BroccoProtect by Designs for Health

POSSIBLY EFFECTIVE

• Breast engorgement. Most research shows that applying cabbage leaves to engorged breasts reduces pain and hardness to the same degree as cold compresses in lactating females with breast engorgement. Details: Several small clinical studies suggest that applying whole cabbage leaves to the engorged breasts of lactating females produces subjective relief similar to the use of chilled gel-packs (6781,6784,93677). Both chilled and room temperature cabbage leaves seem to provide the same relief (6782). Another small clinical study shows that whole cabbage leaves also seem to improve breast pain and hardness when compared with general nursing care (93673). When compared with hot and cold compresses, one small clinical study found that using chilled cabbage leaves reduces postnatal breast engorgement to a similar degree, but is not as effective for reducing pain (101966). The preparation of cabbage leaves for this purpose sometimes includes stripping out the large vein of the cabbage leaf and cutting a hole for the nipple. Cabbage leaves are rinsed and chilled. The chilled cabbage leaf is worn inside the bra or as a compress under a cool towel. This procedure is typically repeated 1-4 times daily for 1-3 days (6781,6784,93673,93677,101966). A cabbage leaf extract applied as a cream has also been tried. The cabbage leaf extract cream seems to provide subjective relief when compared to baseline, but it does not provide superior relief when compared with a placebo cream (6783).

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Bladder cancer. It is unclear if consuming cabbage is effective for the prevention of bladder cancer. Details: Observational research has found that eating about 1.75 cups of cruciferous vegetables such as cabbage or broccoli is associated with a 30% reduced risk of bladder cancer in men and women (14864).
• Colorectal cancer. It is unclear if consuming cabbage is effective for the prevention of colorectal cancer. Details: Observational research has found that consuming large amounts of cabbage and other Brassica vegetables such as kale, broccoli, and cauliflower is associated with a lower risk of developing colorectal cancer (6792).
• Gastric cancer. It is unclear if consuming cabbage is effective for the prevention of gastric cancer. Details: Observational research has found that consuming large amounts of cabbage and other Brassica vegetables such as kale, broccoli, and cauliflower is associated with a lower risk of developing stomach cancer (6792).
• Gastritis. Although there has been interest in using oral cabbage for gastritis, there is insufficient reliable information about the clinical effects of cabbage for this purpose.
• Hyperlipidemia. It is unclear if oral cabbage is beneficial in patients with hyperlipidemia. Details: A small clinical study in Japanese adults with hyperlipidemia shows that adding broccoli and cabbage to a beverage consisting of fruits and vegetables for 3-9 weeks reduces low-density lipoprotein (LDL) cholesterol levels by 8.5% when compared to baseline. The reduction in LDL cholesterol was significant when compared with the same beverage without broccoli and cabbage added (25423).
• Knee pain. It is unclear if topical cabbage is beneficial in patients with knee pain. Details: A small clinical study in males with an acute mild to moderate traumatic knee ligament injury shows that use of crushed fresh cabbage leaf and cooling dressing wraps improves recovery over the first 24 hours of use by a moderate amount when compared with the cooling dressing alone. Normal fluid release occurred in 67% to 80% of patients using crushed cabbage leaf compared with 47% to 50% of those given the cooling dressing alone (101969).
• Lung cancer. It is unclear if consuming cabbage is effective for the prevention of lung cancer. Details: Observational research has found that consuming large amounts of cabbage and other Brassica vegetables such as kale, broccoli, and cauliflower is associated with a lower risk of developing lung cancer (6792).
• Osteoarthritis. Small clinical studies suggest that topical cabbage leaf modestly improves pain and other symptoms in patients with osteoarthritis of the knee. Details: A small clinical study in patients with osteoarthritis of the knee shows that applying cabbage leaf wraps to the knees for at least 2 hours daily for 4 weeks decreases pain by around 12 points on a 100 mm visual analog scale when compared with usual care. The analgesic effect of cabbage leaf wraps in these patients appears to be similar to treatment with topical gel containing the nonsteroidal anti-inflammatory drug diclofenac 10 mg/gram (93671). Another small, open-label clinical study in patients with moderate to severe osteoarthritis of the knee shows that applying cabbage leaf wraps to the knees for 1 hour daily for 4 weeks reduces knee pain and improves symptom severity when compared with diclofenac gel applied four times daily. Improvements in pain and overall symptoms were similar between cabbage leaf and the use of cooling gel pads (110558). The validity of these findings is limited by a lack of blinding.
• Pancreatic cancer. It is unclear if consuming cabbage is effective for the prevention of pancreatic cancer. Details: Observational research in elderly and middle-aged individuals has found that consuming one or more servings of cabbage per week is associated with a 38% lower risk of developing pancreatic cancer when compared with those who do not eat cabbage (25422).
• Peptic ulcers. Although there has been interest in using oral cabbage for peptic ulcers, there is insufficient reliable information about the clinical effects of cabbage for this purpose.
• Prostate cancer. It is unclear if consuming cabbage is effective for the prevention of prostate cancer. Details: Some observational research has found that consuming higher amounts of cabbage and other Brassica vegetables such as kale, broccoli, and cauliflower is not associated with a lower risk of prostate cancer (25417,25419). However, other observational studies have found that consuming higher amounts of cabbage and other Brassica vegetables is associated with a lower risk of developing prostate cancer (25418,25420,25421). More evidence is needed to rate cabbage for these uses.

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LIKELY SAFE ...when used orally in amounts commonly found in foods.

POSSIBLY SAFE ...when used orally and appropriately in medicinal amounts (18). ...when used topically and appropriately, short-term. Topical application of cabbage leaves has been general well-tolerated in short-term studies (6781,6782,6783,6784,93671,110558). However, pain, itching, and burning with topical use of cabbage leaves have been reported in some patients leaving cabbage leaf wraps in place for 2-4 hours (93671,93675).

PREGNANCY:
There is insufficient reliable information available about using cabbage in medicinal amounts during pregnancy; avoid using.

LACTATION: LIKELY SAFE
when used topically and appropriately, short-term. Significant adverse effects have not been reported in short-term studies (6781,6782,6783,6784,93673,93677). There is insufficient reliable information available about using cabbage orally in medicinal amounts during lactation; avoid using.

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ACETAMINOPHEN (Tylenol, others) Interaction Rating = Moderate Be cautious with this combination. Severity = Mild •  Occurrence = Probable •  Level of Evidence = B Cabbage might increase clearance and reduce the effects of acetaminophen.  Details A small clinical study shows that daily consumption of cabbage and Brussels sprout decreases acetaminophen levels by as much as 16%, with some evidence suggesting that this effect is due to increased elimination through glucuronide conjugation (3952).

ANTIDIABETES DRUGS Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Theoretically, cabbage might increase the risk of hypoglycemia when taken with antidiabetes drugs.  Details Animal and in vivo research suggests that cabbage might have hypoglycemic effects (25424).

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Theoretically, cabbage might decrease levels of drugs metabolized by CYP1A2.  Details Some animal research suggests that cabbage or its constituent indole-3-carbinol might increase drug metabolism and elimination by stimulating CYP1A2 activity (7176,7187,51183).

GLUCURONIDATED DRUGS Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Probable •  Level of Evidence = B Theoretically, cabbage might increase clearance and decrease the effects of drugs metabolized through glucuronide conjugation.  Details A small clinical study shows that daily consumption of cabbage and Brussels sprout decreases levels of some drugs metabolized through glucuronide conjugation (3952).

OXAZEPAM (Serax) Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Probable •  Level of Evidence = B Cabbage might increase clearance and reduce the effects of oxazepam.  Details A small clinical study shows that daily consumption of cabbage and brussels sprout decreases oxazepam levels by as much as 17%, with some evidence suggesting that this effect is due to increased elimination through glucuronide conjugation (3952).

WARFARIN (Coumadin) Interaction Rating = Moderate Be cautious with this combination. Severity = High •  Occurrence = Possible •  Level of Evidence = D Theoretically, cabbage might decrease the anticoagulant effects of warfarin.  Details Cabbage contains vitamin K. If consumed in large quantities, cabbage might decrease the anticoagulant effects of warfarin (19).

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General ...Topically, cabbage leaf seems to be well-tolerated.

Dermatologic ...Some preliminary clinical research shows that application of cabbage leaf wraps to knee joints for at least 2 hours daily for 4 weeks is generally well-tolerated. Of the 27 patients using cabbage leaf wraps in this study, one patient reported an itching and burning sensation during the application. This patient was later found to have shingles, which may explain the adverse event (93671). However, in another case, a patient applying fresh Savoy cabbage leaves on his knee to reduce joint pain reported pain and burning after 4 hours of use. Skin patch and prick tests did not indicate an allergic reaction, and the patient's lesion improved with wet dressings, topical antibiotics, and oral antibiotics (93675).

Immunologic ...Topically, cabbage may cause contact dermatitis (93675). Allergic reactions to cabbage-related vegetables are rare. However, anaphylactic reactions to broccoli and cauliflower have been reported. Because the surface proteins believed to cause allergic reactions to brocolli are also found in cabbage, some patients allergic to brocolli or other vegetables in the Brassicaceae family may also be allergic to cabbage (92516).

Other ...Topical application of cabbage leaves to the breasts has been reported to stain clothes and put off an unpleasant smell (6781,6782).

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