BROCCOLI SPROUTS

Broccoli sprouts are uniquely high in active compound glucorphanine which delivers sulforaphane on digestion. Clinical evidence for direct effects in cancer treatment has yet to emerge. There is evidence in prostate cancer that dietary broccoli sprouts slow mutational changes seen in progression of disease, and measurable absorped levels of sulforphane are observable. And though most trials have shown no significant effects. there is some evidence in reducing PSA levels during prostate surgery using 20mg supplements of sulforaphane (see Highlight 4)

Clinical trials in other systemic inflammatory diseases such as diabetes do show sustained reductions in key markers of inflammation including c-reactive proteins and especially IL-6 at 30g daily. And, signifcant influence on glucose levels with a reduced insulin resistance level.

Overall evidence indicates suppression effects in both incidence and progression of some cancers. Some studies have reported postive tendencies in for instance prostate cancer when combined with other neutraceuticals such as green tea, tumeric, tomatos. Thats said, supplement forms are a useful option too, see sulforphane in the Supplements Library

EXAMPLES OF IMPROVED OUTCOMES

PENDING

PRE-DIAGNOSIS OR PREVENTION

YES

Highlighted Studies

In the control arm, there were several hundred changes in gene expression in nonneoplastic tissue during the 12 mo. These were associated with an increase in expression of potentially oncogenic pathways including inflammation processes and epithelial–mesenchymal transition. Changes in gene expression and associated oncogenic pathways were attenuated in men on the glucoraphanin-rich broccoli soup in a dose-dependent manner. Although the study was not powered to assess clinical progression, a...

Both groups had a reduction in mean C-Reactive Protein (CRP) at the end of 12 weeks, however the sulforaphane group had a significantly greater reduction. Subjects in the sulforaphane group experienced a mean reduction in CRP of 40% at the end of 12 weeks…After 6 weeks of intervention, the low-density lipoprotein-C (LDL-C) levels of the sulforaphane group dropped 12% from baseline levels, and the placebo group dropped only 3%….The average change in triglycerides from baselin...

Sixty-three patients were included in the analysis: 10 g/d BSP (n = 21), 5 g/d (n = 22), placebo (n = 20). After 4 weeks, in the BSP treatment groups there was a significant decrease in serum hs-CRP concentration (−20.5% and −16.4%), and also non-significant decrease in serum IL-6 (−3.6% and −0.7%), and TNF-α concentration (−1.6% and −10.9%), in group A and B, respectively. Serum hs-CRP and IL-6 were lower in group A as compared to the controls after intervention. High-sulforapha...

The resulting PSA doubling time increase was substantial (almost double) and if confirmed in further trials, should be clinically relevant. The decline in the PSA slopes became prominent after 3 months of sulforaphane treatment suggesting that longer intervention should be considered in future trials. After stopping treatment, the PSA slopes from M6 to M8 were not different between the 2 arms, although there seemed to be a lag effect, as the difference in PSA slopes between M3 and M8 was sign...

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TABLE OF REFERENCES

URL	Category	Rating	Highlight	Highlight 2	Dose mg/kg
https://pmc.ncbi.nlm.nih.gov/articles/PMC6462431/	Human study	3	In the control arm, there were several hundred changes in gene expression in nonneoplastic tissue during the 12 mo. These were associated with an increase in expression of potentially oncogenic pathways including inflammation processes and epithelial–mesenchymal transition. Changes in gene expression and associated oncogenic pathways were attenuated in men on the glucoraphanin-rich broccoli soup in a dose-dependent manner. Although the study was not powered to assess clinical progression, an inverse association between consumption of cruciferous vegetables and cancer progression was observed.	In the control arm, there were several hundred changes in gene expression in nonneoplastic tissue during the 12 mo. These were associated with an increase in expression of potentially oncogenic pathways including inflammation processes and epithelial–mesenchymal transition. Changes in gene expression and associated oncogenic pathways were attenuated in men on the glucoraphanin-rich broccoli soup in a dose-dependent manner. Although the study was not powered to assess clinical progression, an inverse association between consumption of cruciferous vegetables and cancer progression was observed.
https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2024.1357906/full	Human study	3	Both groups had a reduction in mean C-Reactive Protein (CRP) at the end of 12 weeks, however the sulforaphane group had a significantly greater reduction. Subjects in the sulforaphane group experienced a mean reduction in CRP of 40% at the end of 12 weeks (Table 3), whereas subjects in the placebo group experienced a 12% reduction in CRP at the end of the study intervention. The difference in difference estimate between the two groups at the end of the 12 weeks was −0.61 (p = 0.32). Between cessation of sulforaphane treatment at 12 weeks, and the 16-week follow-up visits, the intervention group’s CRP levels increased by 13%. While a 13% increase was seen following cessation of sulforaphane, a non-significant decrease of approximately 21% was observed as compared to baseline. At the 16-week mark, a decrease of 6% was observed in the control group.	The intricate interplay between chronic inflammation and metabolic disease in this population emphasizes the need for novel and holistic approaches to management of HIV drug-related side effects. Larger randomized controlled trials are warranted to validate sulforaphane as an adjunctive therapy in the comprehensive care of individuals with HIV. To our knowledge, this is the first study to investigate the effects of sulforaphane on chronic inflammation in HIV patients. Despite the small sample size of this pilot study, n = 9, we observed a 40% reduction in CRP over the 12 weeks of the study period, indicating sulforaphane has the potential to be a useful tool in modulating the negative effects of inflammation in virally suppressed patients and potentially in other populations experiencing chronic inflammation.
https://pmc.ncbi.nlm.nih.gov/articles/PMC11174709/	Meta-analysis	3	Twenty-three case–control studies (n = 12,929 cases and 18,363 controls; n = 31,292 individuals) and 12 cohort studies (n = 699,482 individuals) were included in the meta-analysis. The results suggest an inverse association between broccoli consumption and the risk of cancer both in case–control studies (OR: 0.64, 95% CI from 0.58 to 0.70, p < 0.001; Q = 35.97, p = 0.072, I2 = 30.49%—moderate heterogeneity; τ2 = 0.016) and cohort studies (RR: 0.89, 95% CI from 0.82 to 0.96, p = 0.003; Q = 13.51, p = 0.333, I2 = 11.21%—low heterogeneity; τ2 = 0.002). Subgroup analysis suggested a potential benefit of broccoli consumption in site-specific cancers only in case–control studies. Conclusions: In summary, the findings indicate that individuals suffering from some type of cancer consumed less broccoli, suggesting a protective biological effect of broccoli on cancer.	Overall, the analysis suggested that individuals with higher consumption of broccoli were less likely to suffer from some type of cancer. In the analysis by cancer subgroups, individuals who consumed more broccoli were less likely to suffer from some site-specific cancers lung, gastric, colorectal and bladder cancers; reproductive system and breast cancers. A low heterogeneity [so good level of certainty] was confirmed for lung cancer, reproductive system cancer, gastric cancer, and bladder cancer; however, the subgroups of breast cancer and colorectal cancer showed moderate heterogeneity [meaning moderate certainty] breast cancer and colorectal cancer
https://aacrjournals.org/cancerpreventionresearch/article/8/8/712/50472/Effect-of-Sulforaphane-in-Men-with-Biochemical	Human study - adjunct	3	Mean changes in PSA levels between M6 and M0 were significantly lower in the sulforaphane group than in placebo. PSA doubling time was 86% longer in the sulforaphane than in the placebo group (28.9 and 15.5 months, respectively). PSA increases >20% at M6 were significantly greater in the placebo group (71.8%) than in the sulforaphane group (44.4%). Compliance and tolerance were very good. Sulforaphane effects were prominent after 3 months of intervention (M3–M6). After treatment, PSA slopes from M6 to M8 remained the same in the 2 arms. Daily administration of free sulforaphane shows promise in managing biochemical recurrences in prostate cancer after radical prostatectomy.	The resulting PSA doubling time increase was substantial (almost double) and if confirmed in further trials, should be clinically relevant. The decline in the PSA slopes became prominent after 3 months of sulforaphane treatment suggesting that longer intervention should be considered in future trials. After stopping treatment, the PSA slopes from M6 to M8 were not different between the 2 arms, although there seemed to be a lag effect, as the difference in PSA slopes between M3 and M8 was significant. We initially considered that 6 months of intervention was reasonable as patients on placebo were not exposed to too much risk of prostate cancer progression
https://www.sciencedirect.com/science/article/abs/pii/S1756464612000953	Human study	2.5	Sixty-three patients were included in the analysis: 10 g/d BSP (n = 21), 5 g/d (n = 22), placebo (n = 20). After 4 weeks, in the BSP treatment groups there was a significant decrease in serum hs-CRP concentration (−20.5% and −16.4%), and also non-significant decrease in serum IL-6 (−3.6% and −0.7%), and TNF-α concentration (−1.6% and −10.9%), in group A and B, respectively. Serum hs-CRP and IL-6 were lower in group A as compared to the controls after intervention. High-sulforaphane BSP had favorable effects on inflammatory markers in type 2 diabetic patients.	To the best of our knowledge this is a first report of the effects of broccoli sprouts on inflammatory markers in human. The results of the present study demonstrated that 4-weeks supplementation with high sulforaphane-concentration BSP reduced inflammatory markers in group A (dose 10 g/d) as compared to the placebo group. Since the sub-clinical inflammation and increased inflammatory cytokines are central mediators of inflammatory reactions and development of insulin resistance
https://pubmed.ncbi.nlm.nih.gov/29573889/	Human study	2.5	IL-6 levels [inflammation marker] significantly decreased (mean values from 4.76 pg/mL to 2.11 pg/mL with 70 days of broccoli consumption, p < 0.001) and during control phase the inflammatory levels were maintained at low grade (mean values from 1.20 pg/mL to 2.66 pg/mL, p < 0.001). C-reactive protein significantly decreased as well.	This study represents an advance in intervention studies as the broccoli sprouts were included in a daily dietary pattern in quantities that reflect a real consumption. Further studies are necessary to elucidate the role of this healthy rich and nutritious food product, but these promising results support the current evidence on the healthy properties of Brassica varieties.
https://www.aqpingredients.com/assets/lopez-chillon-et-al_-clinical-nutrition-2018-inpress.pdf	Human study	2.5	These proteins are linked to several disease states [18] and C-reactive is an important predictive marker of cardiovascular events [19]; hence the reduction of their levels with dietary intervention could contribute to a better prognosis on obesity-associated disorders. In our study we observed a noticeable anti-inflammatory effect with the ingestion of broccoli sprouts, with a significant reduction by 38% and 59% in IL-6 and C-reactive protein concentrations, respectively.	The consumption of broccoli sprouts in a real dietary serving is able to affect IL-6 and C-reactive protein levels in overweight subjects, hence attenuating chronic inflammation. Further research with broccoli sprouts including other biomarkers and mechanistic studies are necessary to elucidate the role of this healthy rich and nutritious food product, but these promising results support the current evidence on the properties of this Brassica specie for disease prevention.
https://scielo.isciii.es/pdf/nh/v31n2/05revision04.pdf	Meta-analysis	2	The decrease in fasting blood glucose... in four of the studies analyzed here , is one of the most relevant results of this investigation. The only study to measure in- sulin concentration and HOMA-IR index observed a decrease in these parameters26 . DM2 is a progressive disease that requires a growing number of oral hypo- glycemiant agents, which leads 50% of diabetic indi- viduals to need exogenous insulin within a 10-year period after disease onset43 . The investigation of the compounds that may help in the control of diabetes is relevant, and the data obtained here suggest that SFN [sulforaphane] should be considered a possible complementary treatment to control diabetes	With regard to lipid profile, the studies analyzed in this investigation found somewhat controversial results. Three studies showed a decrease in TC, LDL, oxidi- zed LDL, and TG levels and in the atherogenic index of plasma and/or an increase in HDL levels28,29,32 , while two other studies did not observe any change in these parameters after intervention30,31 . However, due to the methodological differences between the studies and to the fact that the number of positive results was grea- ter than that of negative results, the findings on lipid profile may be considered relevant.
https://pmc.ncbi.nlm.nih.gov/articles/PMC4020278/	Human study - adjunct	2	The median rise in PSA in the food supplement group (FSG) was 14.7% (95% confidence intervals (CIs) 3.4–36.7%), as opposed to 78.5% in the placebo group (PG) (95% CI 48.1–115.5%), difference 63.8% (P=0.0008). In all, 8.2% of men in the FSG and 27.7% in the PG opted to leave surveillance at the end of the intervention (χ2 P=0.014). There were no significant differences within the predetermined subgroups of age, Gleason grade, treatment category or body mass index. There were no differences in cholesterol, blood pressure, blood sugar, C-reactive protein or adverse events.	In conclusion, this statistically valid double-blind randomised controlled trial has demonstrated a significant short-term effect on PSA and is food for thought for men living with prostate cancer, 50–70% of whom are reported to have taken ‘over-the-counter' supplements.47 The favourable effect on PSA progression was significant both in men on primary AS and those experiencing a PSA relapse after radiotherapy. This low cost food supplement was well-tolerated and also influenced clinically relevant decisions, as to whether to switch to interventions with more toxicity. Although these results do not prove a long-term effect, they have provided significant encouragement
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9909961/	Meta-analysis	1.5	49 participants was enrolled in this trial and the control group received a 300 mL portion of soup made from standard broccoli weekly, while the intervention group received the same portion of soup but made from glucoraphanin-enriched experimental broccoli genotypes. RNA sequencing revealed inhibition of oncogenic signaling pathways including TGF-β, KRAS, NF-κB, and Notch, in a dose-dependent manner in the intervention group ( Table 1 ). Even though this trial was not designed to assess clinical progression, an inverse correlation between cruciferous vegetables intake and cancer progression was observed, thus indicating the potential benefits of SFN against prostate cancer	Twenty participants were treated with 200 μmol/day of SFN-rich extracts for a maximum period of 20 weeks and their PSA levels were measured. Although the results showed that only one patient exhibited a ≥ 50% PSA decline, SFN lengthened the PSA doubling time (PSADT) of patients from 6.1 months during pre-treatment to 9.6 months during treatment. PSADT is an indicator of prostate cancer progression and predicts the number of months taken for PSA to increase two-folds. In addition, the treatment proved to be safe, with no grade 3 adverse effects. Once SFN treatment may exert positive effects on PSADT and is safe for use in patients, further studies, especially using higher doses, are required to clarify the role of SFN as a prognostic and/or therapeutic agent for prostate cancer
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2862133/	Lab study	1.5	In conclusion, we have demonstrated that sulforaphane was able to target breast CSCs as determined by the mammosphere formation assay, Aldefluor assay, and tumor growth upon reimplantation in secondary mice. Furthermore, our study identified the down-regulation of Wnt/β-catenin self-renewal pathway by sulforaphane as one of the possible mechanisms for its efficacy. These studies support the use of sulforaphane for breast cancer chemoprevention. These findings provide a strong rationale for preclinical and clinical evaluation of sulforaphane or broccoli/broccoli sprouts for breast cancer therapies.	However, the cancer cells obtained from sulforaphane-treated mice largely failed to produce any tumors in recipient mice up to 33 days after implantation (Figure 5A). Figure 5A & 5B showed that tumor cells derived from sulforaphane-treated mice only gave rise to one small tumor (6 mm3) out of 7 inoculations at day 19, while control tumor cells yielded tumors as early as day 7 (P < 0.01). All control inoculations produced tumors by day 15 (Figure 5B). These results suggest that sulforaphane was able to eliminate breast CSCs in primary xenografts, thereby abrogating the re-growth of tumors in secondary mice. Taken together with the in vivo Aldefluor assay results, these findings suggest that sulforaphane targets breast CSCs with high potency.	50
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9105060/	Human study	1.5	Low and higher-dose BSSE showed a mean bioavailability of 11% and 10%, respectively. Higher-dose BSSE significantly upregulated urinary excretion of the mercapturic acids of benzene (p = 0.04), acrolein (p < 0.01), and crotonaldehyde (p = 0.02), independent of GST genotype. Retention and compliance were high resulting in early study completion. In conclusion, BSSE significantly upregulated detoxification of the tobacco carcinogens benzene, acrolein, and crotonaldehyde in current tobacco smokers	Broccoli seed and sprout extract (BSSE) is rich in the isothiocyanate glucoraphanin, which is hydrolyzed to the phytochemical sulforaphane, a potent inducer of cytoprotective enzymes. This randomized, crossover trial evaluated detoxification of tobacco carcinogens by two doses of the BSSE Avmacol® in 49 otherwise healthy tobacco smokers. The higher dose (296 µmol of glucoraphanin daily) significantly upregulated detoxification of benzene, acrolein, and crotonaldehyde.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6425935/	Lab study	1	In summary, our findings indicate that SFN (50 mg/kg) suppresses mammary tumor development in a TNBC animal model, possibly by targeting a CSC population. Further gene analyses revealed that SFN particularly decreased the expression of various stem cell markers including CR1 and its cancer-specific homologue, CR3. Finally, the collective results in this study suggest that the use of SFN for chemoprevention of TNBC is plausible and warrants further clinical evaluation.	We found that sulforaphane can inhibit cell proliferation and mammosphere formation of CSCs in TNBC. Further analysis of gene expression in these TNBC tumor cells revealed that sulforaphane significantly decreases the expression of cancer-specific CR1, CRIPTO-3/TDGF1P3 (CR3, a homologue of CR1), and various stem cell markers including Nanog, aldehyde dehydrogenase 1A1 (ALDH1A1), Wnt3, and Notch4.	50