Food as Medicine Update: Horseradish (Armoracia rusticana, Brassicaceae)

HerbalEGram: Volume 15, Issue 5, May 2018 Editor’s Note: As the Food as Medicine project has evolved at the American Botanical Council (ABC), the editors of HerbalEGram will revisit older articles in this series and update them with current research. This effort will hopefully improve the accuracy and relevance of these articles, in keeping with our commitment to education and empowerment. Food as Medicine: Horseradish was originally published in the January 2015 issue of HerbalEGram. The basic materials for this series were compiled by dietetic interns from Texas State University in San Marcos and the University of Texas at Austin through ABC’s Dietetic Internship Program, led by ABC Education Coordinator Jenny Perez. We would like to acknowledge Perez, ABC Special Projects Director Gayle Engels, and ABC Chief Science Officer Stefan Gafner, PhD, for their contributions to this project. By Hannah Baumana and Natalie Ebromb a HerbalGram Associate Editor b ABC Dietetics Intern (Texas State, 2014) Overview Horseradish is a hardy perennial native to southeastern Europe and western Asia, and it is now grown in Horseradish roots in a baskettemperate areas of Europe, Asia, and North and South America, as well as in some regions of Africa and New Zealand.1 The plant grows in clumps with bright green leaves that radiate out from the main taproot, which is used as a food ingredient.2 The young leaves can also be harvested for use in salads when they reach 2-3 inches (5.1-7.6 cm) in length.3 Small, white, four-petaled flowers grow from a stalk that can reach 2-3 feet (0.6-0.9 m) or higher.2 Horseradish is easy to cultivate and often will continue to thrive even during periods of neglect.4 While technically a perennial, it is best treated as an annual or biennial crop since the root becomes woody and unpalatable with age. Once established, horseradish grows well in full sun and slightly moist soil.1 Phytochemicals and Constituents Glucosinolates, sulfur-containing secondary metabolites, give horseradish its characteristic pungent taste.5 Horseradish contains multiple different glucosinolates such as sinigrin, gluconasturtiin, glucobrassicin, and neoglucobrassicin.5 Inside the body, glucosinolates are broken down into isothiocyanates, which are believed to be the main cancer-preventive compounds in horseradish and other cruciferous vegetables (i.e., vegetables of the family Brassicaceae).1,6 Horseradish also contains minerals such as phosphorus, calcium, magnesium, and potassium.7 Freshly grated roots contain minimal fat, are low in calories, and rich in vitamin C. Heat can destroy some of horseradish root’s beneficial compounds, so it is best used raw or cooked briefly.1 Historical and Commercial Uses Horseradish root has been ground into a spice, prepared as a condiment, and used medicinally for more than 3,000 years. It was used topically by the Greeks and Romans as a poultice to ease muscle pain, back aches, and menstrual cramps.3 Internally, it was used to relieve coughs and as an aphrodisiac.4 Starting in the Middle Ages (ca. 1000-1300), horseradish was incorporated into the Jewish Passover Seder as one of the maror, or bitter herbs.3Illustration of the whole horseradish plant In European countries, horseradish historically was used to treat a wide variety of conditions, including asthma, cough, colic, toothache, and scurvy (due to its vitamin C content). Grated horseradish poultices traditionally were used to ease pain associated with gout and sciatica (pain associated with the sciatic nerve), and were also infused in milk to clarify the skin and remove freckles.3 Additionally, horseradish was considered a strong diuretic and used to treat urinary tract infections.8 In Poland, horseradish leaf and root were used to make bread and pickles, respectively, and as a flavoring agent and preservative.9 In the 16th century, Europeans began using horseradish in sauces and condiments in addition to its medicinal applications. Horseradish root was approved as a nonprescription medicine ingredient by the German Commission E for treatment of infections of the respiratory tract and as supportive treatment in urinary tract infections.10 Isothiocyanates from horseradish and nasturtium (Nasturtium spp., Brassicaceae) are the active ingredients in Angocin Anti-Infekt N (Repha GmbH Biologische Arzneimittel; Langenhagen, Germany). Angocin Anti-Infekt N is indicated for the treatment of acute inflammatory diseases of the lungs, sinuses, and urinary tract. Modern Research Cytotoxic Activity The cytotoxic activity of horseradish’s glucosinolates against various cancer cell lines has been widely studied.11,12 Allyl isothiocyanate, a product of sinigrin metabolism, has been shown to suppress the growth of tumors in vitro and protect against further DNA damage.8,12 One hypothesis is that glucosinolates work by enhancing the liver’s ability to detoxify carcinogens.8 Lipid Metabolism and Cardiovascular Health Based on evidence from a rat model, sinigrin is thought to affect many organs involved in carbohydrate and Horseradish leaf and flowerlipid metabolism, including the liver, pancreas, and intestine.13 The same study reported that sinigrin also reduced triglyceride levels in the blood, and the authors suggested that sinigrin may be beneficial in reducing elevated triglyceride levels (a risk factor for coronary artery disease) after meals. A clinical study that compared the effects of various pungent spices on weight management factors (e.g., diet-induced thermogenesis, energy expenditure, appetite, etc.) found that healthy men who ate a meal supplemented with horseradish showed a significant decrease in heart rate and increase in diastolic blood pressure compared to the control group, who received no supplementation.14 Antibacterial Activity Allyl isothiocyanate has shown antimicrobial activity against a variety of organisms, including Escherichia coli (E. coli), a common food-borne pathogen, and Helicobacter pylori, a bacterium known to cause stomach ulcers and increase the risk for gastric cancer.15 Due to its antibiotic properties, horseradish may prevent or hasten recovery from urinary tract infections and kill bacteria in the throat that can cause bronchitis, cough, and other related problems.10 In an in vitro study, isothiocyanates extracted from horseradish showed antimicrobial activity against 10 different oral microorganisms.16 Isolated allyl isothiocyanate from horseradish also exhibited antiproliferative activity against the multidrug resistant bacterium Pseudomonas aeruginosa in vitro.17 Although broccoli (Brassica oleracea var. italica, Brassicaceae), Brussels sprouts (B. oleracea var. gemmifera), and other cruciferous vegetables also contain these compounds, horseradish has up to ten times more glucosinolates than other members of the Brassicaceae family.8 Consumer Considerations Isothiocyanates in horseradish are released when hydrolyzed by other active enzymes in the root; this enzymatic oxidation occurs when the root is scratched.18 Fumes released from grating or cutting the root can irritate the membranes of the eyes and nose, and, therefore, horseradish should be prepared in a well-ventilated room and care should be taken in its use. Nutrient Profile7 Macronutrient Profile: (Per 1 tablespoon prepared horseradish [approx. 15 grams]) 7 calories 0.2 g protein 1.7 g carbohydrate 0.1 g fat Secondary Metabolites: (Per 1 tablespoon prepared horseradish [approx. 15 grams]) Provides small amounts: Vitamin C: 3.7 mg (4.1% DV) Folate: 9 mcg (2.3% DV) Dietary Fiber: 0.5 g (1.7% DV) Magnesium: 4 mg (1% DV) Provides trace amounts: Manganese: 0.02 mg (0.9% DV) Potassium: 37 mg (0.8% DV) Calcium: 8 mg (0.6% DV) Vitamin B6: 0.01 mg (0.6% DV) Niacin: 0.06 mg (0.4% DV) Phosphorus: 5 mg (0.4% DV) Iron: 0.06 mg (0.3% DV) Riboflavin: 0.004 mg (0.3% DV) Vitamin K: 0.2 mcg (0.2% DV) Thiamin: 0.001 mg (0.1% DV) DV = Daily Value as established by the US Food and Drug Administration, based on a 2,000-calorie diet. Recipe: Horseradish Beer Mustard Adapted from Cuisine at Home19 Ingredients: 1/3 cup malt vinegar 1/3 cup dark beer (optional; substitute with the same amount of additional vinegar, if preferred) 1/4 cup yellow mustard seeds (to learn more about the benefits of mustard, click here20) 2 tablespoons brown or black mustard seeds 1 teaspoon kosher salt 1/4 teaspoon turmeric 1/8 teaspoon each ground allspice and ginger (to learn more about the benefits of ginger, click here21) 1 tablespoon prepared horseradish 2-4 tablespoons warm water Directions: Combine vinegar, beer, and mustard seeds in a glass container. Secure lid and let stand at room temperature for 24 hours. Process mustard mixture with salt, turmeric, allspice, ginger, and horseradish in a food processor or blender until combined, adding water by the tablespoon as necessary to achieve desired consistency. Return mustard to container, secure lid, and chill in the refrigerator overnight. Store mustard in the refrigerator and use within a month. Image credits (top to bottom): Horseradish roots at the Naschmarkt in Vienna, Austria. Photo courtesy of Anna Reg. Horseradish illustration from Flora batava by Jan Kops; 1822. Horseradish leaf and flower; ©2018 Steven Foster. References Small E, ed. Culinary Herbs. Ontario, Canada: NRC Research Press; 1997. Van Wyk B-E. Food Plants of the World: An Illustrated Guide. Portland, OR: Timber Press; 2005. Wright J. The Herb Society of America’s Essential Guide to Horseradish. Kirtland, OH: The Herb Society of America; 2010. Available at: www.herbsociety.org/file_download/inline/00a657ad-4bfa-4db8-945f-526586c09c2f. Accessed April 26, 2018. National Geographic Society. Edible: An Illustrated Guide to the World's Food Plants. Washington, DC: National Geographic Society; 2008. Alnsour M, Kleinwächter M, Böhme J, Selmar D. Sulfate determines the glucosinolate concentration of horseradish in vitro plants (Armoracia rusticana Gaertn., Mey. & Scherb.) J Sci Food Agric. 2013;93(4):918-923. doi: 10.1002/jsfa.5825. Rinzler CA. The New Complete Book of Herbs, Spices, and Condiments: A Nutritional, Medical, and Culinary Guide. New York, NY: Checkmark Books; 2001. Basic report: 02055, Horseradish, prepared. National Nutrient Database for Standard Reference Legacy Release. United States Department of Agriculture Agricultural Research Service website. April 2018. Available at: https://ndb.nal.usda.gov/ndb/foods/show/299594. Accessed April 26, 2018. Patel DK, Patel K, Gadewar M, Tahilyani V. A concise report on pharmacological and bioanalytical aspect of sinigrin. Asian Pac J Trop Biomed. 2012;2(1):S446-S448. doi:10.1016/S2221-1691(12)60204-4. Łuczaj L, Szymański WM. Wild vascular plants gathered for consumption in the Polish countryside: a review. J Ethnobiol Ethnomed. 2007;3:17. Blumenthal M. Goldberg A, Brinkmann J, eds. Herbal Medicine: Expanded Commission E Monographs. Austin, TX: American Botanical Council; Newton, MA: Integrative Medicine Communications; 2000. Hayes JD, Kelleher MO, Eggleston IM. The cancer chemopreventive actions of phytochemicals derived from glucosinolates. Eur J Nutr. 2008;47(2):73-88. doi: 10.1007/s00394-008-2009-8. Bonnesen C, Eggleston IM, Hayes JD. Dietary indoles and isothiocyanates that are generated from cruciferous vegetables can both stimulate apoptosis and confer protection against DNA damage in human colon cell lines. Cancer Res. 2001;61(16):6120-6130. Okulicz M. Multidirectional time-dependent effect of sinigrin and allyl isothiocyanate on metabolic parameters in rats. Plant Foods Hum Nutr. 2010;65(3):217-224. doi: 10.1007/s11130-010-0183-3. Gregersen NT, Belza A, Jensen MG, et al. Acute effects of mustard, horseradish, black pepper and ginger on energy expenditure, appetite, ad libitum energy intake and energy balance in human subjects. Br J Nutr. 2013;109(3):556-563. Luciano FB, Holley RA. Enzymatic inhibition by allyl isothiocyanate and factors affecting its antimicrobial action against Escherichia coli O157:H7. Int J Food Microbiol. 2009;131(2):240-245. doi: 10.1016/j.ijfoodmicro.2009.03.005. Park HW, Choi KD, Shin IS. Antimicrobial activity of isothiocyanates (ITCs) extracted from horseradish (Armoracia rusticana) root against oral microorganisms. Biocontrol Sci. 2013;18(3):163-168. Kaiser SJ, Mutters NT, Blessing B, Günther F. Natural isothiocyanates express antimicrobial activity against developing and mature biofilms of Pseudomonas aeruginosa. Fitoterapia. June 2017;119:57-63. Duke JA, ed. CRC Handbook of Medicinal Spices. Boca Raton, FL: CRC Press; 2002. Spicy mustard. Cuisine at Home. 2017;124:18. Bauman H, Brown Z. Food as Medicine: Mustard (Brassica juncea and B. nigra, Brassicaceae). HerbalEGram. 2017;14(3). Available at: http://cms.herbalgram.org/heg/volume14/03March/FAMMustard.html. Accessed April 26, 2018. Bauman H, Hill K. Food as Medicine: Ginger (Zingiber officinale, Zingiberaceae). HerbalEGram. 2015;12(3). Available at: http://cms.herbalgram.org/heg/volume12/03March/March2015_FaM_Ginger.html. Accessed April 26, 2018.