Lettuce consumption increases the total cholesterol end-products excretion
and improves antioxidant status due to the richness in antioxidants (vitamins C,
E and carotenoids). In a rat study, lettuce clearly shows a beneficial effect on
lipid metabolism and on tissue oxidation. French researchers found feeding
rats a 20% lettuce diet for 3 weeks resulted in a decrease cholesterol LDL/HDL
ratio and a marked decrease of liver cholesterol levels (-41%). Concurrently,
fecal total steroid excretion increased (+44%) and apparent absorption of
dietary cholesterol was significantly depressed (-37%) by the lettuce diet.
Lettuce diet also displayed an improvement of vitamin E/TG ratio in plasma
and limited lipid peroxidation in heart.  Therefore regular consumption of
lettuce should contribute to improve protection against cardiovascular
In fact, epidemiological studies have also shown that consumption of fruits and
vegetables is associated with reduced risk of other chronic diseases.
Increased consumption of fruits and vegetables containing high levels of
phytochemicals has been recommended to prevent chronic diseases related to
oxidative stress in the human body. 
It has been reported that a reduction in risk of colorectal, stomach and lung
cancer was associated with intake of lettuce. [1-4] Slattery ML and co-workers
from University of Utah Medical School found that lutein was inversely
associated with colon cancer in both men and women. And, lettuce is one of
the major dietary sources of lutein. Thus, intake of lettuce may help reduce the
risk of developing colon cancer. 
The lettuce that we see today, actually started out as a weed around the
Mediterranean basin. Served in dishes for more than 4500 years, lettuce has
certainly made its mark in history with tomb painting in Egypt and identification
of different types of lettuces by various Greek scholars. Christopher Columbus
introduced lettuce to the new world and from there, lettuce in the United States
Most dark greens are good sources of Vitamin C and other nutrients. The rule
of thumb is, usually, the darker the greens, the more nutritious the leaf.
A serving (1 cup chopped, raw (56 g) of shredded Romain lettuce contains 10
calories, 0 g of total fat, 0 g of saturated fat, 0 mg of cholesterol, 0 mg of
sodium, 2 g of total carbohydrate, 1 g of dietary fiber, 1 g of sugars, 1 g of
protein, 70% daily value of vitamin A, 20% of vitamin C, 2% of calcium, and 4%
of iron. The percent daily values are based on a 2000 calorie diet.
There are four main types of lettuce and under each type there are different
Butterhead (includes Boston and Bibb)
Loose heads, grassy green leaves, butter texture, mild flavor. Good examples
are Boston lettuce, which looks like a blooming rose, and Bibb lettuce that has
a small cup-shaped appearance. Crisphead
The least nutritious of the salad greens, this pale green lettuce takes on the
cabbage appearance with its leaves more tightly packed together. An example
is the Iceberg lettuce. It's known for the crispy texture and very mild flavor.
This variety doesn't grow to form lettuce heads, but is instead the leaves are
joined at the stem. Good examples of this variety include: oak leaf, red leaf,
and green leaf.
Romaine or Cos
This lettuce has gained tremendous popularity in the past decade as the key
ingredient in Caesar salads. It has a loaf-like shape with darker outer leaves.
It's strong taste and crispy texture has been favored by those who like Iceberg
Selection and Storage
Lettuce is a delicate vegetable and great care should be taken when selecting
and storing. Most lettuce is showcased on ice or in refrigeration. When
selecting your leaves, be sure that they are fresh and crisp, with no signs of
wilting, slim, or dark spots or edges. Remember when selecting your lettuce
that the darker outer leaves are the most nutritious.
Lettuce tends to keep well in plastic bags in the crisper section of the
refrigerator. Iceberg lettuce keeps the best, lasting around two weeks, while
Romaine, ten days, and butterheads types and endives lasts approximately
four days. The very delicate greens don't last very long, so it's best to buy only
as much as you need at one time and use immediately.
Salad greens should not be stored near fruits that produce ethylene gases
(like apples) as this will increase brown spots on the lettuce leaves and
increase spoilage. Greens that are bought in bunches should be checked for
insects. Those leaves that have roots should be placed in a glass of water with
a bag over the leaves and then placed in the refrigerator.
Generally lettuce is eaten raw, so consider removing any browned, slimy, or
wilted leaves. For all lettuce types, you should thoroughly wash and 'dry' the
leaves to remove any dirt or lingering insects. If you eat lettuce often, it's wise
to invest in a salad spinner. Simply rinse the leaves and place in the spinner to
remove the excess water.
In addition to their most common use in salads, you can also braise, steam,
sautè and even grill certain lettuce varieties to create a wonderful and different
taste treat. Try halving a head of radicchio or romaine lengthwise, and brush
on some extra virgin olive oil, and grill until they soften and just begin to
 Trichopoulos D, Ouranos G, Day NE, Tzonou A, Manousos O,
Trichopoulos A. Diet and cancer of the stomach: a case-control study in
Greece. Int J Cancer. 1985 Sep 15;36(3):291-7.  Gao CM, Tajima K,
Kuroishi T, Hirose K, Inoue M. Protective effects of raw vegetables and fruit
against lung cancer among smokers and ex-smokers: a case-control study in
the Tokai area of Japan. Jpn J Cancer Res. 1993 Jun;84(6):594-600. 
Deneo-Pellegrini H, De Stefani E, Ronco A.Vegetables, fruits, and risk of
colorectal cancer: a case-control study from Uruguay. Nutr Cancer.
1996;25(3):297-304.  Fernandez E, La Vecchia C, D'Avanzo B, Negri E,
Franceschi S. Br J Cancer. 1997;75(9):1381-4. Risk factors for colorectal
cancer in subjects with family history of the disease.  Slattery ML, Benson J,
Curtin K, Ma KN, Schaeffer D, Potter JD. Carotenoids and colon cancer. Am J
Clin Nutr. 2000 Feb;71(2):575-82.  Chu YF, Sun J, Wu X, Liu RH.
Antioxidant and antiproliferative activities of common J Agric Food Chem. 2002
Nov 6;50(23):6910-6.vegetables.  Nicolle C et al, Health effect of
vegetable-based diet: lettuce consumption improves cholesterol metabolism
and antioxidant status in the rat. Clin Nutr. 2004 Aug;23(4):605-14.
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