Ayurveda A N I N T R O D U C T I O N T O T H E T R A D I T I O N A L H E A L T H S C I E N C E O F I N D I A

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1 Ayurveda A N I N T R O D U C T I O N T O T H E T R A D I T I O N A L H E A L T H S C I E N C E O F I N D I A P R E S E N T E D B Y K A T H Y G E H L K E N, M A, R D, C M P B A D A M I N I C O N F E R E N C E F E B R U A R Y 2,

2 The science of life Dates back to the Vedic period in Northern India World s oldest known medical text, The Charaka Samhita, BCE Focused on balance within and without Emphasizes prevention through proper diet and lifestyle Ayurveda

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4 5 Elements Combine to Make 3 Doshas Biological energies VATA PITTA KAPHA PRAKRUTI or PHENOTYPE

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8 Ayurgenomics Juyal RC, Negi S, Wakhode P, Bhat S, Bhat B, et al. (2012) Potential of Ayurgenomics Approach in Complex Trait Research: Leads from a Pilot Study on Rheumatoid Arthritis. PLoS ONE 7(9): e doi: /journal.pone N=325 experimental, 356 control Vata : Inflammatory genes IL1b (C-C-C haplotype, p = , OR = 3.09) CD40 (rs allelic, p = 0.04, OR = 2.27) Associate with more pronounced disease characteristics like joint swelling and pain Pitta: Oxidative stress pathway genes SOD3 (rs699473, p = 0.004, OR = 1.83) SOD3 (rs , p = 0.005; OR = 1.88) PON1 rs662, p = 0.04, OR = 1.53) Kapha: Oxidative stress pathway gene SOD3 (rs , genotypic, p = 0.02, OR = 2.39)

9 Ayurgenomics Prasher, Bhavana, et al. Whole Genome Expression and Biochemical Correlates of Extreme Constitutional Types Defined in Ayurveda. Journal of Translational Medicine 6:48 (2008) available from: Homogenous North Indian population N=96 (Vata=39, Pitta=29, Kapha=28) (48 men, 48 women) Results: Biochemical Men had 15 parameters with significant differences Women had 4 parameters with significant differences Genotyping Vata men: upregulation of cyclin dependent protein kinase genes Kapha men: down-regulation of genes involved in fibrinolysis Pitta men: overexpression of genes involved in immune response

10 Eating for Balance Dosha Vata Pitta Kapha Key concepts Digestibility Anti-inflammatory and anti-oxidant Nutrient dense, low calorie When out of balance Weight loss, constipation, hypertension, arthritis, weakness, restlessness, and digestive challenges Skin rashes, peptic ulcers, excessive body heat, heartburn, and indigestion Balancing Tastes Sweet, sour and salty Bitter, sweet and astringent Diet Characteristics Moist, heavy and warm Cool, bland and vegetarian Well-cooked with oils Raw foods ok, lots of for easier absorption, fruits and vegetables, more carbohydrate, milk, whole grains and animal protein ok, less beans gas producing foods like cabbage family and beans Overweight, CVD, asthma, diabetes, and depression. Pungent, bitter and astringent Light and warm Low-calorie, low-fat, low-refined flour and smaller portions

11 Ayurvedic Nutritional Theory Rasa Initial Taste Taste (Rasa) Elemental Composition Effect on Vata Effect on Pitta Effect on Kapha Sweet Earth & Water Sour Earth & Fire Salty Fire & Water Bitter Air & Fire Pungent Ether & Air Astringent Air & Earth

12 Virya Energetic Effect on the Body Rasa Virya Action Sweet Cool Strong Sour Heating Weak Salty Heating Medium Pungent Heating Strong Bitter Cooling Medium Astringent Cooling Weak

13 Vipak Metabolic Effect Rasa Vipak Action Effect on Doshas Sweet, salty Sweet Anabolic Increases Kapha Sour Sour Metabolic Increases Pitta Pungent, bitter, astringent Pungent Catabolic Increases Vata

14 Medical Nutrition Therapy AMLA PITTA AKA GERD

15 A.N.D. Approach Nutrition Therapy for Gastroesophageal Reflux Disease Nutrition Prescription Trial of food restriction to reduce gastric acidity by eliminating the following: Black and red pepper Coffee (caffeinated and decaffeinated) Alcohol Substitute smaller, more frequent meals Trial of food restriction to assess effect on lower esophageal sphincter pressure. Eliminate the following: Chocolate Mint Foods with a high fat content Initiate weight-reduction program if overweight Initiate smoking cessation Improve clearing of materials from esophagus Remain upright after eating Avoid eating no later than 3 hours before bedtime Wear loose-fitting clothing Raise the head of bed for sleeping (Kaltenbach, 2006; Nocon, 2007; Shapiro, 2007; Dore, 2007; Fox, 2007)

16 Ayurvedic Approach Kayachikitsa for Amla Pitta Mentioned in oldest Ayurvedic Medical Text: Charaka Samhita, B.C.E. Precise pathology outlined in Madhavanidana, circa 700 A.D. Pitta reducing diet sweet, bitter and astringents tastes from whole grains, beans, dark green leafy vegetables and dairy Emphasize the bitter taste with food and herbs Low-fat diet, avoiding all fatty and fried foods Avoid foods with the sour and pungent taste: acidic foods, fermented foods, pungent spices like chili. Avoid alcohol, caffeine and chocolate Reduce meal size and practice mindful eating techniques with particular attention to adequate chewing and portion sizes Eat largest meal at lunch with a lighter, smaller dinner. Avoid eating 3 hours before bedtime and do not lie down after eating Limit fluids with meals, favoring them in between meals. Herbs: Aloe vera juice or gel, avipattikar churna (a formulation of powdered herbs), kama duda (a formulation of powdered herbs and minerals) and many others Regular sleep and eating habits Stress reduction Exercise according to Prakriti

17 Science and Ayurveda

18 Spice Science Used as functional foods in Ayurveda Modern science has determined that spices contain bioactive compounds Phenolic compounds Essential oils And that spices act as Anti-oxidants Anti-bacterials Anti-inflammatories Anti-virals Anti-carcinogenics Viuda-Martos, M., Ruiz-Navajas, Y., Fernández-López, J. & Pérez-Álvarez, J.A. (2010) Spices as Functional Foods. Critical Reviews in Food Science and Nutrition. 51:1, 13-28

19 Turmeric or Haridra Curcuma longa Linn. Rasa/Taste: Bitter, Pungent Virya/Energetic Effect: Hot Vipak/Metabolic Effect: Pungent Best for use with Kapha and Pitta Ayurvedic Uses: Externally for skin disorders, wound cleaning Internally for skin disorders and as an expectorant, analgesic, and for hepatitis, worms, anemia, bleeding disorders, diabetes (Ayurvedic Pharmacology & Therapeutic Uses of Medicinal Plants, Vaidya V.M.Gogte) Modern Science: Possibly Effective for Stomach upset (dyspepsia) Pain of Osteoarthritis. (Natural Medicines Comprehensive Database, =kaiser&s=ndc&pt=100&id=662&fs=ndc&searchid= )

20 Cinnamon or Twak Cinamonum zeylonica Rasa/Taste: Bitter, Pungent and Sweet Virya/Energetic Effect: Hot Vipak/Metabolic Effect: Pungent Best for use with Vata and Kapha Ayurvedic Uses: Externally for headache and inflammation Internally as a digestive and for cardiac debility, bacterial infection, diuretic, expectorant, amenorrhea, infertility (Ayurvedic Pharmacology & Therapeutic Uses of Medicinal Plants, Vaidya V.M.Gogte) Modern Science: Possibly Effective for Premature ejaculation (Natural Medicines Comprehensive Database, =KAISER&s=NDC&sh=21)

21 Fenugreek or Methika Trigonella foenumgraecum Rasa/Taste: Pungent Virya/Energetic Effect: Hot Vipak/Metabolic Effect: Pungent Best for use with Kapha and Vata Ayurvedic Uses: Internally: Appetizer, carminative, rheumatoid arthritis, galactogogue, hypoglycemic (Ayurvedic Pharmacology & Therapeutic Uses of Medicinal Plants, Vaidya V.M.Gogte) Modern Science: Insufficient Evidence to Rate Diabetes (Natural Medicines Comprehensive Database, DC&pt=100&id=733&fs=NDC&searchid= )

22 Ginger or Shunthi Zingiber officinale Rasa/Taste: Pungent Virya/Energetic Effect: Hot Vipak/Metabolic Effect: Sweet Best for Kapha and Vata Ayurvedic uses: Externally for painful swollen joints and chills Internally for pain, to enhance digestion, and for nausea, vomiting, indigestion, antiinflammatory, arthritis, edema, asthma, fever with chills (Ayurvedic Pharmacology & Therapeutic Uses of Medicinal Plants, Vaidya V.M.Gogte) Modern Science: Possibly effective for Nausea and vomiting following surgery Dizziness Menstrual pain Arthritis Preventing morning sickness (Natural Medicines Comprehensive Database, ER&s=NDC&pt=100&id=961&fs=NDC&searchid= )

23 Does It Work? Elder, C., Aickin, M., Bauer, V., Cairns, J. Vuckovic, N. (2006) Randomized Trial of A Whole-System Ayurvedic Protocol for Type 2 Diabetes. Alternative Therapies. 12(5): n=60 No significant differences for clinical outcomes at 6 months However, patients with higher baseline HbA1c measurements in the Ayurvedic group showed Statistically significant improvements in HbA1c (P=.006) Fasting glucose (P=.001), Total cholesterol (P=.05), LDL cholesterol (P=.04) Weight (P=.035).

24 During the Six Month Study Ayurvedic Protocol Kaiser Protocol Herbs Meditation Diet Daily routine Exercise 4 sessions of Diabetes patient education 2 visits with primary physician

25 Thank you!