments, supplements, allergies, age group, gender, and lifestyle information.

Top 10 Foods and Supplements to Avoid for Cancer

Go beyond same nutrition guidelines for everyone and make personalized decisions with confidence.


Cancer patients often have to deal with different chemotherapy side effects which affect their quality of life and look out for alternative therapies for cancer.Taking the right nutrition and supplements based on scientific considerations (avoiding guesswork and random selection) is the best natural remedy for cancer and treatment related side-effects.


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