Cruciferous Vegetables Improve Survival in Women With Breast Cancer

At the recent American Association for Cancer Research annual meeting, new evidence highlighted the importance of cruciferous vegetables for breast cancer protection.
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At the recent American Association for Cancer Research annual meeting, new evidence highlighted the importance of cruciferous vegetables for breast cancer protection.

The cruciferous vegetable family:
  • Arugula
  • Bok choy
  • Broccoli
  • Broccoli rabe
  • Broccolini
  • Brussels sprouts
  • Cabbage
  • Cauliflower
  • Collards
  • Horseradish
  • Kale
  • Kohlrabi
  • Mustard greens
  • Radish
  • Red cabbage
  • Rutabaga
  • Turnips
  • Turnip greens
  • Watercress
The cruciferous family is unique among vegetables because of their glucosinolate content -- glucosinolates give cruciferous vegetables their characteristic spicy or bitter tastes; when the plant cell walls are broken by blending, chopping, or chewing, an enzyme called myrosinase converts glucosinolates to isothiocyanates (ITCs) -- compounds with potent anti-cancer effects, including:
  • Anti-inflammatory effects -- ITCs have been found to decrease the secretion of inflammatory molecules.

  • Anti-angiogenic effects -- isothiocyanates can inhibit the development of new blood vessels to limit tumor growth.
  • Detoxification of carcinogens -- Some carcinogens must be converted to their active form before they can bind DNA to cause carcinogenic changes -- isothiocyanates can block this transformation.
  • Preventing DNA damage -- Isothiocyanates also increase the production of our body's natural detoxification enzymes, which protect DNA against damage from carcinogens and free radicals.
  • Stopping cell division in cells whose DNA has been damaged
  • Promoting programmed cell death in cancerous cells
  • Anti-estrogenic activity -- Exposure to estrogen is known to increase breast cancer risk; estrogens can alter gene expression, promoting cell proliferation breast tissue. ITCs have been shown to inhibit the expression of estrogen-responsive genes.
  • Shifting hormone metabolism -- Eating cruciferous vegetables regularly helps the body to shift hormone metabolism, reducing the cancer-promoting potency of estrogen and other hormones.
  • Eating cruciferous vegetables produces measurable isothiocyanates in breast tissue, and observational studies show that women who eat more cruciferous vegetables are less likely to be diagnosed with breast cancer. In a recent Chinese study, women who regularly ate one serving per day of cruciferous vegetables had a 50 percent reduced risk of breast cancer. A 17 percent decrease in breast cancer risk was found in a European study for consuming cruciferous vegetables at least once a week.

    What about women who already have cancer? Is it too late for cruciferous vegetables to improve their prognosis? We know that childhood and adolescence are the most crucial times for environmental stimuli to affect breast cancer risk, but changes made during adulthood and even after diagnosis still have the potential to create positive changes in the body.

    The new study kept track of cruciferous vegetable intake in Chinese women with breast cancer for the first three years after diagnosis, and followed the women for a total of five years. They found dose-response effects -- this means that the more cruciferous vegetables women ate, the less likely they were to experience breast cancer recurrence or to die from breast cancer. When the women were grouped into four quartiles of cruciferous vegetable consumption, in the highest quartile had a 62 percent decrease in risk of death and 35 percent reduced risk of recurrence compared to the lowest quartile.

    This new data supports a previous report from the Women's Healthy Eating and Living (WHEL) study. Breast cancer survivors who reported higher than median cruciferous vegetable intake and were in the top third of total vegetable intake had a 52 percent reduced risk of recurrence -- especially powerful since the average intakes were quite low, 3.1 and 0.5 servings/day of total and cruciferous vegetables, respectively.

    Don't forget: cruciferous vegetables must be chopped, crushed, or chewed well for maximum benefit! The myrosinase enzyme is physically separated from the glucosinolates in the intact vegetables, but when the plant cells are broken, the chemical reaction can occur and ITCs can be formed. The more you chop before cooking (or chew, if you are eating the vegetables raw), the better. Some ITC benefit may be lost with boiling or steaming, so we get the maximum benefit from eating cruciferous vegetables raw -- however, gut bacteria also have the myrosinase enzyme, so additional ITC production may occur in cooked cruciferous vegetables after we eat them. Also, we can increase ITC production from cooked cruciferous vegetables by having some shredded raw cruciferous vegetables such as cabbage, kale, collards or arugula in a salad in the same meal to supply the myrosinase enzyme, which the body can use during the digestive process.

    Combine anti-cancer foods to maximize protection against all cancers: A number of plant foods are associated with lower risk of cancers, and substances contained in these foods display anti-cancer or immune-boosting properties. The cancer-fighting strategy I describe in my book Super Immunity involves eating these super-foods ("G-BOMBS": greens, beans, onions, mushrooms, berries and seeds) simultaneously and in significant quantities. The combination of cruciferous vegetables with the rest of these powerful anti-cancer foods -- the onion family, mushrooms, beans and seeds -- creates delicious, healthful, and powerfully protective meals.

    Read more about breast cancer prevention here.

    For more by Joel Fuhrman, M.D., click here.

    For more on diet and nutrition, click here.


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    3.Zhang CX, Ho SC, Chen YM, et al. "Greater vegetable and fruit intake is associated with a lower risk of breast cancer among Chinese women." Int J Cancer 2009;125:181-188.

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    5.Nechuta SJ, Lu W, Cai H, et al: "Cruciferous Vegetable Intake After Diagnosis of Breast Cancer and Survival: a Report From the Shanghai Breast Cancer Survival Study." Abstract #LB-322. In Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4. Chicago, Il; 2012.

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