WAT E R C R E S S

T H E O R I G I N A L S U P E R F O O D
This report was written and researched by Lyndel Costain B.Sc.RD.
2007
 WAT E R C R E S S
THE ORIGINAL SUPERFOOD
Foreword by Professor Ian Rowland, The University of Ulster
What’s so special about watercress? This report
aims to provide the answers. Watercress is a very
underrated vegetable. It is a good source of many
important nutrients such as vitamin C, calcium,
iron and folate. This report summarises the role of
these vital substances and shows just how valuable
watercress is in contributing to our daily
requirements for them.
Perhaps more importantly, watercress is packed
with a wide range of natural, bioactive plant
compounds (phytochemicals) for which there is
increasing evidence for beneficial effects on human
health. These include antioxidants such as beta-
carotene, lutein and quercetin, which may help
protect the cells of the body from damage from
reactive free radicals (lutein specifically is
considered to be very important for eye health).
But watercress is also a particularly rich source of
a group of phytochemicals called glucosinolates
which, when eaten, break down to isothiocyanates.
It is these compounds that give watercress its
distinctive peppery taste. In addition, a wide range
of experiments using human cells in culture and
studies in animals have demonstrated that
isothiocyanates have anti-cancer potential. Sensibly,
however, we don’t eat the purified compounds, we
eat the whole food, so this report also covers the
evidence relating to cancers and watercress per se.
Epidemiology studies, which look at dietary
patterns of large populations and attempt to
correlate these with cancer incidences, certainly
provide us with important indications that
cruciferous vegetables, like watercress, are
particularly effective in helping to reduce cancer
risk. But epidemiology is a blunt tool, it rarely
allows us to identify the role of specific foods and
crucially it provides information only on
associations between diet and cancer risk not
causal relationships.
At The University of Ulster we wanted to identify
causal effects e.g. whether or not watercress
actually has the potential to help reduce cancer
risk. To do so we needed to perform a dietary
intervention. And therein lay another problem.
Ideally we would like to have used development
of cancer as the end point. But cancer can take
decades to develop, so we had to take some
short cuts.
1
The first of these was to employ a test tube
approach. When we applied an extract of
watercress to cultures of human cells we were
able to show that it slowed the growth of cancer
cells, stimulated the ability of cells to resist DNA
damaging agents thought to induce cancer, and
inhibited the ability of cancer cells to invade tissues
in a model of cancer spread.
These positive results encouraged us to move to
the second stage – to conduct a large scale
watercress dietary study in healthy volunteers.
Happily, our 60 volunteers seemed to have no
problems in eating a bag of watercress each day for
2 months!
The main endpoint of the study was DNA damage
in blood cells. Although not as definitive as cancer,
DNA damage is considered to be an important
event in various stages of development of the
disease, so our finding that eating watercress not
only reduces the level of DNA damage in blood
cells, but also increases the ability of those cells to
resist DNA damage caused by free radicals, is
highly significant.
It is also important to note that our subjects were
not a specially selected group on a restricted diet:
they were very mixed – both men and women,
some were smokers, and they ranged in age from
19-55 years, so the results are very much
applicable to the general population eating a
normal diet.
As I stated earlier, these types of study are not
easy to do and the results represent a huge
amount of work by my colleagues, particularly
Chris Gill, Adele Boyd, and Sam Haldar. Special
thanks also must go to our volunteers, without
whose commitment, patience (and blood!) the
study would not have been possible. Finally, I also
thank the Watercress Alliance, particularly Steve
Rothwell, for having the foresight to fund the study
and for their enthusiastic support over the last few
years.
NB New research from The University of Ulster is summarised
on Page 6
OVERVIEW
No single food can maintain and promote good
health. That comes from the overall benefits of a
healthy diet and lifestyle. But some foods have been
classed as ‘superfoods’ because they are especially
rich in health-promoting nutrients, antioxidants or
phytochemicals (bioactive plant compounds) (1) and
therefore pack more of a nutritional punch than
others. So is watercress one of the original
superfoods? Evidence suggests it is.
This report provides science-based information for
health professionals and focuses on:
• the nutritional composition of watercress
• the potential health benefits of watercress
• a summary of research studies relating to watercress
Key research findings include:
• Watercress is a cruciferous vegetable and population studies
associate an increased intake of cruciferous vegetables with
reduced risk of cancers at several sites.
• Daily consumption of watercress resulted in a significant
decrease in lymphocyte (white blood cell) DNA damage.
DNA damage is an important event in cancer development.
• Watercress is a rich source of the glucosinolate-derivatives
phenylethyl isothiocyanate (PEITC) and methylsulphinylakyl
isothiocyanates (MEITCs), which show a range of anti-cancer
activities.
• Beneficial effects on the three key stages of carcinogenesis
(initiation, proliferation and metastasis) were observed in a
study involving watercress extract and colon cancer cells.
• When smokers ate watercress with each meal for 3 days, the
activation of a key carcinogen (cancer causing agent) in
tobacco was inhibited.
• An in vitro study involving breast cancer cells found that the
addition of a watercress extract inhibited their invasive
potential.
• A study investigating the effects of a diet supplemented with
PEITC in mice grafted with human prostate tumours resulted
in a 50% reduction in tumour weight.
• Watercress is a good source of key nutrients and
carotenoids, such as lutein and beta-carotene, associated with
the maintenance of eye and skin health. Daily consumption of
watercress increased plasma lutein levels by 100% and
beta-carotene levels by 33%.
• Daily watercress consumption has been shown to decrease
plasma triglyceride levels by about 10%.
• Watercress is rich in vitamin A (via beta-carotene) and
vitamin C, and a source of folate, calcium, iron and vitamin E.
It also contains a variety of phytochemicals including
glucosinolates, lutein, flavonoids and hydroxycinammic acids.
• Watercress has significant antioxidant activity in vitro.
• 80g (one cereal bowl full) of watercress provides one of the
‘at least five a day’ portions of fruit and vegetables
recommended by the Department of Health to help reduce
the risk of many chronic diseases.
• As a low calorie vegetable, watercress may play a role in
weight management.
• Nutrients and phytochemicals in fruit and vegetables appear
to work synergistically.
• The mix of nutrients and phytochemicals in watercress make
it a valuable food throughout life, as part of a healthy diet and
lifestyle.
2
INTRODUCTION
Watercress Rorripa nasturtium acquaticum is a member of the
Cruciferae (or Brassicaceae) family, and therefore related to
broccoli, cabbage, Brussel sprouts, cauliflower, rocket and radish.
Cultivated in pure spring water, its health benefits have been
known since ancient times. It is believed to have originated in
Greece and remains an integral part of Mediterranean diets.
In 500BC, Hippocrates, the father of medicine, is said to have
located his first hospital close to a stream to ensure fresh
watercress to help treat his patients. As a longstanding British
favourite, it has been used in herbal remedies from the 1600s,
and has been commercially cultivated since the 1800s.
Watercress is part of the fruit and vegetable food group, with 80g
(one cereal bowl full) providing one of the ‘at least five a day’
portions recommended by the Department of Health to help
reduce the risk of some cancers, cardiovascular disease and many
other chronic conditions (2).
Research indicates that the observed health benefits of diets rich
in fruit and vegetables may come not just from their individual
nutrients or phytochemicals, but from the interactions between
them (3). Watercress is naturally low in calories, virtually fat free
and contains a wide range of essential vitamins and minerals. It is
also a source of a number of phytochemicals with potential health
benefits. These include lutein, quercetin, phenolic acids, and
glucosinolates. The latter release isothiocyanates, including
phenylethyl isothiocyanate (PEITC), of which watercress is the
richest known source. PEITC is a key contributor to the
distinctive peppery flavour of watercress and in a large number of
in vitro and animal studies has been shown to have a range of anti-
cancer effects.
Watercress is sold as a fresh salad vegetable, by itself or mixed
with other salad leaves, and is readily available from greengrocers
and supermarkets. It has been enjoying a renaissance of late with
annual sales increasing by £18 million a year over the past four
years to more than £55 million.
Watercress is very versatile, and can be enjoyed as a salad
vegetable, in soups and smoothies or as an ingredient in cooked
dishes such as stir-fries, sauces for pasta and other meals, jacket
potato fillings and fish dishes.
N U TR I TI ONAL CO MP O SI T I ON O F blood vessels and connective tissues (as required for normal
WATE R C R E S S gums, skin, bones, cartilage and wound healing). It increases the
gastrointestinal absorption of non-haem iron (the form of iron
Watercress is rich in vitamin A (from beta-carotene) and vitamin found in plant foods), and as an antioxidant helps to prevent the
C, and is a source of folate, calcium, iron and vitamin E. It also cell and tissue-damaging effects of free radicals.Vitamin C is
contains useful amounts of vitamin K, thiamin, vitamin B6, needed to synthesize neurotransmitters making it essential for
potassium and iodine and is naturally low in sodium. Due to its normal neurological function (7, 8). Higher plasma vitamin C levels
high water content (93%) it is low in calories. It contains very may benefit cardiovascular health (see page 7).
little carbohydrate and fat but provides some protein.
Folate – and other B vitamins
Table 1. Nutrient content of watercress Watercress is a source of folate with 100g providing 45μg (23%
RDA) and a 80g portion providing 18% of the RDA. Folate is a B
All data taken from (4) unless marked with (5) or (6) vitamin naturally occurring in food. Folate is often referred to as
folic acid, which is a manufactured form of the vitamin. The
Per % EC RDA Per 80g % EC RDA National Diet and Nutrition Survey (NDNS) has indicated poor
100g /DRV or GDA* portion /DRV or GDA* folate status amongst some young women and older people (9).
Energy (kcal) 22 1.1% GDA 18 0.9% GDA Watercress also provides useful amounts - around 11% RDA per
Energy (kj) 94 1.1% GDA 75 0.9% GDA 100g - of thiamin (B1) and vitamin B6 which are required for the
Protein (g) 3.0 6.7% GDA 2.4 5.3% GDA
metabolism of carbohydrate and protein.
Fat (g) 1.0 1.4% GDA 0.8 1.1% GDA
Polyunsaturates (g) 0.4 - 0.3 -
Monounsaturates (g) 0.1 - 0.08 -
Folate (and vitamin B6) is also involved in the maintenance of
Saturates (g) 0.3 1.5% GDA 0.2 1.2% GDA normal blood levels of the amino acid homocysteine. Elevated
Carbohydrates (g) 0.4 0.2% GDA 0.3 0.1% GDA levels have been associated with modestly increased risk of
Sugars (g) 0.4 0.4% GDA 0.3 0.3% GDA coronary heart disease and stroke. The main nutritional cause of
Fibre (g) 1.5 8.3% GDA/DRV 1.2 6.7% GDA/DRV raised plasma homocysteine in most healthy populations is folate
Vitamin A (µg)** 420 53% 336 42% insufficiency (10). There is ongoing debate as to whether this is a
Vitamin D (µg) 0 0 0 0 causal relationship.
Vitamin E (mg) 1.46 14.6% 1.17 11.7%
Vitamin K (µg) (5) 250 - 200 - Folate is also needed for normal cell division, blood formation
Vitamin C (mg) 62 103% 49.6 82.7% (including haemoglobin) and structure of the neural tube in
Thiamin (mg) 0.16 11.4% 0.13 9.1% developing embryos (7). To reduce the risk of neural tube defects,
Riboflavin (mg) 0.06 3.8% 0.05 3%
women who are planning pregnancy are advised to take a daily
Niacin (mg) 0.3 1.7% 0.24 1.3%
400μg supplement of folic acid until the 12th week of their
Vitamin B6 (mg) 0.23 11.5% 0.18 9.2%
Folate (µg) 45 22.5% 36 18% pregnancy and to eat more good sources of folate such as green
Vitamin B12 (µg) 0 0 0 0 leafy vegetables, and foods fortified with folic acid.
Calcium (mg) 170 21.3% 136 17%
Phosphorus (mg) 52 6.5% 42 5.2% Folate is involved in the synthesis, repair, and functioning of DNA,
Iron (mg) 2.2 15.7% 1.8 12.6% and a deficiency may result in damage to DNA, with subsequent
Magnesium (mg) 15 5% 12 4% tumour initiation. This has recently been demonstrated in an
Zinc (mg) 0.7 4.7% 0.56 3.7% animal model study related to colorectal cancer (11). A meta-
Iodine (µg) (6) 15 10% 12 8% analysis found that folate from food sources may offer some
Selenium (µg) (6) 2 3.3% (F), 2.7% (M) 1.6 2.7% (F), 2.1% (M) protection against colorectal cancer (12). However, positive
DRV*** DRV associations may be confounded by nutrients such as fibre, which
Potassium (mg) 230 6.6% DRV 184 5.3%
accompany a diet naturally rich in folate (13).
Sodium (mg) 49 2% GDA 39 1.6%
Salt equivalent (g) 0.12 2% GDA 0.09 1.8%
Iron
Watercress is a source of iron providing 2.2mg iron per100g (16%
* EC RDA – EC Recommended Daily Allowance for selected vitamins and RDA) and 13% of the RDA per 80g portion. Watercress is also
minerals. DRV – UK Dietary Reference Values – used when there is no rich in vitamin C, which is known to increase the absorption of
RDA. GDA – UK Guideline Daily Amounts for adults for key nutrients. non-haem iron. Iron is essential for energy production and the
**Calculated from beta-carotene content normal transport of oxygen in the body via its role in the
***(F) = female, (M) = male DRV. The DRV for potassium is the same for formation of haemoglobin in red blood cells and myoglobin in
men and women.
muscle cells. It is also needed for normal immune function, blood
formation, and neurological development in embryos (7, 8).
Vitamin A
Watercress is a rich source of vitamin A with 100g providing
The NDNS reported that 24% of women (40% aged 19-34) and
420μg (53% of the RDA) and an 80g portion providing 42% of the
3% of men aged 19-24 have iron intakes below the Lower
RDA. Watercress provides vitamin A via beta-carotene which has
Reference Nutrient Intake (LRNI) which puts them at risk of iron
provitamin A activity, where 6μg beta-carotene is equivalent to
deficiency (9). Iron deficiency can lead to anaemia (a deficiency of
1μg vitamin A activity.
red blood cells).
Vitamin A is an essential fat soluble vitamin and is necessary for
Calcium
normal vision (including night vision), structure and function of
Watercress is a source of calcium containing 170mg (21% RDA)
the skin and mucous membranes, reproduction, embryonic
per 100g or 17% RDA per 80g portion. Calcium is needed for the
development, growth and cellular differentiation, and for the
normal structure of bones and teeth, nerve and muscle function,
maintenance of immune function (7, 8).
blood coagulation and the function of digestive enzymes. It can
help to maintain healthy blood pressure and contribute to the
Vitamin C
release of hormones such as insulin (7, 8). Many green leafy
Watercress is a rich source of vitamin C with 100g providing
vegetables, spinach in particular, contain high levels of oxalates,
62mg (103% RDA) and an 80g portion providing 83% of the RDA.
which can significantly reduce calcium bioavailability. However, like
Vitamin C is necessary for the normal structure and function of
kale, watercress is a low oxalate vegetable containing

3
<2.5mg/100g watercress (14). Fairweather-Tait et al (15) have
shown that the fractional absorption of calcium from watercress
soup is 27.4% which compares well to the 35.7% fractional
absorption from calcium-enriched skimmed milk in the
same study.
The NDNS survey indicated that 8% and 5% of 19-24 year old
women and men respectively, have calcium intakes below the
LRNI, which puts them at risk of deficiency (9). This is of
particular concern since the twenties is the last window of
opportunity for increases in bone density before peak bone mass
is attained (16).
Omega-3 fats
Watercress is naturally low in fat. But the little polyunsaturated
fat it does contain has a high proportion of the essential fatty acid
alpha-linolenic acid (18:3n-3), the parent of the omega-3 fatty acid
family. Regular consumption can contribute useful
amounts of omega-3 fatty acids to the diet (17).
While heart health benefits have been more closely associated
with the long chain omega-3 fatty acids (20:5n-3 and 22:6n-3) -
and conversion of 18:3n-3 to long chain omega-3 fatty acids is
inefficient - alpha-linolenic acid is still classified as ‘essential’ and
has key physiological effects. For example, it helps to maintain the
function and integrity of cell membranes (18) and optimises the
ratio of omega-3 and omega-6 fatty acids in the diet. Over the
past few decades there has been a shift in the ratio between
omega-3 and omega-6 fatty acids in the diet, to favour omega-6,
which may interfere with key functions in the body, for example,
optimal prostaglandin and leukotrine formation (18).
P H Y TO C H E M I C A LS A N D A N T I O X I D A N T S
In addition to nutrients, watercress is a rich source of a variety of
phytochemicals. The most clearly identified include glucosinolate
derivatives such as phenylethyl isothiocyanate (PEITC) and
methylsulphinylakyl isothiocyanates (MEITCs), flavonoids such as
quercetin, hydroxycinnamic acids, and carotenoids such as beta-
carotene and lutein. Studies indicate different mechanisms of
action for different phytochemicals (19), which may help to
explain the observed health benefits associated with regular
consumption of fruit and vegetables, including cruciferous
vegetables such as watercress. For example PEITC and MEITC
have been shown to play a role in the suppression of
carcinogenesis in a number of in vitro studies, and flavonoids and
carotenoids have potent antioxidant activity.
Recent in vitro and human intervention studies provide more
specific evidence probably as a result of synergistic activity
between the components of watercress (see pages 6 and 7).
Phytochemical Content of Watercress
Table 2: Flavonoid content of Watercress (20)
Flavonoid mg/100g
Flavones Apigenin 0.01
Luteolin 0.02
Flavonols Kaempferol 1.40
Myricetin 0.20
Quercetin 7.44
Table 3. Rutin and Phenolic acid content of Watercress (24)
Hydroxycinnamic acids (HCAs) are phenolic acids, which are a
major class of phenolic compounds.
Phenolic μmol/g μmol/g
fresh weight dry weight
Q-3-O-Rutinoside (Rutin) 0.05 0.6
Total HCA derivatives 9.4 109.03
4
Table 4. Carotenoid content of Watercress (4, 5)
Carotenoid μg/100g
Beta-carotene 2520
Lutein & zeaxanthin 5767
Glucosinolates
Watercress is one of the most concentrated sources of
glucosinolates. Glucosinolates are sulphur-containing, water
soluble phytochemicals that are widely distributed throughout
cruciferous vegetables. When the vegetables are cut, crushed or
chewed, the enzyme myrosinase is released from the plant cell
compartment to hydrolyze glucosinolates into a number of
breakdown products including aglucones. These aglucones are
very unstable and spontaneously convert to isothiocyanates, such
as PEITC, sulphoraphane and indole 3-carbinol. Isothiocyanates
are absorbed from the upper gastrointestinal tract (21). Cooking
destroys myrosinase, but colon microflora appear to hydrolyse
glucosinolates and allow their absorption, albeit less efficiently
than myrosinase (21, 22).
Isothiocyanates are metabolised in vivo by conjugation with
glutathione, followed by conversion through the mercapturic acid
pathway to N-acetylcysteine conjugates which are excreted in the
urine. The total urinary level of isothiocyanate equivalents is an
excellent biomarker of human consumption of different
glucosinolates (23). Watercress is nature’s richest source of
PEITC, which is derived from the hydrolysis of the glucosinolate
gluconasturtiin.
Cooking can reduce glucosinolate levels by 30-60% depending on
the cooking method, cooking intensity and on the type of
compound, so light and short cooking methods are recommended
to conserve them (21). Since watercress is often consumed raw
this helps to maximise glucosinolate intake.
Table 5. Isothiocyanate content of Watercress (24)
Isothiocyanates are active derivatives of glucosinolates
Isothiocyanate μmol/g fresh weight μmol/g dry weight
7-Methylsulphinylheptyl 0.1 1.07
8-Methylsulphinylheptyl 0.06 0.68
3-Indolylmethyl 0.04 0.43
2-Phenylethyl (PEITC) 1.53 17.98
4-Methoxy-3-Indolylmethyl 0.065 0.791
(4-Methylsulphinylbutane (sulphoraphane): levels on average are 1/20
those of PEITC)
Antioxidants
Diets rich in fruit and vegetables are associated with a reduced
risk of a number of chronic diseases. Protection has often been at
least partly attributed to the antioxidant nutrients in fruit and
vegetables, such as vitamins C and E and selenium (needed to
form glutathione peroxidase, an antioxidant enzyme). However,
many phytochemicals such as phenolics and carotenoids, also have
antioxidant activity and appear to work additively and
synergistically (25-28).
Antioxidants help to protect cells by scavenging highly reactive
free radical molecules (by donating electrons) before they cause
cell and tissue damage. The body constantly reacts with oxygen as
part of the energy producing processes of cells. As a consequence,
free radicals are formed and can be increased by infection, pollution,
cigarette smoke, alcohol and ultraviolet (UV) radiation exposure. The
body has an endogenous (internal) system of antioxidant enzymes
(such as glutathione peroxidase, superoxide dismutase, quinone
reductase, catalase) to counterbalance free radicals. However,
overproduction can cause an imbalance, leading to oxidative stress,
which can damage lipids, proteins, and DNA, and is implicated in the
development of cancer, cardiovascular disease, Alzheimer’s disease
and other chronic diseases (27).
Antioxidants provided by the diet may support endogenous
antioxidant activity. Watercress has significant antioxidant
potential in vitro according to ferric-reducing antioxidant potential
(FRAP) analysis (see Table 6). A number of antioxidants or more
likely, a combination of its bioactive components, might contribute
to this (24, 29). In addition, isothiocyanates have been shown to
stimulate endogenous antioxidant activity (30).
Table 6. Ferric - Reducing Antioxidant Potential (FRAP) (6*, 25, 31**)
The FRAP assay directly measures antioxidants in a liquid sample.
FRAP values are the combined concentrations of all electron
donating antioxidants.
µM/100g
Watercress* 708
Broccoli 580
Spinach 980
Tomato 310
Onion 670
Apple 290
Black tea** 810-1130µM/100ml
P OT E N T I A L H E A LT H B E N E F I T S O F
WAT E R C R E S S
Hippocrates was one of the first to recognise the potential health
benefits of watercress. Today, good intakes of nutrient and
phytochemical-dense green leafy and/or cruciferous vegetables
has been associated with a decreased risk of conditions such as
certain cancers, coronary heart disease, age-related macular
degeneration and skin photodamage. A prospective study of over
6000 adults found that a higher intake of cruciferous vegetables
was linked to a lower risk of all cause mortality (32). However,
epidemiological associations do not show causality. Ongoing
laboratory, animal and human intervention studies are helping to
increase our understanding of why vegetables, including
watercress, offer potential health benefits.
Antioxidant potential of watercress
It is hypothesized that consuming foods rich in antioxidants may
help to prevent or slow the oxidative stress induced by free
radicals. Since there is still much to understand about
phytochemicals, interest is moving towards assessing the
antioxidant activity and in vivo effects of whole foods.
The in vivo evidence that fruit and vegetables actually reduce
markers of oxidative damage has been limited. Null findings may
be influenced by many factors including absorption and
metabolism of phytochemicals, study length and design, and
individual variation in antioxidant status and responsiveness to
dietary antioxidants (33, 34).
Nevertheless, studies have shown that eating fruit and/or
vegetables can reduce the amount of damage free radicals cause
to the blood. For example, it has been associated with markers
such as a reduction in serum oxidizability (35), enhanced
resistance of plasma lipoproteins to oxidation and increased red
blood cell glutathione peroxidase (33). Specifically, fruit and
vegetable consumption can reduce DNA damage (a precursor to
the development of cancer) in blood cells (24, 36, 37). The effects
in blood cells is an indicator of what is happening to tissues less
accessible for sampling and testing. Responsiveness may be
greater for people who are under a higher level of oxidative
stress, such as smokers (34). The University of Ulster study (24)
found that daily watercress consumption resulted in a 100%
increase in plasma lutein, and 33% increase in beta-carotene and a
significant decrease in oxidative damage to white blood cell
(lymphocyte) DNA, especially amongst smokers (see page 6).
5
CANCER
Cancer ultimately stems from damage to cellular DNA, mostly
caused by some form of carcinogen (cancer causing agent) or
virus. Faulty genetic material can also be inherited. If not repaired,
damaged cells have the potential to proliferate uncontrollably to
form a tumour. Cancerous cells may also spread to and invade
other tissues (known as ‘metastasis’). Many diet and lifestyle
factors can influence the development of cancer, a disease that is
expected to affect more than 1 in 3 people in the UK at some
stage of their lives. This section focuses on the potential benefits
of watercress.
Population studies associate an increased intake of cruciferous
vegetables with reduced risk of cancers at several sites (38). In
1977, one of the first papers identifying the potential of
phenylethyl isothiocyanate (PEITC) to inhibit carcinogenesis (the
development of normal cells into cancerous cells) in laboratory
animals was published (39). In 1995, it was demonstrated that
eating watercress protected smokers from a key tobacco
carcinogen implicated in lung cancer (40). In 2000, UK scientists
identified a number of active isothiocyanates in watercress and
found that watercress extract has more powerful anti-
carcinogenic activity than PEITC alone (41). In 2007 an
important study with watercress adds to the few human
intervention studies investigating the effects of cruciferous
vegetable consumption on cancer risk (24).
Isothiocyanates – proposed anti-cancer mechanisms
Many studies – from laboratory and cell culture studies, through
animal models and into human trials – have indicated that
isothiocyanates such as PEITC and MEITCs can inhibit cancer
development by (40-44):
• preventing carcinogen activation by inhibiting phase I enzymes
such as cytochrome P450s - thus stopping a potential
carcinogen becoming a carcinogen.
• increasing the ability of cells to resist attack from carcinogens
by increasing the activity of detoxifying/antioxidant enzymes
known as ‘phase II enzymes’ - such as quinone reductase,
glutathione S-transferases and UDPglucuronosyltransferases.
• inhibiting cell cycle progression - which inhibits the
uncontrolled growth of cancer cells.
• inducing apoptosis (the death of damaged or cancer cells).
Mechanisms of other Components of Watercress
Studies using a watercress extract, which result in antigenotoxic
(reduction in damage to DNA) effects, indicate that PEITC/other
isothiocyanates are not always directly identified as the potentially
active components (29, 45, 46).
Flavonols such as quercetin can accumulate in the plasma (27) and
have been shown to modulate DNA damage from genotoxins in
vitro (47) and have anti-proliferative effects (48). The
hydroxycinnamic acids ferulic acid and p-coumaric acid have been
found to offer free radical scavenging activity, protection against
DNA breakage in mammalian cells and inhibition of phase I
enzyme activity (49).
Watercress is also a good source of lutein and beta-carotene.
Lutein has been shown to have anti-carcinogenic activities in
vitro (50). A placebo-controlled trial in post menopausal women
by Zhao and colleagues (51) with carotenoid supplements (lutein,
β-carotene, lycopene and as mixed carotenoids, at levels
achievable with diet) found a decrease in endogenous lymphocyte
DNA damage as a result of the supplementation. Although
borderline, a recent pooled analysis of 11 cohort studies
investigating intakes of dietary carotenoids and colorectal cancer
risk identified lutein plus zeaxanthin as the only carotenoids to
show any significance (52).
NEW RESEARCH HIGHLIGHT FROM THE
U N I V E R S I T Y O F U LS T E R
Gill CIR, Haldar S, Boyd LA, Bennett R, Whiteford J, Butler B,
Pearson JR, Bradbury I and Rowland IR (2007)
Watercress supplementation in diet reduces
lymphocyte DNA damage and alters blood
antioxidant status in healthy volunteers.
American Journal of Clinical Nutrition 85 (2), 504-510.
Environmental
ks iet
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Gill and colleagues set out to assess the effects of eating
watercress daily on biomarkers related to cancer risk. A single
blind, randomised crossover study was carried out with 30 male
and 30 female healthy volunteers (of which 30 were smokers)
who had a mean age 33 years (range 19-55). During the treatment
phase, subjects consumed one pack (85g) purchased from a local
supermarket of raw watercress for 8 weeks in addition to their
normal diet. During the control phase (8 weeks), subjects were
asked to maintain their habitual diet. The control and the
treatment phases were separated by a 7 week washout phase
when subjects consumed their usual diet, with no watercress. All
volunteers completed a 7-day food diary during each phase of
the trial.
The effect of watercress supplementation was measured on a
range of endpoints including DNA damage in lymphocytes, activity
of endogenous (internal) detoxifying/antioxidant enzymes
(glutathione peroxidase, superoxide dismutase) in red blood cells,
plasma antioxidants (retinol [vitamin A], ascorbic acid [vitamin C],
alpha-tocopherol [vitamin E], lutein, beta-carotene), plasma total
antioxidant status using the FRAP assay and plasma lipid profile.
Watercress leaves were analysed and found to contain a number
of phenolic compounds (rutin, hydroxycinnamic acids) as well as
glucosinolates. They are also known to contain good amounts of
vitamin C, vitamin E, folate, beta-carotene (which can be
converted to vitamin A) and lutein.
All 60 subjects completed the study and food diary, and Body
Mass Index (BMI) analysis found no statistical differences in the
BMI, energy intake and macronutrient intakes between the
control phase and the watercress phase of the study. However,
the mean intakes of dietary fibre, vitamin C, vitamin E, folate and
carotene, were significantly higher during the watercress phase of
the study, suggesting they were a result of the watercress
supplementation.
Compared to the control phase, watercress supplementation was
associated with significant reductions in lymphocyte basal DNA
damage (by 17%) and in basal plus oxidative purine DNA damage
(by 22.9%). Basal DNA damage in response to ex vivo hydrogen
peroxide was reduced by 9.4%. Therefore, watercress
supplementation not only reduced the level of DNA damage in
lymphocytes, but also increased the ability of those cells to resist
DNA damage caused by free radicals. Beneficial changes seen
after watercress intervention were of greater magnitude and
more significant in smokers. This may reflect greater toxic burden
or oxidative stress amongst the smokers, as smokers were also
6
found to have a significantly lower antioxidant status at the start
of the study compared to the non-smokers.
Plasma lutein and beta-carotene were significantly increased by
100% and 33% respectively after watercress supplementation.
However, no significant changes were observed for plasma
concentrations of alpha-tocopherol, retinol, ascorbic acid or in
the total antioxidant potential of plasma (FRAP value). Lipid
profiles (LDL, HDL, total cholesterol) were unaffected by
watercress consumption, with the exception of plasma
triglyceride concentration, which showed a decrease of
around 10% after watercress supplementation, compared to the
control phase. In response to watercress, red blood cell
glutathione peroxidase and superoxide dismutase activity did not
change significantly in the total study population.
Effects of watercress consumption on
blood levels of lutein (100% increase)
µmol/l 0.35
0.3
0.25
0.2 Pre-treatment
0.15
0.1
0.05 Post-treatment
0
Watercress
The exact mechanisms causing the antigenotoxic (anti-DNA
damaging) effects found in this study due to watercress
supplementation are not clear, but may be related to antioxidant
status. A decrease in endogenous lymphocyte DNA damage as a
result of carotenoid supplementation has recently been
demonstrated (51). Therefore, increases in the in vivo
concentrations of lutein and beta-carotene may contribute to the
decrease in DNA damage levels in lymphocytes observed in the
present study.
Watercress contains phenolic compounds and high concentration
of glucosinolates, which may have also contributed to the
antigenotoxicity observed in lymphocytes as a result of
watercress supplementation. However, in this study consumption
of watercress had no effect on antioxidant enzymes such as
glutathione peroxidase or superoxide dismutase activity. Other
potential mechanisms of the antigenotoxicity observed as a
result of watercress supplementation could have been due to
changes in glutathione S-transferase activity as has been
previously observed with cruciferous vegetables.
The authors concluded that the result supports the theory that
consumption of watercress can be linked to a reduced risk
of cancer via decreased damage to DNA and possible affects
on antioxidant status by increasing levels of plasma carotenoids.
C O LO R E C TA L C A N C E R
Epidemiological studies link cruciferous vegetable intake
with a reduced risk of colorectal cancer (30). However, recent
cohort studies appear to question the strength of these findings,
despite plausible mechanisms for anti-carcinogenic activity of
cruciferous vegetables. These inconsistencies may be explained by
factors such as the sensitivity of measuring vegetable intake,
amounts of cruciferous vegetables needed to be consumed to
achieve an effect, and differences in response according to
glutathione S-transferase genotype (sub-grouping populations
according to glutathione S-transferase genotype appears to
strengthen the relationship) (30).
Further supportive evidence comes from a recent investigation
into potential anti-carcinogenic mechanisms for the cruciferous
vegetable watercress, led by scientists at the University of Ulster
(29). They showed for the first time that an extract of watercress
juice can inhibit the three key stages of carcinogenesis. Namely:
initiation (the DNA damage that triggers cancer cell
development); proliferation (uncontrolled growth) of cancer cells;
and metastasis (the spread of cancer cells).
The study involved incubating human colon cancer cells (HT29)
with watercress extract, prepared using watercress bought from
local supermarkets. The cells were then either exposed to toxins
(H202, 4-Hydroxy nonenal and faecal water) known to promote
the DNA damage and abnormal changes that initiate
carcinogenesis, or had their ability to proliferate assessed.
Metastasis (their ability to invade tissues) was assessed by
studying attachment and penetration of HT115, human colorectal
adenocarcinoma, cells through Matrigel.
The watercress extract significantly inhibited DNA damage
induced by oxidative stress from H202 (by 28%) and by faecal
water (by 19%), delayed the cell cycle of the colon cancer cells,
which in turn delays their growth, and significantly blocked the
cells’ invasive or metastatic actions. The study differed from many
others in that it used extracts of whole watercress rather than
individual phytochemicals found in watercress to test for anti-
carcinogenic effects. This provided information on the overall
effect of identified, and still to be identified compounds in
watercress, and how they might work together. The authors
concluded that their studies support the view that watercress
may be effective in helping to reduce cancer risk in humans, and
further studies are warranted.
BREAST CANCER
Inverse associations between vegetable intake, particularly
cruciferous vegetables, and breast cancer have been noted in
some (53, 54) but not all (55) studies. To investigate possible
reasons for these positive associations, Rose et al (56) used a
watercress extract to assess its effects on chemically-induced
cancer cell invasion in human breast cancer cells (MDA-MB-23).
Matrix metalloproteinases are enzymes that break down proteins
such as collagen found in the extracellular matrix, which acts as a
primary barrier to tumour growth and metastasis. Cancer cells
can stimulate abnormally high activity of matrix
metalloproteinases (including metalloproteinase-9), which is
associated with increased invasive and metastatic potential. There
is therefore much interest in agents that may block their action.
The watercress extract (and also a broccoli extract) inhibited
metalloproteinase-9 activities in vitro and also suppressed the
invasive potential of human breast cancer cells. Analysis of the
extracts revealed that the inhibitory effects of each vegetable
were associated with the presence of 7-methylsulphinylheptyl
isothiocyanates (MEITCs) and 4-methysulphinylbutyl
(sulphoraphane).
P R O S TAT E C A N C E R
A number of epidemiological studies link consumption of diets
rich in cruciferous vegetables with a reduced incidence of
prostate cancer (57, 58). One prospective study found a weak
association but suggested that the potential benefits of
cruciferous vegetables may emerge only after many years and
consumption from an early age is recommended (59).
Direct studies with watercress have not been carried out.
However, mechanisms to explain positive associations
with cruciferous vegetables are being investigated. PEITC, the
major isothiocyanate in watercress, has recognised anti-
carcinogenic effects (40). More recent in vivo work suggests a
potential effect on tumour growth. After finding that in vitro
exposure of human prostate cancer cells to the N-acetylcysteine
7
(NAC) conjugate of phenethyl isothiocyanate (PEITC-NAC),
significantly inhibited their growth, Chiao et al (60) assessed the in
vivo affects of a PEITC-NAC supplemented diet versus a non-
supplemented diet on tumours of human prostate cancer cells
grafted on to mice.
After a 9-week treatment period, there was a significant reduction
in tumour size in 100% of the mice on the supplemented diet.
Tumour weight was reduced by 50% compared with mice on the
diet without PEITC-NAC. Mechanisms identified in this study
suggest that PEITC-NAC may reduce tumour growth by inhibiting
proliferation (uncontrolled cell growth) via cell cycle regulators,
and inducing apoptosis (externally triggered cell death).
LU N G C A N C E R
Regular consumption of cruciferous vegetables and associated
isothiocyanates has been linked to a reduced risk of lung cancer,
with stronger effects noted for GST null individuals (who
therefore have no potential protection from the phase II enzymes,
glutathione S-transferases) after sub-grouping according to GST
genotype (61-63).
Anti lung cancer mechanisms for isothiocyanates have been
attributed to the inhibition of phase I enzymes (so neutralizing
potential carcinogens) and/or to the induction of the activity of
phase II enzymes which can detoxify carcinogens. Other possible
mechanisms include acting at the post initiation stage of lung
tumour development via cell-cycle arrest and induction of
apoptosis (64, 65).
Hecht and colleagues (40) had already observed significant
benefits of PEITC for cancer protection in animals and wanted to
assess its potential in humans. Unable to obtain a license for a
human study using pharmaceutical PEITC, Hecht used watercress,
the richest known food source. Eleven smokers volunteered to
expose themselves to the lung-specific tobacco carcinogen 4-
(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) for 3 days,
while consuming 2 ounces (56.8 g) of watercress at each meal.
The result was a highly significant increase in urinary NNK
breakdown products during days 2 and 3 which correlated with
the intake of PEITC from watercress during this period. This
linked PEITC and watercress consumption to the metabolism and
secretion/neutralization of the lung carcinogen NNK.
C A R D I O VA S C U L A R H E A LT H
It has been estimated that eating at least 5 portions of a variety of
fruit and vegetables a day could reduce the risk of deaths from
chronic diseases such as heart disease and stroke by up to 20%
(66). Causal mechanisms are still being clarified, but may involve
reduced lipoprotein oxidation and lipid, homocysteine and blood
pressure reductions. Proposed beneficial components of
vegetables and fruit include: antioxidant nutrients including
vitamin C, folate, flavonoids, lutein, glucosinolates, fibre and
minerals such as potassium and vitamin B6 (67, 68).
The EPIC (European Prospective Investigation into Cancer and
Nutrition) Norfolk population study found that plasma ascorbic
acid (vitamin C) concentration was inversely related to all-cause
mortality, and from cardiovascular disease and ischaemic heart
disease in men and women (69). A rise in plasma ascorbic acid,
equivalent to 50g of fruit or vegetable intake, was independently
associated with about a 20% reduction in all-cause mortality.
While no studies have been carried out with watercress to
specifically assess its potential to help maintain cardiovascular
health, watercress is rich in vitamin C and a good source of most
of the identified beneficial components. In addition, Gill et al (24)
found that blood triglyceride levels were reduced by about
10% after the 8-week test period of watercress consumption
(85g, equivalent to a vegetable portion, daily). Raised blood
triglyceride levels can be a risk factor for cardiovascular disease.
In the same study blood levels of lutein increased by 100%.
E Y E H E A LT H
Watercress is a source of nutrients associated with the
maintenance of normal vision and eye health, including vitamin A,
vitamins C and E, alpha-linolenic acid and the carotenoids lutein
and zeaxanthin, and beta-carotene. Higher intakes of lutein and
zeaxanthin-rich foods have been associated with a lower
incidence of the eye diseases such as cataract and age-related
macular degeneration (50, 70-72) - the most common cause of
poor vision and blindness in people over 60 in the UK.
Diet is the sole source of lutein and zeaxanthin, and they are the
only carotenoids concentrated in the lens and macular pigment
(which protects the macula from the damaging photo-oxidative
effects of blue light). Gradual deterioration of the macular can
cause oxidative stress within the retina, leading to a loss of central
vision. However, it is not currently possible to make clear
conclusions about the distinct role of lutein and zeaxanthin
without more prospective studies. In addition, many other
physiological, lifestyle and dietary factors (such as omega-3 fatty
acids, zinc and the antioxidants vitamins C and E and beta-
carotene) may be associated with the development of these
conditions (73, 74). Nevertheless, a regular intake of lutein-rich
green, leafy vegetables, and other antioxidant rich foods, as part of
a healthy diet and lifestyle (including not smoking) remains a key
recommendation for the maintenance of eye health (75, 76). The
Ulster study (24) showed a 100% increase in plasma lutein levels
in subjects regularly eating watercress.
S K I N H E A LT H
Watercress contains a range of nutrients and phytochemicals
associated with the maintenance of skin health, including vitamins
A (from beta-carotene), C and E, polyphenols and carotenoids
(77, 78).
Phytochemicals such as carotenoids and flavonoids are part of the
light-protecting systems in plants and appear to contribute to the
prevention of UV damage in humans. Free radicals can be
produced in the skin as a result of UV radiation from sun
exposure and pollution, which over time can damage skin DNA,
proteins and lipids, with the potential for skin ageing, immune
suppression and possibly skin cancer. Associations have been
found between higher intakes of carotenoids (from fruit and
vegetables) and reduced risk of melanoma (79) and higher intakes
of green leafy vegetables and reduced risk of recurrence of
squamous cell carcinoma (skin cancer) (80).
The skin has internal antioxidant defence systems but also
appears to make use of dietary antioxidants, including carotenoids
such as beta-carotene, lutein and lycopene, which can accumulate
in the skin (77, 81). Methods such as Raman resonance
spectroscopy have been used to measure the uptake of
carotenoids in the skin, and high levels have been associated with
8
skin protection and reduced wrinkling (81). While no direct
research has been done with watercress, human intervention
studies with supplements or a carotenoid-rich diet have shown
evidence of skin photo-protection after intervention periods of at
least 10 weeks (82). An animal study found that compared to a
standard diet, a lutein-supplemented diet resulted in lutein
accumulation and a decrease in reactive oxygen species (free
radicals) in the skin and a significant inhibition of skin
photodamage (83).
WEIGHT CONTROL
Almost two-thirds of UK adults are overweight and 23% of men
and 24% of women are obese. Based on recent trends, 12 million
adults (33% of men and 28% of women) are predicted to be
obese by 2010 (84, 85).
Most fruit and vegetables have a low energy density, which can
contribute to feelings of fullness and may help with weight
control. Higher intakes of fruit and vegetables have been
associated with better body weight control in women (86).
Watercress is low in fat and calories with 18 calories per 80g
portion. As a salad vegetable it is most often eaten as part of a
mixed salad. Like most vegetables it has a high water content
(93%) and low energy density. Research carried out at
Pennsylvania State University (87) found that eating a large, mixed
low fat salad as a starter resulted in subjects eating 12% fewer
calories (a saving of more than 100 calories) overall at that meal,
compared to when they didn’t start their meals with the salad.
LIFE CYCLE N UT R IT ION
The mix of nutrients and phytochemicals found in watercress
make it a valuable food that can help to support the body’s
natural defences and contribute to health and well being
throughout life.
As a salad vegetable it can contribute to the nutritional benefits
associated with daily salad consumption. A recent analysis found
that salad consumers tended to have more favourable intakes of
vitamins C and E, folate and carotenoids and consistently higher
serum values of these nutrients (88).
All essential nutrients support growth and development (7).
Watercress is an especially good provider of vitamins A (via
beta-carotene), C and K, folate, iron and vitamin E. Calcium is
important to build and maintain strong bones, and vitamin K
contributes to normal bone structure. During pregnancy
requirements increase for vitamins A and C. Folate is needed for
the normal development of the neural tube so helping to prevent
neural tube defects such as spina bifida. Folate also plays a role in
maintaining blood and circulation.
Eating plenty of vegetables (around 3 portions daily), especially
green leafy, yellow and cruciferous vegetables, has been associated
with a slower rate of cognitive decline amongst people aged 65 or
over (89).
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