Carcinogens are believed to alter the DNA in cells, particularly in oncogenes (genes that control the growth and division of cells).
An altered cell divides abnormally fast, passing on the genetic changes to all offspring cells.
A group of cells is established that is not affected by the body’s normal restraints on growth.... carcinogenesis
The best-known physical carcinogen is high-energy radiation, such as nuclear radiation and X-rays. Exposure may cause cancerous changes in cells, especially in cells that divide quickly: for example, changes in the precursors of white blood cells in the bone marrow causes leukaemia. The risk depends on the dosage and duration of exposure. Over many years, exposure to ultraviolet radiation in sunlight can cause skin cancer. Another known physical carcinogen is asbestos (see asbestos-related diseases).
Only a few biological agents are known to cause cancer in humans.
SCHISTOSOMA HAEMATOBIUM, one of the blood flukes responsible for schistosomiasis, can cause cancer of the bladder; and ASPERGILLUS FLAVUS, a fungus that produces the poison aflatoxin in stored peanuts and grain, is believed to cause liver cancer.
Viruses associated with cancer include strains of the human papilloma virus, which are linked to cancer of the cervix; the hepatitis B virus, which is linked to liver cancer; and a type of herpes virus which is associated with Kaposi’s sarcoma.... carcinogen
Nutritional Profile Energy value (calories per serving): Low Protein: Moderate Fat: Low Saturated fat: Low Cholesterol: None Carbohydrates: High Fiber: Moderate Sodium: Moderate Major vitamin contribution: Vitamin C Major mineral contribution: Potassium
About the Nutrients in This Food Beets are roots, high-carbohydrate foods that provide sugars, starch, and small amounts of dietary fiber, insoluble cellulose in the skin, and soluble pectins in the flesh. Beets are also a good source of the B vitamin folate. One-half cup cooked fresh beets has one gram of dietar y fiber and 68 mcg folate (17 percent of the R DA).
The Most Nutritious Way to Serve This Food Cooked, to dissolve the stiff cell walls and make the nutrients inside available.
Diets That May Restrict or Exclude This Food Anti-kidney-stone diet Low-sodium diet
Buying This Food Look for: Smooth round globes with fresh, crisp green leaves on top. Avoid: Beets with soft spots or blemishes that suggest decay underneath.
Storing This Food Protect the nutrients in beets by storing the vegetables in a cool place, such as the vegetable crisper in your refrigerator. When stored, the beet root converts its starch into sugars; the longer it is stored, the sweeter it becomes. Remove the green tops from beets before storing and store the beet greens like other leaf y vegetables, in plastic bags in the refrigerator to keep them from drying out and losing vitamins (also see gr eens). Use both beets and beet greens within a week.
Preparing This Food Scrub the globes with a vegetable brush under cold running water. You can cook them whole or slice them. Peel before (or after) cooking.
What Happens When You Cook This Food Betacyamin and betaxanthin, the red betalain pigments in beets, are water-soluble. (That’s why borscht is a scarlet soup.) Betacyanins and betaxanthins turn more intensely red when you add acids; think of scarlet sweet-and-sour beets in lemon juice or vinegar with sugar. They turn slightly blue in a basic (alkaline) solution such as baking soda and water. Like carrots, beets have such stiff cell walls that it is hard for the human digestive tract to extract the nutrients inside. Cooking will not soften the cellulose in the beet’s cell walls, but it will dissolve enough hemicellulose so that digestive juices are able to penetrate. Cook- ing also activates flavor molecules in beets, making them taste better.
How Other Kinds of Processing Affect This Food Canning. Beets lose neither their color nor their texture in canning.
Medical Uses and/or Benefits Lower risk of some birth defects. As many as two of every 1,000 babies born in the United States each year may have cleft palate or a neural tube (spinal cord) defect due to their moth- ers’ not having gotten adequate amounts of folate during pregnancy. The R DA for folate is 400 mcg for healthy adult men and women, 600 mcg for pregnant women, and 500 mcg for women who are nursing. Taking folate supplements before becoming pregnant and continu- ing through the first two months of pregnancy reduces the risk of cleft palate; taking folate through the entire pregnancy reduces the risk of neural tube defects. Possible lower risk of heart attack. In the spring of 1998, an analysis of data from the records of more than 80,000 women enrolled in the long-running Nurses’ Health Study at Harvard School of Public Health/Brigham and Women’s Hospital, in Boston, demonstrated that a diet providing more than 400 mcg folate and 3 mg vitamin B6 daily, either from food or supple- ments, might reduce a woman’s risk of heart attack by almost 50 percent. Although men were not included in the study, the results were assumed to apply to them as well. However, data from a meta-analysis published in the Journal of the American Medical Association in December 2006 called this theory into question. Researchers at Tulane Univer- sity examined the results of 12 controlled studies in which 16,958 patients with preexisting cardiovascular diseases were given either folic acid supplements or placebos (“look-alike” pills with no folic acid) for at least six months. The scientists, who found no reduction in the risk of further heart disease or overall death rates among those taking folic acid, concluded that further studies will be required to verif y whether taking folic acid supplements reduces the risk of cardiovascular disease.
Adverse Effects Associated with This Food Pigmented urine and feces. The ability to metabolize betacyanins and be taxanthins is a genetic trait. People with two recessive genes for this trait cannot break down these red pig- ments, which will be excreted, bright red, in urine. Eating beets can also turn feces red, but it will not cause a false-positive result in a test for occult blood in the stool. Nitrosamine formation. Beets, celery, eggplant, lettuce, radishes, spinach, and collard and turnip greens contain nitrates that convert naturally into nitrites in your stomach—where some of the nitrites combine with amines to form nitrosamines, some of which are known carcinogens. This natural chemical reaction presents no known problems for a healthy adult. However, when these vegetables are cooked and left standing for a while at room tempera- ture, microorganisms that convert nitrates to nitrites begin to multiply, and the amount of nitrites in the food rises. The resulting higher-nitrite foods may be dangerous for infants (see spinach).... beets
Nutritional Profile Energy value (calories per serving): Low Protein: High Fat: Low Saturated fat: Low Cholesterol: None Carbohydrates: Moderate Fiber: Very high Sodium: Low Major vitamin contribution: Vitamin A, folate, vitamin C Major mineral contribution: Calcium
About the Nutrients in This Food Broccoli is very high-fiber food, an excellent source of vitamin A, the B vitamin folate, and vitamin C. It also has some vitamin E and vitamin K, the blood-clotting vitamin manufactured primarily by bacteria living in our intestinal tract. One cooked, fresh broccoli spear has five grams of dietary fiber, 2,500 IU vitamin A (108 percent of the R DA for a woman, 85 percent of the R DA for a man), 90 mcg folate (23 percent of the R DA), and 130 mg vitamin C (178 percent of the R DA for a woman, 149 percent of the R DA for a man).
The Most Nutritious Way to Serve This Food Raw. Studies at the USDA Agricultural Research Center in Beltsville, Maryland, show that raw broccoli has up to 40 percent more vitamin C than broccoli that has been cooked or frozen.
Diets That May Restrict or Exclude This Food Antiflatulence diet Low-fiber diet
Buying This Food Look for: Broccoli with tightly closed buds. The stalk, leaves, and florets should be fresh, firm, and brightly colored. Broccoli is usually green; some varieties are tinged with purple. Avoid: Broccoli with woody stalk or florets that are open or turning yellow. When the green chlorophyll pigments fade enough to let the yellow carotenoids underneath show through, the buds are about to bloom and the broccoli is past its prime.
Storing This Food Pack broccoli in a plastic bag and store it in the refrigerator or in the vegetable crisper to protect its vitamin C. At 32°F, fresh broccoli can hold onto its vitamin C for as long as two weeks. Keep broccoli out of the light; like heat, light destroys vitamin C.
Preparing This Food First, rinse the broccoli under cool running water to wash off any dirt and debris clinging to the florets. Then put the broccoli, florets down, into a pan of salt water (1 tsp. salt to 1 qt. water) and soak for 15 to 30 minutes to drive out insects hiding in the florets. Then cut off the leaves and trim away woody section of stalks. For fast cooking, divide the broccoli up into small florets and cut the stalk into thin slices.
What Happens When You Cook This Food The broccoli stem contains a lot of cellulose and will stay firm for a long time even through the most vigorous cooking, but the cell walls of the florets are not so strongly fortified and will soften, eventually turning to mush if you cook the broccoli long enough. Like other cruciferous vegetables, broccoli contains mustard oils (isothiocyanates), natural chemicals that break down into a variety of smelly sulfur compounds (including hydrogen sulfide and ammonia) when the broccoli is heated. The reaction is more intense in aluminum pots. The longer you cook broccoli, the more smelly compounds there will be, although broccoli will never be as odorous as cabbage or cauliflower. Keeping a lid on the pot will stop the smelly molecules from floating off into the air but will also accelerate the chemical reaction that turns green broccoli olive-drab. Chlorophyll, the pigment that makes green vegetables green, is sensitive to acids. When you heat broccoli, the chlorophyll in its florets and stalk reacts chemically with acids in the broccoli or in the cooking water to form pheophytin, which is brown. The pheophytin turns cooked broccoli olive-drab or (since broccoli contains some yellow carotenes) bronze. To keep broccoli green, you must reduce the interaction between the chlorophyll and the acids. One way to do this is to cook the broccoli in a large quantity of water, so the acids will be diluted, but this increases the loss of vitamin C.* Another alternative is to leave the lid off the pot so that the hydrogen atoms can float off into the air, but this allows the smelly sulfur compounds to escape, too. The best way is probably to steam the broccoli quickly with very little water, so it holds onto its vitamin C and cooks before there is time for reac- tion between chlorophyll and hydrogen atoms to occur.
How Other Kinds of Processing Affect This Food Freezing. Frozen broccoli usually contains less vitamin C than fresh broccoli. The vitamin is lost when the broccoli is blanched to inactivate catalase and peroxidase, enzymes that would otherwise continue to ripen the broccoli in the freezer. On the other hand, according to researchers at Cornell University, blanching broccoli in a microwave oven—two cups of broccoli in three tablespoons of water for three minutes at 600 –700 watts—nearly doubles the amount of vitamin C retained. In experiments at Cornell, frozen broccoli blanched in a microwave kept 90 percent of its vitamin C, compared to 56 percent for broccoli blanched in a pot of boiling water on top of a stove.
Medical Uses and/or Benefits Protection against some cancers. Naturally occurring chemicals (indoles, isothiocyanates, glucosinolates, dithiolethiones, and phenols) in Brussels sprouts, broccoli, cabbage, cauli- flower, and other cruciferous vegetables appear to reduce the risk of some forms of cancer, perhaps by preventing the formation of carcinogens in your body or by blocking cancer- causing substances from reaching or reacting with sensitive body tissues or by inhibiting the transformation of healthy cells to malignant ones. All cruciferous vegetables contain sulforaphane, a member of a family of chemicals known as isothiocyanates. In experiments with laboratory rats, sulforaphane appears to increase the body’s production of phase-2 enzymes, naturally occurring substances that inacti- vate and help eliminate carcinogens. At the Johns Hopkins University in Baltimore, Maryland, 69 percent of the rats injected with a chemical known to cause mammary cancer developed tumors vs. only 26 percent of the rats given the carcinogenic chemical plus sulforaphane. To get a protective amount of sulforaphane from broccoli you would have to eat about two pounds a week. But in 1997, Johns Hopkins researchers discovered that broccoli seeds and three-day-old broccoli sprouts contain a compound converted to sulforaphane when the seed and sprout cells are crushed. Five grams of three-day-old sprouts contain as much sulphoraphane as 150 grams of mature broccoli. * Broccoli will lose large amounts of vitamin C if you cook it in water t hat is cold when you start. As it boils, water releases ox ygen t hat would ot her wise dest roy vitamin C, so you can cut t he vitamin loss dramat ically simply by lett ing t he water boil for 60 seconds before adding t he broccoli. Vision protection. In 2004, the Johns Hopkins researchers updated their findings on sulfora- phane to suggest that it may also protect cells in the eyes from damage due to ultraviolet light, thus reducing the risk of macular degeneration, the most common cause of age-related vision loss. Lower risk of some birth defects. Up to two or every 1,000 babies born in the United States each year may have cleft palate or a neural tube (spinal cord) defect due to their mothers’ not having gotten adequate amounts of folate during pregnancy. The current R DA for folate is 180 mcg for a woman, 200 mcg for a man, but the FDA now recommends 400 mcg for a woman who is or may become pregnant. Taking a folate supplement before becoming pregnant and continuing through the first two months of pregnancy reduces the risk of cleft palate; taking folate through the entire pregnancy reduces the risk of neural tube defects. Broccoli is a good source of folate. One raw broccoli spear has 107 mcg folate, more than 50 percent of the R DA for an adult. Possible lower risk of heart attack. In the spring of 1998, an analysis of data from the records for more than 80,000 women enrolled in the long-running Nurses’ Health Study at Harvard School of Public Health/Brigham and Women’s Hospital, in Boston, demonstrated that a diet providing more than 400 mcg folate and 3 mg vitamin B6 daily, either from food or supple- ments, might reduce a woman’s risk of heart attack by almost 50 percent. Although men were not included in the study, the results were assumed to apply to them as well. However, data from a meta-analysis published in the Journal of the American Medical Association in December 2006 called this theory into question. Researchers at Tulane Univer- sity examined the results of 12 controlled studies in which 16,958 patients with preexisting cardiovascular disease were given either folic acid supplements or placebos (“look-alike” pills with no folic acid) for at least six months. The scientists, who found no reduction in the risk of further heart disease or overall death rates among those taking folic acid, concluded that further studies will be required to ascertain whether taking folic acid supplements reduces the risk of cardiovascular disease. Possible inhibition of the herpes virus. Indoles, another group of chemicals in broccoli, may inhibit the growth of some herpes viruses. In 2003, at the 43rd annual Interscience Confer- ence on Antimicrobial Agents and Chemotherapy, in Chicago, researchers from Stockholm’s Huddinge University Hospital, the University of Virginia, and Northeastern Ohio University reported that indole-3-carbinol (I3C) in broccoli stops cells, including those of the herpes sim- plex virus, from reproducing. In tests on monkey and human cells, I3C was nearly 100 percent effective in blocking reproduction of the HSV-1 (oral and genital herpes) and HSV-2 (genital herpes), including one strain known to be resistant to the antiviral drug acyclovir (Zovirax).
Adverse Effects Associated with This Food Enlarged thyroid gland. Cruciferous vegetables, including broccoli, contain goitrin, thio- cyanate, and isothiocyanate, chemical compounds that inhibit the formation of thyroid hormones and cause the thyroid to enlarge in an attempt to produce more. These chemicals, known collectively as goitrogens, are not hazardous for healthy people who eat moderate amounts of cruciferous vegetables, but they may pose problems for people who have thyroid problems or are taking thyroid medication. False-positive test for occult blood in the stool. The guaiac slide test for hidden blood in feces relies on alphaguaiaconic acid, a chemical that turns blue in the presence of blood. Broccoli contains peroxidase, a natural chemical that also turns alphaguaiaconic acid blue and may produce a positive test in people who do not actually have blood in the stool.
Food/Drug Interactions Anticoagulants Broccoli is rich in vitamin K, the blood-clotting vitamin produced natu- rally by bacteria in the intestines. Consuming large quantities of this food may reduce the effectiveness of anticoagulants (blood thinners) such as warfarin (Coumadin). One cup of drained, boiled broccoli contains 220 mcg vitamin K, nearly four times the R DA for a healthy adult.... broccoli
Nutritional Profile Energy value (calories per serving): Low Protein: High Fat: Low Saturated fat: Low Cholesterol: None Carbohydrates: High Fiber: High Sodium: Low Major vitamin contribution: Vitamin A, folate, vitamin C Major mineral contribution: Potassium, iron
About the Nutrients in This Food Brussels sprouts are high in dietary fiber, especially insoluble cellulose and lignan in the leaf ribs. They are also a good source of vitamin A and vitamin C. One-half cup cooked fresh brussels sprouts has three grams of dietary fiber, 1,110 IU vitamin A (48 percent of the R DA for a woman, 37 percent of the R DA for a man), 47 mcg folate (16 percent of the R DA), and 48 mg vitamin C (64 percent of the R DA for a woman, 53 percent of the R DA for a man). Brussels sprouts also contain an antinutrient, a natural chemical that splits the thiamin (vitamin B1) molecule so that it is no longer nutritionally useful. This thiamin inhibitor is inactivated by cooking.
The Most Nutritious Way to Serve This Food Fresh, lightly steamed to preserve the vitamin C and inactivate the antinutrient.
Diets That May Restrict or Exclude This Food Antiflatulence diet Low-fiber diet
Buying This Food Look for: Firm, compact heads with bright, dark-green leaves, sold loose so that you can choose the sprouts one at a time. Brussels sprouts are available all year round. Avoid: Puff y, soft sprouts with yellow or wilted leaves. The yellow carotenes in the leaves show through only when the leaves age and their green chlorophyll pigments fade. Wilting leaves and puff y, soft heads are also signs of aging. Avoid sprouts with tiny holes in the leaves through which insects have burrowed.
Storing This Food Store the brussels sprouts in the refrigerator. While they are most nutritious if used soon after harvesting, sprouts will keep their vitamins (including their heat-sensitive vitamin C) for several weeks in the refrigerator. Store the sprouts in a plastic bag or covered bowl to protect them from moisture loss.
Preparing This Food First, drop the sprouts into salted ice water to flush out any small bugs hiding inside. Next, trim them. Remove yellow leaves and leaves with dark spots or tiny holes, but keep as many of the darker, vitamin A–rich outer leaves as possible. Then, cut an X into the stem end of the sprouts to allow heat and water in so that the sprouts cook faster.
What Happens When You Cook This Food Brussels sprouts contain mustard oils (isothiocyanates), natural chemicals that break down into a variety of smelly sulfur compounds (including hydrogen sulfide and ammonia) when the sprouts are heated, a reaction that is intensified in aluminum pots. The longer you cook the sprouts, the more smelly compounds there will be. Adding a slice of bread to the cook- ing water may lessen the odor; keeping a lid on the pot will stop the smelly molecules from floating off into the air. But keeping the pot covered will also increase the chemical reaction that turns cooked brussels sprouts drab. Chlorophyll, the pigment that makes green vegetables green, is sensi- tive to acids. When you heat brussels sprouts, the chlorophyll in their green leaves reacts chemically with acids in the sprouts or in the cooking water to form pheophytin, which is brown. The pheophytin turns cooked brussels sprouts olive or, since they also contain yel- low carotenes, bronze. To keep cooked brussels sprouts green, you have to reduce the interaction between chlorophyll and acids. One way to do this is to cook the sprouts in a lot of water, so the acids will be diluted, but this increases the loss of vitamin C.* Another alternative is to leave the lid off the pot so that the hydrogen atoms can float off into the air, but this allows the smelly sulfur compounds to escape, too. The best solution is to steam the sprouts quickly in very little water, so they retain their vitamin C and cook before there is time for reaction between chlorophyll and hydrogen atoms to occur.
How Other Kinds of Processing Affect This Food Freezing. Frozen brussels sprouts contain virtually the same amounts of vitamins as fresh boiled sprouts.
Medical Uses and/or Benefits Protection against cancer. Naturally occurring chemicals (indoles, isothiocyanates, gluco- sinolates, dithiolethiones, and phenols) in brussels sprouts, broccoli, cabbage, cauliflower and other cruciferous vegetables appear to reduce the risk of some cancers, perhaps by pre- venting the formation of carcinogens in your body or by blocking cancer-causing substances from reaching or reacting with sensitive body tissues or by inhibiting the transformation of healthy cells to malignant ones. All cruciferous vegetables contain sulforaphane, a member of a family of chemicals known as isothiocyanates. In experiments with laboratory rats, sulforaphane appears to increase the body’s production of phase-2 enzymes, naturally occurring substances that inac- tivate and help eliminate carcinogens. At Johns Hopkins University in Baltimore, Maryland, 69 percent of the rats injected with a chemical known to cause mammary cancer developed tumors vs. only 26 percent of the rats given the carcinogenic chemical plus sulforaphane. In 1997, the Johns Hopkins researchers discovered that broccoli seeds and three- day-old broccoli sprouts contain a compound converted to sulforaphane when the seed and sprout cells are crushed. Five grams of three-day-old broccoli sprouts contain as much sulforaphane as 150 grams of mature broccoli. The sulforaphane levels in other cruciferous vegetables have not yet been calculated. Lower risk of some birth defects. Up to two or every 1,000 babies born in the United States each year may have cleft palate or a neural tube (spinal cord) defect due to their mothers’ not having gotten adequate amounts of folate during pregnancy. NOTE : The current R DA for folate is 180 mcg for a woman and 200 mcg for a man, but the FDA now recommends * Brussels sprouts will lose as much as 25 percent of their vitamin C if you cook them in water that is cold when you start. As it boils, water releases oxygen that would otherwise destroy vitamin C. You can cut the vitamin loss dramatically simply by letting the water boil for 60 seconds before adding the sprouts. 400 mcg for a woman who is or may become pregnant. Taking a folate supplement before becoming pregnant and continuing through the first two months of pregnancy reduces the risk of cleft palate; taking folate through the entire pregnancy reduces the risk of neural tube defects. Possible lower risk of heart attack. In the spring of 1998, an analysis of data from the records for more than 80,000 women enrolled in the long-running Nurses’ Health Study at Harvard School of Public Health/Brigham and Women’s Hospital, in Boston, demonstrated that a diet providing more than 400 mcg folate and 3 mg vitamin B6 daily, either from food or supple- ments, might reduce a woman’s risk of heart attack by almost 50 percent. Although men were not included in the study, the results were assumed to apply to them as well. However, data from a meta-analysis published in the Journal of the American Medical Association in December 2006 called this theory into question. Researchers at Tulane Univer- sity examined the results of 12 controlled studies in which 16,958 patients with preexisting cardiovascular disease were given either folic acid supplements or placebos (“look-alike” pills with no folic acid) for at least six months. The scientists, who found no reduction in the risk of further heart disease or overall death rates among those taking folic acid, concluded that further studies will be required to verif y whether taking folic acid supplements reduces the risk of cardiovascular disease. Vision protection. In 2004, the Johns Hopkins researchers updated their findings on sulfora- phane to suggest that it may also protect cells in the eyes from damage due to ultraviolet light, thus reducing the risk of macular degeneration, the most common cause of age-related vision loss.
Adverse Effects Associated with This Food Enlarged thyroid gland (goiter). Cruciferous vegetables, including brussels sprouts, contain goitrin, thiocyanate, and isothiocyanate. These chemicals, known collectively as goitrogens, inhibit the formation of thyroid hormones and cause the thyroid to enlarge in an attempt to produce more. Goitrogens are not hazardous for healthy people who eat moderate amounts of cruciferous vegetables, but they may pose problems for people who have a thyroid condi- tion or are taking thyroid medication. Intestinal gas. Bacteria that live naturally in the gut degrade the indigestible carbohydrates (food fiber) in brussels sprouts and produce gas that some people find distressing.
Food/Drug Interactions Anticoagulants Brussels sprouts are rich in vitamin K, the blood-clotting vitamin produced naturally by bacteria in the intestines. Consuming large quantities of this food may reduce the effectiveness of anticoagulants (blood thinners) such as warfarin (Coumadin). One cup of drained, boiled brussels sprouts contains 219 mcg vitamin K, nearly three times the R DA for a healthy adult.... brussels sprouts
Nutritional Profile Energy value (calories per serving): Low Protein: Moderate Fat: Low Saturated fat: Low Cholesterol: None Carbohydrates: High Fiber: Low Sodium: Low Major vitamin contribution: Vitamin A, folate, vitamin C Major mineral contribution: Calcium (moderate)
About the Nutrients in This Food All cabbage has some dietary fiber food: insoluble cellulose and lignin in the ribs and structure of the leaves. Depending on the variety, it has a little vitamin A, moderate amounts of the B vitamin folate and vitamin C. One-half cup shredded raw bok choy has 0.1 g dietary fiber, 1,041 IU vitamin A (45 percent of the R DA for a woman, 35 percent of the R DA for a man), and 15.5 mg vitamin C (21 percent of the R DA for a woman, 17 percent of the R DA for a man). One-half cup shredded raw green cabbage has 0.5 g dietary fiber, 45 IU vitamin A (1.9 percent of the R DA for a woman, 1.5 percent of the R DA for a man), 15 mcg folate (4 percent of the R DA), and 11 mg vitamin C (15 percent of the R DA for a woman, 12 percent of the R DA for a man). One-half cup chopped raw red cabbage has 0.5 g dietary fiber, 7 mcg folate (2 percent of the R DA), and 20 mg vitamin C (27 percent of the R DA for a woman, 22 percent of the R DA for a man). One-half cup chopped raw savoy cabbage has one gram dietary fiber, 322 IU vitamin A (14 percent of the R DA for a woman, 11 percent of the R DA for a man), and 11 mg vitamin C (15 percent of the R DA for a woman, 12 percent of the R DA for a man). Raw red cabbage contains an antinutrient enzyme that splits the thiamin molecule so that the vitamin is no longer nutritionally useful. This thiamin in hibitor is inactivated by cooking.
The Most Nutritious Way to Serve This Food Raw or lightly steamed to protect the vitamin C.
Diets That May Restrict or Exclude This Food Antiflatulence diet Low-fiber diet
Buying This Food Look for: Cabbages that feel heavy for their size. The leaves should be tightly closed and attached tightly at the stem end. The outer leaves on a savoy cabbage may curl back from the head, but the center leaves should still be relatively tightly closed. Also look for green cabbages that still have their dark-green, vitamin-rich outer leaves. Avoid: Green and savoy cabbage with yellow or wilted leaves. The yellow carotene pig- ments show through only when the cabbage has aged and its green chlorophyll pigments have faded. Wilted leaves mean a loss of moisture and vitamins.
Storing This Food Handle cabbage gently; bruising tears cells and activates ascorbic acid oxidase, an enzyme in the leaves that hastens the destruction of vitamin C. Store cabbage in a cool, dark place, preferably a refrigerator. In cold storage, cabbage can retain as much as 75 percent of its vitamin C for as long as six months. Cover the cabbage to keep it from drying out and losing vitamin A.
Preparing This Food Do not slice the cabbage until you are ready to use it; slicing tears cabbage cells and releases the enzyme that hastens the oxidation and destruction of vitamin C. If you plan to serve cooked green or red cabbage in wedges, don’t cut out the inner core that hold the leaves together. To separate the leaves for stuffing, immerse the entire head in boiling water for a few minutes, then lift it out and let it drain until it is cool enough to handle comfortably. The leaves should pull away easily. If not, put the cabbage back into the hot water for a few minutes.
What Happens When You Cook This Food Cabbage contains mustard oils (isothiocyanates) that break down into a variet y of smelly sulfur compounds (including hydrogen sulfide and ammon ia) when the cabbage is heated, a reaction that occurs more strongly in aluminum pots. The longer you cook the cabbage, the more smelly the compounds will be. Adding a slice of bread to the cooking water may lessen the odor. Keeping a lid on the pot will stop the smelly molecules from floating off into the air, but it will also accelerate the chemical reaction that turns cooked green cabbage drab. Chlorophyll, the pigment that makes green vegetables green, is sensitive to acids. When you heat green cabbage, the chlorophyll in its leaves reacts chemically with acids in the cabbage or in the cooking water to form pheophytin, which is brown. The pheophytin gives the cooked cabbage its olive color. To keep cooked green cabbage green, you have to reduce the interaction between the chlorophyll and the acids. One way to do this is to cook the cabbage in a large quantity of water, so the acids will be diluted, but this increases the loss of vitamin C.* Another alternative is to leave the lid off the pot so that the volatile acids can float off into the air, but this allows the smelly sulfur compounds to escape too. The best way may be to steam the cabbage ver y quickly in ver y little water so that it keeps its vitamin C and cooks before there is time for the chlorophyll/acid reaction to occur. Red cabbage is colored with red anthocyanins, pigments that turn redder in acids (lemon juice, vinegar) and blue purple in bases (alkaline chemicals such as baking soda). To keep the cabbage red, make sweet-and-sour cabbage. But be careful not to make it in an iron or aluminum pot, since vinegar (which contains tannins) will react with these metals to create dark pigments that discolor both the pot and the vegetable. Glass, stainless-steel, or enameled pots do not produce this reaction.
How Other Kinds of Processing Affect This Food Pickling. Sauerkraut is a fermented and pickled produce made by immersing cabbage in a salt solution strong enough to kill off pathological bacteria but allow beneficial ones to sur- vive, breaking down proteins in the cabbage and producing the acid that gives sauerkraut its distinctive flavor. Sauerkraut contains more than 37 times as much sodium as fresh cabbage (661 mg sodium/100 grams canned sauerkraut with liquid) but only one third the vitamin C and one-seventh the vitamin A. * According to USDA, if you cook t hree cups of cabbage in one cup of water you will lose only 10 percent of t he vitamin C; reverse t he rat io to four t imes as much water as cabbage and you will lose about 50 percent of t he vitamin C. Cabbage will lose as much as 25 percent of its vitamin C if you cook it in water t hat is cold when you start. As it boils, water releases ox ygen t hat would ot her wise dest roy vitamin C, so you can cut t he vitamin loss dramat ically simply by lett ing t he water boil for 60 seconds before adding t he cabbage.
Medical Uses and/or Benefits Protection against certain cancers. Naturally occurring chemicals (indoles, isothiocyanates, glucosinolates, dithiolethiones, and phenols) in cabbage, brussels sprouts, broccoli, cauli- flower, and other cruciferous vegetables appear to reduce the risk of some cancers, perhaps by preventing the formation of carcinogens in your body or by blocking cancer-causing substances from reaching or reacting with sensitive body tissues or by inhibiting the trans- formation of healthy cells to malignant ones. All cruciferous vegetables contain sulforaphane, a member of a family of chemicals known as isothiocyanates. In experiments with laboratory rats, sulforaphane appears to increase the body’s production of phase-2 enzymes, naturally occurring substances that inac- tivate and help eliminate carcinogens. At Johns Hopkins University in Baltimore, Maryland, 69 percent of the rats injected with a chemical known to cause mammary cancer developed tumors vs. only 26 percent of the rats given the carcinogenic chemical plus sulforaphane. In 1997, Johns Hopkins researchers discovered that broccoli seeds and three-day-old broccoli sprouts contain a compound converted to sulforaphane when the seed and sprout cells are crushed. Five grams of three-day-old broccoli sprouts contain as much sulforaphane as 150 grams of mature broccoli. The sulforaphane levels in other cruciferous vegetables have not yet been calculated. Vision protection. In 2004, the Johns Hopkins researchers updated their findings on sulfora- phane to suggest that it may also protect cells in the eyes from damage due to ultraviolet light, thus reducing the risk of macular degeneration, the most common cause of age-related vision loss. Lower risk of some birth defects. As many as two of every 1,000 babies born in the United States each year may have cleft palate or a neural tube (spinal cord) defect due to their moth- ers’ not having gotten adequate amounts of folate during pregnancy. The current R DA for folate is 180 mcg for a woman and 200 mcg for a man, but the FDA now recommends 400 mcg for a woman who is or may become pregnant. Taking a folate supplement before becom- ing pregnant and through the first two months of pregnancy reduces the risk of cleft palate; taking folate through the entire pregnancy reduces the risk of neural tube defects. Possible lower risk of heart attack. In the spring of 1998, an analysis of data from the records for more than 80,000 women enrolled in the long-running Nurses’ Health Study at Harvard School of Public Health/Brigham and Women’s Hospital, in Boston, demonstrated that a diet providing more than 400 mcg folate and 3 mg vitamin B6 daily, either from food or supple- ments, might reduce a woman’s risk of heart attack by almost 50 percent. Although men were not included in the study, the results were assumed to apply to them as well. However, data from a meta-analysis published in the Journal of the American Medical Association in December 2006 called this theory into question. Researchers at Tulane Univer- sity examined the results of 12 controlled studies in which 16,958 patients with preexisting cardiovascular disease were given either folic acid supplements or placebos (“look-alike” pills with no folic acid) for at least six months. The scientists, who found no reduction in the risk of further heart disease or overall death rates among those taking folic acid, concluded that further studies will be required to verif y whether taking folic acid supplements reduces the risk of cardiovascular disease.
Adverse Effects Associated with This Food Enlarged thyroid gland (goiter). Cruciferous vegetables, including cabbage, contain goitrin, thiocyanate, and isothiocyanate. These chemicals, known collectively as goitrogens, inhibit the formation of thyroid hormones and cause the thyroid to enlarge in an attempt to pro- duce more. Goitrogens are not hazardous for healthy people who eat moderate amounts of cruciferous vegetables, but they may pose problems for people who have a thyroid condition or are taking thyroid medication. Intestinal gas. Bacteria that live naturally in the gut degrade the indigestible carbohydrates (food fiber) in cabbage, producing gas that some people find distressing.
Food/Drug Interactions Anticoagulants Cabbage contains vitamin K, the blood-clotting vitamin produced natu- rally by bacteria in the intestines. Consuming large quantities of this food may reduce the effectiveness of anticoagulants (blood thinners) such as warfarin (Coumadin). One cup of shredded common green cabbage contains 163 mcg vitamin K, nearly three times the R DA for a healthy adult; one cup of drained boiled common green cabbage contains 73 mcg vita- min K, slightly more than the R DA for a healthy adult. Monoamine oxidase (MAO) inhibitors. Monoamine oxidase inhibitors are drugs used to treat depression. They inactivate naturally occurring enzymes in your body that metabolize tyra- mine, a substance found in many fermented or aged foods. Tyramine constricts blood vessels and increases blood pressure. If you eat a food such as sauerkraut which is high in tyramine while you are taking an M AO inhibitor, you cannot effectively eliminate the tyramine from your body. The result may be a hypertensive crisis.... cabbage
Occupational health includes both mental and physical health. It is about compliance with health-and-safety-at-work legislation (and common law duties) and about best practice in providing work environments that reduce risks to health and safety to lowest practicable levels. It includes workers’ ?tness to work, as well as the management of the work environment to accommodate people with disabilities, and procedures to facilitate the return to work of those absent with long-term illness. Occupational health incorporates several professional groups, including occupational physicians, occupational health nurses, occupational hygienists, ergonomists, disability managers, workplace counsellors, health-and-safety practitioners, and workplace physiotherapists.
In the UK, two key statutes provide a framework for occupational health: the Health and Safety at Work, etc. Act 1974 (HSW Act); and the Disability Discrimination Act 1995 (DDA). The HSW Act states that employers have a duty to protect the health, safety and welfare of their employees and to conduct their business in a way that does not expose others to risks to their health and safety. Employees and self-employed people also have duties under the Act. Modern health-and-safety legislation focuses on assessing and controlling risk rather than prescribing speci?c actions in di?erent industrial settings. Various regulations made under the HSW Act, such as the Control of Substances Hazardous to Health Regulations, the Manual Handling Operations Regulations and the Noise at Work Regulations, set out duties with regard to di?erent risks, but apply to all employers and follow the general principles of risk assessment and control. Risks should be controlled principally by removing or reducing the hazard at source (for example, by substituting chemicals with safer alternatives, replacing noisy machinery, or automating tasks to avoid heavy lifting). Personal protective equipment, such as gloves and ear defenders, should be seen as a last line of defence after other control measures have been put in place.
The employment provisions of the DDA require employers to avoid discriminatory practice towards disabled people and to make reasonable adjustments to working arrangements where a disabled person is placed at a substantial disadvantage to a non-disabled person. Although the DDA does not require employers to provide access to rehabilitation services – even for those injured or made ill at work – occupational-health practitioners may become involved in programmes to help people get back to work after injury or long-term illness, and many businesses see the retention of valuable sta? as an attractive alternative to medical retirement or dismissal on health grounds.
Although a major part of occupational-health practice is concerned with statutory compliance, the workplace is also an important venue for health promotion. Many working people rarely see their general practitioner and, even when they do, there is little time to discuss wider health issues. Occupational-health advisers can ?ll in this gap by providing, for example, workplace initiatives on stopping smoking, cardiovascular health, diet and self-examination for breast and testicular cancers. Such initiatives are encouraged because of the perceived bene?ts to sta?, to the employing organisation and to the wider public-health agenda. Occupational psychologists recognise the need for the working population to achieve a ‘work-life balance’ and the promotion of this is an increasing part of occupational health strategies.
The law requires employers to consult with their sta? on health-and-safety matters. However, there is also a growing understanding that successful occupational-health management involves workers directly in the identi?cation of risks and in developing solutions in the workplace. Trade unions play an active role in promoting occupational health through local and national campaigns and by training and advising elected workplace safety representatives.
Occupational medicine The branch of medicine that deals with the control, prevention, diagnosis, treatment and management of ill-health and injuries caused or made worse by work, and with ensuring that workers are ?t for the work they do.
Occupational medicine includes: statutory surveillance of workers’ exposure to hazardous agents; advice to employers and employees on eliminating or reducing risks to health and safety at work; diagnosis and treatment/management of occupational illness; advice on adapting the working environment to suit the worker, particularly those with disabilities or long-term health problems; and advice on the return to work and, if necessary, rehabilitation of workers absent through illness. Occupational physicians may play a wider role in monitoring the health of workplace populations and in advising employers on controlling health hazards where ill-health trends are observed. They may also conduct epidemiological research (see EPIDEMIOLOGY) on workplace diseases.
Because of the occupational physician’s dual role as adviser to both employer and employee, he or she is required to be particularly diligent with regards to the individual worker’s medical CONFIDENTIALITY. Occupational physicians need to recognise in any given situation the context they are working in, and to make sure that all parties are aware of this.
Occupational medicine is a medical discipline and thus is only part of the broader ?eld of occupational health. Although there are some speci?c clinical duties associated with occupational medicine, such as diagnosis of occupational disease and medical screening, occupational physicians are frequently part of a multidisciplinary team that might include, for example, occupational-health nurses, healthand-safety advisers, ergonomists, counsellors and hygienists. Occupational physicians are medical practitioners with a post-registration quali?cation in occupational medicine. They will have completed a period of supervised in-post training. In the UK, the Faculty of Occupational Medicine of the Royal College of Physicians has three categories of membership, depending on quali?cations and experience: associateship (AFOM); membership (MFOM); and fellowship (FFOM).
Occupational diseases Occupational diseases are illnesses that are caused or made worse by work. In their widest sense, they include physical and mental ill-health conditions.
In diagnosing an occupational disease, the clinician will need to examine not just the signs and symptoms of ill-health, but also the occupational history of the patient. This is important not only in discovering the cause, or causes, of the disease (work may be one of a number of factors), but also in making recommendations on how the work should be modi?ed to prevent a recurrence – or, if necessary, in deciding whether or not the worker is able to return to that type of work. The occupational history will help in deciding whether or not other workers are also at risk of developing the condition. It will include information on:
the nature of the work.
how the tasks are performed in practice.
the likelihood of exposure to hazardous agents (physical, chemical, biological and psychosocial).
what control measures are in place and the extent to which these are adhered to.
previous occupational and non-occupational exposures.
whether or not others have reported similar symptoms in relation to the work. Some conditions – certain skin conditions,
for example – may show a close relationship to work, with symptoms appearing directly only after exposure to particular agents or possibly disappearing at weekends or with time away from work. Others, however, may be chronic and can have serious long-term implications for a person’s future health and employment.
Statistical information on the prevalence of occupational disease in the UK comes from a variety of sources, including o?cial ?gures from the Industrial Injuries Scheme (see below) and statutory reporting of occupational disease (also below). Neither of these o?cial schemes provides a representative picture, because the former is restricted to certain prescribed conditions and occupations, and the latter suffers from gross under-reporting. More useful are data from the various schemes that make up the Occupational Diseases Intelligence Network (ODIN) and from the Labour Force Survey (LFS). ODIN data is generated by the systematic reporting of work-related conditions by clinicians and includes several schemes. Under one scheme, more than 80 per cent of all reported diseases by occupational-health physicians fall into just six of the 42 clinical disease categories: upper-limb disorders; anxiety, depression and stress disorders; contact DERMATITIS; lower-back problems; hearing loss (see DEAFNESS); and ASTHMA. Information from the LFS yields a similar pattern in terms of disease frequency. Its most recent survey found that over 2 million people believed that, in the previous 12 months, they had suffered from an illness caused or made worse by work and that
19.5 million working days were lost as a result. The ten most frequently reported disease categories were:
stress and mental ill-health (see MENTAL ILLNESS): 515,000 cases.
back injuries: 508,000.
upper-limb and neck disorders: 375,000.
lower respiratory disease: 202,000.
deafness, TINNITUS or other ear conditions: 170,000.
lower-limb musculoskeletal conditions: 100,000.
skin disease: 66,000.
headache or ‘eyestrain’: 50,000.
traumatic injury (includes wounds and fractures from violent attacks at work): 34,000.
vibration white ?nger (hand-arm vibration syndrome): 36,000. A person who develops a chronic occu
pational disease may be able to sue his or her employer for damages if it can be shown that the employer was negligent in failing to take reasonable care of its employees, or had failed to provide a system of work that would have prevented harmful exposure to a known health hazard. There have been numerous successful claims (either awarded in court, or settled out of court) for damages for back and other musculoskeletal injuries, hand-arm vibration syndrome, noise-induced deafness, asthma, dermatitis, MESOTHELIOMA and ASBESTOSIS. Employers’ liability (workers’ compensation) insurers are predicting that the biggest future rise in damages claims will be for stress-related illness. In a recent study, funded by the Health and Safety Executive, about 20 per cent of all workers – more than 5 million people in the UK – claimed to be ‘very’ or ‘extremely’ stressed at work – a statistic that is likely to have a major impact on the long-term health of the working population.
While victims of occupational disease have the right to sue their employers for damages, many countries also operate a system of no-fault compensation for the victims of prescribed occupational diseases. In the UK, more than 60 diseases are prescribed under the Industrial Injuries Scheme and a person will automatically be entitled to state compensation for disability connected to one of these conditions, provided that he or she works in one of the occupations for which they are prescribed. The following short list gives an indication of the types of diseases and occupations prescribed under the scheme:
CARPAL TUNNEL SYNDROME connected to the use of hand-held vibrating tools.
hearing loss from (amongst others) use of pneumatic percussive tools and chainsaws, working in the vicinity of textile manufacturing or woodworking machines, and work in ships’ engine rooms.
LEPTOSPIROSIS – infection with Leptospira (various listed occupations).
viral HEPATITIS from contact with human blood, blood products or other sources of viral hepatitis.
LEAD POISONING, from any occupation causing exposure to fumes, dust and vapour from lead or lead products.
asthma caused by exposure to, among other listed substances, isocyanates, curing agents, solder ?ux fumes and insects reared for research.
mesothelioma from exposure to asbestos.
In the UK, employers and the self-employed have a duty to report all occupational injuries (if the employee is o? work for three days or more as a result), diseases or dangerous incidents to the relevant enforcing authority (the Health and Safety Executive or local-authority environmental-health department) under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 1995 (RIDDOR). Despite this statutory duty, comparatively few diseases are reported so that ?gures generated from RIDDOR reports do not give a useful indication of the scale of occupational diseases in the UK. The statutory reporting of injuries is much better, presumably because of the clear and acute relationship between a workplace accident and the resultant injury. More than 160,000 injuries are reported under RIDDOR every year compared with just 2,500 or so occupational diseases, a gross underestimate of the true ?gure.
There are no precise ?gures for the number of people who die prematurely because of work-related ill-health, and it would be impossible to gauge the exact contribution that work has on, for example, cardiovascular disease and cancers where the causes are multifactorial. The toll would, however, dwarf the number of deaths caused by accidents at work. Around 250 people are killed by accidents at work in the UK each year – mesothelioma, from exposure to asbestos at work, alone kills more than 1,300 people annually.
The following is a sample list of occupational diseases, with brief descriptions of their aetiologies.
Inhaled materials
PNEUMOCONIOSIS covers a group of diseases which cause ?brotic lung disease following the inhalation of dust. Around 250–300 new cases receive bene?t each year – mostly due to coal dust with or without silica contamination. SILICOSIS is the more severe disease. The contraction in the size of the coal-mining industry as well as improved dust suppression in the mines have diminished the importance of this disease, whereas asbestos-related diseases now exceed 1,000 per year. Asbestos ?bres cause a restrictive lung disease but also are responsible for certain malignant conditions such as pleural and peritoneal mesothelioma and lung cancer. The lung-cancer risk is exacerbated by cigarette-smoking.
Even though the use of asbestos is virtually banned in the UK, many workers remain at risk of exposure because of the vast quantities present in buildings (much of which is not listed in building plans). Carpenters, electricians, plumbers, builders and demolition workers are all liable to exposure from work that disturbs existing asbestos. OCCUPATIONAL ASTHMA is of increasing importance – not only because of the recognition of new allergic agents (see ALLERGY), but also in the number of reported cases. The following eight substances are most frequently linked to occupational asthma (key occupations in brackets): isocyanates (spray painters, electrical processors); ?our and grain (bakers and farmers); wood dust (wood workers); glutaraldehyde (nurses, darkroom technicians); solder/colophony (welders, electronic assembly workers); laboratory animals (technicians, scientists); resins and glues (metal and electrical workers, construction, chemical processors); and latex (nurses, auxiliaries, laboratory technicians).
The disease develops after a short, symptomless period of exposure; symptoms are temporally related to work exposures and relieved by absences from work. Removal of the worker from exposure does not necessarily lead to complete cessation of symptoms. For many agents, there is no relationship with a previous history of ATOPY. Occupational asthma accounts for about 10 per cent of all asthma cases. DERMATITIS The risk of dermatitis caused by an allergic or irritant reaction to substances used or handled at work is present in a wide variety of jobs. About three-quarters of cases are irritant contact dermatitis due to such agents as acids, alkalis and solvents. Allergic contact dermatitis is a more speci?c response by susceptible individuals to a range of allergens (see ALLERGEN). The main occupational contact allergens include chromates, nickel, epoxy resins, rubber additives, germicidal agents, dyes, topical anaesthetics and antibiotics as well as certain plants and woods. Latex gloves are a particular cause of occupational dermatitis among health-care and laboratory sta? and have resulted in many workers being forced to leave their profession through ill-health. (See also SKIN, DISEASES OF.)
Musculoskeletal disorders Musculoskeletal injuries are by far the most common conditions related to work (see LFS ?gures, above) and the biggest cause of disability. Although not all work-related, musculoskeletal disorders account for 36.5 per cent of all disabilities among working-age people (compared with less than 4 per cent for sight and hearing impairment). Back pain (all causes – see BACKACHE) has been estimated to cause more than 50 million days lost every year in sickness absence and costs the UK economy up to £5 billion annually as a result of incapacity or disability. Back pain is a particular problem in the health-care sector because of the risk of injury from lifting and moving patients. While the emphasis should be on preventing injuries from occurring, it is now well established that the best way to manage most lower-back injuries is to encourage the patient to continue as normally as possible and to remain at work, or to return as soon as possible even if the patient has some residual back pain. Those who remain o? work on long-term sick leave are far less likely ever to return to work.
Aside from back injuries, there are a whole range of conditions affecting the upper limbs, neck and lower limbs. Some have clear aetiologies and clinical signs, while others are less well de?ned and have multiple causation. Some conditions, such as carpal tunnel syndrome, are prescribed diseases in certain occupations; however, they are not always caused by work (pregnant and older women are more likely to report carpal tunnel syndrome irrespective of work) and clinicians need to be careful when assigning work as the cause without ?rst considering the evidence. Other conditions may be revealed or made worse by work – such as OSTEOARTHRITIS in the hand. Much attention has focused on injuries caused by repeated movement, excessive force, and awkward postures and these include tenosynovitis (in?ammation of a tendon) and epicondylitis. The greatest controversy surrounds upper-limb disorders that do not present obvious tissue or nerve damage but nevertheless give signi?cant pain and discomfort to the individual. These are sometimes referred to as ‘repetitive strain injury’ or ‘di?use RSI’. The diagnosis of such conditions is controversial, making it di?cult for sufferers to pursue claims for compensation through the courts. Psychosocial factors, such as high demands of the job, lack of control and poor social support at work, have been implicated in the development of many upper-limb disorders, and in prevention and management it is important to deal with the psychological as well as the physical risk factors. Occupations known to be at particular risk of work-related upper-limb disorders include poultry processors, packers, electronic assembly workers, data processors, supermarket check-out operators and telephonists. These jobs often contain a number of the relevant exposures of dynamic load, static load, a full or excessive range of movements and awkward postures. (See UPPER LIMB DISORDERS.)
Physical agents A number of physical agents cause occupational ill-health of which the most important is occupational deafness. Workplace noise exposures in excess of 85 decibels for a working day are likely to cause damage to hearing which is initially restricted to the vital frequencies associated with speech – around 3–4 kHz. Protection from such noise is imperative as hearing aids do nothing to ameliorate the neural damage once it has occurred.
Hand-arm vibration syndrome is a disorder of the vascular and/or neural endings in the hands leading to episodic blanching (‘white ?nger’) and numbness which is exacerbated by low temperature. The condition, which is caused by vibrating tools such as chain saws and pneumatic hammers, is akin to RAYNAUD’S DISEASE and can be disabling.
Decompression sickness is caused by a rapid change in ambient pressure and is a disease associated with deep-sea divers, tunnel workers and high-?ying aviators. Apart from the direct effects of pressure change such as ruptured tympanic membrane or sinus pain, the more serious damage is indirectly due to nitrogen bubbles appearing in the blood and blocking small vessels. Central and peripheral nervous-system damage and bone necrosis are the most dangerous sequelae.
Radiation Non-ionising radiation from lasers or microwaves can cause severe localised heating leading to tissue damage of which cataracts (see under EYE, DISORDERS OF) are a particular variety. Ionising radiation from radioactive sources can cause similar acute tissue damage to the eyes as well as cell damage to rapidly dividing cells in the gut and bone marrow. Longer-term effects include genetic damage and various malignant disorders of which LEUKAEMIA and aplastic ANAEMIA are notable. Particular radioactive isotopes may destroy or induce malignant change in target organs, for example, 131I (thyroid), 90Sr (bone). Outdoor workers may also be at risk of sunburn and skin cancers. OTHER OCCUPATIONAL CANCERS Occupation is directly responsible for about 5 per cent of all cancers and contributes to a further 5 per cent. Apart from the cancers caused by asbestos and ionising radiation, a number of other occupational exposures can cause human cancer. The International Agency for Research on Cancer regularly reviews the evidence for carcinogenicity of compounds and industrial processes, and its published list of carcinogens is widely accepted as the current state of knowledge. More than 50 agents and processes are listed as class 1 carcinogens. Important occupational carcinogens include asbestos (mesothelioma, lung cancer); polynuclear aromatic hydrocarbons such as mineral oils, soots, tars (skin and lung cancer); the aromatic amines in dyestu?s (bladder cancer); certain hexavalent chromates, arsenic and nickel re?ning (lung cancer); wood and leather dust (nasal sinus cancer); benzene (leukaemia); and vinyl chloride monomer (angiosarcoma of the liver). It has been estimated that elimination of all known occupational carcinogens, if possible, would lead to an annual saving of 5,000 premature deaths in Britain.
Infections Two broad categories of job carry an occupational risk. These are workers in contact with animals (farmers, veterinary surgeons and slaughtermen) and those in contact with human sources of infection (health-care sta? and sewage workers).
Occupational infections include various zoonoses (pathogens transmissible from animals to humans), such as ANTHRAX, Borrelia burgdorferi (LYME DISEASE), bovine TUBERCULOSIS, BRUCELLOSIS, Chlamydia psittaci, leptospirosis, ORF virus, Q fever, RINGWORM and Streptococcus suis. Human pathogens that may be transmissible at work include tuberculosis, and blood-borne pathogens such as viral hepatitis (B and C) and HIV (see AIDS/HIV). Health-care workers at risk of exposure to infected blood and body ?uids should be immunised against hapatitis B.
Poisoning The incidence of occupational poisonings has diminished with the substitution of noxious chemicals with safer alternatives, and with the advent of improved containment. However, poisonings owing to accidents at work are still reported, sometimes with fatal consequences. Workers involved in the application of pesticides are particularly at risk if safe procedures are not followed or if equipment is faulty. Exposure to organophosphate pesticides, for example, can lead to breathing diffculties, vomiting, diarrhoea and abdominal cramps, and to other neurological effects including confusion and dizziness. Severe poisonings can lead to death. Exposure can be through ingestion, inhalation and dermal (skin) contact.
Stress and mental health Stress is an adverse reaction to excessive pressures or demands and, in occupational-health terms, is di?erent from the motivational impact often associated with challenging work (some refer to this as ‘positive stress’). Stress at work is often linked to increasing demands on workers, although coping can often prevent the development of stress. The causes of occupational stress are multivariate and encompass job characteristics (e.g. long or unsocial working hours, high work demands, imbalance between e?ort and reward, poorly managed organisational change, lack of control over work, poor social support at work, fear of redundancy and bullying), as well as individual factors (such as personality type, personal circumstances, coping strategies, and availability of psychosocial support outside work). Stress may in?uence behaviours such as smoking, alcohol consumption, sleep and diet, which may in turn affect people’s health. Stress may also have direct effects on the immune system (see IMMUNITY) and lead to a decline in health. Stress may also alter the course and response to treatment of conditions such as cardiovascular disease. As well as these general effects of stress, speci?c types of disorder may be observed.
Exposure to extremely traumatic incidents at work – such as dealing with a major accident involving multiple loss of life and serious injury
(e.g. paramedics at the scene of an explosion or rail crash) – may result in a chronic condition known as post-traumatic stress disorder (PTSD). PTSD is an abnormal psychological reaction to a traumatic event and is characterised by extreme psychological discomfort, such as anxiety or panic when reminded of the causative event; sufferers may be plagued with uncontrollable memories and can feel as if they are going through the trauma again. PTSD is a clinically de?ned condition in terms of its symptoms and causes and should not be used to include normal short-term reactions to trauma.... occupational health, medicine and diseases
Symptoms. A small lump comes to light while washing, a discharge from the nipple, change in nipple size and colour, irregular contour of the breast surface. Though tissue change is likely to be a cyst, speedy diagnosis and treatment are necessary. Some hospital physicians and surgeons are known to view favourably supportive herbal aids, and do not always think in terms of radical mastectomy. Dr Finlay Ellingwood, Chicago physician (1916) cured a case by injection of one dram Echinacea root extract twice a week into the surrounding tissues.
The condition is believed to be due to a number of causes including suppression of ovulation and oestrogen secretion in pregnant and lactating women. A high fat diet is suspected of interference with the production of oestrogen. Some women are constitutionally disposed to the condition which may be triggered by trauma or emotional shock. Increase in incidence in older women has been linked with excessive sugar consumption. “Consumption overwhelms the pancreas which has to ‘push it out’ to all parts of the body (when broken down by the digestive process) whether they need it or not. The vital organs are rationed according to their requirements of nutrients from the diet. What is left over has to ‘go into store elsewhere’. And the breast is forced to take its share and store it. If it gets too much, for too long, it may rebel!” (Stephen Seely, Department of Bacteriology and Virology, Manchester)
“Women who nurse their babies less than one month are at an increased risk for breast cancer. The longer a woman breast-feeds – no matter what her age – the more the risk decreases. (Marion Tompson, co-founder, The La Leche League, in the American Journal of Epidemiology)
Lactation reduces the risk of pre-menopausal breast cancer. (Newcomb P.A. et al New England Journal of Medicine, 330 1994)
There is currently no treatment to cure metastatic breast cancer. In spite of chemotherapy, surgery and radiotherapy survival rate has not diminished. Herbs not only have a palliative effect but, through their action on hormone function offer a positive contribution towards overcoming the condition. Their activity has been widely recorded in medical literature. Unlike cytotoxic drugs, few have been known to cause alopecia, nausea, vomiting or inflammation of the stomach.
Treatment by a general medical practitioner or oncologist.
Special investigations. Low radiation X-ray mammography to confirm diagnosis. Test for detection of oestrogen receptor protein.
Treatment. Surgery may be necessary. Some patients may opt out from strong personal conviction, choosing a rigid self-disciplined approach – the Gentle Way. Every effort is made to build up the body’s natural defences (immune system).
An older generation of herbalists believed tissue change could follow a bruise on the breast, which should not be neglected but immediately painted with Tincture Arnica or Tincture Bellis perennis.
Vincristine, an alkaloid from Vinca rosea (Catharanthus roseus) is used by the medical profession as an anti-neoplastic and anti-mitotic agent to inhibit cell division.
Of possible therapeutic value. Blue Flag root, Burdock root, Chaparral, Clivers, Comfrey root, Echinacea, Figwort, Gotu Kola, Marshmallow root, Mistletoe, Myrrh, Prickly Ash bark, Red Clover, Thuja, Wild Violet, Yellow Dock.
Tea. Equal parts: Red Clover, Clivers, Gotu Kola, Wild Violet. 1 heaped teaspoon to each cup boiling water; infuse 5-15 minutes. 3 or more cups daily.
Decoctions. Echinacea, Blue Flag root, Queen’s Delight, Yellow Dock.
Tablets/capsules. Blue Flag root, Echinacea, Poke root, Mistletoe.
Formula. Echinacea 2; Gotu Kola 1; Poke root 1; Mistletoe 1; Vinca rosea 1. Mix. Dose: Powders: 500mg (two 00 capsules or one-third teaspoon). Liquid extracts: 1 teaspoon. Tinctures: 2 teaspoons. Thrice daily and at bedtime. According to progress of the disease, increase dosage as tolerated.
Maria Treben’s tea. Parts: Marigold (3), Yarrow 1; Nettles 1. Mix. 2 teaspoons to each cup boiling water. 1 cup as many times daily as tolerated.
William Boericke, M.D. recommends Houseleek. E.H. Ruddock M.D. favours Figwort.
Topical. Treatments believed to be of therapeutic value or for use as a soothing application.
(1) Cold poultice: Comfrey root.
(2) Poultice of fresh Marshmallow root pulped in juicer.
(3) Injection of Extract Greater Celandine (Chelidonium), locally, gained a reputation in the Eclectic school.
(4) The action of Blood root (Sanguinaria) is well known as a paint or injection.
(5) Ragwort poultice: 2oz Ragwort boiled in half a pint potato water for 15 minutes. See: POULTICE.
(6) Popular Russian traditional remedy: Badiaga (Spongilla fluviatilis), fresh water sponge gathered in the autumn; dried plant rubbed to a powder. Poultice.
(7) Maria Treben’s Poultice: Carefully washed fresh Plantain leaves, pulped, and applied direct to the lesion.
(8) If lymph glands are affected, apply Plantain poultice to glands.
(9) Dr Brandini’s treatment. Dr Brandini, Florence, used 4 grains Citric Acid (prepared from lemons) in 1oz (30ml) water for ulcerated cancer of the breast considered incurable. “The woman’s torments were so distressing that neither she nor other patients could get any rest. Applying lint soaked in the solution, relief was instantaneous. Repeated, it was successful.”
(10) Circuta leaves. Simmered till soft and mixed with Slippery Elm bark powder as a poultice morning and night.
(11) Decoction. Simmer gently Yellow Dock roots, fine cut or powdered, 1oz to 1 pint, 20 minutes. Saturate lint or suitable material and apply.
(12) Yellow Dock ointment. Half ounce Lobelia seed, half ounce Yellow Dock root powder. Baste into an ointment base. See: OINTMENT BASE.
(13) Infusion, for use as a wash. Equal parts: Horsetail, Red Clover, Raspberry leaves. 1oz to 1 pint boiling water infuse 15 minutes.
(14) Dr Christopher’s Ointment. Half an ounce White Oak, half an ounce Garden Sage, half an ounce Tormentil, half an ounce Horsetail, half an ounce Lemon Balm. Method: Boil gently half an hour in quart water, strain. Reduce to half a pint by simmering. Add half a pound honey. Bring to boil. Skim off scum. Allow cool. Apply: twice daily on sores.
(15) Dr Finlay Ellingwood. Poke root juice. “Fresh juice from the stems, leaves and roots applied directly to diseased tissue. Exercises a selective action; induces liquefaction and promotes removal, sometimes healing the open wound and encouraging scar formation. Masses of such tissue have been known to be destroyed in a few weeks with only a scar, with no other application but the fresh juice. Produces pain at first, but is otherwise harmless.”
(16) Lesion painted with Mandrake resin. (American Podophyllum)
(17) Dust affected parts with Comfrey powder. Mucilage from Comfrey powder or crushed root with the aid of a little milk. See: COMFREY.
(18) Dr Samuel Thomson’s Cancer Plaster. “Take heads of Red Clover and fill a kettle. Boil in water for one hour. Remove and fill kettle with fresh flower heads. Boil as before in the same liquor. Strain and press heads to express all the liquor. Simmer over a low fire till of the consistency of tar. It must not burn. Spread over a piece of suitable material.”
(19) Wipe affected area with cut Houseleek. (Dr Wm Boericke)
(20) Chinese Herbalism. Take 1-2 Liang pulverised liao-ko-wang (Wickstroemia indica), mix with cold boiled water or rice wine for local compress. Also good for mastitis.
(21) Italian women once used an old traditional remedy – Fenugreek tea.
(22) A clinical trial of Vitamin D provided encouraging results. Patients with locally advanced breast cancer were given a highly active Vitamin D analogue cream to rub on their tumours. “It was effective in one third of the tumours,” said Professor Charles Coombes, clinical oncologist, Charing Cross Hospital, London.
Diet. “A diet rich in cereal products (high in dietary fibre) and green leafy vegetables (antioxidants) would appear to offer women some protection against breast cancer due to the relation between fibre and oestrogen metabolism. Meat-free diet. In a study of 75 adolescent girls, vegetarians were found to have higher levels of a hormone that women suffering from breast cancer often lack. (Cancer Research) Supplements. Daily. Chromium. Selenium (600mcg). Zinc chelate (100mg morning and evening). Beta carotene. “Low levels of Selenium and Vitamins A and E are shown in breast cancer cases.” (British Journal of Cancer 49: 321-324, 1984).
Vitamins A and D inhibit virus penetration in healthy cell walls. Multivitamin combinations should not include Vitamin B12, production of which in the body is much increased in cancerous conditions. Vitamins B-complex and C especially required.
Note: A link between sugar consumption and breast cancer has been reported by some authorities who suggest that countries at the top of the mortality table are the highest also in sugar consumption; the operative factor believed to be insulin.
Screening. Breast screening should be annual from the age of forty.
General. Mothers are encouraged to breast-feed children for the protection it offers against mammary malignancy. (Am.J. Obstet. Gyn. 15/9/1984. 150.)
Avoidance of stress situations by singing, playing an instrument. Adopt relaxation techniques, spiritual healing and purposeful meditation to arouse the immune system; intensive visualisation. Avoid the carcinogens: smoking, alcohol.
Information. Breast Cancer Care. Free Help Line. UK Telephone: 0500 245345. ... cancer - breast
Nutritional Profile Energy value (calories per serving): Low Protein: High Fat: Low Saturated fat: Low Cholesterol: None Carbohydrates: High Fiber: High Sodium: Low Major vitamin contribution: B vitamins, vitamin C Major mineral contribution: Potassium
About the Nutrients in This Food Cauliflower is an excellent source of vitamin C and a moderately good source of folate, a member of the B vitamin family. One-half cup cooked fresh cauliflower florets (the top of the plant) has one gram dietary fiber, 13.5 mcg folate (3 percent of the R DA), and 35 mg vitamin C (50 percent of the R DA for a woman, 39 percent of the R DA for a man).
The Most Nutritious Way to Serve This Food Raw or lightly steamed to protect the vitamin C. Cooked or frozen cauli-flower may have up to 50 percent less vitamin C than raw cauliflower.
Diets That May Restrict or Exclude This Food Antiflatulence diet Low-fiber diet
Buying This Food Look for: Creamy white heads with tight, compact florets and fresh green leaves. The size of the cauliflower has no bearing on its nutritional value or its taste. Avoid: Cauliflower with brown spots or patches.
Storing This Food Keep cauliflower in a cool, humid place to safeguard its vitamin C content.
Preparing This Food Pull off and discard any green leaves still attached to the cauliflower and slice off the woody stem and core. Then plunge the cauliflower, head down, into a bowl of salted ice water to flush out any insects hiding in the head. To keep the cauliflower crisp when cooked, add a teaspoon of vinegar to the water. You can steam or bake the cauliflower head whole or break it up into florets for faster cooking.
What Happens When You Cook This Food Cauliflower contains mustard oils (isothiocyanates), natural chemicals that give the vegeta- ble its taste but break down into a variety of smelly sulfur compounds (including hydrogen sulfide and ammonia) when the cauliflower is heated. The longer you cook the cauliflower, the better it will taste but the worse it will smell. Adding a slice of bread to the cooking water may lessen the odor; keeping a lid on the pot will stop the smelly molecules from floating off into the air. Cooking cauliflower in an aluminum pot will intensif y its odor and turn its creamy white anthoxanthin pigments yellow; iron pots will turn anthoxanthins blue green or brown. Like red and blue anthocyanin pigments (see beets, black ber r ies, blueber r ies), antho- xanthins hold their color best in acids. To keep cauliflower white, add a tablespoon of lemon juice, lime juice, vinegar, or milk to the cooking water. Steaming or stir-frying cauliflower preserves the vitamin C that would be lost if the vegetable were cooked for a long time or in a lot of water.
How Other Kinds of Processing Affect This Food Freezing. Before it is frozen, cauliflower must be blanched to inactivate catalase and per- oxidase, enzymes that would otherwise continue to ripen and eventually deteriorate the vegetable. According to researchers at Cornell University, cauliflower will lose less vitamin C if it is blanched in very little water (two cups cauliflower in two tbsp. water) in a microwave- safe plastic bag in a microwave oven for four minutes at 600 –700 watts. Leave the bag open an inch at the top so steam can escape and the bag does not explode.
Medical Uses and/or Benefits Protection against certain cancers. Naturally occurring chemicals (indoles, isothiocyanates, glucosinolates, dithiolethiones, and phenols) in cauliflower, Brussels sprouts, broccoli, cab- bage, and other cruciferous vegetables appear to reduce the risk of some cancers, perhaps by preventing the formation of carcinogens in your body or by blocking cancer-causing substances from reaching or reacting with sensitive body tissues or by inhibiting the trans- formation of healthy cells to malignant ones. All cruciferous vegetables contain sulforaphane, a member of a family of chemicals known as isothiocyanates. In experiments with laboratory rats, sulforaphane appears to increase the body’s production of phase-2 enzymes, naturally occurring substances that inacti- vate and help eliminate carcinogens. At the Johns Hopkins University in Baltimore, Maryland, 69 percent of the rats injected with a chemical known to cause mammary cancer developed tumors vs. only 26 percent of the rats given the carcinogenic chemical plus sulforaphane. In 1997, Johns Hopkins researchers discovered that broccoli seeds and three-day-old broccoli sprouts contain a compound converted to sulforaphane when the seed and sprout cells are crushed. Five grams of three-day-old broccoli sprouts contain as much sulforaphane as 150 grams of mature broccoli. The sulforaphane levels in other cruciferous vegetables have not yet been calculated. Vision protection. In 2004, the Johns Hopkins researchers updated their findings on sul- foraphane to suggest that it may also protect cells in the eyes from damage due to UV (ultraviolet) light, thus reducing the risk of macular degeneration, the most common cause of age-related vision loss.
Adverse Effects Associated with This Food Enlarged thyroid gland (goiter). Cruciferous vegetables, including cauliflower, contain goi- trin, thiocyanate, and isothiocyanate. These chemicals, known collectively as goitrogens, inhibit the formation of thyroid hormones and cause the thyroid to enlarge in an attempt to produce more. Goitrogens are not hazardous for healthy people who eat moderate amounts of cruciferous vegetables, but they may pose problems for people who have a thyroid condi- tion or are taking thyroid medication. Intestinal gas. Bacteria that live naturally in the gut degrade the indigestible carbohydrates (food fiber) in cauliflower, producing intestinal gas that some people find distressing.
Food/Drug Interactions Anticoagulants (blood thinners). All cruciferous vegetables (broccoli, brussels sprouts, cab- bages, cauliflower, greens, radishes, and turnips) are high in vitamin K, a nutrient that decreases the anticoagulant effect of medicine such as warfarin (Coumadin). Multiple serv- ings of this vegetable, i.e., several days a week, may interfere with the anticoagulant effect of the drug. False-positive test for occult blood in the stool. The active ingredient in the guaiac slide test for hid- den blood in feces is alphaguaiaconic acid, a chemical that turns blue in the presence of blood. Cauliflower contains peroxidase, a natural chemical that also turns alphaguaiaconic acid blue and may produce a positive test in people who do not actually have blood in the stool.... cauliflower
Abnormalities of oncogenes are known to be a factor in the development of cancerous cells.
Mutations in oncogenes, resulting from damage by carcinogens, can cause a cell to grow unrestrainedly and infiltrate and destroy normal tissues (see cancer).
Factors known to cause cancer include ultraviolet light, radioactivity, tobacco, alcohol, asbestos, some chemicals, and certain viruses.... oncogenes
Nutritional Profile Energy value (calories per serving): Low Protein: Moderate Fat: Low Saturated fat: Low Cholesterol: None Carbohydrates: High Fiber: Moderate Sodium: High Major vitamin contribution: Folate Major mineral contribution: Potassium, phosphorus
About the Nutrients in This Food Celery has moderate amounts of dietary fiber and small amounts of the B vitamin folate. One-half cup diced raw celery has one gram dietary fiber and 17 mcg folate (4 percent of the R DA).
The Most Nutritious Way to Serve This Food Fresh, filled with cheese to add protein.
Diets That May Restrict or Exclude This Food Low-fiber diet Low-sodium diet
Buying This Food Look for: Crisp, medium-size pale green celery with fresh leaves. Darker stalks have more vitamin A but are likely to be stringy. Avoid: Wilted or yellowed stalks. Wilted stalks have lost moisture and are low in vitamins A and C. Yellowed stalks are no longer fresh; their chlorophyll pigments have faded enough to let the yellow carotenes show through. Avoid bruised or rotten celery. Celery cells contain chemicals called furocoumarins (pso- ralens) that may turn carcinogenic when the cell membranes are damaged and the furocou- marins are exposed to light. Bruised or rotting celery may contain up to a hundred times the psoralens in fresh celery.
Storing This Food Handle celery carefully to avoid damaging the stalks and releasing furocoumarins. Refrigerate celery in plastic bags or in the vegetable crisper to keep them moist and crisp. They will stay fresh for about a week.
Preparing This Food R inse celery under cold running water to remove all sand and dirt. Cut off the leaves, blanch them, dry them thoroughly, and rub them through a sieve or food mill. The dry powder can be used to season salt or frozen for later use in soups or stews.
What Happens When You Cook This Food When you cook celery the green flesh will soften as the pectin inside its cells dissolves in water, but the virtually indestructible cellulose and lignin “strings” on the ribs will stay stiff. If you don’t like the strings, pull them off before you cook the celery. Cooking also changes the color of celery. Chlorophyll, the pigment that makes green vegetables green, is very sensitive to acids. When you heat celery, the chlorophyll in its stalks reacts chemically with acids in the celery or in the cooking water to form pheophytin, which is brown. The pheophytin will turn the celery olive-drab or, if the stalks have a lot of yellow carotene, bronze. You can prevent this natural chemical reaction and keep the celery green by cooking it so quickly that there is no time for the chlorophyll to react with the acids, or by cooking it in lots of water (which will dilute the acids), or by cooking it with the lid off the pot so that the volatile acids can float off into the air.
Adverse Effects Associated with This Food Contact dermatitis. Celery contains limonene, an essential oil known to cause contact der- matitis in sensitive individuals. (Limonene is also found in dill, caraway seeds, and the peel of lemon and limes.) Photosensitivity. The furocoumarins (psoralens) released by damaged or moldy celery are photosensitizers as well as potential mutagens and carcinogens. Constant contact with these chemicals can make skin very sensitive to light, a problem most common among food work- ers who handle large amounts of celery without wearing gloves. Nitrate/nitrite poisoning. Like beets, eggplant, lettuce, radish, spinach, and collard and turnip greens, celery contains nitrates that convert naturally into nitrites in your stomach and then react with the amino acids in proteins to form nitrosamines. Although some nitro- samines are known or suspected carcinogens, this natural chemical conversion presents no known problems for a healthy adult. However, when these nitrate-rich vegetables are cooked and left to stand at room temperature, bacterial enzyme action (and perhaps some enzymes in the plants) convert the nitrates to nitrites at a much faster rate than normal. These higher-nitrite foods may be hazardous for infants; several cases of “spinach poison- ing” have been reported among children who ate cooked spinach that had been left standing at room temperature.... celery
Habitat: West Bengal, eastern Assam, as a weed in tea gardens; sal and other forests and waste lands. Distributed in tropical America, Africa and Asia.
Folk: Mikaaniaa.Action: Root—anti-inflammatory, hepatoprotective, adaptogenic.
Stigmasterol, beta-sitosterol and sesquiterpene dilactones, mikanolide, dihydromikanolide, deoxymikanolide and scandenolide have been isolated from the weed.The root extract exhibited anti-inflammatory activity; reduced carra- geenan-induced paw oedema in experimental rats.The methanolic extract of the root showed CNS deperssant action. It showed reduction in spontaneous motility, hypothermia, potentiation of pentobarbitone sleeping time, analgesia, suppression of aggressive behaviour and antagonism to amphetamine toxicity on experimental animals.The methanolic extract of the root exhibited adaptogenic activity against a variety of stress-induced effects in albino rats.The chemoprotective, anticarcino- genic and hepatoprotective effect of the methanolic extract of the root were also evaluated in animal studies. Chemical carcinogens were reduced in the liver of rats treated with the plant extract. The root extract induced recovery from carbon tetrachloride-induced damage to liver tissues in mice.... mikania cordataNutritional Profile Energy value (calories per serving): Low Protein: Moderate Fat: Low Saturated fat: Low Cholesterol: None Carbohydrates: High Fiber: High Sodium: Low Major vitamin contribution: Vitamin C (low) Major mineral contribution: Potassium (low)
About the Nutrients in This Food Eggplant is a high-fiber food with only minimum amounts of vitamins and minerals. One cup (100 g/3.5 ounces) boiled eggplant has 2.5 mg dietary fiber and 1.3 mg vitamin C (2 percent of the R DA for a woman, 1 percent of the R DA for a man). In 1992, food scientists at the Autonomous University of Madrid studying the chemistry of the eggplant discovered that the vegetable’s sugar content rises through the end of the sixth week of growth and then falls dramatically over the next 10 days. The same thing happens with other flavor chemicals in the vegetable and with vitamin C, so the researchers concluded that eggplants taste best and are most nutritious after 42 days of growth. NOTE : Eggplants are members of the nightshade family, Solanacea. Other members of this family are potatoes, tomatoes, and red and green peppers. These plants produce natural neurotoxins (nerve poisons) called glycoalkaloids. It is estimated that an adult would have to eat 4.5 pounds of eggplant at one sitting to get a toxic amount of solanine, the glycoalkaloid in eggplant.
The Most Nutritious Way to Serve This Food The eggplant’s two culinary virtues are its meaty texture and its ability to assume the flavor of sauces in which it is cooked. As a result, it is often used as a vegetarian, no-cholesterol substitute for veal or chicken in Italian cuisine, specifically dishes ala parmigiana and spaghetti sauces. However, in cooking, the egg- plant absorbs very large amounts of oil. To keep eggplant parmigiana low in fat, use non-fat cheese and ration the olive oil.
Buying This Food Look for: Firm, purple to purple-black or umblemished white eggplants that are heavy for their size. Avoid: Withered, soft, bruised, or damaged eggplants. Withered eggplants will be bitter; damaged ones will be dark inside.
Storing This Food Handle eggplants carefully. If you bruise an eggplant, its damaged cells will release polyphe- noloxidase, an enzyme that hastens the oxidation of phenols in the eggplant’s flesh, produc- ing brown compounds that darken the vegetable. Refrigerate fresh eggplant to keep it from losing moisture and wilting.
Preparing This Food Do not slice or peel an eggplant until you are ready to use it, since the polyphenoloxidase in the eggplant will begin to convert phenols to brown compounds as soon as you tear the vegetable’s cells. You can slow this chemical reaction (but not stop it completely) by soaking sliced egg- plant in ice water—which will reduce the eggplant’s already slim supply of water-soluble vita- min C and B vitamins—or by painting the slices with a solution of lemon juice or vinegar. To remove the liquid that can make a cooked eggplant taste bitter, slice the eggplant, salt the slices, pile them on a plate, and put a second plate on top to weight the slices down. Discard the liquid that results.
What Happens When You Cook This Food A fresh eggplant’s cells are full of air that escapes when you heat the vegetable. If you cook an eggplant with oil, the empty cells will soak it up. Eventually, however, the cell walls will collapse and the oil will leak out, which is why eggplant parmigiana often seems to be served in a pool of olive oil. Eggplant should never be cooked in an aluminum pot, which will discolor the eggplant. If you cook the eggplant in its skin, adding lemon juice or vinegar to the dish will turn the skin, which is colored with red anthocyanin pigments, a deeper red-purple. Red anthocyanin pigments get redder in acids and turn bluish in basic (alkaline) solutions. Cooking reduces the eggplant’s supply of water-soluble vitamins, but you can save the Bs if you serve the eggplant with its juices.
Adverse Effects Associated with This Food Nitrate/nitrite reactions. Eggplant—like beets, celery, lettuce, radish, spinach, and collard and turnip greens—contains nitrates that convert naturally into nitrites in your stomach, and then react with the amino acids in proteins to form nitrosamines. Although some nitrosamines are known or suspected carcinogens, this natural chemical conversion presents no known problems for a healthy adult. However, when these nitrate-rich vegetables are cooked and left to stand at room temperature, bacterial enzyme action (and perhaps some enzymes in the plants) convert the nitrates to nitrites at a much faster rate than normal. These higer-nitrite foods may be hazardous for infants; several cases of “spinach poisoning” have been reported among children who ate cooked spinach that had been left standing at room temperature.
Food/Drug Interactions MAO inhibitors. Monoamine oxidase (M AO) inhibitors are drugs used as antidepressants or antihypertensives. They inhibit the action of enzymes that break down tyramine, a natu- ral by-product of protein metabolism, so that it can be eliminated from the body. Tyramine is a pressor amine, a chemical that constricts blood vessels and raises blood pressure. If you eat a food rich in tyramine while you are taking an M AO inhibitor, the pressor amine can- not be eliminated from your body, and the result may be a hypertensive crisis (sustained elevated blood pressure). Eggplants contain small amounts of tyramine. False-positive urine test for carcinoid tumors. Carcinoid tumors (tumors that may arise in tis- sues of the endocrine and gastrointestinal systems) secrete serotonin, which is excreted in urine. The test for these tumors measures the level of serotonin in your urine. Eating egg- plant, which is rich in serotonin, in the 72 hours before a test for a carcinoid tumor might raise the serotonin levels in your urine high enough to cause a false-positive test result. (Other fruits and vegetables rich in serotonin are bananas, tomatoes, plums, pineapple, avo- cados, and walnuts.)... eggplant
Nutritional Profile Energy value (calories per serving): Low Protein: Moderate Fat: Low Saturated fat: Low Cholesterol: None Carbohydrates: High Fiber: High Sodium: Low Major vitamin contribution: Vitamin C Major mineral contribution: Iron, selenium
About the Nutrients in This Food Although raw garlic has some fiber and protein plus vitamins and minerals, we rarely eat enough garlic to get useful amounts of these nutrients. Source: USDA Nut rient Data Laborator y. Nat ional Nut rient Database for Standard Reference. Available online. UR L : http://w w w.nal.usda. gov/fnic/foodcomp/search /. Elephant garlic, a cross between an onion and garlic that may grow as large as a grapefruit, has a milder flavor than regular garlic. Garlic contains alliin and allicin, two sulfur compounds with antibi- otic activity. In a number of laboratory experiments, garlic juice appears to inhibit the growth of a broad variety of bacteria, yeast, and fungi growing in test tubes, but its effects on human beings have yet to be proven.
Diets That May Restrict or Exclude This Food Antiflatulence diet Bland diet
Buying This Food Look for: Firm, solid cloves with tight clinging skin. If the skin is paper y and pulling away from the cloves and the head feels light for its size, the garlic has withered or rotted away inside.
The Most Nutritious Way to Serve This Food Fresh.
Storing This Food Store garlic in a cool, dark, air y place to keep it from dr ying out or sprouting. ( When garlic sprouts, diallyl disulfide—the sulfur compound that gives fresh garlic its distinctive taste and odor—goes into the new growth and the garlic itself becomes milder.) A n unglazed ceramic “garlic keeper” will protect the garlic from moisture while allowing air to circulate freely around the head and cloves. Properly stored, garlic will keep for several months. Do not refrigerate garlic unless you live in a very hot and humid climate.
Preparing This Food To peel garlic easily, blanch the cloves in boiling water for about 30 seconds, then drain and cool. Slice off the root end, and the skin should come right off without sticking to your fin- gers. Or you can put a head of fresh, raw garlic on a flat surface and hit the flat end with the flat side of a knife. The head will come apart and the skin should come off easily. To get the most “garlicky” taste from garlic cloves, chop or mash them or extract the oil with a garlic press. When you cut into a garlic clove, you tear its cell walls, releasing an enzyme that converts sulfur compounds in the garlic into ammonia, pyruvic acid, and diallyl disulfide.
What Happens When You Cook This Food Heating garlic destroys its diallyl disulfide, which is why cooked garlic is so much milder tasting than raw garlic.
How Other Kinds of Processing Affect This Food Drying. Drying removes moisture from garlic but leaves the oils intact. Powdered garlic and garlic salt should be stored in a cool, dry place to keep their oils from turning rancid. Garlic salt is much higher in sodium than either raw garlic, garlic powder, or dried garlic flakes.
Medical Uses and/or Benefits Protection against some cancers. The organic sulfur compounds in garlic and onions appear to reduce the risk of some forms of cancer perhaps by preventing the formation of carcinogens in your body or by blocking carcinogens from reaching or reacting with sensitive body tis- sues or by inhibiting the transformation of healthy cells to malignant ones. Protection against circulatory diseases. In a number of laboratory studies during the 1980s, adding garlic oil to animal feeds reduced levels of low-density lipoproteins (LDLs), the fat and protein particles that carry cholesterol into your arteries, and raised levels of high density lipoproteins (HDLs), the particles that carry cholesterol out of the body. However, current studies are contradictory. One year-long study at the Harbor-UCLA Medical Center showed that daily doses of aged garlic (brand name Kyolic) appeared to reduce the formation of cholesterol deposits in arteries while lowering blood levels of homocysteine, an amino acid the American Heart Association calls an independent risk factor for heart disease. But another study funded by the National Center for Complementary and Alternative Medicine (NCCAM), a division of the National Institutes of Health, to determine the safety and effec- tiveness of garlic showed that neither fresh garlic nor powdered garlic nor garlic tablets have any effect on cholesterol levels.
Adverse Effects Associated with This Food Body odor, halitosis. Diallyl disulfide is excreted in perspiration and in the air you exhale, which is why eating garlic makes you smell garlicky.
Food/Drug Interactions Anticoagulants (blood thinners). Garlic appears to reduce blood’s ability to clot, thus increas- ing the effect of anticoagulants, including aspirin. NCCAM recommends using garlic with caution before surgery, including dental surgery. Patients who have a clotting disorder should consult their own doctors before using garlic.... garlic
Others appear under their appropriate alphabetical headings: ACNE; ALBINISM; ALOPECIA; ALOPECIA AREATA; APHTHOUS ULCER; BASAL CELL CARCINOMA; BOILS (FURUNCULOSIS); BOWEN’S DISEASE; CALLOSITIES; CANDIDA; CHEILOSIS; CHEIRAPOMPHOLYX; DANDRUFF; DERMATOFIBROMA; DERMATOMYOSITIS; DERMATOPHYTES; DERMOGRAPHISM; ECTHYMA; ERYSIPELAS; ERYTHEMA; ERYTHRASMA; ERYTHRODERMA; ESCHAR; EXANTHEM; FUNGAL AND YEAST INFECTIONS; HAND, FOOT AND MOUTH DISEASE; HERPES GENITALIS; HERPES SIMPLEX; HERPES ZOSTER; IMPETIGO; INTERTRIGO; KELOID; KERATOSIS; LARVA MIGRANS; LICHEN; LUPUS; MADURA FOOT; MELANOMA; MILIARIA; MOLLUSCUM CONTAGIOSUM; MOLE; MYCOSIS FUNGOIDES; NAEVUS; ORF; PEDICULOSIS; PEMPHIGUS; PHOTOCHEMOTHERAPY; PHOTODERMATOSES; PITYRIASIS; PORPHYRIAS; PRURITUS; PSORIASIS; RINGWORM; ROSACEA; SARCOIDOSIS; SCABIES; SCLERODERMA; URTICARIA; VITILIGO; WARTS; XANTHOMATA.
Skin cancer Primary cancer is common and chronic exposure to ultraviolet light is the most important cause. BASAL CELL CARCINOMA is the most common form; squamous cell carcinoma is less common and presents as a growing, usually painless nodule which may ulcerate. Squamous cancer may spread to regional lymph glands and metastasise, unlike basal cell cancer. Occupational exposure to chemical carcinogens may cause squamous carcinoma – for example, cancer from pitch warts or the scrotal carcinoma of chimney sweeps exposed to coal dust in earlier centuries. Squamous carcinoma of the lip is associated with clay-pipe smoking.
Cancer may arise from the population of melanocytes of the skin (see MELANOCYTE; MELANOMA).
Apart from these three most frequent forms of skin cancer, various forms of cancer can arise from cells of the dermis, of which LYMPHOMA is the most important (see also MYCOSIS FUNGOIDES).
Lastly, secondary deposits from internal cancer, particularly from the breast, may metastasise to the skin.
Dermatitis and eczema These are broadly synonymous, and the terms are frequently interchangeable. Eczema is a pattern of in?ammation with many potential causes. Dermatitis is commonly used to suggest an eczema caused by external factors; it is a common pattern of in?ammation of the skin characterised by redness and swelling, vesiculation (see VESICLE), and scaling with intense itching and often exudation (weeping). Fissuring, thickening (licheni?cation – see LICHEN) and secondary bacterial infection may follow. Dermatitis can affect any part of the body. It may be genetically detemined or due to other ‘internal’ factors, such as venous HYPERTENSION in a leg, or stress. Often it is ‘external’ in origin – due to strong irritants or chemical allergens. (See also ALLERGY; ALLERGEN.) ATOPIC DERMATITIS is genetic in origin and usually begins in infancy. It may persist for years, and ASTHMA, allergic RHINITIS and conjunctivitis (see under EYE, DISORDERS OF) – ‘hay fever’ – may be associated. Atopic children tend to have multiple allergies, especially to inhaled allergens such as house-dust mite, cat and dog dander and pollens. Allergy to foods is less common but potentially more dangerous, especially if to nuts, when it can cause acute URTICARIA or even ANAPHYLAXIS. Atopic subjects are particularly prone to persistent and multiple verrucae (see WARTS) and mollusca (see MOLLUSCUM CONTAGIOSUM) and to severe HERPES SIMPLEX infections. (See also ATOPY.)
EXFOLIATE DERMATITIS (PITYRIASIS RUBRA)
Generalised exfoliation and scaling of the skin, commonly with ERYTHEMA. Drugs may cause it, or the disorder may be linked with other skin diseases such as benign dermatoses and lupus erythematosus (see under LUPUS). SUMMER POMPHOLYX is an acute vesicular eczema of the palms and soles recurring every summer. Inhaled allergens are a frequent cause. VENOUS (STASIS) DERMATITIS begins on a lower calf, often in association with PURPURA, swelling and sometimes ulceration. Chronic venous hypertension in the leg, consequent on valvular incompetence in the deep leg veins owing to previous deep vein thrombosis (see VEINS, DISEASES OF), is the usual cause. NEURODERMATITIS A pattern of well-de?ned plaques of licheni?ed eczema particularly seen on the neck, ulnar forearms or sides of the calves in subjects under emotional stress. IRRITANT CONTACT DERMATITIS Most often seen in an industrial setting (occupational dermatitis), it is due to damage by strong chemicals such as cutting oils, cement, detergents and solvents. In almost all cases the hands are most severely affected. ALLERGIC CONTACT DERMATITIS, in contrast, can affect any part of the body depending on the cause – for example, the face (cosmetics), hands (plants, occupational allergens) or soles (rubber boots). Particularly common allergens include metals (nickel and chromate), rubber addititives, and adhesives (epoxy resins).
Treatment Avoidance of irritants and contact allergens, liberal use of EMOLLIENTS, and topical application of corticosteroid creams and ointments (see CORTICOSTEROIDS) are central.... skin, diseases of
Exercises include the “windmill” movement, stretching the circling arms without straining. Give breasts an invigorating spray of cold water for one minute. Exchange animal fats and cholesterol for unsaturated cold-pressed oils. Daily supplementation includes: Vitamins A, C, E. Zinc, Selenium, for their anti-carcinogenic effect.
Agents known to promote healthy breasts: Red Clover flowers, Sarsaparilla, oil of Evening Primrose, Yarrow, Clivers.
Women with breast disease have high rates of sebum production, a marker of Essential Fatty Acid deficiency. (Goolamali SK, Shuster S. Lancet 1; 428-9, 1975) To make good such deficiency oils of safflower, corn, Soya, etc, being rich in EFAs are indicated. Animal fat should be avoided; butter and dairy products taken sparingly.
Evening Primrose oil capsules (Efamol) can significantly reduce breast pain, breast tenderness and formation of nodules. (Pashby NL, Mansel RE, Preece et. al. British Surgical Research Society, July 1981) ... breasts
Seldom before 45 years. Frequently in lower one-third of gullet. Dysphagia, with sense of obstruction on swallowing food. May perforate wall of trachea. Pain, worse at night, radiates from an exact spot. Eating hot food and drinking piping hot tea are heavily suspect.
At risk. Heavy smokers and alcoholics with depleted reserves of Vitamin A and zinc. These two factors play an important role in modern treatment.
Occurs in areas where the soil is low in molybdenum which causes plants to have a high level of nitrates. When such plants are stored they form nitrites which in turn form nitrosamines – which are carcinogens. Experimental rats given nitrous amines have a strong tendency to form cancer of the oesophagus. Eating pickled vegetables carries a high risk.
There are a few areas of the world where these adverse soil conditions pertain – one in Iran, another in Calvados, but the worst was in Lin Xian of the province of Honan, China. In Lin Xian, in the 1970s, it was found that villagers ate mainly persimmon and corn cakes and pickled vegetables. These, and their water, were high in nitrates. It was also their habit to eat mouldy bread which is high in amines – even nitrosamines. Their food was deficient in Vitamin C, which is likely to produce nitrous amines in the stomach.
The molybdenum problem was solved by sowing seeds with a fertiliser containing molybdenum. Piped water replaced old cistern wells and food was carefully stored. Even the chickens oesophageal cancers were cured. As a result of modern scientific investigation and treatment in which medicinal herbs made an important contribution, what was once a high gullet cancer area was resolved into one of the success stories of modern medicine.
Tannin has long been identified as a cancer-causing chemical, supported by findings of a high incidence of the disease among those who consume large quantities of tannin-containing beverages such as tea. Milk binds with tannin and is advised in tea-drinking where lemon is not taken.
Solid drugs and tablets should not be swallowed in the recumbent position without chewing a piece of banana.
Symptoms. (1) Sensation of obstruction when swallowing food. (2) Sharp pain behind breastbone. (3) “Something stuck in the gullet.” (4) Stomach ache, dry throat. (5) Belching when taking food. (6) Soreness of the upper back. (Dr Ge-ming, Lin Xian, Province of Honan, Chinese People’s Republic)
Of possible value. Alternatives:– Tea. Equal parts: Chaparral, Gotu Kola, Red Clover. 1 heaped teaspoon to each cup boiling water; infuse 15 minutes. Drink freely.
Powders. Combination. Goldenseal 1; Echinacea 2; Slippery Elm 3. Dose: 750mg (three 00 capsules or half a teaspoon). 3 or more times daily.
Tinctures. Combination. Goldenseal 1; Bayberry 1; Thuja 1; Condurango 1; Rosebay Willowherb 2. One teaspoon 3 or more times daily.
Chinese Herbalism. Powdered Huang yao-tzu 3 ch’ien, 3 times daily. Remedy is prepared by taking 12 liang of huang yao-tzu and steeping in 3 chin of white wine 24 hours. Then place huang yao-tzu in cold water and soak for another 7 days and 7 nights. Take out, dry and crush into powder. (A Barefoot Doctor’s Manual)
Diet. Leafy vegetables, carrots, tomatoes and fruit help to protect against the disease. Supplements. Especially Vitamin A, zinc and molybdenum.
Treatment by a general medical practitioner or hospital oncologist. ... cancer – oesophagus
Other diseases recognised to be characteristic of modern western civilisation and claimed to be causally related to diet are: appendicitis, coronary heart disease, hiatus hernia, diverticulosis, piles and other anal disorders, obesity, gall stones, hypertension, deep vein thrombosis and varicose veins.
Low fibre intake results in slow transit of food and exposes potential carcinogens a longer period of time in contact with the alimentary canal. A high fibre diet tends to absorb a variety of environmental pollutants and eliminate them from the body.
Foods rich in fibre: wholemeal bread, grains, cereals, brown rice, beans, peas, boiled cabbage, sweetcorn, banana, prunes (stewed), dried apricots. One of the highest is All Bran, which has the highest proportion of dietary fibre among breakfast cereals with no preserves, artificial colouring or flavouring. Contains one-third fewer calories than most breakfast cereals and because of its glycaemic effect is useful in diabetic diet. ... fibre
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