Download MAGIC SPICES: Ayurvedic Medicine and the Heart By Erica Shroff A

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MAGIC SPICES:
Ayurvedic Medicine and the Heart
By
Erica Shroff
A Thesis Submitted to The Honors College
In Partial Fulfillment of the Bachelors degree With Honors in
Physiology
THE UNIVERSITY OF ARIZONA
MAY2016
Approved By:
__________________________________
Dr. Zoe Cohen
Department of Physiology
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Table of Contents:
Abstract……….Page 3
Cardiovascular System……….Pages 4-12
Heart Disease……….Pages 13-18
Ayurvedic Medicine……….Pages 18-28
Turmeric and Ginger ……….Pages 28-29
Conclusion/ Positive Effects of Turmeric and Ginger on the Heart and
Body……….Pages 30-31
Community Outreach……….Pages 32-36
Poster Session……….Pages 37-41
My Thesis Experience/ Recipes……….Pages 42-50
References……….Page 51
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Abstract: Ayurvedic medicine has been used in India for centuries as a dominant form of
treatment and as a preventative measure for a number of chronic diseases. Not until recently have
scientific studies identified the potential hypolipidemic, antiplatelet, and anti-tumor properties of
various herbs/spices. The phytochemicals in these compounds may suppress the oxidation of bad
LDL cholesterols, stimulate the performance of protective enzymes, and enhance immunestimulating properties that reduce an individual's risk of heart disease. As part of my honors
senior thesis I conducted a literature review with my cardiovascular physiology professor, Dr.
Cohen, which explores the impacts of Ayurveda on the heart. We wanted to investigate the
scientific literature for turmeric and ginger specifically, in order to understand the exact
physiology behind these spices. Overall, it seems as though Ayurvedic medicine can be health
protective for a number of cardiovascular conditions such as high blood pressure and high
cholesterol, but should be used in conjunction to modern medication. In addition, spices have
considerable anti-inflammatory responses which have been shown to improve obesity-related
inflammatory responses. After much research and analysis, these findings were presented at the
Festival of Books in Tucson, AZ on March 12th as community outreach.
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Cardiovascular System Overview:
The cardiovascular system is comprised of three basic units, the heart, the blood, and the
blood vessels. The heart itself is a highly muscular structure that weighs less than one pound, and
is around the size of a clenched fist. The heart is organized into two halves, the right and the left,
which act as two independent pumps to supply blood to the lungs and body. The heart can also
be organized into four chambers, the upper and lower right and left chamber. The names of the
four chambers are the right atrium, right ventricle, left atrium, and left ventricle. Structurally, the
atria are less complex than the ventricles. The two hemispheres of the heart are divided by the
atrioventricular septum. The structure of the heart and its four chambers directly correlate to its
function, to ensure that deoxygenated blood receives oxygen in order to provide energy to the
entire body. Venous blood enters the heart via the superior vena cava and inferior vena cava,
from these two vessels; the blood collects in the right atrium. Subsequently, blood from the right
atrium flows into the right ventricle. Blood from the right ventricle enters the pulmonary artery,
which takes the blood to the lungs to get oxygenated. Once the blood oxygenates, it enters the
pulmonary vein and moves to the left atrium. Then blood from the left atrium flows into the left
ventricle, and finally is ejected into the systemic circulation via the aorta. Blood that enters the
systemic circulation travels to all the various organs of the body, including the brain, stomach,
muscles, etc. As blood flows through the heart chambers, it only travels in one direction
(unidirectional), later we will see how the back flow of blood may lead to bigger problems.
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Figure 1: The above picture shows the heart anatomy, clearly displaying how the
superior vena cava and inferior vena cava bring in deoxygenated blood from the upper and
lower parts of the body, into the right atrium of the heart. All four chambers and four
valves can be seen, along with important structural features such as Purkinje fibers.
Finally, as the blood makes its way through the various structures, oxygenated blood is
able to leave through the aorta.
The Heart:
The heart is comprised of four rings of fibrous connective tissue in order to support the
structures of the atria and ventricles. Not only are there four chambers of the heart, but there are
four valves which carry blood from chamber to chamber. The general term to describe the valve
separating an atrium and a ventricle is known as an atrioventricular (AV) valve. The valve
between the right atrium and right ventricle particularly is called the tricuspid valve. The valve
between the left atrium and left ventricle is called the bicuspid/ mitral valve, since it consists of
two cusps. The leaflets of the AV values are anchored in place by fibrous extensions known as
chordae tendineae. Each cusp has its own extension of chordae tendinaea, which attach to the
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papillary muscles located on the interior portion of the ventricle chamber. The other major
category of valves are called the semilunar valves. The semilunar valves are located between the
ventricles and the major arteries. The valve between the right ventricle and the lungs specifically
is called the pulmonary valve. The valve between the left ventricle and the systemic circulation is
called the aortic valve. Valves are not needed between the atria and veins because atrial and
venous pressures are essentially the same value.
Figure 2: The above figure provides a close up into the chambers and anatomical
structures of the heart. The SA node, which acts as the pacemaker, initiates cardiac action
potentials and is located on the wall of the right atrium, right by the opening of the
superior vena cava. The AV node, which acts as the pacesetter, receives cardiac action
potentials from the SA node and carries this impulse through the AV bundle. The AV node
is located on the floor of the right atrium, between the atrium and ventricle.
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The Heart Wall:
The heart wall consists of three separate layers, the pericardium, the myocardium, and the
endocardium. The outmost layer, the pericardium, encloses the entire heart with a double-walled
membranous sac. The myocardium is the central layer, and thickest portion of the heart wall and
made up of cardiac muscle. The endocardium consists of a thin layer of endothelial tissue that
lines the entire cardiovascular system.
Figure 3: The above picture shows the various layers of the heart walls. The heart wall
is composed of three layers: epicardium (outer layer), myocardium (middle layer), and
endocardium (inner layer). The epicardium is a thin layer comprised of connective tissue
and fat. The myocardium is comprised of muscle tissue. The endocardium is comprised of
endothelial cells and they line the inner surface of the heart. Endothelium provide blood
with a smooth surface to flow through.
Blood Vessels:
The various blood vessels include arteries, arterioles, capillaries, venules, and veins. The
function of arteries is to carry blood away from the heart, they are known as “pressure vessels.”
The arteries are strong, rigid, and contain a thick elastic muscle layer that can withstand high
pressures of blood. This muscle layer also can help maintain pressure even when the heart is
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relaxing. Arterioles are small branches of arteries that assist with blood transport to various
organs in the body. They are known as “resistance” vessels as they can quickly change their
radius, which affects blood flow depending on the needs of the tissues. Arterioles further branch
into capillaries (smallest blood vessels) which are in charge of transferring oxygen and nutrients
to the body’s tissues. Additionally, they collect waste/carbon dioxide which are returned to the
veins. Venules are small vessels involved in the microcirculation, just as arterioles and
capillaries. They function to allow deoxygenated blood to travel from the capillary beds into the
veins in order to be oxygenated in the heart. The veins function to carry blood towards the heart,
and are known as “capacitance vessels.” The veins contain a thin elastic muscle layer, along with
valves which prevent backflow of blood. Veins do not have rigid walls, instead they are more
compliant in nature. These vessels are located closer to the surface of the skin.
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Figure 4: The figure above shows the anatomical differences between the muscular
artery and vein. Arteries have a relatively thin connective tissue layer. The thickest layer in
arteries would be the tunica media, which is comprised of smooth muscle. Arteries also
have a relatively thick elastic membrane. As it can be seen, the outermost layer of the veins
is comprised of a thick connective tissue layer. The middle layer, or tunica media, is
comprised of smooth muscles but this layer is thinner is veins that arteries. Veins contain
venous valves which prevent the backflow and pooling of blood. Both arteries and veins
contain endothelial cells in the tunica interna layer.
Blood:
The blood consists of three cellular components, the red blood cells (erythrocytes), white
blood cells (leukocytes), and platelets (thrombocytes). Red blood cells are in charge of
oxygenating the body’s tissues. White blood cells are the protectors of the human body, by
getting rid of harmful microorganisms and debris. The platelets are a protective agent against
bleeding, by coagulating and creating a clot. Red blood cells appear as flat, disc-shaped cells that
contain the protein hemoglobin. Hemoglobin is comprised of two parts, globin and heme. Each
protein is able to bind four oxygen molecules to transport all over the body and because each
RBC contains approximately 250 million hemoglobin molecules, and every RBC can carry up to
1 billion oxygen molecules. Red blood cells are commonly characterized for their large surface
area, thin diameter, and flexible nature. White blood cells fall into two distinct categories,
granulocytes and agranulocytes. Neutrophils, basophils, and eosinophils all make up the
granulocyte category. Neutrophils play a key role at infiltrating tissue during times of
inflammation, and are known as the “first defenders.” Eosinophils are employed during allergic
reactions, and are also involved in fighting parasitic infestations. Basophils act similarly to mast
cell by storing and releasing heparin and histamine. Monocytes, macrophages, and lymphocytes
all make up the agranulocytes category. Monocytes are premature phagocytes that travel
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throughout the blood for days and become the phagocytic macrophage in the tissue.
Macrophages engulf and breakdown foreign, potentially harmful cellular debris, as well as
pathogens such as viruses and bacteria. They are unique due to their long life span. The last type
of agranulocytes include the T and B lymphocytes. B lymphocytes, or B cells, help fight
infections by secreting antibodies. T lymphocyte, or T cells, bind to specific antigens that are
presented by phagocytic macrophages and dendritic cells, also known as antigen-presenting
cells. After they bind to these APCs, they release lymphokines (a protein made by lymphocytes)
which allow other types of cells to infiltrate the affected area. As a result, inflammation occurs
and the infiltrated cells begin to destroy the antigen.
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Figure 5: The above two figures are a visual depiction of all the various components
that make up blood. As it can be seen, white blood cells fall into two major categories:
granulocytes and agranulocytes. The granulocytes have little grains inside the cells that
perform various cell functions (basophils, neutrophils, and eosinophils). The agranulocytes
do not contain little grains inside the cells (lymphocytes and monocytes).
The non-cellular components of blood include the plasma and plasma proteins. Blood
consists mostly of plasma (55%). Plasma is predominately composed of water, this is how many
organic and inorganic agents are able to be transported in the body. Besides water, plasma also
contains inorganic ions such as sodium, chloride, bicarbonate, potassium, and calcium. The
organic components of blood consist of plasma proteins such as, albumins, globulins, and
fibrinogen. Plasma proteins are integral because they are responsible for controlling the body’s
pH level by acting as a buffer. In addition, plasma proteins maintain an osmotic gradient between
interstitial fluid and blood. Albumins are the most abundant plasma proteins in the body. They
function to bind substances such as drugs (penicillin), bilirubin, and bile salts. There are three
types of globulins, alpha, beta, and gamma. Alpha and beta globulins play an important role in
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the coagulation and clotting process. All of these globulins, including gamma, play a role in body
immunity as well. Fibrinogen is an integral factor in the blood-clotting process. When fibrinogen
gets metabolized to fibrin, this forms the groundwork for a blood clot, which plays a key role in
the healing process.
Figure 6: Above shows the various components of blood with the exact percentage
breakdown of plasma, buffy coat, and erythrocytes. These layers can be obtained once
blood is extracted and centrifuged. Plasma is the least dense component of blood, but
comprises of 55% of whole blood. RBCs or Erythrocytes are the most dense component of
blood, and comprise of 45% of whole blood. The buffy coat (leukocytes and platelets) only
comprise of less than 1% of whole blood.
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Cardiovascular Disease:
Although the heart is a highly organized structure, many things can go wrong if there are
abnormalities of the heart itself, the vessels, or the blood. Currently, the leading cause of death in
the United States is due to cardiovascular diseases. Cardiovascular related deaths kill about 1.3
million American’s yearly (which is more than 3,500 per day). One in every three American will
die from cardiovascular disease. Myocardial infarctions, also known as heart attacks, are caused
blood clots that suddenly obstruct blood flow in the coronary artery and lead to heart muscle
death.
There are numerous heart attack risk factors, both controllable and non-controllable. The
non-controllable factors include age, genetics, and homocysteine. The controllable factors are
smoking, obesity, inadequate exercise, emotional stress, alcohol, iron, high blood pressure,
diabetes, and bacteria (such as H. pylori).
Dyslipidemia is the elevation of plasma cholesterol (low-density lipoprotein) and/or
triglycerides. Dyslipidemia can also be diagnosed with an individual that has a low HDL (highdensity lipoprotein) cholesterol count. All the above abnormalities lead to the development of
atherosclerosis, or vessel stiffening.
Unhealthy practices over a period of time cause damage to lining of blood vessels called the
endothelium. LDL (low-density lipoproteins) traveling in the blood are then able to easily cross
into the damaged endothelium. As the cholesterol begins to accumulate, white blood cells invade
the artery to ingest LDL cholesterol, forming a cholesterol plaque. This process is slow and often
painless, but can lead to myocardial ischemia. Myocardial ischemia occurs when blood flow is
significantly reduced due to partial or complete obstruction of the coronary arteries. This process
reduces the heart's ability to pump blood efficiently to oxygenate the body.
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Myocardial infarctions, also known as heart attacks, occur when cholesterol plaques rupture
or crack, and allow the platelets to clot inside the coronary artery obstructing blood flow
ultimately leading to muscle death (necrosis). Infarcts may result from flow occlusion or stenosis
(narrowing). Another agent that may occlude blood flow besides cholesterol plaques, include
uric acid crystals from the kidney.
The most typical reason blood clots are formed in the artery is due to atherosclerosis, which
is the stiffening of the vessel overtime due to repeated damage.
Angina is severe chest pain associated with ischemia. The severe pain typical spreads from
the left shoulder all the way down the arm. Pain may even diffuse to the jaw or back. Some other
symptoms of ischemia include pale face, sweaty brow, shortness of breath, varied pulse, and
anxiety. The squeezing chest pain that the patient suffers with is due to the lack of blood flow to
the myocardium.
Coronary Artery Disease (or ischemic heart disease) includes numerous of diseases,
including myocardial infarction, angina, and sudden cardiac death.
Typically, if individuals are able to survive after a myocardial infarction, but their standard of
life is significantly reduced. These individuals suffer with symptoms such as shortness of breath
and leg swelling (edema). Strokes are a specific type of artery blockage; during a stroke an
individual’s artery in the brain is severely obstructed leading to the death of brain tissue. Once
again, atherosclerosis is the most common cause for the formation of a blood clot in the artery.
Similarly, individuals can survive strokes but have a significant loss of function, such as the
inability to speak or move their limbs. Risk factors for both heart attack and stroke include: high
LDL cholesterol, low HDL cholesterol, cigarette smoking, hypertension (high blood pressure),
older age, diabetes, and physical inactivity. About 50% of American adults have high cholesterol
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levels, which include over 100 million individuals. Abnormal lipid values are most often due to
heredity and lifestyle choices. Individuals that lead a healthy and active lifestyle typically have
lower LDL cholesterol, in comparison to those that lead sedentary lifestyles.
Heart failure in when the patient experiences weakness, breathlessness or dyspnea,
abdominal pain, and edema (in limbs and lungs). The consequence of heart failure is venous
stasis and reduced blood flow from the heart. Congestive heart failure may occur from narrowed
arteries (coronary artery disease) or high blood pressure.
Heart failure edema may result when one of the ventricles (or both ventricles) are not able to
pump blood properly.
Figure 8: This figure shows an artery that is severely diseases by major cholesterol
plaque formation which damaged the endothelial lining of the vessel.
Cholesterol:
There are two major types of cholesterol, “good” and “bad” cholesterol. LDL or low-density
lipoprotein, is known as the “bad” cholesterol because accumulation leads to plaque build up in
the walls of the arteries. Foods with high levels of saturated fats and trans fats raise LDL levels,
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including butter, lard, and palm oil. HDL, or high-density lipoprotein, is known as the “good”
cholesterol. Numerous studies have actually shown that high HDL levels may be protective
against developing cardiovascular disease. Foods that might raise HDL levels include beans,
whole grains, high-fibered fruits, fish, soy, and avocado. The best treatment for individuals with
high LDL cholesterol is statins. Statins are used to prevent an initial or second myocardial
infarction by blocking a liver enzyme called HMG-coA reductase, which is typically needed to
synthesize cholesterol in the liver. Blocking HMG-coA reductase leads to an increased number
of LDL receptors on the surface of the liver cell, which increases the LDL cholesterol uptake
from the blood. Once the LDL (and VLDL) particles bind to their respective receptors, they are
taken into the liver, emulsified by bile salts (broken down), and excreted from the body.
Blood Pressure:
Hypertension, or high blood pressure, is another common chronic disease around the world
and can lead to a number of complications such as stroke, or myocardial infarction. Lifestyle
factors that contribute to hypertension include: obesity, high salt diet, physical inactivity, highfat diet, and heavy alcohol ingestion. Hypertensive individuals have a blood pressure consistently
over 140/90 mm Hg. Blood pressure or vascular pressure, refers to the force that is generated by
the circulating blood against the walls of the major blood vessels. Blood pressure is maintained
by controlling factors such as blood volume, total peripheral resistance, and cardiac output.
There are numerous antihypertensive drugs available. Diuretics work by reducing body fluid
volume, and this is typically the first drug option. Beta blockers block epi- and nor-epinephrine
receptors on the heart and blood vessels, leading to a decreased heart rate and vasodilation.
Calcium channel blockers slow the influx of calcium ions into muscle cells, causing a decrease in
arterial resistance by forcing relaxation and myocardial oxygen demands by decreasing area of
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contraction. Cardiotonics (negative inotropics) cause a decrease in heart strength, which lowers
blood pressure. Lastly, vasodilators work by expanding the muscular layer on the wall of arteries
which prevents the vessels from stiffening and narrowing, thus a very efficient medication for
patients with atherosclerosis.
Figure 7: Above shows the ranges for normal, pre-hypertensive, stage 1 hypertensive,
and stage 2 hypertensive blood pressures. The normal healthy blood pressure is less than
120 (systolic) and less than 80 (diastolic). Anything above these values will put an
individual in the pre-hypertensive category.
Inflammation
Inflammation in the body is also shown to play an immense role in a number of obesityrelated conditions such as cardiovascular disease, cancer, and type II diabetes. The link between
inflammation and obesity derives from the molecule adipocytokines, which are released from
adipocytes (fat cells). In addition, obese individuals contain an elevated number of adipose tissue
macrophages which also exacerbate the inflammatory response by releasing a number of pro-
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inflammatory agents such as tumor necrosis factor-alpha, interleukin-6, monocyte
chemoattractant protein-1, and reactive oxygen species.
Background Information: Ayurvedic Medicine
Ayurvedic medicine is one of the oldest established medical systems in the world. Broken
down, Ayur means “life” and veda means “knowledge” or “science.” Essentially the term
Ayurveda means the “science of life.” Although Ayurvedic medicine is a 5,000 year old medical
system, it has been continually evolving within India. It is typically categorized as CAM, or
Complementary Alternative Medicine comprised of particular diets and herbs. Ayurvedic
medicine serves the specific purpose of combining the balance of the spirit, body, and mind into
one. For instance, from an Ayurvedic approach, cancer is not only seen as an abnormal growth of
cells in the body. From a holistic approach, it is known to be a homeostatic disorder and
imbalance in the body, mind, and soul. There is also emphasis on disease prevention and
wellness promotion, making the approach very holistic. Very similarly to other classic
civilizations such as the Egyptians, Greeks, and Babylonians, Hindu medicine stemmed from
superstitious beliefs.
According to ancient Ayurvedic philosophies, life, and everything contained in the universe,
can be broken down into 5 basic elements (or panchamahabhutas). These elements are Space,
Air, Fire, Water, and Earth. Each of the five elements give rise to different types of energies
(doshas) that control the human body, including vata, pitta, and kapha. The breakdown of each
of the three doshas vary in each individual, in a genetic matter, and make up an individuals
unique prakruti. The doshas controls aspects of the body, while the gunas regulate the human
mind.
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Dosha Characteristics Out of Balance
Vata people walk Vata influencing
Vata
Pitta
Treatments Lifestyle
Foods:
and talk fast but
areas of the body are Stay away
tire easily. Their
the colon, brain, ears, from cold and
appetite is
bones, joints, skin.
dry foods
variable but good Hence Vata types are such as
digestive strength susceptible to
beans, red
is missing.
diseases such as, cold meats and
They are creative or aching joints, dry
prefer well
and flexible and
skin and hair,
cooked
easily "go with
emphysema, arthritis, vegetables,
the flow."
constipation,
cheese and
flatulence, tics,
milk, wheat
twitches, nerve
bread,
disorders and mental banana, soy
confusion.
beans.
Exercise:
Try Yoga,
low impact
aerobics,
golf, hiking,
baseball.
Medium build,
Pitta people tend to
Foods:
Pitta people have have diseases
Reduce the
strong
involving
amount of
metabolism, good fire principle:
dark meats
digestion and
metabolism/digestion, (beef, dark
strong appetites.
allergies,
chicken),
Hair is soft and
inflammatory
tomato and
has a tendency for diseases, skin rashes, sauces/salsas,
premature graying burning sensations,
hot peppers,
or hair loss. They acid reflux, diarrhea, sour foods.
perspire easily.
ulceration, colitis, or Prefer fruits
Pitta people sleep sore throat, fevers
such as pears,
well in moderate
apples,
duration.
raisins and
eat white
Favor
smaller
meals
made of
foods that
are easy to
digest.
Regulate
the
amount
raw
vegetables
and fruit
taken.
Prefer
lighter,
warm
foods.
Take
fluids
regularly
through
the day.
Watch salt
intake.
Pitta
people
like spicy,
fried
foods.
Make sure
to
integrate
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Kapha Kapha people
They tend to have
have a large build. diseases connected to
This is because
the water principle
their metabolism such as flu, sinus
is slow. While
congestion, and
their digestive
others involving
strength is good,
mucous. Other issues
are sluggishness,
excess weight,
diabetes, water
retention.
meat
(chicken,
duck). Dairy
foods are
very helpful.
cooling,
non-spicy
foods a
few times
a week.
Exercise:
Try team or
group sports
Be aware
of
stimulants
such as
caffeine,
alcohol
and sugar.
Foods:
The nature of
Kapha force
is moist and
heavy.
Exaggeration
of heavy,
moist foods
such as dairy,
eggs, wheat,
rice leads to
imbalances.
Switch to
light or dry
foods such
as; salads,
cooked
vegetables,
poultry.
It is
essential
for a
Kapha
person to
vary their
routine.
http://www.naturesformulary.com/contents/ayurveda/vata-dosha
Table 1: The above table shows the 3 doshas (vata, pitta, and kapha). It explains the
characteristics of each, what happens when there is an imbalance, and ways to treat these
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imbalances in the individual (via food, yoga/exercise, breathing technique, mental outlook,
etc.)
Figure 8: The above figure is a visual depiction of the three doshas (vata: air, pitta: fire, and
kapha: water and earth).
There are three types of gunas, including sattva, rajas, and tamas.
Gunas
Characteristics Out of
Treatments Lifestyle
Balance/
Excessiveness
Sattva
Understanding
Harmony
A downside of
sattva is the
N/A
Don’t settle
into wordly
happiness
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Upward
Light
Serenity
Acceptance
Goodness
delusion of the
ego
Can generate
characteristics
such as
complacency
and selfsatisfaction
Experience
the spiritual
nature of
the universe
Attachment is
another pitfall
Clarity
Appropriateness
Being present
Pure
Consciousness
Wisdom
Rajas
Peace
Activity
Hyper-busy
Passion
Too busy
Fire
Anxiety
Overactive
Irritation
Desire/ Wanting
Chattering Mind
Excessiveness
Foods:. Avoid Go
spicy foods
outdoors
more often,
Exercise: try get in-touch
the lionpose,
with nature
cobra, upward
dog/downward Change up
breathing
dog yoga
posses; focus techniqueson posses that deep
breaths to
get the
individual out calm down
of their mind
and body; hold Slow down
yoga poses for and rest
as long as
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possible
Tamas
Inertia
Laziness
Darkness
Apathy
Dullness
Depression
Ignorance
Darkness
Isolated
Grief
Lacking
Loneliness
Downward
Sluggishness
Insensitivity
Foods: avoid
heavy
carbohydrates
Exercise: try
numerous
yoga poses
such as, the
sun
salutations,
warrior pose,
bow, triangle,
and “the tree”
(balancing
poses)
. Get active
Less
negativity,
more
activity
Become
more
social-leave
the couch,
bed, or any
type of
isolation
http://www.yogabound.com/the-three-gunas-balance-consciousness/
Table 2: The above table shows the 3 types of gunas (sattva, rajas, and tamas). It
explains the characteristics of each, what happens when there is an imbalance, and ways to
treat these imbalances in the individual (via food, yoga/exercise, breathing technique,
mental outlook, etc.)
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Figure 9: The above figure shows the three gunas (sattva, rajas, and tamas) that regulate
the human mind.
Ancient Ayurvedic philosophies also broke up the body into 7 tissue elements or dhatus,
including plasma, blood, muscle, fat, bone, nerve, and reproductive tissues. In addition, they
addressed the presence of 3 excretory products or malas, including feces, urine, and sweat. Agni
or energy metabolism, was another important categorization that is emphasized in this medical
approach. Ancient practicing Ayurvedic physicians believed that disease could develop from
abnormalities in any of the above factors. These physicians believed that keeping the dosha in
balance was the key to good health.
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When diagnosing patients for disease, extra attention was given to the heart, the lungs, and
the intestines. Physicians examined pulse, tongue, eyes, nails, and urine samples extremely
carefully-which differs from modern medicine assessments.
In Ayurveda an individual’s treatment plan consists of shodan (cleansing), shaman
(palliation), rasayana (rejuvenation), and satvajava (mental health).
Cleansing is a central form of treatment when it comes to Ayurvedic medicine. Cleansing is
done to relieve the body from all the undigested food that could be making the individual ill.
Blood purification can be done by removing samples of blood. Cleansing is often achieved
through the use of special teas. They also employed numerous techniques to make the
individuals vomit. Enemas, laxative, or purgatives were also given to cleanse out the GI tract.
Treatment Strategy
Characterization
Cleansing (Shodan)
Therapeutic Vomiting (vaman):
vomiting induced by agents
such as licorice
Purgation (virechan)
Medicated Enema (basti):
removing toxins through agents
such as sesame oil and milk
Blood Letting (rakta moksha):
this was achieved through
leeches or through herbs
(sandalwood and turmeric)
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Nasal Administration or
Insufflation (nasya): nasal
massages and administrating
agents such as oil and herbs to
the nose
Palliation (Shaman)
Fasting (ksud nigraha)
Observing Thirst (trut nigraha)
Exercise Yoga Stretching
(vyayama) and Breathing
Exercises (pranayama)
Lying in the Sun (atap seva)
Table 3: The above table shows specific Ayurvedic treatments for cleansing and palliation.
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Figure 10: Above is the picture of an ancient Indian physician of Ayurvedic medicine
grinding various types of roots in order to extract the medicinal components of these
plants.
Figure 11: Common spices/curries used in numerous Southeast Asian dishes.
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Turmeric and Ginger:
Ayurvedic physicians have established a link between plant-based foods and health
protective properties for centuries now, but exact scientific proof had not been established until
the early 1900s. Herbs and spices used regularly in South East Asian foods have been shown to
have numerous hypolipidemic, antiplatelet, and immune-enhancing properties that reduce an
individual's chance of developing heart disease. The compound that gives plant-based foods a
wide number of distinct characteristics including aroma, taste, color, and smell are called
phytochemicals. Ayurvedic professionals believe the phytochemicals are the agents that reduce
the presence chronic disease.
Turmeric (known as “Haldi” in India) is a small perennial (long-living) herb originating from
South-Eastern Asia, most probably from India. The plant produces a bright yellow/orange color
in its root (rhizome), which is where the active ingredient, curcumin, is extracted from. The root
powder is used as a flavorful spice, food-coloring agent, food preservative, and digestive agent.
Ancient Hindu medicine used turmeric as a treatment for sprains, swellings, cancer, diabetes,
cough, fertility, and HIV.
Ginger (“Saunth”) is another plant native to Asia. Currently ginger can be found in numerous
tropical regions such as the West Indies and Africa. The rhizome is the source of the health
protective phytochemicals, ranging from a white to brown color. The rhizome is most commonly
turned into a powder, syrup, or oil. Science and literature dates the culinary use of ginger all the
way back to the 13th centuries. Ginger has been used for a diverse number of medical conditions
in Asia, India, Europe and the Middle East for centuries. For instance, ginger has been used to
treat menstrual irregularities, diabetes, asthma, upset stomach, and arthritis.
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Turmeric and ginger are part of the Zingiberaceae herbal family, containing numerous active
phytochemicals including curcumin, gingerols, and diarylheptanoids. The rhizomes in each spice
contain essential fats, carbohydrates, proteins, fibers, water, and volatile oils.
Figure 12: The root powder from both turmeric and ginger are extracted and used in a
number of curry dishes, teas, and soups. The root powder can also be turned into a liquid
syrup.
Figure 13: Turmeric and ginger can also be found in tablet form for medicinal purposes.
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Conclusion: Positive Effects of Turmeric and Ginger on the
Heart and Body (Anti-cholesterol, Antioxidant, Anti-platelet,
Anti-obesity, Anti-Inflammation)
Turmeric and ginger have been shown to reduce LDL cholesterol and triglycerides most
likely by decreasing the lipid peroxidation process in which free radicals steal electrons from
lipids in cell membranes leading to cell damage. The polyphenols (a micronutrient) in both
spices are thought to destroy free radicals and prevent LDL oxidation. The reduction in “bad”
cholesterol may be also due to a change in fatty acid metabolism. Instead of increased cholesterol
reuptake in the intestines, more is converted into bile acids in the liver and ultimately excreted.
Additionally, turmeric and ginger have shown anti-platelet activity through the inhibition of
thromboxane synthesis (which typically stimulates platelet aggregation) and the stimulation of
prostacyclin synthesis (inhibits platelet activation and vasodilates in vessel). Due to the spices
effect on serum lipid levels, it proves to be atheroscleroprotective by inhibiting LDL oxidation,
increasing HDL levels, and maintaining NO-mediated endothelial function (a key agent that
promotes health vessel dilation/blood flow/low blood pressure). The vasorelaxant properties of
both spices by maintaining endothelial health shows how both turmeric and ginger are great
antioxidants. The rhizomes of both spices were found the decrease liver and plasma arginase
activity. Studies have found that OxLDL, the pathogenic lipid primarily responsible in
atherogenesis, enhances arginase production. Arginase is an enzyme that binds to the substrate
arginine which competitively binds to eNOS, decreasing NO production. The restoration in
endothelial function is also protective for myocardial ischemia, aging, and hypertension.
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Interestingly enough, the literature also focuses a lot on the anti-inflammatory actions of
turmeric and ginger by reducing obesity-induced inflammation which is linked to a number of
diseases other than cardiovascular disease, such as cancer and type II diabetes. The
phytochemicals present in the spices was shown to stimulate thermogenesis, which increases
energy expenditure and fat oxidation, thus a key contributor to weight control. Turmeric and
ginger also inhibited the migration of macrophages to adipose tissue and thus suppressed the
activity of pro-inflammatory agents such as tumor necrosis factor-alpha, interleukin-6, monocyte
chemoattractant protein-1, and reactive oxygen species.
Most studies with turmeric and ginger, among other Ayurvedic spices, have been successful
in animals, along with in vitro experimentation, but not much has been done on human subjects.
It doesn’t seem likely that Ayurvedic medicine can replace normal medication. As Ayurvedic
and naturopathic medicine continue to gain popularity, hopefully more human-based research
can be conducted to further understand the exact mechanisms behind spices on the heart.
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Community Outreach-Festival of Books
On Saturday March 12th, I volunteered at the Tucson Festival of Books located on the UA
mall all afternoon. During my time volunteering, I worked a booth in the “Science City” section
of the festival teaching Tucson locals about the heart anatomy, disease, and physiology.
Furthermore, I dispensed my brochure, “Ayurvedic Medicine”, to those that visited my specific
booth. While constructing the brochure, I included basic information on the heart anatomy and
physiology, because I know the public may not have much knowledge about the circulatory
system. I broke the circulatory system into three basic components- the heart, the blood, and the
vessels. Additionally, I added information on the most common heart conditions that affect the
American population, including, myocardial infarctions (heart attacks), strokes, high cholesterol,
and high blood pressure. Typically, individuals with no science background have a general idea
of what these diseases are but they may not fully understand the physiology behind it. The rest of
the brochure explained the history of Ayurveda, along with the two spices I focused my thesis
on: ginger and turmeric. Since Ayurvedic medicine and naturopathic medicine is increasing in
popularity, I was interested to share my research findings on the heart protective properties of
ginger and turmeric.
Since I have always been interested in promoting health education to the general community,
I had an excellent experience doing community outreach. Most of the people that visited my
booth were children between the ages of 5 and 14, along with adults 50 and above. The children
had an impressive foundation in science/ anatomy, which was very impressive. They were able
to answer all my preliminary questions regarding the general location of the heart, the general
function of the heart, and why keeping a healthy heart is imperative. I didn’t go into much depth
about the spices with the children. I mainly explained why eating healthy (whole grains, less
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junk food, more vegetable/fruits, and lean meats) is important for the body and heart. I discussed
the difference between good fats and bad fats (HDL and LDL), and how eating unhealthily, not
staying active, and smoking can lead to the clogging of arteries leading to heart attacks/stroke. It
was rewarding hearing that children promised to stay active and eat their veggies!
The adults that visited my booth at the festival were fascinated by the fact that spices/ herbs
could be protective to heart/ endothelial lining. I explained the anti-platelet and antiatherosclerotic effects of ginger and turmeric. In order to explain these heart protective
properties, I explained how unhealthy practices over a long period of time cause damage to the
lining of blood vessels called endothelium. LDL (low-density lipoproteins) traveling in the blood
are then able to easily cross into the damaged endothelium. As the cholesterol begins to
accumulate, white blood cells invade the artery to ingest LDL cholesterol, forming a cholesterol
plaque. I loved seeing people’s face light up when they began to understand exactly what their
doctor meant when they said “cholesterol plaque.” I explained that the process of cholesterol
plaque formation occurs very slowly and is often painless, that’s why it is important to get your
cholesterol levels checked regularly because it can lead to myocardial ischemia. I continued
explaining how myocardial ischemia occurs when blood flow is significantly reduced due to
partial or complete obstruction of the coronary arteries. This process reduces the heart’s ability to
pump blood efficiently to oxygenate the body. Many adults and children asked me exactly what a
heart attack entailed. I explained that a heart attack is when cholesterol plaques rupture and allow
the platelets to clot inside the coronary artery severely obstructing blood flow, ultimately leading
to muscle death. Many adults were not aware that the most typical reason blood clots are formed
in the artery is due to atherosclerosis, also known as, the stiffening of the vessel overtime due to
repeated damage. I also explained the differences between strokes and heart attacks.
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I was surprised that a predominate portion of the adults that I talked with that afternoon had
some previous knowledge on Ayurvedic/ naturopathic medicine. A couple of people told me they
regularly were taking turmeric pills! People mainly associated spices with treating/ preventing
inflammation and arthritis.
Figure 14: The Tucson Festival of Books which takes place March 12th- March 13th on a
yearly basis.
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Figure 15: The brochure I handed out during my community outreach at The Festival of
Books on March 12th. This side of the brochure contained information on the medicinal
uses of turmeric and ginger, along with my scientific references, and a little background
information into my honors thesis project.
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Figure 16: Part 2 of the brochure I handed out at The Festival of Books, this side contained
information on the circulatory system, heart disease, and background information on
Ayurvedic Medicine.
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Physiology Poster Session:
On April 20th, I presented at the Physiology Poster Session in the Student Union at the University
of Arizona. This experience was a little different from my community outreach at the Festival of
Books-both being equally rewarding. I was grateful to be able to work on my presentation skills
and have the experience of preparing a scientific poster. On my poster, my topic was presented in
numerous sections, I had an abstract, breakdown of the cardiovascular system, breakdown of the
progression of heart disease, background information on Ayurvedic Medicine, an overview of
turmeric and ginger, a conclusion of my literature review, and references. The poster was titled
“Magic Spices: Ayurvedic Medicine and the Heart.”
Most of the individuals that visited my poster had knowledge about physiology since they
were Honors Physiology juniors/seniors or professors in the Physiology Department. I let
individuals skim my poster before giving them a summary about my topic. I gave them a quick
summary of what Ayurvedic medicine was, and how spices are commonly used in South East
Asia and beyond as a form of treatment/prevention for numerous ailments. I explained that I
chose to focus on turmeric and ginger specifically because I found extensive scientific research
on these two spices specifically. The students that I talked to were shocked that turmeric and
ginger contained active phytochemicals in their roots/rhizome, which is were the spice is
extracted from. Numerous adults were surprised that turmeric and ginger belonged to the same
herbal family, Zingiberaceae, and contain the same active phytochemicals (curcumin, gingerols,
and diarylheptanoids) which is why they work similarly on the heart.
Since the students and faculty had extensive physiology knowledge, I was able to go into
depth about how these spices decreasing the lipid peroxidation process by destroying free
radicals and changing the fatty acid metabolism. Students were intrigued by how the polyphenols
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help re-route fatty acids to be mixed with bile acids in the liver and ultimately excreted.
Additionally, I discussed how the active ingredients in the spices inhibit thromboxane synthesis
and stimulate prostacyclin synthesis. Finally, I went into the atheroscleroprotective properties of
ginger and turmeric by explaining how the phytochemicals increase HDL levels, decrease LDL
levels, and maintain nitric oxide levels. Since a lot of students were enrolled in Cardiovascular
Physiology, they understood how NO-mediated endothelial function was important for healthy
vessel dilation and maintaining blood flow. Spices were also found to decrease plasma arginase
activity, which inhibits arginine from competitively binding to eNOS, thus increasing NO
production.
Numerous students asked me if spices and herbs could be used as a front line treatment. I
made sure to stress that although spices play an important role for a number of physiological
systems, it cannot be used as a treatment. For instance, if someone had high cholesterol, they
would need to take statins as a primary treatment and supplement through adding spices to their
diet.
One honors physiology student brought up a very interesting point. She asked me about
how spices can be incorporated into American/European cuisine, especially since curries are not
common ingredients in most dishes. I know that turmeric is commonly used in smoothies and
teas. I looked up some teas which incorporated both ginger and turmeric. My mother actually
makes a smoothie with turmeric, watermelon, and pineapple-which tastes great although
turmeric is usually associated with a savory palette. Turmeric can be used to flavor vegetarian
burger patties, scrambled eggs/omelets, and to flavor lean meats. Ginger is typically easier to
cook with since it can be used for a wide range of soups and teas. My mother makes a carrot
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ginger soup, and lentil ginger soup which tastes great and is very healthy. Additionally, ginger
can be used for vegetable stir-fry’s.
Additionally, some student asked me if I think there will be an increase in incorporating
spices to dishes since “exotic” cuisines such as Thai/Indian/African are gaining popularity. I
definitely have noticed that within the past 5 years, people have become more aware of Indian
food especially. It is very common for non-Indians to visit Indian restaurants and begin learning
how to cook these curries on their own. From my experiences at the poster session and at the
Festival of Books alone, I have also noticed a rise in the awareness of naturopathic medicine.
Since the general public has started to value eating healthy, working out, and sticking to all
natural diets-I do think that Ayurvedic Medicine will continue to gain popularity all around the
globe.
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Figure 17: A closer look into my poster titled “Magic Spices: Ayurvedic Medicine and the
Heart.”
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Figure 18: Me presenting my thesis research at the Physiology Poster Session, April
20th.
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My Thesis Experience:
Overall, I learned a lot from my year long thesis experience. This was my first literature
review project, and I feel as though I became better at reading scientific articles. I learned how to
read scientific journals faster, while being able to extract out all the pertinent information and
data. The most rewarding aspect of this year-long process by far was presenting at the
Physiology Poster Session and The Festival of Books. At these two events, I was able to share
the knowledge I’ve accumulated from my 4-year physiology degree with my fellow peers and
the Tucson community. I was given the opportunity to also practice my public speaking and
presentation skills. In addition, these experiences opened up my eyes to the rewarding nature of
health community outreach.
The unique thing about my thesis subject is that it combined both my degree of study and my
heritage (since Ayurvedic medicine originates from India). I was able to share some common
turmeric and ginger recipes that I grew up with, including various teas, soups, and curries. Since
I grew up with my mother always telling us about how the spices she cooked with were
beneficial for a number of health reasons (digestion, inflammation, high blood pressure,
cholesterol, arthritis, etc.), it was rewarding being able to research these claims from a more
scientific perspective.
In addition, I grew up to my grandparents visiting from India every couple of years. When
they would visit, they stayed for months at a time. Every morning, I would find my grandfather
performing yoga, practicing various breathing exercises, meditating, and lying in the morning
sun. As I was researching common Ayurvedic strategies, I realized all four of those practices are
at the very heart of traditional Indian medicine. Furthermore, every Monday, my grandmother
would perform a fasting where she only age fruits all day. I knew that her fasting was done for
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various (Hindu) religious purposes, but I also recalled that she said it was done for her health.
Now I understand exactly what she was referring to after researching Ayurvedic principles in
depth!
Figure 19: Above is a picture of my grandfather and grandmother from India, along
with the rest of my family. They practiced many of the core Ayurvedic principles in their
daily life such as meditation, fasting, lying in the sun, yoga stretches, breathing techniques,
etc. I remember waking up everyday at 6am in the morning to get ready for school, and my
grandfather would be performing yoga outside in the morning sun. I feel as though these
techniques kept my grandparents healthy spiritually, mentally, and physically.
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Indian Recipes with Ginger and Turmeric: “Vegetable Korma”
Ingredients for the Masala or Curry Preparation
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5 to 6 tbsp fresh grated coconut or unsweetened desiccated coconut
5 to 6 whole cashews or ¾ to 1 tbsp chopped cashews
½ tbsp roasted chana dal/daria dal/dalia
½ tbsp coriander seeds/sabut dhania
3 to 4 medium sized garlic/lahsun, chopped
¾ inch ginger/adrak, chopped
3 dry red kashmiri chilies or byadgi chilies - broken and deseeded if
your prefer. substitute with 1 to 2 green chilies or 1 to 2 dry red chilies
of any other variety, depending on the hotness and pungency of the
chilies.
¾ to 1 tsp fennel seeds
1 inch cinnamon stick/dal chini
2 cloves/lavang
1 green cardamom/hari elaichi
1 tsp poppy seeds (if not available then skip)
a small tiny piece of stone flower/dagad phool/kalpasi/patthar ke phool
(skip if not available. stone flower is strongly aromatic and flavored. so
use a very tiny piece.)
½ cup water for grinding
Other Ingredients
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1 medium to large carrot, 80 to 90 gms
½ to ⅓ cup chopped french beans, 50 to 60 gms
½ cup peas/matar, fresh or frozen
1 medium to large potato, 80 to 100 gms
4 to 5 white button mushrooms
1 medium sized onion
8 to 10 curry leaves or 1 small to medium tej patta/indian bay leaf
1 medium sized tomato
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¼ tsp turmeric powder/haldi
2 tbsp fresh full fat yogurt/curd/dahi (avoid using low fat or sour yogurt
as the yogurt curdles when cooking)
1.5 cups water
2 to 3 tbsp oil
salt as required
few chopped coriander leaves for garnish
Recipe From: http://www.vegrecipesofindia.com/veg-korma-recipe-mix-vegetable-kurma/
(Very similar to my mother’s recipe.)
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Aloo Gobi Recipe (Potato Cauliflower Curry)
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1 large onion, peeled and cut into small pieces
1 bunch fresh coriander, separated into stalks and leaves and
roughly chopped
1 small green chili, chopped into small pieces (or one teaspoon
chili powder)
1 large cauliflower, leaves removed and cut evenly into eighths
3 large potatoes, peeled and cut into even pieces
2 (8 ounce) cans diced tomatoes
fresh ginger, peeled and grated
fresh garlic, chopped
1 teaspoon cumin seed
2 teaspoons turmeric
1 teaspoon salt
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2teaspoons garam masala
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(Recipe from: http://www.food.com/recipe/aloo-gobi-84324)
Western Dishes with Ginger and Turmeric
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Ginger Ale
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Ginger water
1 cup peeled, finely chopped ginger
2 cups water
Simple Syrup
1 cup sugar
1 cup water
Club soda
Lime juice
Lime wedges
(Recipe From: http://www.simplyrecipes.com/recipes/homemade_ginger_ale/)
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Ginger Beef Stir Fry
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Marinade Recipe
2 Tbsp unseasoned rice vinegar
5 Tbsp soy sauce
1 Tbsp honey
1 Tbsp peeled, grated fresh ginger
1 teaspoon chile pepper flakes
1 teaspoon ground cumin
Other Recipes:
1 1 1/4 to 1 1/2 lb top sirloin steak
1 Tbsp cornstarch
2 Tbsp vegetable oil (preferably peanut)
1 Tbsp sesame oil (optional)
3-4 green onions, cut on a diagonal, 1/2-inch apart, including the greens
2 cloves garlic, thinly sliced
2-3 hot chilis, preferably red serranos, seeded, sliced
1-inch nob of ginger, peeled, cut lengthwise into matchstick shapes
1/2 cup loosely packed, chopped cilantro
(Recipe From: http://www.simplyrecipes.com/recipes/stir_fry_ginger_beef/#ixzz47HGBabUf)
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Spiced Kale Scramble-Flavored With Turmeric
-2 pasture eggs
-1 cup chopped kale
-1.5 tsp turmeric
-1 tsp garlic powder
-1 tbsp butter
-salt and pepper to taste
(Recipe From: http://healyeatsreal.com/spiced-kale-scramble/img_2567/)
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Watermelon Pineapple Turmeric Smoothie
-2 cups frozen watermelon flesh—cut into 2-inch chunks
-1 cup frozen organic pineapple—cut into 2-inch chunks
-1 orange—peeled, white pith and seeds removed
-½ cup organic coconut milk—preservative free
-1½ cups organic coconut water—sugar free
-1 teaspoon grated fresh ginger
-½ teaspoon organic turmeric powder
-2-3 drops liquid stevia or 1 teaspoon raw honey—optional
(Recipe from: http://aharmonyhealing.com/anti-inflammatory-frozen-watermelon-pineapplesmoothie/)
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References:
1. Cohen, Zoe PhD. Cardiovascular Physiology (PSIO 485) Class Notes. University of
Arizona Department of Physiology. Tucson, AZ, 2015.
2. M. Zahid Ashraf, M.E. Hussain, and M. Fahim. Life Sciences. Volume 77, Issue 8, 8 July
2005, Pages 837-857.
3. Mujeeb and Mohammad Akhtar, International Journal of Green Pharmacy. 7.2 (AprilJune 2013): p85.
4. Ravinder Mamtani, MBBS, MD, MSc, FACPM, and Ronac Mamtani, BS. Cardiology in
Review. Volume 12, Number 3, May/ June 2003, Pages 155-162.
5. Singletary, Keith PhD. Nutrition Today. Issue: Volume 45(4), July/August 2010, pp 171183.
6. Winston J. Craig. American Society for Clinical Nutrition. 1999; 70 (suppl): 491S-9S.
7. Woo, Hae-Mi, Kang Ji-Hye, Kawada, Teruo, Yoo Hoon, Sung, Mi-Kyung, and Yu, Rina.
ScienceDirect. 2007. Pages 926-931.
A special thank you to Dr. Cohen and The Honors College for all their guidance and
assistance through this thesis process. I really appreciate all the support! J