IMPORTANCE OF GEE

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    Ghee

    An Ayurvedic and Biochemical Treatise

    Catherine Robbins, BSc, KYTA, AHE, AHP

    California College of Ayurveda

    AHP-Internship 2012

    [email protected]

    7/14/2012

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    Introduction:

    Ghee, the golden elixir of Ayurveda is an oil with a long and interesting history. A staple of Indian,

    Arabic, and North African cooking, it is also found throughout Indonesian societies. Ghee is the

    rendered fat of butter. Butter is made in several different ways, which result in butters with slightly

    different fat, water and milk solids content. Desi ghee is the traditional Indian ghee made from

    cows milk that is first collected and saved for a few days to culture. The cultured milk is then

    churned to produce butter. Churning separates the emulsified fats in the milk from the liquid oraqueous portion of the milk. The left over liquid is called buttermilk and is used for drinking and

    other cooking. In American creameries, the milk is usually not cultured and it therefore produces

    butter that has a slightly different fatty acid and water content [1].

    The rendered oil known as ghee is called ghrita in Sanskrit, the traditional language of the ancient

    texts of Ayurveda. The Brihat Treya, the three most important Ayurvedic texts are the Caraka

    Samhita [2, 3], the Shushruta Samhita [4] and the Ashtanga Hrdayam [5], and date back as far as

    500BC in written form. It is in these ancient writings where we learn the multiple uses and the

    powerful medicinal effects of ghrita. Caraka clearly states the indications for ghee: promotes

    memory, intelligence, agni, semen, ojas, Kapha and medas. It alleviates Vata, Pitta, poison,

    insanity, phthisis, inauspiciousness and fever. It is the best of all fats, is cold, madhura rasa,

    madhura vipaka, has 1000 potentialities and so, if used properly according to prescribed methods,

    exerts 1000 types of action. Su27#231-232 [2, 3]. Caraka then goes into a greater discourse on

    each use listed for ghee throughout the text.

    Sushruta makes an even stronger statement on the medicinal uses of ghee, Ghrita is sweet, mild

    in action, soft, cold in potency (Virya), not increasing moisture in the tissues, lubricating, relieves

    upward movement in the alimentary tract, insanity, epilepsy, colic, fever, and distension of the

    abdomen, mitigates vata and pitta, kindles agni, increases memory, wisdom, intelligence,

    complexion, voice, beauty, softness of the body, vitality, vigor, strength, and span of life; is

    aphrodisiac, good for vision, increases kapha, wards off sins and inauspiciousness, destroys

    poisons and demons. He further elaborates on the properties and applications of ghees obtained

    from the various types of animal milks including human, elephant and camel milk, Chap XLV

    #5v1-9 [4] stating ghee from cows milk is superior for all ailments.

    In the Ashtanga Samgraha, Vagbhata tells us the use of ghee forsnehavidhi adyaya or oleation

    therapy is best for those desirous of intelligence, memory, wisdom, good digestive capacity, for

    those suffering tumors, sinus ulcers, worms, diseases of kapha, medas and vata origin Chap 25

    10-11 [6]. The quotes of these authors are very strong statements and in todays medical world

    where the search is on for THE one pharmaceutical magic bullet, ghee appears to be just that.

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    Table 1

    From the above table, it is clear that ghee can be tridoshic in small doses. It has a sweet rasa,

    with a cold virya and a sweet vipaka with gunas or qualities being light, penetrating and unctuous

    [2, 4, 8, 9]. Ghees unctuousness makes it an excellent internal and external lubricant for treating

    Vatas dryness, roughness and emaciation and Kaphas hardness. Its cooling virya makes it

    excellent for placating excessive Pitta and yet, it can stimulate agni without exacerbating Pitta

    aggravations. Ghee also has a prabhav that allows it to take on the properties of herbs it is

    processed with without losing its own gunas [2]. This means if it is cooked with a heating herb,

    the ghee will pass on this property without giving up its own oily, cooling properties. This makes

    ghee an excellent anupana and its spreading nature can take the intention of herbs in to the deep

    tissues. Dr. Vasant Lad of the Ayurvedic Institute in Albuquerque, NM calls ghee a catalytic agent

    oryogivahithat carries the medicinal properties of herbs it is processed or taken with in to the

    tissues [10].

    Again, when pondering all the possible uses for ghee from an Ayurvedic standpoint, it would seem

    that ghee is like the magic bullet so sought after in Western medicine [11], however, when the

    subject of dietary fat arises in the American public discourse, the first questions raised invariably

    have to do with is ghee safe? Isnt ghee just rendered animal fat and shouldnt we all be avoiding

    animal fat in general? Isnt ghee, being a by-product of butter, high in cholesterol?

    Indication for ghee Dosha/Subdosha involved Reference

    Promotes memory Vata (prana, samana vyana) Caraka, Sushruta,Vagbhata

    Promotes intelligence/wisdom Vata (prana, samana vyana) Caraka, Sushruta,Vagbhata

    Enkindles agni/digestivecapacity Pitta (pachaka) Caraka, Sushruta,Vagbhata

    Promotes semen/vigor Shukra agni, apana vayu Caraka, Sushruta

    Promotes ojas/vitality Kapha kshaya Caraka, SushrutaPromotes kapha/medas Kapha kshaya Caraka, Sushruta

    Cures diseases ofkapha/medas Kapha kshaya Vagbhata

    Alleviates Vata Vata vruddhi Caraka, Sushruta,Vagbhata

    Alleviates Pitta Pitta vruddhi Caraka, Sushruta

    Poison Vata, Pitta, Kapha[7] Caraka, Sushruta

    Insanity Vata Caraka, Sushruta

    Epilepsy Vata Sushruta

    Phthisis (tuberculosis) Vata, Pitta, Kapha[7] Caraka

    Upward moving Vata in

    alimentary tract Vata SushrutaColic, constipation/gas Vata Sushruta

    Tumors Kapha Vagbhata

    Sinus Ulcers Pitta Vagbhata

    Fever Pitta Caraka, Sushruta

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    Whenever the discussion turns to fat in the American diet, there is so much contradictory

    information in the public domain, a formalized understanding of fat bio-metabolism can be truly

    useful in understanding how ghee could be good. To that end, let us take a closer look at what fat

    is and how, when and why humans require fat in their diet, not only to survive, but to also lead

    healthy productive lives.

    The skinny on fats: whats a fatty acid and why is it essential?Lipids are one of the four major classes of bio-organic compounds required by living organisms,

    the other three being carbohydrates, proteins and nucleic acids. Unlike the other three classes of

    important biochemical compounds, lipids are not characterized by structure but rather, by

    selective solubility in various solvents. Technically speaking, a lipid is an organic (carbon

    containing) compound found in living organisms that is insoluble or sparingly soluble in water but

    is very soluble in non-polar solvents [12, 13] such as oil. There is great structural diversity among

    lipids leading to the following five classifications:

    1. Energy Storing lipids: triacylglycerolsa

    2. Membrane Lipids (phospholipids, sphingoglycolipids and cholesterolb)

    3. Emulsification lipids (bile acids)

    4. Messenger lipids (steroid hormones, cholesterolb and eicosanoids)

    5. Protective coating lipids (plant waxes)

    Fatty Acids (FAs) are naturally occurring monocarboxylic acids which generally contain an even

    number of carbons in their carbon chainc where Long Chain FAs = 12-26 carbons, Medium Chain

    FAs = 6-10 carbons and Short Chain FAs = 4-6 carbons in length. FAs are rarely found free in

    nature as they are usually part of more complex lipid molecules [13, 14].

    a* b*

    Triacylglycerol , aka Triglyceride Cholesterol

    c*

    Butyric acid, a short chain saturated fatty acid found in ghee and butter

    *structures constructed using MarvinSketch Freeware[15]

    A further delineation of FAs is the degree of saturation. Saturated FAs (SFAs) have no carbon-

    carbon double bonds in the carbon chain. Monounsaturated FAs (MUFAs) have one carbon-

    carbon double bond in the carbon chain and Polyunsaturated FAs (PUFAs) have two or more

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    carbon-carbon double bonds in the carbon chain. Up to 6 double bonds are found in biologically

    important PUFAs. Double bonds are significant to the biochemistry of FAs because it is at these

    high-energy bonds that important biochemical reactions take place.

    In plants, FAs are found mostly esterified to glycerol as triglycerides and they make up ~7% of the

    dry weight of a plant [14]. Plant FAs are generally unsaturated (UFAs) as demonstrated by the

    fact that they are liquids at room and body temperature. Seed and nut oils have much higher FAcontent, but again are mainly unsaturated and in the form of triglycerides. Coconut oil is heavily

    saturated at 86.5% while olive and safflower oil have 13.8% and 7.5% saturation, respectively

    [16].

    In general, SFAs come from animal sources and UFAs come from plant sources although there is

    great variability in the FA makeup of various types of plants and animals. Ruminant animals such

    as cows, goats and sheep have much higher SFAs than fish or fowl. Ruminant animals rely on

    gut bacteria to breakdown plant based foods such as grass, forage or corn into usable energy via

    the anaerobic process of fermentation.

    The fermentation carried out by the gut bacteria and the rumen stomach together are considered

    more or less a hydrogenation chamber where plant based UFAs are hydrogenated with the main

    waste product being gaseous methane. Usable byproducts of ruminant fermentation are volatile

    short chain SFAs such as acetic acid, proprionic acid and butyric acid and they are a main source

    of energy for the animal. They also occur in the food we get from the animals such as meat, milk,

    cheese and butter. Other animal meats such as chicken and fish are generally lower in SFAs

    because those animals do not ruminate or, ferment their food before digesting it as do cows [17].

    The chemical properties of FAs and the lipids that contain them are a function of the length of the

    carbon chain they contain and the degree of saturation. SFAs that have fewer than 8 carbons are

    liquid at body temperature and those containing 10 or more carbons are solid at body

    temperature. The presence of double bonds lowers the melting point, hence SFAs have a higher

    melting point than UFAs with the same number of carbons in the chain. The greater the degree of

    unsaturation, the lower the melting point and this is due to decreased molecular attraction

    between carbon chains [12, 13, 18]. The carbon-carbon double bonds in UFAs are usually (but

    not always) in a cis configuration, which introduces a bendin the carbon chain. Such bends

    prevent UFAs from packing as tightly together as SFAs. The greater the number of double bonds,

    the less efficient this packing is and the lower the melting point of the lipid [12].

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    [19]

    In humans, most FAs come from the diet although the body can make many fatty acid containing

    molecules with two key exceptions: the highly unsaturated linoleic acid and alpha-linolenic acid.

    These two FAs have unsaturation beyond carbons nine and ten which the human body cannot

    synthesize. Because these two FAs cannot be synthesized from lipid precursors in the body, they

    are considered essentialand must be obtained from the diet. These are PUFAs and their

    exclusion from the diet leads to severe gastrointestinal and skin lesions similar to Pellegra (vitamin

    B3 deficiency). Since FAs are abundantly available in both plant and animal based foods, it is a

    rare situation where an individual is suffering from essential FA depletion. On the other hand, it is

    generally accepted that diets very low in fat need to be supplemented with linoleic and alpha-

    linolenic acid [20, 21].

    Saturated FAs have been long associated with cardiovascular disease, cerebro-vascular disease

    and atherosclerosis [22, 23]. Although the data have not always been strong, they appear to be

    consistent across years of published research indicating that a diet high in saturated fats

    increases the risk of coronary artery disease (CAD) [24]. Mechanistically, this increase for CAD

    risk appears to involve increased Low Density Lipoprotein (LDL), which has been linked to

    atherosclerosis, a precursor to cardiovascular disease CVD [25, 26]. On the other hand, some

    SFAs such as caproic acid (5 carbons), caprylic acid (8 carbons), decanoic acid (10 carbons) and

    stearic acid (18 carbons) have been shown to have no effect on LDL cholesterol [27].

    Interestingly, butyric acid, the 4 carbon volatile SFA which is found at 2-5% by weight in butter and

    ghee has been shown to be anti-inflammatory in Crohns disease, to improve insulin sensitivity,

    increase energy expenditure in a diabetic mouse model, and to be a modulator of the immune

    response and inflammation as well as an anti-tumor agent [27-30].

    Unsaturated FAs come in 2 types: Monounsaturated (MUFAs) and polyunsaturated (PUFAs). The

    one carbon-carbon double bond in MUFAs is generally in the cis configuration and the dietary

    effect seen in many studies is to reduce cardiovascular risk [31]. Examples of MUFAs are

    palmitoleic acid and oleic acid. Examples of PUFAs are linolenic acid and alpha-linoleic acid.

    PUFAs have more than one carbon-carbon double bond and another important differentiating

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    factor is where along the carbon chain the double bonds occur. -3 PUFAs have their first double

    bond at the third carbon from the methyl end of the carbon chain and the -6 PUFAs have their

    first double bond at the 6th carbon from the methyl end of the carbon chain. These two families of

    PUFAs have received a lot of attention in Western science ever since it was discovered that

    linoleic acid and alpha-linolenic acid are essential [20, 21].

    -3 and -6 Fatty Acids:Linoleic acid (LA) is an -6 PUFA, an 18 carbon mono-carboxylic acid with two cis conjugated

    (separated by one carbon with a single bonds) carbon-carbon double bonds, one that is six

    carbons from the methyl end and one nine carbons from the methyl end [12, 13] and it has a

    melting point of -5 C. This means LA is a liquid at body temperature 37 C [18]. The word

    linoleic comes from the Greek linonfor flax and oleicmeaning of or relating to oleic acid

    (found at high concentrations in olive oil) and it is the most common PUFA found in both plant and

    animal tissue [12, 13]. LA is further metabolized to arachidonic acid (AA), which is metabolized

    into the pro-inflammatory type eicosanoid prostaglandins, thromboxanes and leukotrienes [12, 18,

    24, 32]. When it became clear that a diet high in PUFAs had positive effects on heart health,

    people were encouraged to increase the intake oils high in PUFAs such as corn, peanut and

    safflower. Currently, LA provides approximately eighty-five percent of Americans energy intake

    from PUFAs [24, 33].

    Alpha-linolenic acid (ALA) is an -3 PUFA, an 18 carbon mono-carboxylic acid with three cis

    conjugated carbon-carbon double bonds the first of which is at the third carbon from the methyl

    end of the molecule and has a melting point of -11 C [12, 13, 18, 34]. Like LA, ALA is a liquid at

    room and body temperature. In the human body, ALA is a precursor to eicosapentaenoic acid

    (EPA) (20 carbons) and docosahexaenoic acid (DHA) (22 carbons), two long chain -3 PUFAs

    that came to light during epidemiological studies of Eskimo/Inuit tribes who consume large

    amounts of-3 PUFAs from the fat from fish yet have low rates of CVD [24, 33, 35, 36]. Other

    positive effects attributed to -3 PUFAs, especially EPA and DHA areanti-thrombotic, anti-

    Alzheimers and pro-immune response [35, 37-40].

    cis and trans FAs:

    Most, but not all high energy carbon-carbon double bonds that occur in nature and the human

    body are in the cis configuration where the substituent groups on either carbon involved in the

    double bond are on the same side of the molecule in three dimensional space. The trans

    configuration is when the substituent groups are on the opposite sides of the molecule around the

    carbon-carbon double bond. Carbon-carbon double bonds introduce rigidity to chains of carbon

    molecules and energetically speaking the trans configuration is the most chemically stable. This is

    why hydrogenated FAs as in shortening are in the trans configuration; industrial hydrogenation is

    an uncontrolled reduction reaction where hydrogen is added to the double and triple bonds of

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    vegetable oils in a random, energetically favored way [18]. Biochemical hydrogenation as takes

    place in ruminant animals gives rise to mostly the cis configuration and the products are

    recognized by other biological systems such as in humans. Also, during industrial hydrogenation,

    some of the cis FAs are also converted to trans FAs through a process call cis-trans isomerization

    and this dramatically alters the shape of the fatty acid chain. Not surprisingly, trans FAs produced

    by uncontrolled hydrogenation are not recognized structurally by the enzymes that normally

    process FAs in the body and tend to collect in the liver and at sites of atheroma growth, hencethey are now associated with higher CVD risk [18, 41].

    Cholesterol: What is it and is it really bad?

    Cholesterol is a steroid. A steroid is a lipid structure based on a fused-ring system that involves

    three 6-membered carbon rings and one 5-membered carbon ring. Cholesterol in an integral

    component of cell membranes and a precursor for other steroid based lipids [12, 13, 18].

    [42]

    Cholesterol is the most abundant steroid in the human body. It is found in cell membranes, nerve

    tissue and brain tissue and is also found in nearly all bodily fluids in some form or another. Some

    cholesterol is taken up from the diet in the small intestine, but the majority of cholesterol is

    synthesized in the liver and to some degree in other organs [12, 13, 18, 22]. Ingested cholesterol

    decreases the amount of cholesterol produced by the body via a negative feed back system.

    Since cholesterol is not water soluble, it is packaged with FAs and protein by the body for

    circulation to where it is needed. These proteins are called lipoproteins [12, 13]. Low density

    lipoproteins (LDL) generally carry cholesterol from the liver to the tissues and high density

    lipoproteins (HDL) carry excess cholesterol back to the liver.

    Because of cholesterols abundance in the body in both healthy and pathological conditions, it has

    been closely studied for its role in atherosclerosis for over a century [43]. Originally, it was found

    as a crystalline component of atherosclerotic plaques and gallstones. It is also known that there is

    a direct correlation to age and the lipid and cholesterol content of the aorta of humans [44]. This

    led to Anitschkows landmark study where he showed that feeding rabbits pure cholesterol

    dissolved in oil led to the development of atherosclerotic lesions [45]. Normally rabbits do not

    ingest measurable amounts of cholesterol as the cholesterol content of plants is considered

    negligible [43] and rabbits are obligate herbivores. Clearly, rabbits are not the best cholesterol

    model on which to base human medicine. Regardless of the fact that rabbits and humans process

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    dietary cholesterol differently, the Lipid Hypothesis [46] was born and cholesterol found in LDL

    as a therapeutic target has been doggedly pursued by the Western medical and scientific

    community in the search for a treatment for atherosclerotic diseases ever since. With the advent

    of statins in the 1980s, the lipid hypothesis gained solid acceptance and the data show that for

    people suffering from hyperlipidemia, dietary and lifestyle changes along with the use of a statin

    can dramatically normalize dyslipidemia and reduce the primary and secondary risk for

    cardiovascular disease [47, 48].

    Although the cholesterol in LDL as a primary therapeutic target has shown great success at

    reducing cardiovascular risk over the years, there is a plethora of data that suggest cholesterol

    alone is not the causative agent in cardiovascular disease [22, 27, 31, 33, 49-51]. In fact,

    inhibition of cholesterol biosynthesis has also been associated with impaired insulin secretion and

    other cholesterol mediated membrane processes involving exocytosis [52]. Exocytosis is the main

    process by which cells secrete bioactive molecules such as insulin, neurotransmitters and

    hormones. These data suggest that when cholesterol levels are unnaturally low due to

    medications such as statins, a whole host of serious medical syndromes are experienced by a

    small subset of patients [48, 53, 54] ranging from rhabdomyolysis to death [55].

    One of the most interesting findings was in the ENHANCE study of a combination of Simvastatin,

    a statin and Ezetimibe, a cholesterol uptake inhibitor. This was an imaging study looking at

    regression of fatty plaques in the arteries due to combination therapy. Combination therapy of

    statins with other lipid lowering medications has shown additive results in normalizing

    dyslipidemias [56]. On the other hand, the data on the regression of plaques due to aggressive

    statin and/or combination therapy have been mixed suggesting that statins play more of a role in

    plaque stabilization and that plaques rarely regress very much quantitatively [57]. Patients on the

    combined therapy of Simvastatin + Ezetimibe achieved tremendous reductions in LDL cholesterol

    and yet the patients experienced growth of fatty plaques in their arteries [58]. The study was

    subsequently stopped early [59] because of this. There were also a slightly higher number of

    patients on combination therapy who developed cancer, but the study did not continue long

    enough to determine if this was a significant outcome. This result and similar results in other

    studies where the LDL and total cholesterol levels have been severely reduced and yet have not

    resulted in greater health benefit to the patient have left Western researchers puzzled as to what

    actually contributes to atherosclerotic plaque growth [48, 57, 59, 60]. It has also caused many

    researchers to re-evaluate cholesterol not as a bad or a good thing, but rather as an integral

    membrane steroid responsible for many important physiologic activities that can under certain

    conditions contribute to the pathology of atherosclerotic plaques. On the other hand, it is now

    being established that one can lower the cholesterol too much with unhealthy outcomes in certain

    patients.

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    The original Lipid Hypothesis is actually a consensus on the idea that there is a direct correlation

    between plasma levels of cholesterol and the development of coronary artery disease [61]. At the

    time of its development, it was quite plausible. In fact, as stated before, many lives have been

    saved, improved and prolonged as a result of making the treatment of elevated plasma cholestero

    in LDL a primary therapeutic target. However, this hypothesis completely fails to explain the

    results seen in the ENHANCE study and other, lesser known instances where a patient cohort

    with high LDL cholesterol fail to develop cardiovascular disease [62, 63] or where statin therapydoes not reduce CVD risk [63].

    Attention is now turning more to the role of fat in the diet and more specifically, the role of the -3

    and -6 MUFAs and PUFAs. This new body of evidence points to the importance of a high -3:

    -6 ratio not only for cardiovascular health, but overall health in general. The historical diet in this

    country 100 years ago favored -3 FAs because our food animals were fed mainly a diet high in

    forage and grass. As stated before, -3s have been associated with the anti-inflammatory

    pathways in the body. -3: -6 ratios are estimated to have been ~ 9:1 for ruminant animals who

    were grass fed [24]. With the advent of the post WWII corn-based feed for cattle and other food

    animals in the United States, that ratio has turned in favor of the -6s at a ratio of 20-30:1

    depending on ones diet [24]. Recall again, that the -6 FAs, although considered essential, are

    highly correlated with the inflammatory pathways in the body. The Union of Concerned Scientists

    has suggested that returning the feeding of the USs food animals to a grass and forage based

    system could not only restore farmland ecosystems depleted under the strain of chemical

    fertilizers and pesticides, but that doing so could go a long way in improving the baseline health of

    the population at large [24]. Other data further demonstrate that even the saturated fats from

    plants are associated with less CVD risk than saturated fats from animals and that by substituting

    2% of energy from meat SFAs with energy from dairy SFAs was associated with a 25% reduction

    in CVD risk [64]. It seems a more thorough understanding about the metabolic processes

    involving fats in the body may lead to a better understanding of atheroma formation, CVD risk and

    prevention.

    What is the Fat and Cholesterol Content of Ghee?

    Ghee is the rendered fat of butter, therefore it is considered to be 100% fat. As discussed earlier,

    not all fats are created equal, so what is the chemical fatty composition of ghee?

    Table 2

    FA Composition of 100 g ghee[65]

    ComponentHome made ghee[65]

    Commercial ghee[65] Melting Point [66]

    Triglycerides 97.8% 98.6% ----------------

    Cholesterol 178.2 mg/100g 161.7 mg/100g 148-150 C

    Phospholipids 28.6 mg/100g 10.4 mg/100g ----------------

    Vitamin E 305 ug/100g 491 ug/100g -----------------

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    Vitamin A 447 ug/100g 584 ug/100g -----------------

    Butyric acid C4SFA 4.5-6% by wt[67] -------------- -7.9 C

    Decanoic C10SFA 1.8% by wt 1.3% by wt 31.6 C

    Lauric C12 SFA 2.1 % by wt 2.6% by wt 43.2 C

    Myristic C14 SFA 13.8% by wt 14.3% by wt 54.2 C

    Palmitic C16 SFA 33.0% by wt 32.8% by wt 62.9 C

    Stearic C18 SFA11.8% by wt

    12.0% by wt 69.6 C

    Oleic C18 MUFA 30.2% by wt 30.0% by wt 13-14 C

    Linoleic C18PUFA 2.1% by wt 2.6% by wt -5 C

    These fatty acids exist in ghee in the form of triglycerides, which make up the bulk(~98%) of ghee.

    In order to identify them, they are hydrolyzed to liberate them from the triglyceride molecule [65].

    Butyric acid is one of the volatile fatty acids found in butter and ghee and when it is hydrolyzed to

    the free form, it gives off the well known rancid smell associated with spoiled dairy products. It isincluded here because it is found in a relatively high concentration in ghee compared to other

    volatile FAs [67] and has been associated with decreased inflammation in and normalization of

    several pathological processes, especially gastrointestinal inflammation [27-30].

    What is surprising is actually how low the cholesterol concentration reported here is, yet it is

    consistent with other reports [67] of the cholesterol content of ghee. People who have been

    advised by their doctors to follow a low fat/low cholesterol diet are counseled to take in less than

    300 mg of cholesterol a day from a 1000 kcal/day diet where 30% of the calories come from fat,

    as outlined in the Step I diet by the NIH Heart, Lung and Blood Institute [68]. 100 g of ghee is

    reported here to contain 178.2 mg cholesterol and reported elsewhere to contain ~900 kcal [67] of

    total energy. If one tablespoon of ghee weighs ~ 14 g (data empirically determined), then it

    contains ~ 126 kcal of total energy and ~25 mg of cholesterol. Vagbhata suggests using the least

    quantity of ghee that is effective for treating the patient, Chap 25 sutra19-20 [6], depending on the

    agni and the disease being treated. It is reasonable then, to assume one tablespoon of ghee a

    day can be part of a low fat/ low cholesterol Step I diet without putting the patient at risk for

    complications of too much cholesterol.

    The melting point data are very telling about the nature of cholesterol. A melting temperature of

    150 C is very high and it tells the chemist that cholesterol is a compound with strong

    intermolecular attractions. The density of cholesterol is 1.067 g/cm3, which makes it denser than

    water (1 g/cm3). The density of most of the long chain FAs is ~ 0.89 g/ cm3. In an effort to make

    cholesterol less dense for transport through the blood, the body esterifies it to a FA carbon tail and

    packs it into LDL.

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    The chemists interpretation of the phenomenon of observing crystalline cholesterol in arterial

    plaques and gallstones depends on Density (D) and Melting Point (MP). The magnitude of both

    properties makes cholesterol a happier molecule when it is nice and orderly next to another

    cholesterol molecule until a crystal is formed. The concepts of Entropy Ssurr, Enthalpy H and

    Gibbs Free Energy G illustrate this from a thermodynamic standpoint. Entropy Ssurr is a

    measure of disorder in the universe and in general, is always increasing or becoming morepositive. Enthalpy H is a measure of the energy required or released from a process. Here we

    are looking at the enthalpy of fusion between molecules of cholesterol. Gibbs Free Energy G is a

    measure of the energy available in a system to do work. Here we are looking at the free energy of

    cholesterol crystallization at body temperature. In general, for a process to be spontaneous,

    Ssurr>0, H

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    lumen narrowing. These smaller plaques have no cholesterol or other crystalline deposition, yet

    are highly associated with inflammation and the data show it is these lesser plaques that do not

    even show up by angiography which carry the highest risk for rupture and thrombosis formation

    [70, 71].

    Biochemistry and the Doshic Effects of Ghee

    How does ghee accomplish all the medicinal effects listed in the ancient texts? Table 1 lists someof the actions of ghee given by the ancient authors and yet, there has been very little formal

    Western investigation into these claims. On the other hand there has been some research done

    on biochemical components of ghee and some of these data will be reviewed here.

    The ancient texts tell us that ghee has anti-pitta properties and that small amounts of it can

    stimulate agni without aggravating pitta [2, 4, 6]. Ghee is relatively high in a volatile FA called

    Butyric Acid (BA) and it is this acid in the free form that gives the rancid smell of spoiled dairy

    products [1, 72]. BA is an important short chain (4 carbon) FA, and is one of the several short

    chain FAs that is also produced by anaerobic fermentation of undigested dietary fibers in the

    colon. Recent data have shown that colonic irrigation with solutions of BA not only relieve the

    inflammation associated with Crohns disease, but also results in transcriptional changes in gut

    mucosal cells that are associated with increased FA metabolism and decreased oxidative stress

    [27, 28, 73].

    Ghee is said to increase agni [2-4, 6]. Increased agni can be viewed as an increase in energy

    expenditure. When one is burning calories effectively, the body will respond by increasing hunger

    to take in more food to support that expenditure. In the diabetic mouse model, BA has been

    shown to increase energy expenditure and reverse insulin insensitivity, which from an Ayurvedic

    standpoint is viewed as compromised agni of Kapha origin [74, 75]. Further, BA has been shown

    to have anti-tumor activity [29, 30] which can be attributed to pacifying Kapha dosha. These data

    can be interpreted as increasing agni by pacifying Kapha but without aggravating Pitta.

    The ancient texts tell us that ghee is also good for persons who desire intelligence, good memory

    and wisdom [6]. Alzheimers disease is a neurodegenerative disease characterized by

    progressive cognitive and memory decline leading to dementia [76]. From an Ayurvedic standpoint

    it is viewed as a result of Vata dosha having relocated in the majja and mano vaha srotas. Vata is

    cold, rough and dry and the unctuousness of ghee comes from the fat content. Docosahexaenoic

    acid (DHA) deficiency in particular has been shown to correlate with impaired brain function [77]

    as seen in Alzheimers. Not only is ghee unctuous and penetrating, it is also high in the FA

    precursors for DHA lending to the Ayurvedic notion that ghee improves brain functioning. This

    view can be expanded further to understand how ghee can ameliorate other brain diseases of

    Vata origin such as epilepsy and insanity even in the absence of Western style data.

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    Research more specific to ghee has been done in the area of cholesterol research. Historical

    data have been confusing, presenting contradictory effects of ghee on serum cholesterol levels.

    This may be due to the use of vanaspati ghee or ghee made with hydrogenated vegetable oil [78]

    in older studies. More recent work shows that ghee can slightly raise total cholesterol levels, but

    does so by raising the HDL, the so called good cholesterol from the Western standpoint [79]. The

    National Cholesterol Education Program (NCEP) recommendations for cholesterol managementstate that when HDL is raised above 60 mg/dL, it is considered a negative risk factorfor CVD [80].

    The increase in HDL cholesterol seen with ghee can be interpreted as reducing CVD risk from the

    standpoint of the NCEP guidelines.

    There has also been a question about the formation of cholesterol oxidation products (COPS)

    which are reported to be atherogenic and angiotoxic [81]. Kumar, et al., specifically studied the

    effect of ghee and COPS found in ghee from prolonged heating on serum and liver lipids in male

    Wistar rats [65]. First they demonstrated that heating did indeed decrease cholesterol levels and

    increase the COPS levels in ghee. However, animals fed ghee or ghee with significant levels of

    COPS both showed an overall decrease in serum lipids over a dietary range of 2.5%-10%. Later

    work suggests this decrease in serum levels of cholesterol may be due to increased secretion of

    biliary lipids [82], one of the main ways the body removes excess fat from ingested foods before it

    can enter the systemic circulation.

    Studies that take into account ghees prabhav for carrying herbs to the deep tissues have been

    done using the Western scientific model. For example, Oza, et al. studied Bhringarajadi Ghrita

    Rasayana in premature aging. Here they were able to demonstrate the reversal of several

    Ayurvedic parameters of aging such as muscle weakness and mental acuity. They concluded that

    Bhringarajadi Ghrita probably acts at the level of the dhatuagni which leads to improvement in the

    overall health of the dhatus and hence, the person [83].

    Conclusions:

    Ghee is an important medicine in Ayurveda having tridoshic and doshic specific rasayana

    properties. In the West, the use of ghee as medicine has been circumspect because of its

    association with dairy products and saturated fatty acids. Ghee is a liquid at body temperature

    and is only ~ 68% saturated which means it cannot go in to an organism and suddenly become

    solid. Cholesterol, which is found in ghee esterified to FAs has been implicated in CVD, but

    research through the years has demonstrated that cholesterol is not the causative agent for

    atheroma formation. Although, cholesterol does not appear to be the causative agent, controlling

    the biosynthesis of cholesterol has reduced the primary and secondary risks associated with

    elevated serum cholesterol. That said, the amount of cholesterol in 1-3 tablespoons of ghee is in

    line with the NHILBIs recommendations for a low fat/low cholesterol diet. Further, attention is

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    turning from cholesterol specifically to the role of-3 and -6 PUFAs in CVD. Our current corn

    based food chain system has shifted the ratio of PUFAs favoring -6 over-3. Animals fed grass

    based diets produce products that are higher in -3 than -6. -6 PUFA involvement in pro-

    inflammatory processes versus -3 involvement in anti-inflammatory processes may explain the

    high degree of CVD risk seen in the West. The body of evidence on ghee in specific, controlled

    Western style clinical trials is small, yet promising for explaining the Ayurvedic actions of ghee to

    the Western medical community. Regardless, the ancient texts of Ayurveda clearly state themany medicinal applications of ghee and it is considered one of Ayurvedas most potent

    medicines. Perhaps going forward, more Western style research will be done to support the many

    Ayurvedic medicinal claims for ghee, but that remains to be seen. On the other hand, the

    predictive value of the science that is Ayurveda should be enough for most practitioners to have

    confidence using ghee in the treatment of appropriate patients.

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