On a daily basis, we are eating more than we did fifty years ago, with calories in the US and Western Europe topping 3,500 kcal per day (2). One underlying factor is greater consumption of high calorie ultra-processed foods. In the UK these are estimated to account for 57% of our total energy intake and provide two thirds of the total free sugars in our diets (3).  

These foods are processed and can be characteristically sugary or salty to make them more palatable. We all enjoy tucking into burgers or chocolate, and population-based studies have found that consumption of ultra-processed food is associated with almost every chronic disease (4).

The ‘omic’ studies are showing us that these foods alter the balance of our gut microbiota from helpful Bacteroides species that metabolise non-digestible polysaccharides, leading to a loss of healthy bi-products like butyrate.

By unbalancing the system this allows less helpful bacteria to occupy niches in the intestine (5). In almost every other instance of our modern lifestyles, we see a similar pattern of dysregulation of our microbiota. Exposing it to environmental pollutants initiates a protective response by the gut that releases inflammatory compounds that damages the gut wall – the delicate single layer of epithelial cells on the inner most surface (6).

A commonly used insecticide diazinon disrupted the microbiome in animals for up to 13 weeks following a single dose (7). Multiply that up by the thousands of pesticides used globally (8), even if our agricultural and food systems can adhere to safe levels, the impact on our planetary microbiota – be it the bugs within our soils or our life-giving human and animal microbiomes – is not fully known.

Another area of our modern living that may have a detrimental impact on our microbiomes is our choice of healthcare. In one study, a quarter of commonly used pharmaceuticals were found to prevent the growth of our microbes, potentially adversely affecting our health and also contributing to the risk of antibiotic resistance (9).

Antibiotics are known to create competition within microbial communities and upset the balance of mutually beneficial co-habitation (10). Whilst it might be the case that in adults they can recover from a course of antibiotic treatment, in infants there may be lasting changes along with the risk of building the pool of antibiotic-resistance genes in our residing communities (11).

At this half-way point, there is a picture emerging from the research that how we treat our gut through our foods and medicines causes disturbances that can have lasting ill-effects. However, I believe the gut is not called the “little brain” for nothing (from Michael Gershon MD) and it is well poised to offer us help using herbs and spices.

What we do know is that positive lifestyle changes such as eating more nutritiously can improve health at any stage of life (12). Research is putting the benefits of herbs and spices into the spotlight, with turmeric increasing beneficial butyrate-producing gut bacteria and other herbs also modifying our microbiota (13).

The wide-ranging effects of herbs and spices may reflect the array of polyphenols and plant compounds that we ingest and are consequently metabolised by our bugs.

There is also much more intrigue beyond the gut microbiota. Why is it that our gut walls contain a myriad of receptors for plant-based compounds? I can’t help but think why are they there, and what is their importance? We evolved to eat a diverse plant species that were seasonally available, and this has dwindled in our modern diets. So, can we use herbs and spices to kick-start our physiology again?

Firstly, it is recognised that bitter receptors are located throughout the mouth, throat and gastrointestinal system and enhance digestive processes (increasing secretions and supporting the cardiovascular system in diverting blood flow to the gut). Bitter herbs – ‘bitters’ – like gentian and wormwood have longstanding use as aperitifs as digestive aids (14). Within the gut are also an abundance of cannabinoid receptors which regulate gut function and barrier integrity, located throughout the epithelial cell lining and extensive enteric nervous system (15).

Capsaicin which is a plant compound from chilli peppers binds to vanilloid receptors and also stimulates gut function (16). It is suggested that our body’s processes are now at odds with our unhealthy lifestyles. Just as we need vitamins and minerals in our diets, the presence of these receptors suggests that consumption of herbs, spices and green leafy vegetables, might be just as essential to reset our systems.

The notion of diversity increasingly seems to hold the key to the future, whether we are talking about diversity in our diets, diversity of gut microorganisms, or the diversity of receptors in our gut.

Concepts like the dietary phytochemical index may help us understand the importance of diverse plant compounds like polyphenols and phytoestrogens in our foods and how these relate to our gut processes and body’s health (17).

The latest research is helping us understand the significance of our bug’s bugs – the viruses known as bacteriophages that interact with our bacteria. In this intriguing area of science, the phages become more diverse shortly after birth, and they manipulate our gut bacteria to have both good and bad effects on our health (18).

We know that our modern lifestyles do not allow the orchestral capabilities of our microbiomes or gut receptors to be fully played. The science points towards plant compounds within our herbs and spices as being important elements within these systems. More research is needed to see how we can encourage lifestyle changes to off-set some of our poor habits, and how we can spice up our lives so that our digestive systems can flourish and bring our bodies into better health.

1. Agrawal A, Yadav C, Meena M. Physiological aspects of Agni. AYU (An International Quarterly Journal of Research in Ayurveda). 2010;31(3):395. doi:10.4103/0974-8520.77159
2. Daily supply of calories. Our World in Data. https://ourworldindata.org/grapher/food-supply-kcal?tab=chart&time=1961..2013&country=OWID_WRL~Europe%2C+Western~Eastern+Europe~Africa~Asia~South+America~Northern+America. Published 2021. Accessed October 29, 2021.
3. Rauber F, Louzada M, Martinez Steele E et al. Ultra-processed foods and excessive free sugar intake in the UK: a nationally representative cross-sectional study. BMJ Open. 2019;9(10):e027546. doi:10.1136/bmjopen-2018-027546
4. Consumption of ultra-processed foods and health outcomes: a systematic review of epidemiological studies – Nutrition Journal. Nutrition Journal. https://nutritionj.biomedcentral.com/articles/10.1186/s12937-020-00604-1. Published 2020. Accessed October 29, 2021.
5. Martínez Leo E, Segura Campos M. Effect of ultra-processed diet on gut microbiota and thus its role in neurodegenerative diseases. Nutrition. 2020;71:110609. doi:10.1016/j.nut.2019.110609
6. Defois C, Ratel J, Garrait G et al. Food Chemicals Disrupt Human Gut Microbiota Activity And Impact Intestinal Homeostasis As Revealed By In Vitro Systems. Sci Rep. 2018;8(1). doi:10.1038/s41598-018-29376-9
7. Gao B, Bian X, Mahbub R, Lu K. Sex-Specific Effects of Organophosphate Diazinon on the Gut Microbiome and Its Metabolic Functions. Environ Health Perspect. 2017;125(2):198-206. doi:10.1289/ehp202
8. Pesticide Residues in Food. Report of the 1974 Joint Meeting of the FAO Working Party of Experts on Pesticide Residues and the WHO Expert Committee on Pesticide Residues. Food Cosmet Toxicol. 1976;14(5):491. doi:10.1016/s0015-6264(76)80206-4
9. Maier L, Pruteanu M, Kuhn M et al. Extensive impact of non-antibiotic drugs on human gut bacteria. Nature. 2018;555(7698):623-628. doi:10.1038/nature25979
10. Seelbinder B, Chen J, Brunke S et al. Antibiotics create a shift from mutualism to competition in human gut communities with a longer-lasting impact on fungi than bacteria. Microbiome. 2020;8(1). doi:10.1186/s40168-020-00899-6
11. Gibson M, Crofts T, Dantas G. Antibiotics and the developing infant gut microbiota and resistome. Curr Opin Microbiol. 2015;27:51-56. doi:10.1016/j.mib.2015.07.007
12. Calder P, Carding S, Christopher G, Kuh D, Langley-Evans S, McNulty H. A holistic approach to healthy ageing: how can people live longer, healthier lives?. Journal of Human Nutrition and Dietetics. 2018;31(4):439-450. doi:10.1111/jhn.12566
13. Peterson C, Rodionov D, Iablokov S et al. Prebiotic Potential of Culinary Spices Used to Support Digestion and Bioabsorption. Evidence-Based Complementary and Alternative Medicine. 2019;2019:1-11. doi:10.1155/2019/8973704
14. McMullen M, Whitehouse J, Towell A. Bitters: Time for a New Paradigm. Evidence-Based Complementary and Alternative Medicine. 2015;2015:1-8. doi:10.1155/2015/670504
15. Hasenoehrl C, Taschler U, Storr M, Schicho R. The gastrointestinal tract – a central organ of cannabinoid signaling in health and disease. Neurogastroenterology & Motility. 2016;28(12):1765-1780. doi:10.1111/nmo.12931
16. Du Q, Liao Q, Chen C, Yang X, Xie R, Xu J. The Role of Transient Receptor Potential Vanilloid 1 in Common Diseases of the Digestive Tract and the Cardiovascular and Respiratory System. Front Physiol. 2019;10. doi:10.3389/fphys.2019.01064
17. Sotoudeh G, Abshirini M, Mahaki B, Bagheri F, Siassi F, Koohdani F. Higher intake of phytochemical-rich foods is inversely related to prediabetes: A case-control study. Int J Prev Med. 2018;9(1):64. doi:10.4103/ijpvm.ijpvm_145_18
18. Townsend E, Kelly L, Muscatt G et al. The Human Gut Phageome: Origins and Roles in the Human Gut Microbiome. Front Cell Infect Microbiol. 2021;11. doi:10.3389/fcimb.2021.643214

The extracts used in liquid bitters are often in a base of alcohol, though one can find them made with vinegar, or as powders meant to be mixed in a little water. This liquid form allows for the full experience of the bitter flavour on the tongue – an essential part of how bitters work, and why they seem less effective when taken in capsule form (2).

But alcohol also makes for an excellent solvent and preservative, drawing out bitter and aromatic components from the herbal ingredients and stabilizing the final solution. Alcohol-based bitters are also a very traditional part of mealtimes. But the bitter liqueurs we see today (like Cynar, Fernet, Underberg, Unicum, and so many more) may not have been the first documented medicinal bitters in the European tradition.

That honour may belong to a blend from a now-lost herbal written and illustrated over 2,000 years ago in northern Turkey by a physician known as Crateuas. He helped to develop the formula as an antidote to poison, and it included over 40 different botanicals (3).

The remedy proved popular, and countless variants were passed on through the generations. These became known as “theriac” (the physician Galen coined this name, which roughly means “remedy for the bite of wild beasts”).

Though their ingredients evolved over time, they followed a similar template: strong bitter herbs like centaury (Centaurium erythraea Raf.), costus (Saussurea costus (Falc.) Lipsch), and the wild poppy (Papaver rhoeas L.) were blended with pungent, aromatic herbs like ginger, pepper, and asafoetida (Ferula assafoetida L.). Herbal resins and gums came next – both as flavour, and to soften and harmonise the formula. Finally, the herbs were ground into powder and mixed with a little honey as a binder and sweetener (4).

This same template is still followed today: strong bitter herbs, a custom cocktail of aromatic and pungent spices, and finally gummy, starchy, or sugary ingredients to bind the formula together and offer a (relatively) sweet counterpoint. The indications for these formulas are similar to what they were 2,000 years ago: bitters assist and modulate the process of digestion and assimilation and encourage gentle daily detoxification. These are crucial physiologic functions – no wonder the theriac of antiquity was so revered. At the heart of its power is the bitter taste itself. What might be happening when it hits our tongue?

Our taste buds contain a few types of specialized receptors, each tuned to a broad flavour category. Receptors for sweetness, saltiness, and delicious “umami” (a savoury quality linked to amino acids found in protein, especially glutamate) give us a sense of pleasure and encourage us to eat more of the simple sugars, important electrolytes, and nourishing protein that elicit these flavour experiences (5). There may be a receptor for fats as well (6), another important source of nutrition.

Sour taste receptors have a more neutral role: if coupled with sweetness (think fruit), sourness can be pleasant. In other cases (think spoiled meat, or rancid fat), acidity feels wrong, and leads us to stop eating (7). But bitterness always acts as a deterrent: folks report that they just don’t like the flavour and tend to avoid bitter-tasting foods (8).

This is obvious in children, who may have a higher concentration of bitter taste receptors compared to adults (9): even the small amounts of bitter compounds in vegetables like broccoli send them running. But if you look at the modern Western diet, you will find that we’ve systematically removed bitter ingredients from our food supply (10), and even altered our vegetables to contain fewer bitter constituents (compare the wild versions of carrots and lettuce to their domesticated, supermarket varieties) (11). Indeed Western culture seems to have a child-like palate.

The reason we turn away from the bitter flavour is the same reason children are more sensitive to bitterness: toxic, poisonous substances are often very bitter, and the receptors that detect their presence (known as T2R, or “taste type 2 receptors”) are there to protect us (12). This is important at any age, but even more so for the sensitive metabolisms of children.

T2Rs on the tongue, like other taste receptors, are linked to the brain’s flavour perception centres via nerve fibres (13). There are more than 25 different types, sensitive to hundreds of different bitter compounds from the natural world (14).

This broad spectrum includes simple polyphenols, such as the flavonoids in goldenrod herb (Solidago species); strongly bitter lactones found in roots from dandelion to gentian (Gentiana lutea L.); and alkaloids, from caffeine to atropine, which are rare, intensely bitter, and often deadly. While the protective effect of T2R stimulation makes sense for a poison like atropine (from Atropa belladonna L., the deadly nightshade), you might wonder why we need protection from the non-toxic dandelion root (or broccoli for that matter).

In fact, we don’t – but whether goldenrod or dandelion, plants that are not toxic to humans may still be toxic to many insects, and a deterrent to browsing (15). Insects have primitive taste receptors that are thought to be the evolutionary precursors of T2Rs: similar in structure, they activate a primal, aversive response (16). The insect gets the message, and eats less.

This message alters behaviour in mammals, too. An interesting area of clinical research on the bitter taste involves appetite modulation. In an apparent paradox, bitters have been used to stimulate appetite in conditions like anorexia, or when appetite is suppressed during illness or convalescence (17).

This gentle effect can help folks maintain or recover a healthy weight and may be related to the increase in digestive juice production and stomach muscle tone that accompanies a dose. But for those whose appetites are normal (or excessive), recent clinical research suggests that experiencing a bitter taste before or during a meal reduces overall consumption of food between 20% and 30% (18).

The effect lasts throughout the day and can be valuable for those attempting to control their weight or reduce their intake of carbohydrate-rich foods (19). Bitters may affect our appetite much the same way bitter compounds affect insect browsing.

The protective effect that comes from stimulating T2Rs with bitter compounds starts by slowing down our overall intake of food. But it does not stop there: many of the classic effects we associate with bitters, from improved digestion to enhanced liver function and bile production, are part of an overall protective effect, too.

Bitters inspire the production of digestive juices across the entire GI tract (20): as a result, food is bathed in secretions that neutralise bacteria and break down potential toxins with digestive enzymes. Furthermore, bitters may increase the activity of molecular “pumps” in the intestine that keep harmful substances from entering the bloodstream, favouring their expulsion via the colon (21).

And finally, by supporting the metabolic function of the liver, bitters help ensure that our bodies break down, neutralise, and eliminate unwanted substances (22). When you put it all together and take a step back, the role of T2Rs becomes apparent: these receptors engage multiple physiologic processes that act in concert to protect us from toxicity, enhance digestion, and keep detoxification and elimination working smoothly (23). They are triggered by the bitter taste.

When you taste something bitter, the T2Rs on your tongue send a signal to your brain, and you perceive the flavour. Perhaps there is a brief shudder, but soon you can feel an increase in saliva – a harbinger of things to come, as digestive juice production increases and your body gets ready for a meal.

These are reflex effects: the sensation of bitterness triggers a cascade throughout the gut, mediated by a signal sent via the vagus nerve (a key nerve “superhighway” that regulates the function of our internal organs) (24). But this nerve reflex is just one way bitters activate our digestive and detoxification processes: over the last twenty years, researchers have discovered T2Rs all over the body, not just on the tongue.

Stimulating intestinal T2Rs, for example, triggers the release of hormones that make us feel full (this may help explain the clinical research showing we eat less when tasting bitterness before a meal) (25). T2Rs are also found in the airways, both lungs and sinuses, where they open the passages and stimulate the secretion of antibacterial compounds (bacterial waste, it turns out, tastes bitter) (26). Some immune cells may have T2Rs on their surfaces (27). T

he thyroid gland carries T2Rs (28). Even the heart can “taste” bitterness: cardiac T2Rs may help modulate blood vessel diameter and blood pressure (29). This line of research hints at applications for everything from asthma and sinusitis to high blood pressure. While these effects are not evident when we take liquid bitters by mouth, they still reinforce the understanding that the bitter taste elicits a suite of protective activity from the body.

In the herbal clinic, we turn to bitters to manage and prevent digestive complaints, particularly for simple issues like gas, bloating, and indigestion. Liquid bitters can be taken in moderate doses to address these concerns and, over time, will help them appear less frequently. They do this by encouraging our own bodies to rise to the occasion: as such, they are a more tonic strategy when compared to digestive enzyme pills, antacids, or laxatives.

A few millilitres (about 60-90 drops) is a fine place to start. To address concerns in the lower belly, such as bloating, cramping, or occasional constipation, take bitters before a meal. For indigestion and overfullness, try them after eating.

We also recommend a week or two of thrice-daily bitters during the change of seasons, particularly in early spring and fall, when our diets shift and when many folks experience digestive upset. It is important to remember that, however they are used, bitters are not a “herbal detox”: yes, we feel better after taking bitters. But this is because of their protective, enlivening effects and not because they are “cleaning” us: our liver does a great job of that every day.

Bitters just help support that work. Finally, folks who have active peptic ulcers, or liver disease (including gallstones), should use bitters with caution and only after consulting a competent herbalist. The stimulating effect bitters have on digestive juice production and bile secretion from the liver could complicate those conditions. And because some of the herbs used in bitters can have strong effects, pregnant people should use extra care and try gentle preparations, like dandelion root tea, first.

In conclusion, bitters are supreme allies for digestion and metabolism. Because these functions are foundational, bitters often improve overall health. They help reduce overconsumption of food: the antidote to “super-size” meals. In fact, digestive complaints, metabolic dysregulation, and difficulty with maintaining healthy weight (all of which are so common in the Western world) may be partly due to the child-like diet so many follow: our digestion is drowned in sweet treacle, missing the crucial signal for effective function that the bitter flavour provides. The promise of bitters is the restoration of the theriac in our lives: the antidote to poison, the flavour of the wild, the crisp, clear signal that allows us to maintain moderation, to nourish ourselves with grace.

1. Hoffmann, David. Medical Herbalism: The Science and Practice of Herbal Medicine. United States: Inner Traditions/Bear&Co., 2003:498-500
2. McMullen MK, Whitehouse JM, Towell A. Bitters: time for a new paradigm. Evidence-Based Complementary and Alternative Medicine. 2015;670504.
3. Norton S. The Pharmacology of Mithridatum: a 2000-year-old Remedy. Molecular interventions. 2006;6(2):60.
4. Karaberopoulos D, Karamanou M, Androutsos G. The theriac in antiquity. The Lancet. 2012;379(9830):1942-3.
5. Breslin PA, Huang L. Human taste: peripheral anatomy, taste transduction, and coding. Advances in oto-rhino-laryngology. 2006;63:152-90.
6. Liu D, Costanzo A, Evans MD, Archer NS, Nowson C, Duesing K, Keast R. Expression of the candidate fat taste receptors in human fungiform papillae and the association with fat taste function. British journal of nutrition. 2018;120(1):64-73.
7. Breslin PA, Huang L. Human taste: peripheral anatomy, taste transduction, and coding. Advances in oto-rhino-laryngology. 2006;63:152-90.
8. Drewnowski A. Taste preferences and food intake. Annual review of nutrition. 1997 Jul;17(1):237-53.
9. Correa M, Hutchinson I, Laing DG, Jinks AL. Changes in fungiform papillae density during development in humans. Chem Senses. 2013;38:519–27.
10. Roy GM. The applications and future implications of bitterness reduction and inhibition in food products. Critical Reviews in Food Science & Nutrition. 1990;29(2):59-71.
11. Fenwick GR, Curl CL, Griffiths NM, Heaney RK, Price KR. Bitter principles in food plants. In: Rouseff RL,ed. Bitterness in foods and beverages; developments in food science. 1990;25:205-50.
12. Glendinning JI. Is the bitter rejection response always adaptive?. Physiology & behavior. 1994;56(6):1217-27.
13. Schoenfeld MA, Neuer G, Tempelmann C, Schüssler K, Noesselt T, Hopf JM, Heinze HJ. Functional magnetic resonance tomography correlates of taste perception in the human primary taste cortex. Neuroscience. 2004;127(2):347-53.
14. Meyerhof W, Batram C, Kuhn C, Brockhoff A, Chudoba E, Bufe B, Appendino G, Behrens M. The molecular receptive ranges of human TAS2R bitter taste receptors. Chemical senses. 2010;35(2):157-70.
15. Napal GN, Palacios SM. Bioinsecticidal effect of the flavonoids pinocembrin and quercetin against Spodoptera frugiperda. Journal of pest science. 2015;88(3):629-35.
16. Weiss LA, Dahanukar A, Kwon JY, Banerjee D, Carlson JR. The molecular and cellular basis of bitter taste in Drosophila. Neuron. 2011;69(2):258-72.
17. See, for example, the monograph on gentian root in: Blumenthal M, Goldberg A, Brinckmann J. Herbal medicine. Expanded commission E monographs. Integrative Medicine Communications; 2000.
18. Andreozzi P, Sarnelli G, Pesce M, Zito FP, D’Alessandro A, Verlezza V, Palumbo I, Turco F, Esposito K, Cuomo R. The bitter taste receptor agonist quinine reduces calorie intake and increases the postprandial release of cholecystokinin in healthy subjects. Journal of neurogastroenterology and motility. 2015;21(4):511.
    Kim HM. Modulation of the Bitter Taste to Reduce Calorie Intake. Journal of neurogastroenterology and motility. 2015;21(4):457-8.
19. Mennella I, Fogliano V, Ferracane R, Arlorio M, Pattarino F, Vitaglione P. Microencapsulated bitter compounds (from Gentiana lutea) reduce daily energy intakes in humans. British Journal of Nutrition. 2016;116(10):1841-50.
20. Bone K, Simon Mills MC, Fnimh MA. Principles and practice of phytotherapy: modern herbal medicine. Elsevier Health Sciences; 2012:40
21. Jeon TI, Seo YK, Osborne TF. Gut bitter taste receptor signalling induces ABCB1 through a mechanism involving CCK. Biochemical Journal. 2011;438(1):33-7.
22. Raka F, Farr S, Kelly J, Stoianov A, Adeli K. Metabolic control via nutrient-sensing mechanisms: role of taste receptors and the gut-brain neuroendocrine axis. American Journal of Physiology-Endocrinology and Metabolism. 2019 Oct 1;317(4):E559-72.
23. Harmon CP, Deng D, Breslin PA. Bitter taste receptors (T2Rs) are sentinels that coordinate metabolic and immunological defense responses. Current Opinion in Physiology. 2021; 20:70-6.
24. Darby SA. Neuroanatomy of the autonomic nervous system. Clinical Anatomy of the Spine. Spinal Cord, and ANS. 2017:466-469.
25. Sternini C, Anselmi L, Rozengurt E. Enteroendocrine cells: a site of ‘taste’ in gastrointestinal chemosensing. Current opinion in endocrinology, diabetes, and obesity. 2008;15(1):73.
26. Maina IW, Workman AD, Cohen NA. The role of bitter and sweet taste receptors in upper airway innate immunity: recent advances and future directions. World journal of otorhinolaryngology-head and neck surgery. 2018;4(3):200-8.
    Deshpande DA, Liggett SB. Regulation of Intracellular Calcium by Bitter Taste Receptors on Airway Smooth Muscle. Calcium Signaling In Airway Smooth Muscle Cells 2014;409-421.
    Devillier P, Naline E, Grassin-Delyle S. The pharmacology of bitter taste receptors and their role in human airways. Pharmacology & therapeutics. 2015 Nov 1;155:11-21.
27. Gopallawa I, Freund JR, Lee RJ. Bitter taste receptors stimulate phagocytosis in human macrophages through calcium, nitric oxide, and cyclic-GMP signaling. Cellular and Molecular Life Sciences. 2021;78(1):271-86.
28. Clark AA, Dotson CD, Elson AE, Voigt A, Boehm U, Meyerhof W, Steinle NI, Munger SD. TAS2R bitter taste receptors regulate thyroid function. The FASEB Journal. 2015;29(1):164-72.
29. Bloxham CJ, Foster SR, Thomas WG. A bitter taste in your heart. Frontiers in Physiology. 2020;11:431.

The general consensus is, unfortunately, that climate change and environmental factors stemming from it, such as air and chemical pollution, pesticides, insecticides, heavy metals, wildfires, soil quality degradation, longer flowering seasons due to heatwaves (hence longer exposure to pollen), all contribute to the rise seen in allergies in the recent decades. (2, 3, 4) Interestingly, plants growing in polluted areas with higher exposure to carbon dioxide also release more pollen. (4)

Air pollution is implicated in worsening allergic reactions in city dwellers especially, when the grasslands and thus the exposure to grass pollens in the cities are reducing in the last two decades. Cross-reactivity reactions predispose sensitive individuals to pollen and certain food allergies. (5)

Toxicity and oxidative stress

As external factors befall on wide population, it is clear that internal factors play a major and most likely the decisive role in individual susceptibilities in developing various allergies.

Exposure to toxins and allergens creates oxidative stress in the body, immune dysregulation and consequent inflammatory response. (6) For those individuals who have lowered antioxidant status in their tissues (because of lack of nutrients due to poor diet or genetic predisposition in detoxifying chemicals, toxins and heavy metals) this would add to their load of risk factors.

Gut, lungs and skin microbiome disturbances

Herbalists have always paid attention to gut integrity and the latest scientific research confirms the importance of gut microbiome in many inflammatory conditions, including allergies and asthma. (7) The significance of more recently discovered skin and lungs microbiome and its protective effects is also been investigated. (8)

Dysbiosis – a disturbed gut microflora, is the epicentre of immune and inflammatory imbalances leading to allergic reactions. (9) Gut microflora in children can be affected by a variety of components, such as use of antibiotics, the use of probiotics, dietary fats and fibre, and more. The rise in C-section births might be a possible risk factor in some children for developing allergies. (10)

On the other hand, the protective effect of breastfeeding (especially for 6 weeks to 6 months) is also well documented. (11) In adults, the use of antacids (PPIs), antibiotics, NSAIDs and other medications is hugely disruptive to microbiome and the gut lining integrity, leading to dysbiosis and increased permeability of the intestines (‘leaky gut’).  Food allergies are also linked with dysbiosis. (12) The main culprits are peanuts, cow milk, wheat, egg, soy, fish, shellfish and tree nuts.

The importance of healthy mucosal layer and its protective function is well known, but recently its immune function also has been recognised. (13)

Immune dysregulation and inflammation

As previously mentioned, the imbalances in gut microbiome lead to immune dysregulation, which in turn creates inflammation. Allergies are driven by T helper (Th) 2 responses, mast cell activation and the release of numerous inflammatory cytokines, such as  IL-4 and IL-13 and histamine. (14)

Adding fermented foods or probiotics and eating plenty of dietary fibre has a huge protective role in gut health. Prebiotics are also very important. Commensal gut bacteria ferments fibre into short-chain fatty acids (SCFA), which supports gut lining integrity and regulates immune system response via gut-associated lymphatic tissue (GALT). (15, 16) The latest research shows that regulatory T cells (Treg) have an important balancing effect on immune system and can dampen an allergic response triggered by T helper (Th) 2 cells. (17) 

The older concept of “hygiene hypothesis” introduced by David Strachan in 1989 has been explored for several decades and suggests that increased hygiene and smaller families (less siblings) lead to reduced exposure to infections and can predispose children to developing allergies later on. (18)

This partly can be explained by a lack of protective bacteria. Furthermore, research shows that decreased intestinal microbial diversity is an important risk factor for increased susceptibility to allergies. (19)

The newer biodiversity hypothesis has expanded the understanding of various internal and external factors affecting the microbiome. (20)

As the biodiversity in nature surrounding us (our external microbiome) is reducing and changing, so is our inner microbiome becomes diminished, its diversity reduced, and it has to adapt to changes. The immune system (and the nervous system, for sure!) is trying to catch up and this leads to rise in allergies and immune dysregulation.

It is widely recognised that herbal medicine can help to address the above-mentioned complexities and to correct the arising imbalances in the body. To meet and correct the imbalances arising from such above-mentioned complexities the multifaceted approach employing complex herbal medicines is needed.

Obviously, the herbalists look at the individual’s constitution and their presenting symptoms, which will direct their choice of herbs. Here some possible, more general herbal choices used in treating allergies will be discussed. The list of herbs is not complete and other choices can be made as required.

Allergic rhinitis (AR)

Main signs & symptoms are runny nose with clear mucus, congestion and sneezing. Eyes can also be affected.

In traditional western herbalism, according to Matthew Wood (2004), this energetic picture of AR could be described as a predominantly damp and cold tissue state, with deficiency underneath. The use of warming, aromatic, spicy, clearing, astringent herbs is indicated to reduce catarrh (damp), clear congestion, reduce allergic response, support the mucosal lining.

Nettle (Urtica dioica)

Clinical experiences shared by many herbalists and scientific analyses of the plant, as well as traditional uses across many countries brings nettle into forefront of a group of herbs used for allergies. (22, 23, 24) Sambucus nigra – elderberries and elderflowers are traditionally also used to support immunity, to reduce catarrh, clear congestion, reduce inflammation. (22)

Zingiber officinalis – ginger is a warming, aromatic, pungent spice, which helps to reduce catarrh and nasal congestion. (25) Curcuma longa – turmeric is probably one of the most researched herbs. Traditional and scientific research shows a strong anti-inflammatory effect, useful in allergies and other inflammatory conditions. (26)

• Urtica dioica folia
• Sambucus nigra (flos & fructus)
• Zingiber officinalis
• Curcuma longa

Vitamin C (citrus, peppers, broccoli, blackcurrants) and quercetin (onions, apples, citrus, green leaves) can be added as supplements or through foods. Black pepper is great to clear runny nose and is traditionally used in Ayurvedic medicine to clear catarrh. Warm aromatic and astringent teas – ginger, cinnamon, green tea, can be very useful.

In chronic AR or prevent recurrent episodes, immune modulating herbs such as Astragalus membranaceus can be added to the mix or used in between the flare ups (27).

Urticaria / hives

Main signs and symptoms are red itchy wheels and rash on the skin

In traditional western herbalism, this energetic picture of urticaria could be described as a predominantly a hot tissue state. The stagnation of the tissues (especially the liver and lymph) might be present. Stress is often a strong aggravator, as well as eating allergenic foods.

The use of cooling, detoxifying herbs, having a traditional ‘alterative’ action on the tissues – cleansing and clearing, to help to reduce inflammation, modulate the immune response, support the integrity of the gut and the function of the liver. Nervous system support is often needed in this condition.

German chamomile (Matricaria recutita)

German chamomile is traditionally used in Europe as a tea for allergies, congestion, to reduce inflammation and pain. It also has an anxiolytic and calming effect (28) Caution- sensitivity to Asteraceae family can cause allergic reactions. Albizzia julibrissin – Albizzia or silk tree is traditionally used in TCM and Ayurvedic medicine to help to reduce allergic reactions and ameliorate symptoms such as itching or wheezing. (29)

It is also has a calming, anxiolytic and antidepressant effect, as indicated in ethnobotanical studies and traditional uses. So it can be very useful in various acute and stressful allergic conditions, including urticaria.

• Urticaria dioica folia
• Matricaria recutita
• Albizzia julibrissin
• Arctium lappa radix

Externally creams are used in the herbal clinical practice with Stellaria media – chickweed or Aloe vera to help to reduce itchiness and soothe skin irritations. Vitamin C and quercetin supplements could be useful too, as well as pre- & probiotics (if not further causing more histamine release) to support gut microbiome.

Asthma

Main symptoms are wheezing, cough, tightness of chest, shortness of breath, which might be aggravated on physical exertion, exposure to cold air, on exposure to allergens or with emotional stress.  

Asthma is a complex inflammatory disease. Depending on the severity of it, whether it is chronic or acute, and on the constitutional individual’s type, in traditional western herbalism the energetic picture of asthma could be described as a deficient and stagnant condition with an accumulation of damp, heat, cold or/and dryness in the tissues.

The use of herbs to help to reduce inflammation (heat), reduce cough, expel mucus (damp),  relax bronchospasm, modulate the immune response, support the integrity of the gut and microbiome. Nervous system support is also often needed in this condition and herbs traditionally called nervines can be very helpful.

Herbs

• Curcuma longa
• Inula helenium
• Thymus vulgare
• Verbascum thapsus
• Glycyrrhiza glabra (31)

Herbs to feed gut microbiome, to support biodiversity of microflora and gut health, to support digestion and intestinal absorption, such as Arctium lappa radix and Inula helenium are traditionally used by herbalists. Mucosal membranes and epithelial integrity can be supported by using mucilage – rich herbs such as Althea offcinalis, Aloe vera or Glycyrrhiza glabra.

As allergies always have an inflammatory component, increasing anti-inflammatory unprocessed plant-based foods in the diet is important, as well as feeding the microbiome with plenty of fibre and staying hydrated to support elimination processes.

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Preparation

A simple first step is to eliminate sugars, additives, refined carbohydrates, gluten, meat, dairy, processed foods, caffeine and alcohol which tend to create ama. You are likely to feel cravings for these foods during the first few days and caffeine withdrawal headaches can be severe. 

Eat simple, whole foods (fruits, vegetables, whole grains, legumes, herbs and spices, nuts and seeds) to set the stage for the actual cleanse, though for some a shift to just eating these foods may be a suitable cleanse in itself.

Active cleansing

This stage involves a ‘mono-fast’ of eating one type of simple, easily digestible food such as green juices, mung dhal soup or kitchari (basmati rice with mung) with plenty of fluids. This allows the digestive system to rest while providing nourishment. Two foods which often feature are basmati rice and mung beans. Rice is considered the king of grains in Ayurveda, being sweet to taste, aromatic, cooling and light, healing the digestive tract and clearing stagnation.

Mung beansaresweet and astringent, cooling, light, and dry in quality. They are an excellent detoxifying food for all the doshas, cleansing the tissues, strengthening the eyes, tonify the heart, draining dampness and clearing toxic heat from the body. Research supports that they are one of the healthiest sources of plant protein there is: Mung beans have biological activities including antioxidant, antimicrobial, anti-inflammatory, antidiabetic, antihypertensive, lipid metabolism accommodation, antihypertensive and antitumor effects (Chung et al, 2011).

Using the Ayurvedic doshas (mind body types) can be a helpful way to find a suitable cleansing regimen.

Airy and coldvata specific cleansing regime must support strength and energy levels, so a short cleanse of up to 3 days with simple nourishing foods is best. Warm food is vital, so no raw, cold foods or juices favouring simple, warm and lightly spiced foods such as kitchari, dahl, soups and vegetables, along with aromatic herbs such as fennel, cumin, coriander and turmeric. Hydrate with warm herbal teas that support digestion such as fennel, cardamom and ginger.

Fiery and warm Pitta types benefit from cooling cleanses that help reduce excess heat and can tolerate cooler and raw foods. Favour green juices, fresh fruit and vegetables whilst hydrating with cooling juices and herbal teas that include herbs such as aloe vera, mint, dandelion and licorice. 

Watery and earthed Kapha types benefit from regular, prolonged cleansing being most susceptible to congestion with slower digestion and metabolism. They have a naturally lower body temperature and need some heat to encourage detoxification. Foods should be simple, vegetable based, warm and spiced with ginger, black pepper, ginger, fennel and turmeric limiting any cooking oils. 

Whatever foods are chosen, its vital to use fresh, organic and nutritious food full of prana (life-force) so the amount of toxicity the body is having to deal with is reduced. Prepare all your food for the day first thing in the morning and avoid leftovers from the previous day. Allow at least three hours between meals, aiming or three- four small meals per day though two meals may be enough for kapha types. Eat enough to feel satisfied but do not overeat.

Try not to eat anything after 7 p.m. and drink at least 8–12 cups of room temperature, warm, or hot fluids each day to ensure adequate hydration and to flush toxins as they are released. Most fluids should be taken between meals to avoid diminishing the digestive fire. As toxins are released it is normal to experiencetiredness, headaches, rashes, belly noises, loose stool/constipation, odorous sweat/urine and stool, muscle ache and a foggy head. It’s key to rest and stay hydrated if you experience these.

This process can also stir up unresolved emotions, which need to be witnessed, honoured and released. Having support of family or friends, as well as from a health practitioner, can be key for this.

Ayurveda’s most famous ‘three fruit’ formula triphala has sweet, sour, pungent, bitter, and astringent tastes, pacifies all doshas, rejuvenates all tissues and cleanses all channels, especially those of elimination. Constipation is common during a cleanse, making this formula especially relevant.

Amla has one of the highest vitamin C contents in the plant kingdom and helps regulate the liver. Haritaki means ‘remover of disease’ and helps promote the bowel and tone intestinal muscles. Bibhitaki helps maintain healthy mucus membranes. Its balanced spectrum of the five tastes can also reduce food cravings and over eating.  Take one teaspoon at night with warm water to detoxify the bowel.

Another useful formula is Trikatu (‘three hots’) with ginger, black pepper and long pepper providing a pungent taste and strongly heating effect, along with light, drying qualities. It pacifies vata and kapha but aggravates pitta so is not suitable with hyperacidity, ulcers, with signs of aggravated pitta (heat) or in pregnancy.

It acts on plasma, blood, muscle, fat, channels of digestion, respiration and the colon, being used in Ayurveda to support weight loss, metabolism, digest fats and ama (and LDL cholesterol). Take ½ teaspoon after breakfast and dinner, traditionally taken with honey.  

Aloe Vera juice is bitter and sweet in taste with a cooling effect, reducing all three doshas with heavy, unctuous, slimy nature. It is nourishing, balancing and clears inflammatory heat from the body, whilst supporting gentle detoxification of the liver.  It is one of Ayurveda’s most potent cleansing and rejuvenating elixirs. Take 1-2 tablespoons every morning on an empty stomach.

Massage is a key part of Ayurvedic cleansing. You can give yourself a daily self-massage during the cleanse.

Massage yourself from head to foot every day with 50ml of warm organic oil such as sesame oil. Leave the oil on your body for 15 minutes, then wash off in a hot bath or shower.

By helping congested lymph return to the heart, massage also enables residual toxins to be excreted via the liver and kidneys or surface of your skin and will have an improved cleansing effect both internally and externally.

Generally, its vital to rest and to keep activities as quiet and mindful as possible to ensure your energy is devoted to cleansing.

Surround yourself with things that you find uplifting and nourishing, and minimise screens, stress and exposure to busy environments. Slow, gentle exercise (ideally in nature) supports cleansing but more than that can be counterproductive. Walking, tai chi, qigong, or gentle yoga are ideal. Sleep is the body’s best time to detox so be sure to get plenty of it throughout the cleanse.

Reintroduction

After the active cleansing phase, your body is still processing toxins and the digestive system has got used to a very easy to digest diet. It’s key to take time to go back to your normal diet as digestion needs time to gain strength. Keep the diet light and nourishing, or more toxins can form, gradually reintroducing diverse whole foods over a period equalling the time you spent actively cleansing.  Avoid heavy foods (meat, fish, eggs, sugar, bananas, bread, cakes, biscuits). This can be the most challenging phase as eating a monodiet is often easier than starting to reintroduce only certain foods.

Even after this phase, it may take more time before you feel the benefits of a cleanse. This is normal because the body is often still working to eliminate the toxins released. For women who menstruate, the first menstrual cycle following a cleanse can deliver a meaningful sense of completion to the cleanse.

Rejuvenation

This is the time to offer deep nourishment to the tissues as the body is a little vulnerable after cleansing. Apoptogenic, tonifying herbs like ashwagandha and shatavariare very helpful, alongside the Ayurvedic herbal jam Chywanaprash.

Made in a base of Ayurvedic superfruit amalaki, it is full of antioxidants, and it is said to have been created by an ancient sage to promote energy, vitality, youthfulness and longevity. It contains many of the major Ayurvedic rejuvenative herbs (including ashwagandha, shatavari, guduchi, punarnava, pippali) bringing replenishment to the immune system, metabolism, respiratory, nervous and musculoskeletal systems. 

Focus on foods with high antioxidant capacities, which kindle the digestive fire, build ojas (the essential vitality of the body), and support immunity, such as ghee (clarified butter), dates, almonds, figs, organic raw milk, mung beans, sweet whole grains, and nutritive vegetables like greens and asparagus. Spices that kindle the digestive fire include turmeric, ginger, fennel, saffron, cumin, and cardamom.

Ayurveda says the best time of year to undergo a cleanse is at the change of the seasons around the spring and autumn equinoxes as we are more vulnerable at these transitions. For example, during the winter months there may be a build-up of accumulated damp and mucus, and during the summer months heat and dryness can accumulate. 

Our bodies are having to adapt at these times as seasonal changes in temperature affect our body’s metabolic rate. Women should not actively cleanse during menstruation. If her period comes unexpectedly, she can continue simple food but should suspend all other practices such as self-massage and use of herbs until menstruation is complete.

Mung bean soup

Mung bean soup is simple, nourishing, delicious and easy to make perfect meal for a monodiet while you are cleansing.

Makes 2-3 bowls so double up as needed

Ingredients

• 1 litre water
• 1 tsp turmeric powder
• 1 pinch asafoetida or Hing (from Indian stores, health shops or large supermarkets
• 1-2 tsps. of fresh root ginger
• 3/4 tsp each of cumin seeds, ground coriander, garam masala, ground fennel
• Lemon juice
• 1 tbsp Ghee (clarified butter) or coconut oil
• Salt or herb salt and pepper
• Fresh coriander or other green herbs to garnish

How to make mug bean soup

Wash the mung beans thoroughly and soak overnight or for at least four hours. Add them to a pan with the water with the water and turmeric and simmer gently until soft (around 30-40 minutes), adding more water if needed.

Once cooked, heat the ghee or coconut oil in a small frying pan and fry the cumin seeds, hing (asafoetida) and ginger until aromatic. Add the remaining spices and heat for 20 seconds or so and then stir them into the soup.   Add salt to taste. Serve warm with a squeeze of lemon juice, and some fresh coriander.

For variety, you can add green leafy vegetables (chard, kale, spinach), grated courgettes, carrots or pumpkin.  You can also gentle fry some onions and garlic to add a little sweetness.  You can blend the soup for better consistency and flavour.

Kicharee

Kicharee is known as ‘the food of the gods’ and is an all-round healing and digestion-kindling meal, balancing for all doshas.

Ingredients

• 1 tbsp ghee (clarified butter) or coconut oil
• 2 bay leaves
• ½ tea spoon each of cumin seeds, fennel seeds, mustard seeds, coriander powder, turmeric, fresh grated ginger root
• 1 pinch salt or herb salt
• 2 pinches asafoetida
• 1 cup basmati rice
• 1 cup split mung dal (yellow, green soaked overnight)
• 4-6 cups water
• 60g diced organic carrots/celery/ seasonal vegetables
• Fresh lemon juice and chopped coriander/ herbs to serve

How to make kicharee

Wash rice and dhal separately in at least 2 changes of water. Sauté mustard seeds in ghee till they pop, then add other spices, starting with the seeds and the powders. Add mung dhal and rice and sauté for 2 minutes. Add boiling water, bring to boil and simmer for 30 minutes.

Prepare vegetables that suit your constitution by cutting into small pieces. Add vegetables, salt and extra water if required and simmer for another 20 minutes or until fully cooked.

Aim to have minimal water remaining. Vata dosha types can add a little extra ghee and hemp seed oil to counter vata’s dry tendencies Pitta dosha can add extra coriander which is cooling and calming. Kapha types can add extra fresh ginger and green leafy vegetables to add more spicy, bitter flavours.

A simple cleansing tea

Throughout a cleanse, the following tea can be drunk during the day. It supports agni and helps digest and eliminate toxins. Ensure you drink regularly throughout the day but avoid drinking excessively. Listen to your body and drink according to its needs.

Ingredients

• 1 litre water
• 1 tsp. cumin seeds
• 1 tsp. coriander seeds
• 1 tsp. fennel seeds
• 1 tsp. fresh root ginger juice
• 3 cardamom (discard the pods and grind the seeds)

How to make a cleansing tea

Mix everything and gently heat in a pan. Remove from the heat just before it boils and leave to steep for a further 10 minutes. Filter and drink or keep warm in a flask to consume throughout the day.

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As cleansing is carried out continuously, mainly by the liver and kidneys, some feel emphasis on the need for additional detoxification or cleansing is misguided. Misinformation in the media has also given these a bad name, such as the ‘quick fix detox’ each January. Much of the resulting ‘detox backlash’ has quite rightly focused on the need for a consistently balanced approach to health. However, any increase in toxins- be they from normal metabolism within the body or from external sources- increases the workload for organs which were never designed for today’s toxic overload. 

Our ancestors did not eat ultra-processed diets lacking in diversity, which now make up half the average family’s trolley in the UK (Monteiro et al, 2017). Nor were they exposed to chemicals, pharmaceutical and recreational drugs, atmospheric and industrial pollutants and pesticides which pose novel challenges for our detoxification system.  Numerous studies support the adverse effect these endogenous toxins are having, both on planetary and human health (Schwartz, 2004).

It seems common sense to ensure we help our bodies to cleanse, enhancing our natural ability to metabolise waste effectively. ‘Fasting’ and eating a simplified diet are highly regarded in both Ayurveda and its sister science Yoga, as well as most traditional wisdom systems and religions.

The Ayurvedic view is that eating and digesting food requires significant energy and when you have a break, your body diverts this energy for ‘housekeeping’. It makes sense from an evolutionary perspective in that we have endured feast or famine for much of our history, with an unpredictable supply of food. We have adapted to survive for periods with less food- as opposed to today when most are overfed but undernourished. Whichever way you look at it – from a traditional Ayurvedic or modern biomedical view – there’s no doubt that wastes in our bodies and the stresses of modern life are not good for us.

From an Ayurvedic perspective, not feeling our best offers an invitation from our bodies to correct early imbalances before they progress. Even if we feel full of health, a periodic cleansing is one of the most valuable gifts we can offer ourselves and our clients. In today’s world when so many of us are overly busy, overly toxic and consistently weighed down by stress, a cleanse can be a profound experience. The following signs often indicate that such a cleansing could be beneficial:

• Any digestive issues
• Reduced focus and brain fog
• A lack of energy and fatigue
• Stress and anxiety
• Sleep issues

Ayurveda recognises 3 steps for a practitioner to follow in managing any kind of ill-health:

1. Removal of the causes (primarily a diet and lifestyle approach),
2. Pacify the condition with tailored diet, natural remedies and therapies that are opposite in nature to the aggravated dosha/ qualities of the disease. Or actively purging the body of the disease-causing agents. Both these involve some form of cleansing.
3. Rejuvenation of body and mind

Along with many wisdom traditions, Ayurveda recognises that faulty digestion contributes to any illness. Digestion is likened to a fire (known as agni).  For a fire to burn wood effectively and create heat, the flame needs to be burning brightly.  If it is not and it is just a glowing ember or a small flicker, you could put the best logs on it, but they will just get a little charred with no breakdown nor heat.  This concept of agni can be broken down into 3 main types: 

• The main digestive fire: The digestive processes we have in our digestive tract which break down food to a simple form and allow it to be absorbed
• The elemental fire: The processes in the liver and circulation which transform and sort through the broken-down food into useable nutrients and excretable waste 
• The tissue fire: The transformational processes which use these nutrients to synthesise tissues and provide energy for those tissues

If agni is weak, we suffer with bloating, wind, heartburn, nausea, diarrhoea, constipation, feelings of heaviness, lethargy, lack of energy and a sense of blockage in the body.  This can develop to a whole host of diseases due to the formation of undigested matter or ama. 

With optimum agni, we feel light, energetic and strong, our tissues are nourished, and we have good resilience and immunity.  Ayurveda sees balanced agni as key in achieving optimal health.

A practitioner must rekindle the digestive fire to its optimum capacity so that both food and herbs can be digested and assimilated. To do this we must first cleanse the gastro-intestinal tract of undigested toxins via the process of amapachana. Then restore the digestive fire, a process known as agni deepana. Hence, any Ayurvedic cleansing supports this aim by resting and purifying the digestive system.

It is obvious that the body tissues cannot be nourished and developed when food is not properly digested by your digestive fire (Charaka SamhitaChikitsa Sthana 15/5) 

It is now well known that the role of digesting food is just the tip of the iceberg for the gut, with it being the interface between the outside and our bodies. Its total surface area is two hundred times greater than that of the skin and has major impacts on our health. 

As the gut plays such a central role, anything that stimulates gut signals can have a major impact throughout the body – without being absorbed. The gut hosts most of the immune system, is our largest hormone organ, an extension of the nervous system and is a key recycler of metabolites via the bile, bowel, and microbiome- all of which add weight to Ayurveda’s view that most issues begin with a weak digestive fire. 

When food is undigested because digestion is low, it becomes imbalanced and collects in the stomach. It is known as toxic ama. (Ashtanga’s Heart of Medicine)

Ayurveda’s term ama means ‘unripe, uncooked, immature and undigested’ and offers a broad concept of waste, being any un-metabolised substance not assimilated by your mind or body. Initial signs of ama are food cravings, mood swings, weakness, fatigue, fogginess, anxiety, bad breath, a coated tongue, body odour and sluggishness.

It has damp, sticky, heavy qualities and if left to stagnate, becomes poisonous and can lead to IBS and other digestive issues, rheumatic joint or muscle pain, high cholesterol, autoimmune conditions, weight gain, low energy as well as many other issues.  

Most of us have some degree of ama even if we feel healthy due to the increase in both internal and external toxins today. Beyond increasingly processed diets and environmental pollutants, we are exposed to stress, extreme emotions, negative images and distressing world events through the media on a regular basis. Eating food incompatible with your digestive capability and constitution, incompatible food combinations (such as milk with meat or fish) and withholding urges (e.g., bowel movements, flatus, urine) can also cause agni to diminish allowing ama to form. 

If ama is purely caused by poor digestive power, it may just remain in the digestive tract causing various acute and then chronic digestive issues. Increasing the digestive fire allows this to be digested, the passed out of the body. However, if ama crosses the GI tract membranes and is absorbed into general circulation it can impact deeper metabolic processes (elemental-fires or tissue-fires). 

These blockages cause further reduction in metabolic fires in a vicious cycle leading to many serious, chronic diseases. These depend on where it gets lodged (often at an inherently weak tissue) and with which doshas it combines. If ama remains in the body for a long time, it can lodge deep in the tissues and cells initiating autoimmune reactions (such as in rheumatoid arthritis or multiple sclerosis) and cancer. 

Purging the body was traditionally done through a programme of panchakarma (‘five actions of purgation’). This protocol returns a person to their natural state, free from ama, with balanced doshas, a peaceful mind, good organ function and waste elimination.

It works by drawing deep-rooted toxins and aggravated doshas from tissues and returning them to the gut for elimination through: Vamana (emesis); Virechana (Purgative therapy), Basti (medicated enema), Nasya (nasal therapy) and Rakta mokshana (bloodletting). Before these powerful cleansing therapies can be administered, the patient must be prepared on a strict diet, with ama-digesting herbs, drinking and massaging the body with oily substances and using steam and saunas).

For example, Virechana is used to cleanse the blood, stomach, intestines, liver, spleen and kidneys. It is commonly used in skin disorders, especially eczema where it has been shown to give an 81% cure rate and negligible recurrence (Kaur et al, 2012).  It is useful for any disease caused by high pitta dosha (excess heat and inflammation) and is traditionally recommended each autumn to prevent this build-up. Studies have also looked at panchakarma-style cleansing programmes, showing that taking herbs, a vegetarian diet, using meditation, yoga, and massage reduced markers indicating risk of diabetes and cardiovascular disease and altered gut bacteria (Peterson et al, 2016).

All Ayurvedic cleanses aim to eliminate ama from the system, but one key difference between panchakarma and other types is that it reverses the flow of nutrition. Normally, nutrition flows from the digestive tract into the blood and then tissues. During panchakarma, the digestive fire is intentionally reduced, by intake of medicated ghee.

This reverses the direction so ama moves from the tissues, into the blood and then gut for elimination. While this may occur in other Ayurvedic cleanses on a superficial level, panchakarma intensifies the process to deeply cleanse tissues and channels. It is perhaps the most powerful tool in Ayurveda’s medicine chest, treating serious, chronic and acute issues, as well as maintaining health. However, it is complex and lengthy, taking 3-6 weeks to complete and must be administered by an experienced practitioner. Such strong practices are not appropriate for many people the elderly, and those who are pregnant, breastfeeding, weak or with heart disease.

For those lacking the time, funds, suitability and access to panchakarma, a simpler method is to follow a fasting regime. Fasting is often viewed as a deprivation, but Ayurvedic fasting does not necessarily mean going without food. It can involve eating a cleaner, lighter diet and offers a good alternative to panchakarma. As we’ve seen, a practitioner must first rekindle the digestive fire to its optimum capacity as well as cleanse the gut of undigested toxins.

A cleanse or fast achieves both by minimising potential toxins entering the body so that it can rest and repair, then building agni so that tissues are nourished and ama digested. This experience can still be challenging as toxins are released into the circulation to be eliminated. However, if an Ayurvedic cleanse is undertaken correctly, benefits include:

• A sense of calm and groundedness in the nervous system
• Improved energy and enthusiasm
• A healthy body weight
• Balanced sleep cycles
• Regular elimination of wastes
• The tissues are prepared for rejuvenation

Type 2 diabetes mellitus is most often preceded and is accompanied by an increasing resistance to the action of insulin in moving glucose from the blood into the cells.

This condition has been referred to as metabolic syndrome, insulin resistance syndrome, or syndrome X. It is a disorder of energy utilisation and storage, diagnosed by a co-occurrence of three out of five of the following medical conditions:

• Abdominal (central) obesity
• Elevated blood pressure
• Elevated fasting plasma glucose
• High serum triglycerides
• Low high-density cholesterol (HDL) levels

Metabolic syndrome increases the risk of developing cardiovascular disease, particularly heart failure, and diabetes itself. Some studies have shown the prevalence in the UK to be over a third of the adult population (1) and this increases with age.

We will see there are a number of ways in which we can use plants to reduce insulin resistance.

An immediate impact of increased insulin resistance is on the integrity of the endothelium, the cell wall lining of the blood vessels, and the single interface between blood and tissues at the capillaries.

The endothelium is the frontline in inflammation: this is where the white blood cells are activated and switch on inflammatory cytokines and other initiators. Many long-term complications of diabetes can be laid directly to the direct inflammatory pressures of insulin resistance.

Endothelial dysfunction leads to the following:

• Increased vascular endothelial growth factor (VEGF)
• Capillary basement membrane thickening
• Increased inflammatory cell adhesion
• Increased leptin and inflammatory adipocytokines (from increased fatty tissue)
• Increased inflammatory activity and cytokine concentrations
• Yet more insulin resistance

This in turn leading to the following pathological developments:

•  Oxidation-induced reduction in vasodilation
•  Reduced tissue perfusion and hypoxia
•  Impaired tissue oxidation – fatty infiltration and its pathological consequences
•  Adiposity

There was a recent dramatic illustration of the importance of this endothelial interface in early observations of the incidence of severe complications of Covid-19: that these were associated with health conditions (obesity, cardiovascular disease, diabetes) associated with insulin resistance and endothelial dysfunction.

We will see that there are promising plant based approaches to improving endothelial function.

The most distressing consequences of poorly managed diabetes follow from endothelial dysfunction and disruption in blood supply.

• Retinopathy: Damage to capillary blood supply to the retina, with the development of microaneurysms, retinal haemorrhages, and exudates; this progresses to a ‘proliferative’ phase with the presence of new blood vessels. Blindness is a possible outcome.
• Nephropathy: A persistent proteinuria which can progress to a decline in renal function and end-stage renal disease.
• Neuropathy: Various nerve pathologies with symptoms determined by the nerves involved.

Such macrovascular problems are associated with atherosclerotic plaque formation, affecting blood supply to the heart, brain, limbs, and other organs. Later stages involve complete obstruction of these vessels, which can increase the risks of wider cardiovascular disease, including myocardial infarction, stroke, and gangrene (leading to amputation).

As in the previous section there is considerable evidence that a number of important plant constituents can improve endothelial integrity, and there are indications that this may reduce the incidence of diabetic complications.

Fatty tissues are inherently inflammatory. Adipose cells secrete a variety of cytokines, known as adipokines, including leptin, tumour necrosis factor (TNF)-α, and plasminogen-activator inhibitor type 1 (PAI-1). Fat tissue is also a key regulator of C-reactive protein.

Adipokines generate a state of low-grade generalised inflammation resulting in pathological defects in metabolism and blood flow. These inflammatory agents have been shown as a major mechanism for inducing insulin resistance and diabetes (2).

We shall see that there is promising research pointers to benefits of spices in reducing adipokine activities and in reducing the consequent rises in insulin resistance.

It has long been confirmed that the most effective way to reduce diabetic complications is to bring down the raised levels of blood sugar that accompany the resistance to insulin.

The most useful first approach is to cut the rate at which glucose is produced and absorbed from food. This means at its simplest the reduction in amount of simple sugars, refined carbohydrates and alcohol in the diet and replacing them by complex, slow-release carbohydrates and proteins. To reduce complicating obesity and high cholesterol levels it also makes sense to cut back consumption of saturated fats.

A quick guide to the likelihood of a food pushing up blood glucose levels is its glycaemic index. This is defined by the American Diabetes Association as ‘a ranking of carbohydrates on a scale from 0 to 100 according to the extent to which they raise blood sugar levels after eating.’ Foods with a high GI are those which are rapidly digested and absorbed and result in marked fluctuations in blood sugar levels. Low-GI foods, by virtue of their slow digestion and absorption, produce gradual rises in blood sugar and insulin levels, and have proven benefits for health.

Low GI diets have been shown to improve both glucose and lipid levels in people with diabetes (type 1 and type 2). They have benefits for weight control because they help control appetite and delay hunger. Low GI diets also reduce insulin levels and insulin resistance.

A good GI Index is produced by the Harvard Medical School.

We shall see there are further ways in which we can reduce blood glucose levels using plant foods.

There are several categories of fibre.

• β-glucans such as cellulose in cereals, fruit, vegetables (in all plants in general)

and the mushroom glucans

• Hemicelluloses in cereals, bran, legume
• Lignin invegetables, fruits and cereals
• Resistant starch in barley, wheat, legumes, bananas, etc.
• Fructans such as inulin in onions, bananas, leeks, Jerusalem artichokes, and asparagus
• Polyuronides such as pectin in the fruit skins and vegetables, and alginic acids in agar and other algae

Various fibres are known to have laxative effects, and assist with cholesterol lowering (3). Specific glucose management effects include

• attenuated blood glucose responses (4,5,6)
• prebiotic benefits on gut microbiome (increased Bifidobacteria, Lactobacilli, Faecalibacteria) (7)
• increased production of glucose-sparing short-chain fatty acids (SCFAs) (8)
• increased incretins: glucagon like peptide (GLP-1), peptide YY (PYY) (9)
• reduced body weight (10)
• reduced lipogenesis, adipogenesis, adipocyte numbers and size, inflammation, oxidative stress (11)

Apart form increasing the amount of wholegrains, vegetables, pulses and fruit in the diet, high fibre remedies include linseed (flaxseed), psyllium seed and husk, ispaghula, guar gum, and agar agar.

Bitters have been used for their immediate effect in reducing sugar cravings associated with hypoglycaemic episodes.  They have also been components of traditional formulations in diabetes, accompanied by hyperglycaemia. It has even been possible to speculate from these experiences that such an ‘adaptogenic’ effect is linked with a capacity to modulate insulin release.

Bitter principles in plants activate a family of around 30 receptors (TAS2Rs) tuned to each detect multiple bitter substances (perhaps as a defence mechanism against poisons) and with a wide range of physiological consequences, including changes in digestive activity (12,13) and an increase in blood flow to the digestive tract (14).

They are found throughout the GI tract, airways, and other tissues (15), including pancreatic beta-cells. This latter location adds to the speculation that there is an explanation for the insulin modulating capacity of bitters.

Bitters have been shown to help manage glucose levels (16,17) with effects including the regulation of the hunger hormone ghrelin (18,19) increase in cholecystokinin (20) and regulation of key agents PYY and GLP-1 (21).

Classic bitter remedies associated with managing blood sugar levels include andrographis, neem, gentian root, wormwood, barberry bark (22) and golden seal.

There is increasing evidence that polyphenols, including flavonoids, anthocyanidins (the colours of fruits and vegetables), have a significant effect in glycaemic control (23), and on various aspects of metabolic syndrome (24,25).

In one trial daily cranberry juice (240 mL) consumption for 12 weeks and blueberry extract or powder supplementation (= 9-10 mg of anthocyanins) for 8 to 12 weeks showed a beneficial effect on glucose control in late-onset diabetic subjects (26).

In a major study (PREDIMED-Plus) involving observations over several years of 7447 elderly participants at high cardiovascular risk, polyphenol intakes were calculated from food frequency questionnaires. Analyses were stratified by sex and BMI groups (overweight and obese).

Consumption of polyphenols were inversely associated with incidence of type 2 diabetes, especially on women and those overweight (27). In a subgroup of 3430 elderly persons at higher cardiovascular risk in this same study, a high intake of total polyphenols was also associated with a reduced risk of diabetes (28).

There are several possible mechanisms for such benefits (29). A number of clinical trials point to an improvement of endothelial function in patients whose diets were supplemented with cocoa (30), green tea (31) and anthocyanin-rich berries (32,33,34).

Polyphenols are also prebiotic (35,36) and it may be that changes in gut microbiome can be a significant factor (37,38). The microbiota also process polyphenols (by cleavage into simple phenols) so that large molecules that are poorly absorbed become active modulators of inflammation (39).

Foods that are likely to be helpful in providing useful levels of polyphenols include berries, green tea and high-cocoa, low-sugar chocolate (which has been shown significantly to improve insulin sensitivity and lipid profile (40)), as well as a range of herbal products (41).

Common kitchen spices are showing increasing signs of being very important in the management of metabolic syndrome, blood sugar levels, and particularly vascular complications (42,43).

Cinnamon has been shown to directly regulate blood sugar levels (44,45), to reduce insulin resistance (46,47).

A beneficial effect of various spices on endothelial factors in diabetes is very likely (48).

Turmeric has been shown directly to interact with adipocytes to suppress adipokines. These curcumin-induced alterations reverse insulin resistance, hyperglycaemia, hyperlipidaemia, and other symptoms linked to obesity. Other structurally similar constituents derived from red chili, cinnamon, cloves, black pepper, and ginger, also exhibit effects against obesity and insulin resistance (49).

Turmeric, ginger and other spices also reduce inflammatory activity originating from adipose tissue (50,51)

Ginger has been shown to regulate blood sugar levels by increasing thermogenesis and lipolysis, suppressing lipogenesis, inhibiting intestinal fat absorption, and controlling appetite (52), as well as by reducing insulin resistance (53,54).

The Asian paradox

The rampant increase in the incidence of diabetes in India (55) and China suggests that a high daily spice intake is not sufficient protection against the condition. However the prevalence of peripheral vascular disease in these countries is lower than that reported in European populations (56,57). Levels of retinopathy approximately half that found in the west have been seen in India, Pakistan, Sri Lanka, China (58). This reduces the likelihood that this is due to genetic differences and reinforces the idea that there are dietary reasons, and that it is increased spice intake that reduces vascular complications of diabetes.

After basic exercise and low GI diet:

• Increase consumption in the diet of spices, especially cinnamon, turmeric and ginger.
• Increase polyphenol consumption: green tea, black currant, blueberry, pomegranate, with rewards of 70% chocolate, with any alcohol ration restricted to red wine!
• Ensure high fibre consumption, with supplementation by seaweed and seed sources.
• Consider supplements with spice extracts such as turmeric, and ginger (especially if extra heating appropriate) and also careful use of bitters.

All these measures are on the assumption that the diabetes is being managed without the use of insulin or other medical prescriptions. In these cases there needs to be more care, especially if glycaemic management is not stabilised, as too abrupt a change in regime might precipitate a glycaemic crisis. For the same reason it is not advisable to attempt to add to the management of Type 1 diabetes without careful coordination with medical professionals and monitoring of blood sugar levels.

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23. Rienks J, Barbaresko J, Oluwagbemigun K, et al. (2018) Polyphenol exposure and risk of type 2 diabetes: dose-response meta-analyses and systematic review of prospective cohort studies. Am J Clin Nutr. 108(1): 49-61.
24. Amiot MJ, Riva C, Vinet A. (2016) Effects of dietary polyphenols on metabolic syndrome features in humans: a systematic review. Obes Rev. 17(7): 573-86.
25. Raman G, Avendano EE, Chen S, et al. (2019)  Dietary intakes of flavan-3-ols and cardiometabolic health: systematic review and meta-analysis of randomized trials and prospective cohort studies. Am J Clin Nutr. 110(5): 1067-1078.
26. Rocha DMUP, Caldas APS, da Silva BP et al. (2019) Effects of blueberry and cranberry consumption on type 2 diabetes glycemic control: A systematic review. Crit Rev Food Sci Nutr. 59(11): 1816-1828.
27. Tresserra-Rimbau A, Castro-Barquero S, Vitelli-Storelli F, et al. (2019) Associations between Dietary Polyphenols and Type 2 Diabetes in a Cross-Sectional Analysis of the PREDIMED-Plus Trial: Role of Body Mass Index and Sex. Antioxidants (Basel). 8(11): 537.
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29. Munir KM, Chandrasekaran S, Gao F, Quon MJ. (2013)  Mechanisms for food polyphenols to ameliorate insulin resistance and endothelial dysfunction: therapeutic implications for diabetes and its cardiovascular complications. Am J Physiol Endocrinol Metab. 305(6): E679-86.
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31. Alexopoulos N, Vlachopoulos C, Aznaouridis K, et al. (2008)  The acute effect of green tea consumption on endothelial function in healthy individuals. Eur J Cardiovasc Prev Rehabil. 15(3): 300-5.
32. Amiot MJ, Riva C, Vinet A. (2016) Effects of dietary polyphenols on metabolic syndrome features in humans: a systematic review. Obes Rev. 17(7): 573-86.
33. Martini D, Marino M, Angelino D, et al. (2020) Role of berries in vascular function: a systematic review of human intervention studies. Nutr Rev. 78(3): 189-206.
34. Fairlie-Jones L, Davison K, Fromentin E, Hill AM. (2017) The Effect of Anthocyanin-Rich Foods or Extracts on Vascular Function in Adults: A Systematic Review and Meta-Analysis of Randomised Controlled Trials. Nutrients. 9(8): 908.
35. Igwe EO, Charlton KE, Probst YC, et al. (2019) A systematic literature review of the effect of anthocyanins on gut microbiota populations. J Hum Nutr Diet. 32(1): 53-62.
36. Bond T, Derbyshire E. (2019) Tea Compounds and the Gut Microbiome: Findings from Trials and Mechanistic Studies. Nutrients. 11(10): 2364.
37. Ejtahed HS, Angoorani P, Soroush AR. (2020) Gut microbiota-derived metabolites in obesity: a systematic review. Biosci Microbiota Food Health. 39(3): 65-76.
38. Houghton D, Hardy T, Stewart C, et al. (2018) Systematic review assessing the effectiveness of dietary intervention on gut microbiota in adults with type 2 diabetes. Diabetologia. 61(8): 1700-1711.
39. Nash V, Ranadheera CS, Georgousopoulou EN, et al.(2018)  The effects of grape and red wine polyphenols on gut microbiota – A systematic review. Food Res Int. 113: 277-287.
40. Lin X, Zhang I, Li A, et al. (2016) Cocoa Flavanol Intake and Biomarkers for Cardiometabolic Health: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Nutr. 146(11): 2325-2333.
41. Ejtahed HS, Soroush AR, Siadat SD, et al. (2019) Targeting obesity management through gut microbiota modulation by herbal products: A systematic review. Complement Ther Med. 42: 184-204.
42. Panickar KS. (2013) Beneficial effects of herbs, spices, and medicinal plants on the metabolic syndrome, brain, and cognitive function. Cent Nerv Syst Agents Med Chem. 13(1): 13-29.
43. Skulas-Ray AC, Kris-Etherton PM, Teeter DL, et al. (2011) A high antioxidant spice blend attenuates postprandial insulin and triglyceride responses and increases some plasma measures of antioxidant activity in healthy, overweight men. J Nutr. 141(8): 1451-7.
44. Namazi N, Khodamoradi K, Khamechi SP, et al. (2019) The impact of cinnamon on anthropometric indices and glycemic status in patients with type 2 diabetes: A systematic review and meta-analysis of clinical trials. Complement Ther Med. 43: 92-101
45. Deyno S, Eneyew K, Seyfe S, et al. (2019) Efficacy and safety of cinnamon in type 2 diabetes mellitus and pre-diabetes patients: A meta-analysis and meta-regression. Diabetes Res Clin Pract. 156:107815
46. Sheng X, Zhang Y, Gong Z, et al. (2008) Improved Insulin Resistance and Lipid Metabolism by Cinnamon Extract through Activation of Peroxisome Proliferator-Activated Receptors. PPAR Res. 2008:581348.
47. Qin B, Panickar KS, Anderson RA. (2010) Cinnamon: potential role in the prevention of insulin resistance, metabolic syndrome, and type 2 diabetes. J Diabetes Sci Technol. 4(3): 685-93.
48. Azimi P, Ghiasvand R, Feizi A, et al. (2016 Effect of cinnamon, cardamom, saffron and ginger consumption on blood pressure and a marker of endothelial function in patients with type 2 diabetes mellitus: A randomized controlled clinical trial. Blood Press. 25(3):133-40.
49. Aggarwal BB. (2010) Targeting inflammation-induced obesity and metabolic diseases by curcumin and other nutraceuticals. Annu Rev Nutr. 30:173-99.
50. Woo HM, Kang JH, Kawada T, et al. (2007) Active spice-derived components can inhibit inflammatory responses of adipose tissue in obesity by suppressing inflammatory actions of macrophages and release of monocyte chemoattractant protein-1 from adipocytes. Life Sci. 80(10): 926-31
51. Ebrahimzadeh Attari V, Ostadrahimi A, Asghari Jafarabadi M, et al. (2016) Changes of serum adipocytokines and body weight following Zingiber officinale supplementation in obese women: a RCT. Eur J Nutr. 55(6): 2129-36
52. Ebrahimzadeh Attari V, Malek Mahdavi A, Javadivala Z, et al. (2018) A systematic review of the anti-obesity and weight lowering effect of ginger (Zingiber officinale Roscoe) and its mechanisms of action. Phytother Res. 32(4): 577-585
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Growing the Matcha under shade increases the volume of healing chlorophyll as well as the L-Theanine, amino acids and polyphenols such as EGCG (epi-gallo-catechin-gallate). These natural compounds add to the sweet and savoury-mineral flavour, known as umami- umami, helping to reduce the bitterness of the iridescent green Matcha.

The rare amino acid L-Theanine helps to nourish neurotransmitters in the brain having a positive influence on our mood and sense of inner peace. L-Theanine works synergistically with the low levels of caffeine in green tea and Matcha; it is one of the reasons why it brings such a deep sense of calm as well as alertness. (L-Theanine is five times higher in Matcha than green tea). It actually increases serotonin, dopamine and GABA – all essential neurotransmitters associated with the feel-good factor bringing happiness, inner peace and the general all-round clarity of shanti-ness.

We all know that these qualities help us feel at our best in the midst of our over-stimulated world because they help us focus and feel centered. These more subjective experiences flow into measurable affects such as lowering blood pressure, reducing anxiety and influencing alpha-waves (associated with a relaxed state of mind and also regulated by deep meditation).

We get these effects because humans and plants have evolved so closely together. We can benefit from eating plants that have developed these special compounds because they evolved the ability to protect themselves from invasion by microbes as well as adapting to stressful environments to be successful reproducers.

For example, many of the colourful pigments in plants that protect them from extreme climates help protect us from extreme stresses. It’s now well known that the traditional Indian diet full of healthy spices such as turmeric, cinnamon and ginger help to protect from inflammatory disorders such as heart disease and cancer that are the scourge of modern healthcare.

And green tea is a powerful addition to this protective diet with matcha being the king of all green tea protectors; one cup of Matcha has 100 times the antioxidants compared to green tea (and green has about double the levels in black tea).

Gram for gram it is about 15 times more antioxidant than pomegranates and 100 times more than spinach. So a little goes a long way.

In fact a little can help you to become a little more little because Matcha also helps to burn body fat through a process known as thermogenesis. By enhancing metabolic processes the nearly calorie-free Matcha helps you burn fat four times faster than your usual metabolism.

It’s also important to ensure your Matcha and your green tea (and black for that matter) are organic. Conventionally grown tea has had numerous reports of its pervasive contamination with fat-stored and life-depleting pesticides and herbicides.

This has recently been highlighted by a report by Greenpeace India ‘Trouble brewing: Pesticide residues in tea samples from India.’

Green tea and Matcha don’t have a long history of use in India as the British introduction of the sweet-milky chai has had a more prominent place. Whilst a masala-chai from our favourite chai-wallah is a delight, it’s now questionable if so much sugar and milk are actually healthy.

Perhaps it’s worth reflecting on the goal of Ayurveda; ‘swasta samatva’ or ‘to be established in yourself with balanced health’ and consider how you can include some delicious, uplifting and even spiritual Matcha in your daily experience of drinking some green gold.

• Brunswick Laboratories, Lipophilic and Hydrophilic Antioxidant Capacities of Common Foods in the United States, Journal of Agricultural Food Chemistry 2004, 52, 4026-4037 // ORAC Analysis on Matcha Green Tea.
• Ferrucci et al, Measurement of spices and seasonings in India: Opportunities for cancer epidemiology and prevention, Asian Pac J Cancer Prev . 2010; 11(6): 1621–1629.
• Greenpeace India 2014, Trouble Brewing: Pesticide residues from tea sample in India.
• Hutchins-Wolfbrandt et al,Dietary Turmeric Potentially Reduces the Risk of Cancer, Asian Pacific J Cancer Prev, 12, 3169-3173.
• Mason, R. 200 mg of Zen. L-Theanine Boosts Alpha Waves, Promotes Alert Relaxation. Alternative and Complementary Therapies 2001.
• Weiss, D.J. et al. Determination Of Catechins In Matcha Green Tea By Micellar Electrokinetic Chromatography. Journal of Chromatography. 2003; 1011(1-2): 173-180.

Fats are divided into saturated and un-saturated fats.

Saturated fats

Saturated fats are made from short, medium and long chain fatty acids (also known as triglycerides). Short and medium chain fatty acids are easy to digest whereas long chain fatty acids are not. The short and medium chain fatty acids are absorbed in the upper part of the small intestine, not requiring the liver or gall-bladder for digestion and are used immediately for energy.

Long chain fatty acids have to go through a much more complex process involving being broken down by bile acids and pancreatic lipase into glycerol and free fatty acids. These are absorbed and then reconstitution into triglycerides which need to be bonded with a lipoprotein before they are transported to a site that can use them. This process takes up to 8 hours before they are stored as fat before becoming energy.

Excessive consumption of long chain fatty acids is associated with blood clotting, thrombosis and cancer. Medium chain fatty acids are known to increase metabolism and promote weight loss. Short chain fatty acids help to promote the production of hormones and strengthening cellular membranes. Ghee is high in short chain fatty acids, whilst coconut oil is high in medium chain fatty acids. Commercial margarines, lard and butter are high in long chain fatty acids.

What is the fad with fat?

Saturated fats have a bad public image as excessive consumption of them has become associated with an increased risk of high cholesterol, atherosclerosis, stroke and coronary heart disease. The Seven Countries Trial which began in the late 1950s, was set up to determine the causes of Coronary Heart Disease (CHD). It associated CHD with saturated fats and this has led to a host of ‘low-fat fads’ and an entire low fat industry.

This study is now largely discredited as is the association between saturated fat intake and CHD. Just think what the Eskimos eat…lots of saturated seal and whale blubber. Before westernisation the incidence of CHD amongst traditional Eskimo communities was virtually zero. Another example is Japan, where the rate of saturated fat is increasing but CHD is falling.

The causes of heart disease are much more complex then the ‘fat-heart disease’ hypothesis and involves a balance between the forces of degeneration and the energy of protection including genetic tendency, life-style factors, anti-oxidant status, stress, hostility, hypertension, exercise, sugar metabolism, correct LDL/HDL balance and, of course, dietary factors ensuring sufficient vitamin C, E, soluble fibre, EFAs, flavonoids and carotenoids.

One of the reasons for the controversy regarding the ‘fat-heart disease theory’ is that much research has not differentiated between true saturated fats and synthetically generated saturated transfatty acids. However, this is a misunderstanding of the nature of the saturated fats as some, containing high levels of short and medium chain fatty acids are healthy, such as ghee and coconut oil.

Also many of the saturated fats that people eat come from animals raised in intensive farming where they are grain fed. This leads to a reduction in the heart healthy Omega-3 Essential Fatty Acids made available to grass fed animals. This confusion that all ‘fats’ lead to high cholesterol has led people to embrace a ‘low-fat’ diet which may result in low cholesterol.

Low cholesterol levels and fat free diets have been associated with depression, and violence. Cholesterol helps us ‘feel good’ as it is an important component of serotonin receptors. Cholesterol also helps us to produce essential hormones such as Vitamin D, oestrogen and adrenaline.

So, saturated fats are important to health, benefiting certain specific metabolic functions, cellular interactions and immune responses. Used at an appropriate quantity and with good quality polyunsaturated essential fatty acids they are beneficial to health. My favourite saturated fats are coconut and ghee as they are easy to digest and have numerous health benefits. (Knopp 2004, Lancet 1992)

Unsaturated fats

Unsaturated fats are divided into monounsaturated fats (olive, mustard) and polyunsaturated fats (sesame, sunflower, flax, corn, hemp). Both are required for healthy life. Polyunsaturated fats (PUFAs) are ‘unstable’ oils. If they are not handled properly they can pose a health risk as their cell structure leaves many ‘bond’ sites that are potential sites for oxidisation to occur. They easily go rancid. Essentially this means that under poor processing and storage conditions (i.e. heat and light) they can become oxidised, a process similar to metals rusting, which allows for the release of free radicals in the body. This leads to accelerated ageing and other degenerative diseases.

Interestingly, sesame oil does not become oxidised under heat as its linoleic acid content actually improves its anti-oxidant status but hemp seed does oxidise easily under heat and light which is why it should not be used for cooking.

So, polyunsaturated fats that are handled properly (cold pressed, kept cool, stored away from light) are extremely beneficial for health. If they are not, i.e. when they are processed and stripped of their inherent protective anti-oxidants, then they can create Lipid Oxidation Products (LOPs). As they are toxic to cells, they can damage the lining of the arteries which increases the risk of heart disease and they use up valuable anti-oxidant reserves leaving us exposed to free radical damage.

Because of the way they are processed and handled most commercial, non-organic, PUFAs (sunflower, corn etc.) contain levels of LOPs and so should never be used for frying as this will create more oxidation. Olive oil as a mono-unsaturated fatty acid contains minimal amounts of LOPs and is safe for cooking. However, no oil should ever be re-used as it will harm your health.

Fats and carbs

If carbohydrate or fat consumption exceeds your needs then the glucose-like molecules are stored as glycogen reserves for potentially needed energy release in the muscles and liver. If the glycogen bank is full then the overflow gets laid down as fat molecules in the fat cells. As you reduce your dietary intake and/or increase metabolic needs, fat gets converted back to glycogen. As glycogen gets broken down water is also lost in a ratio of 1 part glycogen to 9 parts water. This is why fasting can bring about rapid weight loss but as food is resumed then glycogen levels go back up and an increase in water retention returns.

Calories

Counting calories is one method of monitoring how much ‘energy’ you are putting into yourself. Men require approximately 2,500 calories/day and women 2,000. One pound of fat is created from 4,000 calories. Whilst calorie counting may be useful for raising awareness of the nutritional components of the food you eat it does not consider the individual metabolic rate which is at the crux of all healthy weight diet and life-style regimes.

Glycaemic Index (GI)

The Glycaemic Index describes how the body’s sugar levels respond to certain foods. It has become an important indicator of how certain foods will affect weight loss and diabetic control. Foods with a low GI release sugar into the bloodstream slowly whilst those with a high GI can cause a rapid increase. Glucose and refined sugars have the highest GI and whole grains and lentils the lowest.

Insulin resistance

Insulin is the hormone that allows for the absorption of various nutrients including glucose and amino acids and keeps the blood sugar within ‘normal’ limits. Whilst insulin production is stimulated by eating carbohydrates it can also reduce the metabolism of fats and proteins thus leading to greater storage of fats. It is estimated that 8 out of 10 overweight people have a blood sugar imbalance including possible insulin resistance.

The term “insulin resistance” means that your body cells are more resistant to the action of insulin than normal. If you are insulin resistant, your pancreas has to make more insulin to keep your sugar normal. As long as your pancreas can meet the excess demand placed upon it, you are OK. If your pancreas cannot keep up with the increased demand, your blood sugar will rise and you will become diabetic.

Evidence points to an inherited abnormal form of insulin that is inefficient at regulating blood sugar levels. There also appears to be a problem with the insulin receptor not allowing insulin to facilitate the entrance of glucose into the cell.

It is fairly easy to determine whether someone is insulin resistant. One of the most common ways to find out is simply to measure the fasting blood sugar and fasting insulin level in the morning. It is also possible to undergo a Glucose Tolerance Test, measuring both blood sugar levels and insulin levels. If the insulin levels are higher than they ought to be, this indicates insulin resistance.

Insulin resistance is affected by:

• A high GI diet as these foods promote the release of high levels of insulin
• A high fat diet helps to lower the GI by slowing digestion and delaying the entrance of sugars into the blood stream
• Excessive insulin secretion creates a negative cycle through over-stimulation. When a cell is exposed to high levels of insulin it starts to alter its relationship with insulin and reduce the number of insulin receptors. This leads to lower levels of fat breakdown and leads to obesity
• Mineral deficiency in chromium and magnesium (also zinc and B vits)
• Obesity creates insulin resistance and insulin resistance creates obesity

Insulin resistance leads to ‘hyperinsulinemia’. It is another vicious cycle. As a tissue becomes increasingly insulin resistant, the uptake of blood glucose becomes more inefficient. As a result, blood glucose levels begin to rise and continue to be raised over ever increasing periods of time. The pancreas, in its efforts to effectively store the glucose, responds by secreting progressively higher levels of insulin. When this pattern occurs insulin levels are higher for longer such that the total hours of insulin exposure in the body may be increased to 50-100% beyond that of normal.

Hyperinsulinemia can cause:

• Sodium metabolism disruption, increased water retention and hypertension
• Oxidative damage and initiation of atherosclerosis and neoplasia (cancer)
• Decrease in the total daily secretion of growth hormone with negative effects throughout the body.One notable effect of this is to inhibit the conversion of the inactive thyroid hormone (T-4) to its active form (T-3). This creates a “functional hypothyroidism,” which is difficult to detect because a routine thyroid blood test will display an otherwise normal level of circulating thyroid hormones
• Compensatory hypercortisolemia (high blood cortisol levels), poor tolerance to stress, depressed immunity, and eventually, adrenal exhaustion
• Chronic, high levels of insulin secretion will eventually exhaust the beta cells of the pancreas, increasing the likelihood of a functional deficit of these tissues, resulting in adult-onset diabetes

The dreaded transfatty acids have become synonymous with poor quality foods and bad health. They are formed when certain polyunsaturated oils are intentionally saturated with hydrogenation under high temperature to make solid fats (an oil is liquid at room temperature and a fat is solid).

The technique of creating transfats was developed in the early 1900s in order to extend the shelf-life of unstable fish and vegetable oils. Widespread introduction of transfats into commercial foods began just after the 1920s with disastrous effects. Because of their harmful effects on health the recommendation to remove them from foods is now being legislated around the world.

Transfatty acids are associated with an accumulation of the potentially harmful LDL, the increased risk of heart disease, prostate cancer, diabetes, fertility and liver dysfunction. Transfats are ‘oxidised’ fats and create harmful free radical generating substances called lipid peroxides. Lipid peroxides (oxidised lipids) actually take up residence on cell walls and obstruct the correct working metabolisms of cells. As they interfere with the delta-6-desaturase enzyme conversion of Omega-3 and Omega-6 fatty acids into inflammation modulating prostaglandins they obstruct this crucial protective process.

Transfatty acids can:

• Increase cancer risk factors by disrupting liver detoxification of carcinogens, change B and T immune cell ratios, interfere with the functions of cancer protecting fatty acids
• Elevate cardiovascular risk factors by increasing total cholesterol levels and potentially harmful LDL cholesterol, lowering protective HDL cholesterol, make platelets more likely to stick to together to form a clot, increase the strongest known risk factor for cardiovascular disease (lipoprotein)
• Interfere with insulin function hence increasing the risk of diabetes
• Disrupt fertility by decreasing testosterone and increasing abnormal sperm
• Be associated with low birth weight babies and lower human breast milk quality
• Interfere with essential fatty acids metabolism
• Interfere with nutrient absorption by reducing Vitamin K absorption

PUFAs contain the fragile Essential Fatty Acids (EFAs) which are found in high concentration in the cells of our brain, nervous system and skin. The cell membranes of the 63 trillion cells we have in us all contain EFAs.

There are three types of EFAs:

1. Omega-3 fatty acids, including alpha-linolenic acid
2. Omega-6 fatty acids, including linoleic acid and gamma-linolenic acid
3. Omega-9 fatty acids, including oleic acid

Examples of some Omega containing oils are;

• Fish oil is all Omega-3
• Flax oil is 60% Omega-3 and 20% Omega-6
• Hemp seed oil is 20% Omega-3, 60% Omega-6, 12% Omega-9 oleic acid and 3% GLA totaling more than 90% unsaturated fatty acid.

We need the EFAs Omega 3 to 6 in a certain ratio. The ratio of 1:3 is considered ideal for health (the ratio is debated, but this is the current most accepted figure). This is the ratio that hemp seed has. Flax has the opposite ratio, which can be beneficial for redressing imbalances in the short-term but not for long-term health as it can lead to omega-6 deficiencies. Commonly people have a ratio of 1 to 10 or 20 Omega 3 to 6! This is because animal fats and many commonly used vegetable oils (soy, corn, safflower, peanut and sesame) are high in Omega 6.

Cells that have a rapid evolution, such as those in the skin, immune and nervous systems, and in growing babies and children, need lots of essential fatty acids to stay healthy. It is vitally important that the correct ratio of Omega 3 to 6 is received or imbalances will occur.

Mental health

60% of the weight of our brain, the fat-richest organ in our body, is fat, and one third of that is EFAs. The ratio of omega 3s to omega 6s in the brain is 1:1. EFAs have been shown to help ADHD, Schizophrenic symptoms, Alzheimer’s disease and senile dementia, Parkinson’s, Lou Gehrig’s disease (ALS), and multiple sclerosis.

Skin health

EFAs help to moisten and nourish the skin preventing dry and flaky skin. As EFAs help form cell membranes they help to keep moisture in the skin and keep cell membrane function at optimum levels. This can positively influence eczema, psoriasis and other inflammatory skin conditions.

Women’s health

EFAs help to reduce Arachidonic Acid levels which can help to reduce menstrual pain. Its mood balancing qualities can also help with PMS.

Fertility

Pregnant women need a larger intake of EFAs to nourish their child, and this need increases with each extra child. Low EFA levels are also associated with post partum depression and some diseases that have a higher incidence in women; multiple sclerosis, thyroiditis, fibromyalgia and lupus. EFAs also help build male fertility through boosting sperm quality and quantity.

Blood

An important function of EFAs is that they make red blood cells more flexible, which means that they can find their way through capillaries more easily. The result is that tissues and cells receive their supply of nutrients and oxygen more effectively, and stamina therefore increases. EFAs also assist in the transport of oxygen and essentially draw oxygen into the cells.

Weight

Getting up to 12% of your diet from EFAs can actually help you to loose weight as EFAs help with our metabolism.

Cardiovascular health

EFAs can reduce blood lipid triglycerides by 65% and have been shown to increase HDL and lower LDL in some people. However they are not sufficient on their own to achieve this in everybody and should be used as a part of a cholesterol reducing programme if this is indicated. They also make platelets less sticky which can reduce the chance of blood clots arising.

Immunity

EFAs are involved in the correct functioning of the DNA and so may help prevent cancers, enhance wound healing and protein metabolism that are so essential for correct immune function. Another important role is that EFAs make hormone-like prostaglandins. There are different forms of prostaglandins, which can either reduce inflammation or be pro-inflammation depending on the source and quality of oil and how it is metabolised in the body. Beneficial prostaglandins (PGE 1 and 3) work to;

• Protect the skin and joints from inflammation
• Reduce cholesterol levels, dilate blood vessels and reduces blood pressure
• Protect integrity of blood vessels and prevent platelet aggregation
• Reduce auto immune inflammation; psoriasis, lupus, crohn’s disease
• Help to reduce menstrual pain
• Reduce the complications of diabetes
• Keep cells functioning properly and reducing cancerous behaviour 

If there is not enough Omega-3 in the diet then the prostaglandin metabolites will convert Omega-6 into a pro-inflammatory Arachidonic Acid process. (Simopoulos 1999, Cullis 1991, Grimble 1998, James 2000)

Omega-3 oils are medium chain fatty acids that are metabolised to long-chain eicosapentaenoic acid (EPA) and decosahexaenoic acid (DHA). EPA, is an Omega-3 derived fatty acid that is a precursor to the eicosanoids; prostaglandin-3, leukotrine-5 and thromboxane-5.  It is associated with a healthy inflammatory, nervous and emotional balance. DHA is another Omega-3 derived fatty acid associated with brain health, retina health, foetal development and immunity.

Omega-3 deficiency leads to dry skin, growth retardation, weakness, impaired learning ability, poor motor coordination, behavioural changes, impaired vision, high blood pressure, sticky platelets, oedema, mental deterioration, low metabolic rate, and immune dysfunction

Nothing in itself, it’s just that we have too much of it in our diets. Although Omega-6 is an EFA, and we need a certain amount of it, unfortunately Omega -6 linoleic acids in excess to Omega-3 can create Arachidonic Acid which can cause an inflammatory cascade disrupting the health of the skin, brain, nervous system, fertility, joints and circulatory system. Excess poor quality Omega-6 linoleic acids in our diet are potentially a causative factor in the increase in heart disease in ‘developed countries’ over the last 90 years.

Some authorities believe that we should be aiming for a 1:1, Omega-3:6 ratio in our diet to redress the imbalances we face from long-term destabilisation in our fatty acid profile.  Others recommend a ratio of 1:3.

Some suggestions for achieving this are (Wallace 2002):

1. Restrict intake of animal-based foods: Meat, dairy, poultry as they are dietary sources of Arachidonic Acid and are precursors to inflammatory PGE2, LTB4, 5-HETE, and 12-HETE
2. Substantially increase dietary sources of omega-3 polyunsaturated fatty acids (PUFAs) ensuring sufficient levels of eicosapentaenoic acid and docosahexaenoic acid that block metabolism of Arachidonic Acid
3. Limit intake of plant-source omega-6 PUFAs, targeting a 1:1 ratio of w3 to w6 PUFAs in severe disease. This helps to prevent enzyme competition and reduce the inadvertent shunt to Arachidonic Acid and inflammatory eicosanoids
4. Increase dietary antioxidants: 7 to 9 servings a day of deeply pigmented fruits and vegetables. This reduces oxidative biosynthesis of inflammatory eicosanoids and isoprostanes
5. Eliminate hydrogenated and trans-fatty acids, alcohol, simple sugars, and refined carbohydrates, and reduce elevated cholesterol levels as these are inhibitors of the desaturase enzyme responsible for converting EFAs to EPA/DHA
6. Ensure adequate intake of zinc, magnesium, ascorbate, niacin, and pyridoxine as these are coenzymes for desaturase metabolism of omega-3 PUFAS
7. Optimize blood glucose regulation: Address hyperinsulinemia as excess insulin shifts dihomogammalinolenic acid toward PGE2 synthesis
8. Provide a combination of several anti-inflammatory botanical agents that help to modulate the inflammatory cascade through multiple and synergistic actions, including COX and LOX inhibition.
9. Monitor inflammatory markers (e.g. C-reactive protein, ceruloplasmin) at baseline and interval and adjust protocol as required

Some authorities (in the fish oil industry?) have said that vegetarian sources of Omega-3 alpha-linolenic acid cannot be efficiently converted into EPA and DHA. However, two studies published in the British Journal of Nutrition which measured the conversion of alpha-linolenic acid (ALA) into EPA, DPA, and DHA have shown otherwise. The first study, carried out with six women, showed that these women converted an average of 36% of the ALA they were given into long-chain Omega-3 derivatives (21% EPA, 6%DPA, 9%DHA).

The second study, done with six men, showed that the men converted an average of 16% of the ALA they received into long-chain Omega-3 derivatives (8%EPA, 8%DPA). In this study, the men produced no DHA. However, another study showed that men convert ALA to DHA as well. It is considered that men can convert 1% of ALA to DHA (Burdge 2002, Emken, Brenna 2002).

It is surmised that women have a better conversion rate as they need to metabolise EPA and DHA for their children as well.

What can influence conversion?

• Too little ALA or Omega-3 intake
• High Omega-6 intake interferes with conversion of Omega-3
• Lack of the vitamins B3, B6 and C and the minerals zinc, calcium, biotin and magnesium necessary for assisting conversion of ALA to EPA and DHA
• Toxic influences
• High carbohydrate diets slow down conversion
• Diets higher in proteins enhance conversion.
• Diets high in saturated or transfats blocks conversion
• Too low a ratio, such as 1 to 10 Omega-3:6 (the average found in Western diets) can lead to symptoms of Omega-3 deficiency. Omega-3 deficiency increases the risk of increasing cardiovascular, immune, autoimmune, diabetic, and inflammatory disease, and leads to sub-optimal intelligence, concentration, mood, and performance. In the two conversion studies published in the BNJ, the diet contained only 1/7^th as much Omega-3 as Omega-6. A better ratio would consist of more Omega-3 and less Omega-6 to redress this imbalance

The global fish stocks are hugely depleted and as it takes 1000Kg of fish to make 1Kg fish oil using fish oil as a health product is not advisable due to the damage it inflicts on our ocean fish stocks. Secondly, our seas are highly polluted. Taking fish oils increases the chance of industrial pollutant toxicity from mercury, dioxins and polychlorinated biphenyls (PCBs). As these toxins tend to accumulate in the fatty parts of fish they are concentrated in the fish oils. They are implicated with a range of diseases from increased aging to neural disorders to cancer.

It is also interesting that the Omega oils and there derivatives ALA and LA are not actually found is fish oils. However EPA and DHA are, but these are metabolised from the ALA and LA found in micro-algae present in the sea. There are all sorts of risks associated with the processing and storage of EPA and DHA due to their tendency to oxidise as they are 5 times less stable than ALA.

So, vegetarian sources are more ethical, more stable and very effective sources of Omega oils.

The National Institute of Health in the US published a report that on average we should have 3% Omega-6 and 1% Omega-3 and 0.3% EPA and DHA as a total of our calorific diet. Pregnant women are recommended to have 650mg/day of EPA and DHA/ day. Other sources recommend 600mg EPA and 400mg DHA per day.

I am giving the following recommended dose based on the profile in hemp seed oil as it contains the perfect balance of Omega oils.

Recommended dose for women

Women with an average weight of 50 kg: Recommended dose 2-3 tablespoons

In order to receive the recommended dose of EPA and DHA from a vegetarian source:

• 1 tablespoon per day of hemp seed oil = 9g (9,000mg)
• 9g hemp seed oil has 6.6g LA and 2.2g ALA

The 36% conversion rate of ALA mentioned in the British Journal of Nutrition means that 1 tablespoon hemp seed oil will give you 792mg of long chain Omega-3 with 21% or 166mg EPA, 6% or 48mg DPA and 9% or 71mg DHA.

If you take the recommended 2 tablespoons per day it will give you a total of 1584mg long chain Omega-3s or 388mg EPA, 96mg DPA and 142mg DHA.

Recommended dose for men

Men with an average weight of 50 kg: Recommended dose 3-4 tablespoons per day

At a conversion rate of 16% ALA to EPA will get 352mg long chain Omega 3s made up of EPA and DPA from 1 tablespoon hemp seed oil. Taking the recommended 3 tablespoons per day will give him 1056mg/day.

This will lead to benefits including lower cardiovascular risk, smoother skin, higher energy levels, better stamina, improved performance and recovery, better insulin sensitivity, lowered cancer risk, lowered inflammation, greater heat production, and improved mood, learning, IQ and calmness, and better ability to handle stress.

• Arnesen H N-3 fatty acids and revascularization procedures. Lipids. 2001;36 Suppl:S103-6. Review.
• Brenna JT. Efficiency of conversion of alpha-linolenic acid to long chain n-3 fatty acids in man. Curr Opin Clin Nutr Metab Care. 2002 Mar;5(2):127-32.
• Burdge G, Conversion of alpha-linolenic acid to eicosapentaenoic, docosapenta-enoic and docosahexaenoic acids in young women. British Journal of Nutrition 2002 Oct;88(4):411-20.
• Burdge G , Jones A, Wootton S , Eicosapentaenoic and docosapentaenoic acids are the principal products of alpha-linolenic acid metabolism in young men, British Journal of Nutrition 2002 Oct;88(4):355-63.
• Cullis P, Hope MJ. Physical properties and functional roles of lipids in membranes. In:V ance DE, Vance JE, eds. Biochemistry of Lipids, Lipoproteins and Membranes. Amsterdam:Elsevier; 1991.
• Emken EA et al Dietary linoleic acid influences desaturation and acylation of deuterium-labelled linoleic and linolenic acids in young adult males. Biochimica et Biophysica Acta 1213, 277-88.
• Grimble RF, Tappia PS. Modulation of pro-inflammatory cytokine biology by unsaturated fatty acids. Z Ernahrungswiss. 1998;37 (suppl 1):57-65.
• James MJ, Gibson RA, Cleland LG. Dietary polyunsaturated fatty acids and inflammatory mediator production. Am J Clin Nutr. 2000;71(1 suppl):S343-S348.
• Knopp R and Retzlaff B,Saturated fat prevents coronary artery disease? An American paradox American Journal of Clinical Nutrition, Vol. 80, No. 5, 1102-1103, November 2004.
• Pereira C et al, 2001. The Alpha-Linolenic Acid Content of Green Vegetables Commonly Available in Australia. Int. J. Vitam. Nutr. Res.;71(4):223-228.
• Simopoulos AP. Essential fatty acids in health and chronic disease. Am J Clin Nutr. 1999;70(3 suppl):S560-S569.
• Storelli MM et al, 2002. Total and Methylmercury Residues in Tuna-Fishfrom the Mediterranean Sea. Food Add. And Contam.;19(8):715-720.
• Wallace J, Nutritional and Botanical Modulation of the Inflammatory Cascade—Eicosanoids, Cyclooxygenases, and Lipoxygenases—as an Adjunct in Cancer Therapy, Integrative Cancer Therapies Vol 1, Number 1, 2002.

A healthy weight is a balanced proportion of body weight to body height. There is no one ideal weight as we are all uniquely different but a general guide has been devised and is described via the Body Mass Index (BMI). A healthy weight is 20-25, overweight is 25+, obesity is defined as a BMI of 30 or more and gross obesity as 40+. Your BMI can be worked out by taking your weight in kilograms and divide it by your height in metres and then divide the result by your height in metres again.

With obesity being described as a global epidemic by the World Health Organisation (WHO) a balanced perspective to eating, exercise and life-style is evidently required.

In the UK, 68% of adults are overweight with 22% of these being obese and 20% of children are overweight. Unhealthy weight levels are a real problem. However, there is also a cultural gender bias with regards to attitudes towards weight loss; 37% of men are overweight whilst only 22% of women but twice as many women diet as men!

The simple fact is that taking in more energy than you use creates an excess that accumulates as fat. There is also a genetic factor that can increase your tendency for a large appetite and also affect metabolism, but the quantity and types of foods consumed in relation to exercise has the greatest effect on your weight. Of course behind these external factors of food consumption and exercise are the internal emotional reasons why we ‘over’ eat and ‘under’ exercise. Resolving these patterns are at the heart of achieving a healthy weight.

Obesity sets up vicious malevolent circles that degrade health. For example, obesity increases insulin resistance which prevents the metabolism of sugars which are stored as fats and increase obesity. The upward spiral of weight gain becomes a downward spiral of health quality.

The proliferation of diets (Atkins, Zone, F Plan, South Beach, Mayo clinic, Mediterranean, Low carb etc.) clearly shows the need for our modern society to regulate its weight. It also displays the high level of confusion associated with the issue of body weight. The bottom line is that there is no right diet for everybody but Ayurveda offers some very personal and insightful advice.

Fats and carbs

If carbohydrate or fat consumption exceeds your needs then the glucose-like molecules are stored as glycogen reserves for potentially needed energy release in the muscles and liver. If the glycogen bank is full then the overflow gets laid down as fat molecules in the fat cells.

As you reduce your dietary intake and/or increase metabolic needs, fat gets converted back to glycogen. As glycogen gets broken down water is also lost in a ratio of 1 part glycogen to 9 parts water. This is why fasting can bring about rapid weight loss but as food is resumed then glycogen levels go back up and an increase in water retention returns.

Calories

Counting calories is one method of monitoring how much ‘energy’ you are putting into yourself. Men require approximately 2,500 calories/day and women 2,000. One pound of fat is created from 4,000 calories. Whilst calorie counting may be useful for raising awareness of the nutritional components of the food you eat it does not consider the individual metabolic rate which is at the crux of all healthy weight diet and life-style regimes.

Glycaemic Index (GI)

The Glycaemic Index describes how the body’s sugar levels respond to certain foods. It has become an important indicator of how certain foods will affect weight loss and diabetic control. Foods with a low GI release sugar into the bloodstream slowly whilst those with a high GI can cause a rapid increase. Glucose and refined sugars have the highest GI and whole grains and lentils the lowest.

Insulin resistance

Insulin is the hormone that allows for the absorption of various nutrients including glucose and amino acids and keeps the blood sugar within ‘normal’ limits. Whilst insulin production is stimulated by eating carbohydrates it can also reduce the metabolism of fats and proteins thus leading to greater storage of fats. It is estimated that 8 out of 10 overweight people have a blood sugar imbalance including possible insulin resistance.

The term “insulin resistance” means that your body cells are more resistant to the action of insulin than normal. If you are insulin resistant, your pancreas has to make more insulin to keep your sugar normal. As long as your pancreas can meet the excess demand placed upon it, you are OK. If your pancreas cannot keep up with the increased demand, your blood sugar will rise and you will become diabetic.

Evidence points to an inherited abnormal form of insulin that is inefficient at regulating blood sugar levels. There also appears to be a problem with the insulin receptor not allowing insulin to facilitate the entrance of glucose into the cell.

It is fairly easy to determine whether someone is insulin resistant. One of the most common ways to find out is simply to measure the fasting blood sugar and fasting insulin level in the morning. It is also possible to undergo a Glucose Tolerance Test, measuring both blood sugar levels and insulin levels. If the insulin levels are higher than they ought to be, this indicates insulin resistance.

Insulin resistance is affected by:

• A high GI diet as these foods promote the release of high levels of insulin
• A high fat diet helps to lower the GI by slowing digestion and delaying the entrance of sugars into the blood stream
• Excessive insulin secretion creates a negative cycle through over-stimulation. When a cell is exposed to high levels of insulin it starts to alter its relationship with insulin and reduce the number of insulin receptors. This leads to lower levels of fat breakdown and leads to obesity
• Mineral deficiency in chromium and magnesium (also zinc and B vits)
• Obesity creates insulin resistance and insulin resistance creates obesity

Insulin resistance leads to ‘hyperinsulinemia’. It is another vicious cycle. As a tissue becomes increasingly insulin resistant, the uptake of blood glucose becomes more inefficient. As a result, blood glucose levels begin to rise and continue to be raised over ever increasing periods of time.

The pancreas, in its efforts to effectively store the glucose, responds by secreting progressively higher levels of insulin. When this pattern occurs insulin levels are higher for longer such that the total hours of insulin exposure in the body may be increased to 50-100% beyond that of normal.

Hyperinsulinemia can cause:

• Sodium metabolism disruption, increased water retention and hypertension.
• Oxidative damage and initiation of atherosclerosis and neoplasia (cancer).
• Decrease in the total daily secretion of growth hormone with negative effects throughout the body. One notable effect of this is to inhibit the conversion of the inactive thyroid hormone (T-4) to its active form (T-3). This creates a “functional hypothyroidism,” which is difficult to detect because a routine thyroid blood test will display an otherwise normal level of circulating thyroid hormones.
• Compensatory hypercortisolemia (high blood cortisol levels), poor tolerance to stress, depressed immunity, and eventually, adrenal exhaustion.
• Chronic, high levels of insulin secretion will eventually exhaust the beta cells of the pancreas, increasing the likelihood of a functional deficit of these tissues, resulting in adult-onset diabetes.

• Excess fat around the buttocks, breasts, abdomen, hips and extremities
• Decreased activity, tiredness
• Shortness of breath on exertion
• Excessive sweating
• Low back pain
• Joint pain

Involving the complications of:

• Diabetes (NIDDM)
• Arthritis and Osteoporosis
• Ischaemic Heart Disease
• Hypertension
• High cholesterol
• Congestive heart failure
• Gall bladder disease
• Various cancers; breast, uterus, prostate (caused by excess adipose tissue aromatase and increased free sex hormones)
• Hypothyroidism
• Low libido
• Impotence
• Infertility
• Menstrual irregularities
• Depression
• Snoring, sleep apnoea

Rule out pregnancy, cyclic premenstrual oedema, ascites, kidney disease in the diagnosis of obesity.

• Excessive intake of heavy, fatty and sweet foods
• Alcohol
• Lack of exercise
• Excessive sleeping during the day
• Excessive steroid use causing increased weight

Described by the Caraka Samhita* as one of the “eight despicable diseases” as it is hard to treat and because patient willpower is essential for any management plan to be effective.

Ayurvedic view

Obesity is characteristically a disease of low digestive fire and an excess of kapha. The qualities of kapha become predominant in the person’s diet and life-style; cold, damp, heavy, slow, oily, static, sticky, cloudy.

Foods such as dairy, wheat, sugars, cold drinks, ice, refrigerated foods have these qualities. They also weaken the digestive fire. Activities such as sleeping in the day time, sleeping straight after a meal, regular snacking, lack of exercise, living in a damp climate all promote these qualities and increase kapha.

The digestive fire in the fat tissue is sluggish and this leads to an accumulation of fat throughout the adipose system; central abdomen, hips, thighs. Fatty tissue accumulates around the abdomen and blocks the natural flow of digestive energy downwards. This obstructs vata dosha (the bodily humour responsible for all movement in the body). 

This causes vata to reverse backwards and to accumulate in the stomach which – because vata’s predominant element is air – fans the digestive fire leading to a hyperactive digestive system.  Any food ingested thereafter “cooks” too quickly causing rapid stomach emptying with a resultant excessive hunger and the patient to continually over-eat. However the food is not utilised and the result of this over-eating builds up in the fat tissue.

Eventually all three dosas become imbalanced and improper nourishment of the tissues leads to a chronic depletion of the body’s natural immunity leading to multiple complications and premature death.

So fat metabolism is weak, the channels are obstructed, digestive fire is low but the appetite is large.

Conventional treatments

• Xenical (orlistat) is a lipase inhibitor. Lipase is an enzyme that helps to metabolise fats to become available for the body. By obstructing the activity of lipase about 30% less fat is available to the body. Its use may result in various digestive disorders such as cramping, diarrhoea, flatulence and fatty stools.
• Meridia (sibutramine) is an appetite suppressant. It appears to have serious effects on the heart and may increase blood-pressure, irregular heartbeat, congestive heart failure and headaches.
• Surgery: Various techniques have been evolved to induce a feeling of satiation and hence prevent over eating. Complications such as pulmonary embolisms, liver disorders, kidney disease, cancer of stomach, bowel and pancreas.

Please note that pharmaceutical medication should only be altered with the advice of a registered medical doctor.

* The definitive Ayurvedic text written circa 2000 BC

• Empowering the individual towards a life-long healthy eating pattern that regulates weight and brings good health.
• Engender willpower and motivation.
• The diet must be simple, delicious and nourishing but also help you loose weight.

Diet

• Avoidyeast, salt, cheese, yoghurt, chocolate, alcohol, refined sugars, oils and flours as these reduce digestive fire and increase weight. It is also advisable to avoid saturated fats in meat and fried foods.
• Include ginger in your daily diet: take a pinch of fresh ginger root with a few drops of lemon juice before each meal.
• Favour foods that are light, dry, and warm as these reduce mucus (e.g. soups, basmati rice).
• Reduce foods that are heavy, oily, and cold as these increase weight and mucus (e.g. pizza, ice cream, bananas).
• Favour foods that are spicy, bitter, and astringent (e.g. ginger, asparagus, tea) as these help to dry excess fluids in the body.
• Reduce foods that are sweet, salty, and sour (e.g., cakes, crisps, vinegar) as these increase fluids in the body.
• Eat foods which are heavy, and therefore “filling”, but which have a lightening effect e.g. barley, green mung and black urad lentils, honey and buttermilk. This will quell feelings of hunger while promoting weight-loss.
• Eating complex carbohydrates encourages an even hunger and a slow release of energy that allows for a balanced use of the food without any excess being turned into fat.
• Include natural fibre from vegetables, wholegrains, lentils and nuts to assist a slow release of energy helping to control blood sugar levels.
• Drink plenty of tepid water mixed with honey morning and evening (4:1 water:honey). Honey helps to satiate the appetite and removes fat.
• Drink plenty of warm water and Revitalising tea throughout the day.
• Maintain the rules of healthy eating e.g.
• Wait until the previous meal is digested before eating again.
• Eat slowly with concentration.
• Do not overeat (ideal ratio is 1/3 liquid: 1/3 solid food: leave 1/3 portion of the belly empty to allow for circulation to promote proper digestion).
• Eat lightly at night.
• Do not eat when you are not hungry. 
• Do not eat between meals.
• Do not eat cold foods and ice.
• Avoid too much water (especially cold from the ‘fridge).
• A primarily vegetarian diet is highly recommended.

A note on ghee: Clarified butter is praised in Ayurveda for its ability to nourish all the tissues. It has been shown that as part of a whole-grain vegetarian diet (using up to 2 tsp per day) it can actually increase the HDL cholesterol (the positive aspect) and reduce the LDL cholesterol (the negative aspect). However if the person has high cholesterol ghee (and other saturated fats) should be avoided. However, as we have seen above, low fat diets can increase the GI and lead to weight increase as well, so some high quality fats should be included in the daily diet.

Lifestyle

• Gradually increase mental and physical activity.
• Practice anaerobic activity that builds muscle rather than stamina. Practice for 20 minutes 5 times per week.
• Yoga; dynamic sun salutation, bellows breath, twists, backward bends, cobra, bow, locust.

Trikatu, triphala, turmeric, fenugreek and guggul

For weight loss these herbs help to increase metabolism, clear excess fluids, reduce fat, regulate digestion and aid the body in its natural elimination of excess wastes. They can also be used to reduce cholesterol and prevent clogging of the arteries.

• Guggul, turmeric and fenugreek to clear excess weight. Guggul literally ‘scrapes’ excess fat deposits from the body.
• Trikatu stimulates the digestive tissues. The black pepper in this blend of ginger and long pepper contains chromium forming part of Glucose tolerance factor (GTF) essential for normalising blood sugar levels and food cravings.
• Triphala clears toxins, regulates the liver and stimulates bowel movements.

Gymnema, guduchi, amla, turmeric, fenugreek, triphala, neem and black pepper

These herbs balance blood sugar levels, increase insulin resistance and can help manage diabetes. They can also reduce sugar cravings and help with weight management programmes.

Triphala, rhubarb root, psyllium seed, linseed, liquorice and fennel

These herbs act as a combination of purgative and bulk laxatives to help eliminate accumulated waste and toxic congestion.

Trikatu formula (Long pepper, ginger, black pepper)

Trikatu can be used as part of a weight loss regime to increase metabolism, digest fats and balance appetite. It is traditionally taken with honey. It will correct digestive sluggishness.

Effects of Sweetness Perception and Caloric Value of a Preload on Short Term Intake (BRALA, P.M. AND R. L. HAGEN. Effects of sweetness perception and caloric value of a preload on short term intake. PHYSIOL BEHAV 30(1) 1—9, 1983).

To determine the effects of calories and sweetness perception on intake, fasted normal weight subjects drank a preload sweetened with sucrose (1.1 g/kg) or L-asparthyl-L-phenylalanyl-methyl ester (Aspartame, 0.011 g/kg), or with no added sweetener.

Sweetness perception of the load was reduced in half of the subjects by oral application of Gymnema sylvestre extracts. One hour after the preload, a meal of snack foods was presented and amounts of nutrients eaten were calculated. Subjects whose perception of sweetness had been decreased for the preload ate less total and sweet calories than did those with normal perception. Calories did not affect intake. The effect of calories and perception of the load was also assessed on variables presumed to correlate with satiety.

Sucrose pleasantness ratings were not related to calories, perception or intake. Subjects’ estimates of the amount of milkshake that they would drink if given the opportunity to do so and hunger ratings were related to overall intake and carbohydrate intake, respectively. The findings indicate that hedonistic aspects of taste are of greater importance than calories in determining short term intake.

GUGULIPID: A natural cholesterol-lowering agent (Urizar NL, Moore DD. Annual Review of Nutrition. 2003;23:303-13. Epub 2003 Feb 26).

The resin of the Commiphora mukul tree has been used in Ayurvedic medicine for more than 2000 years to treat a variety of ailments. Studies in both animal models and humans have shown that this resin, termed gum guggul, can decrease elevated lipid levels. The stereoisomers E- and Z-guggulsterone have been identified as the active agents in this resin. Recent studies have shown that these compounds are antagonist ligands for the bile acid receptor farnesoid X receptor (FXR), which is an important regulator of cholesterol homeostasis. It is likely that this effect accounts for the hypolipidemic activity of these phytosteroids.

Environmentally vegetarianism is more sustainable Its that simple. The livestock industry is one of the largest contributors to environmental damage. It takes 7 Kg of grain to produce 1 Kg of red meat and 2 Kg grain to produce 1Kg of poultry. One quarter of the earth’s surface is now pastureland to support livestock.  

¾ of all grains and beans grown in the US are destined for animal feed which would feed 800million people. The livestock industry uses 50% of all US water resources. These easily could be used to satisfy humans nutritional needs.

It is estimated that 50% of the world’s rainforests have been cleared to support livestock for the meat industry. And 70% of the world’s fish populations are threatened by over fishing.  The livestock industry (meat, dairy, poultry, fisheries) contributes towards 17% of greenhouse gases (Transportation is 13.5%).

All these figures means that it takes ten times more resources to get our nutrition from meat as from grains. Whilst not an absolute answer to the earth’s environmental problems (as modern farming techniques as a whole need to be addressed) becoming a vegetarian is THE single most influential impact that an individual can have on the environment.

I don’t think that being a vegetarian makes you ‘absolutely’ a better or more moral person, but I do think it makes you relatively better. I mean, why would we kill another animal when we can get plenty of nutrition from plants? Of course, if you think we are superior to other animals then maybe that is your answer. Why would we impose such fear and pain on another animal if we don’t have to?

If you have ever visited a battery chicken farm or seen cattle slaughtered at an abattoir you will know what I mean. However hard they try all meat eaters end up eating this sort of mass processed meat because that is what is generally available in restaurants. Fortunately I have chosen to be vegetarian.  I don’t live in the Khalahari desert and ‘need’ animal flesh to support me and my family. I live in the UK where vegetarian options are plentiful.

It’s about a choice. The very nature of our existence means that we kill all the time; washing our hands destroys millions of bacteria, driving a car kills lots of insects, digging the earth kills lots of worms. So to live we must kill. But to live consciously we do not need necessarily have to eat another being. It’s a balance.

For me, this is the intention. To try and live a life that causes no other beings intentional pain. This is the yogic attitude known as ahmsa  or non-violence. Of course I trip up. Ask my calm but chicken loving-wife about my occasional lapse of sense of humour. But in essence the intention of vegetarianism induces a moral code by which I can attempt to live.

The health reasons to be vegetarian are legendary. Of course, it is about what is appropriate for each individual but generally speaking vegetarians suffer less heart disease, diabetes, cancer (breast, bowel, prostate, pancreatic), hypertension, gall bladder problems, obesity and osteoporosis than non-vegetarians.

Vegetarians also make less visits to their GPs and spend less time in hospital (about 22% less than the meat eater). Sounds like a good opportunity for a tax break and an insurance premium! Although it is very easy to eat an ‘unhealthy’ vegetarian diet of white bread, loads of cheese and processed foods. You can still be a meat eater and include high levels of these healthy foods (in fact I would recommend it).

Eating a healthy vegetarian diet means that you comply with the government recommended levels of fruit, vegetable, whole grain, fibre and low saturated fat consumption. These volumes of vegetarian foods also contain a high amount of various ‘super-nutrients’ such as protective anti-oxidants, healing phytochemicals and essential micronutrients.

Ayurveda considers that different foods have different qualities that effect the make-up of our mind and body. You are what you eat and all that. Ayurveda divides all of nature into three qualities called sattva, rajas and tamas. Sattva  refers to qualities of balance, equality, stability. It is light and luminous and holds the capacity for happiness. It is conscious and intelligent, moving inwards and upwards.

Think Gandhi, Mother Teresa, sunrise, hugs and meditation. Rajas generates activity, change and disturbance. It is mobile and excitable. It is the motivator and expressor. It has a centrifugal force causing dispersion and disintegration. Think Led Zeppelin, volcanoes, arguing and Saturday night in the pub.

Tamas is the immobile, still and stuck quality. It is heavy and causes obstruction or lack of perception. It moves down and is responsible for degeneration. Through the force of tamas there is delusion and confusion. Think  being lazy, night time, hangovers and Boxing day.

Generally speaking vegetables, fruits, nuts, grains and milk (organic) are considered to be sattvic and increase awareness, meat is considered to be rajasic and increasing the passions and processed foods are considered to be tamasic.

There are a few good reasons not to be vegetarian. Anyone who is undernourished or recovering from a debilitating illness is a candidate for a bit of chicken soup. New mums often need a bit of extra protein. If you do eat meat keep the portions low to about 30g a couple of times a week and insist on organic.

Indian culture has been associated with vegetarianism (Hinduism, Buddhism and Jainsim all support vegetarianism) from antiquity and it was prevalent in Greece around 6th century BCE. The rise of Christianity wiped vegetarianism from Europe and its green shoots did not reemerge with significance until the 19^th century.  From the traditional medical point of view Ayurveda is primarily but not wholly vegetarian. Ayurveda is a science in pursuit of health. It is not a moralistic system, although morality does creep into its practices.

If someone’s health can benefit from the properties of eating some animal meat, then this is recommended. Ayurveda would understand that there is some karma, or effect, from using animal products, but argues that the health of the individual is paramount. That being said it does recommend a primarily vegetarian diet that is easy to digest. In accordance with Ayurvedic principles it would also encourage an awareness of one’s actions and there is little doubt that the massive impact of the meat industry on the environment, economy and health of society would influence the opinion of the original propounders of Ayurveda.

Any vegetarian who has visited a Chinese medicine practitioner will know what they think. Chinese medicine likes people to eat meat to build the strength of the blood, qi and tissues. Whilst it can help some people regain certain aspects of health when needed it reveals Chinese medicine’s interest in the quantitative approach (how much one is getting) versus Ayurveda’s qualitative (the essence of what one gets) approach to health.

I have seen too many unhealthy vegetarians in my clinic. It is essential for vegetarians to eat an especially healthy diet and supplement their diet with super tonics. This takes a fair bit of effort; soaking, boiling and kneading….but its fun and has results. You MUST eat lots of whole grains, pulses and nuts. Include seaweeds and herbs in your diet.

Ginger, turmeric and coriander are essentials. In both India and China it is a tradition to make herbal decoctions and boil rice and vegetables in them. Try making teas of astragalus and boiling rice in this, add goji berries to porridge, mix amla berries into soups.

Definitely take chywanaprash which is a super herbal tonic jam. Where appropriate, use rejuvenating herbs such as ashwagandha, shatavari, Aloe vera juice and the ginsengs. Make sure you are getting the correct balance of healthy oils, especially Omega-3 to Omega-6s (it should be a 1:2 proportion). Vegetarian sources of Omega-3 do not convert to DHA and EPA very well and so keep your levels of hemp and flax seed high. Ayurveda recommends taking ghee (clarified butter) with food (2 tsp/day) to nourish the tissues. I would recommend supplementing with a wholefood multi-vitamin as well.

Ingredients

• 100g rice pudding rice (You can also try with black or red rice)
• 1 I litre of cow’s, almond, coconut or rice milk
• 3 tbs almond powder
• 7 strands of saffron
• 5 cardamom pods
• Rose jam or water
• Ghee, hemp seed or honey, optional

How to make a nourishing vegetarian breakfast

• Place the rice in a heavy pan and add the milk. Bring to boil and simmer for 1 hour. Add the almond powder. Add more milk as desired. (coconut milk is an interesting change).
• Soak the strands of saffron in a tablespoon of milk for 10 minutes to extract its golden pigment and then add to rice pudding. Add cardamom and rose jam.  Serve and add ghee or honey as desired.
• You can also add grated carrots or beetroots to this recipe for a colourful and nourishing variation. Also try with roasted walnuts, hazelnuts or raisins or goji berries.

This is a very nourishing food for strengthening the tissues and building deep strength.

At the very heart of being a vegetarian is its spiritual quality. Spiritual in the sense of connecting with that part of life that honours all beings as being an expression of the unconditional love that we all are.

Spiritual in the sense of slightly removing oneself from the material world to a more contemplative place where you can reflect on who you are and what you are doing here. Spiritual in distinction to material flesh. I am sure that many enlightened yogis have eaten meat so lets not get too high and mighty about this ‘spiritualism of vegetarians’ but some of us need all the help we can get! If you want it to be vegetarianism can be a part of your spiritual practice.

Blessings to you all. Blessings to the plants. Blessings to the animals. Blessings to the earth.

• Burr, M & Butland, B. (1988) Heart disease in British vegetarians. Am Jnl Clinical Nutrition v.48 p.830-2.
• Claude-Chang, J et al. (1992) Mortality pattern of German vegetarians after 11 years of follow-up. Epidemiology v.3 (5) p.395-401.
• Cummings, J & Bingham, S. (1998) Diet and the Prevention of Cancer BMJ v.317 p.1636-1640.
• Doll, R. (1990) Symposium on diet and cancer. Proc of the Nutrition Society v.49 p.119-31.
• Dwyer, J T. (1988) Health aspects of vegetarian diets. Am Jnl Clinical Nutrition v.48 p.712-38.
• Gale, Catharine R; Ian J Deary, Ingrid Schoon, G David Batty, G David Batty (2006-12-15). “IQ in childhood and vegetarianism in adulthood: 1970 British cohort study”. British Medical Journal 333 (7581).
• Key, T J. et al. (1999) Health Benefits of a vegetarian diet. Proceedings of the Nutrition Society v.58 p.271-5.
• Margetts, B M et al. (1986) Vegetarian diet in mild hypertension: a randomised controlled trial. BMJ v.293 p.1468-71.
• Marsh, A G et al. (1988) Vegetarian lifestyle and bone mineral density. Am Jnl Clinical Nutrition v.48 (3) p.837-41.
• Sellmeyer, D E et al. (2001) A high ratio of dietary animal to vegetable protein increases the rate of bone loss and the risk of fracture in postmenopausal women.
• Am J Clin Nutr 2001; 73:118-22. Spencer, Colin: The Heretic’s Feast. A History of Vegetarianism, London: Fourth Estate 1993,
• Thorogood, M et al. (1994) Risk from death from cancer and ischaemic heart disease in meat and non meat-eaters.
• BMJ v.308 p.1667-1671.
• Thorogood, M et al. (1987) Plasma lipids and lipoprotein cholesterol in people with different diets in Britain.
• BMJ v.295 p.351-3.
• Vesterby, Marlow and Krupa, Kenneth S. 2001 Major Uses of Land in the United States, 1997 Statistical Bulletin No. (SB973) September 2001. 
• LEAD digital library: Livestock’s long shadow – Environmental issues and options.
• Walters, K and Portmess, L, Religious Vegetarianism From Hesiod to the Dalai Lama, Albany 2001.
• Willett, W C et al. (1990) Relation of meat, fat and fibre intake to the risk of colon cancer in a prospective study among women.
• New England Jnl of Medicine v.323 p.1664-72.
• World Health Organisation (1990). Diet, nutrition and the prevention of chronic diseases. WHO, Geneva.

We are increasingly aware that many of the very compounds that protect plants from attack may also have an immensely beneficial and protective effect on the humans that ingest them. We often refer to these compounds as phytonutrients. They help prevent damage to cells throughout the body, they regulate inflammatory responses in the body and genetic expression, and they protect our all-important genetic code, DNA.

Compounds found in plants as diverse as turmeric root, grape skins and seeds, broccoli (and other cruciferous vegetables), leafy vegetables, garlic, carrots and many herbs and spices, have been shown to reduce the risk of cancer, heart disease, stroke, osteoporosis, Alzheimer’s and Parkinson’s disease. Experts believe that eating plenty of nutrient-dense, phytonutrient-rich foods promotes healthy ageing.

Hundreds of thousands of phytonutrients have been identified across our vegetable, fruit and herb crops. Many of them have multi-target functions, unlike most synthetically-manufactured drugs. Well researched phytonutrients include:

• Carotenoids: These provide the yellow, orange and red colours in fruits and vegetables, such beta-carotene and other carotenoids in carrots (antioxidant), lutein in marigolds (helpful against macular degeneration and cataracts) and lycopene in tomatoes (protective against heart disease and some cancers).
• Curcuminoids: Found in turmeric root, a powerful antioxidant, immune modulator and anti-inflammatory and neuro-protective agent.
• Flavonoids: Such as catechins from green tea that may prevent some forms of cancer, hespiridins from citrus fruits that help to reduce inflammation and thereby chronic disease; and flavonols found in apples and berries as well as kale and onions that may be used to reduce the risk of asthma, some forms of cancer and coronary heart disease.
• Resveratrol: A well-known and popular one found in red grape skin and red wine, linked to reduced levels of heart disease
• Glucosinolates: From cruciferous vegetables like broccoli, cabbage and kale that have been to reduce cancer risk and high blood pressure.

Different varieties of the same crop can often contain quite different levels of secondary metabolites depending on where they have grown and when they were harvested.  Unripe fruits and vegetables may often contain fewer secondary metabolites than ripe ones, and artificial ripening may prevent the development of the same, full complement of phytonutrients as compared with sun-ripened crops.

You can often taste the difference, the taste buds on your tongue being particularly sensitive to phytonutrients. If a fruit or veg is lacking in flavour or taste, chances are it’s got a low quotient of phytonutrients. If the flavour is full, the reverse may be true.  This is particularly evident with crops like tomatoes.

With some crops, younger plants can have higher levels of phytonutrients.  Broccoli sprouts, for example, contain much higher levels of the sulforaphane (a glucosinolate derivative) than mature broccoli heads.

So, what are adaptogens? Well, the clue is their name. They help the body to adapt, adjust and recalibrate itself depending on our emotional and physical surroundings. So, for example, they can foster a sense of calm in times of stress; bring peace to a racing mind in the middle of the night; offer clarity amidst turmoil; and imbue us with energy in the face of exhaustion.

The term adaptogen was introduced into scientific literature by Russian toxicologist Nikolay Lazarev in 1957 to refer to “substances that increase the state of non-specific resistance” in stress.

Broadly, an adaptogen must have the four ‘Ns’:

• Nourishing: Bring nutritive strength.
• Normalising: Raise what is low and lower what is high (e.g. energy, stress).
• Non-specific: Act on multiple parts of the body at the same time.
• Non-toxic: Safe when used over extended periods of time.

Adaptogens relieve stress by modulating the release of stress hormones from the adrenal glands. As biological response modifiers, adaptogenic herbs restore the body’s innate immune function and help the body adapt to different stressors. This gives them preventative and protective as well as curative activity in compromised immunity.

By replenishing our deeper immunity and regulating our response to stress, adaptogenic herbs replenish the wellspring of health and vitality and are true rejuvenating tonics helping to:

• Improve overall wellbeing
• Increase energy
• Optimise organ function
• Reduce stress response
• Improve blood sugar levels
• Optimise protein synthesis
• Reduce inflammatory cortisol levels
• Improve cholesterol ratios
• Regulate the hormonal balance

I often marvel at the fact that there are plants that can do all, yes, all of these things. And, there are plenty. Here are three of my favourites.

Ashwagandha

Ashwagandha is the 21st century perfect herb as it both calms and energises, helping us to adapt to the stresses of everyday living. It’s helpful for assisting deep sleep and calming nervous tension.

Its ability to replenish the blood, enhance nutrients and build bone strength make it indispensable in disorders of degeneration and ageing. Its affinity for the adrenal, endocrine and nervous systems point to its use in any imbalances affecting our energy or vitality.

Holy basil

This leafy member of the mint family is known in Hindu mythology as an incarnation of the Goddess Tulsi, offering divine protection. As well as increasing circulation, aiding digestion and helping to protect against seasonal malaise, holy basil is also good for calming busy minds. 

Turmeric

Turmeric is the superspice par excellence. High in flavonoids and with over 6,000 clinical studies attesting to its ability to protect and nourish the body, it improves circulation, reduces inflammation, heals wounds and protects the liver and bowels. It has gained the reputation of one of nature’s most potent remedies for many of today’s health challenges.

Finally, perhaps our greatest rejuvenating friend is letting our hair down and peeling with laughter. There is a great Hindi adage that goes: “There is medicine for 100 problems, but laughter is my best healing friend!” 

There is a great deal of media and advertising coverage surrounding various ‘detox’ and cleansing regimes, but very little of this coverage really examines what detoxification means. One place to start might be a definition of detoxification. The Oxford English Dictionary describes it as a process that ‘removes toxic substances or qualities’.

It is well documented in medical literature that the body uses the liver, kidneys, bowels, skin and lungs as organs of elimination as well as detoxification. Traditional systems of healthcare have used purification and cleansing techniques for centuries. But what are the ‘toxins’ that are being ‘detoxified’?

A toxin is anything that is potentially poisonous, causing damage or death to an organism. A toxin may be endogenous or exogenous. By endogenous, we mean that the toxins grow or originate from within the body. We create endogenous free radical toxins all the time.

Free radicals are a part of normal biological processes such as cell signalling and are created from molecular oxygen. They are the waste products of normal cellular metabolism but can also be generated in response to environmental sources. Some sources of free radicals from cellular metabolism are prostaglandin synthesis, phagocytosis and enzyme activities.

If excessive free radicals are produced they can compromise the body’s normal defence mechanism as they overwhelm our elimination systems. Free radicals are known to produce adverse changes throughout the body by causing chemical bonds to occur between molecules that are programmed to operate independently. These bonds, known as cross-linking, reduce the ability of the cell to adjust to change. By affecting the molecular bonding of cells, free radicals can damage the formation of the cell wall and the nucleus.

They may also set off a chain reaction that damages cells, eating away at their membrane and corrupting their genetic DNA. This ability to influence cellular behaviour by disrupting the exchange of information and nutrients across the cell membrane makes the cell sick. A free radicals’ ability to damage DNA and impair its information managing function causes the DNA within the cell to mutate. This mutation implicates free radicals in numerous degenerative disorders.

Exogenous toxins are those that originate outside of the body but, in some way, make contact with our internal environment to cause potential damage. Examples include mycotoxins, neurotoxins, aflatoxins, venomous toxins, environmental toxins and many more. In Ayurveda toxins are called ‘ama’ and refer to anything that is undigested. We all know about poisonous mushrooms such as ‘The Poison Deathcap’ mushroom, Amanita phalloids., causing poisoning and death.

Aflatoxins, a type of fungus commonly found on peanuts and grains, are one of the leading causes of liver cancer in the world. Alcohol is a renowned toxin, causing liver damage through repeated exposure. Acetaldehyde is a toxic substance produced in the body from alcohol and is one of the impurities found in cheap wine spirits.

Some researchers believe that an acetaldehyde build-up is the cause of hangovers. If the liver’s detoxification pathways are impaired, aldehydes can, instead of being converted to the next intermediate product, build up to harmful levels and cause damage as they are often more toxic than the original substances from which they are derived.

It is probably the metabolism of methanol to formaldehyde and formic acid that caused the symptoms of the hangover. People who are efficient methanol metabolizers suffer more. This is reinforced by the fact that the types of drinks associated with more severe hangovers contain higher levels of methanol (Calder, 1997).

All types of alcoholic drinks contain some methanol, a substance blamed for the worst hangovers. Whiskey, cheap red wine, fruit brandy and other dark spirits contain the most methanol, sometimes as much as 2% by volume. Vodka and other clear drinks contain the least. In the liver, methanol takes 10 times longer than ethanol to break down.

Human generated poisons are now omnipresent in our environment. The chemical, pharmaceutical, agriculture and food industries have created a host of poisons that have infiltrated our air, water and soil. We are exposed to these products every day. They have penetrated our food chain, our homes and are a part of our eco-system in the guise of insecticides, pesticides, herbicides, flame retardants, heavy metals, petrochemicals, pharmaceutical drugs and radiation. Numerous studies attest to the direct relationship between the increase in poisons in our environment, their detrimental effect on our ecosystem and both adult and children’s health (Schwartz, 2004).

Fortunately, the body has its own in-built protection system. Many toxins and free radicals are metabolized and de-toxified through the liver via the Phase 1 and Phase 2 detoxification pathways. The liver clears many pharmaceutical drugs, hormones, and industrial pollutants. The Phase 1 pathway is comprised of a range of systems, including the cytochrome P-450 enzyme system, that can convert poisons via certain chemical reactions (such as oxidation, hydrolysis or reduction) into a less toxic state.

The Phase 2 process then binds or ‘conjugates’ cysteine, glutathione or sulphur with these metabolites from Phase 1 and they are excreted by the bile via the bowel or as a water-soluble compound via the bladder.

However, if Phase 1 is overly ‘induced’ it can create an overload of free radicals which can damage the liver and swamp Phase 2. An overactive Phase 1 and underactive Phase 2 is a recipe for illness. The ‘toxins’ that the liver cannot metabolise often end up stored in fatty tissue, including the brain, nerves and endocrine glands. Hence toxicity being associated with neurological, fertility, metabolic and energy issues. Herbs such as rosemary and milk thistle may be used to support Phase 1 and 2 detoxification pathways (Morgan and Bone, 2011).

There are many natural supplements that can support a body’s detoxification and eliminative processes. It is perhaps useful to look at some of these in turn and consider their application.

Turmeric

Turmeric (Curcuma longa) is a member of the ginger family and contains a number of active compounds including curcumin and essentials oils such as tumerones. The curcuminoids have attracted the most media and research attention for their anti-inflammatory and anti-cancer properties but are also valued by herbalists for several other applications. In clinical trials, turmeric has been found to protect the liver from many toxic substances, including alcohol (Rukkumani et al, 2004).

Additionally, turmeric may be used therapeutically to reduce cholesterol, help manage blood sugar levels and improve the flow of bile from the liver (Jentzsch et al, 1959). This latter action on bile also supports its role in aiding elimination as bile is used by the body as a natural laxative.

Nettle

Nettle leaf (Urtica dioica fol.) is a perennial plant native to the UK but found in temperate zones worldwide. Nettle is regarded in traditional medicine as an ‘alterative’, meaning a substance that improves detoxification and promotes elimination to increase the excretion of metabolic waste products from the body (Bone, 2003).

Its major application in this traditional sense was to alleviate skin conditions such as acne, eczema and psoriasis that were seen to be caused by congestion within the body. In more modern medicine (and particularly in Germany), nettle is approved for the treatment of benign prostatic hyperplasia, infections of the lower urinary tract and rheumatic conditions (Fisher, 2009). However, western herbalists will commonly use nettle to support elimination and support the cleansing process in inflammatory conditions of all kinds.

Celery seed

Although historical uses of this celery seed (Apium graveolens) include indications such as ridding the body of worms and alleviating insomnia, more recently it has been used in conditions requiring detoxification and cleansing. It has an ayurvedic use in treating liver dysfunction and in Germany is regarded as a medicine for improving bowel function. Where western herbalists often see a strong value in celery seed is as a herb that aids the excretion of waste metabolites, such as uric acid, through the renal system. For this reason, it is strongly indicated for gout and other rheumatic or arthritic conditions (Australian Patent, 1995).

Ginseng

Korean ginseng (Panax ginseng) is a plant with a fascinating history of use both in medicine, where it was regarded as a panacea for illness, and in cultural festivals. It is native to mountainous regions in Russia, Korea and China where it prefers the cool climates and is harvested for its valuable roots.

Due to extensive research into Korean ginseng, we know that it contains numerous active compounds called ginsenosides, which are triterpene saponins in structure. It is a potent antioxidant (Zhang et al, 1996), which assists the body with detoxification, but also has adaptogenic action. By exerting an adaptogenic influence, it helps the cope with stressors more effectively and achieve a more favourable state. This effect is widespread throughout the body and may be seen in both hormonal and reproductive mechanisms, nervous system effects and in digestion (Fisher, 2009).

Tulsi

Although not regarded as the most obvious of detoxification or cleansing herbs, tulsi (Ocimum tenuiflorum) has a broad spectrum of activity which includes strong antioxidant actions. More colloquially known as ‘holy basil’, tulsi has a long and proud history of use as a sacred and medicinal plant in its native habitat of Sri Lanka, India and China.

A large part of its antioxidant action appears to be attributable to two particular enzymes, superoxide dismutase and superoxide catalase (Gupta et al, 2002). However, tulsi also demonstrates support in detoxification and cleansing through a variety of other means such as helping to clear lung congestion, support effective digestion and helping to clear the ‘mental fog’ that often arises where a body in overly taxed. In the Ayurvedic tradition, tulsi is regarded as having an action of deepana, which rekindles the digestive fire.

• Australian Patent 99469910-A. January 1995, Mobius Consultancy Pty Ltd.
• Bone, S, A clinical guide to blending liquid herbs, 2003, Churchill Livingstone
• Calder, I, Hangovers: Not The Ethanol, Perhaps The Methanol, British Medical Journal, Vol.14, pp.2-3
• Fisher, C, Materia Medica of Western Herbs, 2009, Vitex Medica
• Gupta et al, Validation of traditional claim of Tulsi, Ocimum sanctum Linn. As a medicinal plant, 2002, Indian J of Exper Biol., Vol.40, pp.765-773
• Jentzsch et al, Paper chromatographic and pharmacological investigations on curcuma pigments, Pharm acta Helv., 1959, Vol.34, pp.181-188
• Morgan, M and Bone, K, Herbs for enhancing Phase I/II hepatic detoxification, 2011, No.56 Mediherb
• Rukkumani et al, Comparative effects of curcumin and an analog of curcumin on alcohol and PUFA induced oxidative stress, J Pharm Pharm Sci., 2004, Vol.7(2), pp.274-283
• Schwartz, J, Air pollution and children’s health, 2004, Paediatrics, Vol.113 (4 Suppl.), pp.1037-1043
• Zhang et al, Ginseng extract scavenges hydroxyl radical and protects unsaturated fatty acids from decomposition caused by iron-mediated lipid peroxidation, Free Radic Biol Med., 1996, Vol.20(1), pp.145-150

According to Ayurveda, skin has seven layers, corresponding to the seven dhatus. Similarly, in modern physiology, skin has been found to have seven layers, stratum corneum, on the surface, stratum lucidum, stratum granulosum, stratum spinosum, stratum basale, the basement membrane and the dermis.

At the same time, the epidermis of the skin, as whole, is seen as an secondary (upadhatu) of plasma tissue (rasa dhatu), and the dermis as part of muscle tissue (mamsa dhatu). Skin belongs to bahya marga, the external pathway of disease, and as such is very vulnerable to toxins carried by plasma rasa) and blood (rakta dhatus) during the spreading (prasara) stage of disease, accounting for the relatively common nature of skin inflammations. 

Let us turn our attention first to atopic dermatitis (AD). Also called eczema, this condition is due to a hypersensitivity reaction in bahya marga, leading to long-term skin inflammation which creates itchy and scaly skin. Long-term irritation and scratching may cause the skin to thicken and develop a leathery texture. If the ear canal is affected there may be discharge from the ears (for pictures of atopic dermatitis, for atopic dermatitis on ankles, for atopic dermatitis on arms, for atopic dermatitis in infancy).

Atopic dermatitis is most common in infants, often clearing by the age of three, while in adults it becomes a yapya condition that persists or recurs throughout the lifetime. In infants, lesions of AD begin on the cheeks, elbows and knees, while in adults the lesions are more commonly found on the knees and elbows alone.

Typically, AD occurs on the flexor surfaces (the parts of the skin that touch when a joint bends). It arises most often where there is a family history of atopic conditions such as hay fever, asthma and eczema. Because skin belongs to bahya marga, AD is typically the first condition in the atopic picture, later followed by asthma or allergic rhinitis as the atopic process moves from the prasara stage to localize in prana vaha srotas (1).

A combination of genetic factors (adi bala pravrutta), doshic skin type (dosha bala pravrutta), exposure to environmental allergens (parya varana) and immunological reactivity (pittaja), come together to create the tendency to AD. (1) Vata skin is more prone to AD because of dryness and pitta skin because of its greater irritant response. Manasaja or psychogenic causes also play a part, as stress can trigger an outbreak of AD in both children and adults. Annaja or dietary causes are extremely important in AD, and so are agantu causes or infective agents.

In one study, 56% of children with AD were found to have food allergies that could trigger the condition. (3) Major food allergens associated with AD are eggs, cow’s milk, wheat, soy and peanuts (1, 3). Most patients with AD are colonized with Staphylococcusaureus instead of healthy, normal skin flora (1). Hence secondary (anubandha) Staphylococcus aureus overgrowths or infections are typical and can create AD relapses (1, 4).  Although AD is not in itself infectious, lesions infected with Staph. aureus can be passed on to others.

Dermatitis treatment

Because AD is a multi-factorial condition, it can only be addressed effectively in a holistic manner, taking into account emollients for doshic skin type, removal of environmental toxins, pacification of pitta and cleansing of pitta ama with a herbal blends such as guduchi and neem or Neem and Sarsaparilla, dietary modifications to address annaja causes and ointments to address infective agents. Neem or coconut oil will act as excellent pitta emollients and can be mixed with neem powder as an anti-infective agent. For psychogenic causes, counselling, stress management, yoga and meditation will be beneficial.

Case studies: Patient A

A thirteen year old pitta prakruti girl presented in great distress with AD that affected her arms and face. As a teenager, she found an assault on her appearance to be unbearable. Fortunately for the practitioner, her exasperation rendered her a highly compliant patient. She agreed to use Neem and Sesame oil and to take triphala and an herbal formula containing guduchi, turmeric, neem and manjista with aloe vera as an carrier (anupan). She was even willing, in her desperation, to follow a one month exclusion diet, eliminating eggs, cow dairy products, wheat, soy and peanuts from her diet completely.

We explained to her that exclusion diets are only effective if followed meticulously. “This is an experiment. You don’t have to eat this way for the rest of your life.” Within two weeks of the exclusion diet, her skin had cleared completely. She then began challenging the allergens, one allergen per week. The challenge process used was to eat a significant amount of the suspected item, wait two days and then eat it again.

During this process, she learnt that dairy products were the trigger food for her unwanted symptoms. She thus became a staunch devotee of the casein-free diet.  She continued her herbal regimen for three more months to ensure that pitta was pacified and pitta toxins removed, after which she remained symptom free by following her prescribed diet.

Case studies: Patient B

A forty two year old pitta woman presented with eczema localized to the fourth finger of her left hand. The symbolism of this location was not lost on us and we explored emotional causes in detail. She had a history of relationships with unavailable men and had remained unmarried as result. Currently, she was in her first promising relationship, with a man who wished to marry her and adopt a family. It is worth noting that her AD remained intractable when treated with a similar herbal regimen to the one which proved highly effective for patient A. 

In her case, emotional toxins were of more significance than physical ones. Accordingly, we started her on brahmi tea to help move the emotional toxins.  On her third follow up she had an epiphany, realizing that she feared intimacy and had created the eczema, “To make sure I can’t wear a wedding ring.”  Following this realization, her eczema rapidly cleared. I last met her in the grocery store. She was proudly wearing a wedding ring and carrying her adopted son in her arms.

Turning now to psoriasis; this is a condition opposite in many ways to AD. Psoriasis is a non-contagious, genetically based condition that typically appears as inflamed, oedematous skin lesions. The lesions are red and are covered with distinctive silvery white scales.

It is a lifelong illness for which there is no known cure, although it can be quite effectively managed Ayurvedically. Severe cases often move into asthi dhatu, presenting with pitted nails and painful joints. Unlike AD, psoriasis typically manifests on extensor surfaces, is not associated with atopy and does not result in frequent staphylococcal skin infections. 

It also begins in an older age group, with typical onset between the ages of ten and forty rather than in infancy. Although psoriasis is one of the most common skin conditions, affecting over 7 million Americans, its aetiology has long been poorly understood. It is now widely accepted as an auto-immune disorder sharing the same disease pathways as rheumatoid arthritis and inflammatory bowel disease (6, 7, 8).

In psoriasis, the journey of the keratinocytes from stratum basale to stratum corneum is shortened from 311 to 36 hours (5). The epidermal layer of the skin becomes thicker and cells are distributed abnormally (5).

Psoriasis treatment

As an auto-immune condition, psoriasis requires a rather different treatment protocol than AD. It is not sufficient to clear pitta toxins and return pitta to its seat. In addition, anti-inflammatory herbs are needed, while pancha karma is necessary to reverse the disease pathways involved in auto-immunity.

Case studies: Patient C

A forty five year old pitta woman presented with psoriasis on her scalp and extensor surfaces.  She was vata provoked and under great stress as she was conflicted in her marriage and currently involved in an extra-marital affair. She was given a medicated ghee containing ashwagandha, neem and manjista to apply topically, and an herbal formula which also included ashwagandha and manjista, but not neem, on account of her vata provocation.  It is important to note the value of ashwagandha in dry, scaly skin conditions such as psoriasis, and also the role vata provocation may play in flaring up the condition. She took Brahmi tea to help her depression and stress and a formulation of guduchi and guggulu as an anti-inflammatory helpful in many auto-immune conditions. With this herbal regimen and a pitta-soothing diet, her psoriasis began to improve gradually. 

She then did seven days of pancha karma treatments using Refresh Pitta Massage Oil with a few drops of added cold pressed neem oil for therapeutic massage (abhyanga), amalaki for its mild laxative effect (virechan) and decoctions of Dashamoola and Guduchi for basti. After this process, the psoriasis went into complete remission for the first time since its onset at the age of fifteen. She continued to maintain this level of improvement except for a small patch on her scalp, which would flare up whenever she stepped out of integrity with herself in terms of relationships. It was as if this remaining patch on her head acted as a kind of visible moral compass, calling her back to the journey of truth and compassion for self and others. 

Both AD and psoriasis are quite prevalent inflammatory skin conditions which are very responsive to the holistic approach of Ayurveda. By combining topical and systemic herbs, appropriate diet and lifestyle, pancha karma therapies and emotional awareness, these conditions can be effectively cured or brought into remission.

1. Donald Y.M. Leung, Mark Boguniewicz, et al, New insights into atopic dermatitis J. Clin. Invest. 113(5): 651-657 (2004).
2. Gupta, Gupta (1998) Depression and suicidal ideation in dermatology patients with acne, alopecia areata, atopic dermatitis and psoriasis. British Journal of Dermatology 139 (5).
3. Sampson HA, McCaskill CC. Food hypersensitivity and atopic dermatitis: evaluation of 113 patients J Pediatr. 1985 Nov;107(5):669-75.
4. James J. Leyden¹¹Department of Dermatology, School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, U.S.A., Richard R. Marples¹¹Department of Dermatology, School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, U.S.A. and Albert M. KligmanStaphylococcus aureus in the lesions of atopic dermatitisBritish Journal of Dermatology Volume 90 Issue 5 Page 525-525, May 1974.
5. Gerald D Weinstein, Jerry L McCullough and Priscilla A Ross Cell Kinetic Basis for Pathophysiology of Psoriasis Journal of Investigative Dermatology (1985) 85, 579–583; doi:10.1111/1523-1747.ep12283594.
6. Davidson, A, Diamond, B: Autoimmune diseases. N Engl J Med 2001 345: 340–350.
7. Frank O Nestle and Michel Gilliet, Defining Upstream Elements of Psoriasis Pathogenesis: An Emerging Role For Interferon Journal of Investigative Dermatology (2005) 125, xiv–xv; doi:10.1111/j.0022-202X.2005.23923.x.
8. Joshi R. Immunopathogenesis of psoriasis. Indian J Dermatol Venereol Leprol [serial online] 2004 [cited 2008 Jun 15];70:10-2.

Nutritive food protects health and prevents disease. It is as simple as that. It is estimated that at least 30% of all cancers are diet related and it is also known that 70% of these cancers are connected with typical diets that are high in animal fat, low in fruit, vegetables and fibre (1). Prostate, breast and colon cancer are frequently connected with diet. Why is this? Perhaps it is to do with dietary changes?

Since 1950 there has been a global reduction of calorific intake in the consumption of complex carbohydrates by 38% and an increase of 12% for meat and 46% for vegetable oils. In the same period in the UK there has been a fall in fresh vegetable consumption by 24% and in the EU and US there has been a 35% increase in sugar and refined starch consumption.

In the USA 35% of all fruit and vegetables consumed are consumed as ‘french fries’! Our shift in nutritional habits over the last 60 years has evidently had a negative impact on society’s health as the same time period has seen cancer rates double and also sharp increases in heart disease, alzheimers, diabetes and other chronic degenerative diseases. Despite there being a surplus of food quantity there has been a decline in food quality to the extent that Type-B malnutrition is now prevalent in the industrialised world with up to 60% of hospital admissions displaying nutritional deficiencies (2,3,4).

An increase in nutrition received from meat is a good example of how more can be less. Well-cooked meat, especially barbequed meat contains aromatic amines, including 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine (2, 3), more accessibly known as PhIP, which is associated with bowel, breast and prostate cancer in human cell line studies. The increase in meat consumption is directly correlated with an increased incidence of death from cancer, as seen by statistics showing New Zealand as having the highest meat consumption and the highest levels of colon cancer. Conversely, vegetarian diets are known to extend life and reduce degenerative diseases (see below) (6).

Other qualitative and quantitative nutritional factors are altering society’s health. Obesity has clear links with some forms of cancer as well as heart disease, diabetes, infertility and bone disorders (5). Low selenium levels are specifically implicated in prostate cancer (6). In contrast to this, the increased use of protective oils containing Omega 3 and Omega 6 fatty acids is linked to a reduced rate of cancers.

Certain plant nutrients, known as ‘phytochemicals’, such as lycopene (the red pigment in tomatoes), carotenoids (the orange in carrots) and flavonoids (found in onion) have proven to be protective against prostate cancer. Studies have shown that increasing essential nutrients can give essential protection against degenerative diseases such as Alzheimer’s, arthritis, coronary heart disease, macular degeneration, depression and cancer. Changing one’s diet to a health promoting diet has been shown to reactivate certain genes known as Tumour Suppressor Genes, especially p53, that can keep tumours in check and force their cells to die (7, 8, 9,10,11).

Interestingly, but not surprisingly, organically grown food has been shown to have higher levels of nutrients and anti-oxidants than non-organic products. Studies comparing the nutritional value of organically grown and conventionally grown fruits, vegetables, and grains conclude there are significantly more nutrients in organic crops. These include: 27% more vitamin C, 21.1% more iron, 29.3% more magnesium, and 13.6% more phosphorus, 70% higher omega 3 content and certain vegetables have been shown to have 100% higher levels of cell protective flavonoids.

In addition, organic products have 15.1% less toxic nitrates than their conventional counterparts. Interestingly, the government recommended five daily servings of vegetables (lettuce, spinach, carrots, potatoes and cabbage) provided the recommended daily intake of vitamin C for men and women when they are organically grown but their non-organic counterparts did not. Eating organic affects the amount of flavonoids, quercetin, and anti-oxidants that are protecting and nourishing you. You are also avoiding exposure to excessive levels of immune damaging pesticides and organophosphates (12, 13, 14, 15).

“It is obvious that the body tissues cannot be nourished and developed when food is not properly digested by the digestive fire.” – Charaka Samhita

Ayurvedic Nutrition is a deep science. It is not a one-diet-fits-all approach. And that is the beauty of Ayurveda, the traditional medical system of India. It recommends what is right for you. It also reminds us that what is right for us one day may not be right for us the next. It teaches a deep awareness and connection with our digestive system. If you practice Ayurveda, you begin to fall in love with your belly…’if music be the food of love, play on!’ The negative impact that a poor diet can have on our health, as we have seen above, shows that there has never been such a need for some salient nutritional advice. Ayurveda can help add to this nutritional advice.

Ayurveda has a theory that anything can sometimes be a food, sometimes be a medicine or sometimes be a poison depending on ‘who’ is eating, ‘what’ is eaten, and ‘how much’ is eaten. For example, fresh ginger root is delicious in cooking as a food to flavour and help digestion. It is a stimulating medicine that can help clear a cold and induce a sweat when taken as a strong hot tea. However, if too much is taken it can make you sick causing acidity and vomiting, hence acting as a poison in the wrong circumstances.  This refers to Ayurveda’s focus on the ‘quality’ of what we eat as well as the ‘quantitative’ nature of the food. So, there is no strict ‘Ayurvedic diet’ per se, only sage recommendations to help you find the tastiest and healthiest diet for your personal optimum health.

Eating is considered to be the most important activity that can affect health. Whilst eating is an essential habit, and for some an addiction, it can be empowering to transform your eating habits to only include healthy foods that are rejuvenating and life-giving. This is a healthy habit. Whilst herbal remedies, massage, exercise and spiritual practice can balance and repair health it is a ‘good’ diet that gives us an every day opportunity to take control of our health. We are stuck with our genes, family and climate but we can change our diet; when it comes to what we put in our bodies, we are in charge.

Generally speaking, Ayurveda considers that the most beneficial foods are rice, wheat, barley, mung beans, asparagus, grapes, pomegranates, ginger, ghee, milk and honey. These are all tonics to the tissues and digestion. It also generally recommends that it is best to avoid habitual use of heavy meats, cheeses, yoghurt, refined salt, processed foods, refined sugar, coffee, tomatoes, bananas, citrus fruits and black lentils. These can create stagnation and undigested toxins, the scourge of all of our health problems.

Of course, many people have now become ‘intolerant’ to wheat and dairy. In my experience this is a result of a combination of a weak digestive fire with ‘unnatural’ foods.

For example, I call bread ‘unnatural’ as modern baking techniques require that it is leavened with synthetic yeast in a couple of hours. For a proper healthful fermentation bread should leaven over an 8 hour period using a natural sour-dough fermentation; this neutralises phytic acid which helps make the nutrients in the bran more bio-available and does not block calcium and iron absorption; it creates gut-healthful lactobacillus bacteria (as opposed to Candida albicans-promoting synthetic yeast) which assist with assimilation and the health of the digestive tract and also increasing the B vitamin content of bread. Add a powerful digestive system and you get optimum absorption of the best quality food.

Commercially yeasted bread causes bloating, gas and aggravates the nutritional state of the tissues and the micro-flora in the digestive tract. No wonder so many people are intolerant to it. Ayurveda says that yeast is a negative ingredient that aggravates every constitution.

This sort of understanding pervades Ayurveda. After all it is literally translated as ‘the Science if Life’. It has detailed practical theory covering all aspects of living a positive and health generating life-style. It literally gives you the clear information to live healthily and fulfill your potential. I have seen its innate wisdom empower and transform hundreds of people’s lives.

I clearly remember one 48 year old woman with ulcerative colitis who had been on various courses of steroids that helped whilst she remained on the medication but all the symptoms flared when she came off the drugs. Minimal dietary advice had been given by her primary carer. She ate a typical British diet including coffee, cereals, milk, sandwiches, frequent meat, low vegetables  and occasional alcohol.

Through simply applying some of the principles mentioned in this article to strengthen her digestive fire, adjust her diet to a more wholegrain (rice, quinoa, barley), high vegetable, low sugar diet along with some herbs to clear intestinal inflammation (triphala, neem, turmeric) she has remained almost symptom free and has not needed steroids for over 3 years. It was by allowing her digestive energy to flourish that her health was able to heal.

Now let’s look at how we can all look after our digestive altar. Remember that digesting your food properly depends on:

• A strong digestive fire called agni in Ayurveda
• Eating appropriate foods in the correct quantity and of the correct quality
• Healthy food combining based on Ayurvedic principles

The Indian Vedic culture revered agni or fire, which gave them light, warmth and cooked their food. Agnideva is the Fire god who acts as a messenger between the mortal world and the heavens. In Vedic rituals humans offer oblations (the act of offering something such as worship or thanks to a deity) to the sacred fire. The fire takes a portion for himself and then vaporises the rest for the benefit of the gods. The gods imbibe this nutritious fragrance and in return give life-giving waters and favourable environmental conditions from which crops flourish and humans can feed themselves. This benevolent cycle continues as long as both parties are happy.

It is a metaphor of our own digestive system. We eat and ‘offer’ food into the fire of our bellies. Agni digests this food and the control centres in the brain are nourished by these fragrant nutritional ‘vapours’. This nourishment feeds the nervous impulses, which release enzymes and hormones. This stimulates systemic metabolic activity so that the whole body-mind complex functions efficiently.  Hence eating is seen as a sacred act that should be given its full attention away from stress, disturbance and distractions.

Agni is seen as the metaphor for all metabolic functions in the body. It includes the digestive function, sense perception, cellular metabolism and mental assimilation. The agni’s ability to transform also gives it a pivotal role in absorbing life’s experiences as it works through the heart and mind to help process emotional and cognitive experiences. It is said to carry the inherent cosmic intelligence into our tissues.

Agni is involved in many functions:

• Absorption
• Assimilation
• Metabolism
• Digestion
• Perception
• Taste
• Touch
• Hearing
• Vitality
• Clarity
• Alertness
• Regular appetite
• Immunity
• A sparkle in the eyes
• Lustre to the whole body

The qualities of digestive agni are:

• Hot
• Light
• Sharp-penetrating
• Pungent
• Luminous-clear

When it is balanced it causes emotions that are beneficial to health: courage, happiness, cheerfulness, lucidity, optimism, enthusiasm and intelligence. It also provides energy, vitality and a system able to maintain homeostasis.

When it is out of balance it causes emotions that are destructive to health: fear, anger, confusion, idiocy, depression. This also leads to low energy, congestion and an accumulation of wastes. Modern research also shows that gut health is closely linked to energy levels, mental clarity and wellbeing.

There are four types of digestive fire that generally categorise people’s digestive tendencies. Which one are you?

Ayurveda recommends specific foods for each type of digestive fire.

1. Irregular digestion

This is an irregular appetite and digestive system with signs of variable hunger, bloating, indigestion, intestinal cramps, constipation, dry stools, gurgling and gas. It is common in nervous people (known as vata types in Ayurveda).

Using spices that have a carminative, warming and relaxing action can be useful. Ayurveda has a formula called Asafoetida Plus (made from asafoetida, fennel, cumin, nigella seed, ginger, black pepper) taken 30 minutes before meals can help balance this erratic type of digestive system.

2. Intense digestion

Intense hunger but with poor digestion is a sign of a hyperactive digestion. There may also be symptoms of thirst, parched mouth, dry throat, loose stool and a burning sensation in intestines are common concurrent symptoms. It is more common in ‘fiery’ people known as pitta types in Ayurveda.

Using herbs that can dilute the acidity in the stomach can help.  Amla and Peppermint formula mixes certain bitter and cooling herbs to help balance this intensity of pitta in the digestive system.

3. Weak digestion

Weak hunger is a sign of low metabolism and sluggishness. These types of people also commonly have slow digestion, heaviness after eating a meal, sluggish bowels, bulky stool, feeling cold, sweet cravings and they crave stimulants. It is more common in kapha types of people in Ayurveda.

Stimulating spices such as in the formula Trikatu (Ginger, black pepper and long pepper) before a meal it can help alleviate this tendency and works a bit like proteolytic enzymes.

4. Balanced digestion

Balanced hunger and digestion; food is digested within 4 hours with no excess craving or lack of interest in food. These people can just use Ayurveda’s premium digestive regulator Triphala to help maintain a healthy digestive system.

If you really know your digestive system and how it reacts to the different challenges of your diet and the day then you can understand how to live right for your own needs. It is the best way to perfect health.

In fact, the simplest and best suggestion of any diet is just to follow your hunger. Only eat when you are hungry. This way your digestive fire will express its own innate wisdom and let you know when it is time to eat, when it is time to drink and when it is time to rest. It really is that simple. Learning to really understand true hunger gives you an insight into the deeper workings of your self, your attachments to food, how you are nurtured by what you eat and how you care for yourself by what you eat. A beautiful way to love yourself is by giving yourself the food you really need. We all love a bit of chocolate cake and so you should enjoy it. It tastes great and chocolate is a wonderful mood enhancing food. Just make sure that the remaining 99% of the time you are giving yourself what you truly need.

Ayurvedic food combinations

It is not just the food you eat that affects digestion but how you put them together that affects your health. When it comes to food, not everything is equal. Foods have different tastes, heating or cooling qualities, moistening or drying qualities and building or cleansing effects. According to Ayurveda, if foods with different energetic qualities are combined then they can cause incompatibilities which can upset digestion leading to indigestion, gas, diarrhoea, constipation and ama. This ultimately leads to food intolerances and other health imbalances such as sinus congestion, lowered immunity and skin problems.

Ayurveda has these lovely balancing tricks. Its not a puritanical system dictating what is ‘good’ and what is ‘bad’. It is an experiential system based on creating what is right for you. If we can agree that foods have effects: e.g. beans are good for your heart via their plant sterol cholesterol lowering function but beans are also hard to digest, then we can agree that foods can have opposing effects. These can be balanced with careful food combining and Ayurveda recommends cumin, coriander and asafoetida to help with the digestive disrupting side effects of beans.

Incompatible foods can cause problems because they digest at different speeds and can cause fermentation or excessive mucus.

Overview of foot compatibilities

Food type	Compatible with	Exceptions
Fruit	Other food. It should be eaten at least 2 hours away from other foods	Dates together with milk are ok.
Milk	Bananas, bread, yoghurt, fish, meat, melons, cherries, sour foods
Yoghurt	Fruit, milk, meat, solanacea family, eggs, fish
Eggs	Milk, fruit, yoghurt, cheese, fish, meat
Grains	Fruit
Beans	Fruit, cheese, eggs, yoghurt, milk, fish, meat
Lemons	Milk, yoghurt, tomatoes, cucumbers
Honey	Ghee (by weight) 1tsp honey = 3tsp ghee Honey should not be heated	Adding honey to a warm drink is ok.
Radishes	Bananas, raisins, milk
Melons	Any other food
Raw food	Cooked food
Fresh food	Leftovers

Incompatible foods and antidotes for balance

Food	Antidotes	Effect
Dairy	Black pepper	Reduces mucus
Coffee	Cardamom	Reduces nervous system aggravating effect of caffeine
Potatoes	Ginger or black pepper	Makes them easier to digest and less heavy
Potatoes	Ghee, olive oil	Makes less dry and reduces gas
Cucumber	Black pepper	Makes less cold and easier to digest

• Start each meal with chutney of ginger, lime and a pinch of rock salt (or just chew a piece of fresh ginger)
• Eat warm food that is freshly cooked (Ayurveda promotes the use of warm food as this is easier to digest)
• Avoid processed, cold-refrigerated and stale foods
• Chew properly to ensure that digestive enzymes get to work in the mouth
• Sip warm water with each meal but do not drink lots of fluids within an hour after finishing your food as this can weaken the digestive fire
• Avoid iced water
• Eat in peace
• Do not eat when stressed, angry or depressed
• Eat with awareness; be aware of how your digestive fire is every day and eat appropriately for your constitution.
• Stop eating when you are half full of food and a quarter full of liquid, leaving a quarter of your digestive capacity free for life-giving prana to circulate and help digestion
• Eat your food with respect for nature and the gift of nutritious food she has bestowed upon you. Give thanks to the creator of your meal
• Eat sitting down. Do not eat standing up. (16)
• Have a short walk after each meal, however do not take excessive exercise, sleep or have seat for an hour after eating
• Do not eat a heavy meal at night and leave at least two hours from eating before going to bed

Although Indian culture is often associated with vegetarianism, Ayurveda is not wholly vegetarian. Ayurveda is a science in pursuit of health. It is not a moralistic system, although morality does creep into its practices. If someone’s health can benefit from the properties of eating some animal meat, then this is recommended. For example, this might happen if someone is extremely weak after an illness. Ayurveda would understand that there is some karma, or effect, from using animal products, but argues that the health of the individual is paramount. That being said it does recommend a primarily vegetarian diet that is easy to digest. In accordance with Ayurvedic principles it would also encourage an awareness of one’s actions and there is little doubt that the massive impact of the meat industry on the environment, economy and health of society would influence the opinion of the original propounders of Ayurveda.

Environmentally vegetarianism is more sustainable. One quarter of the earth’s surface is now pastureland to support livestock! ¾ of all grains and beans grown in the US are destined for animal feed (17).

Economically vegetarianism costs the world less. As demand grows, intensification practices rush to support the market. This means that many animals are kept in conditions that increase the risk of disease, requiring persistent treatment with anti-biotics. Of all food poisoning incidents in the UK 95% are due to animal products.

Vegetarians have been shown to have longer and healthier lives than meat eaters as well as less cancer, obesity and heart disease. Interestingly, New Zealand has the highest per capita levels of meat consumption and the highest levels of bowel cancer in the world. Globally calorific intake from meat has increased by 36% since 1950 and vegetable consumption has dropped by 24% in the same time period in the UK. The shift in our nutritional habits is clearly having a negative impact on society’s health as the WHO state that 30% of all cancers are diet related and that 70% of all cancers are connected with typical diets that are high in animal fat, low in fruit, vegetables and fibre (18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31 32, 33, 34).

Whatever your dietary predilection Ayurveda would recommend eating with awareness.

The following are tried and tested delicious recipes.

Kicharee

Serves 2-3

Ingredients and preparation

• 1/3 cup or 100 gms split mung dal, 2/3 cup 200gms or basmati rice (or other grain) simmered in 3-4 cups of water (a ratio of 1:3 or 1:4).
• Add 1/4 tsp organic turmeric, ginger, roasted cumin and coriander.
• Add seasonal vegetables: spinach, peas, carrots or seaweeds and simmer on low heat in the lentil-rice mix for 30-40 minutes for an all round healing, healthy and agni enkindling meal.
• It’s best not to stir this once all the ingredients are in as it can go ‘mushy’. Mix it once, put a lid on, turn the heat down and enjoy the fragrant aromas filling your house. Leave it to sit for 10 minutes at the end.
• Add a teaspoon of ghee or hempseed oil at the end.
• Salt and pepper to taste.

 Other kicharee tips

• Whilst fasting on kicharee it can be useful to sip hot drinks; try spicy teas of black pepper, cinnamon and cardamom to burn ama, clear toxins and relax your contracting stomach.
• For a ‘medicinal’ meal add powders of shatavari, bala, ashwagandha, pippali, amla, almonds, walnuts; approx 1 tsp/person.
• Try adding fresh rose, marigold, borage petals.
• Try adding rose petal jam or rose water.

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Rice pudding elixir

Ingredients

• 100g rice pudding rice (You can also try with black or red rice)
• 1 litre of cow’s, almond or rice milk (option of more)
• 3 tbs almond powder
• 7 strands of saffron
• 5 cardamom pods
• Rose Jam
• Ghee or honey, optional

How to make rice pudding elixir

1. Place the rice in a heavy pan and add the milk. Bring to boil and simmer for 1 hour.
2. Add the almond powder. Add more milk as desired. (coconut milk is an interesting change)
3. Soak the strands of saffron in a tablespoon of milk for 10 minutes to extract its golden pigment and then add to rice pudding. Add cardamom and rose jam.  Serve and add ghee or honey as desired.
4. You can also add grated carrots or beetroots to this recipe for a colourful and nourishing variation.
5. This is a very nourishing food for reducing vata and pitta, strengthening the tissues and building reproductive tissues.

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Hot milk recipe

Serves 1

Ingredients

• 1 cup of cow’s, almond or rice milk
• 2 tsp organic almond powder
• 2 cardamom pods
• 5 strands saffron   
• Pinch of nutmeg

How to make a delicious hot milk

1. Put all the ingredients into a pan and heat until boiling.
2. Allow to cool and add 1 tsp honey (optional). Take with 1-2gs or caps of organic ashwagandha at night to help nourish the nervous system, reproductive system and it helps you sleep.

I hope that some of this wisdom that Ayurveda offers you for dietary balance helps you towards healthier and more delicious eating.

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However, Summer doesn’t last forever. Autumn is a beautiful season seeing an extravaganza of golden colour but also a keen increase in cooler winds. The characteristic windy, cold and dry weather in Autumn naturally aggravates the vata dosha, which is unsurprisingly governed by the element air. The qualities of vata are cold, light, rough, mobile, subtle, clear, dry and astringent.

After the heat of the summer and with the change of the season these qualities can increase, thereby aggravating vata. Vata regulates the nervous system, moisture in the body, how relaxed we feel and how well we digest food. So, keeping our vata in check during this seasonal change is key to feeling fit and healthy.

Interestingly, vata is responsible for all communication and movement in the body; the flow of breath and blood, elimination of wastes, expression of speech for example. It can be described as a current of electricity responsible for regulation of all electrical impulses in the body and mind. Optimal balance of the vata in all of us is crucial. In fact without vata the other dosha are inert. Especially during those times of the year where it is at risk from becoming out of balance, such as in Autumn. As it is said in the ancient writings Sharangadhara Samhita without vata, “pitta is lame, kapha is lame”. So, how can we keep our inner vata in balance? Here are a few top tips:

• Rise early when the world is still calm
• Daily 5-10 minute morning self-massage with a warming and relaxing oil like sesame oil. This offsets seasonal tendencies to dryness, joint cracking, stiff muscle pain and poor circulation.
• Diet to consist of warm, sweet, mildly spicy, sour and salty foods. Here are just a few that suit vata: Soups, casseroles, warming spices such as ginger, turmeric, fennel, root vegetables, ghee, hemp seed oil and kicharee.

Autumn is also a common month to perform a seasonal cleanse to prepare for the winter ahead and to clear the excess heat accumulated during the winter months. Kapha types are particularly prone to accumulation, and a seasonal cleanse can be especially beneficial for them. A successful fast leaves you feeling lighter, refreshed and energised.

The first and most important point to consider when undertaking a cleanse is to pick one that suits your personal constitution. There are many types of fasts; water fasts, fruit juice fasts, rice fasts, soup fasts, kicharee fasts. Here are some top tips for each of the three dosha:

• Kapha types store energy and a tendency to be too static. They can tolerate longer fasts and benefit the most from them. Their fasts can be more light soup/broth based or just hot water and spicy teas.
• Pitta types are good at managing energy but accumulate excess heat and inflammation. They benefit from a fast of one to three days and can manage on fruit or vegetable juices as their high levels of digestive fire at the best at breaking down raw fruit and veg.
• Vata types have difficulty holding on to energy and have a tendency to be ungrounded. Fasting must be undertaken with caution and should only fast for a short time of between one and three days. Their fast should always contain some nourishment and could be a mono fast of brown rice, mung soup or kicharee.

Here are some top tips to keep in mind for anyone undertaking a seasonal fast:

• Drink lots of warm water and replace caffeinated drinks for spicy teas that help to burn toxins
• You’re not eating your regular diet, so your body will need time to adjust. Rest and take plenty of sleep.
• There is a saying ‘Any fool can fast but it takes a wise one to break it’. It is very important to break a fast slowly, one day fast requires one day of re-introduction to normal diet.

Another very useful way to build the strength of your digestive fire that is in some way a light fast is to follow an incremental diet. Its very useful to help people with IBS, Crohn’s, Ulcerative colitis, acidity, recovery from fever, for removing toxinc ‘ama’. It is based in a traditional Ayurvedic practice known as ‘samsarjana karma’ that gradually cleanses and buolds digestive strength.

• Use basmati rice or quinoa and follow each stage for a day or two depending on your digestive strength.
• Drink lots of ginger tea during this time.

Phase 1: Rice water (manda)

• 14 parts of water to 1 part of rice simmered for 30-40 minutes: Strain the grains out.
• Add a pinch of salt and cumin powder to taste.
• This is a milky-coloured liquid, and is the easiest of all the foods to digest, usually given just once at the outset of the practice.
• Then follow the below having each one for a day or two.

Phase 2: Rice water with rice part 1 (peya)

• 8 parts of water to 1 part of rice simmered for 30 minutes: Leave the grains of rice in.
• Add a pinch of salt, cumin and ginger powder to taste.

Phase 3: Rice water with rice part 2 (yavagu)

• 6 parts of water to 1 part of rice simmered for 30 minutes: Leave the grains of rice in.
• Add a pinch of salt, cumin and ginger powder to taste.

Phase 4: Rice water with rice part 3 (vilepi)

• 4 parts of water to 1 part of rice simmered for 30 minutes: Leave the grains of rice in.
• Add a pinch of salt, cumin, coriander, ginger powder to taste. Also add1/2 tsp ghee.

If your digestion is feeling strong add some steamed vegetables such as carrots or spinach.

Phase 5: Rice water with rice part 4 (odana)

• 2 parts of water to 1 part of rice simmered for 20 minutes.
• Add a pinch of salt, cumin, coriander, ginger powder to taste.
• Also add1/2 tsp ghee.

Eat this with some yellow split mung lentils: Simmer 1 part lentils in 14 parts of water for 40 minutes with some spices and ghee in.

Then start to eat kicharee. Try eating kicharee regularly. It is easy to digest and very nourishing.

• 1/3 cup split mung beans, 2/3 basmati rice (or other grain) simmered in 3-4 cups of water (a ratio of 1:3 or 1:4).
• Add 1/4 tsp each of organic turmeric, ginger, roasted cumin and coriander.
• Add seasonal vegetables: spinach, peas, or seaweeds, shitake mushrooms for an all round healing, healthy and digestion enkindling meal.
• The best practice is to cook it on a very low heat in a covered saucepan and it is best not to stir it after all the ingredients are added or it will go mushy.
• Add a teaspoon of ghee or hemp seed oil at the end with some salt to taste.