Cabbage, Broccoli, Cauliflower, Collard, Kale, Brussels sprouts, Kohlrabi (Brassica oleracea)
Natural Standard Bottom Line Monograph, Copyright © 2013 (www.naturalstandard.com). Commercial distribution prohibited. This monograph is intended for informational purposes only, and should not be interpreted as specific medical advice. You should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.
While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy.
Related terms: Antioxidant, biotin, Brassica (genus), Brassica vegetable, Brassicaceae (family), broccoli seed extract, broccoli sprouts, cabbage butterfly, cabbage extract, cabbage leaves, cabbage soup diet, caffeic acid, calcium, carotenoids, Chinese cabbage, chlorogenic acid, chlorophyll, coleslaw, colewort, coumarins, cruciferous vegetables, daikon, dietary indoles, dithiolethiones, ferulic acid, fiber, flavonoids, folate, glucosinolates, glutamine, goitrin, Helicobacter pylori, histidine, hydroquinone, indole-3-carbinol (I3C), isothiocyanates, kepis, kimchi, lutein, magnesium, manganese, Oriental cabbage, phylloquinone, phytochemicals, phytoestrogens, pickled cabbage, pierisin, potassium, radishes, riboflavin, sauerkraut, sinigrin, sulforaphane, sulfur, thiamine, vitamin A, vitamin B3, vitamin B6, vitamin C, vitamin E, vitamin K, zeaxanthin.
Brassica oleracea L. var. acephala: Brassica oleracea L. (acephala group), Brassica oleracea L. var. viridis, borecole, chou vert (French), chou vert non pommé (French), chou cavalier (French), chou à grosses côtes (French), collard, collard greens, couve galega (Portuguese), couve tronchuda (Portuguese), kale, leaf cabbage, sukuma wiki (Swahili), tronchuda cabbage.
Brassica oleracea var. alboglabra: Brassica oleracea L. (alboglabra group), brocoli de Chine (French), chou de Chine à fleurs blanches (French), bróculi (brócoli) chino (Spanish), Chinese broccoli, Chinese kale, Chinesischer Brokkoli (German), gai lan (Chinese), jie lan (Chinese), kailan (Malay), kairan (Japanese), phak khana (Thai), white flowering broccoli.
Brassica oleracea var. botrytis: Blumenkohl (German), Brassica oleracea L. (botrytis group), broccoli, brocoli, calabrese, cauliflower, cavolfiore (Italian), chou brocoli (French), chou-fleur (French), coliflor (Spanish), common cauliflower, couve brócolo (Portuguese), couve flor (Portuguese), hana kyabetsu (Japanese), hua ye cai (Chinese), kalafior (Polish), kapusta tsvetnaia (Russian), karifurawaa (Japanese), phuul gobhii (Hindi, Urdu).
Brassica oleracea L. var. capitata: Brassica oleracea L. (cabbage group), Brassica oleracea L. forma alba, Brassica oleracea L. var. conica, Brassica oleracea L. var. rubra, band gobhii (Hindi), cabbage, cavolo cappuccino (Italian), chou cabus (French), chou pommé (French), chou rouge (French), col (Spanish), couve repolho (Portuguese), Early Jersey Wakefield, gan lan (Chinese), headed cabbage, January King, kabichi (Swahili), kabichu (Swahili), kanran (Japanese), kapeti kovu (Fiji), kapisi, kapisi palangi (Tuvalu), kapusta belokachannaia (Russian), kraut, kyabetsu (Japanese), lombarda, red cabbage, red drumhead, repollo, Rotkohl (German), savoy, Weißkohl (German), white cabbage, wild cabbage.
Brassica oleracea var. costata: Bedford cabbage, Brassica oleracea L. (costata group), Brassica oleracea L. (tronchuda group), chou à grosses côtes (French), chou de beauvais (French), col portuguesa (Spanish), couve portuguesa (Portuguese), couve tronchuda (Portuguese), Madeira cabbage, Portugiesischer Kohl (German), Portuguese cabbage, Portuguese kale, ribbekaal (Danish), seakale cabbage, tronchuda cabbage, tronchuda kale, Tronchudakohl (German), white-flowered cabbage.
Brassica oleracea var. gemmifera: bao zi gan lan (Chinese), Brassica oleracea L. (brussels sprouts group), Brassica oleracea var. gemmifera Zenker, brussels sprouts, brysselkål (Swedish), chou de Bruxelles (French), col de Bruselas (Spanish), couve de Bruxelas (Portuguese), kapusta warzywna brukselka (Polish), me kanran (Japanese), me kyabetsu (Japanese), repollo de Bruselas (Spanish), rosenkål (Danish), Rosenkohl (German), spruit (Dutch).
Brassica oleracea var. gongylode: bladkoolachtigen (Dutch), Brassica oleracea L. (kohlrabi group), Brassica oleracea var. caulorapa, cabbage turnip, cai tou (Chinese), cavolo rapa (Italian), chou-rave (French), col rábano (Spanish), colinabo (Spanish), couve rábano (Portuguese), Hungarian turnip, kalarepa (Polish), kålrabbi (Swedish), kålrabi (Danish), karalábé (Hungarian), knolkhol, knolkool (Afrikaans), knudekål (Danish), Kohlrabi (German), kol'rabi (Russian), koolrabi (Dutch), kyuukei kanran (Japanese), pie lan (Chinese), ryukyu kanran (Japanese), stem turnip.
Brassica oleracea L. var. italica: Asparagus broccoli, Brassica oleracea L. var. italica Plenck, broccoli, brocoli asperge (French), brokkoli (Russian), Brokkoli (German), calabrese, cape broccoli, cavolo broccoli (Italian), chou brocoli (French), heading broccoli, kapústa sparzhevaia (Russian), lu hua cai (Chinese), parsakaali (Finnish), purple cauliflower, Spargelkohl (German), sprouting broccoli, winter broccoli.
Brassica oleracea var. medullosa: Brassica oleracea var. medullosa Thell., cavolo a midollo (Italian), cavolo da foraggio (Italian), cavolo Mellier bianco (Italian), chou fourrager (French), chou moellier (French), col de meollo (Spanish), col meollosa (Spanish), couve cavaleiro (Portuguese), couve forrageira (Portuguese), couve-repolho branca (Portuguese), fodermärgkål (Swedish), fodermarvkaal (Danish), formargkål (Norwegian), marhakáposzta (Hungarian), Markkohl (German), Markstammkohl (German), marookeeru (Japanese), marrow kale, marrow-stem kale, mergkool, rehukaali (Finnish), rehuydinkaali (Finnish), si liao wu tou gan lan (Chinese), voederkool (Dutch), voederzomerkool (Dutch), witte mergkool (Dutch).
Brassica oleracea L. var. ramosa: branching bush kale, branching cabbage, bush kale, chou branchu (French), chou cavalier (French), col caballar (Spanish), couve cavaleiro (Portuguese), perennial kale, perpetual kale, qian tou gan lan (Chinese), si liao gan lan (Chinese), Staudenkohl (German), Strauchkohl (German), Tausendkopfkohl (German), thousand-head kale.
Combination product examples: Ascorbigen®, OncoPLEX SGSTM, Pure Encapsulations®.
Brassica oleracea belongs to the Brassicaceae (Cruciferae) family. The wild form of the plant originated along the Atlantic seaboard of Western Europe and along the Mediterranean basin. Brassica oleracea has been cultivated as a vegetable for more than 2,500 years, and through selective breeding, particular characteristics of the plant have been developed. A number of types of vegetables have been derived from this wild stock through selection of favorable cultivars. Colewort (cole-plant) is the wild form; its basic domesticated forms are collard, which has enlarged leaves, and kale, which typically has curled leaves. Cabbage is another variety, whose terminal bud consists of enlarged leaves in a tight mass (a head of cabbage). Brussels sprouts are lateral buds, which appear as miniature tight forms of cabbage, and kohlrabi are the enlarged stems. Broccoli and cauliflower are inflorescences, which are clusters of flower buds atop a stem.
The Brassica vegetables have many nutrients and bioactive substances, such as vitamins, minerals, fiber, carotenoids, bioflavonoids, sulfur, dithiolethiones, and glucosinolates. The Brassica vegetables, especially cabbage, can withstand extremely cold temperatures. Thus, cabbage is a diet staple in many countries.
Ethnic folk healers from the Hispanic and African-American communities have long used cabbage juice for yeast infections. Other traditional uses of cabbage include as a treatment for gout and rheumatism, and as a poultice to cleanse infected wounds.
Good scientific evidence supports the use of Brassicaoleracea for treating breast engorgement in breastfeeding women. Clinical studies in humans have also investigated the potential beneficial effects of Brassica vegetables for cancer prevention, and for various conditions, such as high cholesterol and high triglycerides, fibromyalgia, and Helicobacter pylori infection.
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
Breast feeding (breast engorgement)
Limited scientific evidence exists for the use of cabbage leaves in breastfeeding women to reduce painful engorgement and increase the average length of time of exclusive breastfeeding. Results of other studies reported that cabbage did not perform better than a placebo treatment for relieving symptoms of breast engorgement in breastfeeding women. Additional research is needed.
Epidemiological research suggests that as consumption of Brassica vegetables increases, the risk of cancer may decrease. Additional research is required before firm conclusions can be made.
Limited human research shows that broccoli or its constituents may decrease symptoms of fibromyalgia in women. Additional research is needed before general conclusions can be made.
Helicobacter pylori infection
Preliminary human research indicates that Brassica vegetables may aid in the treatment of Helicobacter pylori infection. Additional high-quality research is needed.
Limited human research suggests that consuming Brassica vegetables, especially cabbage, may decrease blood levels of low-density lipoprotein (LDL, or "bad") cholesterol. Further research is needed before a conclusion can be made.
*Key to grades:A: Strong scientific evidence for this use; B: Good scientific evidence for this use; C: Unclear scientific evidence for this use; D: Fair scientific evidence against this use (it may not work); F: Strong scientific evidence against this use (it likely does not work).
The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious and should be evaluated by a qualified health care professional.
Anemia, antibacterial, antidepressant, antifungal, antihelminthic, antioxidant, antiseptic, antiviral, appetite stimulant, arthritis, asthma, cardiotonic, cataracts, colitis, common cold, constipation, cough, diarrhea, diuretic, gastritis, hangover remedy, hot flashes, immune stimulant, improved blood circulation, inflammation, iodine deficiency, ischemic heart disease, joint pain, laxative, macular degeneration, menstrual pain or irregularities, mineral source, osteoporosis, neural tube defects (birth defects; prevention), Raynaud's disease, rheumatic diseases, scurvy (prevention), skin wounds (blisters, sores, and skin eruptions, as in psoriasis, burns, and ulcers), tonic (gastrointestinal), voice strain, warts, weight loss.
The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.
Adults (18 years and older)
Traditionally, one liter of cabbage juice has been taken by mouth daily. To relieve gastric pain and hyperacidity, one tablespoon of raw cabbage juice three times daily or 125 milliliters (1/2 cup) has been taken by mouth in the morning and evening before meals. Intestines may be regularized or excess body water removed with the consumption of five cups of cooked or raw cabbage by mouth twice weekly.
The cabbage soup diet has been reported to be a short-term rapid weight loss program, during which cabbage soup is consumed for approximately seven days, followed by a normal diet for at least two weeks. Because it does not contain sufficient nutrients, the cabbage soup diet should not be used for more than seven days.
For high cholesterol, two cans of mixed green vegetables and fruits with broccoli and cabbage (160 grams per can) has been taken by mouth daily for 12 weeks.
For cancer prevention, a daily dose of 193 grams of Brassica vegetables, together with a normal diet, has been taken by mouth for four weeks.
For fibromyalgia, 500 milligrams of a blend containing 100 milligrams of ascorbigen and 400 milligrams of broccoli powder has been taken by mouth daily for one month.
For Helicobacter pylori infection, broccoli sprouts (14, 28, or 56 grams) have been taken by mouth twice daily for seven days.
For breast engorgement in breastfeeding women, a cream containing cabbage leaf extract or cabbage leaves may be applied to the skin of the engorged breast for 2-8 hours between feedings.
For cuts and minor injuries, raw cabbage leaves may be crushed in a mortar and applied as a poultice to the skin of the affected area.
For stings, cabbage leaves may be applied to the affected area.
Children (under 18 years old)
There is no proven safe or effective dose of Brassica in children. The cabbage soup diet may not be suitable for children and adolescents.
The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.
Avoid in individuals with a known allergy or hypersensitivity to Brassica species or to any of their components.
Avoid in individuals allergic to cabbage, mustard, peach, or mugwort pollen, as there is the potential for allergic reactions or cross-reactions.
Foods rich in histamine, such as pickled cabbage or red wine, may cause allergy-like symptoms, such as sneezing, flushing, skin itching, diarrhea, and even shortness of breath.
Side Effects and Warnings
Brassica vegetables are generally considered safe and well tolerated when consumed in common dietary amounts.
Brassica may lower blood sugar levels. Caution is advised in patients with diabetes or hypoglycemia, and in those taking drugs, herbs, or supplements that affect blood sugar. Blood glucose levels may need to be monitored by a qualified healthcare professional, including a pharmacist, and medication adjustments may be necessary.
Due to its high vitamin K content, Brassica may increase the risk of clotting. Caution is advised in patients with bleeding disorders or those taking drugs that may affect bleeding. Dosing adjustments may be necessary.
Use cautiously in patients who have an intolerance to histamine-rich foods or in persons with deficiency of diamine oxidase. Foods rich in histamine, including pickled cabbage, may cause allergy-like symptoms, such as flushing and skin itching. Histamine-rich foods may also cause worsening of symptoms in patients with chronic headache and may induce intolerance to some foods and red wine, particularly in persons with a deficiency of diamine oxidase.
Use cautiously in patients with gas syndromes, such as irritable bowel syndrome, bacterial infection of the intestines, or lactose intolerance. Cabbage and other vegetables, such as brussels sprouts, may cause gas and increase symptoms of these conditions and cause diarrhea.
Use cautiously in patients with pre-existing thyroid conditions, such as iodine deficiency or hypothyroidism, due to the potential for hypertrophy, hyperplasia, or neoplasia of the thyroid.
Avoid in patients who are allergic to cabbage, mustard, peach, or mugwort pollen, due to the potential for allergic reactions or cross-reactions.
Avoid in pregnant or breastfeeding women in amounts greater than those normally found in food, due to a lack of safety information.
Pregnancy and Breastfeeding
Glucosinolates and their derivatives, found in Brassica vegetables, may be transferred to the milk of breastfeeding animals, causing thyroid enlargement in young animals or in humans ingesting the milk. However, increased iodine uptake may lessen this effect.
Women of reproductive age, as well as pregnant and breastfeeding women, are advised to maintain a healthful, nutritious diet that includes folic acid-rich foods, such as broccoli and brussels sprouts.
Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.
Interactions with Drugs
Brassica may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar. Patients taking insulin or drugs for diabetes by mouth should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.
Due to its high vitamin K content, Brassica may increase the risk of clotting when taken with drugs that affect bleeding. Some examples include aspirin, anticoagulants (blood thinners) such as warfarin (Coumadin®) or heparin, antiplatelet drugs such as clopidogrel (Plavix®), and nonsteroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).
Brassica may interfere with the way the body processes certain drugs using the liver's cytochrome P450 enzyme system. As a result, the levels of these drugs may be changed in the blood and may cause altered effects or potentially serious adverse reactions. Patients using any medications should check the package insert and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.
Brassica may affect the amount of drowsiness caused by some drugs. Examples include benzodiazepines such as oxazepam (Serax®), lorazepam (Ativan®), or diazepam (Valium®), barbiturates such as phenobarbital, narcotics such as codeine, some antidepressants, and alcohol. Caution is advised while driving or operating machinery.
Because Brassica contains estrogen-like chemicals, namely phytoestrogens, the effects of other agents believed to have estrogen-like properties may be altered.
Brassica may also interact with acetaminophen, agents that lower blood cholesterol, anticancer agents, calcium salts, and oxazepam.
Interactions with Herbs and Dietary Supplements
Brassica may lower blood sugar levels. Caution is advised when using herbs or supplements that also may lower blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.
Due to its high vitamin K content, Brassica may increase the risk of clotting when taken with herbs and supplements that are believed to affect bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.
Brassica may interfere with the way the body processes certain herbs or supplements using the liver's cytochrome P450 enzyme system. As a result, the levels of other herbs or supplements may be changed in the blood. It may also alter the potential effects of other herbs or supplements on the P450 system.
Because Brassica contains estrogen-like chemicals, namely phytoestrogens, the effects of other agents believed to have estrogen-like properties may be altered.
Brassica may also interact with anticancer agents, antioxidants, calcium, cholesterol-lowering herbs and supplements, iron, quercetin, vitamin A, and foods containing Bra o 3.
This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).
Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.
Blomhoff R. Dietary antioxidants and cardiovascular disease. Curr Opin Lipidol 2005;16(1):47-54. View Abstract
Bramwell B, Ferguson S, Scarlett N, et al. The use of ascorbigen in the treatment of fibromyalgia patients: a preliminary trial. Altern Med Rev 2000;5(5):455-462. View Abstract
Galan MV, Kishan AA, Silverman AL. Oral broccoli sprouts for the treatment of Helicobacter pylori infection: a preliminary report. Dig Dis Sci 2004;49(7-8):1088-1090. View Abstract
Hakooz N, Hamdan I. Effects of dietary broccoli on human in vivo caffeine metabolism: a pilot study on a group of Jordanian volunteers. Curr Drug Metab 2007;8(1):9-15. View Abstract
Nikodem VC, Danziger D, Gebka N, et al. Do cabbage leaves prevent breast engorgement? A randomized, controlled study. Birth 1993;20(2):61-64. View Abstract
Palacin A, Cumplido J, Figueroa J, et al. Cabbage lipid transfer protein Bra o 3 is a major allergen responsible for cross-reactivity between plant foods and pollens. J Allergy Clin Immunol 2006;117(6):1423-1429. View Abstract
Roberts KL, Reiter M, Schuster D. Effects of cabbage leaf extract on breast engorgement. J Hum Lact 1998;14(3):231-236. View Abstract
Roberts KL, Reiter M, Schuster DA. A comparison of chilled and room temperature cabbage leaves in treating breast engorgement. J Hum Lact 1995;11(3):191-194. View Abstract
Roberts KL. A comparison of chilled cabbage leaves and chilled gelpaks in reducing breast engorgement. J Hum Lact 1995;11(1):17-20. View Abstract
Shapiro TA, Fahey JW, Dinkova-Kostova AT, et al. Safety, tolerance, and metabolism of broccoli sprout glucosinolates and isothiocyanates: a clinical phase I study. Nutr Cancer 2006;55(1):53-62. View Abstract
Snowden HM, Renfrew MJ, et al. Treatments for breast engorgement during lactation. Cochrane Database Syst Rev 2001;(2):CD000046. View Abstract
Steinkellner H, Rabot S, Freywald C, et al. Effects of cruciferous vegetables and their constituents on drug metabolizing enzymes involved in the bioactivation of DNA-reactive dietary carcinogens. Mutat Res 2001;480-481:285-297. View Abstract
Takai M, Suido H, Tanaka T, et al. [LDL-cholesterol-lowering effect of a mixed green vegetable and fruit beverage containing broccoli and cabbage in hypercholesterolemic subjects]. Rinsho Byori 2003;51(11):1073-1083. View Abstract
Thomas M, Weisman SM. Calcium supplementation during pregnancy and lactation: effects on the mother and the fetus. Am J Obstet Gynecol 2006;194(4):937-945. View Abstract
Whanger PD. Selenium and its relationship to cancer: an update. Br J Nutr 2004;91(1):11-28. View Abstract
Copyright © 2013 Natural Standard (www.naturalstandard.com)
The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.
March 22, 2017