A strain is caused by overstretching a muscle and/or a tendon (1), usually caused by overstretching the fibres, leading to bruising, pain, spasms, weakness, oedema (swelling) inflammation, and cramping in the muscle, and even tears in the muscle fibres (2). A sprain, in contrast, is injury to a ligament, which connects bone to bone, and is often caused by a sharp twisting motion. The symptoms are often similar to those of a strain.

Treatment of sprains and strains should be approached carefully, particularly when in the acute stage, immediately following the injury.

The role of aromatherapy here is primarily to help reduce swelling and pain through the gentle application of anti-inflammatory essential oils, and to help move lymph around the area, through the use of astringent essential oils and herbal extracts. Since temperature also has a role to play with the reduction of pain and swelling, it is advisable to use a cool pack alongside the oil blend to aid the healing process. Although the injury is acute, applying neat or undiluted essential oils to the skin is not advised, since it may cause irritation or damage to the skin.

Instead, a strong blend of around 5% can be made and applied to the area, then occluded with a cold compress, and alternated with a hot compress if desired, to increase blood flow to the area and speed up the absorption of the remedy. A carrier oil will be needed to dilute the blend; a herbal-infused oil such as arnica is helpful for addressing bruising, for example. Alternatively, witch hazel (Hamamelis virginiana), which is astringent, can be blended with a dispersant such as Solubol, and the essential oils added and applied to the area with a cold flannel.

Safety note: Do not mix witch hazel and essential oils without the dispersant, since oil and water will not mix and thus the essential oils would effectively be neat, and undiluted, and could irritate the skin.

Suggested blend for sprains and strains

5% blend

• 10ml Arnica Arnica montana-infused carrier oil e.g. Sunflower (Helianthus annuus) (or 10ml of Witch Hazel / Solubol mixture as described above)
• 10 drops (total) of cooling, anti-inflammatory astringent essential oils, to include any of the following:
  • Grapefruit (Citrus paradisii): Lymphatic drainage, astringent (Safety note: Phototoxic. Avoid application before exposure to sunlight.)
  • Juniper (Juniperus communis): Lymphatic drainage, astringent
  • German Chamomile (Matricaria recutita): Anti-inflammatory
  • Roman Chamomile (Chamaemelum mobile): Anti-inflammatory
  • Peppermint (Mentha piperita): Cooling, analgesic (Safety note: do not use whilst pregnant, breastfeeding or with children under 2 years old.)
  • Lavender (Lavandula angustifolia): Anti-inflammatory, analgesic

Stir well to combine, and apply to the affected area using gentle massage. Cover with a cold flannel or ice pack if desired.

Please note: Only use on small, injured areas, not suitable for full-body

Many of my clients exercise regularly, but also have desk-based jobs. This means that they often arrive at the clinic with various low-level aches, pains and tension which they are unable to relieve through stretching at home.

Usually poor posture or overuse of the muscle are to blame for these kinds of aches and pain, and symptoms can include pain, inflammation, oedema (swelling), tightness or tension, and reduced motion in the affected area. Also tendonitis, plantar fasciitis, or carpal tunnel syndrome may be the result of repetitive strain injury (RSI). In such instances, there are several treatment options available to clients, both at home and on the massage couch.

Preventative measures include regular stretching as part of the working day (3), and post-exercise, to ensure the muscles are adequately moved and stretched, and tension build up is prevented. Supportive desk chairs, mouse mats, and armrests can prevent RSI in the wrists, for example, and support healthy back posture whilst seated (4).

Maintaining a regular physical practice such as gentler forms of yoga, e.g. yin yoga, can also be enormously helpful for maintaining flexibility, since they focus on releasing the fascia that connects the musculoskeletal system (5), reducing tension in the muscles and keeping joints mobile. Mixing up exercise regimes and not over-working one muscle group can also help to prevent muscle pain from overuse (RSI).

However, there are always times when we might overdo it on a run or in the gym, sit for too long at our desks, or lift something heavy. We then wake up the next morning with a crick in the neck, sore legs, or a painful shoulder. Perhaps we even suffer from a ‘pinched nerve’ due to the inflammation in the surrounding muscle tissues. In these cases, aromatherapy can be a gentle and enjoyable way to help alleviate pain and tension, and to help relax and release muscle tissue.

Since pains and tension of this type tend not to be as limiting or acute as sprains, strains and other injuries, they require a different approach to treatment. Ingrid Martin recommends the use of “strongly analgesic and cooling” (6) essential oils for pain caused by overuse of a muscle, however, oils that are considered warming are also useful for longer-term chronic stiffness (7) and tension.

Some useful oils for chronic pain, tension and RSI

Carrier oils

St John’s Wort (Hypericum perforatum): herbal infused oil, e.g. sunflower Helianthus annuus. A carrier oil infused with St John’s Wort is extremely anti-inflammatory, and is recommended for bruising, reddened skin, as well as being calming for neuralgia and sciatica (inflamed nerves). The herb gives its carrier oil a gorgeous blood red colour.

Jojoba (Jojoba sinensis): Actually a liquid wax, jojoba absorbs very easily into the skin, having a similar molecular structure to that of skin’s natural sebum. It is also anti-inflammatory and is often recommended for treating arthritis and other inflammatory conditions, so can be useful for relieving chronic joint pain.

Essential oils

Cooling, anti-inflammatory essential oils such as those mentioned above for the treatment of acute injuries can also be applied here, but sometimes a more “warming” approach is needed, particularly in cases of stiffness and stagnation in the muscles and joints. Some of these oils include:

Cinnamon (Cinnamomum verum): A warming, stimulating oil that has antirheumatic properties. A lovely addition to a muscle-warming blend.

Safety note: This oil should be treated with caution and not used above 0.1% in any blend due to its skin-sensitising properties (8).

Black pepper (Piper nigrum): Another stimulating, warming oil, with anti-inflammatory and analgesic properties (9). This oil promotes good blood circulation and is particularly recommended for overworked muscles, chronic inflammation, stiffness, and both osteoarthritis and rheumatoid arthritis (10).

Safety note: Use in low doses on sensitive skin.

Rosemary (Salvia rosmarinus): A stimulating, invigorating oil, which is an excellent vasodilator (11) and can alleviate muscle tension and pain through bringing blood to the area. “Stiffness and the related pain are usually relieved if local circulation is improved” (12) states Ingrid Martin.

Marjoram (Origanum majorana): Primarily a relaxant and hypotensive oil, which I use a lot in my clinic for clients with muscular pain and tension. Due to its ability to act on the nervous system as well as on smooth muscle tissue (13), it is a powerful oil for treating physical conditions such as muscle aches and rheumatism (14) caused by excessive tension in the body. It is an excellent accompaniment to some of the more stimulating, anti-inflammatory oils mentioned above.

I would normally combine these oils at no more than a 2% dilution in an appropriate carrier oil for use in massage during a treatment, however I regularly make muscle rubs and balms for clients to take home, as these can be useful to carry with them for use at home, work and more.

Usually, a product at a 4-5% dilution is prepared, using a mixture of carrier oils, essential oils and waxes to create a thick balm that is solid at room temperature. This is then applied three times a day to the affected area. A balm of this strength, however, would be too strong for a full-body massage, and is designed for localised, topical use only.

Muscle rub/balm recipe

Makes 1 ~60ml pot

Ingredients

• 7.15ml Beeswax (or soy wax)
• 50ml Carrier oil (e.g. herbal infused St John’s Wort oil)
• 57 drops (~2.85ml)  total essential oil (from list above)

Method

1. Use a bain-marie over a low heat to melt the carrier oils and wax together. Stir until completely melted and combined.
2. Take off the heat. Allow to cool to 50-60 degrees centigrade. If the essential oils are mixed in before the mixture is left to cool much of the essential oils will be evaporated and lost.
3. Add up to 57 drops of essential oils, from those listed above
4. Stir well to combine, pour into a 60ml sterilised tin and allow to cool
5. When solid, the balm is ready to use. Use within 6 months.
6. Apply topically to the affected area up to three times per day, massaging gently.

Fibromyalgia is a chronic health condition that can affect the whole body (15). Symptoms include increased sensitivity to pain, tenderness and soreness, fatigue, and stiffness. Brain fog, insomnia and digestive issues can also be accompanying symptoms. Whilst it has a strong muscular component, when treating fibromyalgia, an aromatherapist will take into consideration the symptoms as a whole, and create a blend of oils according to each individual’s unique needs.

Massage can be a wonderful way to treat fibromyalgia and other chronic muscular conditions, since it works not only on the site of the pain, i.e. the muscles, but on the emotional body and nervous system, too.

A 2014 systematic review concluded that “Massage therapy with duration ≥5 weeks had beneficial immediate effects on improving pain, anxiety, and depression in patients with [Fibromyalgia]. Massage therapy should be one of the viable complementary and alternative treatments for [Fibromyalgia]” (16) although more, large-scale research is needed to provide confirmation of the findings.

My favourite essential oils for treating fibromyalgia are those that work synergistically on the nervous system as well as the physical body, since my clients presenting with fibromyalgia often experience depression, anxiety, and frustration along with their chronic pain.

Inhalation as well as topical application of essential oils is key in treatment of conditions such as this, since inhalation is the most effective method of application of aromatherapy for psychotherapeutic effect (17).

Coriander seed (Coriandrum sativum)

Coriander seed is analgesic and antispasmodic, but also a powerful antidepressant oil. It is also excellent for digestive issues, and in Traditional Chinese Medicine, it is indicated for clearing ‘painful obstruction’ which refers to rheumatic pain (18).

Marjoram (Origanum majorana)

Marjoram is mentioned above, and is an excellent dual function oil, working to calm the nervous system whilst simultaneously relaxing the muscle tissue

Grapefruit (Citrus paradisii)

Grapefruit is also mentioned above; a “cooling, cleansing and decongesting” (19) oil that is helpful for clearing the mind, stimulating lymph and can help ease feelings of frustration and tension.

Safety note: Phototoxic. Avoid application before exposure to sunlight.

Cardamom (Elettaria cardamomum)

Cardamom is a digestive oil, helpful for treating IBS and other digestive complaints that are often associated with Fibromyalgia. It is also considered a “gentle tonic of the brain and nervous system”(20) and therefore complements the more stimulating oils with its gentler nature.

Melissa or lemon balm (Melissa officinalis)

Melissa is one of the most regularly-used oils in my clinic. Particularly as an inhalation oil, it works beautifully, though I often include it in massage blends, too. Analgesic and anti-inflammatory, it is also calming and sedative, so can be wonderfully effective for calming the nerves and the muscle tissues. The fresh or dried leaves can also be taken as an infusion in hot water.

Safety note: Safe for topical use at dilutions of 1% or less. Melissa should be avoided if pregnant or breastfeeding.

A balm or oil blend for fibromyalgia can be made in much the same way as in the other recipes suggested above, though for full-body application, the dilution of essential oils should be no more than 2% in total, with those essential oils which are potential irritants or sensitisers being used at their much lower, appropriate dilutions.

Alternatively, a bath oil at a 2% dilution could be prepared. Heat aids the absorption of essential oils into the bloodstream, and the steam will increase the evaporation, aiding inhalation and speeding up the therapeutic properties. Equally, the heat will help to increase blood flow to the sore muscles as well as releasing tension. For a further benefit, Epsom salts (Magnesium sulphate) may be added to the bath.

The magnesium in these healing salts is known for speeding up muscle recovery and reducing inflammation (21), as well as for reducing tiredness and fatigue more generally so it may be helpful for post-workout recovery too. It can cause dehydration, though, so make sure to top up on water before and after an Epsom salt bath.

It is clear that aromatherapy products such as massage oils, therapeutic baths and muscle rubs have a large part to play in the prevention and treatment of both chronic and acute musculoskeletal conditions. These recipes and oil blend suggestions have been specifically designed for treatment of the conditions explored here.

Do check allergy information and consult a health professional before using these products on children, if you have any health conditions, are pregnant or breastfeeding.

1. Martin, I. Aromatherapy For Massage Practitioners. 1st ed. Baltimore: Lippincott Williams & Wilkins; 2007: 209.
2. Mulcahey, MD, FAAOS, M., 2020. Sprains, Strains and Other Soft-Tissue Injuries – OrthoInfo – AAOS. [online] Orthoinfo.aaos.org. Available at: <https://orthoinfo.aaos.org/en/diseases–conditions/sprains-strains-and-other-soft-tissue-injuries/> [Accessed 29 July 2022].
3. nhs.uk. 2019. Common posture mistakes and fixes. [online] Available at: <https://www.nhs.uk/live-well/exercise/strength-and-flexibility-exercises/common-posture-mistakes-and-fixes/> [Accessed 29 July 2022].
4. Pruthi, M.D., S., 2021. Office ergonomics: Your how-to guide. [online] Mayo Clinic. Available at: <https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/office-ergonomics/art-20046169#:~:text=If%20you%20 sit%20behind%20a,joints%20stay%20 comfortable%20at%20work.> [Accessed 29 July 2022].
5. Morris, N., 2022. 5 Common Questions About Yin Yoga. [online] Yoga International. Available at: <https://yogainternational.com/article/view/questions-about-yin-yoga> [Accessed 29 July 2022].
6. Martin, I. Aromatherapy For Massage Practitioners. 1st ed. Baltimore: Lippincott Williams & Wilkins; 2007: 211
7. Martin, I. Aromatherapy For Massage Practitioners. 1st ed. Baltimore: Lippincott Williams & Wilkins; 2007: 211
8. Tisserand, R. and Balacs, T., 2000. Essential oil safety. London: Churchill Livingstone, pp.129-130.
9. Caddy, R. Essential oils in colour (2nd ed.). Amberwood Publishing. 1997, pp 8.
10. Caddy, R. Essential oils in colour (2nd ed.). Amberwood Publishing. 1997, pp 8.
11. Martin, I. Aromatherapy For Massage Practitioners. 1st ed. Baltimore: Lippincott Williams & Wilkins; 2007: 121
12. Martin, I. Aromatherapy For Massage Practitioners. 1st ed. Baltimore: Lippincott Williams & Wilkins; 2007: 121
13. Martin, I. Aromatherapy For Massage Practitioners. 1st ed. Baltimore: Lippincott Williams & Wilkins; 2007: 100
14. Caddy, R. Essential oils in colour (2nd ed.). Amberwood Publishing. 1997, pp 49.
15. nhs.uk. 2022. Fibromyalgia. [online] Available at: <https://www.nhs.uk/conditions/fibromyalgia/> [Accessed 29 July 2022].
16. Li, Y., Wang, F., Feng, C., Yang, X. and Sun, Y., 2014. Massage Therapy for Fibromyalgia: A Systematic Review and Meta-Analysis of Randomised Controlled Trials. PLoS ONE, [online] 9(2), p.e89304. Available at: <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3930706/> [Accessed 29 July 2022].
17. Mojay, G. Aromatherapy for healing the spirit. London: Gaia. 2005, pp 15.
18. Mojay, G. Aromatherapy for healing the spirit. London: Gaia. 2005, pp 64.
19. Mojay, G. Aromatherapy for healing the spirit. London: Gaia. 2005, pp 80.
20. Mojay, G. Aromatherapy for healing the spirit. London: Gaia. 2005, pp 57.
21. Cleveland Clinic. 2022. Epsom Salt: Potential Benefits and How to Use It. [online] Available at: <https://health.clevelandclinic.org/7-things-you-probably-didnt-know-about-epsom-salt/#:~:text=Epsom%20salt%20is%20used%20to,recovery%20period%20after%20a%20workout.> [Accessed 29 July 2022].

Bibliography

• Caddy, R. Essential oils in colour (2nd ed.). Amberwood Publishing. 1997
• Cleveland Clinic. 2022. Epsom Salt: Potential Benefits and How to Use It. [online] Available at: <https://health.clevelandclinic.org/7-things-you-probably-didnt-know-about-epsom-salt/#:~:text=Epsom%20salt%20is%20used%20to,recovery%20period%20after%20a%20workout.> [Accessed 29 July 2022].
• Li, Y., Wang, F., Feng, C., Yang, X. and Sun, Y., 2014. Massage Therapy for Fibromyalgia: A Systematic Review and Meta-Analysis of Randomised Controlled Trials. PLoS ONE, [online] 9(2), p.e89304. Available at: <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3930706/> [Accessed 29 July 2022].
• Martin, I. Aromatherapy For Massage Practitioners. 1st ed. Baltimore: Lippincott Williams & Wilkins; 2007
• Mojay, G. Aromatherapy for healing the spirit. London: Gaia. 2005
• Morris, N., 2022. 5 Common Questions About Yin Yoga. [online] Yoga International. Available at: <https://yogainternational.com/article/view/questions-about-yin-yoga> [Accessed 29 July 2022].
• Mulcahey, MD, FAAOS, M., 2020. Sprains, Strains and Other Soft-Tissue Injuries – OrthoInfo – AAOS. [online] Orthoinfo.aaos.org. Available at: <https://orthoinfo.aaos.org/en/diseases–conditions/sprains-strains-and-other-soft-tissue-injuries/> [Accessed 29 July 2022].
• nhs.uk. 2019. Common posture mistakes and fixes. [online] Available at: <https://www.nhs.uk/live-well/exercise/strength-and-flexibility-exercises/common-posture-mistakes-and-fixes/> [Accessed 29 July 2022].
• Pruthi, M.D., S., 2021. Office ergonomics: Your how-to guide. [online] Mayo Clinic. Available at: <https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/office-ergonomics/art-20046169#:~:text=If%20you%20sit%20behind%20a,joints%20stay%20comfortable%20at%20work.> [Accessed 29 July 2022].
• Tisserand, R. and Balacs, T., 2000. Essential oil safety. London: Churchill Livingstone
• https://www.herbalreality.com/conditions/musculoskeletal-system/

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.

1. Mainous AG, Tanner RJ, Baker R, et al (2014) Prevalence of prediabetes in England from 2003 to 2011: population-based, cross-sectional study. BMJ Open 2014; 4: e005002.
2. Kwon H, Pessin JE. (2013) Adipokines mediate inflammation and insulin resistance. Front Endocrinol. 12 (4): 71.
3. Liu F, Prabhakar M, Ju J, et al. (2017) Effect of inulin-type fructans on blood lipid profile and glucose level: a systematic review and meta-analysis of randomized controlled trials. Eur J Clin Nutr. 71(1): 9-20.
4. Silva FM, Kramer CK, de Almeida JC, et al. (2013)  Fiber intake and glycemic control in patients with type 2 diabetes mellitus: a systematic review with meta-analysis of randomized controlled trials. Nutr Rev. 71(12): 790-801.
5. Al-Mana NM, Robertson MD. (2018) Acute Effect of Resistant Starch on Food Intake, Appetite and Satiety in Overweight/Obese Males. Nutrients. 15;10 (12): 1993.
6. Lin Y, Huybrechts I, Vereecken C, et al. (2015) Dietary fiber intake and its association with indicators of adiposity and serum biomarkers in European adolescents: the HELENA study. Eur J Nutr. 54(5): 771-82.
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Oestrogen is a catabolic sex hormone that has a large array of roles and influences including reproduction, digestion, mood, fat-balance, fluid ratios, skin pigmentation, breaking down muscle mass that leads to an increase in body fat and aromatase. Testosterone, and to a slight degree progesterone, are anabolic sex hormones that promote lean body mass.

Aromatase is an enzyme that is found in oestrogen-producing cells located in the adrenal glands, ovaries, placenta, testicles, brain and fat tissue. Higher levels of aromatase in the body convert more testosterone and progesterone into oestrogen. With the increased prevalence of Environmental Endocrine Disruptors, we are exposed to multiple triggers for endocrine disruption.

Elevated aromatase activity and oestrogen dominance are some of the most common factors associated with breast, uterine and ovarian cancers in women. Prostate, colon and breast cancer in men are associated with oestrogen dominance. Other symptoms include PMS symptoms, cervical dysplasia, uterine fibroids, endometriosis, decreased libido, fatigue, fibrocystic breasts, headaches, infertility and weight gain.

Cruciferous veggies

Cruciferous vegetables such as broccoli, cauliflower Brussel sprouts and cabbage contain several powerful nutrients that help metabolise oestrogenic molecules. These nutrients include Indole-3 Acetate, Indole-3 Carbonyl and Diindolylmethane. These cruciferous veggies also contain sulfur containing nutrients such as Sulfurophane and Phenyl Isothiocyanates that enhance liver detoxification processes and destroy cancer cell formation.

Broccoli sprouts 50-100g/day are a good way to get this.

Healthy fat-rich foods

These are foods that are rich in saturated and omega-3 fatty acids. It includes plant based fats such as coconut oil, hemp seed oil, extra virgin olive oil and avocados. Raw nuts (other than peanuts) and seeds contain oestrogen balancing plant sterols. Organic poultry, wild-caught salmon, wild game and 100% grass-fed beef are the best animal-fats for healthy hormone function.

Allium family

The alliums include garlic, onions, scallions, chives and leeks. These are all rich in sulfur-containing amino acids and the powerful flavone anti-oxidant quercetin that both help the liver detoxify and reduce the production of oestrogen.

Flavone rich herbs

Dietary flavones and flavonones have been demonstrated to be the most potent aromatase-inhibitory flavonoids. The most powerful flavones include chrysin which is found in passionflower and apigenine which is found in chamomile.

Flavonones

These are found in citrus fruits and in particular lemons and limes. They are classically called citrus bioflavonoids and they include diosmin, hesperidin, rutin, naringin, tangeretin, diosmetin, narirutin, neohesperidin, nobiletin and quercetin.

Antioxidant-rich herbs

Herbs such as oregano, thyme, rosemary, sage and turmeric are loaded with volatile oils that promote liver detoxification. Turmeric has a potent ability to destroy oestrogen receptor positive cancer cells which are the most commonly found cells in breast, uterine, ovarian and prostate cancer.

Chlorophyll

One of the most powerful life-giving substances on the planet is chlorophyll. This is the pigment that gives green foods their color. Chlorophyll-rich foods have a very deep green color and they are extraordinarily useful in purifying the body of toxins.



Fermented foods

These contain organic acids, anti-oxidants, enzymes and probiotics that enhance gut function and eliminatory channels. Fermented veggies include sauerkraut, kimchi and fermented soy.

Lignans

Using 2 tablespoons of freshly-ground flaxseed everyday helps to establish a healthy oestrogen balance.

Herbal teas

Green tea and Licorice specifically balance oestrogen levels. 

Mushrooms

All mushrooms regulate aromatase and regulate oestrogen levels. Use shitake, maitake, button, cep.

Lentils

All lentils contain appreciable amounts of phyto-oestrogens that help to balance oestrogen-progesterone levels. Soy is well known for this but all pulses are helpful.

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.

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• 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.

The Sanskrit word for taste is rasa, and it is a very pregnant word: as well as meaning taste, it can mean ‘essence’, ‘juice’, ‘sap’, ‘lymphatic fluid’, ‘flavour’ and ‘delicious’. Just saying the word sounds ‘juicy’ … raa-ssa, rasa, RASA. Flavour is the essence of life – it affects everything.

Ayurveda identifies six tastes: sweet, sour, salty, pungent (spicy), bitter and astringent, which we will discuss later. Remarkably, how we ‘taste’ life affects our health and mood. If your experience of life is ‘sweet’ you are usually happy, whilst ‘bitter’ episodes are less savoury. Because our taste of life becomes our rasa, our essence, it is helpful to learn how taste affects us.

Taste (rasa)	Element (tattva)	Quality (guna)	Effect on dosha
Sweet (madhura)	Earth, Water	Heavy, Wet, Cold	K+, P-, V-
Sour (amla)	Earth, Fire	Heavy, Wet, Warm	K+, P+, V-
Salty (lavana)	Water, Fire	Heavy, Wet, Warm	K+, P+, V-
Pungent (katuka)	Fire, Air	Light, Dry, Warm	K-, P+, V+
Bitter (tikta)	Space, Air	Light, Dry, Cold	K-, P-, V+
Astringent (kasaya)	Air, Earth	Dry, Cold	K-, P-, V+

Ayurveda states that every substance, including taste, has all of the five natural elements – Space, Air, Fire, Water and Earth – within it, but that usually only one or two are dominant. For example, the pungent flavour is dominated by Fire and Air and, like a fire and the wind, is hot, drying and light. In addition to possessing elemental qualities, taste has a number of effects on the body and mind.

Temperature (hot or cold)

Each specific taste affects the thermo-regulatory and metabolic qualities in the body (i.e. heating it up or cooling it down). For example, cinnamon is pungent and hot, which raises body temperature; grapes are sweet and cooling, which can help to cool you down.

Quality (heavy or light, wet or dry, penetrating or soft)

Taste also defines the qualities of whether a particular herb or food is light or heavy to digest, and wet or dry on the mucus membranes. It also defines if the herb is penetrating or soft. For example, black pepper is spicy and also hot, light, dry and penetrating: it is easy to digest, dries the mucus membranes and penetrates deeply into the tissues. Chew on a peppercorn and these qualities will become clear.

Direction (where the food goes in the body)

Tastes also have an affinity for certain parts of the body. We all know that garlic goes to our lungs as we can smell it on our (and other people’s) breath. Asparagus is renowned for making our urine smell – Ayurveda knows asparagus is a bitter and cooling food that clears internal heat via the urinary system. Ginger has multiple ‘sites’, clearing mucus from the lungs, warming the skin, invigorating the blood and relaxing the muscles.

Taste also has an effect on the movement of energy in the body, by influencing the direction that vata (the dosha responsible for movement) travels in. For example, the pungent taste (e.g. in chillies) ascends and spreads energy outwards, causing sweating, whilst the bitter taste (e.g. in coffee) descends, causing energy to move downwards, sometimes with a laxative effect.

Dosha (effect on the constitution)

Tastes also influence your dosha. For example, the sweet flavour builds earthy kapha, cools hot pitta and reduces airy vata. As it is a nourishing taste, it increases the volume of all the tissues. Hence, it is no surprise that we live off sweet-tasting foods, like wheat and rice, as they keep us strong.

The sweet flavour is made from the elements of earth and water. This means that it has the qualities of these two building blocks; ie earth is heavy and descending and, like water, it is wet and cold (when water is subjected to heat it becomes hot but in its ‘primordial’ state it is cold). Sweet is the flavour of love, of sharing and of compassion. We give sweets to friends as an act of sharing and companionship. It is considered the most spiritually sattvic of flavours and is used to heighten experience of clarity and awareness of the spiritual aspect of life.

We all know the sweet flavour. Its main receptors are at the front of the tongue. Sweet comes from sugars; glucose, sucrose, fructose, maltose. They are made up of short (mono) and long (poly) chains of saccharides. It is the flavour of energy. Many carbohydrates, fats and proteins are sweet and their potential energy is measured in kilajoules. Foods and herbs with the sweet flavour are considered to be tonics. They build and nourish all seven tissues.

Liquorice (Glycyrrhiza glabra), beetroot (Beta vulgaris) and shatavari (Asparagus racemosa) are sweet and nourish the deeper reproductive tissues. The sweet flavour increases ojas and the integrity of the immune system. Many renowned immune tonics have a sweet flavour and are full of immune-modulating saponins and polysaccharides.

Sweet substances and experiences increase fluid-kapha and reduce hot-pitta and nervous-vata. As a demulcent, soft, soothing and wet flavour it reduces some of the dryness and weakness associated with vata. It is a tissue healer and sweet herbs are often used for hastening wound repair (e.g. aloe vera or liquorice).

Sweet benefits the mucus membranes lining the mouth, lungs, digestive, urinary and reproductive systems. The sweet taste can help to clear a dry throat and lungs by enhancing expectoration. Its cooling anti-inflammatory tendencies help to remove the intense heat of pitta or ‘-itis’ conditions (e.g. bronchitis). This is also helped by its softening mild laxative effect. It benefits the complexion, improves hair and nail quality and is the best flavour for a smooth voice.

Following the principle of ‘like increases like’ you want to increase your sweet experiences and flavours in life to be truly nourished, loved and cherished. This will create a cycle of ever increasing benevolence.

Used in concentrated excess, such as with refined sugar/pastries/ice creams, it can increase mucus and promote congestion. It can cause toxins, ama, fever, chest and breathing problems, swollen lymph glands, flaccidity, heaviness, worms, fungal infections, obesity, and diabetes. Exceptions to this rule of sweet substances increasing kapha are honey, mung beans and barley; they are actually considered to balance excess moisture.

The sour flavour is made from the elements of earth and fire. Its qualities are hot, oily and light. It creates both dampness and heat in the body and mind. It stimulates digestion and clears dryness. Sour foods make the mouth moist and increase the flow of saliva. When taken in excess it draws the tissues inwards and ‘puckers’ the lips, making the body horripilate all over. This contraction creates an emotional reluctance to share things. Eating too much sour flavoured food encourages envy and can make your experience of life feel like ‘sour grapes’.

The sour flavour is found in acids; citric, lactic, malic, oxalic and ascorbic. The receptors for the sour flavour are found on taste buds on the sides of the tongue. The acids have a direct effect on digestion by promoting liver function through various mechanisms; as sour flavours can reduce stomach acid it also means that the liver needs to produce less acid neutralising alkaline fluids.

Sour flavours also increase the flow of bile that helps to encourage digestion of fats. Unripe fruits are sour and are commonly used as digestive chutnies in India. Sour fruits such as amalaki (Emblica officinalis) are high in vitamin C and are considered to be anti-oxidant, rejuvenating and tonic herbs.

As the sour flavour aggravates pitta and liquifies kapha it is not usually beneficial in hot and damp conditions. It is also considered to vitiate the blood and it is recommended that the sour flavour is avoided in skin diseases. Most fermented foods are sour; fermented yoghurt, sour dough breads, vinegar, pickles and alcohol are sour foods that increase heat and mucus in the body.

Sour nourishes all the tissues bar the deepest reproductive tissue (shukra). It alleviates vata and aggravations of the nervous system; it draws scattered energy back in. It is a specific carminative useful to promote digestion whilst also removing gas and indigestion. Amalaki, lemons and pomegranate seeds (Punica granatum) are the exception to the rule that the sour flavour aggravates pitta as they actually reduce heat and inflammation.

In excess sour can cause dizziness, thirst, burning sensations, fever, itching, anaemia and skin diseases.

Salt is predominantly made from the water and fire elements. It creates moisture and heat and is heavy and sinking. A grain dropped onto the tongue is instantly moistening. A sprinkle on food enkindles digestion. It is an easily recognisable flavour and its receptors are at the front of the tongue. Its sinking and heavy effect is very grounding for the nervous system and this encourages stability. People who are solid and reliable become known as ‘the salt of the earth’.

The use of salt is a good lesson in the importance of dosage. In correct quantities it is vital to our very existence and is as essential to our health as water and food. It can save life when there is dehydration. In contrast to this a sprinkle too much will cause an ulcer and aggravate stomach acidity.

Excess salt consumption also causes water retention with the concomitant results of oedema and High Blood Pressure. This physical holding is reflected in its emotional effects as it causes greed and encourages the desire for more flavour. To repeat the famous Ayurvedic adage, it is all about who is taking how much, of what and when.

Salt is found in minerals and there are different types of salt classified in Ayurveda; rock, sea, black, pink and sonchala. Rock is considered the best as it is very high in minerals and, unlike the other salts, does not cause such water retention and it is not detrimental to the eyes. Salty is the rarest flavour in the Ayurvedic materia medica, not found in many herbs. It is found in Shilajit, a natural mineral rock exudate, full of numerous nourishing minerals. Seaweeds and celery are other examples of the salty flavour.

Salt aggravates pitta and kapha. It also disrupts the blood and is contraindicated in skin diseases as well as bleeding problems. Its use in marinades reflects its softening quality and it is used to soften masses and as a demulcent to liquefy kapha. It alleviates any excess of vata by stimulating the appetite, moistening dryness and nourishing the nervous system. It is a mild laxative at a medium dose (3g) and an emetic at higher dose (5-10g).

In excess it causes ulcers, skin diseases, grey hair, baldness and thirst.

The pungent flavour is a combination of the fire and air elements. Its qualities are hot, dry and light as well as penetrating and ascending. The acrid heat of hot foods and spices spreads throughout the whole system. Too much heat, whether climatic or dietary, is known to cause ‘hot’ emotions ranging from passion and excitement to anger and irritation. It is the most rajasic and volatile of the tastes.

It is primarily found in the aromatic volatile oils, resins, oleo-resins and mustard glycosides. All these compounds are used to stimulate, invigorate, dry and clear the accumulation of wet, stagnant and congestive conditions.

The essential oils of ginger (Zingiber officinale) and black pepper (Piper nigrum) are often used for clearing mucus congestion or warming a cold condition. Pungent resins such as guggul (Commiphora mukul) and frankincense (Boswellia serrata) also invigorate the flow of blood, scrape out toxins and reduce cholesterol. The aromatic cardamom (Elettaria cardamomum) is an excellent digestive for encouraging sluggish digestion. Unlike the other tastes it does not have a specific taste bud receptor site but works through irritation of local tissue and nerve endings.

Pungent herbs and foods are a panacea for kapha as they dry the excess moisture and mucus so prevalent in this humour. Pungent herbs are vital for any weight-loss programme as they stimulate the metabolism and reduce fat. They directly cook and burn ama as well as also clearing it via diaphoresis.

The heat encourages vasodilation of the pores of the skin and encourages the body to sweat, therefore throwing off unmetabolised toxins through the skin. The pungent flavour usually increases vata but, in moderation, it can also help to remove the cold stiffness of vata whilst also encouraging the elimination of wind and digestive cramps. The heat of pungent herbs irritates pitta and should not usually be used where there is inflammation, especially with aggravation of the plasma (rasa) and blood (rakta) tissues. Its drying effect on bodily fluids can cause constipation.

In excess it creates burning, dizziness, thirst and excessive dryness. Ginger (Zingiberis officinalis) and cooked garlic (Allium sativum) are the exceptions to the rule that pungent flavours aggravate vata; in fact they benefit it as they increase digestion and reduce intestinal gases.

This therapeutically priceless taste is created from a combination of space and air elements. Its dominant qualities are cooling, drying and light. It creates space in the body by draining and drying excess fluids. Too many bitter herbs can literally ‘space you out’ and leave you feeling disorientated. Many psychotropics are bitter; e.g. Psilocybe spp.

It has a particular affinity for the blood (rakta). Bitters are usually classified as ‘alteratives’ as they alter the chemical balance of the blood by clearing toxins. As they encourage the flow of bile and the activity of the liver this may account for some of bitter’s detoxifying activity. Too much bitter flavour can weaken the kidneys, cause excess urination and emotionally encourages fear and anxiety. The bitter flavour has a negative effect on the strength of avalambaka kapha and ojas which reside in the heart. Again, it is all about an accurate diagnosis and using an appropriate dose for each individual person.

Whereas in Western herbalism bitters are associated with a tonic effect, in Ayurveda they are considered depleting. The tonic association comes from the low dose, digestive stimulating and liver promoting perspective. The depleting and cleansing view comes from the experience that relatively larger doses of bitter herbs are cooling, reducing, detoxifying, laxative and diuretic. Studying and applying the insights of herbalism is a constant reminder to be specific.

Everything is unique; how you apply the medicine, when you apply it, to whom it is applied and where it is administered. Ayurveda clearly teaches that any substance can be a food, a medicine or a poison depending on how much is given, who is eating it, when it is eaten and where it is taken.

The reason that the bitter flavour is found in plants is often attributed to its ability to defend itself; if you taste nasty noone will eat you! The bitter taste receptors are at the back of the tongue; they are the body’s way of giving us a last line of defence. The bitter flavour is found in sesquiterpenes, anthraquinones, alkaloids and some glycosides.

Plants with these properties are renowned for their anti-inflammatory, anti-bacterial, anti-pyretic and digestive secretion enhancing activities. These compounds are usually found intermixed with pungent and aromatic or astringent tasting plants; all drying flavours. Neem (Azadiracthta indicia), andrographis (Andrographis paniculata) and chamomile (Matricaria recutita) are well-known bitters famed for their ability to clear infection, heal skin problems and purify the blood.

Bitter herbs clear kapha and pitta whilst aggravating vata. Excess dampness and heat are reduced as the bitter flavour drains them out of the system. Bitters also promote peristalsis and urination. They are often indicated in lung conditions, especially with infections manifesting with green and sticky mucus. They excel at clearing itching, swelling and oozing on the skin. A little is used as a stimulant to the appetite as the light quality can enhance the appetite and clear the palate. Higher doses are used to kill worms and parasites in the intestines and blood. Bitter herbs also benefit overweight conditions as they can dry and scrape away the adhesions and fatty accumulations.

When misused or incorrectly prescribed they can cause too much dryness and wasting in the body and mind; this can upset the nervous system causing constipation, dizziness, weakness, reduction in semen and dryness of the whole body. Guduchi (Tinosporia cordifolia) is a bitter herb that is an exception to the above contraindications as, along with the bitter benefits, it is also an aphrodisiac.

Astringent is the driest flavour. Made from a predominance of the earth and air elements it is heavy, cold and dry. As it draws inwards it dries and reduces them. On eating something astringent your whole mouth contracts and draws the mucus membranes closer together. Having too many ‘dry’ and unfulfilling experiences can leave you with a lack of taste for life and even resentful at its lack of zest.

The astringent flavour is found in tannins. These polyphenols are particularly concentrated in the bark, leaves and outer rind of fruits of plants and trees. They appear to offer some form of outer protection by repairing wounds and neutralising bacteria. They are especially soluble in water; hence the drying nature of a strong cup of tea left to steep for too long. Astringency is often found in combination with plants that also taste sweet or sour.

Bibhitaki (Terminalia belerica), haritaki (Terminalia chebula), arjuna (Terminalia arjuna) and guggul (Commiphora mukul) are especially astringent.

Therapeutically the astringent flavour clears kapha and pitta whilst aggravating vata. It is very useful where there is any leakage of body fluids; bleeding (externally and internally), excessive sweating, enuresis, diarrhoea, excess catarrh, leucorrhoea and premature ejaculation. It holds tissues together and astringent herbs are often used as a wash to help heal wounds.

This holding effect also prevents loose and flaccid tissue from accumulating. Using astringent herbs is appropriate to treat sinking problems such as prolapses. Its effect on the digestive system benefits diarrhoea by astringing the bowel and stopping excessive downward flow. This also helps absorption by drawing fluids and nutrients inwards. Astringents are used for pitta inflammations to draw the swelling inwards, cool the heat and also drying any damp suppuration.

These dry, rough and light qualities are similar to vata. Because astringent tastes contract the tissues and obstruct the flow of prana and nervous energy in the system it is detrimental to vata. In excess it can cause vata diseases like rigidity, pain in the heart, convulsions and retention of gas, urine and faeces.

Our fat, or ‘lipid layer’ protects us, comforts us as well as helps to carry fat-soluble nutrition into our body and brain. According to Ayurveda our fat tissue is made from a combination of the Water and Earth elements that bring protection to our organs, bones and tissues.

However, if we have too much or too little or poor quality fat tissue then health can become imbalanced. Too little fat tissue then we can be too thin with cracking joints, joint weakness, tired and brittle hair, bones, nails and teeth.

Too much and there can be obesity, excess fat tissue around the breasts, abdomen and buttocks, sexual debility, asthma, poor mobility, fear, hypertension and diabetes. If the fat is of poor quality and the doshas (Ayurvedic constitutions) invade it then there can be multiple symptoms from hard and small lumps, excessive sweating, kidney infections, diabetes, fibroids and other growths dependant on the causative factors.

Ayurveda can help people to balance their fat tissue and regulate the lipid layer. If the digestive fire (metabolism) in the lipid tissue (medas-dhatu-agni) is low then fatty tissue accumulates in the body, especially around the abdomen. This is often due to excessive intake of sweet, poorly digested, low quality fatty foods that block the vata dosha (the bodily humour responsible for all movement in the body). This causes vata 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 excessive hunger and the patient to continually over-eat.  This causes a vicious circle of increased hunger but reduced metabolism. Eventually all three doshas become imbalanced and improper nourishment of the tissues leads to a chronic depletion of the body’s natural immunity and an increase in weight. It is worth noting that obesity is described in the Charaka Samhita as one of the “eight despicable diseases” as it is so hard to treat because the enduring willpower of the client is essential for any management plan to be effective.

Modern science has determined that one of the main causes of weight imbalance and hence imbalanced medodhatu, is insulin resistance. The term “insulin resistance” means that your body is more resistant to the action of insulin than normal. Insulin is the hormone that keeps your blood sugar within “normal” limits.

It helps to open the keyhole for the glucose to lock onto so that it can be metabolised in the liver and muscle ready to be used as energy. ‘Insulin resistance’ makes you less sensitive to insulin and less able to absorb glucose and this results in higher blood sugar levels.  It is a complex process involving, amongst other things, thyroid function, oestrogen levels, leptin resistance and glycosylation.

When there is excess sugar in the blood stream it gets deposited as stored energy, otherwise known as fat. The body’s genetic wisdom is ‘to make hay whilst the sun shines’ and it stores that potential energy for a time when it really needs it. If this cycle of high blood sugar being converted to fat stores continues, it leads to weight increase, obesity and the associated health implications of high blood sugar levels including weakened immunity, repetitive infections, inflammation and blood clots.

The high blood glucose levels cause the red blood cells to become coated in excess sugar that damages the protein leading to something known as ‘glycosylated heamoglobin’. This causes the formation of Advanced Glycation End products- known as AGE- damaged molecules that literally cause ageing.

Glycosylation is a natural process where sugar molecules bind with another molecule through a process known as cross-linking, and impair its function. It’s more common in diabetics and people with insulin resistance but happens to us all as we age.

When crystalline proteins in the eye are ‘glycosylated’ it leads to cataracts; when collagen and elastin are ‘glycosylated’, and sugar molecules attach to these extra cellular matrix proteins, it can disrupt the integrity of the connective tissue which can harden and become less flexible; in the arteries this causes arteriosclerosis, or hardening of the arteries and in the skin it causes wrinkles. Even insulin can become glycosylated, leading to more deep-set insulin resistance. 

Looking at treatments from a purely plant chemistry perspective, flavonoids are the remedy par excellence for addressing glycosylation. It is why foods, such as colourful berries (think blueberries, amla and acerola), with the highest levels of sweetness in foods, often have high levels of protective flavonoids, as nature has an in-built protective mechanism to help offset any of the potential damage of exposure to excess natural sugars. Other vibrant and colourful spices, such as Turmeric, are also excellent and reducing glycosylated cross-linking and just half a teaspoon a day (1-2g) is protective.

When continually exposed to sugars, the high insulin levels trying to manage the high blood sugar levels also leads to excessive tissue growth, particularly due to something called Insulin-like Growth Factor-1 (IGF-1), which is implicated in some forms of cancer. IGF-1 also leads to a high release of free radicals that cause more tissue oxidation, which disrupts the integrity of the dhatus. In fact, it is this high insulin level causing oxidation of LDL cholesterol that is now associated as one of the causes of the high levels of heart disease that we have in many industrialised countries.

Conversely, high levels of free radicals have also been implicated in causing insulin resistance. This eventually leads to pancreatic burn-out. After years of over-activity, the insulin producing pancreas eventually tires of all the extra insulin it has had to produce to ‘force’ the glucose into the cells and it ‘packs up’ and diabetes develops. Insulin resistance is also associated with depression, cognitive decline and some forms of cancer (notably, breast and colon).

It is thought that 35% of the population have some form of insulin resistance, otherwise known as dysglycaemia. More than 50% of women with Poly Cystic Ovarian Syndrome (PCOS) have insulin resistance. 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. Mixed with poor eating habits, low exercise and plenty of stress you have a dangerous cocktail.

Fortunately nature and Ayurveda have an answer. Mixed with a kapha-reducing diet, high quality Omega-3 oils and sensible amounts of short and medium-chain-fatty-acid-easy-to-digest oils (such as flax, hemp, coconut oil and ghee), regular exercise, reduced stress and a by using certain plants that have been shown to assist with glucose and lipid metabolism, you can help to regulate your body to find your perfect balance of medodhatu.

Cinnamon (Cinnamonum verum var zeylanicum)

Cinnamon regulates blood sugar, increases digestion, reduces weight and helps normalise intestinal flora by reducing pathogenic Candida. A study in 2003, gave three groups of diabetics 1, 3 or 6 grams of cinnamon per day. All responded to the cinnamon within weeks, with blood sugar levels 20 per cent lower on average than those of a control group.

Some of the volunteers taking cinnamon even achieved normal blood sugar levels. Reports suggest that improvements can be seen after just 20 days. Cinnamon on its own will not remove insulin resistance but as part of a healthy diet and exercise programme it can be of great benefit due to its ability to strengthen agni (digestive fire) and regulate kapha with its warming, light and astringent qualities.

Fenugreek seed (Trigonella foenum-graecum)

The pungent, bitter and astringent seed of fenugreek has been used in Ayurveda to improve digestion and help reduce weight for centuries. Its spicy and bitter flavour have been shown to increase digestion, reduce lipid levels and removes fats. It has a positive effect on the digestive fire in medas-dhatu helping the agni to metabolise food into useful nutrition. It also increases the efficiency of the water circulating channel (ambuvahasrotas) and the urinary channel (mutravahasrotas) helping to regulate fluid retention and proper moisture levels in the tissues.

Ginger (Zingiber officinale)

Considered to be the universal healer in Ayurveda, and known as vishvabheshaja, ginger has been used in food and medicine for thousands of years. It is a wonderful warming spice that is superior at assisting digestion and circulation. It specifically helps with the assimilation of nutrients, quickens circulation and warms the body. By increasing the digestive agni in all the tissues it helps to assimilate the other herbs in any formula whilst also strengthening digestion and thermogenically increasing metabolism.

Green tea (Camellia sinensis)

Though not a traditional Ayurvedic plant the Camellia plant is indigenous to India. As India is now a large producer of green tea it would also be a great addition to the Indian diet as a replacement for all that deliciously sweet masala-chai.Green tea is a potent antioxidant whose slightly stimulating nature brings a lift to your energy.

Green tea is made by lightly steaming the fresh leaves to inhibit enzymes that breakdown the important polyphenol compounds, known collectively as catechins. The water soluble properties of green tea have been shown to help reduce cholesterol, regulate weight, increase metabolism, correct gene function, reduce bacterial and viral overload as well as help absorb oxidative molecules that damage cells and encourage aging. It helps to regulate the body’s detoxification mechanisms in the liver. It is slightly bitter and astringent helping to remove lipid accumulations and stimulate the agni in medas-dhatu.

Guggul (Commiphora mukul)

Guggul is a pungent and acrid oleo-gum-resin that has a very special property appropriate for regulating medas-dhatu, and more specifically as a medhogna, a herb that reduces fatty accumulations. It increases the digestive fire in the lipid tissue and through its ‘scraping’ (lekhaniya) properties clears toxic ama that coats cells, tissues and organs to reduce insulin resistance, imbalanced cholesterol levels and weight accumulation.

Its effect on metabolism has been verified by its ability to help with the conversion of T4 to the more active T3 and increasing iodine uptake in the thyroid, enhancing its homeostatic regulatory function. It is usually used after being ‘purified’ in a decoction of triphala (amla, bibhitaki, haritaki) and then used as a powder at doses from 50-500mg 2-3x/day. It is combined with other remarkable regulating plants such as kanchanara (Bauhinia variagata) that has potent effects on lymphatic congestion, glandular swellings and growths and with trikatu and triphala.

These combinations incorporating guggul are so important to treatments that a large range of ‘guggul’ containing products have been developed in the Ayurvedic pharmacy including kancanara guggil, kaishore guggul, punarnava guggul, triphala guggul, yogaraj guggul and gokshuradi guggul, to name just a few.

Bitter melon (Momordica chiranta)

A common food in Asia, this member of the cucumber family helps to regulate blood sugar, reduce insulin resistance and reduce fats. It is extremely bitter but has a pungent effect after digestion (and therefore a metabolic enhancing action that does not aggravate vata) and is very useful for helping to regulate weight. Bitter melon has a specific action, known as bhedaniya, which means to remove accumulations, and in Karavella’s case, specifically from the digestive, fat and water systems.

Seaweed (Ascophyllum nodosum)

Also known as Arctic wrack and Ascophyllum nodosum, this sea vegetable is renowned for its diverse range of essential macro and micro-nutrients that provide the nutritional foundation to health. Not a traditional plant used in Ayurveda, but a crucial part of every island-faring nation’s diet, seaweeds are in fact the most nutritious form of vegetation on the entire planet.

They are full of nutrients that help facilitate the absorption of vital proteins and other nutrients. This includes 14 times more calcium, 200 times more iron, 8 times more magnesium and 100 times more iodine than any land vegetable. They are also filled with detoxifying polysaccharides that can help to bind with toxic heavy metals. There is a substantial body of research showing how seaweeds can improve the thyroid function, heart health, cancer and high blood pressure.

The improved thyroid function can benefit metabolism and help reduce excess weight, fat and blood sugar control. Use at least 1g per day with food, and it makes an excellent salt replacement.

Turmeric (Curcuma longa) has a long tradition of use in Indian Ayurvedic medicine over at least the last 4,000 years. Having a sweet, bitter and astringent flavour with the ability to drive out toxins turmeric balances the fundamental principles of health bringing equilibrium to all three constitutional dosha.

Modern medical descriptions include diverse biological activity including antioxidant, anti-inflammatory, anticancer, antigrowth, anti-arthritic, anti-atherosclerotic, antidepressant, anti-aging, antidiabetic, antimicrobial, wound healing, hepatoprotective and memory-enhancing activities.It has many names in India (over 45!) including ‘Haridra’ (The Yellow One) and my preferred, ‘Kanchani’ (The Golden Goddess). The word ‘turmeric’ comes from medieval Latin ‘terra merita’, meaning ‘blessing of the earth’.

Turmeric has over 300 compounds including volatile oils (e.g. tumerone and zingiberone), sugars, proteins and resins and owes its bright yellow colour to polyphenolic pigments also known as curcuminoids, including demethoxycurcumin and bisdemethoxycurcumin.

It is believed that turmeric’s effectiveness may, at least partially, be attributed to its immunomodulatory properties and the ability to affect multiple signalling pathways initiating inflammatory and neurological modulation via multiple pathways including COX-2, LOX-5, Nrf2, NF-KB etc. Turmeric has compared positively when compared with statins, corticosteroids and aspirin revealing it as nature’s answer to the side-effect free treatment of inflammation.

When you consider that whole turmeric contains at least 20 phytochemicals that are anti-biotic, 14 that are known cancer preventatives, 12 that are anti-tumour, 12 are anti-inflammatory and there are at least 10 different anti-oxidants it makes you realize that turmeric is rather a lot more than curcumin. It makes me think that I want to use a whole turmeric formula that brings out the best of the curcumin as well as the volatile tumerone, the resins and other yellow pigments.

It’s worth noting that in Traditional Chinese Medicine turmeric has long been selected from the ‘Invigorate Blood’ category and is used as a water extract (decoction) showing that as curcumin is not water soluble, the other 299 compounds are also able to deliver a therapeutic benefit. Recent studies indicate that curcumin-free turmeric (CFT) possess numerous biological activities including anti-inflammatory, anticancer, and antidiabetic activities.

In a previously published review of Aggarwal et al., 2013, the anticancer and anti-inflammatory activities of CFT and the individual components of turmeric, including turmerin, turmerone, elemene, furanodiene, curdione, bisacurone, cyclocurcumin, calebin A, and germacrone are exhibited.

Murakami et al. published an article showing that curcumin combined with turmerones, the essential oil component of turmeric, abolishes inflammation-associated colon carcinogenesis. These beneficial compounds – the tumerones – are only one example of the various bioactive compounds beyond curcumin in the whole turmeric root. Practitioners should note that this broad range of turmeric compounds are rarely present in the solvent extracted curcumin products on the market.

Whilst it has entered the natural medicine vernacular that curcumin is poorly absorbed it is less well known that you only need very small amounts for effectiveness; studies point to its chemotherapeutic and chemopreventive activity even at low concentrations ranging from 5-50µm.

Turmeric’s traditional use with black pepper, ginger, milk or ghee reveals an ancient insight into how we can enhance the bioavailabilty and efficacy of the turmeric; take your whole turmeric with spice and fat. It also shows how the positive epidemiological benefits of using turmeric powder in the Indian diet (at around 1g/day) may contribute to lower cancer rates, alzheimer’s and diabetic complications seen on the India subcontinent.

Most curcumin on the market today is extracted with hexane, ethyl acetate, acetone or methanol. All have questionable environmental credentials and as this process strips the other synergistic compounds out of the turmeric it often requires curcumin products to then be further processed into liposomes or miscelles to have any significant absorption (as well as requiring toxicological studies in animals to prove safety).

More cutting-edge methods such as wholistic extracts that combine super critical extraction (using carbon dioxide) with tincture extraction (using water and alcohol) are leading the way in capturing the holy grail of herbal extraction; concentration of the parts while still representing the whole spectrum of plant compounds that, in turmeric’s case, is to capture the curcumin as well as the resinous and essential oil turmerone compounds.

Every clinician is faced everyday with complex degenerative illness. Its become the norm in our society. And we need solutions that offer multi-organ and multi-dimensional protection. And this is where whole herbs, notably turmeric come into their element.

Let’s look at turmeric’s effect on Nuclear factor erythroid 2-related factor 2 (Nrf2). Nrf2 is a protein involved in the cellular response to oxidative damage caused by injury or inflammation. It is pivotal in the regulation of various cellular processes, such as antioxidant defences, redox equilibrium, the inflammatory process, the apoptotic processes, detoxification, and cellular proliferation (Morales-González et al. 2015) and furthermore offers a strategy for cancer chemo-preventive phytochemicals (Becks et al. 2010).

Numerous studies have shown this Nrf2-conferred, multi-organ protection phenomenon protects many cell types and organ systems from a broad spectrum of toxic insults and disease pathogenesis (Lee et al. 2005).Nrf2 moderates gene regulation and the Antioxidant Response Elements to protect neurological pathways making it especially relevant to focus on for treating Parkinson’s, ALS and Alzheimer’s.

It was found that Nrf2 has an antagonistic effect on the NF-κB pathway (Cuadrado A. et al. 2014). When Nrf2 is activated, NF-kB pathways are also mediated, such multiple interactions allow bioactive compounds, including turmeric, to exert their beneficial preventive and therapeutic effects.

Studies comparing isolated curcumin extracts, turmeric powder and wholistic extracts show that Nrf2 activation is most potent in wholistic extracts (75% more effective at enhancing Nrf2 compared to a 95% curcumin product and 93% more than conventional turmeric). From this it can be suggested that compounds other than the curcuminoids activate the multi-organ protector and a synergistic effect may occur. These results are in line with the outcome of the antioxidative potential determined by ORAC analysis where a super critical/tincture combined turmeric showed outstanding activity of antioxidant scavenging compared to a combination of fresh fruits and vegetables.

The microvascular bed comprises of countless small arterioles, capillaries and venules. It regulates the contractile relationship between blood vessel walls and circulating blood, regulating haemostasis and is a gateway to our immune cells. Its health affects hypertension, diabetes, cholesterol, atherosclerosis, Alzheimer’s, liver disease, erectile dysfunction and cancer. Because of turmeric’s fundamental ability to enhance circulation through influencing platelets and thinning the blood it serves as a key-stone species in the treatment of today’s epidemic of diseases stemming from microvascular, inflammatory and neurodegenerative disorders.

The history, the science and the experience of turmeric stand as testimony to its deserved position as one of the most relevant herbs for today’s health challenges. It is the herb of choice for inflammation, injuries, neuronal degeneration, digestive disorders and cellular irregularities. Just remember that each and every one of turmeric’s 300 phytochemicals are there to help you achieve success in your clinical practice.

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.

While pharma engaged in intensive research and developments on new, patented drugs, and was forced to spend more and more money on both safety and efficacy trials required by licensing authorities, its earlier research on nutrients was largely abandoned.

The companies continued to manufacture and sell vitamins and minerals, and the one-a-day multi-vitamin and – mineral supplement became the norm on many a breakfast table.

These products, like their counterparts today, were seen largely as daily insurance for the prevention of deficiency diseases like scurvy, beriberi, pellagra and rickets.

But during the 1960s and ‘70s, an aspiring group of scientists, doctors, naturopaths, hippies and all-round natural health nuts—basking in the new-found freedom of the flower power generation—decided it was time to take this work out of mothballs and bring products to market. These individuals went on to establish some of the first US food/dietary supplement companies—or nutraceutical companies, as they are commonly referenced in the USA.

Many of these are still in existence today in the USA, some of which trade in Europe and beyond. Not only were these nutraceuticals marketed as a means of preventing deficiency diseases, they were also seen as an alternative to pharmaceuticals. The products were purportedly natural and were promoted as working with the body, hence few or no side effects.

As the nutraceutical industry developed, it took a greater interest in other healthcare traditions, such as Ayurveda and Unani from the Indian subcontinent, traditional Chinese medicine (TCM) and Kampo from Japan. These traditions were of course not reliant on synthetics, nature-identical or otherwise. They used a diverse range of naturally sourced ingredients, especially from plants, but also ones derived from microorganisms, fungi, minerals, animal organs, seaweeds and the like.

Increasingly, the US nutraceutical industry took on-board elements from both the East and the West. This represented the start of the East-West fusion phase of the natural products industry—one that is still very much alive and well today.

While the nutraceutical industry continued to grow in the USA during the 1970s and ‘80s, Europe quietly continued much as it had before. Pharmaceuticals became the primary choice of most when it came to treating diseases and infections, while simple multi-vitamins and -minerals, cod liver oil and other essential nutrients were available and widely used to maintain general health, and prevent deficiency diseases.

Where natural product traditions were existent prior to the pharmaceutical boom, these traditions continued and evolved, but were seen as appropriate only for minor ailments, the serious stuff being the sole domain of by-now Big Pharma, and its ‘miracle drugs’.

So, is tea drinking good for you? As is so often the case when it comes interpreting the health sciences and the benefits, or risks, of natural products, consensus isn’t easy to come by. Tea drinking is no exception.

There are a multitude of reasons for the discrepancies in view, among them:

• The results from different studies are often inconsistent and don’t always show benefits.
• The natural products under investigation are often not sufficiently well characterised to allow meaningful comparisons to be made.
• Different population groups experience different benefits and risks.
• There are discrepancies between the findings from lab studies versus those on human populations.
• There are simply not enough high quality human studies covering the gamut of effects that different teas can have on the body.

Despite this seeming quagmire of evidence, conflicting results and divided opinion on tea drinking, there is some key information that can be teased out. This article serves to address some of the key questions relevant to tea drinkers, including: how and why tea drinking can help to keep you healthy, which teas might be better for you than others, and when and how much tea you should consider drinking daily?

To avoid any confusion, all references to tea in this article refer to use of the leaves of the tea plant, Camellia sinensis. Both green tea and black tea come from leaves of the same plant, although different parts of the leaves are used for different teas, and post-harvest treatment can vary hugely.

Green tea is not fermented; the leaves are simply withered and steamed before being dried. Black and oolong teas are both crushed and fermented in various ways. Matcha is simply a powdered green tea, so instead of only benefiting from the compounds that are infused into water during the brewing process, the powdered tea is consumed in its entirety, so increasing the amount of beneficial phytochemicals, vitamins, minerals and amino acids consumed in a given volume of tea.

Oxidation happens when oxygen atoms (radicals) bind to elements or compounds, be they complex organic molecules or simple elements. Rust is an oxidation product that develops on the surface of iron or steel when exposed to oxygen. Our bodies are also susceptible to oxidation, and the result is the production of radical oxygen species (ROS), sometimes also referred to as ‘free radicals’, that if not scavenged by antioxidants produced naturally within our bodies or consumed in our diets, can lead to excessive oxidative stress.

Many metabolic processes rely on a degree of oxidation to trigger a particular beneficial response, such as an immune response or wound healing. But oxidation is generally short-lived and counteracted by antioxidants which scavenge or quench the ROS. Uncontrolled oxidative stress, which can be thought of as ‘rusting from the inside out’, has been shown to increase our risk of many chronic diseases, including heart disease and cancer, as well as contributing to premature ageing.

Making sure there is an adequate supply of antioxidants in the body is one of the best ways of guarding against oxidative stress, as well as managing related processes like a healthy inflammatory response and a resilient immune system.

In essence, we have two main antioxidant systems, an endogenous one in which we produce our own antioxidants internally, and en exogenous one, which relies on us consuming antioxidants in our diets and through drinks and beverages.

While tea supplies some essential nutrients, such as certain vitamins and minerals, and amino acids, the most important group of compounds in teas found to deliver beneficial effects are the flavonoids and other polyphenols that can act as antioxidants in the body.

Different studies quote differing ‘horse power’ ratings for the antioxidant capacity of teas. Many of these are the result of laboratory or ‘test tube’ studies in which the antioxidant capacity of a given tea, or tea extract, has been measured according to its ability to ‘quench’ particular ROS (notably peroxyl, hydroxyl, peroxynitrite, superoxide anion, singlet oxygen or hypochlorite radicals).

The most common kind of test is one called an ‘ORAC’ assay which stands for ‘oxygen radical absorbance capacity’. The assay was developed by one of the leading antioxidant testing facilities in the world, Brunswick Laboratories in Southborough, MA, USA.

The ORAC assay evaluates the antioxidant capacity of a test material under laboratory (in vitro) conditions notably against peroxyl radicals. It measures the value as Trolox equivalents (TE), usually expressed by weight of a given food or ingredient or per serving, and includes both inhibition time and the extent of inhibition of oxidation. There are various different types of ORAC assay, including hydrophilic (H-ORAC) and lipophilic ORAC (L-ORAC) assessments for water soluble and fat soluble antioxidant compounds respectively. Total-ORAC (Table 1) takes into account the ROS scavenging capacity of both the hydrophilic and lipophilic components.

Most recently, Brunswick has developed a Cellular Antioxidant Assay (CAA) which measures antioxidant capacity of a test material within a human cell culture. While this test still doesn’t equate to a human clinical study, it is an important step closer to deriving a more realistic perspective of how a natural product might act as an antioxidant within the human body.

Despite its shortcomings, the ORAC test has long been regarded as a laboratory standard for determining the relative antioxidant capacity of natural products, although it has also been misused or misinterpreted by some given that ORAC values cannot be regarded as having a direct bearing on human health because antioxidant compounds are absorbed to differing extent (i.e. have different bioavailability), others are subject to chemical transformation in the body, there are genetic differences between individuals (so affecting both benefits and risks) and there may be a host of other interactions with other compounds present or consumed concomitantly.

Some so-called antioxidants, when consumed at very high doses, may I some circumstances act as pro-oxidants, having the exact opposite effect to that which is expected. This has been shown for sustained very high doses of vitamin C.  All these issues are very relevant when it comes to tea and its benefits.

In short, an ORAC lab test provides information about the theoretical antioxidant potential of a substance outside the body.  This can be very useful for phytochemical profiling or quality control. The ORAC value does not, however, tell you anything about how the antioxidant substances are absorbed through the digestive tract or how they may subsequently interact in the bloodstream, in different tissues or in particular organs. 

A number of other antioxidant assays are also quite often used to test antioxidants, including ferric reducing antioxidant power (FRAP) assay and the Trolox equivalence antioxidant capacity (TEAC) assay. These assays generate very specific data linked to specific antioxidant properties and so cannot be compared with each other or with ORAC values.  

Table 1, based on analyses reported by the US Department of Agriculture (USDA), shows that brewed green and black teas have modest antioxidant capacities when measured in a laboratory. For a given volume, they are greater than beverages like apple juice, on par with unsweetened (but not blended, sweetened) cranberry juice, but somewhat less than well-known antioxidant ‘superfoods’ such as pomegranate, goji berries and even red wine.  Additionally, ready-made teas were found to have substantially lower antioxidant capacities compared with brewed teas.

Foodstuff	Total-ORAC (μmol TE/100g) (Mean/Min/Max)	n	Reference
Black tea, black, ready-to-drink (plain and flavoured)	Mean: 31/3 Min: 170 Max: 59/0	9	Seeram et al., J. Agric. Food Chem., 2008, 56: 1415-1422.
Black tea, brewed, prepared with tap water	Mean: 11/28 Min: – Max: –	1	Welch Foods, Inc. 2006. Unpublished Data.
Green tea, brewed	Mean: 12/53 Min: – Max: –	1	Welch Foods, Inc. 2006. Unpublished Data.
Green tea, ready-to-drink	Mean: Min: Max:	1 1	Seeram et al., J. Agric. Food Chem., 2008, 56: 1415-1422.
Black tea, with milk powder, ready-to-drink	Mean: 52/0 Min: 320 Max: 61/0	7	Seeram et al., J. Agric. Food Chem., 2008, 56: 1415-1422.
Apple juice, unsweetened, without added vitamin C	Mean: 26/4 Min: 100 Max: 48/0	7 5	Prior et al. J. Agric. Food Chem., 2003, 51:3273-3279; Seeram et al., J. Agric. Food Chem., 2008, 56: 1415-1422; Welch Foods, Inc. 2006. Unpublished Data
Blueberries raw	Mean: 46/69 Min: 2746 Max: 92/45	4 7	Cho et al. J. Sci. Food Agric., 2005, 85:2149-2158; Wang et al. J. Agric. Food Chem., 2008, 56:5788-5794; Wolf et al. J. Agric. Food Chem., 2008, 56:8418-8426; Wu et al.  J. Agric. Food Chem., 2004, 52:7846-7856.
Cranberry juice, unsweetened	Mean: 14/52 Min: 852 Max: 20/14	9	Seeram et al., J. Agric. Food Chem., 2008, 56: 1415-1422.
Goji berry, raw	Mean: 32/90 Min: – Max: –	1	Seeram et al., J. Agric. Food Chem., 2008, 56: 1415-1422.
Black cherry juice	Mean: 23/70 Min: 2070 Max: 29/70	9	Seeram et al., J. Agric. Food Chem., 2008, 56: 1415-1422.
100% cranberry juice blend	Mean: 86/5 Min: 2341 Max: 86/5	5	Welch Foods, Inc. 2006. Unpublished Data.
Raw pomegranate juice, bottled	Mean: 26/81 Min: 2341 Max: 44/44	1 3	Prior et al. 2006. Unpublished data on pomegranate juice; Seeram et al., J. Agric. Food Chem., 2008, 56: 1415-1422; Welch Foods, Inc. 2006. Unpublished Data.
Pomegranate, raw	Mean: 44/79 Min: – Max: –	3	Wolf et al. J. Agric. Food Chem., 2008, 56:8418-8426.
Cocoa-mix, powder	Mean: 48/5 Min: – Max: –	2	Welch Foods, Inc. 2006. Unpublished Data.
Red wine, Merlot	Mean: 26/70 Min: 2670 Max: 26/70	3	Seeram et al. J. Agric. Food Chem., 2008, 56:1415-1422.
Red table wine, Zinfandel	Mean: 24/00 Min: 2400 Max: 24/00	3	Seeram et al. J. Agric. Food Chem., 2008, 56:1415-1422.
White table wine	Mean: 39/2 Min: 318 Max: 48/4	1 2	Dávalos et al. J. Agric. Food Chem., 2004, 52: 48-54; Welch Foods, Inc. 2006. Unpublished Data.

Tea contains a variety of constituents including the alkaloids caffeine, theobromine, and theophylline, polyphenols, tannins, trace elements and vitamins. Tea polyphenols, are the key antioxidant components, while the alkaloids, including caffeine, are nervous system stimulants.

The chemical composition of green or black teas vary according to the leaf size, the nature of processing, fermentation and drying, the infusion time. Even a particular type of tea can vary considerably, depending on factors like the prevailing climate during the growing season, the time or conditions during plucking, horticultural practices and the age and position of the leaf on the harvest shoot.  The major polyphenols include catechins, epicatechin, epicatechin gallate, epigallocatechin-3-gallate (EGCG) and proanthocyanidins.

There is accumulating evidence for the role of tea as means of reducing the risk of serious chronic diseases such as heart  and neurodegenerative diseases, cancer, metabolic syndrome and type 2 diabetes. Most of these beneficial effects appear to be related to the potent  antioxidant and anti-inflammatory activities of EGCG, which typically comprises around 50% of the polyphenols present. Recent studies suggest EGCG may act by modulating the effects of the energy-producing organelles in cells, the mitochondria, as well as altering the cell cycle and mitochondria-related cell death (apoptosis).

Data from the Zutphen Elderly Study in the Netherlands revealed that tea drinking reduced the heart attack, but not stroke, risk among the elderly, the authors relating this to the high EGCG content especially in green teas (30% of the dry weight, as against just 9% of the dry weight of black tea). Both EGCG and other catechins have been implicated as the most significant antioxidants in tea. The bud leaf and the first leaves, as found in teas such as orange pekoe, tend to be richest in EGCG.

High-grade matcha green tea — as used in traditional Japanese tea ceremony — has the highest levels of L-theanine, thought to promote a state of alert relaxation.

There has been considerable scientific debate about how easily catechins in tea are absorbed by the body. Most studies suggest bioavailability is far from complete, one study estimating key flavonol absorption being around 40% of those ingested. Bioavailability also appears to be reduced (up to 3.5 times) when tea is consumed along with food compared with when it is consumed on an empty stomach.

While we so often find ourselves asking for more, believing that ‘more is better’, in the case of antioxidants, this isn’t necessarily the case. There are two important aspects to consider. First, how long does the antioxidant effect last after consuming a single cup of green or black tea, and second, what is the extent and nature of the effect. On both counts, the results are impressive and remind us just how valuable tea drinking can be to our health.

While the caffeine levels typically peak within an hour of tea consumption, the catechin levels for someone having 4 cups of tea over a 6 hour period will typically peak in the bloodstream at 5 hours, with the super-catechin, EGCG, peaking after 24 hours. This means that regular tea drinking contributes to sustained levels of antioxidants in the bloodstream — a great way to reduce your long-term chronic disease risk and maintain neurological health.  

For the over 90% of people who consume tea with milk, the good news is that the addition of milk to tea doesn’t compromise the bioavailability of catechins.

On that note, given you’ve got to the end of this article, perhaps you might consider making yourself a cup of matcha, green or even black tea before you resume your next task?

The Ayurvedic cannon details very specific treatments for bone and joint diseases. The earliest texts of Charaka Samhita (150BCE-100CE) and Sushruta Samhita (50-500CE) detail various symptoms associated with joint pain as part of other diseases involving fever (jwara) and neurological vata disorders (vatavyadhi).

Vaghabata in his Ashtanga Hridaya Samhita (600CE) mentions a disease named vatashonita meaning ‘vata in the blood’ which is associated with intense joint pain and has symptoms similar to gout. Madhava Nidana (c650-950) in his classic on pathology is the first to mention amavata as a disease in its own right. Amavata literally means ‘toxic vata’ and is commonly associated with Rheumatoid Arthritis.

Ama is a term used to describe all unmetabolised wastes that have cold, heavy, wet and sticky qualities infamous for obstructing the channels and causing degeneration of health. Vata relates to the functional principle in the body associated with all movement and is associated with the qualities of cold, dry, lightness and irregularity. Vata is also associated with the experience of pain so commonly felt in bone and joint diseases.

• Low digestive fire leading to creating of toxins (mandagni, ama)
• Vata aggravating diet and lifestyle (vatakara ahara vihara)
• Malnutrition including nutrient deficiency and wasting of the tissues (dhatu kshaya)
• Incompatible foods; milk and fruit, milk and fish, meat and dairy
• Inappropriate diet: stale foods, cold foods, constitutionally inappropriate foods, processed foods, fermented foods.
• Excessive exercise (Ati vyayama)
• Deficient exercise (Kashaya vyayama)
• Injury
• Hormonal disorders
• Hereditary causes (sahaja vikritis)

The basic pathogenesis of bone related diseases is due to the intimate connection between vata and the bones. There is an inherent link between the main site of vata in the colon and the bones. The colon is responsible for the uptake of many types of minerals that nourish the bones. This is the link to their natural qualitative relationship as both vata dosha and the bones are high in the air element.

This means that a healthy vata directly nourishes the bones. The other association is that from the colon excess ‘wind’ and ‘toxic gases’ can be expelled, whilst important minerals are absorbed, ensuring that an excessive accumulation of vata does not occur.

If the digestive fire is low then vata will be aggravated in the colon. This will lead to a dual problem. Firstly, there will be reduced assimilation of these precious mineral nutrients intended to nourish the bones, hence leading to a deficiency. Secondly there will be an increased accumulation of toxic wastes (ama) leading to an excess. These toxins will be carried by vata to the connective tissue, joints and bones where the ensuing congestion will lead to the multiferous forms of ‘arthritic’ diseases.

These ama toxins have a watery, sticky and mucoid like nature and hence have an affinity for similar kapha-like tissues in the body; hence the attraction to the protective linings of the connective tissue and synovial fluid covering the joints. Vata is the mover and ama is the obscurer. The joints then become involved which can result in pain and deformity.

Whilst the main dosha involved with bone and joint disorders is usually vata the other doshas may also be involved. Some general signs and symptoms of bone and joint diseases are:

• Vata: Thin body and bones, fragile, bones breaking easily, rough and dry skin, cavities, rough, severe pain, migrating pain, loose joints
• Pitta: Inflammation, red hot joints, sharp pain, fever, infective disorders
• Kapha: Excess and large bones/teeth/hair, stiffness, itching, pitting oedema over joint, less pain, thickening skin, osteo-tumours, heaviness, hirsutism

It is said that when one dosha is involved the disease is curable, if two dosha are involved the disease can be managed and if all three dosha are involved then it is incurable.

Ayurveda has a time tested ability to differentiate the causative factors, the pathogenesis and the diversification of the different forms of every disease. This allows for remarkably precise and accurate treatments that are individualised to suit every patient, which is why we recommend seeing a herbalist rather than simply buying an over-the-counter product.

Rheumatoid arthritis is a chronic condition involving loss of mobility and enduring pain of the joints with some swelling of the synovial joints. It has similarities to many arthritic diseases with specific clinical features associated with Rheumatoid Arthritis (RA).

Arthritis is the generic name for a number of diseases involving inflammation of the tissue surrounding one or any number of joints with pain, redness, warmth, pain and restricted motion. Such conditions may include rheumatoid, osteo, psoriatic, gout, ankylosing spondylitis and tuberculosis.

RA is a chronic inflammatory disease which typically affects the synovial membrane involving the peripheral joints of the joints of the fingers, wrists, feet and ankles and later the hips, knees and shoulders. The symptoms manifest between exacerbation and remission and are three times more likely to occur in women than in men. RA is diagnosed by a blood test indicating the presence of rheumatoid factor. It is also diagnosed by X-rays revealing rheumatoid erosions around the joints. The exact causative factors of RA are not known by are thought to involve some form of autoimmune condition or some infective pathogen. It affects 1-3% of the population and peaks between 30-50 years of age.

Arthritic diseases are usually treated with pharmaceutical medication that may have associated side-effects; Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), steroidal anti-inflammatories (corticosteroids), immunosuppressive drugs (methotrexate, cyclosporine) and remittive drugs (penacillamine). Whilst these drugs may offer symptomatic relief they have been associated with hepatotoxicity, kidney damage and immunodeficiency.

Whilst there are obvious similarities, amavata cannot be directly linked with arthritis as it has a distinct pathology and treatment strategy with different objectives to those sought by allopathic mediciation. It involves the diagnosis of the three dosha and the treatment of them along with the tissues, channels and digestive fire. The objective is to treat the root causative factor as well as the symptoms.

Weak digestive fire, sedentary lifestyle, heavy oily food, no exercise or exercising directly after eating heavy food can all make people more susceptible to the onset of arthritis.

People of a vata/kapha constitution become susceptible to this condition due to the extreme opposites of qualities. This constitutional combination can be like two people living in one body, always contradicting oneself…I should, shouldn’t etc.

The seasonal change that takes place moving from the heat of summer to the coolness of Autumn can aggravate chronic conditions that may have remained dormant during the summer months where heat and dryness kept them under control.

Arthritis is a condition that often manifests in the autumn season as it is aggravated primarily by an excess of vata that builds up in this season.

Toxins are produced from the causative activities associated with vata and are carried quickly to seats of kapha (joints) and fill the channels with a waxy toxic material (ama) which has similar qualities to kapha. Joints are a primary site of kapha. This produces weakness of body, heaviness of heart, affects the joints (comprising of synovial fluid) of waist, neck and shoulder, stiffness and is itself a cause of many diseases.

Low grade fever, reduced appetite, increased thirst, lethargy, alternate feelings of heaviness and hollowness (kapha/vata). Symptoms can be reversed at this early stage by correcting digestion and with simple Ayurvedic treatments such as steaming and oil massage.

• Stiffness
• Pain
• Inflammation
• Excess saliva
• Coated tongue
• Lack of enthusiasm
• Thirst
• Bloating
• Insomnia
• Fainting and constipation. At this stage stronger treatment such as cleansing the system and herbs are required.

Ayurvedic treatment methods for arthritis:

• Support digestion
• Remove toxic ama
• Rejuvenate the whole system and repar damage

The first line of treatment should be ‘lightening’ therapy involving strengthening the digestion whilst initiating cleansing treatments. Enkindle digestion with spices such as ginger, asafoetida and trikatu. Once digestion is working well and toxins (ama) have been removed through appropriate diet and herbs you move to a rejuvenation treatment to restore vitality (ojas).

Diet should be light and warming with lots of digestive spices. Including some high quality essential fatty acids and oils is important. It is worth avoiding foods with the same sticky-clogging-inflammatory nature of amavata; dairy, gluten, flour, sugar, greasy foods and rich meats such as pork.

Some people benefit from avoid members of the Solanaceae family (potatoes, aubergines, peppers) as well as other potential irritants such as peanuts, soya and corn.

Recommended herbs are guggul, ginger, celery seed, castor oil, haritaki, boswellia, gotu kola, turmeric, ashwagandha and sariva. Triphala powder at night to clear ama from the colon is also beneficial. Warming and invigorating oils, such as mahanaryan oil and castor oil packs, help to remove congestion and gentle exercise and yoga are recommended but avoid strenuous exercise such as jogging or weights.

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

Indeed that is true. According to the UK Tea and Infusions Association, without any regulation or official permissions, Britons drink just over 60 billion cups of tea (regular, herbal, fruit and speciality) each year – that’s before we even get to the numbers for green tea supplement use – and most of us certainly don’t think of it as a herbal remedy.

That puts the apparently ‘dozens of cases’ in medical literature cited by the authors, documenting people becoming ill after ingesting tea in the form of drinks, pills, powders and supplements into some real world perspective – and equates to a number so infinitesimal that it would be hard to quantify it as a meaningful percentage.

In contrast, the respected University of Maryland database lists a multitude of well-researched benefits from green tea including treating atherosclerosis, high cholesterol, inflammatory bowel disease, liver disease, weight loss and several forms of cancer (3).

Even more interesting, WebMD, a website not known for its liberal views, has this to say about green tea:

“The commonly used dose of green tea is based on the amount typically consumed in Asian countries, which is about 3 cups per day, providing 240-320 mg of the active ingredients, polyphenols.” This amount is based on the ‘dose’ typically consumed in Asian countries (4).

This context, was of course missing. As was any acknowledgement that case reports are not studies. They do not carry the same weight and, in isolation, do not allow us to understand anything other than there are exceptions to every rule; and yet they are often reported as if they are the rule itself.

Apart from asking by what standard this story was considered a ‘news’ story, we might also ask why is there still so much antagonism towards botanicals in the mainstream media and why the idea that someone might exercise a choice to use alternatives is still seen as so ‘wacky’.

That there is a negative bias against herbs in the media is without question. We see it far too often, but as a phenomenon it has not benefitted from much examination.

However, one study that looked specifically at the way botanicals were covered in the media found that despite the overall positive results and tone of clinical trials in major medical journals, newspaper coverage of botanical clinical trials was more negative than similar coverage for pharmaceutical clinical trials (5).

This wasn’t a dewy eyed look at herbs. It acknowledged, for example, the often small size of botanical trials and how this can affect outcomes. Nevertheless, the authors noted that when reporting studies into herbal remedies, journalists displayed “a degree of scepticism rare for medical reporting” and that that: “It may be considered more newsworthy to debunk commonly held beliefs and practices related to CAM, to go against the trend of positive reporting in light of evidence.”

They hypothesised also that journalists who used press releases from peer-reviewed, high-impact journals as their main sources may “have subtle biases towards scientific method and conventional medicine.”

These same journalists may turn to conventional experts for comments on study outcomes, for both herbal and pharmaceutical trials, and this can exacerbate the problem of bias.

With commercial magazines and newspapers, and even TV news programmes, there is also the growing problem of advertiser influence.

Pharmaceutical advertising money talks, whether it’s for a prescription drug or an over-the counter one. Few botanical companies have the money to compete, and online content is no safer since on big news sites, content is even more strategically tailored to suit advertisers (6).

But advertiser pressure can make itself felt even before story hits the mainstream. 

For instance, a 2008 study of 11 medical journals investigated the relationship between pharmaceutical advertising and articles about dietary supplements in medical journals. It found that:

• Journals with the most pharmaceutical ads published significantly fewer major articles about dietary supplements per issue than journals with the fewest pharmaceutical ads.
• Amongst those journals with the highest percentage of pharmaceutical ads, the percentage of major articles concluding that dietary supplements were unsafe 67%. In those journals with the fewest pharmaceutical ads this figure was just 4%.
• The percentage of articles concluding that dietary supplements were ineffective was almost twice as high (50%) among journals with more pharmaceutical ads than among those with fewer pharmaceutical ads (27%).

Overall, the more pharmaceutical advertising there was in a medical journal, the fewer articles about dietary supplements, and more articles concluding dietary supplements were unsafe, there were (7).

The recent St John’s wort recall threw up another media issue – ignorance.

Eight products in total, produced by ASDA, Superdrug and HRI Good Mood, were the subject of a “precautionary recall” (8) because they had levels of toxic pyrrolizidine alkaloids (PAs) above the threshold recommended by the European Committee on Herbal Medicinal Products (HMPC).

Although much was made in the news coverage of the toxicity of PAs and potential dangers of herbs containing them, most missed a vital fact: St John’s wort does not naturally contain PAs. Instead the contamination is the result of accidental co-collection of weeds like ragwort during harvesting.

This kind of harvesting contamination isn’t just a problem with St John’s wort, other herbs can be affected. Good Agricultural and Collection Practices, as defined by the World Health Organization (9), are the best way to avoid this problem. So is being careful what you buy.

The fact is that complementary and alternative medicines, including botanicals, are growing in popularity.

In the UK, 46% of the population can be expected to use one or more CAM therapies in their lifetime (10). In the United States, approximately 38% of adults and approximately 12% of children are using some form of CAM (11).

This means there’s a marketplace, and cut price/high volume companies who want in on the action may have less scrupulous quality control than smaller dedicated suppliers. If you use St John’s wort, as with most herbals, there is an argument that you get what you pay for – though this context, too, was lost in the rush to print another bad news story about herbs.

But there is also another largely ignored influence that makes reporting on herbs so unsatisfactory: language – specifically the way language expresses our beliefs and philosophical underpinnings.

Users of CAM have been consistently shown to be well-educated, and well informed individuals making different choices about how to treat common health problems such as anxiety, backache, chronic pain, and colds and flu – conditions for which conventional medicine can offer very little.

This choice of an alternative isn’t necessarily dependent on dissatisfaction with conventional medicine but is more commonly based on a philosophical orientations towards choice, health, culture, individuality, nature, spirituality and personal growth.

Of course, it is only rarely that these things are reflected in news reporting and even more rarely in medical research, which strives to disassociate itself from such things.

Yet those who appreciate the study and the use of herbal remedies have been described as medically ‘bilingual’ – with the ability not only to understand the varied approaches to health, the differences in language, history and also conceptual differences, but also how the past can positively inform the present.

A good example of this medical bilingualism is Tu Youyou, co-recipient of the 2015 Nobel Prize in Physiology or Medicine (12), and a researcher who has spent her entire career researching traditional Chinese medicine. Tu won the prize for her discovery of artemisinin, derived from sweet wormwood, as an alternative malaria cure to the standard chloroquine, which is now largely ineffective due to resistance.

Tu maintains that she drew her inspiration not from JAMA or the BMJ, or even the Journal of Alternative and Complementary Medicine, but from the medical text of a fourth-century Chinese physician and alchemist named Ge Hong (circa 283-343).

In most parts of the developed world the media has grown deeply conservative and corporate in its outlook. As such it is a media that has proved itself unworthy of the challenge of dealing with alternatives or opposition.

Examples abound from climate change, to alternative energy, economics and new politics – and it is also true in health. However, in upholding the status quo we also have a media that is increasingly out of touch with its readers and the momentum of the times.

Yet occasionally there is a chink of light. As if in a nod to Tu Youyou the Daily Mail also recently reported on a trial of artesunate, derived from the leaves of sweet wormwood, as a treatment for bowel cancer (13).

Scientists, researching the substance claim that early trials show that bowel cancer patients who took the drug for two weeks before surgery were six times less likely to have a recurrence of the disease, compared to those who took a placebo.

This means it could be an effective treatment for the estimated 40,000 Britons who are diagnosed with the disease every year.

The question to our media is: do we abandon that potential benefits of botanicals to uphold outdated prejudices, or do we move into a new era of deeper understanding – and better health?

1. Davies M, Teenager who drank three cups of green tea a day develops hepatitis and turns YELLOW due to liver damage, Daily Mail, 24 September 2015. http://www.dailymail.co.uk/health/article-3247325/Teenager-drank-three-cups-green-tea-day-develops-hepatitis-turns-YELLOW-liver-damage.html
2. Gompertz S et al, Chinese green tea and acute hepatitis: a rare yet recurring theme, BMJ Case Reports, published online 23 September 2015. http://casereports.bmj.com/content/2015/bcr-2014-208534.abstract
3. University of Maryland Medical Center, Green Tea. http://umm.edu/health/medical/altmed/herb/green-tea
4. WebMD, Green Tea.  http://www.webmd.com/vitamins-supplements/ingredientmono-960-GREEN%20TEA.aspx?activeIngredientId=960&activeIngredientName=GREEN%20TEA      
5. Caulfield T et al, Herbal remedy clinical trials in the media: a comparison with the coverage of conventional pharmaceuticals, BMC Medicine2008; 6: 35. http://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-6-35
6. Filloux F, Dangerous blend: how lines between editorial and advertising are blurring, Guardian, 16 May 2011. http://www.theguardian.com/technology/2011/may/16/blurring-lines-between-advertising-and-editorial
7. Hood KL and Kemper KJ, Does pharmaceutical advertising affect journal publication about dietary supplements?, BMC Complementary and Alternative Medicine2008; 8: 11. http://bmccomplementalternmed.biomedcentral.com/articles/10.1186/1472-6882-8-11
8. Medicines and Healthcare products Regulatory Agency, Precautionary recall – six batches of St John’s Wort Tablets, 8 February 2016. https://www.gov.uk/government/news/precautionary-recall-six-batches-of-st-johns-wort-tablets
9. World Health Organization, WHO Guidelines on Good Agricultural and Collection Practices (GACP) for Medicinal Plants, 2003. http://apps.who.int/medicinedocs/en/d/Js4928e/
10. Lewith GT and Bishop FL, Who Uses CAM? A Narrative Review of Demographic Characteristics and Health Factors Associated with CAM Use, Evid Based Complement Alternat Med, 2010; 7(1): 11-28. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2816378/
11. National Center for Complementary and Integrative Health, The Use of Complementary and Alternative Medicine in the United States, 2008 https://nccih.nih.gov/research/statistics/2007/camsurvey_fs1.htm
12. The Nobel Prize in Physiology or Medicine 2015. http://www.nobelprize.org/nobel_prizes/medicine/laureates/2015/
13. Mail on Sunday Reporter, The £1 pill taking on bowel cancer: Malaria drug based on a Chinese herbal remedy could be the latest weapon in the battle against the deadly disease, 30 January 2016 http://www.dailymail.co.uk/health/article-3424600/The-1-pill-taking-bowel-cancer-Malaria-drug-based-Chinese-herbal-remedy-latest-weapon-battle-against-deadly-disease.html

Let’s start with sugar. Sugar has not always been used as a sweetener or preservative, it actually has a strong medicinal history. In Ayurveda, the sugar cane plant was used to treat skin and urinary tract infections in addition to relieving constipation and a low blood pressure.

A paste made from the plant was also used to pack wounds and promote healing. Although it may seem somewhat obvious, sugar was traditionally used to sweeten foods, whereas now, sugar is seen as a valuable preservative increasing the shelf-life of foods that wouldn’t traditionally contain sugar. It is increasingly difficult to locate foods that do not have added sugars.

Sugar cravings

But, what has made these two plants so popular in our modern world?

A lot of it has to do with how they make us feel. All sugars are broken down by the body into glucose and fructose and are processed in the liver. Sugars are converted into glycogen or fat for storage, or kept as glucose in the blood as potential energy for use by our body’s cells. Our body recognises ‘sweet’ and cannot immediately differentiate between un-natural and natural sources of sweetness.

Sucrose is a carbohydrate also broken down into glucose and fructose. The body and brain processes glucose and fructose in different ways, and it may be this differentiation that is contributing to our modern sugar craving. When glucose is processed by the body it reduces blood flow and activity in the regions of the brain that regulate feelings of satisfaction, leaving us feeling ‘full’.

Fructose, however, appears to have the opposite effect, increasing our natural ‘food-seeking’ behaviours. It may not be such a surprise to learn that the majority of added sugars and sweeteners now being used in our food and drinks industry are in fact fructose based, including the rather infamous ‘fructose corn syrups’. What this explains is why we are never satisfied after consuming high levels of refined sugars, whether it’s in foods or drinks. It appears to be a bit of a vicious cycle, where the more ‘un-natural’ sugar we consume, the more we crave.

Sugar has actually been found to induce addictive behaviour. Specifically, sugar dampens the suppression of the hormone ghrelin, which signals hunger to the brain. It also interferes with the normal transport and signalling of the hormone leptin, which helps to produce the feeling of satiety and satisfaction.

One other important point of consideration are the links between sugar and the onset of metabolic syndrome. Sugar consumption raises plasma glucose, which can influence hypertension due to fructose increasing uric acid levels. It also influences high levels of triglycerides and insulin resistance through the synthesis of fat in the liver. Similarly, these increases in liver fat are also associated with the onset of diabetes. So, we can clearly see why there are so many current concerns over the increased levels of added sugars in food and drinks.

And what about coffee? The coffee bean, Coffea arabica, was traditionally recognised as a stimulating and diuretic medicinal herb but its unique roasted-bitter taste has fashioned it into one of the world’s most popular drinks. Caffeine is the most well-known component of coffee with caffeine being the primary pharmacologically active compound to which the majority of coffee’s therapeutic effects are attributed. Coffee is the world’s principal source of caffeine, accounting for 54% of our caffeine intake, and is the most widely consumed psycho-physiologically active substance in the world. Just try an espresso and see for yourself.

The love for caffeine

And what about coffee…?

The link between caffeine and its stimulatory effects has developed the belief that coffee influences human cognitive processes such as thinking learning and memory. Caffeine has a direct affect upon the sympathetic neurotransmitter known as adenosine found in the sympathetic nervous system. Caffeine blocks adenosine receptors and, when uninhibited, adenosine reduces physiological activity, for example by reducing heart muscle contraction Therefore, when adenosine receptors become blocked by caffeine, a stimulant effect is produced. Caffeine also increases the rate of synthesis and turnover of noradrenaline, an excitatory neurotransmitter in the sympathetic nervous system. Noradrenaline is implicated in maintaining levels of alertness in the human brain.

Habitual coffee drinkers are chronically exposed to caffeine as a result of consuming the beverage at intervals throughout the day. Evidence exists that coffee consumption after periods of caffeine abstinence may increase its stimulant effects but that there is nothing to gain from habitual consumption. As a consequence, it has to be questioned whether habitual consumption of coffee is due to a psychological association between coffee ingestion and cognitive stimulation. What’s also worth remembering is that caffeine is a psycho-physiologically active substance with the documented withdrawal effects of fatigue and migraine, one significantly reported withdrawal symptom of coffee is the onset of hyperacidity in the form of heartburn and/or acid reflux. So, habitual consumption of highly caffeinated drinks may also be a result of avoiding the effects of the withdrawal.

So, what can we deduce from this? The motto, ‘everything in moderation’ comes to mind.

Can we combat our regular sweet cravings and what can use as an alternative to highly caffeinated drinks to help nourish our energy? Well, of course, there are herbal alternatives. This is where herbal medicine becomes the star of the show. There are some fantastic herbs that can help our body regulate our excessive sugar cravings and provide alternatives to excessive caffeine consumption. Here are Herbal Reality’s favourites:

Cinnamon (Cinnamomum zeylancium and aromaticum)

Cinnamon has a direct balancing effect on the blood sugar. Cinnamon impacts on insulin resistance through increasing the body’s sensitivity to insulin, so that we are more reactive to changes in blood sugar levels; constituents in cinnamon such as cinnamaldehyde mimic insulin and improve glucose uptake in the body.

Cinnamon also decreases the amount of glucose that enters the bloodstream after a meal through its impact on numerous digestive enzymes slowing the breakdown of carbohydrates in the digestive tract. Cinnamon’s warmth improves overall digestive metabolism and nutrient absorption. It stokes a sluggish digestion, firing up our digestive ‘agni’.

Licorice (Glycyrrizha glabra)

Liquorice is the perfect natural replacement for sugar without the added calories. The primary constituent, glycyrrhizic acid, is naturally sweet in taste and is responsible for the characteristic taste associated with this herb. Liquorice is also a natural adaptogen that nourishes the adrenal glands, helping to support and sustain energy levels.

Green tea (Camellia sinensis)

The therapeutic properties of green tea are attributed to its antioxidant capacity which protect cells from the damage caused by free radicals. The presence of (epi-gallo-catechin-gallate) EGCG’s in the plant make it incredibly supportive to the cardiovascular system as a whole, protecting the integrity of the heart and blood vessels. Constituents such as caffeine, which is naturally present in this plant, works synergistically with compounds such as L-Theanine to increase serotonin, dopamine and gamma-Aminobutyric acid (GABA) in the brain.

This significantly boosts mood without causing the characteristic ‘crash’ you may experience after drinking a strongly caffeinated drink. EGCG has also demonstrated the ability to reduce atherosclerosis and the build-up of cholesterol by reducing serum cholesterol, triglycerides and high density lipoproteins (HDLs), all of which can be an issue with excessive sugar consumption. Green tea is an excellent herb for improving overall metabolic rate without influencing ‘crashes’ in energy.  

Ashwagandha (Withania somnifera)

Ashwagandha is the perfect herb for encouraging endurance and boosting core energy levels. Ashwagandha is unusual in that it brings both energy and calm. It brings strength by helping you to rest more efficiently and helps you rest by making you stronger. It will enhance endocrine communication, strengthening the adrenal glands whilst also calming a hyperactive nervous system through moderation of cortisol, the thyroid and the reproductive organs. It is particularly useful in nervous exhaustion.

Nutritional research during the early and mid-20th century was heavily engaged in establishing which nutrients were essential to life, which had to be ingested via the diet and which could be made in the body.

By definition, essential vitamins and minerals of which there are 14 and 15 respectively, and essential amino acids, of which there are 9, need to be ingested via the diet.

We now know more about essential fats, and call these essential fatty acids (or EFAs) and they include certain omega-3 and omega-6 fatty acids.

As more and of these essential nutrients were discovered, it became evident that they had the ability to resolve many illnesses. Therefore, diseases like scurvy, beriberi, pellagra and rickets, caused by vitamin C, thiamine (vitamin B1), niacin (vitamin B3) and vitamin D deficiency respectively, were soon largely consigned to the history books.

What we now recognise as the pharmaceutical industry also emerged in Germany, France and Switzerland shortly post-WWII. The huge growth of this industry was driven both by developments in organic chemistry—the chemistry of carbon—as well as recognition that new-to-nature molecules could be patented. These patented molecules, or drugs, had to be different from natural products to be eligible for patents. While this remains the principle business model of today’s Big Pharma, the fact our bodies have not had millennia to adapt to patented drugs means they often disrupt aspects of our physiology—hence the common side effects and poor safety record of pharmaceutical medicine. In fact, the unintended side effects of properly prescribed drugs makes them one of the leading causes of death in modern society.

In its infancy in the pre-WWII period, the embryonic pharmaceutical industry was busy finding ways to produce vitamins, amino acids and other essential nutrients synthetically. The two main perceived advantages were low cost and high stability, which also has a bearing on keeping shelf lives long, reducing distribution costs, increasing profit margins — and generally contributing another vital piece to the highly viable business model of the rapidly growing pharma industry.

With the wind in its sails after global sales of broad spectrum antibiotics like penicillin and pain relievers like aspirin, 1965 saw pharma’s first big shock. It was the thalidomide disaster. This spawned the first attempt to comprehensively regulate drugs and, in Europe, regulation took the form of its first pharmaceutical directive, Directive 65/65/EEC. Existing EU medicines law is still based on this first Europe-wide medicinal code.

Our modern day desire to want to ingest concentrated nutrients in the form of food supplements is quite likely a survival mechanism, one triggered by the increasingly simplified and processed diets to which so many of us are exposed. Not only has food supplementation always existed to see us through leaner times, today, it’s arguably a necessity. This is especially so if we’re to endeavour to live long and vital lives in which our final decades are untarnished by debilitating chronic disease.

Symptoms of pravahika include frequent elimination, often of small quantities of faeces, mucus in stools and tenesmus. The small quantity is accounted for by the fact that mucus is extremely irritating and can trigger an urgent call to stool simply to pass some mucus or a small amount of mucus-filled stool.

As described in the classical texts, pravahika is characterized by bahusam (frequency), alpalapam (small quantity), sashulam (with pain), sapravahikam (straining i.e. a very intense urge again caused by the irritant effect of mucus), saraktam (blood in stool), sapicham (jelly-like mucus), upveshayte (urgency of defaecation) (2).

Vataj pravahika is characterized by frequent defaecation accompanied by pain, a typical symptom of Crohn Disease. Pittaja pravahika is accompanied by burning sensation, kaphaj pravahika by mucus in stools, common in amoebic dysentery and raktaj pravahika with blood in the stools, as in the case of ulcerative colitis (2).

Crohn disease is a typical form of vataj pravahika, since its main symptoms are dysentery and pain. In addition, the course of the illness is unpredictable (3), a typical vata quality.

The disease affects the small intestine, particularly the terminal ileum, as well as the ascending colon (3). Thus as it progresses it can lead to malabsorption as well as to small bowel obstruction and abscess formation. Secondary conditions resulting from fat malabsorption include steatorrhoea (fatty diarrhoea), fat-soluble vitamin deficiency, gallstones, kidney stones, clotting disorders and osteoporosis (4).

The causes include a genetic khavaigunya in the digestive tract along with dietary and lifestyle factors, notably a high fat diet and smoking. In our clinical experience, a combination of a high-fat junk-food diet of pizza, burgers and fries, accompanied by smoking, is often a prelude to Crohn Disease in susceptible subjects (5). Crohn Disease typically begins in young people between the ages of fifteen and thirty. (4) It occurs with increased frequency in Ashkenazi Jews (6).

Ulcerative colitis (UC) is a type of raktaj pravahika, characterized by rectal bleeding, mucus discharge from the rectum and frequent stools. Tenesmus may also occur. Unlike Crohn disease, it is confined to the large intestine, beginning in the rectum and spreading into the rest of the colon. UC is three times more common than Crohn disease (7).

It frequently begins in young people aged 15-25 although onset can occur at any age (8). Like Crohn disease, it is more common in Ashkenazi Jews. An autoimmune condition, UC may be associated with autoimmune disorders outside the digestive tract. Up to 6.2% of patients with UC have such manifestations, which include autoimmune eye disease (uveitis), ankylosing spondylitis, inflammatory back pain and sclerosing cholangitis (9).

Primary sclerosing cholangitis is a severe autoimmune liver disease leading to jaundice and liver failure and is found mainly in patients with IBD (10). Genetics (11), diet and stress (12) play a role in the development of UC. A pittagenic diet high in sulphur, as found in heavy consumption of red meat and alcohol, is associated with increased likelihood of relapse (13).

Micropscopic colitis includes both collagenous colitis and lymphocytic colitis (14). This milder form of colitis presents as atisar or diarrhoea and lacks the typical features of pravahika. Indeed, microscopic colitis is often misdiagnosed as diarrhoea dominant irritable bowel syndrome, although it is actually a mild form of IBD. The colloidal colitis form of microscopic colitis is twenty times more common in women than in men (15).

Microscopic colitis occurs more commonly over 40, peaking in the sixth and seventh decades of life, and should be considered in the differential diagnosis of atisar (diarrhoeal disease) in older women (16). Most if not all patients with microscopic colitis have lived for decades with undiagnosed coeliac disease (17). These patients respond extremely well to a gluten free diet, usually getting complete remission of symptoms when this diet is used in tandem with Ayurvedic herbs.

Treatment of pravahika is carefully described in both Sushrut and Vagbhat. Diet is of course of great importance since the condition arises due to use of unsuitable diet. During an acute episode, diet begins with rice gruel seasoned with cumin (18).

Ghee

When solid food can be taken, the first food is rice with curds or yoghurt (19). After this, soups, kitcheri and boiled rice with rock salt and ghee can be given. Once the condition is in remission, patients with Crohn disease (vataj pravahika) can take a vata soothing diet while carefully avoiding trans fats and deep-fried foods.

They should also be counseled to quit smoking. Patients with UC should adopt a vegetarian or semi-vegetarian pitta-soothing diet, avoiding alcoholic beverages. They should be instructed in relaxation and meditation techniques to manage their stress. Patients with microscopic colitis should adopt a gluten free diet regimen tailored to their constitution.

Herbs to improve pravahika

Herbs can be used both rectally and orally. Sushrut mentions the use of picchila vasti with liquorice powder, unpastueurized boiled milk, Salmali stems (silk cotton tree), kusha grass and ghee (20). Today, licorice ghee vasti can be used as a simplified version and in our clinical experience has proved highly effective in ulcerative proctitis and UC, due to the ropan or wound-healing properties of licorice (21). Vasti with a decoction of dashamoola will relieve pain in the case of painful tenesmus (20).

Takram or buttermilk is the ideal vehicle for oral herbs during episodes of pravahika (22). When rectal bleeding is present, arjun, both haemostatic and ropan (wound healing) can be used in takram (23). Other astringents herbs favoured for dysentery include bilva ( 24) and kutaja (25).

Ajwain, black pepper and ginger are used to stimulate normal agni (25). Triphala in small amounts (pinch size) is also effective in dysentery because of its astringency (22). As well as these herbs and remedies for use during the acute phase, guggulu is extremely valuable for maintenance and relapse prevention. Guggulu blocks pro-inflammatory gene expression, thus addressing IBD at the profound level of epigenetics (26).

Because Guduchi (Kaishore) is anti-inflammatory and anti-spasmodic (27), the best guggulu formulation for IBD is kaishore guggulu. Therefore, in the absence of contra-indications, Kaishore guggulu should be continued long term in patients with IBD. Due to the autoimmune aetiology of IBD, shodhan therapies such as pancha karma should be effective to maintain remission and prevent relapse (28).

Diet

As we have seen, IBD is a disease of Western lifestyles, linked to consumption of high-fat, high meat diets, junk foods and stress (29). The Ayurvedic texts have considered mainly tropical diseases under the heading of pravahika. Yet Crohn disease, UC and microscopic colitis fit well into the descriptions of vataj pravahika, rakta pravahika and atisar, respectively. Furthermore, the traditional treatments for these conditions offered in the texts remain highly effective today, accompanied by lifestyle modifications. Due to the persistent and relapsing nature of IBD, maintenance therapies are also necessary in the long term.

1. Bishagratna KL tr, Sushrut Samhita, Chowkhamba Sanskrit Series, Varanasi, 1981 ut XL 82-83
2. Srikantha Murthy KR tr. Madhava Nidhanam, Chaukhambha Orientalia ,Varanasi Ch 3 v 21-22.
3. Farmer RG, Hawk WA, Turnbull RB Jr. Clinical patterns in Crohn’s disease: a statistical study of 615 cases. Gastroenterology. Apr 1975;68(4 Pt 1):627-35.
4. Kornbluth A, Sachar DB, Salomon P. Crohn’s disease. In: Feldman M, Scharschmidt BF, Sleisenger MH, eds. Sleisenger & Fordtran’s Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, and Management. Vol 2. 6th. Philadelphia, Pa: WB Saunders Co; 1998:1708-34.
5. Kornbluth A, Sachar DB, Salomon P. Crohn’s disease. In: Feldman M, Scharschmidt BF, Sleisenger MH, eds. Sleisenger & Fordtran’s Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, and Management. Vol 2. 6th. Philadelphia, Pa: WB Saunders Co; 1998:1708-34.
6. Duerr RH. Update on the genetics of inflammatory bowel disease. J Clin Gastroenterol. Nov-Dec 2003;37(5):358-67.
7. Garland CF, Lilienfeld AM, Mendeloff AI, Markowitz JA, Terrell KB, Garland FC. Incidence rates of ulcerative colitis and Crohn’s disease in fifteen areas of the United States. Gastroenterology. Dec 1981;81(6):1115-24
8. Jang ES, Lee DH, Kim J, Yang HJ, Lee SH, Park YS. Age as a clinical predictor of relapse after induction therapy in ulcerative colitis. Hepatogastroenterology. Sep-Oct 2009;56(94-95):1304-9.
9. Bernstein CN, Blanchard JF, Rawsthorne P, Yu N. The prevalence of extraintestinal diseases in inflammatory bowel disease: a population-based study. Am J Gastroenterol. Apr 2001;96(4):1116-22.
10. Cox KL, Cox KM. Oral vancomycin: treatment of primary sclerosing cholangitis in children with inflammatory bowel disease. J Pediatr Gastroenterol Nutr. Nov 1998;27(5):580-3.
11. Xavier RJ, Podolsky DK. Unravelling the pathogenesis of inflammatory bowel disease. Nature. Jul 26 2007;448(7152):427-34.
12. Levenstein S, Prantera C, Varvo V, Scribano ML, Andreoli A, Luzi C, et al. Stress and exacerbation in ulcerative colitis: a prospective study of patients enrolled in remission. Am J Gastroenterol. May 2000;95(5):1213-20
13. S L Jowett, C J Seal, M S PearceInfluence of dietary factors on the clinical course of ulcerative colitis: a prospective cohort study Gut 2004;53:1479-1484
14. Baert F, Wouters K, D’Haens G, Hoang P, Naegels S, D’Heygere F, et al. Lymphocytic colitis: a distinct clinical entity? A clinicopathological confrontation of lymphocytic and collagenous colitis. Gut. Sep 1999;45(3):375-81
15. Margret Agnarsdottir, Olafur Gunnlaugsson, Kjartan B. Orvar,Collagenous and Lymphocytic Colitis in Iceland Digestive Diseases and Sciences Volume 47, Number 5, 1122-1128
16. Fernandez-Banares F, Salas A, Forne M, Esteve M, Espinos J, Viver JM. Incidence of collagenous and lymphocytic colitis: a 5-year population-based study. Am J Gastroenterol. Feb 1999;94(2):418-23
17. Matteoni CA, Goldblum JR, Wang NCeliac disease is highly prevalent in lymphocytic colitis.J Clin Gastroenterol. 2001 Mar;32(3):225-7.
18. Bishagratna op cit ut XL 90
19. ibid 87
20. Bishagratna op cit ut XL 84-86
21. Tuhin Kanti Biswas,Biswapati Mukherjee Plant Medicines of Indian Origin for Wound Healing Activity: A Review The Journal of Lower Extremity Wounds 2003 2, 1, 25—39
22. Ashtanga Hridayam chi IX 25-28
23. Rethinam Sundaresan Devi, Shoba Narayan, Ganapathy Vani, Gastroprotective effect of Terminalia arjuna bark on diclofenac sodium induced gastric ulcer Chemico-Biological InteractionsVolume 167, Issue 1, 5 April 2007, Pages 71-83
24. Ashtanga Hridayam chi IX v 23- 25
25. Bishagratna op cit ut XL 92
26. Cheon JH, Kim JS, Kim JM, Kim N, Jung HC, Song IS (2006) Plant sterol guggulsterone inhibits nuclear factor-kappaB signaling in intestinal epithelial cells by blocking IkappaB kinase and ameliorates acute murine colitis. Inflamm Bowel Dis 12:1152–1161.
27. Avnish K. Upadhyay, Kaushal Kumar, Arvind KumarTinospora cordifolia (Willd.) Hook. f. and Thoms. (Guduchi) – validation of the Ayurvedic pharmacology through experimental and clinical studies Int J Ayurveda Res. 2010 Apr-Jun; 1(2): 112–121.
28. Ram Harsh SinghExploring Quantum Logic in Ayurveda with special reference to Srotovijnana of AyurvedaAyu-Vol.30,No.4(October-December)2009, pp.360-368
29. Yang, S.-K., Loftus, E. V. and Sandborn, W. J. (2001), Epidemiology of inflammatory bowel disease in Asia. Inflammatory Bowel Diseases, 7: 260–270. https://pubmed.ncbi.nlm.nih.gov/11515854/

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.

To stay hydrated, drink plenty of cooling herbal teas of peppermint, chamomile, licorice, fennel and roses. These have a soothing effect on your thermostat and will help to rehydrate you. They don’t have to be drunk piping hot: you can let them cool, bottle them and take them with you if you are out and about. Your aim should be to match your alcohol intake with water.

If you have fair skin or haven’t been in the sun much then build up your tolerance slowly. Some exposure to the sun is a good thing: the sun is a great source of Vitamin D. Cover-up in light cotton and wear a sun hut to protect from burning and dehydration.

At the end of the day use some aloe vera juice directly on your skin. You can make ice cubes from it and then let it luxuriantly melt as it cools you down or just dab the juice on cool from the fridge. Forget all the aloe vera ‘gels’ around. They have minimal aloe vera and are mainly made from water and thickening agents. For a quick and cooling ‘spritz’ mist yourself in rosewater. Roses have long been used for tightening the skin and are used to soothe and cool that prickly heat sensation. You will smell divine too.

Refreshing aloe vera juice at breakfast time to will set you up for a cool day. Green leafy vegetables and colourful vegetables and fruits that flourish in the summer contain phytonutrients that protect against oxidative skin damage from too much sun exposure. After all, in the pursuit of optimum photosynthesis, plants have to protect themselves from intense sun exposure and they develop compounds that act as powerful leaf-guarding antioxidants.

Avoid too many heating foods – often on the menu at festivals. All dark meats (beef, lamb, pork) as well as citrus fruits (except lemons and limes), tomato, raw garlic, raw onion, chillies, excess salt and sour dairy products all increase heat in our bodies.

If you want to superboost your plant-protection then try taking some ginseng or tulsi. They provide all-day festival energy and vitality without exhausting your adrenal glands and influencing the common ‘energy-crash’ often experienced when taking more conventional stimulants and consuming high levels of caffeine.

Build up your energy and stamina a couple of weeks in advance with supportive and energising foods and herbs, so that your body is prepared. And, don’t forget to take them with you to the festival itself so that you have a healthy ‘pick-me-up’ to hand when your need it.

If you feel that your body is in need of a good detox once the festival is over, classic greens such as spirulina and chlorella can help to rid the body of any excesses that you brought back from the fields, whilst also nourishing the liver; the perfect antidotes to a weekend of excess.

The technique of Yoga Nidra is broken into several sections. Initially you rotate your awareness through the parts of the body to remove muscular tensions. Then you focus on your breath aiming to maintain unbroken awareness of a slow breathing pattern. Staying awake while you do this can be difficult and most people find that they will doze at this stage, if not before, especially if they are tired. If you can remain awake you can then go into the deeper parts of your being, developing awareness of mental images and other internal experiences that arise as your awareness becomes subtler. Yoga Nidra can be a deep meditative process.

So Yoga Nidra has two main phases of practice. The first is called the phase of relaxation and recuperation and the second is called the phase of meditation. In the phase of relaxation and recuperation relaxing the muscles and following the breath will remove tensions and exhaustion and enable better sleep. Once you have practiced this for a while and have restored your vitality you will effortlessly go into meditative states that are both empowering and life affirming, and that lead to better mental calm and strength.

For most of us leading busy lives we need Yoga Nidra as a tool to support health and energy. This is the foundation of a good life. A good night’s sleep enables us to engage with and get the most of life.

Modern research has shown that as we age our sleep architecture can be disturbed so that we have less deep cycles of sleep and wake up more often. Though it was once thought that older people needed less sleep it is now known that this is not true.

Regardless of age we all need around 7 to 8 hours of deep sleep per 24-hour cycle. Research has also shown that when healthy adults had a siesta during the day their quality of nighttime sleep improved. Not only did they sleep longer but their quantity and quality of deep sleep also improved. It seems that if you are more relaxed and rested during the day that you sleep better at night.

The ultimate aim of Yoga Nidra is to induce deep relaxation and recuperation of the body-mind that leads to greater self-awareness. As you learn to relax and to direct your attention deeper and deeper into yourself, you can discover who you are and all the great things that lie within you.

There is a great variety of videos and recordings for Yoga Nidra. We are happy to recommend taking a looking at the Yoga Nidra Network website. They offer guidance, resources and free Yoga Nidra recordings in different languages.