By Dr. O. P. Kapoor
It is a great honour and privilege to contribute a foreword to thisexcellent monography on "The Role of Vegetarian Diet in Healthand disease", a publication of the Bombay Hospital Institute ofMedical Sciences. It is one of the first such books written byMedical Professionals of great repute. The book is remarkablycomplete as it deals with the role of a vegetarian Diet in Healthas well as in a very large number of disease conditions, witheach chapter contributed by the medical experts in their fields.Further it is heartening to learn that the vegetarian diet by itselfcan be balanced and complete if scientifically observed. This facthas a great bearing in our country where the poor masses cannotafford expensive non-vegetarian food(Buy now from http://www.drugswell.com).
The preface should be read with care as it emphasises theevolution of the vegetarian diet in our hospitals. It furtherstresses the fact that vegetarianism is gaining great popularity inthe western countries where such trends are adopted afterprolonged observation supported by extensive research.
It is also gratifying to note that contributions are made by themembers of the medical faculty of the Bombay Hospital andMedical Research Centre as well as outstanding scholars fromother hospitals and abroad. I have no doubt that this volume willnot only be beneficial to the public but would also be appreciatedby the members of the medical profession. Since primarily thebook is published for the general public, the simple language inwhich most of the chapters are written makes the contents easilyassimilable and the book easy to read
To my knowledge, this book is the first of its kind to be compiledby medical experts and I have no doubt that it will serve topromote the cause of vegetarianism in our country and abroad.
. "You are what you eat" is an age old adage—and it is a fact thatit is food(Buy now from http://www.drugswell.com) that maketh a man. The food(Buy now from http://www.drugswell.com) we eat, its quality,quantity, its timing and combinations is proven time and again tobe of utmost importance in Health as well as in Disease.
At the Bombay Hospital we have been serving vegetarian food from the inception of this institution and now we feel that the time has come to offer scientific justification for this. Not only on religious or moral grounds is this justifiable, but also on scientific grounds vegetarian food(Buy now from http://www.drugswell.com) seems the more suitable diet for human beings. More scientific work has been done on vegetarianism in the last two decades than in the entire previous history of the world. Therefore, we felt that we should take the lead and bring to the fore all that there is to know on vegetarianism from the scientific angle and thereby justity the use of vegetarianism in health and in disease.
There is a myth amongst people that consumption of meat wouldmake them strong. It is also commonly believed thatnonvegetarian food(Buy now from http://www.drugswell.com) has more nutritive value. It is significant andembarrassing to note, that while in U.S.A. nearly 10 millionpeople have adopted vegetarianism and more and more peoplein U.K., U.S.S.R., West Germany, Japan, Switzerland, Israel andMexico are gradually turning to vegetarian diet not only onhumanitarian grounds but more so on medical grounds, in Indiamany vegetarians have started eating meat and eggs only on"wrong" beliefs of the supposedly good qualities ofnonvegetarian diet.
There are many books written for lay public on vegetarianismbased on cruelty to animals, spirituality, cultural andphilosophical values, economic, ecological, anthropological andhumanitarian grounds. This book is being written by a team ofspecialists from various faculties of our institute and from otherinstitutes in Bombay and abroad. Here they discuss and showthat from the medical point of view the vegetarian diet is as goodor is more suited to the human system than a nonvegetariandiet. Unlike other books written on vegetarianism which showthat non-vegetarian food(Buy now from http://www.drugswell.com) is bad for health, we have tried toprove, with medical evidence that vegetarian food(Buy now from http://www.drugswell.com) is as nutritiousor superior in some cases, to non-vegetarian food(Buy now from http://www.drugswell.com).
If only this publication can remove the bias from the minds of thepublic; if only they could be convinced that they could not onlylive longer with vegetarian diet, but also not suffer from manycrippling diseases, we would feel that we have been amply
rewarded.
Since this book is a joint effort of many scientists it has beendifficult to prevent the overlap of views. In fact, at times,repetitions have intentionally been retained to maintain theindividual readability of the chapter. To give this scientificpublication a well rounded look, chapters on growth, immunityand microbiology have been included. Immunology for thegeneral physician is, at best, complicated and so it is for the layperson. Hence the chapter on Immunity and Vegetarian Diet maymake heavy reading. Similarly the chapter on microbiology hasbeen written only to emphasize the fact that the kind of food(Buy now from http://www.drugswell.com) weeat decides the kind of bacteria that are present within us. Factsof their functions are pouring in every day and their realimportance will be evident to us very soon.
Religion or spiritualism are not the field of doctors. But the Indianpublic should be enlightened about the good qualities ofVegetarian diet which are the high fibre content, low cholesterolcontent and low incidence of zoonotic disorders. Also, there is strong evidence that vegetarians are at a lesser risk foralcoholism.
In this monograph we have reproduced a few articles from 'TheBombay Hospital Journal' which is the regular scientificpublication of Bombay Hospital Institute of Medical Sciences.
Vegetarianism can be divided into vegetarian, lacto-vegetarianand lacto-ovo-vegetarian diets. In this book lacto-vegetarian diethas been accepted as the Indian vegetarian diet. Similarly, manypeople, who eat fish, chicken and meat also eat vegetabies,fruits and cereals. Thus, really speaking scientifically they shouldbe labelled as 'Omnivorous'. Instead for them, we have in this book used the colloquial term 'non-vegetarian'. The debate iswide open but it seems from the facts presented herein that thescales are tipped heavily in favour of vegetarianism.
. • Dr. B.K. Goyal, Dean of the Bombay Hospital Institute ofMedical Sciences for being a constant source ofinspiration to us.
Hospital, who has been a constant source of guidance inthe Editorial Committee. And all the contributors to this monograph who have helped to gather information onVegetarianism under 'one roof'.
Editor
Assistant Editor
. The health of an individual depends on his nutrition. It is this well-known fact that has led man to be more aware of the food(Buy now from http://www.drugswell.com) he consumes. A large number of diseases are known to be dietrelated. A certain diet may itself be the cause of disease or alterthe course of a known disorder such as diabetes or kidneydisease.
The food(Buy now from http://www.drugswell.com) consumed by any individual or a community is determined by a number of factors viz. socio-economic status, religion, food(Buy now from http://www.drugswell.com) availability and family traditions. Medical factors like food(Buy now from http://www.drugswell.com) allergy, intolerance, diabetes and heart disease sometimes force a change in diet.
Diet patterns may be classified broadly as vegetarian or nonvegetarian. Vegetarians can be further classified, depending
on the food(Buy now from http://www.drugswell.com) consumed, into fruitarians, vegans, lacto-vegetariansand lacto-ovo-vegetarians. The term vegetarian is generally usedto refer to the lactovegetarian. The basic difference between thevegetarian and the non-vegetarian diet is the exclusion orinclusion of eggs, fish, meat and poultry.
The difference in the nutritive value of the diets is dependent onthe nutritive value of these food(Buy now from http://www.drugswell.com)s. In general, the food(Buy now from http://www.drugswell.com)sconsidered as non-vegetarian are high in protein and fat, low infibre and are poor sources of carbohydrates, whereas vegetarianfood(Buy now from http://www.drugswell.com)s are rich in fibre, carbohydrate, vitamins, minerals and canbe adequate in fat and protein as well. These differences in thenutritive value have given rise to the question - which diet issuperior?
All food(Buy now from http://www.drugswell.com)s of animal origin are said to contain proteins of highbiological value, viz. proteins that may be better utilized by thebody. Proteins consist of amino acids, some of which can besynthetized by the body while some cannot. Amino acids that arenot synthesized by the body are referred to as essential aminoacids. Non-vegetarian food(Buy now from http://www.drugswell.com)s contain all the essential amino acidsunlike any single vegetarian protein source(except milk).However, all the essential amino acids can easily be obtained in avegetarian meal by the judicious combinations of various food(Buy now from http://www.drugswell.com)s.
That a vegetarian diet is deficient in vitamin B12 is another boneof contention. Though most sources of vegetarian food(Buy now from http://www.drugswell.com) are low intheir vitamin B12 content, there are never any manifestdeficiencies of this vitamin even in strict vegans. It is thereforelikely that vitamin B12 is required in very minute quantities.Hence B12 cannot be the justification for resorting to food(Buy now from http://www.drugswell.com)s ofanimal origin.
It is widely believed that a vegetarian diet cannot provideadequate calories, but it is untrue. Balanced vegetarian diet cangive adequate calories quite easily.
food(Buy now from http://www.drugswell.com) may be divided into groups on the basis of the nutrientsupplied:
The main difference in the vegetarian and the non-vegetarianfood(Buy now from http://www.drugswell.com)s is the quantity and quality of proteins available in both. Thenon-vegetarian food(Buy now from http://www.drugswell.com) is said to be rich in proteins but asmentioned earlier, vegetarian sources can supply the same ifjudiciously combined. Hence when a vegetarian seeks protein he has to focus his attention on pulses, nuts and milk.
Pulses, the seeds of the leguminosae family are the main sourceof protein in a vegetarian diet. The major portion of the pulsecultivated is consumed after being dehusked and decorticated.This process not only shortens cooking time but also makes themmore easily digestible. Whole pulses are best consumed afterbeing soaked and sprouted. These sprouts have a high dietaryfibre. Being live food(Buy now from http://www.drugswell.com)s, they have the capacity and potential tocreate and generate new life.
Seeds, grains, beans and even nuts can be sprouted. Sproutedfood(Buy now from http://www.drugswell.com) is easily accepted, digested and assimilated. Sprouting alsogives a tremendous boost to the vitamin and enzyme content. Infact, in growing children, where extra proteins and vitamins areneeded, lightly steamed sprouts are the best choice of food(Buy now from http://www.drugswell.com). Abiogenic diet includes fruits, fresh vegetables, whole grains, nuts,beans and seeds which contain life-generating and cell renewalcapacities for youth and life.
Sprouts (see fig. alongside) are livingplant life, easily digested andinvigorating in their effects.
This group supplies 350 cats/ 100 gms and has a protein contentof 20 % with the exception of soyabean (40%). To ensure the bestutilization of this protein the first criterion is to meet the energyrequirement. If the diet is deficient in calories the protein is usedto make up this deficiency.
Proteins are made up of units called amino acids. The quality of aprotein is dependent on the amount of essential amino acidsavailable from it. A protein that has all the essential amino acidsin the desirable amount is said to be of the best quality. Non-vegetarian sources of protein are complete in their amino acidcontents whereas vegetarian sources of protein are not ascomplete. However, the combination of two food(Buy now from http://www.drugswell.com) substancesmore than makes up for individual deficiencies e.g. pulses aredeficient in sulphur containing aminoacids whereas cereals are rich in sulphur containing amino acids. This makes a cerealpulsecombination a complete source of protein. Hence it is a mistakenbelief that non-vegetarian food(Buy now from http://www.drugswell.com) is essential to provide adequateproteins for growth and development.
Looking into any of the traditional vegetarian meals of India wesee that this is a practice that has been followed since ages. Notonly is every meal a cereal-pulse combination, but in most cases,is accompanied by a complete protein source (milk or any of itsproducts). The traditional idli-sambar, varan-bhat, thepla-dahi aresome of the many examples of cereal-pulse, cereal-milkcombinations.
Pulses have a carbohydrate content of 60%, most of which is in acomplex form. Certain oligosaccharides present in pulses escapedigestion and are responsible for flatulence in a few susceptibleindividuals. Common home processing methods like sproutingand germinating decrease the amount of flatulence producingoligosaccharides. Garlic is a bacteriostatic agent and aids indecreasing flatulence.
Fat
The fat present in pulses has a higher polyunsaturated fatty acidcontent (1.5%). This makes pulses not only qualitatively but alsoquantitatively better than meat.
The minerals present in pulses are calcium, phosphorus,magnesium, sodium, potassium and iron. Of the phosphoruspresent, 80% is bound to phytate and is biologically unavailable.Soaking of pulses in water before preparation decreases some ofthe bound phytate, thus increasing the amount of availableminerals.
The thiamine and carotene content of pulses is similar to that ofcereals. Pulses are rich in niacin but devoid of vitamin C and poorin riboflavin. Once sprouted, pulses are excellent source ofvitamin A, B complex, C, D and K.
Sprouting dramatically increases the vitamin C content of thefood(Buy now from http://www.drugswell.com). The vitamin E content of sprouted wheat increases 300% infour days. So much so, that because of the excess of vitamin Econtent, sprouted food(Buy now from http://www.drugswell.com) administrated to patients of submucosalfibrosis of the mouth over two to three years, halts the progressof the disease and in some cases can cause actual regression.
The vitamin C content also increases 600%. There is more carotene in sprouted wheat than in a carrot.
The edible pulses contain two thermolabile factors that have beenimplicated in toxic effects. They are the trypsin inhibitors andhaemagglutinins. The trypsin inhibitors suppress the release ofamino acids making it unavailable and may also stimulate extraproduction of trypsin which leads to a loss of pancreatic activity.Sprouting of legumes causes a loss of this inhibitor and, if stillpresent, it is then more susceptible to destruction by heat.Haemagglutinin present in pulses may combine with haem andresult in destruction of haemoglobin. This constituent of pulse isgenerally not absorbed and is destroyed by cooking.Fermentation and sprouting help to speed up this destruction.
Maximum utilization of pulses is thus obtained if the diet isadequate in calories and the whole pulses are soaked andsprouted prior to cooking. Soda, often added to pulses whilecooking, decreases cooking time but also decreases the nutrientsand is therefore best avoided.
MILK
Milk is considered as a perfect food(Buy now from http://www.drugswell.com) because itconstitutes the entire diet for the young of allmammals. Milk has a protein of excellent quality(second to that of an egg).The efficiency with which itis converted to bodyprotein is second best tothat of an egg
The quantitativecomposition of milk varieswith breed, season, stageof lactation etc. Fat is the most variable constituent, with protein following. Thecomposition of the milk ofa mammal is best for the young of that mammal.The milk having the closestsimilarity to that of humanmilk, with regards tocomposition, is that ofgoats, followed by that ofcows (refer fig alongside)
The main protein of milk is casein (80%), the rest is lactalbuminand lactaglobulin which are the whey proteins. Most of the caseinis bound to calcium. Casein is easily coagulated by acid or byenzyme renin while the other proteins are not. The milk proteincontains all the essential amino acids and has a high digestibilityco-efficient (97 - 98%).
Fat
Milk fat is also called butter fat and is characterised by thepresence of short chain saturated fatty acids. The fat content ofmilk is variable (3 - 5%) and is present as an emulsion making iteasily digestible.
Lactose is the carbohydrate in milk which is broken down by theenzyme lactase. An absence or insufficiency of lactase causesmicro-organisms to act on lactose leading to the formation ofgases and thus the cramping discomfort and diarrhoea in 'lactoseintolerence'. The lactose content of the milk can be decreased byfermenting milk to form yogurt (curd) where the amount of lacticacid is higher. The lactose content of milk is 5%.
The minerals present in milk are sodium, phosphorus, sulphur,magnesium, manganese, calcium and iron. Calcium is bound tophosphate which, with casein, forms a phosphoprotein. It is alsopresent with fat. The quantity of iron is low in milk, but is of anexcellent quality resulting in its ready absorption.
Vitamin A - carotene present gives the milk yellowish tinge andis obtained from plant feed. The amount varies with the breed,the amount present in the feed and the fat content of milk.
Vitamin D, E & K - These nutrients are present in smallamounts. As they are fat soluble, they are associated with the fatcontent of the milk. The skimmed milk has an even smaller amount of these vitamins.
Thiamine - This nutrient is also dependent on the amountpresent in the feed but it is also synthetized by the lumen of thegut of the cow and is therefore present in fair amounts in cow'smilk.
Riboflavin - The colour of the whey is due to the presence of this nutrient. It is present in very small amount (0.05 -0.1%) and isdependent on the amount present in the feed.
Niacin - Milk is a good source of tryptophane which is a precursorof niacin.
Vitamin C - This vitamin is easily destroyed by application ofheat and exposure to air. The small amount present in the milk isdestroyed during pasteurisation.
Milk is a food(Buy now from http://www.drugswell.com) that is highly perishable. Thus processing it willhelp to store it. Spray drying of the milk to powder or condensingit are some examples. Processing, in most cases, involves hightemperatures and this destroys some of the nutritive value. Thisloss can be overcome by fortification.
There are a number of dairy products and these may be classifiedinto 'fermented' & 'unfermented'. The most common in India is dahi (curd). This has a better nutritive value, not due to anincrease in nutrients but an increase in digestibility. Fermentationincreases the vitamin content and lactose is converted to lactic acid. The calcium and phosphorus of curd are more easilyassimilated.
Nuts, which are the seeds of fruits, contain nutrients to aid in the growth of anew plant. This is why allnuts are not only a goodsource of nutrients quantitatively but alsoqualitatively. Nuts areclassified, depending ontheir nutrient content (protein, fats andcarbohydrates). The nutswith a high fat content, inmost cases, are also highin protein, and this groupincludes most of the nuts. Those high incarbohydrate are few e.g.chestnut. On an average,nuts are found to contain 50% of fat and 25% of protein. Nuts are a richsource of essential fattyacids. This group of food(Buy now from http://www.drugswell.com)thus supplies not onlycalories but also, weight for weight, twice as muchprotein as any other food(Buy now from http://www.drugswell.com)crop (fig.2). Nuts are agood source of vitamin Bcomplex in particular.Groundnuts are rich in thiamine and nicotinic acid. They have a mineralcontent of 2%, a largefraction of it beingphosphorus andpotassium.
The most common complaint regarding nuts is indigestion. This,in a majority of the cases, is due to over-indulgence and poormastication, both of which we can easily rectify. In order to getthe maximum utilization, nuts must be consumed in limited amount. Nuts may also be soaked overnight. Humidity andunhygienic storage conditions cause food(Buy now from http://www.drugswell.com) to get easilycontaminated with fungi. Groundnuts are prone to suchinfestation which produces aflatoxin. This toxin causes damage tothe liver and can be avoided by proper storage.
Nuts are consumed in various forms. They may be had fresh,dried, dehydrated or roasted. Nuts are used for oil extraction.
The meal left after the extraction of oil from nuts is rich in protein. Nuts are most often considered to be expensive and outof the common man's reach. Comparing the cost of almonds andcashewnuts per kg with that of eggs and meat, the cost of 10gms of protein is similar, if not less, in the case of nuts.
Coconuts are botanically stone fruits and not nuts as they aretermed. This stone fruit is largely used for oil extraction and it isthus classified as an oilseed.
This fruit is consumed at different stages of maturity and itsnutritive value varies accordingly.
Tender Coconut: The most tender coconut contains only a liquidin it and no kernel meal. The tender coconut water is a common food(Buy now from http://www.drugswell.com) in the sick room and this drink has the advantage of beingsterile. This drink is a good source of electrolytes. As this-fruitmatures the amount of water decreases and the amount of meal increases. The thin initial layer of meal has a high percentage ofwater and so is not a dense source of nutrients, this is one of the reasons that makes it an easily digestible food(Buy now from http://www.drugswell.com).
Ripe Coconut: The thick layer of kernel is much lower inmoisture and high in calories. The coconut kernel is high in oilcontent and is used for oil extraction. The coconut oil has a high percentage of medium chain triglycerides (M.C.T.). This M.C.T. isof great therapeutic value when other forms of fat are nottolerated. Another byproduct is the coconut milk which isobtained from the endosperm. This is grated, ground andsqueezed to expel milk. The endosperm on grating can be airdried to reduce its moisture content to less than 2% to obtain the dessicated coconut. This is commonly used for the preparation ofsweets and biscuits.
Nutritive Value of The Coconut at Different Stages of
Coconut Tender Coconut
Fresh Dry
Water Coconut Milk
Moisture (%) 93.8 90.8 42.8 36.3 4.3
C alories 24 41 430 444 662
Protein (gms) 1.4 0.9 3.4 4.5 6.8
Fat (gms) 0.1 1.4 41 41.6 62.3
Carbohydrate (gms) 4.4 6.3 11.9 13 18.4
Dry Coconut: This is the coconut at its maximum degree ofmaturity and thus with the lowest percentage of moisture. At thisstage the coconut has only 4.3% of moisture as compared to thetender coconut that has 90.8%. This is also the most concentrated form of nutrients. It supplies 6.8 gms of proteinsand 62.3 gms of fat per 100 gms.
The above discussion on the nutritive value of pulses, nuts, milk and coconut makes it clear that the nutrients supplied by a non- vegetarian diet can be obtained from a vegetarian meal. All this calls for is an intelligent combination of the food(Buy now from http://www.drugswell.com)s permitted. The vegetarian sources of protein are low in saturated fat and thus have an advantage over protein obtained from meats.
Thus a vegetarian meal that is well balanced can be as nutritious, if not more, than a non-vegetarian meal.
. 'Heart attacks', which have become so common, occur due to involvement of coronary arteries, which carry the blood supply tothe heart. An 'attack' results when one of the coronary arteriessuddenly gets blocked and causes death of the muscle tissue ofthe heart supplied by that artery. This is clinically known as an'attack' of myocardial infarction.
Why do coronary arteries get blocked ? There are two reasonswhich have been detected on post-mortem examination:
I. Blockage due to gradual narrowing of these arteries as a resultof a degenerative disease known as atherosclerosis. Even asearly as fifty to sixty years ago this atheroma was seen only inold people and was synonymous with the aging process. As thecivilization has progressed, the time has come when thepostmortems done on young children and young adults who havedied due to accidents or other causes, have been showingatherosclerosis of the coronary arteries. Smoking, presence oflong standing diabetes and high blood pressure, overweight andsedentary life are some of the known causes. However, the mostimportant single biochemical abnormality which can be spottedand correlated with atheroma is the level of blood cholesterol. In the last few years the whole family of blood lipids has come tolight. This consists of triglycerides, HDL and LDL cholesterol anda variety of apolipoproteins. It has been found that if the diet isrich in saturated fatty acids as in the case of non-vegetariandiets, the blood fat levels become highly abnormal and theprocess of atherosclerosis starts right from childhood. So strikingwas this association, that ten years back in the Westerncountries, the public was warned through the television and radiomedia, that their children should not be given more than twoeggs per week. In fact such sensational discoveries have ledmany people in the West to take to vegetarianism.
Vegetarians have low intakes of total fat, saturated fatty acidsand cholesterol. Their intake of polyunsaturates is equal orslightly higher and dietary fibre intake is usually much higherthan w that of nonvegetarians. Some evidence exists that proteinor dietary fibre in vegetarians may be involved in reducingcoronary heart disease. The type and amount of dietary fat andcholesterol are most strongly associated with changes in serumlipids, apolipoproteins and blood rheology, all of which are thecauses of coronary heart disease and heart attacks and arediscussed below:
Cholesterol circulates in the blood in two forms. The high densitylipoprotein (HDL) cholesterol is protective for the heart andreduces the risk of coronary artery disease. As against this thelow density lipoprotein (LDL) cholesterol increases the risk ofcoronary artery disease. The blood cholesterol levels are affectedby the type of dietary fat and the amount of cholesterol presentin it, alcohol, smoking and physical activity. The consumption ofhigh saturated fatty acids (as in ghee and coconut oil) andcholesterol increases the LDL cholesterol levels. On the other hand the consumption of polyunsaturated fatty acids lower thelevels of LDL cholesterol and not only that, they also increaseHDL cholesterol levels thereby protecting the patients fromcoronary artery disease.
Apo-lipoprotein levels may be better than serum lipid levels forpredicting the risk of coronary heart disease. Table 1 shows thatin most but not in all studies, lipid-modified vegetarian dietswere found to change levels of apolipoprotein as well aslipoprotein composition and levels.
II. The second reason for sudden blocking of the coronaryarteries is the occurrence of a blood clot in an otherwise clean blood vessel. This type of blockage is specially seen in youngpeople dying of heart attacks. Although there are a number ofconstituents in the blood responsible for this clotting, the role ofplatelets in blood seems to be outstanding.
Table I
Studies of Vegetarians and Coronar y Artery Disease
| Outcome Vanable | Study or Observations |
| Mortality from coronary arterydisease | Negative association betweenvegetarianism and ischemic heart diseasemortality, even after removing confoundingeffects of smoking, especially in males.35-64-y-old Seventh-day Adventistvegetarian men had lower mortality thandid nonvegetarians although in men over 65and women differences were significant,even after taking smoking into account. |
| Serum cholesterol levels: comparisons ofvegetarians andnonvegetarians | Total serum cholesterol, low-densitylipoprotein cholesterol, and to a lesserextent high-density-lipoprotein cholesterolsare lower in vegetarians and especiallyvegans compared with lactovegetarians oromnivores. |
| Vegetarian diets usually produce a selectivelowering of LDL levels, with lowered totalcholesterol: LDL or LDL:HDL ratios. | |
| Serum cholesterol levels | Groups such as Macrobiotics and HareKrishnas with members eating vegan orvery restrictive vegetarian diets low in fat,high in polyunsaturated: saturated fattyacid ratios, high in dietaty fiber, and low incholesterol show decreased total |
| cholesterol and LDL cholesterol than do | |
| omnivores. | |
| Vegetarians' LDL cholesterol levels areusually decreased but HDL cholesterollevels vary, some being higher than thoseof nonvegetarians, some lower. |
Serum cholesterol levels: feedingvegetariansanimal food(Buy now from http://www.drugswell.com)s
Serum cholesterol levels: feedingvegetariansanimal food(Buy now from http://www.drugswell.com)s
Serum cholesterol levels: feedingnonvegetariansvegetarian diets
Apoprotein levels
Platelet levels
Feeding vegetarians beef, which is high intotal fat and saturated fatty acids andcholesterol, causes 19% increases in total plasma cholesterol because of increase inLDL cholesterol whereas HDL cholesterol levels stay constant over a 2-wk periodFeeding lactovegetarians eggs for 3 wks,which increases dietary cholesterol,increases total and plasma cholesterol.
Decreasing the amount and altering type offat in Seventh-day Adventist vegetarians'diets further decreases serum lipid levels.
Nonvegetarians have decreased totalcholesterol and LDL and HDL cholesterols when they are fed vegetarian diets low intotal fat, saturated fatty acids, cholesterolprotein, and high polyunsaturated fattyacids, P: S ratios carbohydrate, and dietaryfiber for several months, Decreases are onlyone-third of those observed in lifelongvegetarlans.Normolipidemic nonvegetarians fed a low-fat, semivegetarian diet for 3 mo havedecreased total cholesterol, LDL cholesterol, and LDL: HDL ratios whereas HDL levels, weights, and plasma triglycerides stay constant.
Nonvegetarians fed vegetarian diets exhibitdeclines in apoprotein Al levels when diet islow in total fat, saturated fatty acids, andcholesterol and moderate in polyunsaturates .Vegetarians on low fat, total fat, andsaturated fatty acid diets show decreasedapoprotein AI and B levels and elevatedHDL cholesterol apoprotein Al and HDL: LDLcholesterol ratios increased. Addition of eggs high in cholesterol to thediet of lactovegetarians increasesapolipoprotein B levels in 3 wk.Lactovegetarian diets fed to nonvegetariansfor 6 wk led to no changes in apoprotein Blevels although apoprotein B: totalcholesterol and apoprotein B:LDLcholesterol ratios increased.
Lactovegetarians have altered plateletlinoleic and arachidonic acid concentrations in comparison with nonvegetarians. Vegansand vegetarians do not differ in serumthromboxane or prostacyclin levels orplatelet aggregation .
Nonvegetarians show changes in plateletfunction when saturated fatty acids aredecreased and P: S ratios are increased platelet aggregation to thromboxane andclot ting activity of platelets is decreasedand response to adenosine diphosphateaggregation is enhanced.Saturated fatty acids increase thrombinaggregation and platelet function can bedecreased by altering diets.
Platelets are important in clotting and in the development of thearterial thrombi that underlie most 'heart attacks' due to acute myocardial infarctions. They may also modulate coronary arterydisease independently of factors such as smoking, bloodpressure and genetics. Platelet composition and functionalchanges can be induced by dietary fat modifications. Saturatedfatty acids are most highly associated with the changes inplatelet aggregation to thrombin and platelet clotting activity.One of the theories is that, by decreasing saturated fatty acids asin the vegetarian diet, platelet aggregation and blood clottingchanges predisposing to thrombosis will decrease.
Also clotting of a blood vessel depends on the blood fluidityknown as "Blood Rheology". Possibly vegetarians have a betterthan average blood fluidity and this puts them at a lower risk ofsuffering coronary artery disease.
Finally in vegetarians, factors other than the diet may also beinvolved in lowering the risk of heart disease. These include i)the nonsmoking and the non-alcoholic status of vegetarians,which may affect HDL-cholesterol levels, ii) their physically activelives, which may favourably alter apo-lipoproteins as well as HDLcholesterol, iii) their relatively low weights, which may decreaserisks of hypertension and non-insulin dependent diabetes.
It is also worth noting that the reduction in risks of coronaryheart disease seem to be associated with the type of vegetariandiet that is followed rather than some genetic protective effect ofvegetarianism per se.
The fact that mortality and morbidity from coronary arterydisease is lower in vegetarians than in non-vegetarians has alsobeen confirmed at the Bombay Hospital.
Although this hospital caters to all the communities the patientsare strictly provided with vegetarian diet only. The studies are inprogress at the Bombay Hospital Institute of Medical Sciences togo into the dietary causes of coronary artery disease and ourinitial data from these studies shows that out of the last hundred coronary heart disease patients, only thirty six patients werevegetarians.
Are there any special substances in the vegetarian diet whichgive protection against coronary heart disease? In India a lot ofwork has already been done on the role of garlic and onion inlowering blood cholesterol. Maize bran has also been shown tohave a protective effect on the cardiovascular status. Many othervegetarian food(Buy now from http://www.drugswell.com)s, protective to the heart, have been discussed inanother chapter.
Hence it seems evident, that vegetarianism offers definiteprotection from coronary heart disease.
. That man is a vegetarian animal is amply exemplified by his basicanatomy. Unlike carnivorous animals, man has teeth suited for bitingand grinding and not for tearing. The intestines of man are longer ascompared to their carnivorous counterparts. These are but the mostbasic of differences that exist between vegetarian and non-vegetarian'animals'.
The digestive tract of man starts in the mouth. The lips, the teeth andthe tongue play an important role in the mastication and the softening ofthe food(Buy now from http://www.drugswell.com). Digestion commences in the mouth with the help of the saliva.The food(Buy now from http://www.drugswell.com), after due mastication is swallowed whence it enters the oesophagus (or food(Buy now from http://www.drugswell.com) pipe). The food(Buy now from http://www.drugswell.com) pipe empties into the stomach. Thefood(Buy now from http://www.drugswell.com) in the stomach is acted upon by gastric acid and enzymes whichhelp in digesting the food(Buy now from http://www.drugswell.com) to its more basic constituents. The continuouschurning of the stomach further helps in breaking down the food(Buy now from http://www.drugswell.com). Fromthe stomach the food(Buy now from http://www.drugswell.com) enters the intestines which are the longest part ofthe gastro-intestinal tract. Here various enzymes complete the digestiveprocesses and absorption of the various elements of the food(Buy now from http://www.drugswell.com) begins.What is undigested and unabsorbed enters the colon (large intestine).Here the faeces are formed which are gradually taken upto the rectumand anal canal and egested at periodic intervals (Refer figs. I and 2below for anatomical topography) .
Fig. 1 Fig. 2
Let us now consider the advantages of a vegetarian diet in relation toeach of the parts of the gastro-intestinal tract.
5.
The intestines are the home of manyparasites. The longest of them—taeniasaginata and taenia solium (Fig alongside) arefound almost exclusively in non-vegetarians,especially in those who eat beef and pork.These worms are almost never found in vegetarians.
The larger undigestible matter present in fruits and vegetables providesbulk which enhances the forward passage of undigested waste matterfrom the caecum to the rectum and anal canal. It also reduces the transit time from caecum to rectum. This prevents stasis of poisonous end-products of digestion and resulting diseases of the colon. Thus, whilenon-vegetarians pass small stools (on an average 100 gm), thevegetarians pass large bulky stools (on an average 300 gm). Alsovegetarians pass less foul smelling stools. A few years ago, in my bookon 'Common Chronic Disease Patterns in the Arabian Gulf, Saudi Arabia and Yemen', I mentioned that constipation is extremely common in theArab popula tion. It has been noticed time and again that when thesepatients are given more vegetables and fruits (in addition to plenty ofwater to drink), their bowels move freely and they are relieved of theirconstipation.
In elderly subjects the incidence ofconstipation increases markedly due tothe development of the above condition.Fig. alongside shows the small poucheslooking like pseudopodia which appearon different sides of the colon. Not onlydo these pouches make the colon verysluggish, but they can get inflamed likethe appendix or can bleed like an ulcer.The modern refined and non-vegetariandiet is responsible for this disease. Thereduced faecal bulk causes narrowing ofthe colonic lumen and an increase in intraluminal pressure. This results inprotrusion of these pouches known asdiverticula. Diverticula may also developdue to the attempts of the proximalcolon to overcome obstruction caused by the segmented and narrowed distalcolon. Owing to the high fibre content ofthe vegetarian food(Buy now from http://www.drugswell.com), this disease isinfrequent in a vegetarian population.
This illness is the most common cause of bowel irregularities and colonicgripes. Incidentally it is less frequent in vegetarians owing to the highfibre content of such a diet.
Unlike amoebiasis and giardiasis which are easily treated with drugs,ulcerative colitis is a 'lifelong bloody dysentery'. The incidence of thisdisease is much less in vegetarians because of the high fibre content.
It has been proved all over the world that the incidence of the cancer ofthe colon is very low in vegetarians. It is postulated that the high fibrecontent of pulses, cereals, vegetables and fruits increases the amount offaeces and reduces the transit time through the colon. As mentionedearlier, the latter reduces the exposure to carcinogens responsible forthe development of the cancer of the colon. These substances includetryptophane, tyrosine, methionine, basic amino acids, cholesterol andbile acids. The bile acids are the most important carcinogens. A numberof epiderniological studies have shown and several authors have found asignificant relationship between the faecal bile acid concentration andcolonic cancer.
8. Rectum and anal canal—The diseases of the terminal end of the gastrointestinal tract e.g. fissure and piles are abundant in thenormal population. In fact, the incidence of these diseases ishighest in the Arab population as described by me in my book on Arab diseases. The fact is that both are related to underlyingsevere constipation. The straining done to expel the hard stoolsfrom the rectum and anal canal, "keeps up" the piles and thefissures. In the medical world, it is a very common observation that thesediseases are much less common in vegetarians. This seems to berelated to the low incidence of constipation amongst vegetarians.
9.
The liver and the gallbladder are alsoaffected by the vegetarian diet. Fig.alongside shows the presence of stonesin the gall-bladder which can occur in asmuch as 10% of the population abovethe age of 70 years. It is interesting tonote that the incidence of gall-stones invegetarians is significantly less. The highfibre content of the vegetarian dietcauses reduced deoxycholate absorptionwhich in turn increases the synthesis ofchenodeoxycholate. The latter affectsthe cholesterol saturation of the bile resulting in less stone formation. In factpatients having gall-stones areprescribed high fibre vegetarian diets inorder to reduce further gall-stoneformation.
10.
Liver is discussed in a separate chapter.
11. Pancreas—Pancreatic malignancies are known to be less commonin vegetarians.
All-in-all it appears that vegetarian food(Buy now from http://www.drugswell.com) is beneficial in prevention aswell as in the management of most of the gastro-intestinal diseases.
. In order to evaluate the role of vegetarianism in diabetes we shallreview the current dietary recommendations in diabetes. We shallfurther examine the suitability of vegetarian food(Buy now from http://www.drugswell.com)s in composing suchdiets.
Diets prescribed for diabetics have gone through remarkable changesin the insulin era, post-insulin era, and most importantly in the lasttwo decades. Diets in the pre-insulin era consisted of a very lowcarbohydrate content. In insulin-dependent diabetics, thecarbohydrate content was reduced to 10-20 gm/day. Thus, in order toprovide the requisite amount of calories the fat content of the diethad to be proportionately increased. Such diets were highlyunpalatable. Diabetic diets in the post-insulin era derived 40%, 20%and 40% of their calories from carbohydrates, proteins and fatsrespectively. This has further changed in the past two decades. Thepresent day diabetic diets derive 50 - 60% of their calories fromcarbohydrates and proportionately reduced amount of calories fromfats (Table 1). Diets in India, where vegetarianism is practisedextensively, have always been high in carbohydrates and low in fats.
Nutrients
Starch & Sugar
Total
Other & Protei Alcoho
Diet Carbohydrat Fat
polysacharid Dextrin n l
es
es s
| 36 | ||||||
|---|---|---|---|---|---|---|
| Normal | 45 | |||||
| Western diets in | 25-35 | 20-30 | 45-50 | p/s*ratio | 12-19 | 0-10 |
| the Past | abou | |||||
| t 0.3 | ||||||
| Tradition | ||||||
| al Diabetic | 25-30 | 10-15 | 35-40 | 4045 | 16-21 | 0 |
| Diets | ||||||
| Newer | ||||||
| diabetic diets in Western | 30-40 | 5-15 | 45-55 | 2535 | 12-24 | 0-6 |
| countries | ||||||
| Diabetic | 50-55 | 5-15 | 60-65 | 20 | 15 | 0-5 |
| Diets in | 25 | |||||
| India | p/s | |||||
ratio abou t1 or mor e
* p/s: is the total intake of polyunsaturated fat divided by the intakeof saturated fat.
Currently prescribed diabetic diets are high carbohydrate, high fibre,low fat diets. The amount of saturated fats is usually half of the totalfat intake. We shall examine how an optimal diabetic diet can bederived from vegetarian sources.
High Carbohydrate Diet
Traditionally, diabetes mellitus has been treated with a lowcarbohydrate diet because of the misconception that carbohydrateswill cause an increase in the blood glucose levels. As early as 1935, itwas reported that carbohydrate tolerance in healthy adults wasimproved by an increase in the proportion of carbohydrate in the diet.By 1960, it was appreciated that rural Africans eating a traditionalhigh carbohydrate diet had low fasting blood glucose levels andreduced plasma insulin responses to glucose loads as compared witha matched group of whites. Although all dietary carbohydratesprovide the same amount of energy (as measured by kilocalories),they are not all handled with equal efficiency by the body.
Initially, it was assumed that the blood glucose responses (glycaemicresponses) after ingestion of various carbohydrate food(Buy now from http://www.drugswell.com)s are directlycorrelated with their carbohydrate content. However, it was clearlydisproved by Dr. David Jenkins and co-workers at the University ofToronto who introduced the concept of the glycaemic index:
Glycaemic Index= 100 * (Blood glucose rises after ingestion of food(Buy now from http://www.drugswell.com)under study) / (Blood glucose rise after ingestion of equivalentamount of standard carbohydrate glucose.)
The blood glucose response to various food(Buy now from http://www.drugswell.com)s of similar carbohydratecontent varies widely (Table 2). These variations are attributed to thevariable quantity and quality of fibre contained in these food(Buy now from http://www.drugswell.com)s. Solublefibre tends to lower the glycaemic index more effectively thaninsoluble fibre.
Table 2 Glycaemic Indices of Selected food(Buy now from http://www.drugswell.com)s
100 Glucose %
Comflakes, carrots, maltose, honey 80
90%
| Bread (whole meal), millet, rice (white), broad beans (fresh),potato (new) | 7079% |
| Bread (white), rice (brown), shredded wheat, beetroot,bananas, raisins. | 6069% |
| Spaghetti (white), sweet com, peas (frozen), yam, canesugar(sucrose), potato chips. | 5059% |
| Spaghetti (whole meal), porridge (oats), potato (sweet),beans(canned, navy), peas (dried), oranges, orange juice | 4049% |
Black eyed peas, chick peas, apples, milk (skim), milk (whole), 30
yogurt, tomato soup. 39%
20Kidney beans, lentils, fruit sugar (fructose) 29%
10Soyabeans, soyabeans (canned), Peanuts.
19%
The glycaemic indices are further influenced by the processing andcooking methods. For example, ground rice has a higher glycaemicindex than whole rice. Mixed meals produce variable glycaemicresponses because of the interaction between starches and othernutrients.
It is important to appreciate that 55-60 per cent of the energyrequirements can be derived from the complex carbohydratescontained in cereals and pulses. This does not present any difficulty inachieving control of diabetes, both in insulin-independent and non-insulin dependent diabetics. This was well documented by manyIndian investigators much before the resurgence of interest in highcarbohydrate diets in the western countries.
It is further advantageousto combine cereals and pulses, as is traditionallydone in a vegetarian diet.our own data con firms that this produces a lowerglycaemic index, partlydue to the high dietaryfibre content and partlydue to an increases insulin secretion followingingestion of a pulse-baseddiet. The mixing of cerealsand pulses also removesthe imbalance of essential arnino-acids. Cereals are limiting in Iysine andpulses it methionine, thus,when both are taken together, their amino acid compositions complementeach other, producing aprotein mixture of fairlyhigh biological value. Notjust cereals ant pulses, butproteins from allvegetable food(Buy now from http://www.drugswell.com) sourcesalso cornplement eachother (Fig. 1).
The edible, but indigestible, component of plants contain two types offibres: soluble and insoluble. Chemically, the fibre in plants is eithercellulose and lignin which are insoluble or noncellulosepolysaccharides like hemicellulose, gum and pectin, which aresoluble. Although many diet plans take the crude fibre into account, itis important to study the total fibre content and its soluble andinsoluble components(Table 3).
Table 3 Comparison of Crude Fibre and Total Dietary Fibre Content ofVanous food(Buy now from http://www.drugswell.com)s
Noncellulose
Crud Total Cellulose
polysaccharid
e DietaryLignin( insoluble
es
fibrea fibre fibre)
(soluble fibre)
food(Buy now from http://www.drugswell.com) (g/100 g edible portion)
Cereals
Flour, white 0.3 3.2 2.5 0.6 0.03
Flour. whole 2.3 9.5 6.3 2.5 0.8
Wheat 0.2 2.7 2.0 0.7 TrBread, white
Bread, whole 1.6 8.5 6.0 1.3 1.2
wheat
Fruits
Apples 0.6 1.4c 0.9c 0.5c 0.1c
Oranges0.5 0.29 0.22 0.04 0.03
(peeled)
Pears 1.8 11.0c 5.04c 2.9c 3.0c
Banana 0.5 1.8 1.1 0.4 0.3
Peaches 0.6 2.3 1.5 0.2 0.6
Legumes
and Nuts
Kidney1.8 7.3 5.7 1.4 0.2
beans
White beans 1.7 7.3 5.7 1.4 0.2
Peanuts 2.0 9.3 6.4 1.7 1.2
(roasted)
Peas 2.0 7.1 4.5 2.4 0.2
Vegetables
Beans, green 1.0 3.4 1.9 1.3 0.2
Carrots 1.0 3.7 2.2 1.5 Tr
Cabbage,0.8 2.8 1.8 .07 Trwhite
Cauliflower 1.0 1.8 0.7 1.1 Tr
Lettuce, 0.6 1.5 0.5 1.0 Trromaine
Pepper, 1.4 0.9 0.6 0.3 Trgreen
Potatoes 0.05 3.5 2.5 1.0 Trsvith skin
Corn, cooked 0.8 4.7 4.3 0.3 0.1
Tomatoes.
0.5 1.4 0.7 0.4 0.3
fresh
Turnips, raw 0.9 2.2 1.5 0.7 Tr
Tr = Traces
a= Crude fibre,g/100 edible portion, method of Weende. inComposition of food(Buy now from http://www.drugswell.com)s (Agncultural Hand-book No.456'. Washington.D.C.: U.S. Department of Agriculture, 1975.
b = Total dietary fibre. Southgate method. D.A.T. Southgate et al.J.Human Nutr. 30: 303 - 313, 1976.
c = Flesh only.
The soluble fibre forms a gel in the gut and retards the absorption ofmost nutrients. It effectively lowers the glycaemic indices of food(Buy now from http://www.drugswell.com)s. Itsprolonged use lowers the blood lipids. The insoluble fibre is fermentedby the gut bacteria. It maintains normal gut flora and also contributesto the increased faecal bile excretion along with pectin and othersoluble fibres.
The fibre content of diets in western countries varies from 5-25 gm/dav. In African countries the fibre content is as high as 75-150gm/day. In Asian countries, usually 25-50 gm of fibre is ingested perday. Probably, an intake of 30 gm/day is adequate, which is easilyachieved in vegetarian diets. This effectively lowers the blood glucoseand lipids, and assists in weight loss.
A high fibre diet also has important effects on metabolism in the liver,as it reduces the urea synthesis by the liver.
The high fibre vegetarian food(Buy now from http://www.drugswell.com)s also contain phytates and lectins.These substances reduce the rate of digestion of starch and therebydiminish post-meal hyperglycaemia. Tannins contained in these food(Buy now from http://www.drugswell.com)smay have a similar effect.
The vegetarian diet is generally a high carbohydrate-high fibre diet. Itusually contains the recommended amount of fibre intake of 10 gmcrude fibre or 50 - 60 gm of total fibre per day. It is unwarranted tosupplement it with any other fibre. For research purposes, guar gumhas been used extensively as a fibre supplement in diabetics. Theresults have mostly been gratifying in both insulin-dependent andnon-insulin dependent diabetics, with an occasional study reportingthe failure of guar gum in reducing post-prandial hyperglycaemia. It isalways more pleasant to ingest a high fibre diet in the form of highfibre food(Buy now from http://www.drugswell.com)s instead of a fibre supplement.
Ingestion of fibre in excessive amounts can result in flatulence,abdominal distension and diarrhoea. It may also result inmalabsorption of many micronutrients like calcium, iron, copper,magnesium, phosphorus and zinc.
The currently prescribed diabetic diets are low fat diets; only about25-30 per cent of the calories being derived from fat. The fat intake inour diet occurs from two sources; visible fat and invisible fat. It is easyto control the quantity of visible fat ingested. Most vegetarian food(Buy now from http://www.drugswell.com)scontain intrinsically a very low quantity of fat except the nuts, seeds,whole milk and its products. It is easy to separate out the milk fat andhence control the overall amount of fat eaten in a vegetarian diet.The nonvegetarian food(Buy now from http://www.drugswell.com)s carry various amounts of invisible fat withthem; which progressively increases from lean meat (fish andchicken) to medium fat meat (ham, egg and beef) to high fat meat(corned beef, pork, cold cuts). One ounce (30 gm) of lean meat,medium fat meat and high fat meat contains 3, 5 and 8 gm of animalfat respectively. For a vegetarian, the only source of animal fat is milkproducts. By using skimmed milk and its products such as curds,cottage cheese or paneer made from skimmed milk, the vegetariancan minimise the amount of animal fat ingested.
Vegetable fats are used for cooking by both the vegetarians and non-vegetarians. It is advisable to derive half of the fat intake fromsaturated fats and the other half from polyunsaturated fats.
Alternatively, one-third of the fat intake can be derived from eachgroup of fats, i.e. saturated, monounsaturated and polyunsaturatedfats (Table 4). A vegetarian can easily accomplish this goal by usingsmall amounts of butter or cream with bread or chapati and by usingpolyunsaturated oil for cooking. Such dietary approaches involving alow &t diet containing polyunsaturated fats have resulted in a hopefultrend towards lowering of the incidence of coronary artery disease inU.S.A.Such dietary trends are easy to achieve in vegetariancommunities.
food(Buy now from http://www.drugswell.com)s of vegetable origin also contain certain metabolically activecompounds which act on specific tissues. One of such compounds ismyoinositol, which is deficient in a diabetic with peripheralneuropathy. Hence, ingestion of vegetarian food(Buy now from http://www.drugswell.com)s containingmyoinositol can improve peripheral nerve function. The vascularcomplications of diabetes are ascribed to an increased generation ordeficient removal of free oxygen radicals, which have the potential ofdamaging various tissues. Our own research shows that inuncontrolled diabetics, certain enzymes required for the removal offree oxygen radicals are functioning poorly.
This situation improves with good control of diabetes. Treatment withknown antioxidants, like vitamin E, which also has the potential ofremoving the free oxygen radicals has thus far produceddisappointing results. Vegetarian food(Buy now from http://www.drugswell.com)s like fruits, vegetables andspices contain large amount of bioflavonoids, which have the capacityto mop up the free oxygen radicals.
The commonest misconcept regarding vegetarian diet is that it maybe deficient in protein. It is important to appreciate that the quantityof protein intake will be sufficient if a diet of adequate caloric contentis prescribed. On the other hand, a hypocaloric diet, irrespective of itshigh protein content will produce a negative nitrogen balance andloss of body proteins. Qualitatively, vegetable proteins from a singlesource possess a low biological value. A vegetarian diet obviates this difficulty by incorporating about 10 gm of milk protein in diet.Alternatively, a cereal pulse mixture provides protein of a fairly highbiological value, which approximates that of animal protein.
To summarise, a vegetarian diet is eminently suitable for all non-insulin dependent and insulin-dependent diabetics. It is easy toprovide a high carbohydrate, normal protein, low-fat diet throughvegetarian food(Buy now from http://www.drugswell.com)s. Such a diet is always high in fibre content andallows a highly selective and well regulated fat intake. This type ofdiet permits good metabolic control to be achieved. Thehyperglycaemia, as well as hypercholesterolaemia, can be normalisedor reduced significantly by such a dietary approach, thus minimisinglong-term complications of diabetes.
. The normal diet consists of fat, carbohydrate and proteins. Instructure, both fat and carbohydrate are very similar, in that theycontain only carbon, hydrogen and oxygen; whereas the proteinsdiffer by the extra content of nitrogen. When digested fats andcarbohydrates are metabolised they breakdown into carbondioxide and water, both of which are volatile and can be excreted by the lungs. Water is also excreted by the kidneys in urine andby the skin as sweat. The protein, however, metabolises to formnon-volatile material called the 'nitrogenous waste', a mixture ofmany compounds of which urea and creatinine are mostimportant and well known. One of the main functions of thekidney is to remove these poisons, urea and creatinine, from thebody through the urine. It naturally follows that the greater theprotein intake of a human being, the larger will be thenitrogenous waste load produced and greater the work demandon the kidneys to excrete it in the urine. Non-vegetarian dietshave much larger protein content than the vegetarian diets.Eating a non-vegetarian diet produces a larger work demand onboth kidneys. This has been clearly demonstrated by scientificmethods.
Until recently it was thought that in health, the kidneys are able to meet this extra demand quite well and perform satisfactorily, but recent animal experiments have revealed quite clearly that when healthy kidneys are constantly exposed to very large
protein loads, they seem to age much faster and may be tnecause of the development of high blood pressure in animals.With the appearance of this scientific data the whole world isnow sitting up to realise that too much protein is deleterious tohealthy kidneys. In fact the average adult western non-vegetarian diet consists of I - 1.5 gms/kg body weight of proteinwhereas the minimum requirement for good health is only 0.75gms/kg body weight which is the requirement quite adequatelymet by the average Indian adult vegetarian diet.
In Renal Failure, where the kidney's efficiency slowly and subtlyreduces from 100% to 30% without even giving a slight warningto the patient, it is quite obvious that a greater work demand onthe kidneys put by a non-vegetarian diet would further produce agreat strain on the already diseased kidney. This has been veryexhaustively proved in patients of renal disease such asglomerulonephritis, chronic renal failure, renal disease due todiabetes (diabetic nephropathy) and renal disease due to highblood pressure (hypertensive nephrosclerosis). In these diseases,the patient suffers an initial mild and prolonged phase of"azotaemia" wherein life is possible without dialysis beforereaching the stage of "uraemia" at which stage life can only bemaintained by doing dialysis. The phase of "azotaemia" is besttreated by a very strict dietary protein restriction and this is bestachieved by a vegetarian diet containing 30 gms proteins ofwhich 20 gms are supplied by milk and milk products while theremaining 10 gms comes from vegetable, cereals etc.'Azotaemia" is best tolerated this way and the "uraemia" phascmay be postponed by years by this dietary principle inconjunction with other dietary restrictions of salt, water,potassium and the usage of certain drugs.
Gout is a disease affecting joints and causing kidney stones. It isdue to deposition, in joints and kidneys, of uric acid which is bothgenerated in the body and also derived from food(Buy now from http://www.drugswell.com) products likeall meats. Those suffering from gout and uric acid kidney stonesbenefit most by omitting meat from their diet and converting to avegetarian diet. With proper adjuvant therapy the incidence ofkidney stones reduces and the patient suffers less joint pains.
In Conclusion The Nephrologist, like the diabetologist uses dietas a major part of his therapeutic armamentarium mosteffectively and must prescribe the total diet of his patient takinginto consideration the calories, fluid intake vis-a-vis urine output,protein, carbohydrate and fat intake, potassium and salt intake.Each patient will be given a different diet prescription but theone universal advice that will apply to all will be "It is better foryou to become a vegetarian ". Nephrologists have come tobelieve that this advice is applicable even to those who have norenal disease so as to prevent normal kidneys from overworkingand aging rapidly. In fact, many nephrologists in westerncountries have become vegetarians due to this belief !
1. Barry M. Brenner and Jay H. Stein. "The ProgresslveNature of Renal Disease" Churchill Livingstone Ed. Williarn
E. Mitch, 1986
2. Brenner B.M., Meyer T.W. and Host setter T.H. DietaryProteins Intake and the Progressive Nature of KidneyDisease. New Eng Journal Medicine 1982, 307, 652.
.
The liver has been described as a chemical workshop of the human body. All the nutrients and other substances absorbed from the intestines pass through the liver before entering into the systemic circulation. Thus the liver is vulnerable to the damage caused by a host of infections and toxic agents. Several types of viruses and alcohol are by far the commonest of these agents. The impairment of the liver function usually manifests as jaundice. Persistent infection and continuing impairment of function may be followed by death unless these changes can be controlled.
The morphological changes in liver damage can manifest as fattyliver, hepatitis, cirrhosis of the liver and cancer of the liver.
A well planned dietary regimen is of utmost importance in the prevention and treatment of most hepatic disorders. It has been proved beyond doubt that some of the proteins derived from animals are responsible for producing persistent symptoms related to liver disease. Thus vegetarian diet, as mentioned below, has gained momentum in the treatment of hepatic disorders.
Since there are no antiviral agents against hepatitis,rest, abstinence from alcohol and dietary modifications form the mainstay of the treatment. Most patients have nausea and lack of appetite. They should be served with attractive and well cooked food(Buy now from http://www.drugswell.com)s. Small meals served separately will be better tolerated than three large meals. A diet containing approximately 2000 kcal which can be provided by 20-25 gms fat, 80-90 gms pro teins and 400 gms carbohydrate is suitable. This requirement can be fulfilled by glucose, sugar, fruits, fruit juices, bread, cereals, vegetables, salads, jelly, jam, rice, boiled potatoes and puddings made with cereals and sugar. Though diets high in their fat content do not ultimately influence the course of the disease they are poorly tolerated by jaundiced
patients. Fried food(Buy now from http://www.drugswell.com), milk and butter cause dyspepsia and shouldbe avoided. Thus a vegetarian diet is better tolerated by thepatients suffering from viral hepatitis.
Most of the patients of cirrhosis of liver are severelymalnourished and require a high calorie and high protein diet. Ahigh protein diet, particularly if derived from animal proteins,carries a high risk of precipitating hepatic encephalopathy. Thebest source of vegetarian proteins is milk, its products andCasilan. Choline present in food(Buy now from http://www.drugswell.com)s like wheat germ, soyabean,peanuts and skimmed milk may prevent the formation of a fattyliver. It is also believed that cerebral disturbances due to liver damage are caused by the type of protein in the diet. Cirrhoticdiet prescribed in a standard Indian books on diet and nutritiondoes not contain proteins derived from animal sources. A diethigh in carbohydrate and proteins low in fat and fortified withvitamins would be most suitable. Thus a vegetarian diet is moresuited to patients having cirrhosis of liver.
In terminal stages of cirrhosis fluid accumulates in the abdominalcavity due to failure of the liver to synthetize plasma albumin.For such patients, a high protein diet which is low in sodiumwould be most suitable. But since these patients have noappetite, milk is the only practical diet which can supply theabove requirements.
Finally when the liver fails - the condition is known as hepaticencephalopathy. There is a strong incidence of animal proteinintake increasing the incidence of hepatic encephalopathy. Theclinical features of this syndrome are sleep disturbances,restlessness, drowsiness, impaired intellectual function,confusion and stupor progressing to coma. Significant number ofthese patients develop chronic encephalopathy and can bemanaged successfully at home. They should be given 20 gms ofprotein in the diet. This should mainly be derived from skimmedmilk.
Thus, it is very obvious that a vegetarian diet is more useful inthe treatment of all liver disorders including the last stage ofliver failure.
76.
.
Looking at this suggestion from both the philosophical angle and the scientific angle, it is clear th there is enough to maintain a good quality of life. If Nature created life on Earth it also arranged subsistence. This assumption is appealing because, in it, may lie the answer to a host of diseases.
Are we damaging our food(Buy now from http://www.drugswell.com) unknowingly? Are we depriving our bodies of the essential, vital ingredients which go to make a healthy body?
Cooking, freezing, preserving, drying, salting, dehydrating etc. are processes which take away so from our food(Buy now from http://www.drugswell.com). It is that 'something' that we may be lacking—which makes us prone to so many d know of so many of the essential elements that go to constitute the human body,but do we know there is to know. . . ? We can never claim that we know it all because new discoveries are being m day.
With the ever increasing variety of illnesses and the grotesque statistics which show that disease increasing and life expectancy rapidly decreasing, it is clear that there is something wrong with o
There were times when reaching the late eighties was routine but now the approaching fifties bri them diabetes, hypertension, ischaemic heart disease and so many other problems.
Can we stem the rot? May be we can, with a volte-face in our attitude. Maybe in Nature itself lies the answer to our dise
A pilot study on the role of raw vegetarian food(Buy now from http://www.drugswell.com)s (i.e. fresh fruits, nuts, and raw vegetables alongother natural food(Buy now from http://www.drugswell.com)s like honey, garlic and coconut) was conducted at the Bombay Hospital and MResearch Centre. The cases studied were those of bronchitis, asthma and other respiratory disord abdominal problems like hyperacidity, peptic ulcer, constipation, piles and flatulence, infections ometabolic problems like gout, hypercholesterolaemia and diabetes, hypertension, ischaemic hearand peripheral vascular disease and malignancy (cancer).
The above items were used exclusively and no form of cooking, preserving etc. was attempted.The patients showed varied responses which can be discussed under the following heads:
Young patients in the early stage of the disease recovered very well and maintained good healthcolds and sinusitis could be completely eradicated. Older patients with more permanent damageassociated emphysema required supportive medications albeit in smaller doses. There was a uniimprovement in the quality of life.
While the patient was on this kind of diet the symptoms of discomfort subsided completely. But othe original food(Buy now from http://www.drugswell.com) habits, symptoms recurred in varying intensity, thereby demonstrating amply thsymptoms are largely related to the kind of food(Buy now from http://www.drugswell.com) we eat and when we eat it.
Infections, however severe, improved very well on this diet obviating the need for antibiotics andeven the need to incise and drain abscesses.
These patients showed remarkable improvement in the control of the respective lab parameterssubsequently on the re-introduction of cooked food(Buy now from http://www.drugswell.com) (provided it was minimally cooked) along with share of uncooked food(Buy now from http://www.drugswell.com). They showed good control of these metabolic parameters and required mmedication for the control of the disease.
Patients on raw vegetarian food(Buy now from http://www.drugswell.com) for these ailments showed easier control of hypertension, lessersymptoms and in the early stages even improvement in effort tolerance. This could be attributed concomitant weight loss, improvement in constipation, diabetes, salt retention and maybe the rereversible aspect of atherosclerosis.
The toxaemia of pre-gangrenous conditions also reduced tremendously.
F. Malignancy (Cancer)
The results in this category can always be debated and will continue to be debated. However, ingeneral sense, all patients with malignant disease consuming only raw food(Buy now from http://www.drugswell.com)s had a better qualityThere may not have been improvement in quantity of Life but quality certainly was far superior wcompared to those having the same disease and consuming a 'normal diet'.
Those who received raw vegetarian food(Buy now from http://www.drugswell.com) tolerated chemotherapy much better than those on a noand those who had very early stage disease, and received no chemo-or radiotherapy, had an exc qualitative and quantitative prognosis.
In general, all malignancy cases treated without surgery, chemotherapy or radiotherapy showedimprovement as far as quality of life was concerned. Only time will tell how much influence this thas on quantity of life?
Whatever the problem be—be it a common cold and sinusitis or be it cancer, there is definite respwith raw vegetarian food(Buy now from http://www.drugswell.com)s in the diet.
Though no concrete proof is available as to how this therapy works it could, by logical deduction,up in two points:
Table I shows the effects of cooking on various nutrients present in food(Buy now from http://www.drugswell.com). It is small wonder thatconsume only cooked and overcooked food(Buy now from http://www.drugswell.com) develop deficiencies of these elements which are vitabody function. Raw vegetarian diet consists of all these substances in abundance and maybe mosubstances which we yet don't know about.
Vitamin
Vitamin
C
Cooking A
Starch Fat Proteins (Ascorbic Thiamine Riboflavin Niacin
Method & Carotene
Acid) Moderate Heavy Loss Loss
Gelatinisation (Heavy (Heavy
Cooking in No
and formation Denaturation Slight Loss if Loss if Nil Nil
excess water Effect loss
of paste excess excess water is water is rejected) rejected)
(Heavy Loss if excess water i Cooking in Moderate Slight
Gelatinisation No Denaturation Slight Nil Nil
Steam Effect loss Loss Loss Cooking in
Moderate Moderate
Pressure Gelatinisation No Denaturation Slight -Nil
Effect loss Loss loss
Cooker Decrease in Moderate
Dry Bursting of Moderate Moderate
-nutritive to Heavy Slight loss Nil
Toasting Granules loss Loss
value Loss Short Periods (upto 30 min) (no effect); Long Decrease in
Deep Fat Bursting of Heavy Heavy Heavy Moderate
periods nutritive Nil
Frying Granules loss loss loss loss
(1 hr or value more) Toxic products are formed
Slight Moderate Moderate Shallow Pan Bursting of No decrease in to Heavy to Heavy Moderate Slight Nil Frying Granules Effect nutritive loss loss
value Effect of Addition of Decrease in
Cooking No Heavy Heavy Heavy
No Effect nutritive Nil Nil
Soda to Effect loss loss loss
value
Cooking Water Baking, Gelatinisation No Slight Moderate Slight
No Effect Slight loss Nil
bread of starch Effect loss Loss loss Slight Baking, Gelatinisation No decrease in Moderate Moderate Moderate Moderate
Nil
biscuits of starch Effect nutritive Loss Loss Loss Loss value Gelatinisation No Slight
Puffing Denaturation --Nil Nil
of starch Effect loss Slight
No Slight Slight Slight Slight
Germination Hydrolysis to No Effect
Effect Increase Increase Increase Increase Dextrins
Hence we can conclude that raw vegetarian food(Buy now from http://www.drugswell.com) has a deEnite role in the promotion of good heaprevention of disease. We do not claim that the use of raw vegetarian diets can cure all diseases certainly there is evidence that it improves quality of life.
It is impractical in our present society to live only on raw vegetarian food(Buy now from http://www.drugswell.com)s on a permanent basis.always follow the middle path, i. e. the incorporation of both cooked and uncooked food(Buy now from http://www.drugswell.com) in one'sobservations only go to show that a vegetarian diet in its natural form has a lot to offer in healthand using a fair amount of raw vegetarian food(Buy now from http://www.drugswell.com) in our daily diet goes a long way in keeping us hemind, body and spirit.
.
Cancer, the most dreadful disease never fails to arouse fear, apprehension and anxiety in those who are associated with it— especially those who are affected by it—the patients and their near ones. Cancer has been the subject of much research, and every year new discoveries are being made which go to contribute to the patients' treatment. Newer drugs, newer investigations, newer procedures for treatment have changed the outlook of the disease today. However, thousands of people are still suffering and thousands are dying painful deaths every year.
Research has been focussed on many aspects of this disease and one of the aspects has been nutrition.
Diet is one of the vital factors essential for sustenance of life. However in as much as food(Buy now from http://www.drugswell.com) is vital for maintenance of various biological processes within our body, it is even more vital to know that the type of food(Buy now from http://www.drugswell.com) we select as a diet can turn out to be the cause of our death.
Diet could exert its effect on human cancers in a number of
different ways
| i. ii. | Through carcinogens produced by food(Buy now from http://www.drugswell.com) processing orcooking Through carcinogens in the body produced duringdigestion, especially in the stomach, small or largeintestines |
| iii. | From food(Buy now from http://www.drugswell.com) constituents itself |
| iv. | Through the indirect effects of undernutrition,malnutrition and overnutrition and |
| v. | Through the protective effects of certain dietary factors. |
The relationship of cancer with nutrition is one of the oldestknown, but, perhaps one of the most neglected facts.
Let us study the relationship of cancer of various organs anddiet.
Data collected from 24 countries has concluded that the best correlation between the diet and cancer is in the case of the breast. Several other international correlation studies have been conducted with similar conclusions.
Surveys on international incidence have shown that Asians andAfricans have much lower incidence than Europeans and NorthAmericans. Thus it is much more common in countries with a high level of affluence. It has been suggested that the overstimulation of the hormonal system by an 'affluent' diet mightlead to growth of hormone dependent cancers such as carcinomabreast.
In Japan dietary fat has increased from per capita consumption of23 to 52 gm per day between 1957 and 1973. In this period oftime the annual breast cancer mortality rate increased from1572 to 3262. In the U.S. where already there is a high incidenceof cancer of the breast, the incidence has further increased because the per capita dietary consumption of fat per day hasrisen from 125 gms in 1909 to 186 gms in 1972.
Besides the relationship with high fat diet, mainly animal fat,breast cancer has also been associated with protein intake.Actually there has been a much stronger relationship betweenanimal protein, rather than total protein and breast cancer.
In fact it has been shown that cancer patients on high fat diethave a poorer prognosis than low fat diet patients. This allprobably explains the high incidence of breast cancer in U.S. women.
Similarly breast cancer has also been associated withnonvegetarian diets and obesity. These associations have beenseen in several epidemiological surveys and has also been ourexperience at the Bombay Hospital.
Surveys of the incidence of gastro-intestinal cancers suggest thatas total per capita food(Buy now from http://www.drugswell.com) intake (i.e. caloric intake) increases, theincidence of colorectal cancer increases.
It was further found that colorectal cancer has been frequentlyassociated with the intake of animal protein. High intake ofanimal protein, particularly beef in Hawaii and pork in Japan havebeen clearly shown to be associated with a high incidence ofcancer of the bowel.
Certain data has shown that this cancer is very commonamongst several fish eating communities particularly Japan,Iceland, Finland, Soviet Union (along the Baltic Sea) and SouthAfrican Coast. Japan has a higher consumption of fish than thatof the U. S. and has a five times higher incidence of the cancer ofthe stomach.
The association between dietary fat and prostatic carcinoma isseen in international comparison. Surveys conducted in U. S. byBlair and Fraumany identified the midwest and north centralareas of the U. S. as those with the highest rate of prostaticcarcinoma and this was related to the greatest consumption ofbeef.
Other organ cancers in the body, like testes and corpus uterihave all shown a relationship with dietary factors which pointmainly to the animal component of diet as carcinogens.
As has been discussed in various chapters throughout this book,vegetarian diet seems to be the diet more suited to man. Hencewhen a person is on a vegetarian diet he receives most of hisnutrition in the optimal form and hence keeps the body goingwithout imposing a load on the elimination systems.
Consumption of a vegetarian diet particularly in the fresh anduncooked form supplies the body with all the carbohydrates,proteins, fats and especially the trace elements, vitamins,minerals, and other micronutrients. These go to enrich the internal environment and enhance the functioning of all theorgans of the body wherein the body is able to cope with anykind of foreign invasion or any kind of derangement likemalignant disease.
When a patient suffers a malignant disease he has probably novitality or resistance to foreign invasion. A normal person is ableto keep healthy inspite of such a diverse array of influencesacting upon him because his immune system is competent andcan quell any foreign invasion. In a patient suffering from cancer,the immune system is very weak due to chronic influences likepoor nutrition, nutritional deficiencies (especially of micronutrients), cigarette smoking, alcohol and tobacco abuse andmental stress, altogether or individually. This is the reason whythe malignancy can flourish unchecked. However, if the patient isgiven nutrition which is natural to his system then gradually thedeficiencies get corrected and the immune system getsrejuvenated. This assists in the fight against the disease process.And, it appears, that it is one of the causes of some patientsresponding very well to therapy and some not responding at all.
Vegetarian nutrition definitely imposes a smaller load on theelimination systems, it also contains all the nutrients in theirnatural concentrations and combinations whereby digestion,absorption and assimilation are done easily. Due to the high fibrecontent, poisonous waste matter is propelled rapidly down thecolon and egested intermittently—hence it serves a cleansingfunction. Vegetarian food(Buy now from http://www.drugswell.com)—particularly in its natural, uncookedform possesses all these properties of nourishing and cleansingthe system.
It has also been established that eating of hypoealoric dietsinhibit many tumours e.g. breast carcinoma, lung carcinoma,hepatoma, leukaemia, skin turnouts and sarcoma. This ispossibly true due to the inhibition of mitotic activity due tolimited carbohydrate and carbohydrate intermediates availablefor energy.
adequate proteins of high biological value with all
essential aminoacids and in a much more assimilable
form. Thus the common excuse for consuming non-veg.
diet as a rich source of protein is a myth, not backed up
by any scientific observation.
Table below depicts a list of mutagens present in food(Buy now from http://www.drugswell.com), bothvegetarian and non-vegetarian. The elimination of non-vegetarian food(Buy now from http://www.drugswell.com) from the diet reduces the load of mutagenssignificantly hence placing the consumer at a lower risk level.
Mutagens food(Buy now from http://www.drugswell.com)s Containing the Mutagen
1. Charred Grilled or smoked fish, meats or poultry Protein food(Buy now from http://www.drugswell.com) Meats cured by nitrates2. Nitrosamines Present in hard water and in vegetablesNitrates grown in nitrate fertilizers (inorganic farming)
Most meats, milk, eggs, fruits and root
vegetables are poor sources of folicin
Alcohol
Presently it is established that simply by applying the knowledgewe have now, we could reduce the occurrence of new cancer cases by upto 40% but we are kept from realising this potentialbecause of certain deficiencies, at the level of the individual and the society.
It is clear that diet acts as a double edged razor. While rightselection can promote health and well being a faulty choice ofour diet can jeopardise our health. Unfortunately, there is a lackof organised and systematically collected data to show us thetrue status of cancer in our country. It may not te very longjudging by the present rate of adopting the westernised life style,before India lands up high on the list of countries with major
cancer deaths.
.
The nervous system is unique in that it has very specific demands to maintain normal function. Complex thinking processes, articulate movements, complicated tasks involving coordination, judgement and skill (both learned and innate) are performed by activity in the neurones of the brain, spinal cord and the peripheral nerves. Various neurotransmitters, hormones and other chemical mediators co-ordinate the activity of these neurones. Disturbance in the balance of these mediators is considered to be the basis of disease—be it inflammatory, metabolic, degenerative or neoplastic (cancerous).
It is a well-known fact that nutrition plays a vital role in themaintenance of health and formation of disease. There are certain diseases where nutrition plays a direct role in altering thecourse of the disease e.g. peripheral neuropathy. There are otherdiseases e.g. cerebrovascular accidents where nutrition affectsthe risk factors significantly so as to change the entire prognosisof the disease. And there are still other diseases (like Parkinson'sdisease, motor neurone disease and multiple sclerosis) wheregood nutrition plays a vital role in supporting the patient throughthe chronic progressive course. Nutrition is also important inunconscious patients, who have either had a head injury or acerebrovascular accident or have been operated for a braintumour. Furthermore it is now commonly seen that evenmentation i.e. our thinking processes, are governed by the kindof food(Buy now from http://www.drugswell.com) we eat.
The issue before us is—What kind of nutrition is good for the neurological patient—vegetarian or non-vegetarian? A difficult question to answer, indeed. There is scant research data implicating either vegetarian or non-vegetarian diets directly in any disease process concerned with the nervous system.
Starting with the thinking process—mentation and intellectual activity—there is a long list of intellectuals in history who made an indelible mark in their times and who were vegetarians. They were Isaac Newton, George Bernard Shaw, Shelley, Milton, Voltaire and more closer to home, Mahatma Gandhi, Rajendra Prasad, Rajagopalachari, Lal Bahadur Shastri and many more. It is widely believed and it is probably true, that vegetarianism does promote intellectual activity of a very high order. Mahavira, Gautam Buddha and Saints of Hinduism all advocated
vegetarianism.
Like intellectual activity, even physical functions seem to bebetter preserved in vegetarians as compared to non-vegetarians.
For the sake of convenience the relationship of a vegetarian dietto specific neurological disease can be discussed individually.
Headache is one of the commonest complaints in outdoorneurological practice. Migraine ranks second only to tensionheadaches. Migraine has a very close relationship to the kind offood(Buy now from http://www.drugswell.com) we eat. The substance implicated in causing exacerbationsis tyramine. Tyramine is formed by the decarboxylation of theamino-acid tyrosine by bacteria and enzymes. Hence it is best toavoid food(Buy now from http://www.drugswell.com)s that contain tyrosine. These are aged meats andmeat products, fish, cheese, brinjals, pods of beans, alcoholicbeverages (wines, ale and beer). The entire range ofnonvegetarian food(Buy now from http://www.drugswell.com)s seems to be implicated thus suggestingthat a vegetarian diet may be a more suitable diet for a migrainesubject.
It would not be wrong to say that this group of diseasescomprises 40% of all hospital-based neurology practice. This is asignificant disease as it is responsible for maximum morbidityand mortality. Its medical, social and economic implications aretremendous. C.V.A s . are situations that lead to paralysis oflimbs and disturbed mental function. Though nutrition does notaffect C.V.As. directly it affects each and every risk factor andhence plays a large role in preventing C.V.As.
The main risk factors for C.V.A. are:
There is ample evidence in the nutritional literature that avegetarian diet is beneficial in the treatment and the preventionof hypertension, diabetes mellitus, hypercholesterolaemia,obesity and that vegetarians are less inclined to tobacco andalcohol abuse. Hence the corollary is that vegetarian diet isbeneficial for the prevention of cerebrovascular accidents.
Multiple Sclerosis, Motor Neurone Disease, Parkinson's
Disease and Other Chronic Progressive Diseases of the brain and spinal cord have been found by some to have anutritional basis. For instance, some workers have suggestedthat multiple sclerosis can be benefitted by a diet high inessential amino acids. The sources of essential amino acids e.g.safflower, sunflower, soyabean, corn oil, walnuts, peanuts,almonds are all vegetarian. Though no double blind trials can bequoted it is our observation that patients suffering from theabove mentioned chronic neurological problems are morecomfortable on vegetarian diets than on non-vegetarian diets.
The significant relief in constipation, which is a serious problemin all these patients, is probably due to the high fibre content ofthe vegetarian diet. Those patients who consume more fruits andvegetables are also less prone to the chronic infections to whichthis group of patients are highly susceptible. This may beattributable to the rich supply of vitamins, minerals and traceelements obtained from fruits and vegetables, which areessential for the integrity of the immune system.
Peripheral Neuropathies are said to improve with the help offood(Buy now from http://www.drugswell.com)s containing high amounts of vitamins, minerals andessential fatty acids. These elements are in abundance inuncooked vegetarian food(Buy now from http://www.drugswell.com) e.g. fresh fruits, raw vegetables (forvitamins and minerals) and nuts like almonds, walnuts, peanuts(for essential fatty acids). Though there is no significant proof oftheir efficiency by themselves, fresh fruits, raw vegetables andother similar food(Buy now from http://www.drugswell.com)s improve the general well-being of the patientand thereby enhance overall recovery.
These and many more instances in daily practice, and in thescientific literature, definitely suggest that a vegetarian life styleis superior to a non-vegetarian life style from the angle ofprevention of disease. Vegetarian diet also plays a goodsupportive role in the treatment of many chronic, progressiveneurological diseases. Hence, taking into consideration theavailable data, it would not be incorrect to conclude that vegetarianism is beneficial not only for the prevention of manyneurological diseases but also in the treatment and support ofsome of the diseases.
59:219.
.
Diet is always connected with health. But then, health is a combination of physical and mental health. It is a fact that without having a healthy soul or mind, there is no sense in having a healthy physical body (Mens sana corpora sana).
It is our experience in clinical practice, that mental illnesses inour country are on the increase, as in all other parts of the world.In fact even people having a physical illness like an enlargedheart or cirrhosis of the liver or arthritis are being harassed moreby associated complaints related to their abnormal mentalhealth. Also straight forward psychiatric illnesses are increasingday by day.
The public is being educated on the role of different diets and food(Buy now from http://www.drugswell.com)s for maintaining health. Little does the public realise that this education and knowledge holds true only for physical health. The people should know that the recent knowledge about our body requirements of proteins, vitamins etc. has enlightened us to the fact that these requirements are much less than we ever thought of.
It is so common to see people who are consuming a very rich diet supplemented by heavy doses of vitamins (which are all excreted in the urine or stools), are still very unhealthy and ill (because of poor mental health). As against this, even footpath dwellers enjoy good physical health (with the so-called poor food(Buy now from http://www.drugswell.com) which they can obtain). They can walk and run faster than the affluent class. Surprisingly vitamin deficiencies are very rare in these people(because in adults the vitamin requirements are very little). Not only that, they are mentally very healthy. Thus their total health is better than the rich people. Also, they do not suffer from many chronic diseases which are related to an unhealthy mind brought about by the stresses of life.
There are so many diseases related to stress. To quote a few, stomach ulcers, coronary heart disease, high blood pressure, irritable colon etc. These stresses are increasing in domestic life, in professional life or at work and even during commuting.
In trying to deal with these stresses, people are turning to smoking, alcoholism, and socialising at parties - all of which increase the above illness.
Then what is the food(Buy now from http://www.drugswell.com) for good mental health? The people shouldunderstand that like a regular breakfast, lunch and dinner tomaintain your physical health, this food(Buy now from http://www.drugswell.com) will have to be consumeddaily.
Stresses cannot be reduced. You cannot change the pace of lifein big cities or temporarily forget it by smoking or drinking.
This is where spiritualism, religion or faith in God plays its role.This is being forgotten in this fast life. This is 'the' food(Buy now from http://www.drugswell.com) for mentalhealth. We doctors should be thankful to our present modernspiritual leaders - like Satya Saibaba, Radhoswami,Chinmayanand, the Pope, Aghakhan and many more-who aremaintaining the mental health of our public without chargingthem any fees. But for them, our clinics would have beenoverflowing with patients. Of course others who have no spiritualleaders, get their 'food(Buy now from http://www.drugswell.com)' from their religious 'Gurus' and Lords.
Now the prime question which we have to consider is that canthe 'food(Buy now from http://www.drugswell.com)' for physical and mental health be correlated ? Is therea common food(Buy now from http://www.drugswell.com), beneficial to both ?
Can we doctors answer this question ? Unfortunately since we,the medical scientists have not devoted any time to mentalhealth, we will not be on the proper platform to advise. We spendall our time in diagnosing, treating and calculating the incidenceof mental and stress-induced illness in our practice.
Surely then, the people to answer the above question are thosedoctors (spiritual leaders) who have been quietly handling themental health of our population.
It happens to be true that many of the different saints, sages andperfect masters who have come at different times, in differentparts of the world and spoken in various languages— havesuggested that "Vegetarian diet is good for a peaceful mind".
The following quotations and sayings from Mahabharat and Biblewill possibly make you reflect on the above subject.
A wise sage said in 'Mahabharata', "Those to possess goodmemory, beauty, long life with perfect health, and physical,moral and spiritual strength should abstain from animal food(Buy now from http://www.drugswell.com)".
Talking about Christianity and vegetarianism, there are manyquotations in the Bible against flesh-eating e.g. (Chap VII V 23)"Ye shall eat no fat, of ox or sheep or goat. And the fat of whichdiet of itself and the fat of that which is torn of beast, may beused for any other service. But ye shall in no wise,eat it: Forwhosoever eateth the fat, of the beast, of which men offer an offering made by fire unto the lord, even the soul that eateth itshall be cut off from his people".
If that is so, it is for us doctors to stop encouraging the use of sedatives and tranquillisers to treat the stress and mental component of illness, and to advise people on the benefits of vegetarian diet in maintaining good mental health. The public should know that statistically it has already been proved, that the incidence of alcoholism is markedly reduced in the vegetarian population. This may be the first scientific proof, because alcohol is certainly related to mental health.
In another chapter in this book, the effect of various articles of vegetarian diet on mental health have been discussed. Whether scientifically proved or not (by allopathic standards), if in the age old literature food(Buy now from http://www.drugswell.com) articles like "Amala " have been linked to a cleaner "mind ", sure enough there are no articles in the literature to suggest, that eating pork, beef or sausages keeps mental health in good shape !!
In the meanwhile, it has been now shown, that drinking a glass ofbutter milk produces chemical substances in the stomach whichact on the brain to induce drowsiness. Similarly it appears thatthe vegetarian food(Buy now from http://www.drugswell.com) will stimulate formation of endorphins andenkephalins which are known to act on the brain to reduceanxiety and create a sense of well being.
Finally it will not come as a surprise if in the future, research reveals that vegetarian food(Buy now from http://www.drugswell.com) has a superior effect on the mind and the intellect.
.
High blood pressure (B.P.) or hypertension (HT) has been described as a silent "killer." Apart from its own morbidity, HT facilitates and accelerates another killer viz. atherosclerosis.Naturally there has been world-wide concern about prevention of these diseases by dietary alterations or drugs. Currently there is an increasing scientific interest in vegetarian diets in the prevention of several diseases. The questions to be tackled here are:
A number of vegetarian populations have been reported withlower blood pressure, serum cholesterol and body weight thanomnivores, but there is a strong possibility that an effect of dietmay be confounded by other lifestyle factors. A study in WesternAustralia was particularly commendable since it attempted toisolate the influence of vegetarian diet from other potentiallyconfounding life style factors associated with hypertension andcardiovascular disease.
In one of the studies 59 healthy omnivores were allocated to acontrol group (which ate an omnivorous diet for 14 weeks) or toone of two intervention groups whose members ate anomnivorous diet for the first two weeks and a lacto-ovovegetarian diet for one of two six-week experimental periods.Home, clinic, and laboratory blood pressures, dietary intake,body weight and lifestyle factors were carefully month bredthroughout the project. Urine and blood collections were madefor each experimental period.
There were no appreciable differences between vegetarians andomnivores with respect to mean age and height. For weight andQuetelets' index, however, vegetarians of both sexes were lowerthan omnivores. Mean blood pressures adjusted for age, heightand weight were significantly lower in vegetarians thanomnivores, and were not related to past or present use ofalcohol, tobacco, tea and coffee, physical activity, personality orreligious observance.
The prevalence of mild hypertension ( ' 140 mmHg systolicand/or 90 mmHg diastolic) was 10% in omnivores and 1% invegetarians.
Analysis of the diet records showed that the vegetarians atesignificantly more dietary fibre, polyunsaturated fats, magnesiumand potassium, and significantly less total fat, saturated fat andcholesterol than did the omnivores.
There was a significant fall in mean systolic and diastolicpressures in both experimental groups during the period onvegetarian diet. Mean blood pressure in experimental group Irose after resumption of the omnivore diet (period 2) to the level which preceded the vegetarian diet. Considering bothexperimental groups together, the mean fall in blood pressureassociated with a vegetarian diet was 6.8 mm Hg systolic (SD8.8) and 2.7 mm Hg diastolic (SD 6.3). Multiple regressionanalysis showed that the change in B.P. was associated witheating a vegetarian diet independent of age, sex, Quetelet'sindex, blood pressure before dietary modification or change inbody weight.
Analysis of diet records indicated that intake of several nutrientschanged with change to the vegetarian diet, particularlysignificant increases in polyunsaturated fat ( + 96%) dietary fibre(+75%), vitamin C (+80%), vitamin E (+ 85%) magnesium ( +34%), calcium ( + 36%) and potassium ( + 18%) significantdecreases were in protein (-27%), saturated fat (-16%),monounsaturated fat (-19%) and vitamin B12 (- 61%). The P:Sratio of the diet changed from 0.29 to 0.68, intake of sodium,calories and total fat did not change with change to thevegetarian diet. Factor analysis suggested that changes inpolyunsaturated fat, fibre or protein were most likely to havemediated the observed changes in blood pressure.
It would now be worthwhile to examine the following nutrients inrelation to blood pressure—sodium, potassium, calcium andmagnesium, dietary fibre, polyunsaturated fats and low proteins
The recognition that modifying renal excretory capacity forsodium and thus changing sodium balance can induce high B.P.in experimental animals focussed attention on sodium as theprinciple nutritional factor in the development of high B.P.Epidemiological surveys are often cited as proof that excessivesodium intake increases the prevalence of high B.P. However,sodium does not meet a number of criteria listed above. Intrasocietal studies have not shown a difference in the sodium chloride consumption between normal and hypertensivesubjects. Animal studies have not used levels of intake thatreflect reasonable variations in the human diet. Adverse effects of excess sodium have not been shown in normal persons. Westill do not understand how dietary sodium exerts its pressoreffects, when it does so and why it does so only in certainpeople. Whether the action of sodium is a direct effect or anindirect effect through changing the activity of other ions such aspotassium, magnesium and calcium is also not clear. Theavailable scientific evidence does not allow a blanket recommendation of restriction of salt intake to 5 gm/day for theentire population.
Potassium
Clinical, experimental and epidemiological evidence suggests that a high dietary intake of potassium is associated with lower
It has been observed in epidemiological studies that bothpotassium and calcium intake are significantly reduced in bothwhite and non-white hypertensive subjects (27% less Ca and17% less K in whites; 42% less Ca and 34% less K in nonwhites).It is postulated that an inadequate calcium intake may contributeto elevate B.P. Milk, peas, beans and cereal grains are a goodsource of calcium in the vegetarian diet. Drinking water canprovide significant amount ranging from 75 mg to over 200 mgper day in water obtained from wells sunk in chalk or limestone.
Vegetarian diet is rich in magnesium, which could affect plasmaand intracellular magnesium and hence influence cardiac orvascular smooth muscle contraction.
The vegetarian diet is rich in fibre, which is not digested by thehuman digestive enzymes. Some types of dietary fibres, notablyhemicellulose of wheat, increase the water-holding capacity ofcolonic contents and the bulk of the stools, thus relievingconstipation. Other viscous indigestible polysaccharides such aspectin and gum guar slow gastric emptying, contribute to satiety,retard the absorption of glucose and cholesterol and reduceplasma cholesterol. Some dietary intervention studies in humanshave been compatible with effects of dietary fibre on bloodpressure but they do not have an entirely satisfactoryexperimental design.
Humans are unable to svnthetize fatty acids with double bondsmore distal to the carboxyl end of the fatty acid than the 9thcarbon atom. Thus linoleic acid (C18: 2 ~- 6) is an essential fattyacid which must be provided in the diet. It is also called X 6 oromega 6 fatty acid. It is the principle polyunsaturated fatty acidin oil from plant seeds (e.g. corn oil, safflower oil). Anotheressential fatty acid alpha linolenic acid, is present in greenleaves, and some plant oils, notably linseed, rapeseed andsoyabean oil. Elongation and further desaturation of alphalinolenic acid (C 18:3co3) occurs in animals and (slowly) inhumans to yield eicosapentaenoic acid (EA) anddocosahexaenoic acid (DA). These fatty acids enter the food(Buy now from http://www.drugswell.com)chain with marine phytoplankton, which are eaten by fish, whichare in turn eaten by seals, walruses and whales—the principlecomponent of Eskimo diet in Greenland. The low prevalence ofatherosclerosis and myocardial infarction in Eskirnos had beenattributed to their daily dietary consumption of 5-10 g of the longchain n-3 polyunsaturated fatty acids EA (C20: Sco3) and DA(C22: 6a3). When s 3 fatty acids are introduced in the diet, theirderivatives EA and DA compete with arachidonic acid in severalways. The net result is a change in the homeostatic balancetowards a more vasodilatory state, with less plateletaggregation. They reduce the viscosity of whole blood byincreasing the deformability of red blood cells. They cause amoderate reduction of blood pressure both in normal and mildhypertensive subjects. Further they reduce the vasospasticresponse to catecholamines and possibly to angiotensin. Theanti-atherogenic properties of Go3 fatty acids have also beendescribed.
The higher content of these vitamins in vegetarian diet is a greatadvantage in protecting against high concentrations of co3 fattyacids, which can increase the likelihood of lipid peroxidation, withits toxic effects on the cell. Those who ingest large amounts offish oil would need added supplements of vit C and E for theiranti-oxidant effects.
It seems clear that vegetarians tend to have lower bloodpressure than omnivores and that a shift in dietary patterntowards a lacto-ovo-vegetarian diet would result in reducedincidence of hypertension, strokes and cardiovascular disease inthe community. The identification of specific nutrientsresponsible for this benefit is still not precise although a highpotassium polyunsaturated fat and fbre content of thevegetarian diet seem to be significantly associated. The subjectshould be approached with an open mind with the realisationthat newer knowledge will emerge with continued research.
Anand Gokani
.
Sports medicine is the science of treating sports-related diseases and the study ofenhancing sporting performances. Largely it deals with sports injuries, diet insportsmen and development of techniques to improve performance. The qualitiesrequired in a sportsman are strength, speed and endurance (stamina). Thesequalities are honed by vigorous training in the field, strict mental discipline andcorrect balanced nutrition. It is the latter that we are going to deal with in thischapter.
A sportsman, however hard he works on his event, will not achieve his goal unless heis supported with the right kind of nutrition,both qualitative and quantitative. Asportman is considered to be under severe stress, both physical and mental. This combination of physical and mental stress does a lot to disturb the milieu intereur byreleasing several hormones in very large quantities. The combination of extremephysical activity, severe mental stress, increased metabolic demands of the bodyassociated with a high level of hormones in the blood creates a rather delicatesituation which has to be balanced precisely to prevent a break down of the system.
The Nutritional Needs of a Sportsman.......
Simply stated - proteins, carbohydrates, fats, minerals and vitamins along with traceelements and micronutrients are needed. However, the nutrition of a sportsman isnot so easy. These ingredients are required in very large quantities and this putsimmense pressure on the digestive and assimilative processes and imposes a greatstrain on the elimination processes. This strain makes it quite possible for some linkin the intricate metabolic chain to snap. All this indicates that the food(Buy now from http://www.drugswell.com) must be verycarefully selected so as to be adequate in quantity, appropriate in quality and ofminimal toxic value.
The important constituents required by sportsmen are:
Generally it is said that a sportsman requires 2 gm/kg of Ideal Body Weight. Thisdictum is not always true in every case. Individual variations are always to beaccounted for. Protein sources are indicated in Table I.
Table I. Comparative Nutritive Value of Proteins
Chemic Protein al Limitingfood(Buy now from http://www.drugswell.com)stuff Conte Score of Amino Acid
nt %
Whole Egg 12.3 100 Tryptophan
Beef (lean,raw) 20.0 72 Lysine
Wheat (Wholemeal13.0 38 Lysine flour) TryptophanRice (Polished raw) 6.5 59 +Lysine
Cystine +Maize (Cornflour) 0.6 Methionine
Maize (Wholemeal) 9.5 36 Cystine
Soya flour (low fat) 45 58 Methionine
Beans (Haricot, raw) 21 39 Tryprophan
Fish 21.5 77.7 Tryptophan
Chicken 25.6 66.6 Tryptophan Pulses are deficient in amino acids which are present in cereals. Thus protein ofcereals help supplement that of pulse and thereby improve the chemical score. Acombination of nce and dal has a better quality of protein than either of them alone.
The protein should not only be in abundance but it should also be utilizable by thebody. It should be rich in essential amino acids which are the main building blocks ofour body proteins. Furthermore, the availability of the protein should not be offset bythe disadvantages imposed by putrefaction of the protein source—thus imposing atoxin load and stressing elimination processes. In this respect (Ref. Chart I), cottagecheese (paneer), cheddar cheese, indigenous traditional cereal pulse combinationsand milk products like curd and butter-milk are far superior to meat and fish. Thelatter, non-vegetarian sources of protein—though being individually far superior tovegetarian sources of protein—offset this advantage by fermenting and putrefying inthe gut and releasing toxins which are not easily eliminated.
They should constitute 50% of the calories consumed daily. The sources ofcarbohydrates are fruits, vegetables, rice, wheat etc. These should be in the naturalform preferably because in the natural form they are in combination with theappropriate vitamins which act as co-factors in their metabolism. Furthermore,natural carbohydrates are preferred to refined carbohydrates e.g. refined wheat andwhite sugar because the natural carbohydrates are closely enmeshed in the fibre ofthe parent food(Buy now from http://www.drugswell.com) substance, in this way retarding their absorption and thus avoidinglarge fluctuations in blood sugars.
These are essential for the integrity of the body. For example metabolism of variousvitamins (A,D,E,K), immune function, nerve myelination, repair of the body tissues and as a source of energy during periods of high demand associated with starvation(as in the marathon runner). In fats, of particular importance are essential fatty acids
These are required in abundance and are very sensitive to heat, cold, processing,storage and dehydration. Hence, in theory some food(Buy now from http://www.drugswell.com)s may contain this ingredientbut due to cooking and or storing processes it may no longer be presente.g.skimming milk takes away the vit. D, the fat and fat soluble nutrients and thusthe most important elements of milk are lost by skimming. These are present inabundance in fruits of the season, fresh vegetables, nuts and other naturalvegetarian food(Buy now from http://www.drugswell.com).
e. Micronutrients
These are an ever-increasing list of substances necessary for metabolism and areavailable mostly from raw vegetables.
…. And Their Clinical Importance
1. Proteins
These are needed in fair amount for both strength and bulk of muscles and areessential to sportsmen who undertake events like football, rugby, shotput, wrestling,boxing, etc. Vegetarian sources of protein are superior to non-vegetarian sources inthat they contain all the necessary ingredients and in their utilizable forms. Due to the increased toxin load of non-vegetarian protein sources, their superior biologicalvalue is rendered less advantageous (in terms of net advantage) (Chart 2).
2. Carbohydrates
These are fuel source for athletes wanting speed,as in short distance running,swimming and in fast field games like hockey, football, etc. The carbohydrate sourcesare rice, fruits, some group A vegetables like carrots, beetroots, potatoes, wheat to acertain extent and honey to a large extent. Non-vegetarian food(Buy now from http://www.drugswell.com)s do not feature inthis category at all. The most superior source of carbohydrates for stamina in sportsis Honey which is quickly converted to glycogen and stored in the liver. This store ofglycogen builds up rapidly because of the presence of all the vitamins and mineralspresent in honey. In India, rice and wheat are the main source of carbohydrates andthis should be backed solidly with a fair share of fruits and their juices. Even thoughwhite sugar and glucose powder are vegetarian sources of food(Buy now from http://www.drugswell.com), they are detrimentalto sportsmen because these substances decrease the pH of the blood, causedemineralisation of bone and 'steal' vitamins from the liver for their metabolism.
3. Fats
The fats from vegetarian sources have the advantages that they contain poly andmonounsaturated fatty acids and essential fatty acids whereas meat like beef, pork,mutton contain largely saturated fatty acids which are detrimental to health.
4. Vitarnins, Minerals and Micronutrients
These are essential for the thousands of reactions in the body taking place inpractically every organ. For instance calcium and potassium are essential for musclefunction. Calcium and phosphates are essential for the strength and resilience ofbones. Sodium chloride is essential for the maintenance of blood pressure andvitamins and minerals act as co-factors in practically every metabolic reaction of thebody whether it be the conversion of glucose to glycogen or burning of fats to obtainenergy. A slight deficiency of these constituents can prevent an athlete fromachieving his maximum potential.
It is clear from the data above and the illustrations that the nutrition of an athlete is not simply an 'eat-more' phenomenon. The quality is as important as the quantity, ifnot more. The timing of food(Buy now from http://www.drugswell.com) and the changes of 'in-season' and 'off-season' nutritionare extremely important because that helps athletes to build up their reserves duringoff-season and hence have them prepared for in-season, high level energyexpenditures.
After observing the effects of putting young school athletes on a balanced vegetariandiet, I am convinced that in order to perform well in any sport it is not necessary tohaves a predominantly non-vegetarian diet. In April, 1988, 60 athletes ranging from 9to 16 years in age were counselled on vegetarian diets. Their performances weremonitored throughout the year upto the competitive season. It was noted that theseathletes had all improved as compared to previous years' performances. Many wereconvincing winners in their events. This however, has been an informal,nonrandomised study. The results are quite evident that, it is not necessary to have apredominantly non-vegetarian diet in order to perform well in sports.
The subject of vegetarianism has been a topic for hot debate ever since the ancientGreek athletes. Various theories were put forward perpetuating the 'veg'-'non-veg'tug-of-war. The vegetarian cause has been amply supported by many athletes. Theathletes who excelled in cycling, long distance walking, marathon running,swimming, tennis and other athletic events like short and middle distancerunning,could perform these feats not only because they set their rrind to it, butbecause a vegetarian diet has every thing that a sportsman needs. In modern timesmany athletes have changed over to a vegetarian diet pattern. Prominent amongstffie celebrities is Martina Navratilova who has dominated the world of tennis for so many years. Many more athletes are changing over and more will, in future.
From the data presented, it is simple to note that for every need of the athlete thereis an adequate vegetarian source. Hence it is not mandatory, as is widely believed,that for an athlete to be successful he must have a non-vegetarian diet. A carefullyplanned vegetarian diet can be as nutritious, if not more, for a sportsman.
Bones and Joints - Some Hard Facts In Vegetarianism
K.T. Dholakia
.
The locomotor system—consisting of bones and joints is the frame of our body. On it are anchored our muscles, with the help of which we are able to move around and perform tasks which would be impossible were it not due to the suppleness of our joints and their wide range of movements. Calcium, phosphorus, Vitamin D and a host of hormonal, dietary and emotional factors play a major role in the integrity of the locomotor system.
The delicate balance between these factors permits many things to go wrong in this system—for instance a deficiency in calcium will cause the entire matrix of the bone to become weaker, or an upset in the Ca:P ratio/product can cause demineralisation of the bone. Under normal circumstances, if we adhere to the norms of Nature this system operates beautifully and permits us to achieve our life's ambitions with the utmost ease.
However, when things go wrong, there are arthritis of various types like osteo-arthritis (OA), rheumatoid arthritis (RA), cervical and lumbar spondylosis, etc., osteoporosis (softening of bones) leading to pathological fractures of bones and resultant morbidity, osteomalacia and a host of other disorders. utmost importance that the correct food(Buy now from http://www.drugswell.com) be consumed in order to maintain our bones and joints in a healthy condition.
Various studies conducted on vegetarians, lacto-ovovegetarians, and omnivores have concluded that there are too many factors affecting bone mineral metabolism and hence it is not possible to state dogmatically the superiority of any one nutritional lifestyle over another. There are points in favour of both sides and both schools of thought have their disadvantages. The calcium content of vegetarian and non-vegetarian sources differs widely
in quantity and the form in which it is present. There are manyfactors that affect calcium absorption and these factorsdetermine the amount of calcium available. Hence the concensus is divided on the superiority of a vegetarian diet over a non-vegetarian diet.
However, on examining the problem many important pointssurface and come to the fore. The most important observation isthat when sulphur-containing food(Buy now from http://www.drugswell.com)s (e.g. meats) are consumedthey change the pH of the blood. So also do the fried food(Buy now from http://www.drugswell.com)s, sourfood(Buy now from http://www.drugswell.com)s and the spicy food(Buy now from http://www.drugswell.com)s in our diet. But, meat has the strongestacid load owing to its rich sulphur content. This increases theacidity of the blood which, in turn, demineralizes bones. Thisleads to osteoporosis. Many surveys have demonstrated thatpost-menopausal women who are vegetarians have a higherbone mineral content as compared to their non-vegetarian(omnivorous) counter parts. Similarly it has also been observedthat though young Caucasian whites measure equally with youngEskimos in bone mineral density, the older Eskimos have a muchlesser bone mineral density as compared to an age matchedCaucasian white.
The reason behind this seems to be the diet of the Eskimos, which is predominantly meat, the blubber of seals, and fish. Thehigh sulphur content of these food(Buy now from http://www.drugswell.com)s causes acidification of theblood which 'melts the bones' in an attempt to buffer this excessacid load.
Furthermore, it has also been noticed that there is a very strongrelationship between joint pains like 'frozen shoulder, cervicalspondylosis and arthritis of other kinds and the kind of food(Buy now from http://www.drugswell.com)eaten. Fried food(Buy now from http://www.drugswell.com)s, spicy, oily food(Buy now from http://www.drugswell.com)s, excessive meats and refinedfood(Buy now from http://www.drugswell.com)s like sweets, confectionery, bread and other refined wheatproducts are the main incriminating factors in joint diseases. Thekind of food(Buy now from http://www.drugswell.com) leads to excess acid load in the blood which the kidneys are unable to cope with. Hence this acid causesinflammation of all joints.
Constipation also initiates the formation of toxins in the gut,which get absorbed into the blood and increase its acidity. This,too, contributes, along with other factors, in the development ofarthritis and bone demineralisation.
Hormones like oestrogen, testosterone, adrenocorticalhormones, thyroid and growth hormone also play a very majorrole in the maintenance of normal body structure and function. Astrong link between hormonal activity and the kind of food(Buy now from http://www.drugswell.com) weeat has been established in several studies.
In perspective, a vegetarian diet, which is rich in fibre and, in theuncooked form, contains a lot of vitamins and minerals provesvery beneficial as it prevents constipation, removes toxic matter from the gastrointestinal tract, thereby preventing increasedacidity of the blood. The increased amounts of minerals andvitamins in vegetarian food(Buy now from http://www.drugswell.com)s contribute richly to the smoothfunctioning of bone metabolism. The acidity (sulphur related) ofa non-vegetarian diet initiates and perpetuates bonedemineralisation as seen by serial bone mineral density studiesdone by direct photon absorptiometry. In contrast the vegetariandiet which contains predominantly uncooked food(Buy now from http://www.drugswell.com) doesn't havethis disadvantage. However, fried food(Buy now from http://www.drugswell.com)s, spicy food(Buy now from http://www.drugswell.com)s andexcessively sour food(Buy now from http://www.drugswell.com)s—whether vegetarian or non-vegetarianare detrimental to bone and joint integrity.
It is a common conception that vegetarians lack calcium in theirdiet and as a result they suffer from bone demineralisationleading to osteoporosis and osteomalacia. This is not true in thecase of a lacto-vegetarian because milk and its products are avery rich source of calcium which is easily available to man.However, there are reports and it is our experience that as ageadvances the digestion of milk becomes more and more difficultowing to decreased gastric acid,enzyme content. Themaldigestion of milk not only gives gastrointestinal discomfortbut also gives an increased acid burden to the body which leadsto joint pains and aggravation of arthritis. Cottage cheese (alsoknown as paneer, clabbered milk, kefir) and whey (the waterobtained during the preparation of cottage cheese) are excellentcalcium sources for a vegetarian and are much less toxic thanthe nonvegetarian sources of protein.
Analysis of the available data shows that vegetarian diets byvirtue of their:
are helpful in preventing and, to a certain extent, relieving thepain and progression of arthritis and bone demineralisation.Owing to the high fibre content vegetarians are rarelyconstipated and this helps a lot in healthy bone and jointmetabolism. Furthermore the reduced acid load and increased vitamin and mineral content of vegetarian food(Buy now from http://www.drugswell.com) makes it thepreferred food(Buy now from http://www.drugswell.com) for preventing joint and bone complications.
Vegetarian Sources of Calcium
1. Milk: in order of preference
i. Goat's
ii. Cow 's
iii. Buffalo 's
Factors that Hinder or Block Calcium Absorption
A. food(Buy now from http://www.drugswell.com)s containing oxalic acids
e.g. spinach, lotus stem, horsegram
B. Lack of Vit. D.
C. Overuse of proteins
e.g. excessive consumption of protein-rich food(Buy now from http://www.drugswell.com)s likemeat, fish, poultry, eggs, etc
D. Excessive use of common salt
E. Excessive use of alcohol
F. Excessive use of coffee
G. Excessive tobacco smoking
H. Excessive use of soft drinks containing phosphorus
I. Excessive use of fat
Finally, an analysis of the risk factors of osteoporosis shows thatstatistically vegetarians have a lesser risk of bone diseasebecause of certain traits e.g. the decreased incidence of tobaccouse, alcoholism, obesity, constipation and hormonal (especiallyoestrogen) imbalance amongst them.
Hence it is evident that vegetarian diets do offer substantialprotection from bone and joint disease provided adequate care istaken to meet the daily calcium, protein and vitaminrequirements.
REFERENCES
Ayurveda - In Depth Vegetarianism
Suresh Chaturvedi
.
Taking care of one's body is every man's primary duty. That is the reason why it is said in Ayurveda—'Only a person with a healthy body can accomplish the four basic principles of life, namely: Dharma (religion), Artha (money), Kama (sexual desires), Moksha (salvation). To attain good health it is essential to follow the rules of good nutrition, regular exercise and regulation in sexual activity. These are said to be the four pillars that keep the body in perfect harmony. Thus a nutritious diet, proper lifestyle, adequate sleep and exercise are instrumental in keeping the body free of all ailments. Human beings have four instincts i.e. appetite, sleep, fear and sexual desire. In life these instincts have played a prominent role.'
In Ayurveda, it is believed that all living beings are a composite of the five basic elements i.e. Earth, Water, Fire, Air and Sky. In order to keep life going, it is important to replenish these elements through natural food(Buy now from http://www.drugswell.com)s which are the sources of these elements. Natural food(Buy now from http://www.drugswell.com)s, which are vegetables, fruits, nuts, cereals and other food(Buy now from http://www.drugswell.com)stuffs are essential to obtain these ingredients and these food(Buy now from http://www.drugswell.com)s are all classed as vegetarian food(Buy now from http://www.drugswell.com) sources. Grains like rice, wheat, pulses have been given a very special place in Ayurvedic literature as the main food(Buy now from http://www.drugswell.com)s for man.
It is said in the Sanskrit literature that within grains there is life and it is with grains only that life persists. It is only within the vegetarian diet that you find all these components of food(Buy now from http://www.drugswell.com). Similarly the milk obtained from buffalos, cows, goats and other animals and milk products like curd, butter, ghee, etc. are also obtainable within a vegetarian diet. These vegetarian food(Buy now from http://www.drugswell.com)s supply nutrients in adequate quantity and quality right through life. Regular intake of these vegetarian food(Buy now from http://www.drugswell.com)s ensures appropriate development, both mental and physical, and also protects the consumer from various diseases. Given below is a brief discussion on the values of individual food(Buy now from http://www.drugswell.com) items:
A. CEREALS
Wheat
In a vegetarian diet the various products made from wheat flour play an important role. Wheat strengthens the body and its use increases all the elements of the body. Wheat products like roti, broken wheat (dalia), sheera (halwa), bread, biscuits, etc. not
only taste good but are also easy to digest.
Rice
Rice forms an important component of our diet. Rice, too, is lightand easy to digest. The use of rice increases the enzymes,components of blood, muscles and other elements of the body. Itis owing to rice that the body remains light and energetic. Riceand its products are useful in the treatment of constipation,fever, diarrhoea, dysentery, abdominal complaints andemaciation.
Barley
Barley helps to stimulate the digestive system and increasesvitality and makes you alert. Barley is useful in the treatment ofcommon colds, fever, asthma, sore throat, urinary tract infectionand skin diseases. Barley water is used in various diseases.
Bajra
Bajra is useful for body building. Its consumption strengthens thebody and forms all the elements of the body in the rightproportions.
Jawar
Jawar reduces the heat in the body and is useful in pitha andPitha-related diseases. This is easy to digest and is also used incuring abdominal diseases. Jawar increases strength and sexual potency.
B. PULSES
Bengal Gram (Chana)
It is Bengal Gram dal and Gram flour (besan) that also improveshealth, gives strength and stimulates sexual potency. A fistful ofgram soaked overnight and tied in a cloth will stimulatesprouting of gram. The use of these sprouts is very nourishing.
Red Gram Dal (Toor Dal/Arhar)
Toor dal is easy to digest, helps in the formation of stools, and isusefuL in piths and pitha-related diseases. Similarly green gram(moong) is also easy to digest and is useful in eliminating pithaand helps to ease burning sensations of the body anti stomach. Itcan also be consumed in diseases of bones and diarrhoea.
Black Gram (Udad); Black Gram Dal (Udad Dal)
Black Gram is useful in treating the various diseases caused byvata. It increases the muscle strength and sexual potency of the consumer.
Lentil (Masoor and Masoor Dal)
Masoor is light to digest and helps in the formation of wellformed stools. It is also helpful in blood and skin diseases.
C. OILS AND OILSEEDS White and Black Gingelly Seeds (Til Seeds)
Both white and black gingelly seeds are useful. Consumption ofthese increases strength, eliminates worm infestation from theintestine, strengthens the roots of hair thereby making themhealthy. They are useful in increasing the milk production inlactating mothers and is also used in treating complaints likepolyuria.
The presence of some sort of oil/fat in our diet is also essential.This can be obtained from milk and various oilseeds. Different types of oils are used in different regions of our country.
Gingelly Oil (Til Oil)
It strengthens the body and stimulates and improves thedigestive system. A massage with this oil is beneficial to the skinand eyes.
Mustard Oil (Sarso or Rai Oil)
This oil is mainly consumed in the north-easternregion.Consumption of this brings about the elimination of Kaphaand vata-related disorders. It also eliminates worm infestations from the intestine. A massage of the body with this oil removesdryness of the skin, makes it soft and smooth and strengthensthe muscles.
Groundnuts
These nuts are predominantly used in the western coast of Indiaand are useful in the elimination of abdominal and body vata.
D. VEGETABLES Potato
Potatoes are a very common constituent of our diet and they canbe served in combination with many other vegetables. They areavailable in all seasons. Potatoes stimulate the formation of all the elements of the body and impart strength to the body.
Beetroot
Beetroots destroy vata and diseases arising from the formationof vata. They are also useful in kappa diseases. They increasethe muscle and fat content of the body and thereby make it strong.
Mustard (Sarson)
Mustard is good for constipation and other abdominal diseases.
Cabbage
Cabbage is a sweet vegetable useful in kapha and pithadiseases. It helps in the treatment of diabetes, diseases of theurinary system, skin diseases, leucoderma, leprosy, asthma,bronchitis, infections of the skin like boils, cellulitis etc.
Bitter Gourd (Karela)
Karela is useful in the treatment of fever, diabetes and jaundice.In addition it is also useful in the treatment of intestinal worms, dysentery and some skin diseases.
Amorphophallus (Jimikand Suran)
Suran is useful in the treatment of piles and diseases related toan enlarged spleen.
Brinjal (Baingan)
Brinjal relieves diseases related to vata and kapha. It is a sexualstimulant and increases fertility.
Beans (Same Phalli)
Beans increase strength and are useful in diseases related toVats and Pitha.
White Gourd (Dudhi)
Dudhi improves vision and is useful for all loose constipation,diseases of the female reproductive organs, fevers, bronchitis,asthma, dysentery and urinary infections.
Snake Gourd (Padwal)
Snake gourd is good for abdominal disorders like constipationand dysentery. It is good for fevers, liver and spleen disorders.
Spinach (Palak)
Spinach is a mild laxative. Thereby it serves to stimulate theappetite also. It stimulates the production of many enzymes inthe gastrointestinal tract and also helps to enrich the blood withmany minerals especially iron. Various abdominal problems, mildto moderate fever, swelling of the eyes and long-standingconstipation are all the other indications for the use of spinach.
Amaranth (Chaulai)
Amaranth stimulates digestion, improves urinary flow and easesbowel movements It improves appetite and enriches the blood.This vegetable is very useful in constipation, some kinds ofdysentery, liver disorders, enlarged spleen, eye diseases andlong standing fevers.
Fenugreek (Methi)
Fenugreek improves the digestive power. It also helps inconditions where there is loss of appetite, bowel disorders (likedysentery) intestinal worm infestation, fever, swelling of theeyes, pain in the joints, distension of the abdomen and othervata-related disorders. (Its role in reducing blood sugar isacclaimed by some researchers).
Ghosala (Turia)
Turia increases milk production in lactating mothers. It is asexual stimulant. Abdominal pain, distension, flatulence, feverand diseases of the uterus are relieved by the use of thisvegetable. It also destroys intestinal worms and helps cure piles.
Coriander (Dhania) and Mint Leaves (Phudina)
Coriander improves the taste of food(Buy now from http://www.drugswell.com). They are useful inconditions like indigestion, piles, emaciation, intestinal wormsand dysentery.
Cucumber (Kakdi)
Cucumber is beneficial in Pltha and various diseases related to it. It helps to cleanse the urine and is also useful in cases of renalstones. It has also been proved to be very useful in leprosy,burning paresthesiae and burning in the urine.
Radish (Mulah /Muli)
Radishes cure various abdominal disorders like stomach aches, abdominal distension, flatulence or gas formation, loss ofappetite and constipation. They are also used in the treatment ofpiles, obstruction in urinary flow and renal stones. Chewing on aradish instantly cures hiccups. It is also used in skin diseases andleprosy.
Onions (Pyaz / Kanda)
Onions stimulate the digestive systems. They are nourishing andincrease the elements of the body. Consumption of onionscauses reduction in fever. They are used in epilepsy and in casesof hysterical unconsciousness where, if a person is made to smellit, he awakens. It is also helpful in the treatment of sun-stroke.
Garlic (Lasoon)
The daily consumption of garlic chutney cures abdominal pain,formation of flatulence/gas, abdominal cramps and other vatarelated diseases. Consumption of garlic juice frequently in smallamounts is useful in cholera. It is used in disorders of the spleen,high blood-pressure, epilepsy, old wounds, scabies, persistentcough, boils in the ear and syphilis too.
E. FRUITS
Grapes (Angur)
Grapes are consumed in various diseases as they are consideredto protect health. They alleviate sour eructation, burning ulcers,heaviness in the stomach, constipation, head-ache, fever,weakness and giddiness.
Mango (Aam, Amba)
Mango increases strength and sexual potency and cleans andimproves the colour of the skin. Besides carbohydrates, it alsocontains vitamin B and E in adequate amounts. It is beneficial inchronic abdominal disorders, diarrhoea, bowel disorders, tuberculosis, cough and deficiencies.in the blood. A beveragecalled Hannah which is made from raw mangoes helps in theprevention of sun-stroke.
Banana
Banana is a good source of energy. It finds use in the treatmentof dysentery, burning in the stomach, piles and intestinalproblems. Due to its 'cold' nature it finds use in bilious disordersand problems related to heat. It is useful in urinary disturbances.
It is considered to be a complete food(Buy now from http://www.drugswell.com).
Orange (Santra)
Oranges are useful in the treatment of fever and constipation.
Custard-Apple (Sitaphal)
Custard Apple is beneficial in the treatment of nausea, vomitingand apathy.
Sapota (Chikoo)
Chikoo is used as an ideal food(Buy now from http://www.drugswell.com) during an illness as it promotesstrength and gives energy.
Guava (Amrud, Peru)
Guava is strengthening as well as it helps to increase theelements of the body. It is useful in treating abdominal pain,unconsciousness and worm infestation.
Apple (Sev)
Apples are useful in the formation of enzymes, blood, muscle andfat. They are also useful in the treatment of bowel disorders likeconstipation, dysentery and piles.
Figs (Anjeer)
Figs are beneficial in the treatment of constipation, piles, heartproblems, jaundice and various diseases of the urinary tract.They also purify the blood.
Musk Melon (Kharbooja)
Musk Melon stops burning sensation of the skin and reducesexcessive thirst. It has been proved to be useful in insanity andfor development of neurons of the brain.
Lichi
Lichies are very nourishing. They are beneficial in overcomingweakness that follows an illness. They also purify the blood. Theystrengthen the digestive system. Lichi juice is useful in urinarydisturbances. They have also been proved to be beneficial inregulating heart beats and improve the general resistance of thebody.
Pomegranate (Anar)
Pomegranate is useful in the treatment of bowel disturbances,dysentery, nausea, vomiting, eructations and disorders of thestomach. It is very beneficial for the heart. It is useful in thetreatment of burning sensation of the eyes, worm infestation inthe intestine, fever and burning rnicturition.
Water Melon (Tarbuj / Kalingad)
Water Melon destroys various disorders caused by pitha andreduces the body heat. It tranquilizes the mind.
Pear (Nashpati)
Regular consumption of Pears has an aphrodisiac effect. Its useis beneficial in loss of appetite, excessive thirst, vomiting andchronic constipation.
Plum (Aloobokhara)
Plums are useful in the treatment of piles, body-ache, pain in thejoints and in vata-related diseases. It is especially useful injaundice.
Wood-Apple (Kaith)
Wood Apple is highly beneficial in the treatment of boweldisorders, hiccups, asthma, ear-ache, and in abdominal disordersof children.
Pineapple (Ananas)
Pineapple is very beneficial for the heart and in the treatment ofworm infestation in the intestine, fever, diphtheria, swelling inthe body, excess heat in the body, excessive thirst, giddinessand weakness.
Dates (Khajur)
Dates enrich the blood. They are also useful in the treatment ofnausea, stomach-ache, fever, influenza, urinary obstruction,constipation and headache. Drinking milk after consuming datesmakes the body healthy and strong. Dates are also sexualstimulants.
Dried Dates (Chooara)
Dried dates are beneficial in various abdominal disorders and also stimulate the digestive system. They also increase sexual potency.
Bael Fruit (Bel Phal)
Bael Fruit is beneficial in various abdominal disorders and it stimulates the digestive system.
Zizyphus (Ber)
Zizyphus is useful in fever, bowel disturbances, burningsensation of the body, burning sensation while urinating andurinary obstruction. It also helps in reducing excessive thirst andacts as a sexual stimulant.
Almond (Badam)
Almonds increase kapha and all the elements in the body, andare also essentially very nourishing. They also increase the memory.
Makhana
Consumption of makhana reduces the body heat, and is alsoideal in bowel disturbances. It is very beneficial for the heart andis very nutritious and acts as a stimulant.
F. MILK AND MILK PRODUCTS Milk (Dudh)
Milk increases the elements of the body and their resistancepower. It is a laxative. It is taken as a complete food(Buy now from http://www.drugswell.com) by allanimals. Its consumption is beneficial in the treatment of chronicfever, dizziness, weak-mindedness, tuberculosis, anaemia, fatigue and tiredness, leprosy, piles and complaints of theurinary organs.
Curd / Yogurt (Dahi)
Curd can be used as lassi and its use is beneficial in chronic fever, dizziness, weak-mindedness, tuberculosis, anaemia, when the body elements decrease, fatigue and tiredness, leprosy, pilesand complaints of the urinary organs.
Clarified Butter (Ghee)
Consumption of ghee rids the body of dryness and the skinbecomes soft and the face glows. It also strengthens the bones.It is useful in the treatment of body-ache, pain in the joints andvarious other vata-related disorders. Regular consumption of ghee wards off mental disorders. However, excessiveconsumption, too, is not advisable.
G. SPICES
In our diet we also use small quantities of spices which play aprotective role.
Salt (Nimak)
It stimulates the digestive system and thus also improves theappetite. In cases of chest congestion, stomach-aches,abdominal distension and abdominal cramps and in other suchdiscomforts, relief can be obtained by sucking on a pinch of salt.
Turmeric (Haldi)
Turmeric is useful in conditions of vats, pitha, and kapha. It hasbeen proved to be beneficial in the treatment of cough, syphilis,fever, influenza, polyuria and worm infestation of the intestine.
Asafoetida (Hing)
Asafoetida has been proved to be beneficial in the treatment offlatulence / gas formation, high fever, hysteria, stomach-ache inchildren, indigestion, distension and toothache.
Cumin Seeds (Jeera)
They have been proved to be beneficial in loose motions, heart burn, chronic fever and eructations.
Omum (Ajwain)
Ajwain is used in the treatment of stomach-ache, loss ofappetite, indigestion, distension, constipation, worm infestationof the intestine, asthma, for proper digestion of food(Buy now from http://www.drugswell.com) anddiseases of the uterus.
Aniseeds (Saunf)
Aniseeds are useful in the treatment of stomach-ache, piles,constipation, nausea ancvomltmg.
Cloves (Lavang / Long)
Cloves have been proved to help in the treatment of slight fever,influenza, chronic cold, vomiting during pregnancy andtoothache.
Cardamom (Elaichi)
Cardamom is useful in fever, flatulence / gas formation, weakeyesight, aphthous ulcers, nausea and cough with mucus.
Ginger (Adrak)
Ginger should be regularly used to avoid flatulence/gasformation, stomach ache, indigestion, vata-related disorders andloss of appetite. It stimulates the digestive system. It is useful inthe treatment of gout, pain in the joints, swelling, abdominaldistension, diarrhoea, headache, earache, chronic bowel disorders, excess mucus, cold with a sore throat and cough.
Black Pepper (Kali Mirch/Miri)
Black Pepper is beneficial in the treatment of heart diseases,flatulence / gas disturbances, stomach-ache, abdominaldistension, piles, bowel disturbances, diarrhoea and worminfestation of intestine, cholera, cold, cough, hiccups, pitharelated disorders, weak memory, sore throat and stammering.
Nutmeg (Jaiphal)
Nutrneg has been proved to be beneficial in treating headachesin children, cough, pain in the chest, influenzas pneumonia,bowel disturbances and vomiting. It is also helpful in thetreatment of toothache and worm infestation.
Cinnaznon (Dalchini)
This helps in the digestion of food(Buy now from http://www.drugswell.com). It destroys flatulence. It isuseful in bowel disturbances like diarrhoea.
Bay Leaf (Tej Parta)
Bay Leaf is beneficial in cold, cough, asthma, chronic cold,bodyache, pain in the joints, stomach ache and disorders of the uterus.
Tarnarind (Imli)
It is beneficial in the treatment of Pitha in the body, nausea,bleeding piles and tendency towards sun-stroke.
Sugarcane (Ganna):
Sugarcane is a good source of energy. It promotes the flow ofurine,hence it is useful in urinary stones and urinary infections. Itis also useful in jaundice, anaemia and constipation. It strengthens the heart muscle, it is a good source of minerals andit also is a mild sexual stimulant. It is also useful in the treatment of nasal bleeding, hiccups, headache and helps to quench thirst.
Sugar (Shakkar)
Sugar is a good source of energy and it provides relief in fatigue, nausea and vomiting.
Honey (Shahad)
It provides energy and is versatile in its qualities. It enhances the value of the food(Buy now from http://www.drugswell.com) it is consumed with (e.g. milk). It is useful for treating sore throats, it also improves digestion and is useful in the treatment of cough, asthma, piles, leprosy, tuberculosis, blood disorders, urinary disorders, nausea, vomiting, hiccups, constipation. It is also food(Buy now from http://www.drugswell.com) for the complexion. It helps in weight reduction when taken with water. It is very nutritious in combination with milk.
Jaggery (Gur/Gud)
If jaggery is regularly consumed along with the meals, it is highly beneficial to the heart and also helps to prevent various kinds of heart diseases. It also acts as a sex stimulant. Consumption of jaggery with dry fruits is very strengthening. It is beneficial in various vata-related disorders, gout and body ache. Jaggery water cleanses the urinary system and ensures a good flow of urine.
From the above observations it is apparent that the vegetarian cuisine promotes quality of life. Vegetarian food(Buy now from http://www.drugswell.com)s can also play a role in healing diseases, In fact in Ayurveda the medicine itself is vegetarian food(Buy now from http://www.drugswell.com).
Vegetarianism- Naturally Speaking
M.M. Bhamgara
.
Yoga per se, does not say much about diet, except that we should be 'Mitahari' (Mita-Ahar-ee), 'Mita' meaning 'proportionate' or 'enough to nourish', and 'Ahar' meaning 'food(Buy now from http://www.drugswell.com)'. 'Mitahar therefore, has come to mean 'moderation in eating'. But, we know, it is not enough to be moderate in intake of pebulum. It is not enough to mind the quantity of food(Buy now from http://www.drugswell.com); quality of food(Buy now from http://www.drugswell.com) ingested is of even greater importance. In Yoga shastras, Mitahar has been described as diet that is
Hindu shastras also speak about the three 'Guna' of food(Buy now from http://www.drugswell.com), 'Guns' meaning quality. 'Sattwic' food(Buy now from http://www.drugswell.com) is variously understood as'contributing to serenity', 'providing the essentials', Keeping thehuman organism sweet and clean', etc. 'Rajasic' food(Buy now from http://www.drugswell.com) contributes to dynamism and other requisite qualities needed bya householder or housewife. 'Tamasic' food(Buy now from http://www.drugswell.com) is strong in taste orsmell and can be 'heaty' or 'exciting passions'.
Revelations of Science
In the light of modern nutritional researches, we have to find outthe ideal diet which is both 'Mita and Sattwic, so that the Yogapractitioner benefits therefrom both physically and mentally. Letus find out whether Yoga should favour the intake of flesh, fish orfowl. What does human anatomy and physiology tell us? It maybe news to many that structurally and functionally, we arevegetarian animals in the same class as the primates, the higherapes, such as gorilla, chimpanzee or orangutan. Here are someof the salient similarities:
bile into the gut to deal with the high-fat meat diet.
These facts are convincingly in favour of vegetarianism for all ofus. But just any type of vegetarian diet is not alright for oursystems. For example, we do not have several stomachs that aruminating cow has, and we do not chew the cud as she does;therefore, we cannot live off pasture-lands. We are frugivoreslike gorilla (diet 15% fruits), or chimps (67% fruits), or orang(50% fruits), who besides fruits eat some vegetables, shoots,flowers, seeds, etc.
Adaptability of the Human System
Of course the human system does adapt itself to non-vegetarianfood(Buy now from http://www.drugswell.com)s, but this is not without certain drawbacks. Eskimos, for example may live on reindeer and seal meat, but they die early,their average life span being about thirty years. What our humansystem can easily and profitably utilise, digest, absorb andassirnilate, is a diet consisting of fresh fruits, leafy and othervegetables, seeds, nuts, cereals and legumes.
We have domesticated certain animals whose milk we use— and justify the use. However we should bear in mind that no adultdrinks other animal's milk and no animal continues to drink milk after it is weaned ! In this discussion, we have included dairyproducts in vegetarian diet, though it must be pointed out thatthere are vegans who maintain excellent health on a vegetariandiet excluding dairy produce. Chinese and Japanese vegetarianstoo, do not take dairy products.
Cholesterol versus Chlorophyll
Nowadays, flesh diet is increasingly incriminated by discerningmedical men for creating pathological disturbances in the humanbody.
Animal fats are a well-known cause of increase in cholesterol in our blood. This increase may result in the narrowing of the lumenof arteries by fatty deposits; if this happens in coronary arteries,the blood supply to heart muscle itself may be affected, thuscausing a heart attack. When several major arteries andarterioles develop atherosclerosis, blood pressure may increase;and with high blood pressure, several pathological conditionsmay develop in various organs. Cerebral haemorrhage, too, canoccur, resulting in paralysis.
Since half of the fat in all meats is saturated and cholesterol producing, and since even the most lean part of meat also hassome fat in it, all types of meat should be prohibited in personssuffering from cardiovascular disorders. Non-flesh food(Buy now from http://www.drugswell.com)s excepteggs, hydrogenated oils and dairy products have no cholesterolproducing fats. Coconut oil has no cholesterol, though it is high in saturated fats.
Cardiologists now increasingly advise their patients againstmeat. As early as 1961, the Journal ofAmerican MedicalAssociation conceded that a strict vegetarzan diet could preventninety seven per cent of coronary occlusions ! Dr. Donald Ross,Director of Surgery in the National Heart Hospital, London,advocates a study of vegetarian communities, since theincidence of heart disease in them is much lower than non-vegetarian communities. He advises his patients to halve theirmeat intake, and double their vegetable intake, also cautioningat the same time to restrict dairy fats. He also moots thepossibility that the human race has not yet adapted to meatprotein; in fact, he believes that atheroma could be a process ofthe body's rejection of meat proteins taken over a long period oftime.
It is also to be noted that gall-stones are usually composed ofcholesterol; hence, the less one takes of animal fat, the less one is likely to suffer from stone formation in the gall-bladder(cholelithiasis ) .
The Nature Cure dietetic injunction is on sound footings; NatureCure suggests that chlorophyll which is present in leafy and othergreens, be eaten in large enough quantities to keep the bloodstream free of cholesterol deposits, so that neither the clots,known as thrombi, form in the blood, nor are the arteries affected. Vitamins C and E derived from uncooked (reallyspeaking sun-cooked) fruits and vegetables, including the innerrind of citrus fruits, are also Nature's anti-thrombosis agents.
Vitamin C is important for inter-cellular respiration, fightinginfections and healing inflammations. Dr. Linus Pauling, thechampion advocate of Vitamin C in mega doses, avers that manonce lived mainly on vegetables and fruits, consuming up tothree grams of vitamin C daily. Later, with the inventions of fire,and cooking of food(Buy now from http://www.drugswell.com), and also with man becoming a hunter andflesh eater his intake of vitamin C was greatly reduced; theaftermath was loss of health and vigour. Flesh eaters should notethat meat mostly lacks vitamin C.
Vegetarian diet Spares Kidneys
Another drawback of the meat diet is that it has a high uric acidcontent. In the last throes of death, all animals produce acids intheir tissues; these are not drained offwith blood. Mutton, beef, pork, etc. contain fourteen to sixteen grains (1 grain=60 grams)of uric acid per pound of meat. Human kidneys not being madefor excretion of fleshy toxins, cannot easily cope with excretionof more than seven grains of uric acid per day. No wonder then,that large flesh eaters who consume more than half a pound ofmeat daily, over-load their kidneys. Result may be kidney stones or inflammation in kidney tissue, to start with; and kidney failurein the long run. Dialysers and surgical transplants do not solvethe problem of increase in kidney diseases.
Research has shown that the flesh-eater has also to eliminate tissue wastes in the meat, which the animal's kidneys wouldhave excreted if it had not been slaughtered. Nephritis is oftenthe result of these excess fleshy wastes. Seventh Day Adventistdoctors who advocate vegetarianism, rightly feel that themeatless diet spares the kidneys, for they have seen quite oftenthat meat acts like a poison to Bright's disease or nephritispatients. In cases that show albumin in appreciable amount intheir urine, they advise a diet free of all meat, fish, fowl andeggs; the result is clear urine in a week or two. Uric acid alsoleads to troubles such as gout and to a lesser extent, all types offibrositis, neuritis and neuralgia, including what are calledlumbago and sciatica, besides arthritis or inflammation of thejoints.
Meat and Cancer
Another drawback of meat is that it has no fibre content; it lacks cellulose or roughage, which is a must in the human diet; withoutroughage, bowels cannot move properly, and we suffer fromconstipation. Unfortunately, most medical men believe thatconstipation is not a health problem; they think it is alright evenif stools are voided once in two or three days or even a week !But those who know better, lift a cautionary finger againstconstipation, calling it 'the fertile mother of many diseases'.Comparing our system again to the organism of our arborealancestors, the apes, we find that they eliminate faeces at leasttwice a day; so should we!
Now, however, the orthodox medical view is also changing.Bowel cancer is on the rise in countries which are traditionallynon-vegetarian, and where, therefore, constipation is rife.Australia which consumes 130 kilograms of beef per year perhead, suffers more from bowel cancer than other countries; no other country eats so much of flesh food(Buy now from http://www.drugswell.com), though Scotland,Finland and USA are very near the mark. Incidence of cancer ofcolon is high in these countries too.
Dr. Alan Lorg, writing for 'The Vegetarian' magazine of U.K. says"Intestinal flora of vegetarians differ from flesh-eaters; theycontain more aerobic bacteria. The flesheaters' anaerobic bacteria include bacteroides containing the enzyme 7alphadehydroxylase, which converts components in the bilejuices into deoxycholates, known to be carcinogenic in animals.Concentration of deoxycholates in the faeces is related to theprevalence of colonic cancer. A survey published in 1973 in theJournal of the National Cancer Institute compared the faeces ofpeople on a normal high-protein-high-fat U. S. diet with those from vegetarians, Seventh Day Adventists and recent Chineseand Japanese immigrants. Excretion of the degradation productsof cholesterol and of total and degraded bile acid was higher inthe flesh-eating group, which bore out earlier contentions. Low-residue diets (deficient in fibre) with correspondingly prolongedtransit-tirnes (constipation) and greater opportunities for theaction of 7-alpha-dehydroxylases were incriminated in 1971 byDr. Burkitt. Reports in the 'Gut' Journal in 1969, and in the BritishJournal of Cancer in 1973, remark that rates of mortality fromcancer of the colon relate with consumption of animal protein. "
Let alone the fell disease cancer, the less serious conditions of appendicitis and haemorrhoids—commonly called piles—arealways due to constipation, whether latent or patent.
....And Diabetes Too!
Diabetes is generally associated with too much intake of refinedcarbohydrates, i.e. starches and sugars. In Bombay, theincidence of diabetes is twice as high among vegetarians thanamong non-vegetarians. Medical men recommend a high-proteinmeat diet to their diabetic patients, under the notion that thiswould not tax the pancreas to secrete insulin, because, withincrease in meat intake, carbohydrate intake would ipso factodecrease. Here, the surmise is correct, but it is a very myopicview of total metabolism.
A study by a medical team led by Prof. N.S.P. Verma, AssociateProfessor of Medicine at the Maulana Azad Medical College, NewDelhi, has found that the fibre content of vegetables acts as aprotection against diabetes in many cases. Dr. Verma said at aseminar on 'Diabetes and Cardio-vascular Diseases' on 23rd October, 1975, that the best way to reduce chances of 'catching'diabetes was to eat more vegetables and unpolished cereals.
Since meat constipates, it dams excretion, throwing extra burdenon kidneys and liver, the two important depurative organs, whichoften are involved in the genesis of diabetes. A better plan is tokeep the diabetic on a vegetarian diet, induding whole-graincereals, sprouted legumes and plenty of non-starchy vegetables,leafy greens and fruits. Papaya, oranges, grape-fruits, amalas,apples, peaches, plums and pears are especially prescribed.
A detailed study of diabetes reveals that it is not only an excesscarbohydrate disease; it can be a high-protein or even high-fatdisease.
Since there is too much fat in some meats—mutton has 13% fat though it may look all muscle; beef meat has 10% fat—it canresult in obesity. Dr. O.S. Parrett, M.D., has pointed out that in fatpeople, some fat infiltrates the liver tissues. The liver is thestore-house of glycogen (liver carbohydrate), but in the obese, the extra useless fat cells in the liver impede the function of thehealthy liver cells; this results in poor storage of sugar and starchin liver, thereby the blood being over-loaded with sugar. Thekidneys have to do the job of eliminating this sweet burden ofthe blood; thus sugar makes its appearance in the urine. It willbe seen, then, that in obese diabetics, the fault may not lie withthe pancreas, but with the liver. The cure results when thesufferer reduces weight.
Regarding the prescription of a meat diet by medical men totheir diabetic patient, Dr. Parrett explains: "food(Buy now from http://www.drugswell.com)s to be avoidedin diabetes are starch and sugar in excess. When the bloodwhich normally carries a maximum of 120 mg of sugar, reaches175 mg or so, there is spill-over of sugar into the urine throughthe kidneys. We then seek a diet for the patient that yields itscarbohydrates as slowly as possible, lest the blood stream tooquickly reach the spill-over level, and it appears in the urine ....Meat which is mostly protein with little carbohydrate—glycogen—would seem to answer this diet need admirably, except for twoimportant reasons. "
These two important reasons are:
As it is, even the vegetarian diabetic's system is usuallyburdened with toxins; the non-vegetarian's would be all the moreloaded, increasing the risk of acidosis. Dr. Parett suggests a dietprogramme of low proteins for the diabetic. He also suggests lowstarch vegetables which add carbohydrates slowly to the bloodstream. He considers tomatoes as ideal because of their low starch and high vitamin and mineral content. Dr. Andrew Gold inhis book 'Diabetes: Its Causes and Treatment' suggestsvegetarian diet, because he also has noticed that "the ingestionof butcher meat increases the toxaemic condition underlying thediabetic state and reduces sugar tolerances On the other hand,the non flesh, non-stimulating and especially unfried vegetariandiet promotes and increases sugar tolerance, "
Meat is Not Mita
Now if we revert to the definitions of Mita and Sattwic diet, we find meat totally contra-indicated in Yoga.
Be a Vegetarian—But Eat Wisely
Meat diet is wrong; but vegetarian diet can also be wrong. It isgood to be a vegetarian, but not enough. Many vegetarian itemsare Tamasic, unhealthy, even poisonous to the system. We knowalcohol is not Sattwic; we ought to know also that tea, coffee andcocoa, containing harmful alkaloids such as theine, caffeine andtheobromine, are also not Sattwic, Chocolate made out of cocoa, and Coca which contains caffeine, and therefore can be addictive, are also not for Yoga Practitioners. Tobacco isunhealthy on all counts, whichever way it is used. All these areproscribed items, though there is nothing nonvegetarian about them.
Few, however, even among vegetarians know about the harm ofrefined carbohydrates, i.e. sugars and starches. Refined sugar,which is, chemically speaking 99 per cent sugar, and is devoid ofall vitamins and minerals originally contained in sugarcane fromwhich it is made, is a very harmful substance. Not only does itcontribute to dental cavities and diabetes, but also to osteoporosis and arthritis. Though by chemical reaction it isneutral, it is acidic in our system, and may cause hyperacidityand peptic ulcers. According to Prof. John Yudkin, it also leads toheart disease, as much as animal fats do. Moreover, a research project in USA has traced the connection between anteriorpoliomyelitis and much sugar intake. Links betweenhypersucrophagy (too much eating of sugar) and psychologicaldisturbances also have been established. For some years of hislife, Adolf Hitler was a vegetarian under medical advice but hewas too fond of sugar, putting sugar in everything he ate ordrank. Nutritionists are of the opinion that he was sugar-drunk,time and again, which affected his psyche.
Even in children, it is observed that hyper-sucrophagy tends tomake them peevish or cantankerous. We all need sugar, but ithas to come from naturally sweet fruits; if these are not easilyavailable, dry fruits are a good substitute.
Vegetarians also need to avoid fried items. Boiling, baking andsteaming are conservative modes of cooking to recommend.
Spicy Yoga
A word about strong spices and condiments. Yoga tradition is toavoid onion and garlic, as these are strong smelling andtherefore in the category of Tamasic; chillies and pepper thougha greater irritant to the mucous lining of the gastrointestinaltract, get a clean chit from Yoga practitioners because they donot have a strong odour. In the light of new discoveries, howeverwe may have to include onions and garlic in a health promotingYogic diet, as these two have been variously ascribed the virtuesof lowering high blood pressure, disinfecting bowels and curbingtuberculosis. On the other hand, chillies have no such merits, though they are high in vitamin C if taken fresh. The demerit isthat chillies cannot only set the so-called delicate but in realitytough inner walls of the alimentary canal aflame, their irritatingfactor can similarly cauterise or scorch the cells of the liver andthe kidneys. Indians in England are said to suffer from 'CurryKidneys' due to an excess of chillies.
Here, the plea for onions and garlic is only as herbs and to addflavour and taste to other dishes; these need not be taken to the extent that one smells of them.
Thou Shalt not Kill
This study of a non-vegetarian diet is made from a medical n~e.However, since Hatha Yoga cons sts of eight facets (Ashes Anga),one of which is Yama which again includes Ahimsa, Yogic dietmay be studied from the angle of Ahimsa also.
Ahimsa means non-violence, or non-killing. It is wrongly believed that the intention not to kill implies not killing other human beings. This is a very narrow view. Non-killing means not killing any animal, whether for food(Buy now from http://www.drugswell.com), clothing or sport. Under this broad definition of Ahimsa therefore, Yoga indirectly proscribes and prohibits meat diet.
Vedic Rishis may have partaken of meat under some dire circumstances, but these do not exist for us in modern times. From the humanitarian angle, the spiritual angle, the nutritional angle as well as the ecological angle, meat diet has no locus standi; it had better be eschewed.
Vegetarianism- From The Dentist's Chair
N. C. Sharma
.
It appears that nutritional factors have definite influence on the incidence of periodontal problems (Table 1).
Table 1 Summary of Literature Pertaining to the Influence of Nutritional Factors on the Incidence of Periodontal Problems
Positive Correlation Absence of any PositiveFactors Found Correlation
Good Nutrition 22
Protein 41
Minerals 3
Calcium &
1
Phosphorus
Iron -1
Vitamins
51
(general)
A4 3
B9 1
C 29 11 D3
For more than 37 years we have been treating people from allwalks of life and from practically all economic groups for theirdental problems. From our records, using a random samplingtechnique, we have analysed these data. Table 2 shows theincidence of dental problems in Bombay Hospital. Bombay'spopulation being so cosmopolitan in caste, creed, hygienichabits, nutritional behaviour and income groups that the figuresmight as well be taken as representative of the entire country(except, of courses for climatic and hereditary condition).
Table 2 Incidence of Dental Problems in Bombay
| Problems | Male % | Female % |
| Caries | 31.8 | 43.9 |
| Periodontal bone | ||
| absorption: | ||
| (a) Vertical | 5.3 | 4.5 |
| (b) Horizontal | 10.7 | 15.4 |
The Relationship of Nutrition with the Incidence of DentalProblems
To examine the effect of nutritional factors, the patients weredivided in two main groups on the basis of inquiry regarding theirfood(Buy now from http://www.drugswell.com) habits. These were classified into
The protein and caloric groups were determined on the basis ofaverage daily intake of food(Buy now from http://www.drugswell.com) and on the basis of standard food(Buy now from http://www.drugswell.com)value tables showing the nutritional values of various Indianfood(Buy now from http://www.drugswell.com)s. It could be summarised from these data (Table 3) that theincidence of caries is lower in vegetarians.
Table 3 Incidence of Dental Problems in Bombay in Relation toGeneral Nutrition
Problems Mixed Diet Vegetarian Diet
High Protein-Low Protein-Low Calorie High Calorie
Group Group Protein Intake 60g Protein Intake 35g
| Daily | Calorie Intake | Calorie Intake |
| 1900 | 2500 | |
| % | % | |
| Caries | 55 | 45 |
| Periodontal Bone Absorption | 45 | 55 |
The following ingredients in the food(Buy now from http://www.drugswell.com) are connected with dentalproblems.
Vitamin C
Vitamin C has been implicated in various physiological andbiochemical functions of the body. Besides its involvement in thefunctions like electron transport, metabolism of tyrosine,absorption of iron and incorporation of plasma iron in ferritin,adrenal cortex functions and formation of collagen andintercellular cement substance, it has also been shown to exert its influence on bone formation. It was therefore well within the context to examine intake of this vitamin in relation to the occurrence of periodontal problems. The sufficient and lowvitamin C intakes were arbitrarily grouped according to thestandard food(Buy now from http://www.drugswell.com)-value tables and the inquiries regarding food(Buy now from http://www.drugswell.com)-habits with the subjects. There seems an apparent influence ofthe high vitamin C intake in vegetarians on the occurrence ofperiodontosis.
Fluorides and Other Allied Agents
Aminoacids and proteins have potential of being classified asanti-caries nutrients, like fluorides and phosphates. Both theamount and quality of protein are important factors ininfluencing dental caries. In vegetarian diet, a large proportion ofthe ingested protein is digestible and therefore, utilizable. This isnot so in the non-vegetarian diet. Only 6-8% of the protein froma steak is digestible whereas over 70-80% of the protein inpulses (dal) is digestible.
The other important aspect of the vegetarian food(Buy now from http://www.drugswell.com) is its fibrecontent. Since almost 30-40% of the vegetarian food(Buy now from http://www.drugswell.com) is celluloseand therefore non-digestible, it forms the major part of theroughage. This acts as a bolus and in turn helps in maintainingregular bowel movements. A stomach upset or constipationresults in the formation of various organic acids such as lacticacid, pyruvic acid, citric acid etc. in the mouth. These organicacids are known to form dental plaque which is responsible for
the formation of caries.
Total daily dietary fluoride in various countries ranges from 0.2to 2.7 mg. Absorbed fluoride ions are transported in the blood inboth exchangeable and bound forms. Soft tissues do not storefluoride other than in sites of ectopic calcification. Excretion ofabsorbed fluoride is chiefly by way of urine. Levels of skeletalfluoride are directly related to the levels of fluoride found indrinking water and to age. Fluoride is well known for its anticaries properties. The fluoride content of vegetarian and non-vegetarian diet is given below.
Fluoride Content
food(Buy now from http://www.drugswell.com)
(PPM)
Meats 0.14-2.0
Fish 1.00-1.86
Citrus fruits 0.07-0.17
Noncitrus fruits 0.03-0.84
Cereals 0.18-2.8
Vegetables and
0.02-0.9
tubers
It can be seen from the table that vegetarian diet does not showwide variation in terms of its fluoride content and therefore in turn provides a constant dose of fluoride. A daily dose of 1-2 ppmseems optimal for the prevention of dental caries.
Other Considerations
The traditional belief and recent interest in 'natural food(Buy now from http://www.drugswell.com)' suggests that fruits and vegetable make a positive contributionin dental health by inhibiting caries and increasing the resistanceof the periodontal tissues.
Human dentition is better suited for vegetarian diet. Broadsurface molars are specially suited to chew coarse fibrous food(Buy now from http://www.drugswell.com).
Most vegetarian food(Buy now from http://www.drugswell.com)s have a cleansing action. A few garglesafter a meal may be enough to clean the mouth. However, ifsome fibrous particle remains in between the teeth (inter dentalspace) unlike meat fibres, they do not ferment or traumatise thetissue. Thus brushing morning and night may be enough toprevent dental problems.
Vegetables and fruits are a very healthy source of naturalvitamins like vitamin C and other minerals.
Salivary pH does not change fast and therefore vegetarian food(Buy now from http://www.drugswell.com)does not decompose. Salivary pH has an important role to play inoral health. Most dairy products like milk, butter, and vegetableoil keep saliva almost neutral. Most vegetables, dry fruits,apples, grapes and bananas may keep saliva slightly alkaline.Meat, sea food(Buy now from http://www.drugswell.com) and chicken are acid forming food(Buy now from http://www.drugswell.com)s. Acidic salivanormally helps causing dental decay.
Hence, it appears that evidence is strongly in favour of avegetarian diet. There seems to be no doubt that the incidenceof dental problems is less in a vegetarian population.
REFERENCES
ACKNOWLEDGMENT
I am very thankful to:—
Part of the article is from the paper read by Dr. N. C. Sharma inthe Ist Int. Conference of the surgery in Tropics January 1978 atBombay Hospital.
Growth Children and Vegetarian Diet
P.M. Udani
.
Introduction
The most important aspect of paediatrics or childhood is growth anddevelopment, as they are the parameters of health and disease.
Definition of Vegetarian food(Buy now from http://www.drugswell.com)s in Relation to Milk
It should be emphasized that the milk which is produced by human andother animals is also one of the most important items of vegetarian dieteven though it is of animal origin. For example, human milk produced bythe baby's mother is the best and most suitable food(Buy now from http://www.drugswell.com) for the baby and fromevery angle, it is vegetarian even though it is of animal (human) origin. Godhas provided specific milk for human babies. Its function is not bnly toprovide essential nutrients of specific composition, so that it is easilydigested by babies and utilized for their rapid growth but also to providestrong and special defence against various infections, infestations andallergens. It also leads to emotional bonding between the mother and child.
When human milk is not available, we have to take recourse to animal milk like that of a cow, a buffalo or a goat.These animals' milk can be used forchildren, particularly infants, but in a modified manner, because of theirrelatively poor digestibility, lack of supply of defensive substances which ahuman new born or infant needs and absence of true emotional bondingbetween the mother and the child which occurs when the baby is breast-fed.
Basic Vegetarian food(Buy now from http://www.drugswell.com)s
Cereals and Sugar
These are mainly concerned with growth and tissue repair. They areparticularly important in childhood when the body is growing rapidly.
Fats
It is essential to emphasize that the fat cells laid down in infancy and earlychildhood are very difficult to reduce even at a later age. Henceprogrammes of prevention of obesity and its various complications shouldbe started in childhood by restricting too much fat in the diet as it is a richsource of calories.
Pulses
The combination of cereals and pulses makes very good food(Buy now from http://www.drugswell.com) as it providescalories for energy, protein for growth in children and for repair of thetissues.
Vegetables
Vegetables are very important items of a child's diet. They are rich inminerals like iron and some vitamins particularly vitamin A and C and manyother nutrients mentioned in the earlier chapters.
Fruits
Immunity and Vegetarianism
Vrinda Trikannad
. In the ancient medical system in India there exists one of theoldest and most time tested approaches to nutrition. Science offood(Buy now from http://www.drugswell.com) and diet became an integral part of the philosophy of rnan, of his consciousness and of his relation to the Universe The result was an approach to diet that was unsurpassed both in itsprofundity and sophistication as well as in its practicality andsimplicity. Here the selection and preparation of food(Buy now from http://www.drugswell.com) is seen asinseparable from the treatment of disease and cultivation ofvibrant health. Both these goals are in fact a part of traditionalIndian medicine.
Immunity
The body protects itself against the various diseases by: 1. Physical barriers like the skin and mucous membranes which form the security guards preventing the entry of foreign bodies like the micro organisms, 2. Systemic immunity by which specialized cells respond to the sensitization of foreign bodies like the bacteria, viruses, fungi, and neoplastic cells. The cells involved in the immune responses are located throughout the body. Some are in fixed tissues like the bone marrow, thymus, Iymph nodes, spleen, Kupffer cells of the liver and Peyer's patches of the small intestine, while the leucocytes are mobile and circulate in the blood stream and go to the site of infection when required. Imrnune responses are of two types, nonspecific and specific. The non-specific immune response involves a generalized defense to any foreign body. A specific immune response is acquired. Here the response is specific and selective, in that it is mediated by lymphocytes specifically for that particular foreign body or antigen. There are two types of such specific immune responses. One is known as Cell-Mediated Immunity and the other is termed as Humoral Immunity.
Cell-Mediated Immunity
It involves the thyrnus. Here the immunity is mediated by thymus-dependent lymphocytes designated as 'T' cells. These 'T' cells are produced by the bone marrow stem cells and are derived from the thymus after getting educated or mature there. So a cell-mediated immune response is triggered when 'T' cells are sensitized by an antigen. The 'T' cells respond to the antigen directly and produce certain substances or mediators called lymphokines. These lymphokines then proceed to kill or destroy the antigen. The 'T' cells are further divided into various subpopulations according to their functions in the immune response. They are mainly helper, suppressor, memory and cytotoxic or killer cells. Cellular immunity is measured by delayed hypersensitivity. In, for example, the Tuberculin test, a small amount of antigen is injected under the skin. Redness or
erythema and hardening or induration in the skin is looked forafter 24 to 48 hours. Presence of erythema and indurationindicate a positive reaction which indicates that 'T' Iymphocytesand macrophages have migrated to the site of antigen injection.
Humoral Immunity
As shown in the figure illustrating Humoral Immunity, here theimmunity is mediated by 'B' cells or 'B' Iymphocytes. Here theantigen is presented to the B Iymphocytes via the cooperation ofthe 'T' Iymphocytes and macrophages. Once the processedantigen is presented to the 'B' Iymphocytes, they are triggeredand elicit an immune response by producing the variousimmunoglobulins or antibodies to the stimulating antigen. Thevarious classes of immunoglobulins being designated as IgG,IgM, IgA, IgD and IgE according to their molecular weight andproperties Antibodies or immunoglobulins activate yet anothersystem, called the complement system. The complement systemis made up of nine components, which are triggered sequentiallyin a cascading system bringing about antigen destruction.
Effects of Malnutrition on the Immune System
Upto 1955, it was generally agreed that severe proteindeficiencies suppressed antibody formation. In addition,deficiencies of pyridoxine, pantothenic acid, and pteroyl glutamicacid resulted in a suppressed antibody response. Deficiencies ofcomponents of the vitamin B complex also cause somedepression in antibody formation. Some questions were debatedregarding the role of malnutrition in defective release of antibodyor increased destruction resulting in subnormal values.
Naturally occurring states of malnutrition are difficult to interpretlargely because deficiencies usually involve multiple dietaryfactors. This problem is further compounded by infection,anorexia, debilitation and a negative nitrogen balance. Forexample a marked reduction in food(Buy now from http://www.drugswell.com) intake is seen commonlywith vitamin and mineral deficiencies, thus contributing to theeffects of protein-calorie undernutrition.
Coming to protein and protein-calorie malnutrition, studiesconducted by Cooper et al have revealed that the number ofplaque-forming Iymphocytes became activated and thecorresponding amount of antibody synthesized was directlycorrelated with protein or protein-calorie intake, when threelevels of dietary protein were given (6%, 12%, 27%). In contrast,under conditions of chronic protein or protein calorie deprivation,some 'T' cell mediated immunologic functions were decreased
e.g. proliferative responses to mitogens like Concanavalin A andPhytahaemagglutinin (PHA), development of delayedhypersensitivity and formation of migration inhibition factor(MIF). Studies on tumour immunity further illustrated thedepression of B-cell system and sparing of the 'T' cell systemwhen moderate protein-calorie restriction occurred. 'T' killer cellactivity was also reduced in experimental tumour systems, soalso the formation of cytotoxic and blocking antibodies in proteincaloric malnutrition. Decline in the phagocytic function was alsoobserved, and depression of opsonization was evident. Serumcomplement levels—C3, was significantly lower. So protein orcalorie malnutrition in human beings results in markedimpairment of both humoral and cell-mediated functions. Severethymic atrophy and associated 'T' cell deficiencies were observedin undernourished children. A depression of 'T' helper cells and apossible increase in 'T' suppressor cells also could occur inprotein-calorie malnutrition. Salimoner et al and Schlesinger et alreported decreased killer cell activity and decreased productionof interferon in children with protein-calorie malnutrition, andpatients with marasmus. Reduced levels of serum IgA inpharyngeal secretions, tears and saliva could be responsible forthe compromised resistance to organisms that cause respiratoryinfections. Impairment of sIgA is thought to represent depressionof IgA synthesis in the submucosa or impaired synthesis ofsecretory components or both. These observations arecompatible with the findings in protein-calorie malnutrition, ofthe loss of intestinal epithelium, mucosal thinning and atrophy of gut-associated lymphoid tissue (Tablel).
Table 1 Protein Calorie Malnutrition Immune Function in Humans
Response Humoral Immunity
Decreased
Cellular ImmunityRespons
Decreased
Immunity to irltracellular
DecreasedorganismsDecreased
Decreased
Lymphokine production
Most clinical studies of nutrition-related immuno-deficiencies in humans involve multiple deficiency states complicated byinfection. A summary is well elucidated in Table 2 , as shown by Beisel et al.
Ashkenasy noted that isoleucine and valine deficiencies impairedthe recovery of both thymus and peripheral Iymphoid populationafter acute protein deficiency. In addition, deficiencies ofmethionine and cysteine—cystine also resulted in delayed effectson the recovery of the thymus, Iymph nodes and spleen. Theabove mentioned amino acids, when deficient also cause severe Iymphocyte depletion of gut-associated Iymphoid tissue similarto that seen in total protein malnutrition. Tryptophane is alsovital in the maintenance of normal antibody production.Methionine appears to be essential for Iymphopoiesis.
Deficiencies in minerals also have an effect on the immune syst ems. Zinc deficiency causes atrophy of lymphoid tissue andprod uces abnormalities in both cellular and humoral immunity.The average adult must obtain atleast 15 mg of zinc per dayfrom the diet. Clinically zinc deficient children present with lymphopenia, reduced capacity to exhibit delayedhypersensitivity and increased susceptibility to disease. A similarpattern was observed in children with acrodermatitisenteropathica, a defect in intestinal absorption of zinc describedin 1942. However, when zinc was supplemented, the childrenwere cured. Zinc is also necessary for stored Vitamin A in theliver to be released in the blood. Iron deficiencies exhibit impaired delayed hypersensitivity reactions as well as defectiveneutrophil and macrophage killing functions.
Vitamins play an important role in the immune response sincethey function as co-enzymes. Experiments were carried out by several doctors on human beings with a pyridoxine andpantothenic acid deficient diet, and severe impairment inantibody response resulting in hypogammaglobulinaemia wasobserved. Pyridoxine deficiency markedly affects cell-mediatedimmunity. Vitamin C deficiency abolished tuberculinhypersensitivity, impaired the formation of collagen, the fibrousconnective tissue that is so important in the repair and healing ofwounds. It was shown as early as 1943 that proper levels ofascorbic acid maintained the activity of white cells—'the bacteriadestroyers' of the blood stream. Large doses of Vitamin C inhibitthe action of histamine released in an allergic reaction. Vitamin Cmay also be involved as a co-factor in the production of thymichumoral factors.
Vitamin A maintains epithelial and mucosal surfaces andsecretions as a form of primary defence. When vitamin A isdeficient, the innermost, columnar, mucus-secreting epitheliummay lose its ability to maintain itself and areas degenerate intotheir layered flattened cells called squamous metaplasia. Suchcells may be seen in the glandular epithelium of the cervix inwomen. Teenagers whose diet is deficient in vitamin A tend todevelop acne which may be treated with zinc. Zinc, as mentionedearlier, helps release the stored vitamin A from the liver to theblood. Furthermore vitamin A deficiency significantly reducesboth cell-mediated immune responses and humoral immuneresponses. Vitamin B12 and folic acid deficiencies result inmegaloblastic changes of replicating cells. Biotin deficiencyresults in impairment of both primary and secondary antibody responses.
Immunological deficiencies in some malnourished children are aresult of thymic atrophy. Marked depression of cell mediatedimmune responses was noted in all severely malnourishedchildren. The recovery of cell-mediated immune responsesreverted to normal after nutritional rehabilitation. Serum complement levels are also markedly reduced in children withprotein calorie malnutrition. Suppression upto 50% of lysozymesecretion into tears, so also the synthesis of secretory IgA ismarkedly reduced.
So it can be concluded that protein-calorie malnutrition has arelatively greater effect on cell-mediated immunity than onhumoral immunity. Besides an impairment of the B & TIymphocyte network and defective afferent responses, it ispossible that impaired phagocyte function may also result due tomalnutrition. Phagocyte defects in protein calorie malnutritioncould include impaired chemotaxis, phagocytosis, bacterialaction and metabolic responses. Single vitamin deficiencies mayalso impair immune response. Of the so called trace elements,zinc undoubtedly plays an essential role in the lymphocyte and mononuclear phagocyte systems.
Vegetarian food(Buy now from http://www.drugswell.com)s which are vegetables, fruits, nuts, cereals, sprouted pulses, milk and milk products contain all the essential nutrients required for maintaining the integerity of the immune systems. Vitamins and minerals which are so vital in the functioning of the immune system are best availed from fresh fruuts and vegetables. Hence a vegetarian diet is apparently adequate in all respects to maintain good immune function. In fact, if well balanced it may be more suitable to the efficient functioning of the immunological system.
REFERENCES
Microbiology and Diet
K. Dhunjibhoy
. The microflora of the gut varies according to the milieu intereur of the body.Various factors influence the microflora of the oral cavity and the gut.
Let us first consider the normal microflora and the time in growth when theorganisms start living in the host.
Mouth: The bacteria present in the mouth are subject to great variation bothin number and in kind. Even the fairly clean and healthy mouth contains aconsiderable amount of detritus and other organic matter derived fromparticles of food(Buy now from http://www.drugswell.com), desquamated epithelium, pharyngeal mucus and othersources; these provide nutrition to the flora which frequently change.
The saliva as is initially secreted, is sterile but contains growth promotingsubstances for members of a few species such as lactobacilli, Shigella,salmonella, bacillus, vibrio. The following organisms are found in the mouthand saliva:
Counts of organisms per ml of saliva are
In infants the mouth becomes colonized shortly after birth; staphylococci,streptococci, lactobacilli and coliform bacteria being readily detectable.Within a few days the flora is largely that of the adult. The maternal vaginaand later the upper respiratory tract appear to be the source of thecolonizing organisms. The intestine, at birth contains at most a few bacteria,is colonized rapidly "per os" and to some extent "per anum".
The intestinal flora of the breast-fed infant consists largely of anaerobiclactobacilli of the Bifidobacterium group. They may constitute 99% of totalviable organisms in the faeces. Secliger and Werner record counts of 1010 per gm of stool as compared to 109 in adults and a predominance of 3 to 300 foldover the remainder of the flora. Coliforms, enterococci, staphylococci andaerobic lactobacilli are also present.
With weaning, or in bottle-fed infants the flora tends to resemble that of theadult, the number of anaerobic lactobacilli declines slightly; bacteria of thefusobacterium group and proteolyiic bacilli appear in large numbers; andsmall numbers of aerobic and anaerobic spore-bearing organisms appear.
In adults the empty stomach is generally sterile. Immediately after a meal it contains numerous organisms which have been ingested with food(Buy now from http://www.drugswell.com), but thesewith the exception of acid resistant vegetative bacilli and sporing bacteria,appear to be killed rapidly. If however the motility of the stomach isexcessive or the acidity is less than normal, this sterilizing effect of gastricjuice is incomplete. Thus, in cases of gastric disease particularly carcinoma,saranae, saprophytic bacilli and other organisms may multiply in thestomach.
In the healthy adult the jejunum and upper ileum are practically sterile.
The number of organisms mainly facultatively anaerobic Streptococciviridans, staphylococci, lactobacilli and fungi increase from the stomach tothe ileocaecal valve beyond which the flora becomes much more abundantand qualitatively deficient. The duodenum may contain 100-1000 organismsper ml, the jejunum 1000-10,000, the upper ileum about 1,00,000 and thelower ileum 1,000,000, but there is a lot of variation from sample to sample.
Coliform bacilli appear in the jejunum in certain diseases such as infantilegastroenteritis, hepatic cirrhosis after gastrectomy and in chronic debilitated states.
The flora of the lower part of the ileum is relatively scanty but includes mostof the organisms found in abundance in the large intestine. The flora of thelarge intestine and faeces is same.
Anaerobic bacteria make up about 99% of the faecal flora. Most of theanaerobic bacteria belong to Gram-positive bifidobacteria and Gram-negative bacteroides (their number varies from 109 to 101° per gm offaeces). Lactobacilli, clostridia and fusobacterium, average each about 103to 105 per gram; Enterobacteria 106 and enterococci 106 per gram. Lessfrequent are proteus spp., pseudomonas aeruginosa and spirochaetes.
Among the entero bacteria E. coli is the commonest. Klebsiella and otherenterobacters follow.
Importance of Micro Organisms in the Intestine
Presence of bacteria in the intestine is very essential for the life of the hostfor the following reasons. They assist in the digestive processes and withoutthem much of the food(Buy now from http://www.drugswell.com) taken in would be passed out of the body in anunassimilable condition.
Production of vitamin K, biotin, folic acid and riboflavin by the gut flora isvery well known. Also the gut flora prevents other intestinal pathogens frominvading the mucosa.
The factors which influence the intestinal flora are
The faecal flora is a lot dependent on the diet and is different in differentcountries. For example bacteroides spp. are found in great numbers insubjects who consume mixed western diet that contains a large amount offat and stimulates the production of a large volume of bile. In peopleconsuming vegetarian diet, fewer bacteroides spp. are found. In people fromAfrica, Asia and Japan, who consume a vegetarian diet Gram positiveanaerobes and enterococci are the predominant faecal organisms. Howeversubjects who change to a vegetarian diet do not convert their faecal flora toa Gram positive predominance but retain their bacteroides organism.
The following relationship between diet and the organisms isolated from thefaeces has been found.
Diet Mixed Western Wholly or Primarily Veg.
Matoke Rice Vega
USA Scotlan EnglanUgand Rice
Country of Origin Ugand Japa n
d d a India
a n Eng
Enterobacteria 7.4 7.6 7.9 7.4 7.9 8.0 9.4 7.0 Enterococci 5.9 5.3 5.8 5.3 7.3 7.0 8.1 4.8 Lactobacilli 6.5 7.7 6.5 5.3 7.6 7.2 7.4 7.4 Clostridia 5.4 5.6 5.7 4.7 5.7 5.1 5.6 5.4 Bacteroides 9.7 9.8 9.8 9.8 9.2 8.2 9.4 9.7 Gram Positive sporing
10.0 9.9 9.8 9.5 9.6 9.3 9.7 9.6
anaerobes
subject living on strictly veg. diet. (Figures indicate loglO number of bacteria per gram of faeces. Western—Diet—rich in fat and animal proteins) (Matoke—boiled mashed banana)
Tbe people living on the high carbobydrate diet had significantly fewer bacteroides and more enterococci in their faeces than did those on a Western diet; aerobic bacteria were also more prominent.
Draser B.S. (1974) corroborated the previous study. His findings of faecal flora in different human populations are tabulated below:
Faecal Flora of Different Human Population
Diet Country Mean Log10 number of Bacteria/gm of Faeces
Entero
Entero Lacto Bacte Bifido
- Clostridi Eubacteri
-- r-bacteriu
bacteri a a
cocci bacilli oides m
a LargelyIndia 7.9 7.3 7.6 5.7 9.2 9.6 9.5 Carbohydrat Japan 9.4 8.1 7.4 5.6 9.4 9.7 9.6 e Uganda 80 7.0 7.2 5.1 8.2 9.4 9.3
Englan
7.9 5.8 6.5 5.7 9.8 9.9
9.3
dMixed Scotlan
Western 7.6 5.3 7.7 5.6 9.8 9.9 9.3
d
U.S.A. 7.4 5.9 6.5 5.4 9.7 9.9 9.3
Whereas
Bacteroids occurred in greater number in (English, Scots & Americans) developed counties. Eubacteria was prominent in India & Japan. Enterococci-most numerous in India, Japan and Uganda. Streptococcus faecalis-dominant in English, Scots and Arnericans. Streptococcus faecium—dominant in India, Japan and Uganda Cl. perfringens & bifermentans—occurred in all groups. Cl. Paraputrificum—English. Scots & Americans but rare in other sources.
Recently sarcina ventriculi, type of organism, has been isolated in the stools of vegetarian people. The.importance of this will be evident very soon.
Thus it may be noted that since the bacterial flora appears to be strongly dependent on the kind of food(Buy now from http://www.drugswell.com) we eat, it is obvious that we must select the food(Buy now from http://www.drugswell.com) we eat very carefully. The bacterial population in our intestines is ultimately going to enhance .the value of the food(Buy now from http://www.drugswell.com) by improving the efficiency of digestion and also by the manufacture of important vitamins as mentioned above. All this can occur only if the bacteria are congenial and not if they are pathogenic or non-contributory to the good health of the host.
REFERENCES
1. Cregan J. and Harvard N. J. Brit Med. J. i 1356 from Normal bacterialflora of the human body in Topley & Wilson's principles ofBacteriology, Virology and Immunology, sixth edition Vol. 2 by Wilson
G.S. & Miles A by Edward Arnold publishers Ltd. 1953, pg. 2604-2609.
Iron Zinc and B12 in Vegetarians
Rudolph Ballentine
.
Introduction
While there are many well-documented advantages of avegetarian diet, it is also true that a vegetarian diet must bedone skilfully and with knowledge of how to provide completenutrition for the body. If one eats a well-balanced and well-cooked diet of fresh and whole food(Buy now from http://www.drugswell.com)s and avoids fats and refined sugars, most nutritional requirements will easily be met. Thereare a few nutrients which are likely to be deficient in vegetarians,however, especially in those vegetarians who are in transitionfrom a meat-based diet. The purpose of this chapter is to discussthree of these common pitfalls: iron, zinc, and Bl2.
Iron
An appreciation of the importance of iron in the diet goes back further than perhaps that of any other mineral. The ancients thought of it as a carrier, and it was identified with the planet Mars, perhaps because of the distinctive redness of Mars. Iron has a tendency to take up oxygen readily, changing its colour to red. This is the basis for its function in the blood, where it is the carrier of oxygen to the tissues of the body.
Iron's tendency to take up oxygen comes from its curious abilityto change valences—it can have either two or three electricalcharges. This means it can, by altering itself from one state tothe other, take up or let go of an extra oxygen atom. Because ofthis ability, iron is the centre of the body's oxygen transportsystem, which is based on hemoglobin. Hemoglobin is a giantcomplex molecule which contains, like a tiny jewel in the centreof each of its four basic components, a single atom of iron. Thisiron in the centre of the hemoglobin molecule accepts theoxygen and as it does so develops the bright red colour whichdifferentiates oxygenated blood from the dark red or bluish bloodof the veins.
Anemia, which is a relative lack of red blood cells, usually shows up as tiredness, fatigue, paleness, and a tendency to dizziness on standing. Although many other substances besides iron are also necessary to build red blood cells, iron deficiency is one of
the most common causes of anemia.
Many nutritionists are concerned that vegetarians may be atspecial risk for iron-deficiency anemia. These fears are notunfounded; in fact a number of cases of such anemia have been reported among vegetarians. Although iron has been shown bysurveys to be low in diets of many populations, some groupswithin any population are at particular risk. These include infants,because of the low iron content of milk; children and adolescents, because of their rapid growth; and women duringtheir reproductive years, both because of blood losses duringmenstruation and because of the demands of pregnancy. Forsuch persons, moving toward a vegetarian diet requires specialattention to the issue of iron.
There is no question that red meat, such as beef, is richer in ironthan many other food(Buy now from http://www.drugswell.com)s. (See table below.) Yet it is also clear thatmany plant food(Buy now from http://www.drugswell.com)s, such as beans and green leafy vegetables,may equal or surpass red meat in iron content.
Amoun Iron(mgfood(Buy now from http://www.drugswell.com)
t) Blood Sausage 3oz 17.0 Liver,Beef 3oz 7.5 Beef,sirloin 3oz 2.5 Fish(Halibut) 3oz 0.6
1(Large
Eggs 1.2
) Milk(W hole) 1 cup 0.1 Kidney beans 1/2 cup 3.4 Lentils 1/2 cup 2.1 Navy beans 1/2 cup 2.1 Whole-wheat
1 piece 1.0
bread Spinach* 3/4 cup 2.3 Kale* 3/4 cup 1.7 Collards* 3/4 cup 0.6 Raisins 2 T 0.6 Molasses 2 T 2.0
* Cooked in own broth until water evaporates ( not drained ).
Sources : Truesdell et al: Nutrients in Vegetarian food(Buy now from http://www.drugswell.com)s.
U.S. Dept of Agriculture: Nutritive value of American food(Buy now from http://www.drugswell.com)s.
Davidson et al: Human Nutrition and Dietetics.
The problem is in the different absorption rates of iron from meatversus iron from plant food(Buy now from http://www.drugswell.com)s. Half or more of the iron in musclemeats such as beef is of a sort that nutritionists refer to as "heme" iron. It is found in hemoglobin, the molecule in blood that turns red on picking up oxygen, and in myoglobin, the pigmentthat makes muscle tissues red. Heme iron, in the form of iron-containing fragments of the hemoglobin and myoglobinmolecules, crosses the intestinal wall intact. This seems both to accelerate the absorption of the iron and to protect it from beingpicked up by and bound to substances in the diet which formcompounds with iron. For this reason heme iron is absorbed at arate of from 25% to 35% of what is ingested.
By contrast, iron absorption from plant food(Buy now from http://www.drugswell.com)s usually runs in the2% to 10 range. Certain iron-binding substances in plant food(Buy now from http://www.drugswell.com)s,such as the fiber in fruits and vegetables, the phytates of grains,or the oxalic acid in spinach, have been observed to bind iron,and are thus thought to carry it out of the body, preventing theabsorption of much of what is present.
Happily, however, recent studies have taught us more about thesubtleties of iron absorption from non-meat food(Buy now from http://www.drugswell.com)s. Contrary toearlier opinions, new work has shown that oxalates and most ofthe fiber in fruits and vegetables, when taken in moderateamounts, do not interfere with iron absorption in the living body,though some of them may bind iron in the test tube. Phytates,indigestible substances especially concentrated in the bran layerof whole grains, remain controversial. It has been shown in thecase of calcium that the intestine can develop the ability tobreak down phytates, thus freeing the mineral bound by them.Current research has not yet demonstrated conclusively whetherthe intestine can develop the ability to break down the phytatewhich binds iron, but is true that other components of bran suchas its phosphates, do seem to inhibit iron absorption.
However, the effects of one previously suspected inhibitor havedefinitely been confirmed: that of tea. Black tea is a very potentobstacle to the assimilation of iron. This effect comes from the tannic acid in the tea, which combines with the iron to form an insoluble compound. For this reasons tea probably should not betaken along with meals, although it is possible that some of thetraditional additives such as mink or lemon may neutralize thetannic acid and reduce its interference with iron absorption.
Boosting Available Vegetarian Iron
One of the most interesting and important discoveries about ironis that its absorption from grains and legumes can be greatlyenhanced by the presence of ascorbic acid (vitamin C). Vitamin Cis plentiful in such food(Buy now from http://www.drugswell.com)s as tomatoes, green peppers, turmeric,and lemons. A recent report states: "The effect of ascorbic acidon non-heme iron absorption has been tested in a number ofdietary settings and in every case has been shown to beprofound. It plays a particularly critical role in diets in which litheor no meat is present. Non-heme iron absorption in one studywas quadrupled by including in the meal enough vegetables to provide 65 milligrams of vitamin C. This amount is exceeded by acup of broccoli or half a green pepper.
Green leafy vegetables, which are often high in both iron andvitamin C, can be exceptionally good sources of dietary iron.Favourite non-meat recipes in many parts of the world makegenerous use of ingredients rich in vitamin C, such as tomatoes,green peppers, or hot chillies. This is especially true of beandishes, and it is interesting to discover that legumes such aslentils, beans and peas have recently been recognized as beingparticularly rich in iron. The potential use of ascorbic acid tofacilitate the assimilation of such iron makes it a valuable source of this mineral for the vegetarian. Lactic acid (in yogurt) hasbeen thought to play a similar role, but other acids probablydon't.
Vitamin C Content of food(Buy now from http://www.drugswell.com)s Often Used in VegetarianMeals
Vitamin C food(Buy now from http://www.drugswell.com) mg. per 1/2
cup Onion 5 Green Beans 9 Potato 10 Tomato 25 Spinach 2 5 Mustard
38
Greens Broccoli 50 Kale 75
Green Peppers 90 Lemon Juice 1T = 7mg.
Source : Nutritive value of American food(Buy now from http://www.drugswell.com)s.
There are other tricks for boosting the iron available in non-meatfood(Buy now from http://www.drugswell.com)s. For example, it has been shown that the iron from potsand skillets can add significantly to absorbable iron in the diet. Itis leached from the inside of the pot and combines with the food(Buy now from http://www.drugswell.com).Available iron in food(Buy now from http://www.drugswell.com) can be increased by 100% to 400- when itis prepared in iron cookware. This effect might even be excessivewhen very acidic dishes, such as concentrated tomato sauce, areprepared in iron cookware. In that case, the inside of the cookingutensil will lose its shiny surface and the food(Buy now from http://www.drugswell.com) will becomedarkened and develop an unpleasant metallic taste. Regularconsumption of such food(Buy now from http://www.drugswell.com) could eventually lead to iron overload.Although a certain amount of iron from cooking utensils ishelpful, too much can cause iron to accumulate in tissues andcause illness. Very little iron is carried over into the food(Buy now from http://www.drugswell.com) whennon-acidic dishes are cooked in ironware, especially if some cooking fat is present. Thus, an appropriate rule of thumb for avegetarian would be to cook about half his food(Buy now from http://www.drugswell.com), (an assortmentof dishes, but not very acidic ones) in iron pots and pans. Aheavy iron skillet with beans, peppers and tomatoes simmeringaway may be appetizing in part because of the satisfaction ofiron that it suggests. Minerals often compete with one anotherfor absorption. food(Buy now from http://www.drugswell.com)s very high in calcium can interfere with theabsorption of other minerals, such as zinc. Too much milk, whichis high in calcium and low in iron, can block iron intake.
Researchers who have studied the iron levels of long-termvegetarians have demonstrated that iron and hemoglobin levelswere within normal levels. These researchers termed the results "surprising", and suggested that the vegetarians had somehowadapted their diet in such a way as to enable them to increasetheir efficiency of iron absorption. It seems reasonable topostulate that long-term vegetarians can handle the iron in plantfood(Buy now from http://www.drugswell.com)s differently from persons accustomed to mixed meat andvegetable diets. In any case, it seems clear that one need notbecome iron deficient on a meat-free diet. Following are the mainpoints to remember in obtaining optimum dietary iron:
ZINC
Zinc is a trace mineral which is important for the health of theskin and perhaps the lining of the arteries. Veterinarians foundthat animals whose feed contained inadequate amounts of zincdeveloped red and cracked skin with loss of hair or wool, as wellas other problems. In humans, zinc supplementation is a well-documented, effective treatment for acne.
Zinc is found in dramatically high concentrations in the prostategland and semen, and we now know that adequate levels of zincare required for the proper functioning of the sexual organs ofthe male. Zinc deficiencies have also been found in children who had a history of poor appetite and failure to gain in height andweight. One of the symptoms noticed among boys in one studywas a loss of sense of taste. Loss of taste is important, since ittends to decrease appetite and the enjoyment of food(Buy now from http://www.drugswell.com), and thisleads to further malnutrition and failure to grow properly. Inevery case, the sense of taste was restored by taking zinc, and
other health improvements were dramatic.
Meat, poultry and fish are by far the richest sources of zinc.Although some vegetable food(Buy now from http://www.drugswell.com)s contain substantial amounts ofit, fibre and phytates appear to carry much of it out of the body.Phytates are phosphorus compounds found in most plant food(Buy now from http://www.drugswell.com)sbut especially in whole grains, beans, and peas. They have theproperty of combining with minerals, especially calcium, iron,and zinc, to form insoluble compounds which are carried out inthe stool. Though other minerals are well absorbed from plantfood(Buy now from http://www.drugswell.com)s, zinc—like iron or calcium—seems more problematic, andnutritionists have expressed concern over the availability of zincin the vegetarian diet.
There are recent research studies that indicate this concern maywell be justified. For example, when a group of students were puton a vegetarian diet for three weeks, their tissue levels of zincdropped and they responded to physiological tests in a way thatsuggested they had developed a mild zinc deficiency.
But three weeks isn't long. As mentioned, we know that in thecase of other minerals such as calcium, some adaptation to thepresence of fibre and phytates occurs and that, over time,absorption improves. So the research team looked next at agroup of 79 persons that had been vegetarian for a year orlonger. They found that their body levels of zinc were also low,despite the fact that they had been vegetarian for a longerperiod of time.
This is different from other minerals, where adaptation seems totake place and phytates and fibre seem to lose their tendency tointerfere with mineral absorption. Why would zinc be different?The answer may lie in the fact that the enzyme that is developedto break down phytates—intestinal phytase—is itself zincdependent. Zinc is needed for the manufacture of phytase, andwhen zinc is deficient the enzyme cannot be produced inadequate amounts. So a vicious circle ensues: less phytasemeans more phytate to interfere with the absorption of zinc,which in turn results in more severe zinc depletion and still lessphytase.
Therefore, once a zinc deficiency is established, it would appearthat it would be difficult to climb out of it—even with adequatezinc intake was long as one's diet is rich in whole grains, whichcontain so much phytic acid. Once phytase production has beenstarted, and zinc can be released from phytate and absorbed,handling a vegetarian diet is possible. But if a person's zincstores are depleted during the transition phase, he won't be ableto increase his output of phytase and adjust to the new diet. Forsuch reasons, zinc supplements may be necessary during thetime when one is changing over to a vegetarian diet.
Though the transition period is always tricky and is a time whendeveloping a zinc deficiency is especially likely, this risk is evenhigher if one starts out with a borderline zinc deficiency. There isevidence, such as low zinc levels in patients with retardedwound-healing, indicating that a significant percentage of thegeneral, non-vegetarian population suffers from marginal zincstatus. Girls and young women seem to have substandardintakes most often, though men and boys, who tend to eat moreanimal food(Buy now from http://www.drugswell.com)s, may become deficient despite their larger intakessince the normal development and functioning of the malereproductive system requires a substantial intake of zinc. This isthought to be why it is mostly boys who have been found to beundersize as a result of zinc deficiency. In adult males, zincdeficiency can contribute to sterility and impotence.
Zinc nutrition for pregnant and nursing women is of seriousconcern, since the infant must draw its supply of zinc from themother. Materrial zinc deprivation in experimental animals hasproduced offspring with learning disabilities and abnormalities inthe chemistry and structure of the brain, especially that part thatis related to emotions. (In view of this it is interesting that somecases of schizophrenia seem to clear dramatically when givenzinc.) There is also evidence that zinc deficiency duringpregnancy can lead to later impairment of immune function.
Low zinc later in life may also lead to a number of symptoms ofimmune deficiency as well as impairment of the capacity to healquickly. Inadequate tissue repair has been suspected of playing arole in the earliest stages of the development of atherosclerosis,where failure to properly heal some form of injury to the arteriallining may set the stage for plaque formation.
Getting Enough Zinc
If one does decide to take zinc supplements while adjusting to avegetarian diet, 15 to 20 milligrams a day should be sufficient,since the recommended daily intake is only 15. Since absorptionis only partial on any diet, this amount would not be excessive,especially when fibre and phytate levels are substantial.
In fact, zinc is one of the nutrients with the largest margin ofsafety. One would have to take vvell over 100 milligrams a dayto cause any toxicity. Unfortunately, some physicians andlaypersons recommend 135 milligrams per day for treatment ofacne, much higher than what is necessary or desirable.
Even at moderate doses zinc can compete with copper forabsorption or utilization. Since vegetarian diets tend to berelatively rich in copper, this is not likely to be a problem.However, zinc can also interfere with selenium utilization, and though selenium, too, is generally ample in vegetarian diets, zinc
doses should be kept at reasonable levels for this reason.
Zinc Checklist
Besides milk and eggs, the non-meat food(Buy now from http://www.drugswell.com)s richest in zinc arebeans, tofu, seeds, nuts, and hard cheeses. If these food(Buy now from http://www.drugswell.com)s are taken in the diet and the fibre intake is kept moderate, zincshould not be a problem. Those in transition, and pregnant ornursing women should consider supplementation. Because of itsrole in the sense of taste, it is a happy coincidence that those inneed of zinc generally find its taste agreeable, and those whohave adequate levels find the taste unpleasant. This has led to asimple taste test for deficiency. Other signs of zinc deficiencyare: white spots on nails, slow wound healing, poor resistance toinfections and acne.
Vitamin B12
Vitamin Bl2 is unique in many ways. First of all, it is the vitaminwhich is needed by the body in the tiniest amounts. Only a fewthousands of a milligram (3 or 4 micrograms) per day arenecessary to prevent the symptoms of deficiency. Even moreimportant for vegetarians is the fact that vitamin Bl2 is the onlyvitamin which is not found in strictly vegetarian diets, e.g. thosewithout dairy products. Vitamin Bl2 is present in milk, eggs, andmeat, and is manufactured by many bacteria and yeasts. Anyfood(Buy now from http://www.drugswell.com) which is strictly of plant origin, not ferrnented, and free ofall bacteria and insects, will be found to contain no vitamin Bl2
In cultures where food(Buy now from http://www.drugswell.com) is grown organically and processed littleor not at all, deficiencies of vitamin Bl2 are uncommon, even when there is no meat, milk, eggs or other animal food(Buy now from http://www.drugswell.com) in thediet. This is thought to be due to the fact that organically grownfood(Buy now from http://www.drugswell.com)s will often contain traces of bacteria from the soil or even tiny bits of insects which are difficult to see or removecompletely. These alone may be enough to provide theextremely small doses of vitamin Bl2that are necessary. Whenfood(Buy now from http://www.drugswell.com)s are grown with the use of pesticides, however, insects andbacteria are likely to have been thoroughly exterminated, andthe processing of food(Buy now from http://www.drugswell.com) to make it suitable for long storage orshelf-life will be even more likely to remove any traces of vitamin Bl2. Thus vegans who eat processed food(Buy now from http://www.drugswell.com)s are at increased risk.
It is often said that a vegetarian diet can supply everythingexcept vitamin Bl2. Physicians and nutritionists are trained tocaution those who are eliminating all animal food(Buy now from http://www.drugswell.com)s about thegrave consequences of Bl2 deficiency and to advise them that, at the very least, Bl2 supplements should be taken. This concern isunderstandable. Pernicious anemia, the disease connected with insufficient body stores of vitamin Bl2, is a serious disease.
In the early stages of the illness there are numbness and tinglingof the hands and feet with a loss of sensation. Blood tests done on such patients reveal low hemoglobin levels and large, pale,red bloods cells. Gradually a lack of motor coordination develops.These symptoms are now known to be due to an in ability tosynthesize myelin, the fatty sheath that insulates nerve fibres. Asa result, the nerves to the limbs degenerate. If allowed toproceed unchecked, the deterioration progresses into the spinalcord and ultimately to the brain. Moodiness, poor memory, andconfusion give way gradually to delusions, hallucinations, andovert psychosis. For vitamin Bl2to be absorbed, the stomach wall must secrete a substance called intrinsic factor, which combines with the Bl2, forming a complex that can then be taken up by thelower end of the small intestine. Patients with pernicious anemiawere found to lack intrinsic factor because of the destruction of stomach wall cells. Thus Bl2, even when present in the diet inample quantities, cannot be absorbed.
When originally described, the disease was observed to occursporadically in most populations without regard to dietarypractices. It was not considered to result from inadequate dietaryintake of vitamin Bl2. Indeed there was no reason to assume that the disease had anything to do with the amount of vitamin Bl2 consumed, since amounts many times than ordinarily neededare of no use without intrinsic factor.
Nevertheless, because it has long been known that vitamin Bl2 is absent from food(Buy now from http://www.drugswell.com)s that are strictly of plant origin, whennutritionists and dieticians began to encounter growing numbersof strict vegetarians, they were alarmed. While vegetarians whoused dairy products were generally thought to be on safeground, vegans, who take no food(Buy now from http://www.drugswell.com)s of animal origin, were adifferent matter. A diet with no Bl2) it was felt, was sure to produce vitamin Bl2 deficiency and ultimately pernicious anemia.
Dietary Deficiency of Bl2: Myth or Reality ?
In the 1960s and 1970s a large number of case reports inmedical journals seemed to fulfill this dire prophecy: "Subacutecombined degeneration of the spinal cord in a vegan","Megaloblastic anemia in an adult vegan," and so on. Nutritionmanuals warned of the danger of developing pernicious anemia from an inadequate intake of vitamin Bl2. But despite theominous tone of such case reports, surveys of groups of vegansreported with some surprise that most of the subjects theystudied seemed quite well, with no signs of anemia orneurological degeneration. The occurrence of symptoms was, atmost, rare. one might expect, after all, to find some cases of thedisease in any population.
Were the cases of pernicious anemia that were reported merelypersons with the disease who happened to be vegans, or werethese cases caused by the all-plant diet? Of course, vegansargued the former in their magazines and newsletters, whilenutritionists argued the latter in their books and scientificjournals. As is usual with such debates, the ardour of thecontroversy yielded little in the way of illumination.
Nevertheless, by the beginning of the 1980s there was enoughpublished literature to make evident some of the oversights thathad led to premature conclusions: many of the diagnoses ofinadequate vitamin Bl2 in the diet had been hastily made. Forexample, problems that can interfere with absorption, such as alack of intrinsic factor, had not been ruled out as causes of the low body level of Bl2. To establish firmly that a person is sufferingfrom a dietary deficiency of vitamin Bl2, certain criteria must be met.
A critical review of reports published up to 1980 on vegansshowed that none of them met all these criteria. In each case, other explanations were possible, including deficiency of intrinsicfactor, iron deficiency anemia, and neurological problems fromother causes. In fact, in many of the published case reports, theauthors noted that these alternative explanations seemed themost likely. Yet the cumulative weight of the first impressionscreated by numbers of such scientific papers is persuasive initself and has tended to support the view not only that dietarydeficiency of vitamin Bl2 is an actuality, but that it is commonamong vegetarians who use no animal food(Buy now from http://www.drugswell.com)s. Despite thisprevailing impression, in point of fact there is littleincontrovertible evidence that a diet low in Bl2 can, in and of itself, cause problems.
Vitamin B12 Vegan Sources
If it's true that a purely dietary deficiency of Bl2 occurs rarely, if atall, the question is, Why? How could it be that vegans, whoconsistently consume no BI2-containing food(Buy now from http://www.drugswell.com)s at all, might beperfectly healthy, with adequate tissue levels of the vitamin?
At least part of the answer to this question becomes apparentwhen we look at the origin of vitamin Bl2. Though it is found inanimal food(Buy now from http://www.drugswell.com)s, it is not manufactured by animal cells. It must beabsorbed from their food(Buy now from http://www.drugswell.com) by most animals, as it must be by humans. All Bl2 is made by bacteria. Ruminants, such as cows, doquite well, because bacteria in an accessory stomach, or rumen,produce Bl2 as they break down the fibre of the animal's food(Buy now from http://www.drugswell.com). Butbacteria aren't just in cows' stomachs; they're practicallyeverywhere. Researchers studying B12 have complained that it isnecessary to carefully clean all instruments to get meaningfulmeasurements of Bl2 -since even tap water can containsubstantial amounts. ("Substantial amounts" in the sense thatthey can approach the range of what is needed in the humandiet.)
It is for this reason that some batches of beans, bean sprouts,comfrey leaves, turnip greens, peanuts, lettuce, fermentedsoybeans, and whole wheat have been reported to containsignificant amounts of Bl2—while other batches of the same food(Buy now from http://www.drugswell.com)s have been found to have none at all. The presence of bacteria onsuch food(Buy now from http://www.drugswell.com)s is incidental; that is, the presence or absence of thevitamin will depend on whether the plants were fertilized withmanure or not, how well they were washed and with what, andso forth. So as sources of Bl2 any one of such food(Buy now from http://www.drugswell.com)s must beconsidered unreliable, though on any average day several ofthem might happen to bring along some small but significantamounts of the vitamin.
What's more, bacteria also grow on and in the body. In fact, ithas been estimated that the microorganisms between the teethand gums, around and in the crevices of the tonsils, in the foldsat the base of the tongue, and in the upper respiratory passageswill make up to half a microgram of B12 a day. This is at least halfof the minimum requirement, though some nutritionists thinkthis quantity may be all that is needed for most people. Officialrecommended intakes by the World Health Organization and thefood(Buy now from http://www.drugswell.com) and Nutrition Board provide for generous margins of safety,and up the level to as high as 3 or 4 micrograms for adults, but itis unlikely that it is necessary or even useful to consume suchlarge amounts. An egg or a cup of milk will contain 1 microgramof vitamin Bl2 (see table below).
B12 Content of Common food(Buy now from http://www.drugswell.com)s
Food
Organ meats(e.g., liver)
Bivalves (clams, oysters)
Milk
Fish
Beef
Chicken
Amount
3 oz
3 oz
1 cup
3 oz
3 oz
3 oz
B12(mcg)
>10
>10
1
1-3
1-3
1-3
Cheese,hard
1 oz
0.3
Egg yolk
1
1
Fermented soy products:
Miso
Tempeh
Seaweed
Yogurt
1T
3 oz
-
-
1c
c. 0.03 (variable)
c.3 (variable)
variable
variable
0.3
* See p. 168
Sources : Goodman and Gillman : Pharmacological Basis ofTherapeutics. U.S Dept. of Agriculture : Vitamin B12 in food(Buy now from http://www.drugswell.com)s. Shurtleff : Sources of B12
Other Complications in Vitamin B12 absorption
There are countless bacteria in the human intestinal tract, too. Whether or not they make a contribution to the Bl2 needs of their human host is the subject of another long-standing controversy.Early studies on the bacterial flora of the gut focused on thecolon, where the bulk of the intestinal microorganisms are found.Although producers of Bl2 were found there, there was a controversy around whether this would pass through the wall ofthe large intestine. More refined research techniques revealedthat a smaller but still substantial community of bacteria inhabitsthe small intestine. Recent studies have demonstrated that these organisms do produce vitamin Bl2 and that they do so highenough in the intestinal tract to allow it to combine with intrinsicfactor before it reaches the lower end of the small intestine, where the vitamin is absorbed.
Another complication is that some bacteria will compete withtheir host for dietary B12 without contributing significantquantities in return. They can even deplete body stores, sinceBl2 is constantly being secreted with the bile. Ordinarily much ofthis Bl2 is reabsorbed as the bile passes through the intestinaltract; but occasionally an unfriendly population of bacteria withan inclination for robbing their host of vitamins will preventreabsorption. It's also known that B12 absorption is morethorough when intake is lower. In other words, the meat-eaterwho consumes 10 micrograms of vitamin Bl2 in a day will absorbonly 16% of it, while the vegan who takes in a mere fraction ofthat will absorb 70%. All of these factors add up to a ratherdelicate balance, which can be disturbed by any majordisruption, such as migration to a different culture, or the use of antibiotic medications. Other important factors:
Vitamin B12, Mega C, and other supplements
Another ongoing controversy is that surrounding the effects oflarge doses of vitamin C on Bl2 availability. In 1974, one of themost respected authorities on vitamin Bl2 reported that mixing vitaniin C with vitamin Bl2 and incubating the combination in away that would mimic digestion destroyed B12. Both the population news media and the medical literature were quicklyfilled with warnings about the danger of vitamin C. Two yearslater, however, a different author observed that the original hadbeen done using methods of B12 measurement that were designed to test blood, not food(Buy now from http://www.drugswell.com). Since the B12 in food(Buy now from http://www.drugswell.com) is more tightly bound to protiens he concluded that the tests used hadfailed to pick it up. Using more apporopriate techniques, nodestruction of B12 was found. The researcher who had done the first study retaliated in 1978, demonstrating low blood levels ofvitamin B12 in patients who took 2 grams of vitamin C in a dayand noting that another study had reported similar results.
Although the issue is still not completely resolved, it wouldappear that anyone taking more than 500 milligrams of vitamin C a day for a long period of time should have his or her vitaminBl2 status monitored. An alternative that might provide someprotection is to take vitamin C in high doses only for shortperiods of time, allowing intervals when it is stopped so that Bl2stores can be replenished. A convenient regimen is one week onand one week off.
Other nutritional supplements can cause trouble, too. It is wellestablished that vitamin Bl2 is destroyed by oxygen in thepresence of vitamin C, vitamin B. (thiarnine), and copper ions.This may affect the Bl2 present in multivitamin preparations. Ithas been reported that 20% to 90% of the vitamin present insuch supplements can be degraded to vitamin B1, analogues.
What to Do About Bl2.
These are Bl2-like molecules that are similar enough to the realthing to replace it in metabolic reactions, but different enough tolack the effectiveness of the vitamin. Some of them can thus block the activity of the Bl2 that is present, preventing it from being used normally.
Spirulina, a dietary supplement widely acclaimed as anextraordinary source of Bl2, has also been found to contain many more Bl2 analogues than genuine Bl2—five to eight times asmany. Whether or not these analogues are Bl2 antagonists and cause harm awaits investigation.
Bl2 as an oral supplement, when taken separately from othernutrients that can degrade it, such as vitamin C, copper, andthiamine, can be of help, however. It can be used by those withinadequate dietary Bl2 or when illness may increase one's needs beyond what is a normally adequate dietary intake. It can evenbe effective in those cases where absorption is impaired by alack of intrinsic factor, since somewhere between 1% and 3% of vitamin Bl2 passes across the intestinal wall by simple diffusion.But much higher doses must be used when the normalmechanisms of fictive uptake are missing.
Nutritional yeast is sometimes used as a dietary supplement tosupply vitamin Bl2 by those who are consuming only vegetablefood(Buy now from http://www.drugswell.com)s. Not all nutritional or brewer's yeast, however, will furnishthe vitamin. In order to contain Bl2, the medium on which such yeast is grown must contain it or it must be added during thefinal processing. If one wishes to use yeast as a source, one mustread labels carefully to be sure that the yeast in question doesindeed contain the vitamin, and in adequate amounts (at least 1microgram in 1 tablespoon, since a tablespoonful is a maximalappropriate regular daily dose of yeast).
Thus with a little bit of care, vegetarians can have the best of both worlds—they can be certain of adequate nutrition, and avoid the atherosclerosis and cancer so common among meateaters. In addition, the transition to vegetarianism entails a transformation of consciousness as well.
The resources expended by those who are eating in a self-destructive way are not available for higher purposes such as creativity, self-development, and the exploration of the inner world. For us to progress to a new stage of development we must carefully examine our way of living and divest ourselves ofthose habits that are most limiting. A vegetarian diet which skilfillly includes all the necessary nutrients for human functionappears more and more to be an evolutionary step that is inevitable.
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