Ayurveda in Modern Medicine,
by Dr. Venkateswarrao Karuparthi
Ancestral Stories Hidden in Our DNA
High Density Lipoproteins (HDL)
Cholesterol Reducing Drugs and Women
Mother's oral health and children's risk
Supersize (meals-waistline-pharmaceutical-research) America
Second Hand Smoke
Fruits and Vegetables
Recipe: Apricot And Brown Rice Pilaf
A Natural Anti-depressant for Women
Cancer Causing Snacks
Insulin Without Injections
How are we related?
AYURVEDA IN MODERN MEDICINE: GUGGULU
There has been tremendous interest in Ayurveda recently as an alternative medicine in the US, for example, Guggulu. The research interest on Guggulu will be on the burner as long as the modern medicine recognized the cholesterol problem and scientists like Dr. Moore are interested to investigate. If this Guggulu is safe and effective then why is it not widely used and spreading like a wild fire all over the world?
First reason is ‘bottom line’ economic profitability reasons override the common good and humanity. The pharmaceutical industry cannot survive on research like Dr Moore’s work, because they cannot patent Guggulu and make profits. Currently, lipid-lowering drugs on the market are close to billion-dollar industry, even though all of them have side effects in long-term use and stop working as soon as patient stops taking.
The second reason is evaluation of Ayurveda as an alternative medicine using the model of "modern science" and its research methodology. We are trying to understand Ayurveda through modern science, while the fundamentals of Ayurveda are quite different. The two systems may be integrated to take advantage of each other, but one system cannot be evaluated and researched with fundamentals of the other. However, independent overall clinical outcomes and evidence can be evaluated.
Ayurveda did not discuss the concept of cholesterol, but prescribed Guggulu for disorders like obesity. So, Dr. Moore predicted that it might have lipid-lowering effect seen through the eyes of modern medicine and proved that Guggulu, in fact, lowered the cholesterol levels. Does this mean that this can translate into a ‘magic drug’ that can be mass-produced and used effectively? Not so, if you look carefully into fundamentals of Ayurveda. Further, if you look at the listing of Ayurvedic applications of Guggulu, it is prescribed for arthritis, bronchitis, diabetes, obesity, back pain, throat ulcers and the list goes on. In fact, every herb or medicine in Ayurveda has a long list of conditions that it is used to treat.
Isn’t this absurd that a single medicine can be used effectively for so many diseases and symptoms? It only makes sense, if you understand Ayurvedic fundamental principles.
Isn’t this like a magic pill that works for everything? Yes, but only for a patient who follows a regimen of a combination of herb, yoga, diet, and a prescribed daily routine according to Ayurveda. A combination of the above to match an individual’s constitution and external environment is more important than any single item from the regimen.
So, if you use a certain herb or a protocol to treat everybody with, you will not see any statistically significant outcome under the scrutiny of modern medicine. However, if you test the active ingredient, it may work in a statistically significant number of individuals to affect a specific symptom like high cholesterol but not the entire disease process. However, this invariably results in side effects, as the disease is not treated in its entirety. For example, all the cholesterol-lowering drugs that are currently on the market have side effects and limitations. Another example is ayurvedic herb ‘sarpagandha’ to treat hypertension.
The modern medicine produced ‘reserpine’ the active ingredient of sarpagandha. This works for hypertension but the side effect profile is so bad that we now abandoned this drug. We have better drugs for hypertension in our medical arsenal now, but with side effects. However, we still haven’t found a drug for hypertension without side effects and work more than a day each time you take the pill. The story is same with every known disease as the emphasis is on disease management rather than a permanent cure. Here, Ayurveda differs from Allopathy.
On a fundamental level, Ayurveda treats the patient who has the disease but not the symptoms alone. Fundamental to Ayurveda is clinical classification and understanding the patient before even thinking about treatment. This involves identification of ‘prakriti’ (nature) of the patient by intricate clinical methods. This is basically "Bio-Genetic Mind-Body Typing" of each patient and perfectly matching his or her treatment regimen. Each individual is unique in their bio-genetic-mind-body type including twins. This means each patient is unique and his or her treatment is different from any other existing in this world. Is this too "Sci-Fi" to be true to achieve just by clinical examination of the patient without labs, microscope etc.? No, not really if you understand and follow the fundamental principles of Ayurveda.
Ayurveda explains 6 stages of the disease process.
1. Accumulation: One or more doshas (humors)
2. Aggravation: The excess dosha starts to spread
3. Dissemination: Dosha moves throught the body
4. Localization: Dosha settles at weakest location depending on particular biotype of patient involved.
5. Manifestation: Physical symptoms arise at that location (eg: headache or increased acidity symptoms in stomach)
6. Disruption: Disruption of anatomy and physiology of location and full-blown disease.
Ayurveda treats effectively first 4 stages of the disease where the symptoms are very vague and occasional such as stomach acidity, headaches etc., and modern medicine treats these with over the counter (OTC) medicines. During these stages if the patient visits an MD, he or she would not find any serious clinical signs or symptoms of the disease and lab tests will be perfectly normal and patient is sent back home. This window of courtship of imbalance of health lasts many years before the tests show any abnormality. Modern medicine starts to recognize symptoms of any disease in the 5th stage and starts to treat 6th stage of disease. So, 80% to 90% of ill health is waiting to mature to be treated as heart attacks, total knee replacements, open heart surgeries, etc. Thus, one can argue that Ayurveda is a preventive medicine treating healthy population, while modern medicine is for totally sick patients. Ayurvedic clinical methods are sensitive enough to pick up subtle imbalance in the mind and body functioning and so we are treating very, very, early before localization of the disease. According to Ayurveda the standard of health is very high and perfect health is not mere absence of disease.
How is this done? Ayurveda classifies every patient’s prakriti (internal nature), which does not change that patient’s mind-body type from birth to death. We know everything from color of hair, eyes, build of the body and behavior of each individual is programmed in genetics and the surrounding environment. As long as one is close to the original constitution, patient stays healthy. Constant inevitable interaction with external surroundings by violating the rules of nature for that particular individual gives rise to imbalanced internal nature, which is vikriti. It is best to treat any first signs of vikriti in any individual.
The unique thing of Ayurveda is this clinical reading of genetic expression of each individual’s prakriti and its interaction with external nature producing internal derangement vikriti. This clinical reading is done by tridosha (three-humor) theory involving three humors, namely vata (wind), pitta (bile), and kapha (phlegm). Vata controls movement, pitta controls metabolism, and kapha controls structure.
Nobody fits into one type but some combination of all three humors. If we consider two predominant humors of one’s constitution, we have at least 6 types of prakriti to be classified, vata-pitta, pitta-vata, pitta-kapha, kapha-pitta, vata-kapha and kapha-vata. The next step an Ayurvedic physician looks at is at least 25 or more gunas (attributes) of each of the dosha and their expression in the patient to narrow down to accurate diagnosis.
The next step is to consider 5 sub-types of each dosha and a combination of those each expressing an imbalance or manifestation of symptoms in 10 or more anatomical locations of the body to nail down the way the unhealthy imbalance is spreading in that particular patient. The next thing an Ayurvedic physician will also look for the expression of not only anatomic locations but also 7 dhatus (dhatu means roughly constituent elements or tissues). The above two are also correlated with srotamsi (at least 20 or more channels in the body through which the humors move in the body. We haven’t yet considered other concepts like ojas, tejas, and prana (pure essence of humors), which would be considered by an Ayurvedic physician in the same context to bring back the balance of health and vitality. All the above information is gathered and processed by interview, clinical examination, pulse and tongue evaluation and other tests.
The above is a very brief description of Ayurveda methodology to stimulate reader’s interest. Now let us apply the above methodology, for example, to Guggulu. In a vata-kapha type individual with a vata imbalance and depending on the sub-type of affected vata, the srotamsi (channel) and dhatu (tissue), the imbalance may express as nervous disorder, low back pain or arthritis and counter balancing kapha may produce hypercholesteremia (in ayurvedic terms kapha character is accumulation and stagnation including fat). These conditions can be treated with Guggulu. In a pitta-kapha type individual pitta aggravation imbalance can cause bronchitis, cystitis, throat ulcers and counter-balancing kapha can cause hypercholesteremia, which can be treated with the same Guggulu.
Actually, Guggulu is not used alone usually, but used in combination with other herbs to balance other doshas, to improve accuracy and tailor fit to each patient. Some formulations, to name a few are Kaishor Guggulu, Yogaraj Guggulu, Punarnavadi Guggulu etc. These are essential because if you give a blanket standard treatment of all hyper-cholesterol patients with Guggulu, it may not work. For example, if you administer Guggulu to an individual with hypercholesteremia of pitta-kapha type you may end up aggravating pitta and have cystitis or bronchitis aggravated. In addition, timing of administration of medicine to each patient is also very important. Diurnal variation of vata, pitta, and kapha times of the day has to be matched to the timing of the intake of medicine.
So, Ayurveda is the ultimate art of holistic medicine where individual ingredient in a formulation is as important as the timing of its administration. An experienced Ayurvedic physician should give these global holistic treatments while closely watching vikriti. It takes long years of practice gathering clinical acumen to really harness the science and art of Ayurveda unlike modern medicine which is more and more based on technology, labs and procedures.
An unfortunate side product of recent hype in alternative medicine is commercialization of these products to claim benefit specific symptoms like hypercholesteremia etc., which was never the intention of Ayurveda in its pristine practice.
On one hand it is important to have studies like Dr. Moore’s to authenticate the scientific basis of these ancient medicines, and on the other hand it is a mistake to try to insert and practice ayurvedic-allopathic medicine thinking that we are integrating the two systems of medicine. The real integration of Ayurveda and modern medicine is achieved by following the principles of Ayurveda with the aid of modern technology. It is very important to follow the methodology of Ayurveda in its entirety, if we want to achieve the goal of overall health of the individual and the society.
High Density Lipoproteins (HDL)
Low blood levels of High Density Lipoproteins (HDL), increase the risk of dementia in the elderly, even if they show no signs of heart disease or stroke, researchers report in a new study, published in the June issue of the Annals of Neurology, 51:716-721 (2002). In the study of 561 85-year-old men and women, those with the lowest blood levels of HDL levels were more than twice as likely to have dementia as those with the highest HDL levels. When the researchers excluded patients with documented heart disease or stroke, they found that those with the lowest HDL levels were nearly four times as likely to have dementia as those with the highest levels. And neither of these findings was affected by a person's educational background or their blood levels of two types of harmful lipids: "bad" Low Density Lipoproteins (LDL) or triglycerides. The researchers said it is possible that patients without documented cardiovascular disease may have had a stroke that went undetected, and that this contributed to their dementia. It is also possible that HDL helps slow mental decline by preventing the formation of plaques associated with dementia or by reducing inflammation in the brain, they suggest. In the average man, HDL cholesterol levels range from 40 to 50 milligrams per deciliter (mg/dL) of blood, according to the American Heart Association. In the average woman, they range from 50 to 60 mg/dL. An HDL level below 40 mg/dL is considered low. People can raise their HDL level by losing excess weight, exercising regularly and stopping smoking. Click here for more on Lipids.
Currently, there is an annual reduction of about 6 million in the number of hungry people in the world. That must increase to 22 million a year to meet the 1996 U.N. targetto reduce the number of the world's hungry people from about 800 million to 400 million by 2015.
-A $180 billion annual investment in agriculture, infrastructure and services in the developing world is needed to meet the target.
-About 12.8 million people in six southern African nations - Zimbabwe, Zambia, Malawi, Lesotho, Swaziland and Mozambique - are at risk of starvation because of drought, floods, depleted food stocks and economic instability.
-Of the 9.5 million undernourished people living in transition countries of Europe, nearly 60 percent live in Azerbaijan, Armenia, Georgia and Moldova.
-UNAIDS estimates that more than half of the 28 million people living with HIV/AIDS in sub-Saharan Africa are in rural areas, devastating thousands of farming communities and leaving families struggling to produce enough food to survive.
-About 54 million people suffer from chronic malnutrition in Latin America and the Caribbean.
Cholesterol Reducing Drugs and Women
Treatment with a cholesterol-lowering statin can significantly reduce the risk of heart disease and possibly death in postmenopausal women taking hormone replacement therapy (HRT), investigators report in the rapid access issue of Circulation: Journal of the American Heart Association. This article focuses on women who have reached menopause. Women taking statins had a 21 percent lower risk of heart attack and death related to heart disease and a 33 percent lower risk of dying from any cause during four years of treatment, compared to women who did not take statins. Statin therapy was also associated with a 55 percent lower risk of venous thromboembolism (VTE, blood clots in veins), a potentially life-threatening problem that can occur in women on HRT. "Statin" is the popular name for the class of cholesterol reducing drugs including Mevacor, Zocor, Lipitor, Pravachol, and Lescol. Statins help prevent heart attacks for women as much as they do for men.
Mother's oral health and children's risk
A study published in the June issue of Community Dentistry and Oral Epidemiology by the researchers from the Montefiore Medical Center and the Montefiore Dental Center, Bronx, New York, and the New York University College of Dentistry, New York, New York indicate that a mother's oral health and dietary habits may help to predict the risk of tooth decay in her young children. If mothers had high levels of mutans streptococci, bacteria known to contribute to dental decay in the mouth, their 3- to 5-year-old children had more than 11 times the risk of decay than children of mothers with low levels of these bacteria. If mothers had treated tooth decay or consumed large amounts of sugar, their children had four times the risk of decay compared with children of mothers without decay or those with low sugar consumption.
Supersize (meals-waistline-pharmaceutical-research) America
Americans are being manipulated by the (food) industry into eating far more than they need, or even want to. Those supersize portions at fast-food outlets may look like bargains, but they cost Americans billions of dollars in obesity-related illnesses. But, don't worry, that money is well spent on research on obesity, heart diseases, diabetes and cancer related research. It is a nice food-auto-pharmaceutical-research-industry cycle that sustains the economy. So, we should eat more and buy more cars, exercise equipment and pills, right? Wrong! The AICR, which advocates better diets to prevent cancer, teamed up with the Consumer Federation of America and the Center for Science in the Public Interest for the campaign, and wants Americans to rebel against supersized and value-sized food portions. More than 60 per cent of Americans are overweight and more than a quarter are obese, meaning they are 20 percent over ideal weight and face health problems. Overweight people have a higher risk of diabetes, heart disease and some cancers.
Generation X-Tra Large: A study found: Twenty-six percent of men and 28 percent of women were obese by the time they were 35 to 37. Young adults are becoming obese faster. People born in 1964 became obese 26 percent to 28 percent faster than those born in 1957. Ethnic differences appeared in weight development. Black women and Hispanic men became obese most rapidly. Overweight young adults, especially women, were at significant risk of becoming obese by age 35 to 37. In women, mild overweight was linked with at least a 60 percent chance of obesity.
Note from Whitehouse
President Bush urged Americans on 20th to make themselves and their nation healthier through exercise, proper diet and regular checkups. "The evidence is clear: A healthier America is a stronger America," the president said while kicking off a four-day fitness campaign. Already, a curious phenomenon has gripped the Bush White House. Inspired by their fitness-crazed president, these pasty-faced presidential aides are going to the White House gym daily to get buff pecs, ripped abs, tight buns and just overall huge. As President Bush sets out this week to highlight the need for Americans to exercise more --half are completely sedentary and 300,000 die annually of obesity-related disease -- his advisers truly have put their muscles where their mouths are. Bush aides say they are cutting back on caffeine and alcohol in favor of soy milk and three liters of water a day. They are forming into groups called the ``Dixie Chicks'' and ``Girls With Gloves'' (weightlifting gloves, that is) to employ the services of personal trainers who advise them in everything from meal size to dental flossing. Last week, when the White House announced a three-mile run scheduled for Saturday with Bush at Fort McNair -- part of this week's physical fitness campaign -- 400 White House staffers signed up in the first hour.... Bearden, who declines to be interviewed, leads them in strength training, endurance and yoga. She has Matalin taking antioxidant vitamins and minerals, a soy drink called Silk, yogurt and colorful fruits and vegetables. The women do three sets each of chest presses, curls, squats, flies, pulldowns, lunges and, as Matalin calls it, “glute something'' for the gluteus maximus. As Matalin sees it, the workout routine is good for both body and country.
HHS Secretary Tommy G. Thompson released on 22nd a new report that underscores the importance of physical activity in preventing disease and outlines the physical and financial costs associated with a sedentary lifestyle, including a cost of billion annually associated with overweight and obesity. HHS report says that frail health often associated with aging is in large part due to physical inactivity, but that it's never too late to benefit from becoming physically active.
Second Hand Smoke
A comprehensive review of medical studies by researchers at the International Agency for Research on Cancer (IARC) showed passive smoking causes cancer and that chemicals and gases in tobacco contribute to cancer of the stomach, liver, kidney, uterus, cervix and to myeloid leukemia. IARC, based in Lyons, France, is an extension of the World Health Organization (WHO). Its findings on smoking are based on an independent analysis of more than 50 medical studies by 29 experts from 12 countries. An estimated 1.2 billion people worldwide smoke cigarettes, cigars, pipes or bidis—tobacco rolled in a leaf—and expose billions more non-smokers to the carcinogenic chemicals. Tobacco smoke contains over 4,000 chemicals in the form of particles and gases. Carbon monoxide, ammonia, formaldehyde and hydrogen cyanide are among the potentially toxic ones. About one half of persistent smokers will be killed by a tobacco related disease and half of those deaths will occur in middle age.
Light Smokers: People who smoke just a few cigarettes a day may reasonably assume that they are in less danger than heavier smokers. But a new study offers evidence to the contrary when it comes to cardiovascular disease. Regardless of the amount of tobacco use, smokers exhibited the same changes in the blood vessel lining.
Soy supplements may be able to help diabetic women to control both their blood sugar and their cholesterol, researchers reported in a small study conducted in Hull and Yorkshire, England presented in San Francisco at the annual scientific sessions of the American Diabetes Association. The women taking the soy supplement showed significantly better control over their blood sugar, according to several standard tests, and their levels of total cholesterol and low-density lipoprotein dropped.
Fruits and Vegetables
A report examined the relationship between fruit and vegetable consumption and the risk of cardiovascular disease (CVD) and stroke in a large group of subjects over a period of roughly 2 decades. Researchers found that stroke incidence and mortality, as well as mortality from ischemic heart disease and CVD, were all significantly reduced in those who consumed at least 3 servings of fruits and vegetables per day. Those who had consumed at least 3 servings per day of fruits and vegetables had a 27% lower incidence of stroke and 42% lower stroke mortality rate among all subjects, and risk of death from ischemic heart disease and CVD was reduced by 24% and 27%, respectively. The research, part of the first National Health and Nutrition Examination Survey (NHANES I), involved prolonged follow-up of 9608 adults ages 25-74 who were randomly distributed by sex, race, and sociological group. All subjects were free of CVD at the study's inception between 1971-1975, and follow-up data on dietary intake, disease and mortality were collected in 1982-84, 1986, 1987, and 1992.
Vegetarian Recipe: Apricot and Brown Rice Pilaf
Ingredients:1 cup shredded carrot, 1 tablespoon pine nuts, 1 tablespoon margarine, 3/4 cup quick-cooking brown rice, 1 cup apple juice, 3/4 cup water, 6 dried apricot-halves chopped, 2 tablespoons raisins.
Preparation: Combine carrot, pine nuts and margarine in 1-quart glass dish. Microwave on high for 2 minutes. Add rice, apple juice and water; mix well. Microwave, loosely covered on high for 5 minutes, stirring once. Stir in apricots and raisins. Microwave, covered, on medium for 12 minutes or until liquid is absorbed and rice is tender.
Nutritional Analysis Per Serving: Calories, 234; Protein, 4 grams; Carbohydrates, 44 grams; Total Fat, 5 grams (19 percent of calories from fat); Cholesterol, 0 milligrams; Fiber, 3 grams; Sodium, 49 milligrams. Bread 1 1/2; Fruit 1; Vegetables 1/2.
A Natural Anti-depressant
A new study compared women whose partners wear condoms with those whose partners don't. It showed that the women who were directly exposed to semen were less depressed. The team divided 293 female students into groups depending on how often their partners wore condoms, and assessed their happiness using the Beck Depression Inventory, a standard questionnaire for assessing mood. People who score over 17 are considered moderately depressed. The team found that women whose partners never used condoms scored 8 on average, those who sometimes used them scored 10.5, those who usually used them scored 15 and those who always used them scored 11.3. Women who weren't having sex at all scored 13.5. The longer the interval since they last had sex, the more depressed the women who never or sometimes used condoms got. But the time since the last sexual encounter made no difference to the mood of women who usually or always used condoms. Semen contains several mood-altering hormones, including testosterone, estrogen, follicle-stimulating hormone, luteinizing hormone, prolactin and several different prostaglandins. Some of these have been detected in a women's blood within hours of exposure to semen.
Cancer Causing Snacks
A study found high levels of acrylamide in French fries, some brands of potato chips, some types of breakfast cereal and crispbread and some types of bread fried or baked at high temperatures. Boiled foods did not contain the substance. After the Swedish findings were announced, studies in Norway, Britain, Switzerland, Germany and the United States made similar observations. However, the experts did not issue guidelines warning consumers against eating foods with the potentially cancer-causing substance, acrylamide. Health experts were concerned enough to call a special 3-day meeting in Geneva, which grouped 23 scientists from universities and national food authorities, including the US Food and Drug Administration.
REFERENCES AND NOTES
I am very pleased to introduce to you Dr. Venkateswarrao Karuparthy, Asst. Professor (Clinical) University of Iowa School of Medicine, who kindly volunteered to join the Telangana Science Journal. SV
 Text Book of Ayurveda: Fundamental Principles Vasant Lad, MASc, Ayurvedic Press, Albuquerque New Mexico; Perfect Health: The Complete Mind Body Guide Three Rivers Press New York
 Sources: UN Food and Agriculture Organization, World Food Program, UNAIDS.
 Says the National Alliance for Nutrition and Activity
 "The Natural History of the Development of Obesity in a Cohort of Young U.S. Adults Between 1981 and 1998," appears in the June 18, 2002, issue of Annals of Internal Medicine.
 Washington Post.
 Surprised authors reported in The Journal of the American College of Cardiology.
 A report in the American Journal of Clinical Nutrition
 The results appear in the journal Archives of Sexual Behavior. ANI.
 A study by Sweden's National Food Administration this year (2002), AP
The World Health Organization and Food and Agriculture Organization sponsored the conference. They said further study is necessary to determine the extent of the risk - and how to reduce it, to the relief of the snack and fast-food industry.