Mustard

June 2010

Sinapis alba L. (white or yellow mustard), Brassica nigra L. Koch (black or true mustard), Brassica juncea L. Czern. et Cosson (oriental, leaf, or Indian mustard). Family: Brassicaceae.

Mustard , black mustard , Indian mustard , leaf mustard , true oriental mustard , white mustard , yellow mustard

Uses

Derivatives of the mustard constituent allyl isothiocyanate form the basis for toxic agents such as mustard gases and antineoplastic drugs (eg, bendamustine). Mustard is used as a food flavoring, for forage, as an emetic, and diuretic, as well as a topical treatment for inflammatory conditions such as arthritis and rheumatism. Mustard also has potential pharmacological effects in cardiovascular disease, cancer, and diabetes; however, there are limited clinical trials to support its use for any indication.

Dosing

Limited clinical trials are available to guide dosage. Patients with suspected acute myocardial infarction received mustard oil 2.9 g/day orally.

Contraindications

None well documented. Avoid use in patients who are hypersensitive to mustard or related plant species. Topical mustard oil should not be used for massaging newborn infants.

Pregnancy/Lactation

Information regarding safety and efficacy in pregnancy and lactation is lacking. Avoid dosages higher than those found in food.

Interactions

None well documented.

Adverse Reactions

Allyl isothiocyanate and mustard oil are irritants and induce lacrimation, hyperalgesia, inflammation, and neuroexcitation. Immunoglobulin E (IgE)-mediated food allergy to mustard and other members of the mustard family, as well as cross-sensitivity to other plants, is documented.

Toxicology

Data are limited.

The genus Brassica contains over 150 species that are cultivated worldwide as oilseed crops or vegetables. The mustards are annual or biennial herbs that grow from 1 to 3 m in height. The dried, ripe seed is used commercially. Ground mustard, derived from the powdered mustard seed, is known as mustard flour. Single or mixed white, black, or brown mustard seeds are the main types. More pungent mustards are derived from seeds from which the fixed oil has been removed. ^1, , ²

Mustard seed has been used internally and externally since ancient times. Mustard and its oil have been used as a topical treatment for rheumatism and arthritis, as a foot bath for aching feet, and in the form of plasters over the back and chest to treat bronchitis and pneumonia. ^3, Internally, mustard seeds have been used as appetite stimulants, emetics, and diuretics. ⁴

When black mustard is prepared as a condiment with vinegar, salt, and water, the product is known as German-prepared mustard. S. alba seed, when prepared in a similar manner but without spices, is known as English mustard. Mustards are grown extensively as forage crops. ⁴

Mustard seeds contain numerous chemical constituents, including phytoalexins (sinalexin, sinalbins A and B), sterols and steryl esters (primarily sitosterol and campesterol), and flavonoids (eg, apigenin, chalcone). Crude mucilage from mustard has been analyzed and contains 80% to 94% carbohydrates, 1.7% to 15% ash, and 2.2% to 4.4% protein. ^5, The flavor of mustard seeds is derived from glucosinolates, which are thiocyanate glycosides. Sinalbin is responsible for the flavor of white mustard seed; sinigrin is responsible for the sharper taste associated with black and brown mustard seeds. Volatile mustard oil is derived from steam distillation or by expression. The fixed oil does not contribute to the mustard's pungency, and ground mustard does not have a pungent aroma. The pungency is produced by glucosinolates, which are hydrolyzed by the enzyme myrosinase (a thioglucoside glucohydrolase) to flavor-active isothiocyanates (mustard oils). Sinalbin primarily yields the nonvolatile 4-hydroxybenzyl isothiocyanate, while sinigrin yields the volatile allyl isothiocyanate, which is responsible for the pungent aroma. Depending on the variety of mustard, the yield of allyl isothiocyanate is approximately 1%. Brassica species produce large quantities of isothiocyanates; more than 50 different isothiocyanates have been reported as glucosinolate hydrolysis products. Other components of the oil include fixed oil, proteins, sinapic acid, and sinapine. ^2, , ^5, , ^6, , ^7, , ^8, , ⁹

There have been numerous phytochemical investigations on mustard seed; however, few clinical trials exist to support a clinical application of mustard seed oil. Derivatives of allyl isothiocyanate have formed the basis for toxic agents such as mustard gases and antineoplastic drugs (eg, bendamustine).

Cancer Numerous mechanisms of action are proposed for potential cancer chemoprotective activity of organic isothiocyanates. The cytotoxicity of mustard derivatives on neuroblastoma cells has been investigated. ^10, , ¹¹

Mustard juice was protective against benzo[a]pyrene (B[a]P)-induced DNA damage in human-derived cells in a dose-dependent manner. Chemoprotective properties may be associated with induction of detoxifying enzymes. ^12, Another study examined the effects of organic isothiocyanates on P-glycoprotein and multidrug, resistance-associated, protein (MRP1)-mediated transport in multidrug resistant (MDR) human cancer cell lines. Both P-glycoprotein and MRP1 are involved in the bioavailability, distribution, and elimination of many drugs. Dietary organic isothiocyanates inhibited the P-glycoprotein– and MRP1–mediated efflux of daunomycin and vinblastine in MDR human cancer cells, enhancing the efficacy of cancer chemotherapy. The study also found evidence of organic isothiocyanates inhibiting tumor formation in breast, colon, lung, and skin tissue in animal models. ¹¹

Mustard essential oil reduced tumor cell proliferation via apoptotic and antiangiogenesis mechanisms in mice, while the mucilage fraction of S. alba inhibited colonic preneoplastic changes in rats. ^13, , ¹⁴

Cardiovascular disease The potential of B. juncea as a natural source of the antioxidant alpha-tocopherol has been described. ¹⁵ Aqueous extracts of mustard inhibited lipid peroxidation induced by FeSO₄ -ascorbate on human erythrocyte membranes in one study. ¹⁶

No difference was found in serum cholesterol or triglyceride levels in rats fed the mucilaginous fraction of mustard. ^14, Epidemiological studies suggest that higher levels of monounsaturated fats were associated with erucic acid–rich mustard seed oil intake. ¹⁷

A 12-month, randomized, placebo-controlled trial examined the effects of fish oil versus mustard oil in 360 patients with suspected acute myocardial infarction (MI). Treatments were administered to all patients approximately 18 hours after symptoms of an acute MI. Patients in group A (n = 122) received fish oil 1.08 g/day orally, group B (n = 120) received mustard oil 2.9 g/day orally, and 118 patients received placebo. Results indicated a reduction in total cardiac events in patients treated with fish oil or mustard oil compared with placebo (24.5% and 28% vs 34.7%; P < 0.01). Nonfatal infarctions also occurred less frequently in patients treated with fish oil or mustard oil compared with placebo (13% and 15% vs 25.4%; P < 0.05); however, total cardiac deaths were not reduced in patients treated with mustard oil or fish oil. When compared with the placebo group, patients treated with fish oil or mustard oil showed a reduction in total angina pectoris, cardiac arrhythmias, and left ventricular enlargement. Diene conjugates were reduced in both treatment groups, indicating antioxidant activity. ¹⁸

Another randomized, single-blind clinical trial enrolling 1,000 patients with angina pectoris, MI, or surrogate risk factors for coronary heart disease documented similar results in patients who increased intake of whole grains and mustard or soybean oil. ¹⁹

Hyperglycemia Clinical trials are lacking.

Studies in rats exhibited a hypoglycemic effect in normal animals, as well as effects (decreased serum glucose and increased insulin response) on postprandial glucose in diabetic-induced animals, using both the whole plant and mucilaginous extracts. Proposed mechanisms include modulation of gluconeogenic and glucolytic enzymes. ^20, , ^21, , ^22, , ^23, , ²⁴

Other uses

Antibacterial Allyl isothiocyanate has antimicrobial and antifungal activity, and the antibacterial effect of mustard flour and oil has been evaluated for application in the processed meat industry for its inhibitory effect on Escherichia coli and salmonella. ^9, , ^25, , ^26, , ²⁷

Nociceptive Because of its topical irritant effects, mustard has been used traditionally as a rubefacient and irritant. These properties have served as models for animal analgesia experiments. ^28, , ²⁹

Numerous studies elucidating the mechanism of action of nociceptive chemicals, including mustard oil, have been published and describe the transient receptor potential ankyrin-1 and related ion flow within specific neurons. ^30, , ^31, , ^32, , ^33, , ^34, , ³⁵

Limited clinical trials are available to guide dosage. Numerous commercially available products contain mustard in capsule, powder, and tablet forms.

Patients with suspected acute MI received mustard oil 2.9 g/day orally. ¹⁸

A study in humans determined that the major urinary metabolite of allyl isothiocyanate is excreted within 8 hours. A dose-dependent excretion of the metabolite was observed. ³⁶

Safety and efficacy have not been established. Avoid dosages higher than those found in food.

None well documented.

Allyl isothiocyanate and mustard oil are irritants, inducing lacrimation, hyperalgesia, inflammation, and neuroexcitation. ^4, , ^37, , ³⁸

IgE-mediated food allergy to mustard and other members of the mustard family, as well as cross-sensitivity to other plants, is documented. ^39, , ^40, , ^41, , ^42, , ^43, Although there are few reports of anaphylaxis, allergy to mustard is not uncommon. ⁴⁴ Rhinitis associated with S. alba has been reported, ^45, as well as sensitization by mustard in atopic individuals. ^46, , ⁴⁷

A case report of a pityriasis rosea–like eruption after topical application of mustard oil has been documented. ⁴⁸

Toxicological studies of mustard oil are lacking.

The use of mustard oil for massaging newborn infants is not recommended based on studies in mice with suboptimal skin barrier function in which increases in transdermal water loss and structural changes in epidermal keratinocytes were observed. ⁴⁹

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