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CABBAGE

Brassica Oleracea var. viridis

COMMON NAME

It is most commonly known as cabbage. In other languages, this plant is known as Collard, Chou Cavalier, Collard Greens, Cow Cabbage, Spring Heading Cabbage, Tall Kale and Winter Greens, among others.

TAXONOMICAL NAME

This species is part of the Brassicaceae or Cruciferae plant family. The general botanical name is Brassica oleracea L. However, from this general name, many phenotypical varieties arise. The latter are used both in the food and herbal industry, with some names standing out: B. oleracea var. acephala DC (kale), B. oleracea var. capitata L. (traditional cabbage), B. oleracea var. italica Plenk (broccoli), and B. oleracea var. viridis.

Description

Cabbage is a cruciferous vegetable plant. The dark and fleshy leaves are the main characteristic of the plant, which are traditionally cooked as a staple food. It has been grown in western agriculture since a long time. As an example, it was grown in the South of the United States since the beginning of the XIX century and became a key staple food for people during the American Civil War. Regarding the etymology of the common English name, “collard”, it comes from the word “colewort”, which is a term used to describe the cabbage plant when it has not formed the compact “head” yet. The metabolic composition is notably rich in different compounds derived from sulphur.

Part used

Aerial parts are used for medicinal formulas and consumption. More specifically, what is used is the juice, aqueous extract, and the leaf (fresh, cooked or fermented) of cabbage and kale. In the particular case of broccoli, other parts are also used: the juice, whole mature inflorescences (fresh or cooked), and fresh sprouts and seeds, which are rich in oils.

Active compounds

The different varieties of Brassica oleracea stand out thanks to plenty of sulphur and nitrogen compounds, notably glucosinolates. These are divided into aliphatic glucosinolates (like sinigroside, glucoiberin, glucoerucin and progoitin) and indolic ones (such as glucobrassicin). There is also an enzyme in the plant’s cells called myrosinase (a thioglusidase), which is stored separately. When the tissue is damaged by chewing or cuts, myrosinase interacts directly with glucosinolates. This catalyses a hydrolysis reaction that results in the synthesis of indoles (indole-3-acetonitrile, Indole-3-Carbinol and 3,3'-Diindolylmethane), nytril and bioactive isothiocyanates like sulforaphane.

The phytochemical profile of cabbage also includes S-methylcysteine sulphoxide and ascorbigen. It provides high proportions of phenolic compounds such as sinapic, ferulic, caffeic and p-coumaric acids. There are plenty of flavonoids (quercetin derivatives, kaempferol, isorhamnetin, apigenin and rutoside), tannins, sterols, saponins, terpenes and anthocyanidins. In addition, it provides fats, fatty acids (in the seed: palmitic, stearic, oleic, linoleic and erucic acids), carotenoids (lutein, β-carotene, zeaxanthin), vitamins B, C, E, K, U and inositol.

Pharmacological action

  • Anticancer and chemoprophylactic effect: Isothiocyanates (ITCs) provide a deep anticancer function by enhancing and inducing the activity of phase II detoxicating enzymes in the liver. At the same time, they notably inhibit the enzymes from phase I. This process facilitates the safe clearing of carcinogen substances from the body and inhibits the pathological cell growth by inducing cell apoptosis. Indoles pave the way for modification during synthesis and metabolism of oestrogens towards excretable pathways, providing a protective environment from hormone dependant tumours like breast and cervical cancers.
  • Antidiabetic effect: Supplying the aqueous extract through various dosages promotes the reduction and control over glucose levels in circulating blood.
  • Protective and gastrointestinal effects: The juice, as well as the fresh and fermented leaves, act vigorously as healing, anti-ulcerative, and demulcent protecting agents.
  • Lipid-lowering action: Decreases high concentrations of cholesterol in blood. This effect is partially mediated by the metabolic actions of S-methylcysteine (SMCO).
  • Anti-inflammatory effect: Generally decreases the levels and expression of proinflammatory cytokines (TNF-α, IL-1β, IL-6 and the COX-2 enzyme), while increasing, at the same time, anti-inflammatory and protective factors of the immune system (such as interleukin IL-10).

Indications

In traditional uses, cabbage is prescribed orally to counteract affections such as gastroduodenal ulcer, constipation (used to regulate bowel transit), scurvy and to sooth irritated stomachs. It is also advised in case of certain clinical pathologies like anaemia, cardiovascular disorders, diabetes, obesity, macular degeneration and glaucoma. When applied on the skin, boiled leaves pressed as a compress are effective to favour the healing of venous ulcers, skin eczema, dermatitis and breast inflammation during lactation. Regarding the high dietary intake, it is highly advised due to its preventive and healing properties. The aim is to delay and help reverting the promotion of systemic carcinogenic process, as well as to counteract the development of breast, bladder and prostate tumours.

Contraindications

Formulation containing this medicinal plant are highly contraindicated in those patients suffering from hypersensitivity towards the plant or towards any of its botanical components from degradation. Since the formal toxicological assessment is not complete, there is not enough and trustworthy information about the specialised therapeutic dosage for especial populations. This is the reason why pregnant and breastfeeding women are to avoid the use and supplementation with cabbage at higher dosages than those purely food-related.

Precautions

Clinical theory indicates that an excessive intake of this vegetable - and thus, of vitamin K -, and specially a higher intake than 450 g/day of broccoli, can unchain an acquired resistance and develop antagonising interactions with anticoagulant drugs like warfarin. Furthermore, consumption of B. oleracea has the potential of inducing variations on the metabolization patterns of analgesics such as acetaminophen or phenacetin, which theoretically affects the kinetic behaviour of the cytochrome P450 (CYP) liver enzyme. This is caused by the stimuli originated from the intake of sulphur-rich compounds. There are some serious precautions for diabetic patients who are being treated. The coadjutant use of cabbage with antidiabetic drugs like glimepiride, insulin or rosiglitazone; or any hypoglycaemic herbal remedy, since it moderately but dangerously increases the chances suffering a fast and sudden decrease of glucose, so a health expert should monitor the patient in many clinical cases and decrease the dosage, if needed. Finally, the longstanding fear of a potential anti-thyroid activity causing goitre has been refuted recently. Recent studies demonstrate that the intake of plenty of cabbage is harmless and safe, respecting the functioning of the thyroid gland, as long as the diet assures the needed supply of iodine.

Side effects and toxicity

It is a plant classified as probably and reasonably safe under all metrics, showing optimal tolerability for nutritional consumption for the vast majority of people. The only notified side effect, with a high incidence, is mild to moderate flatulence after the intake of cabbage. This is caused by the high content in fermentable carbohydrates and sulphuric character compounds. There are no systematic clinical trials or extensive official evaluations explicitly exploring the acute side effects linked to overdoses generated by extremely high concentrations of cabbage under medical protocols and purely related to food supplements.

Studies

There are many preclinical studies among the selected bibliography. On one hand, clinical observations confirmed that taking an estimate of 0.88 daily cups of nutrient-rich Cruciferae decreases the incidence percentage of epithelial bladder cancer up to 30%. In vitro research centred around broccoli’s degradation showed an aggressive inhibition and stop of the natural growing cycle of some cancer pathologies. In vivo trials on genetically healthy mice showed notable reductions of harmful cholesterol with no hepatotoxic reactions reported. On the other hand, in vivo-validated trials made on rats affected by diabetic conditions showed that exact dosages of 60 mg/kg of cabbage are statistically as competitive and beneficial as equivalent doses of therapeutic glyburide (5 mg/kg), when modulating and soothing severe hyperglycaemic features. The control over local inflammatory response is experimentally confirmed thanks to reducing toxic cytokines. This is achieved by using combined lyophilized extract of sprouts, which ends up effectively protecting multiple models or mice with artificially induced diseases.

Bibliography

  1. Galanty A, Grudzinska M, Pazdziora W, Sluzaly P, Pasko P. Do Brassica vegetables affect thyroid function? A comprehensive systematic review. Int J Mol Sci. 2024; 25(7): 3988-8.
  2. Amssayef A, Eddouks M. Antihyperglycemic Effect of the Moroccan Collard Green (Brassica oleracea var. viridis) in Streptozotocin-Induced Diabetic Rats. Endocr Metab Immune Disord Drug Targets. 2020.
  3. Zhao H, Lin J, Grossman HB, et al. Dietary isothiocyanates, GSTM1, GSTT1, NAT2 polymorphisms and bladder cancer risk. Int J Cancer. 2007; 120: 2208-13.
  4. Baenas N, Vega-García A, Manjarrez-Marmolejo J, Moreno DA, Feria-Romero IA. The preventive effects of broccoli bioactives against cancer: Evidence from a validated rat glioma model. Biomed Pharmacother. 2023; 168: 115720.
  5. Asadujjaman M, Hossain MS, Khan MRI, Anisuzzaman ASM, Ahmed M, Islam A. Antihyperglycemic and glycogenesis effects of different fractions of Brassica oleracea in alloxan induced diabetic rats. Int Pharm Sci Res. 2011; 2(6): 1436.
  6. Wagner AE, Huebbe P, Konishi T, et al. Free radical scavenging and antioxidant activity of ascorbigen versus ascorbic acid: studies in vitro and in cultured human keratinocytes. J Agric Food Chem. 2008; 56(24): 11694-11699.
  7. Farnham MW, Davis EH, Morgan JT, Smith JP. Neglected landraces of collard (Brassica oleracea L. var. viridis) from the Carolinas (USA). Genet Resour Crop Evol. 2008; 55: 797-801.
  8. Conaway CC, Yang YM, Chung FL. Isothiocyanates as cancer chemopreventive agents: their biological activities and metabolism in rodents and humans. Curr Drug Metab. 2002; 3(3): 233-255.

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