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Ayurveda offers insight into the earlier stages and enables those monitoring their health to take care of any small imbalances well before developing any serious illness. The length of the each stage may vary from weeks, to months, even years, depending on the person and the degree of aggravation.

The six stages of disease development are:

1. Accumulation
   
2. Aggravation
3. Dissemination
4. Localization
5. Manifestation
6. Complication
   

The first stage, accumulation, represents imbalance, a build up or collection of something in the body. Being exposed to and acquiring a pathogen via the external environment is an example of accumulation. This stage can also be caused by the internal environment, such as from eating an imbalanced diet leading to excess inflammation or mucous. Accumulation in the body leads to the the next stage, aggravation.

As the imbalanced elements continue to increase, the symptoms become more aggravated and will begin to be noticed throughout the body. This stage is a sign of continued accumulation. This stage can manifest, as seen in the Kapha state, as loss of appetite, indigestion, nausea, excess saliva, oversleeping, sluggishness; or as seen in the Pitta state, as increased acidity, burning sensations in the abdomen, lowered vitality, or insomnia; or as seen in the Vata state, as pain in the lower abdomen, excess flatulence, and light-headedness.

Once the site of origin is full with excess accumulation and is aggravated, it will begin to overflow into or disseminate throughout the rest of the body using different channels of transportation. Overflow typically begins in the GI tract, then spilling into the circulating plasma and blood, allowing the accumulation to spread systemically, and eventually seeping into the organs and tissues (dhātus). Simultaneously, the symptoms at the site of origin will grow worse.

The excess accumulation will then move to wherever a weak site exists in the body. This is where and when diseases begin to develop. This stage is also where genetics matter; the weak spots are determined by genetics - as the saying goes, genetics loads the gun, environment pulls the trigger. This stage can manifest, as seen in the Vata state, as arthritis. In a Pitta state, this can be seen as an ulcer, and in the Kapha state, manifestation may begin in the lungs. At this stage, healing is still regarded as simple.

This is the first state of the development of illness for which modern Western medicine can detect signs of disease. It is at this stage where diseases progress and become fully developed, showing signs of clinical features. Manifested imbalances are given names at this stage, such as arthrosclerosis, cancer, colitis, etc. It is at this stage where conventional medicine attempts to mask the symptoms by offering pharmaceutical drugs.

Complications of the dis-ease begin at this final stage. Often times, conventional medicine attempts to solve the problem by simply removing the affected tissue (e.g., small intenstine, colon, thyroid, etc.) from the body. The symptoms become clear enough so that the elemental cause (i.e., dosha constitution such as Vata, Kapha, Pitta) may be determined. Some medical professionals describe this stage as the chronic phase of development. For example, if one develops inflammation in the manifestation stage, in this stage, complications set in, and the inflammation may grow worse into a chronic problem.

Being aware of the stages of the dis-ease process is helpful because one can gain a better understanding in how prevent, and perhaps even reverse, it. To be clear, the information provided here is not claiming to treat, cure or diagnose disease.

Cabral, S. (2018). The 6 Stages of the Disease Process (Ayurvedic Principle). [podcast] The Cabral Concept. Available at: https://itunes.apple.com/us/podcast/cabral-concept-by-stephen/id1071469441?mt=2

Tirtha, S. (2007). The Āyuveda encyclopedia. Bayville, NY. Ayurveda Holistic Center Press.

It's that time: time to test your blood. Most blood tests include a fasting lipid panel to assess one's risk of cardiovascular disease. A lipid panel is a test that measures fats and fatty substances used as a source of energy in the body. Lipids include cholesterol, triglycerides, high-density lipoprotein (HDL) and low-density lipoprotein (LDL).

Triglycerides are a powerful cardiovascular risk marker. Elevated triglyceride levels are a hallmark of too many carbohydrates in the diet.

60 percent of fructose is shunted toward the liver, where it is converted to triglycerides (which causes heart disease) (Gundry, 2017). In fact, fructose, which is the sugar found in most processed foods (often in the form of high-fructose corn syrup) can only be metabolized by your liver. If you eat a typical Western-style diet, you consume high amounts of it. The overload of fructose ends up damaging your liver in the same way alcohol and other toxins do (Mercola, 2017).

Our culture is obsessed with cholesterol levels, to the point that one in four adults in the U.S. take a statin drug to lower cholesterol levels. Nevertheless, elevated cholesterol levels are rarely a risk factor for heart disease, although elevated triglycerides clearly are. Fortunately, elevated triglycerides can easily be corrected and lowered to an ideal level of below 75 with the proper lifestyle interventions. The following tests can give you a far better assessment of your heart disease risk than your total cholesterol alone:

• HDL/Cholesterol ratio: HDL percentage is a very potent heart disease risk factor. Just divide your HDL level by your total cholesterol. That percentage should ideally be above 24 percent.
• Triglyceride/HDL ratios: You can also do the same thing with your triglycerides and HDL ratio. That percentage should be below 2.
• HS-CRP: This test measures the amount of a protein called C-reactive protein (CRP) in your blood. CRP measures general levels of inflammation in your body. There are two types, the regular test and the high sensitivity test (HS). It is best to get the more sensitive HS test done to measure CRP levels, which ideally should be below 0.7 mg/L.
• Your fasting insulin level: Any meal or snack high in carbohydrates like fructose and refined grains generates a rapid rise in blood glucose and then insulin to compensate for the rise in blood sugar.
• Your fasting blood sugar level:  Studies have shown that people with a fasting blood sugar level of 100 to 125 mg/dL had a nearly 300 percent higher risk of having coronary heart disease than people with a level below 79 mg/dL. This is easily monitored at home using a blood glucose meter.
• Your iron level: Iron can be a very potent driver of oxidative stress, so if you have excess iron levels you can damage your blood vessels and increase your risk of heart disease. Iron levels can be monitored by testing blood levels of ferritin; ideally, your level should be between 60 and 80 ng/nl.
  

High triglyceride levels (over 100 mg/dL) is known to cause leptin resistance. Leptin is a hormone located in fat cells, and like most hormones, it's function is complex. Leptin is tied to the coordination of our metabolic, hormonal, and behavioral response to starvation. Leptin essentially controls mammalian metabolism. Leptin decides whether to make us hungry and store more fat or burn fat. In other words, when your stomach is full, fat cells release leptin to tell your brain to stop eating. This is why people with low levels of leptin are prone to overeating.

One study observed participants with a 20 percent drop in leptin experienced a 24 percent increase in hunger and appetite, influencing their cravings for calorie-dense, high-carbohydrate foods, especially sweets, salty snacks, and starchy foods. The researchers discovered the drop in leptin was caused by sleep deprivation.

Leptin is also a pro-inflammatory molecule - it controls the creation of other inflammatory moleciles in your fat tissue throughout your body. This explains why overweight individuals are susceptible to inflammatory problems. Leptin is ranked highly on the body's chain of command, so imbalances tend to spiral downward and wreak havoc on virtually every system of the body beyond those directly controlled by leptin. Leptin, like insulin, is negatively influenced by carbohydrates. The more refined and processed the carbohydrate, the more imbalanced leptin levels become. When the body is overloaded and overwhelmed by substances that cause continuous surges in leptin, leptin receptors begin to turn off and you become leptin resistant. So even though leptin is now elevated, it doesn't work - it won't signal to your brain that you're full so you can stop eating.

Not a single drug or supplement can balance leptin levels. But better sleep, as well as better dietary choices will (Perlmutter, 2013).

Preventing cardiovascular disease involves reducing chronic inflammation in your body, and a proper diet is an absolute cornerstone. Although saturated fat has taken the blame for causing heart disease for the last several decades, the primary culprit in heart disease is sugar consumption.

A 2015 study published in the Journal of the American Medical Association concluded that there is " a significant relationship between added sugar consumption and increased risk for cardiovascular mortality." the 15-year study, which included data for 31,000 Americans, found that those who consumed 25 percent or more of their daily calories as added sugars were more than twice as likely to die form heart disease as those who got less than 10 percent of their calories from sugar. On the whole, the odds of dying from heart disease rose in tandem with the percentage of added sugar in the diet regardless of the age, sex, physical activity level, and body mass index (Dhurandhar & Thomas, 2014).

A 2014 study came to very similar conclusions. Here, those who consumed the most sugar - about 25 percent of their daily calories - were twice as likely to die form heart disease as those who limited their sugar intake to 7 percent of their total calories (Yang et al., 2013).

A 2013 study, published in the Journal of the Academy of Nutrition and Dietetics, looked at the differing effects of high-fat diets versus low-fat diets on blood lipid levels. The study included 32 studies and found that high-fat diets resulted in significantly greater improvements in reductions of total cholesterol, LDL cholesterol, and triglycerides and benificial increases in HDL cholesterol (Schwingshackl et al., 2013).

Of course, the choice to take medications, if referred by your physician is, and should, always be your choice. However, you have the right to be fully informed of the side effects of consuming anything. With this in mind, it is important to be aware of the unintended side effects of taking statins.

A study published in Clinical Cardiology concluded that "Statin therapy is associated with decreased myocardial [heart muscle] function," which often leads to heart failure. The  study did not address causes, but it's widely known that statins lower your CoQ10 levels by blocking the pathway involved in cholesterol production -- the same pathway by which Q10 is produced. Statins also reduce the blood cholesterol that transports CoQ10 and other fat-soluble antioxidants. The loss of CoQ10 leads to loss of cell energy and increased free radicals which, in turn, can further damage your mitochondrial DNA, effectively setting into motion an evil circle of increasing free radicals and mitochondrial damage (Mercola, 2011).

Moreover, for those at risk of heart disease taking statins who are unwilling or unable to bring down their cholesterol and/or triglyceride levels naturally with dietary changes, the potential for liver or muscle damage should be acknowledged. In addition, the potential for brain-related side effects, such as memory loss and confusion, as well as Parkinson’s-like symptoms is of concern. Statin drugs also appeared to increase the risk of stroke and developing diabetes. In 2013, a study of several thousand breast cancer patients reported that long-term use of statins may as much as double a woman's risk of invasive breast cancer.

There are 71 diseases that may be associated with these drugs, and this is only the tip of the iceberg. There are actually over 900 studies showing the risks of statin drugs, which include:

• Cognitive loss
• Neuropathy
• Anemia
• Acidosis
• Frequent fevers
• Cataracts
• Sexual dysfunction
• An increase in cancer risk
• Pancreatic dysfunction
• Immune system suppression
• Serious degenerative muscle tissue condition (rhabdomyolysis)
• Hepatic dysfunction

Plant-based diets have been shown to lower cholesterol just as effectively as first-line statin drugs, but without the risks. In fact, the "side effects" of healthy eating tend to be good - less cancer and diabetes risks and protection of the liver and brain (Gregor, 2015).

Baker, A. (2012). What's the real driver of elevated cholesterol? hint: it's not saturated fat! - Nourish Holistic Nutrition. [online] Nourish Holistic Nutrition. Available at: nourishholisticnutrition.com/whats-the-real-driver-of-elevated-cholesterol/ [Accessed 8 Feb. 2019].

Dhurandhar, N. and Thomas, D. (2015). The Link Between Dietary Sugar Intake and Cardiovascular Disease Mortality. JAMA, 313(9), p.959. https://doi.org/10.1001/jama.2014.18267 [Accessed 8 Feb. 2019].

Gregor, M. (2015) How Not to Die. London: Pan Books

Gundry, S. (2017). The Plant Paradox. New York, NY: Harper Wave

Hyman, M. (2016). 7 Ways to Optimize Cholesterol. [online] Dr. Mark Hyman. Available at: https://drhyman.com/blog/2016/01/14/7-ways-to-optimize-cholesterol/ [Accessed 8 Feb. 2019].

Mercola, J. (2017). Fat for Fuel. Carlsbad, CA: Hayhouse Inc.

Mercola, J. (2011). New Study Shows Using Statins Actually Harms Heart Function. [online] Mercola.com. Available at: https://articles.mercola.com/sites/articles/archive/2011/06/22/new-study-show-using-statins-actually-worsens-your-heart-function.aspx [Accessed 8 Feb. 2019].

Mercola, J. (2015). Conventional Heart Disease Advice May Make Matters Worse. [online] Mercola.com. Available at: https://articles.mercola.com/sites/articles/archive/2015/08/02/heart-disease-risk-factors.aspx [Accessed 8 Feb. 2019].

Perlmutter, D (2013). Grain Brain. New York, NY: Little Brown

Ray, K. et al. (2010). Statins and All-Cause Mortality in High-Risk Primary Prevention. Archives of Internal Medicine, 170(12), p.1024. Available at: https://doi.org/10.1001/archinternmed.2010.182 [Accessed 8 Feb. 2019].

Rubinstein, J., Aloka, F. and Abela, G. (2009). Statin Therapy Decreases Myocardial Function as Evaluated Via Strain Imaging. Clinical Cardiology, 32(12), pp.684-689. Available at: https://doi.org/10.1002/clc.20644 [Accessed 8 Feb. 2019].

Schwingshackl, S., et al. (2013). Comparison of Effects of Long-Term Low-Fat vs High-Fat Diets on Blood Lipid Levels in Overweight and Obese Patients: A Systematic Review and Meta-Analysis. Journal of the Academy of Nutrition and Dietetics, 113(12), pp. 1640-61. Available at: https://doi.org/10.1016/j.jand.2013.07.010 [Accessed 8 Feb. 2019].

Wallerwellness.com. (2019). Understanding Triglycerides. [online] Available at: https://www.wallerwellness.com/health-and-aging/understanding-triglycerides [Accessed 8 Feb. 2019].

Williams, J. (2017). How To Lower Dangerously High Triglyceride Levels. [online] Renegade Health. Available at: http://renegadehealth.com/blog/2017/03/31/how-to-lower-dangerously-high-triglycerides-levels [Accessed 8 Feb. 2019].

Yang, Q., et al. (2014). Added Sugar Intake and Cardiovascular Diseases Mortality Among US Adults. JAMA Internal Medicine, 174(4), pp.516-24. Available at: https://doi.org/10.1001/jamainternmed.2013.13563 [Accessed 8 Feb. 2019].