Rationalized approach towards milk consumption integrating ayurveda principles and recent advances for health promotion

Introduction

Ayurveda has mentioned the role of Trayopastambha (Ahara, Nidra, and Brahmacharya) in health maintenance.^[1] Ahara being the foremost has the utmost importance. Ahara and its Varga are extensively described in Ayurveda. Dugdha Varga is one of them. Dugdha is considered a Jeevaniya Dravya and is consumed from birth till death.^[2] Dugdha has its therapeutic utility in healthy as well as diseased. Milk is an essential component of diet owing to its high nutritional status. It is vital in physical growth as well as health maintenance. However, there is a considerable discrepancy between the demand and supply of milk especially in India. To address this gap, various methods are being employed, including genetically modified cattle and synthetic milk. These innovations have health implications, posing a threat to the nutritional profile of milk. Thus, it is important to understand a rational approach to milk consumption to achieve the desired outcomes.

Aim

To rationalize the approach of milk consumption integrating Ayurveda principles and recent advances.

Objectives

To review milk as Pathya and Apathya in diseases as per Ayurveda.

To explore recent advances in the milk industry and assess milk's nutritional profile.

Materials and Methods

A literature review of Ayurveda texts and relevant studies was conducted to explore the nutritional and therapeutic values of Ashta Ksheera. The electronic databases searched included Google Scholar, PubMed, the Ayush research portal, and the DHARA database. The search terms used were: Ksheera, Dugdha, Milk, and Synthetic milk.

Observation

Dugdha is extensively elaborated in Ayurveda classics. Paya, Ksheera, and Prasravana are some of the synonyms of Dugdha.^[3] "Dugdha” originates from the Sanskrit root "Duhyate Smeti," which means "to milk out." "Paya" is derived from "Pane Karmani," signifying "for drinking." Going through compiled texts, the following observations can be drawn. the general qualities of milk as per various classics are described in [Table 1].^[4], ^[5], ^[6], ^[7], ^[8], ^[9]

The general aspects of Ashtadugdha are described in [Table 2].^[10], ^[11], ^[12], ^[13], ^[14], ^[15], ^[16], ^[17], ^[18], ^[19], ^[20], ^[21], ^[22], ^[23], ^[24], ^[25], ^[26], ^[27], ^[28], ^[29], ^[30], ^[31], ^[32], ^[33]

Yogaratnakara extensively elaborated on other aspects related to milk consumption. While describing the freshness of milk, it is stated that Akwathita Dugdha can be consumed till ten Ghatika (approx. 10 hours) and Kwathita Dugdha till twenty Ghatika (approx. 20 hours). ^[34] Dugdha can be consumed even beyond if its taste and palatability are intact. [Table 3] describes the most suitable Dugdha. [Table 4] describes the impact of vessel on milk properties. [Table 5] describes the difference in qualities of milk based on Agni Sanskara. [Table 6] elaborates on the difference in benefits of milk based on time consumption. [Table 7] illustrates the compatibility and incompatibility of Dugdha with another Dravya. [Table 8] describes the indications of milk according to conditions.^[35], ^[36], ^[37], ^[38], ^[39], ^[40], ^[41], ^[42], ^[43], ^[44], ^[45], ^[46], ^[47], ^[48], ^[49], ^[50], ^[51], ^[52], ^[53], ^[54], ^[55], ^[56], ^[57], ^[58], ^[59], ^[60], ^[61], ^[62], ^[63], ^[64], ^[65]

Nutritional Profile of Milk

Milk is an emulsion or colloid of butterfat globules within a water-based fluid that contains dissolved carbohydrates and protein aggregates with minerals.^[67] Because it is produced as a food source for the young, all its contents provide benefits for growth. The principal requirements are energy (lipids, lactose, and protein), biosynthesis of non-essential amino acids supplied by proteins (essential amino acids and amino groups), essential fatty acids, vitamins and inorganic elements, and water.^[68] [Table 9] describes the nutritional composition of milk.^[69], ^[70]

Recent Advancements in the Milk Industry

White Revolution emphasized, adopting new and modern methods to hold and milk cows, changing the composition of animal feed for better adjustment to the condition and others.^[71]

A 1984 review concluded that cross-bred cows are better suited for high milk production compared to Indigenous cattle or buffaloes. They also demonstrated greater efficiency in converting feed into milk.^[72] Since then, Dairy production in India has been largely dependent on cross-bred cattle.^[73] Various mutations in the bovine beta-casein gene have resulted in the emergence of 12 genetic variants, among which A1 and A2 are the most prevalent. These A1 and A2 variants exhibit disparity at amino acid position 67, where histidine (CAT) characterizes A1, and proline (CCT) characterizes A2 milk, owing to a single nucleotide disparity. This polymorphism induces a significant conformational alteration in the secondary structure of the expressed β-casein protein. Digestion of the A1 variant of β-casein (found in raw or processed milk) in the gastrointestinal tract leads to the formation of a bioactive peptide known as beta-casomorphin 7 (BCM7). Infants may absorb BCM-7 due to the immaturity of their gastrointestinal tract, whereas adults primarily encounter its biological activity at the intestinal brush border.

A1 and A2 Milk

In hydrolysed milk containing the A1 variant of beta-casein, the level of BCM-7 is four times higher compared to A2 milk. Initial investigations on indigenous cattle breeds (such as Zebu type), buffalo, and exotic cattle breeds (such as taurine type) have shown that the A1 allele is more prevalent in exotic cattle, while Indian native dairy cattle and buffalo exclusively possess the A2 allele, making them a reliable source of safe milk.^[74]

Adulterants in Milk

Synthetic milk closely mimics natural milk. Milk fat is replicated by vegetable oil; the nitrogen component in milk is mimicked by urea; detergents are added to make it frothy.^[75] Neutralizers are added to mask synthetic milk's developed acidity or bitter taste. Among these neutralizers, sodium hydroxide is the most common, but it can be very harmful if ingested. Swallowing it may lead to a burning sensation, abdominal pain, shock, or collapse. These contaminants pose a danger and can inflict permanent harm on the organs. In a previous report, the Indian Council of Medical Research noted that detergents in milk can lead to food poisoning and gastrointestinal complications. Additionally, other synthetic compounds have been linked to conditions such as impairments, heart issues, cancer, and even fatalities.^[76]

Discussion

Milk is one of the basic food products consumed in the world owing to its rich source of nutrients. Ayurveda has extensively described milk in Dugdha Varga. For assessing the purity of Dugdha, it is stated that, if the color of the milk has changed (from white to another color), it is not sweet, has a foul smell, is sour or salty, and has curdled like yogurt, such milk should be discarded.^[77] Being mindful of the Pathya and Apathya related to milk consumption can aid in the prevention of diseases as well as further worsening of conditions. Moreover, while consuming milk one must keep in mind Dashavidha Pariksha, for judicious use. Acharya Charaka described Ashtavidha Ahara Vidhi Visheshayatana, i.e., eight factors to decide the wholesomeness and unwholesomeness of Ahara. One can think on similar lines while rationalizing the approach toward milk administration.

Prakruti: Prakruti of Godugdha is Sheeta, Manda in Guna, thus it can be administered in Paittika Prakruti Purusha as well as Paittika conditions.

Karana: Methods like Agni Sannikarsha and Toya Sannikarasha can reduce the Guruta of Dugdha.

Samyoga: Dugdha with Sharkara or Ghrita is beneficial. Dugdha with Mudga causes Kushtha.

Rashi: Mahisha Dugdha is Guru, Abhishyandi thus should be consumed within limits.

Desha: Anupa Desha and Jangala Desha have a predominance of Kapha and Vata Dosha, respectively. Consumption of Dugdha should be promoted in Jangala Desha. In, Anupa Desha, the use of Aja Dugdha should be promoted as it is Laghu in nature.

Kala:

Nityaga: Godugdha is referred to as Rasayana and thus can be consumed regularly in healthy.

Avasthika: Ksheera is considered as Pathya in Garbhini Awastha.

7. Upayoga Sanstha: Dharoshna Dugdha is considered best.

8. Upayokta: Persons Satmya to Dugdha can take regularly. However, those who are Asatmya to Dugdha (Lactose Intolerance) should be advised with Shunthi, Pippali preparation.

Employing parameters from Dashavidha Pariksha while planning diet with Dugdha.

1. Prakruti: Since milk is Madhura, Snigdha in nature, it may be beneficial in Vata-Pitta Prakriti, and should be administered carefully in persons with Kapha Prakriti predominance.

2. Vikruti: Ayurveda classics have mentioned milk as Pathya in Unmada, Apasmara; and Apathya in Kushtha, Shiroroga.

3. Sara: If all the Dhatus exhibit Dhatu Sarata Lakshana, then it is said to be Pravara Sara. In the case of Avara Sarata one can consume Dugdha as it is Brimhaniya.

4. Samhanana: Avara Samhanana can be due to deformity in the strong adhesion of Dhatus. It may be caused due to Dhatu Shaithilya or due to Vikrut Dhatu Bandhana. In the case of Dhatu Shaithilya, Dugdha should be avoided. In the case of Vikruta Dhatu Bandhana, Dugdha can be advised, which is Sandhanakruta, along with Abhyanga and Vyayama.

5. Pramana: Persons with Hina and Adhika Pramana may fall under Karshya and Sthoulya respectively (with exceptions). Hina Pramana should consume Dugdha and Adhika Pramana persons should avoid Dugdha.

6. Satmya: Persons Satmya to Dugdha can take regularly. However, those who are Asatmya to Dugdha (Lactose Intolerance) should be advised with Shunthi, Pippali preparation.

7. Sattva: Dugdha is said to be Manaskaram. Hence is an excellent Dravya for promoting Sattva.

8. Aharashakti: One after assessing the cause of Avara Aharashakti, one can plan the diet based on Apatarpanjanya or Santarpanjanya Samprapti.

Apatarpanjanya Vyadhi: Dugdha should be advised.

Santarpanjanya Vyadhi: Dugdha should be avoided.

In the case of Pravara Aharashakti: Mahisha Dugdha can be advised as indicated in Atyagni.

9. Vyayamashakti: After assessing the cause of the Avara Vyayamashakti, the diet can be planned based on Samprapti. Dugdha can help in promoting Vyayamashakti.

10. Vaya: In Balyavastha, Dugdha is indicated as it is Agnivriddhikara.

Owing to the recent advancements in milk production, one should emphasize milk obtained from indigenous cows. To meet the increasing demand of the population, natural methods can be implemented like exposure to Indian classical music among others which has demonstrated efficacy.^[78] To identify the adulterations in the milk, the public should be properly educated regarding the same. Synthetic milk is significantly more alkaline (pH-10.5) than natural milk, which has a pH range of 6.4 to 6.8. Additionally, synthetic milk has a bitter taste, unlike the taste of natural milk. These are some key distinguishing factors among others. Resorcinol test and Rosaline test can also be implemented for the same.^[79]

Conclusion

Dugdha has been used for ages and extensive literature on the subject is available. This literature covers both the benefits and drawbacks of milk consumption, along with the associated rules and regulations. As the population grows, the demand for milk has significantly increased. However, there is a notable gap between milk production and consumption. To meet the needs of the growing population, genetically modified cattle are being used to produce milk, which has its health implications. Additionally, synthetic milk is being introduced to the market, which has adverse effects on health. Due to these advancements, the nutritional value of milk is at risk. A rational approach to milk consumption, based on proper education, can help achieve the desired benefits.

Source of Funding

None.

Conflict of Interest

None.