Inhibition of low-density lipoprotein oxidation by oral herbal mixtures Maharishi Amrit Kalash-4 and Maharishi Amrit Kalash-5 in hyperlipidemic patients

Efficacy and safety of the Ayurvedic herbal preparation Maharishi Amrit Kalash: a systematic review of randomized controlled trials

Background

Maharishi Amrit Kalash (MAK) 4 and 5 are Ayurvedic herbal nutritional supplements that are believed to have beneficial effects on overall health and wellbeing. This study aimed to systematically review all available randomized controlled trials (RCTs) investigating the clinical effects and safety of MAK.

Methods

We included RCTs on therapy, health promotion, and prevention for patients and healthy volunteers of all ages. We systematically searched MEDLINE (via PubMed), EMBASE (via Ovid), the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library), DHARA, Clinicaltrials.gov, the World Health Organization (WHO) International Clinical Trials Registry Platform, and Google Scholar from inception through 7 May 2023, with no time or language restrictions. The risk of bias was assessed using the Cochrane Risk of Bias Tool version 1. The protocol was registered with PROSPERO before conducting the review (CRD42023421655).

Results

Three RCTs with 418 study participants were included. Two studies were on breast cancer patients and one on healthy adults. The two studies on cancer evaluated the efficacy of MAK in reducing the side effects of chemotherapy in women with breast cancer. The study on healthy adults evaluated whether MAK has an effect on an age-related alertness task as an indicator of cognitive aging. Both studies on breast cancer patients found beneficial effects on performance status, anorexia, vomiting, and body weight. One study reported positive effects regarding stomatitis. Regarding visual alertness, results showed that individuals who received MAK improved in performance. None of the three included studies reported adverse events. The risk of bias was mixed. Due to the small number and heterogeneity of the RCTs, no meta-analysis could be performed.

Conclusion

There is evidence that MAK may have supportive effects in chemotherapeutic treatments for breast cancer patients and for healthy individuals regarding visual discrimination. However, it is difficult to verify treatment effects due to the small number of RCTs and the mixed risk of bias. Furthermore, none of the included studies recorded adverse events. Therefore, further high-quality studies are warranted to confirm the potential health benefits of MAK and to determine its optimal dosage and duration of use.

Systematic review registration

PROSPERO, CRD42023421655.

The effect of ghee (clarified butter) on serum lipid levels and microsomal lipid peroxidation

Ghee, also known as clarified butter, has been utilized for thousands of years in Ayurveda as a therapeutic agent. In ancient India, ghee was the preferred cooking oil. In the last several decades, ghee has been implicated in the increased prevalence of coronary artery disease (CAD) in Asian Indians due to its content of saturated fatty acids and cholesterol and, in heated ghee, cholesterol oxidation products. Our previous research on Sprague-Dawley outbred rats, which serve as a model for the general population, showed no effect of 5 and 10% ghee-supplemented diets on serum cholesterol and triglycerides. However, in Fischer inbred rats, which serve as a model for genetic predisposition to diseases, results of our previous research showed an increase in serum total cholesterol and triglyceride levels when fed a 10% ghee-supplemented diet. In the present study, we investigated the effect of 10% dietary ghee on microsomal lipid peroxidation, as well as serum lipid levels in Fischer inbred rats to assess the effect of ghee on free radical mediated processes that are implicated in many chronic diseases including cardiovascular disease. Results showed that 10% dietary ghee fed for 4 weeks did not have any significant effect on levels of serum total cholesterol, but did increase triglyceride levels in Fischer inbred rats. Ghee at a level of 10% in the diet did not increase liver microsomal lipid peroxidation or liver microsomal lipid peroxide levels. Animal studies have demonstrated many beneficial effects of ghee, including dose-dependent decreases in serum total cholesterol, low density lipoprotein (LDL), very low density lipoprotein (VLDL), and triglycerides; decreased liver total cholesterol, triglycerides, and cholesterol esters; and a lower level of nonenzymatic-induced lipid peroxidation in liver homogenate. Similar results were seen with heated (oxidized) ghee which contains cholesterol oxidation products. A preliminary clinical study showed that high doses of medicated ghee decreased serum cholesterol, triglycerides, phospholipids, and cholesterol esters in psoriasis patients. A study on a rural population in India revealed a significantly lower prevalence of coronary heart disease in men who consumed higher amounts of ghee. Research on Maharishi Amrit Kalash-4 (MAK-4), an Ayurvedic herbal mixture containing ghee, showed no effect on levels of serum cholesterol, high density lipoprotein (HDL), LDL, or triglycerides in hyperlipidemic patients who ingested MAK-4 for 18 weeks. MAK-4 inhibited the oxidation of LDL in these patients. The data available in the literature do not support a conclusion of harmful effects of the moderate consumption of ghee in the general population. Factors that may be involved in the rise of CAD in Asian Indians include the increased use of vanaspati (vegetable ghee) which contains 40% trans fatty acids, psychosocial stress, insulin resistance, and altered dietary patterns. Research findings in the literature support the beneficial effects of ghee outlined in the ancient Ayurvedic texts and the therapeutic use of ghee for thousands of years in the Ayurvedic system of medicine.

Use of Ayurvedic diagnostic criteria in Ayurvedic clinical trials: a literature review focused on research methods

OBJECTIVES

The objective of this literature review is to evaluate whether Ayurvedic diagnostic criteria or Western medicine diagnostic criteria have been used in published clinical trials testing an Ayurvedic intervention/treatment.

DESIGN

The PubMed, Embase, and Allied and Complementary Medicine databases were searched to identify Ayurvedic clinical trials published from 1980 to 2009. A total of 45 Ayurvedic clinical trials were identified and grouped into two time periods: pre- and post-2000 periods. Each article was independently reviewed by two calibrated reviewers.

RESULTS

Analysis revealed that not 1 of these 45 studies, in either time period, reported "only-and-full" use of the 23 available Ayurvedic diagnostic criteria. In fact, 24.4% of these 45 articles never specified any diagnostic criteria at all. While the percentage of articles using Ayurvedic diagnostic criteria (either as "only use" or "combined use with Western Medicine diagnostic criteria") doubled over the two time periods (27.7% to 59%), rarely were more than 2 of the 23 Ayurvedic diagnostic criteria ever used.

CONCLUSIONS

To improve confidence in their findings, future studies should strive to correct this observed inappropriate and gross underuse of Ayurvedic diagnostic criteria in the designing of clinical studies that aim to rigorously test the effectiveness of Ayurvedic treatments.

MAK-4 and -5 supplemented diet inhibits liver carcinogenesis in mice

Background

Maharishi Amrit Kalash (MAK) is an herbal formulation composed of two herbal mixtures, MAK-4 and MAK-5. These preparations are part of a natural health care system from India, known as Maharishi Ayur-Veda. MAK-4 and MAK-5 are each composed of different herbs and are said to have maximum benefit when used in combination. This investigation evaluated the cancer inhibiting effects of MAK-4 and MAK-5, in vitro and in vivo.

Methods

In vitro assays: Aqueous extracts of MAK-4 and MAK-5 were tested for effects on ras induced cell transformation in the Rat 6 cell line assessed by focus formation assay. In vivo assays: Urethane-treated mice were put on a standard pellet diet or a diet supplemented with MAK-4, MAK-5 or both. At 36 weeks, livers were examined for tumors, sera for oxygen radical absorbance capacity (ORAC), and liver homogenates for enzyme activities of glutathione peroxidase (GPX), glutathione-S-transferase (GST), and NAD(P)H: quinone reductase (QR). Liver fragments of MAK-fed mice were analyzed for connexin (cx) protein expression.

Results

MAK-5 and a combination of MAK-5 plus MAK-4, inhibited ras-induced cell transformation. In MAK-4, MAK-5 and MAK4+5-treated mice we observed a 35%, 27% and 46% reduction in the development of urethane-induced liver nodules respectively. MAK-4 and MAK4+5-treated mice had a significantly higher ORAC value (P < 0.05) compared to controls (200.2 ± 33.7 and 191.6 ± 32.2 vs. 152.2 ± 15.7 ORAC units, respectively). The urethane-treated MAK-4, MAK-5 and MAK4+5-fed mice had significantly higher activities of liver cytosolic enzymes compared to the urethane-treated controls and to untreated mice: GPX(0.23 ± 0.08, 0.21 ± 0.05, 0.25 ± 0.04, 0.20 ± 0.05, 0.21 ± 0.03 U/mg protein, respectively), GST (2.0 ± 0.4, 2.0 ± 0.6, 2.1 ± 0.3, 1.7 ± 0.2, 1.7 ± 0.2 U/mg protein, respectively) and QR (0.13 ± 0.02, 0.12 ± 0.06, 0.15 ± 0.03, 0.1 ± 0.04, 0.11 ± 0.03 U/mg protein, respectively). Livers of MAK-treated mice showed a time-dependent increased expression of cx32.

Conclusion

Our results show that a MAK-supplemented diet inhibits liver carcinogenesis in urethane-treated mice. The prevention of excessive oxidative damage and the up-regulation of connexin expression are two of the possible effects of these products.

MAK-5 treatment enhances the nerve growth factor-mediated neurite outgrowth in PC12 cells

The effects of an ayurvedic compound (MAK-5) alone or together with nerve growth factor (NGF) on the neurite outgrowth of PC12 cells was studied. PC12 cells treated with NGF alone showed a clear neurite outgrowth with a decrease of the proliferation at the dose higher than 5 ng/ml. MAK-5 alone does not induce significant neurite outgrowth in the PC12 cells and does not decrease the proliferation. The PC12 cells treated with NGF supplemented with MAK-5 showed a well-evident morphological differentiation also at low doses of NGF (less than 5 ng/ml), however, the proliferation does not decrease. We suggest that MAK-5 could contain some differentiating agents that are able to potentiate NGF inducing neuronal differentiation in PC12 cells without decreasing the cell proliferation.

Nutritional issues and supplements in amyotrophic lateral sclerosis and other neurodegenerative disorders

PURPOSE OF REVIEW

Aggressive nutritional intervention has become a cornerstone of treatment for many patients with neuromuscular diseases, in particular, motor neuron disease. Malnutrition is a common problem among patients with amyotrophic lateral sclerosis. Over the past decade, the recognition of nutrition as an independent, prognostic factor for survival and disease complications in amyotrophic lateral sclerosis has illustrated the importance of individualized nutritional management in symptomatic treatment. Paramount issues for nutritional management in amyotrophic lateral sclerosis include caloric supplementation, the diagnosis/treatment of dysphagia, and the timing/safety/efficacy of percutaneous endoscopic gastrostomy placement.

RECENT FINDINGS

In addition, many amyotrophic lateral sclerosis patients self-medicate with a variety of vitamins, herbs, and other dietary supplements. Outcome-based research for the use of nutraceuticals and functional foods in the treatment and prevention of amyotrophic lateral sclerosis and other neuromuscular diseases is in its early stages. In the past year, however, several interesting papers have been published that lend support to the use of dietary supplements as primary treatments for amyotrophic lateral sclerosis and other motor neuron disorders.

SUMMARY

Common or overlapping etiologies in disparate neurodegenerative diseases have led to the promise that optimal nutritional care and the appropriate use of dietary supplements in amyotrophic lateral sclerosis will have implications for the nutritional management of other degenerative conditions such as Parkinson's, Alzheimer's, and Huntington's disease. Furthermore, evidence supporting the efficacy of dietary supplements in amyotrophic lateral sclerosis may lend clues to the treatment of other neuromuscular disorders such as the muscular dystrophies.

Disease prevention and health promotion in the aging with a traditional system of natural medicine: Maharishi Vedic Medicine

OBJECTIVE

This review focuses on a comprehensive, sophisticated system of natural medicine that appears to hold promise for prevention of chronic diseases and disabilities, loss of independence, suffering, and health care costs often associated with "usual" aging.

METHODS

The authors discuss the negative impact of usual aging on our society, with its rapidly growing percentage of elderly, and the challenge of promoting "successful aging." Emphasis is given to research literature suggesting that Maharishi Vedic Medicine (MVM) is particularly effective in retarding usual aging.

RESULTS

Proposed mechanisms for the antiaging effects of MVM include reductions in physiological and psychological stress and enhancement of homeostatic and self-repair processes.

CONCLUSIONS

The authors conclude that this set of innovative strategies may help society achieve recommended health objectives for disease prevention and health promotion in older adults and that widespread implementation of this self-empowering, prevention-oriented approach in the elderly is feasible, cost effective, and timely.

Ayurvedic medicine. Core concept, therapeutic principles, and current relevance

In the prebiblical Ayurvedic origins, every creation inclusive of a human being is a model of the universe. In this model, the basic matter and the dynamic forces (Dosha) of the nature determine health and disease, and the medicinal value of any substance (plant and mineral). The Ayurvedic practices (chiefly that of diet, life style, and the Panchkarama) aim to maintain the Dosha equilibrium. Despite a holistic approach aimed to cure disease, therapy is customized to the individual's constitution (Prakruti). Numerous Ayurvedic medicines (plant derived in particular) have been tested for their biological (especially immunomodulation) and clinical potential using modern ethnovalidation, and thereby setting an interface with modern medicine. To understand Ayurvedic medicine, it would be necessary to first understand the origin, basic concept and principles of Ayurveda.