The effect of Laja in dyslipidemia: an interventional pre-post test

INTRODUCTION

Dyslipidemia is a disorder caused by defective lipid metabolism. Unhealthy diet, lack of exercise, genetic disorders, and certain drugs are the main factors causing dyslipidemia.¹ It is one among the major modifiable risk factors of cardio vascular diseases and stroke. Worldwide cholesterol levels are estimated to cause 56% ischemic heart disease and 18% Strokes amounting to 4.4 million death annually.² As Per NCEP guidelines dietary modifications, exercise, and weight control are the foundation of treatment of dyslipidemia and thereby reducing the risk of cardiovascular disease and stroke.³

In Ayurveda dyslipidemia does not bear a precise reference. In charakasamhita sutrastana Medodoshaja rogas described in Atisthooladirogas and Prameharoga poorvaroopas. Santharpana medojanyarogas are; Prameha, Kandu, Pitaka, Kota, Pandu, Jwara, Kushta, Amadoshaja rogas, Atisthoulyam etc.⁴ Acharya Adhamala (Commentator of Sarangdhar Samhita) also describes the medodhatu vikriti and divided it into two groups. (i) Medoroga (ii) Medodusti.⁵ So there is involvement of kapha and medas along with vishamagni or mandagni in dyslipidemia. For managing dyslipidemia kapha and medas should be reduced along with normalizing agni.⁶

Lāja or brown puffed rice is one among the aharavarga (krithaannavarga) used as a remedy for kaphameda predominant conditions.⁷ It has great nutritional values. In modern researches, it has been found that Lāja has good portion of digestible nutrients. It is rich in carbohydrate (88%), low fat (0.2%), protein (8.6%), low salt, low cholesterol, contains rice bran, easily digestible and immediate source of energy (high calorific value1,754/pound), makes it healthy nutritive and balanced diet.⁸ Lāja can be used as a diet as well as medicine in many diseases like Trit, Chardhi, Meha, Meda ,Atisara etc. Lāja has Kashaya madhura rasa, Seetha veerya, Alpa rooksha, laghu guna and deepana property. It pacifies Pitta and kapha and doesnot aggrevate vatha.⁷

This study aimed to evaluate the effect of Lāja in dyslipidemia by reduction in level of serum cholesterol, serum triglyceride, serum LDL, serum VLDL and Increase in level of serum HDL.

METHODS

Study area

An interventional study pre post study with control group conducted in the OPD, Govt. Ayurveda College Hospital, Tripunithura, Kochi.

Study period

Study was conducted From November 2016 to May 2017.

The current study was conducted at Govt. Ayurveda College, Tripunithura, Kochi, to assess the effect of Lāja along with diet restriction and exercise. For the study, 60 Patients satisfying inclusion and exclusion criteria were selected from OPD, Govt. Ayurveda College, Tripunithura, assigned into 2 groups. All 60 patients were advised to follow diet restriction (avoid junk and fried food items) and exercise (30 minutes Morning walk). In addition 30 patients in the study group were advised to take Lāja during the 90 days of study.

Laja was prepared by boiling 10 gm (5 table spoon) of Laja in 200ml of water for 5 minutes and administered two times daily, 7am and 6pm for 3 months. Lipid profile assessment were done on 0^th, 46^th and 91^st day of the study.

Inclusion criteria

Individuals from both sex, patients between the age group 30-50 years, ranges between in any one of the following parameters: serum cholesterol between 200-250 mg/dl, HDL level between 35-45 mg/dl, LDL level between 100-159 mg/dl, VLDL level between 30-40 mg/dl, and triglycerides level between 150-199 mg/dl were included.

Exclusion criteria

Patients with uncontrolled diabetes, patients are known to have history of systemic disorders like cardiac diseases, endocrinal disorders, thyroid dysfunction, liver diseases, kidney disorders, and pregnant woman and lactating mother were excluded.

Statistical analysis

Analysis of each group was done by paired t test/Wilcoxon signed Rank test and comparison between groups was done by unpaired t test /Wilcoxon Mann-Whitney U test. The obtained results were statistically analyzed and compared in between two groups.

RESULTS

In this study, the lipid profile variations of 30 patients each in both study and control groups were analyzed by comparing, before treatment and after treatment - mean difference, by Paired t Test and the comparison of two groups analyzed by Unpaired t test except in the analysis of triglycerides. Triglycerides of each groups of before and after treatment results were compared by Wilcoxon Signed Rank Test and the two groups were compared by Mann Whitney Test.

Both groups statistically calculated by using paired t test and that shows statistically significant results. The mean difference of the Study Group and Control Group were compared and the result was highly significant (Table 1).

Comparison of Study Group with Control Group was analyzed by Using Mann Whitney Test. After Treatment values of both groups were compared and the obtained result was statistically highly significant (Table 2).

The mean difference of the Study group and Control group were compared, by using Unpaired t test, and the P value was <0.001, considered highly statistically significant (Table 3).

The mean difference of the Study group and Control group were compared, by using Unpaired t test, and the P value was <0.001, considered highly statistically significant (Table 4).

The mean difference of the Study group and Control group were compared, by using Unpaired t test, and the P value was <0.001, considered highly statistically significant (Table 5).

After comparing both study group and control group the results were found to be extremely significant in reducing the total cholesterol VLDL cholesterol and LDL cholesterol but the HDL were found to be not significant.

DISCUSSION

Dyslipidemia is a condition formed due to the involvement of kapha and medas. So the drugs having agni deepana and pachana property helps to correct the medo datwagni and the proper formation of medo dhatu.⁹ This study was conducted to find out the solution for normalizing the lipid profile without therapeutic medicines by the changing diet habit and reducing the risk of occurrence of cardio vascular diseases and stroke. In this present study, the patient was given Lāja peya as a diet two times daily before food for 3 months. Study shows that Lāja manda having the properties like stimulate digestive fire, light to digest, increases appetite, reduces urine output, imparts strength and nourish dhatus is used for amapachana and correct the mandagni.¹⁰

Lāja have Kashaya, Madura rasa, lakhu alparooksha guna, agnideepana, kaphachida and medahara properties. Though possessing lakhu rooksha guna and seetha veerya, Lāja pacifies vata because of madura rasa. Madura rasa and seetha veerya of Lāja also helps to pacify the pitta dosha. Its Kashaya and alparooksha property is indicated in kapha predominant conditions. Deepana property helps to improve the functions of agni. Acharya specifically mentioned Lāja have the medahara and kaphachida property. So in dyslipidemia the above mentioning properties of Lāja were acting effectively.

The study results are significant in both groups. But in comparison to control group, the study group shows more result. This additional benefit may be due to the effect of laja peya. Reduction in lipid profile (total cholesterol, LDL, triglycerides, VLDL) after intervention may be due to the deepana property of laja and this deepana property may have increase the datwagni and thereby resulted in the normal transformation of asthayi medodatu to sthayi medodhatu. There is an association between physical activity and HDL cholesterol.¹¹ In this study both groups shows significant result in increasing HDL cholesterol but after comparison with control group the study group was not found to be significant.

The objective assessment was made on the lipid profile levels of the subject showed satisfactory improvements after treatment in both study and control group. But in the statistical analysis, Study group shows highly significant effect as compared with Control group except in HDL level.

This study has limitations. In this study borderline below range lipid profiles cases only included. It should be given as a diet above the range of borderline.

CONCLUSION

The study shows that Lāja was effective in reducing total cholesterol, LDL, triglycerides, and VLDL as because of its lakhu ruksha guna, kapha hara and medachidah property and there is not significant effect found in HDL cholesterol.

ACKNOWLEDGEMENTS

We would like to thank Dr. Sajeeshan A. K., Former Professor and HOD Department of Swasthavritta, Govt. Ayurveda college, Tripunithura and Dr. Sheela S., Professor, Department of Swasthavritta, Govt. Ayurveda College, Thiruvananthapuram for their leadership and guidance in this article.

Funding: No funding sources

Conflict of interest: None declared

Ethical approval: The study was approved by the Institutional Ethics Committee of Govt. Ayurveda College hospital Tripunithura

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