Digestive Functional Foods 4

Dopo il post monografico, torniamo ad analizzare il dato etnobotanico. Nel seguente spezzone tento di riassumere parte dei dati etnobotanici più recenti relativi all’utilizzo dei cibi funzionali tradizionali latu sensu nei disturbi gastroenterici, cercando, quando possibile, di limitarmi a disturbi non specifici (indigestione, gonfiore, dispepsia, ecc.), e cercando di trarre qualche indicazione di massima sulla eventuale segregazione rtassonomica dei rimedi. Come vedrete le conclusioni sono chiare (ma con vari caveat): esistono poche famiglie nelle quali si concentrano molti dei rimedi, e questi rimedi sono caratterizzati molto spesso dalla presenza di principi amari, pungenti e/o aromatici.  Buona lettura!

——————————————————————————————-

Digestive Functional Foods in the ethnobotanical literature

The author compiled a non-systematic survey of FF plants used world-wide for digestive complaints, limiting, when possible, the analysis to plants used only for non specific gastrointestinal complaints, to remain coherent with the spirit of the FF definition. The plants listed were mainly used as digestives, appetite stimulants, antidyspepsics, carminatives, and antispasmodics. Plants with very specific activities (antiulcer) or with specific indications (IBS, etc.) were excluded, when possible.[1]

In a paper on edible plants of Palestine,[2] of the 103 edible plants, 64 (62 %) were used as food-medicines, and the two most important botanical families for food-medicines were Asteraceae and Lamiaceae.  This is in agreement with the findings of a similar study on food plant consumption in seven Mediterranean countries.[3]
Of the 78 alimentary species collected in Cyprus, 20 (25,6%) belonged to the Asteraceae, 7 each to Apiaceae and Brassicaceae, and 6 to the Lamiaceae. 40 were used only as food, and 37 (47,4%) as both food and medicine.[4]

In a study on Sicilian wild food plants, of the 188 food species recorded, 37 (19,6%) were used as both food and medicine, and of these 12 (32,4%) belonged to Asteraceae,  4 (11%) to Lamiaceae,  3 each to Brassicaceae and Apiaceae.[5]

In a review of plant foods as medicines in Mediterranean Spain, the authors found that  the percentage of edible plants used as medicines varied between 13,39 and 21,42 (17,52% on average), and that of spices and culinary herbs used as medicines varied between 5,74 and 9,25 (7% on average). All in all an average of around 24,5% of edible plants and spices were used as medicines.[6] Lamiaceae  and Asteraceae played major roles both in terms of recorded medicinal uses (146 the former and 57 the latter, of all 559 recorded uses) and of number of species used in medicinal treatments (42 the former and 29 the latter).

According to Rivera and coworkers, of the 145 wild gathered food species from Southern Spain, 81 (55,9%) are also used medicinally, and, more importantly, 61 (42%) are administered orally using the same plant part used in the culinary preparations.  This proportion was halved when examining   cultivated food species.[7]

In an ethnobotanical research in Kenya, the authors found that wild edible-medicinal plants represent  30,2% of all edible plants.⁠

The main datum that emerges from this exercise is the predominance of some taxa.

At a higher level the Family Asteraceae dominates with 41 citations of 25 different Genera, amongst which Matricaria, Sonchus and Artemisia are the most often cited.  The second Family by number of citations is that of Lamiaceae, with 24 citations of 16 different Genera, vastly dominated by Mentha and Ocimum.

Also important are the Apiaceae family with 12 citations of 12 Genera, Zingiberaceae (9 citations of 8 Genera) and Rutaceae (9 citations of 3 Genera, dominated by Citrus spp.).

As an aside, similar data emerge when we examine functional foods in general: a significant percentage, between 20 and 60% (average 40%) of edible wild plants is used in traditional societies as a medicine; and secondly, the family  Asteraceae seem to be the main source of medicinal plant species used by traditional societies (at least in the northern hemisphere) and one of the main sources of functional foods/medicinal foods/food medicines.[8]  Lamiaceae and Apiaceae are also very important in terms of number of species used.[9]
These taxa share a similar chemical make-up: they contain very salient organoleptic compounds, such as essential oils, resins and pungent compounds, and bitter compounds, mainly in the Asteraceae and Cucurbitaceae, usually showing low toxicity.

Similar results can be seen in wider reviews including medicinal plants stricto sensu:  still dominant is the triad of Asteraceae, Lamiaceae and Apiaceae, but with a high frequency of  Euphorbiaceae (8 citations of 4 Genera), Fabaceae (15 citations of 12 Genera) and Solanaceae: all families with a potentially more toxic chemical profile, containing irritant latex, toxic lectins and cyanide-producing molecules, often characterized by a strong bitter taste. ⁠.[10]

Bitters and Spices

The majority of the plants rich in essential oil and pungent compounds have been historically classified as spices.  For most of human history, spices have been a canonical example of a fluid entity shifting from the food to the medicine field: they were sold by grocers and spice merchants but also by apothecaries and physicians; they have been used extensively as ingredients in the preparations of dishes, usually accompanying and exalting the main food crops, while at the same time being consumed as infusions and decoctions, like many other medicinal plants. When used as foods, they were very rarely the main ingredient, and seldom provide high primary metabolite intake. Even when used as a medicine, their sensual, organoleptic quality played an important role, quite apart from their effective therapeutic quality.

In fact spices are more akin to medicinal foods that FF proper, and they were ascribed potent medicinal qualities well before empirical validations were available, most probably because they resemble the prototypical medicinal product: “they are specific (have unique and distinguishing tastes), small (in volume), and powerful (in the stimuli they emit and, in many cases, physiologic action)”.

The characteristic aroma and taste of spices is imparted by volatile essential oils and pungents (mono- and sesquiterpenes plus a few shikimic acid derivatives, plus thioethers in Alliaceae and isothiocyanates in Brassicaceae) and non volatile pungent compounds (mainly belonging to the acid amine group, like capsaicin in Capsicum and piperine in Piper).

Although very different from spices in term of economic and cultural importance, bitters too have a recognized place in many different cultures all over the world, in promoting the state of health. The almost universal use of bitter-tasting drinks as aperitif, digestives or fasting tools emphasizes this important role.[11]

Pungent, aromatic and bitter compounds do not exhaust the chemical variety of digestive FF, and their predominance cannot be taken without some caution. It is in fact probable that this predominance is due to many cultural, economical and social factors beyond the biological ones. Having said that, these compounds are extremely interesting because they seem to be able to act on gastrointestinal physiology before or even without systemic absorption, hence potentially with low toxicity profiles.
Moreover, in the last ten years research on gastrointestinal physiology has focused more and more on the health implications of tastants and olfactants, and this research has blended very well with the hypothesis of the coevolution of plant secondary compounds and human defense mechanisms.

——————————————————————————————–
[1] Dufour DL and Wilson WM “Characteristics of ‘wild’ plant foods used by indigenous populations in Amazonia” in Etkin 1994, Op. Cit.; Vickers WT “The health significance of wild plants for the Siona and Secoya” in Etkin 1994, Op. Cit.; Price LL “Wild food plants in farming environment”s in Pieroni and Price 2006 Op. Cit.; Pieroni, A. and Quave, C. “Functional foods or food medicines? On the consumption of wild plants among Albanians and Southern Italians in Lucania”  in Pieroni and Price 2006 Op. Cit.; de Santayana, M.P., San Miguel, E., Morales, R. “Digestive beverages as a medicinal food in a cattle-farming community in Northen Spain (Campoo, Cantambria)”.  in Pieroni and Price 2006 Op. Cit.; Volpato and Godinez 2006 Op. Cit.; Vanderbroek, I.,  Sanca, S. “Food medicines in the Bolivian Andes (Apillapampa, Cochabamba Department)” in Pieroni and Price 2006 Op. Cit.; Ladio 2006 Op. Cit.; Ogoye-Ndegwa, C., Aagaard-Hansen, J. “Dietary and medicinal use of traditional herbs among the Luo of Western Kenya” in Pieroni and Price 2006 Op. Cit.; Eddouks, M. “Aspects of food medicine and ethnopharmacology in Morocco” in Pieroni and Price 2006 Op. Cit.; Curtin 1997, Op. cit.; Quave, C.L. and Pieroni, A “Traditional health care and food and medicinal plants use among historic Albanian migrants and Italians in Lucania, Southern Italy”. in Pieroni & Vandebroek 2007, Op. Cit.; Ceuterick, Vandebroek, Torry, & Pieroni Op. Cit; Van Andel, T and van’t Klooster, C. “Medicinal plant use by Surinamese immigrants in Amsterdam, The Netherlands: Results of a pilot market study”. in Pieroni & Vandebroek 2007, Op. Cit; Lundberg, P.C. “Use of traditional herbal remedies by Thai immigrant women in sweden” in Pieroni & Vandebroek 2007, Op. Cit; Vandebroek, I., Balick, M.J., Yukes, J., Duran, L., Kronenberg, F., Wade, C., Ososki, A.L., Cushman, L., Lantigia, R., Mejia, M., Robineau, L. “Use of medicinal plants by Dominican immigrants in New York City for the treatment of common health conditions: A comparative analysis with literatue data from the Dominican Republic” in Pieroni & Vandebroek 2007, Op. Cit; Manandhar, N.P. Plants and people of Nepal. Timber Oress, Oregon, USA, 2002; Ruffo, Birnie, Tengnas 2002 Op. Cit.; Germosen-Robineau, L Farmacopea vegetal caribena. Ed. Universitaria TRAMIL, ENDA-Caribe, 1998; Lewis, W.H., Elwin-Lewis, M.P.F. Medical Botany: Plants affecting human health 2nd edition. Wiley and sons, London, 2003; Williamson, E.M. (Ed.) Major herbs of Ayurveda. Churchill Livingstone, London, 2002; Williamson, Yongping Bao, Chen, Bucheli  2004, Op. Cit.; Akerreta, S., Cavero, R.Y., Lopez, V., Calvo, M.I. “Analyzing factors that influence the folk use and phytonomy of 18 medicinal  plants in Navarra”. Journal of Ethnobiology and Ethnomedicine 2007, 3:16; Lans, C. “Comparison of plants used for skin and stomach problems in Trinidad and  Tobago with Asian ethnomedicine” Journal of Ethnobiology and Ethnomedicine 2007, 3:3; Tilahun Teklehaymanot, Mirutse Giday “Ethnobotanical study of Medicinal plants used by people in Zegie peninsula, Northwestern Ethiopia” Journal of Ethnobiology and Ethnomedicine 2007, 3:12; Bussmann, Sharon and Lopez 2007 Op. Cit.; John Warui Kiringe “A Survey of Traditional Health Remedies Used by the Maasai of Southern Kaijiado District, Kenya” Ethnobotany Research & Applications, 2006 4:061-073;
[2] Ali-Shtayeh et al., 2008
[3] Hadjichambis ACH, Paraskeva-Hadjichambi D, Della A, Giusti M, DE Pasquale C, Lenzarini C, Censorii E, Gonzales-Tejero MR, Sanchez- Rojas CP, Ramiro-Gutierrez J, Skoula M, Johnson CH, Sarpakia A, Hmomouchi M, Jorhi S, El-Demerdash M, El-Zayat M, Pioroni A: Wild and semi-domesticated food plant consumption in seven circum-Mediterranean areas. International Journal of Food Sciences and Nutrition; 2008, 59 (5):383-414
[4] Della, Paraskeva-Hadjichambi, & Hadjichambis, 2006
[5] Lentini & Venza, 2007
[6] Rivera & Obón, 1996
[7] Rivera et al. 2005, cited in Leonti, S Nebel, Rivera, & M Heinrich, 2006
[8] Leonti, S Nebel, Rivera, & M Heinrich, 2006
[9] Ali-Shtayeh et al., 2008; Hadjichambis ACH, Paraskeva-Hadjichambi D, Della A, Giusti M, DE Pasquale C, Lenzarini C, Censorii E, Gonzales-Tejero MR, Sanchez- Rojas CP, Ramiro-Gutierrez J, Skoula M, Johnson CH, Sarpakia A, Hmomouchi M, Jorhi S, El-Demerdash M, El-Zayat M, Pioroni A: Wild and semi-domesticated food plant consumption in seven circum-Mediterranean areas. International Journal of Food Sciences and Nutrition; 2008, 59 (5):383-414; Della, Paraskeva-Hadjichambi, & Hadjichambis, 2006; Lentini & Venza, 2007; Rivera & Obón, 1996; Rivera et al. 2005, cited in Leonti, S Nebel, Rivera, & M Heinrich, 2006
[10] (Liu, et al., 2009; Long, et al., 2009; Kala, 2005; Muthu, et al., 2006; Pradhan & Badola, 2008; Bussmann & Sharon, 2006; Volpato, et al., 2009; Luziatelli, et al., 2010; Lulekal, et al. 2008; Yineger, Yewhalaw, & Teketay, 2008; Teklehaymanot & Giday, 2007; Mesfin, Demissew, & Teklehaymanot, 2009; Bhattarai, Chaudhary, & Taylor, 2006)
[11] Mills, SY, Bone, K Principles and Practice of Phytotherapy: Modern Herbal Medicine. Churchill Livingstone, 2000; Scarpa A,  Guerci A Actes du 2e Colloque European d‘Ethnopharmacologie et de  la 1 le Conférence internationale d‘Ethnomédecine, Heidelberg. 1993, 30-33; Johns 1990 Op. Cit.

Digestive Functional Foods 2

Nella seconda installazione mi concentro su due dati interessanti: l’importanza dei disturbi gastrointestinali nelle farmacopee tradizionali, e la predominanza di alcuni taxa nelle piante medicinali ad attività gastrointestinale: Asteraceae, Lamiaceae ed Apiaceae.
——————————————————————————————————————-

Plants used for gastrointestinal complaints in the folk traditions
In analyzing the literature on traditional remedies, it is quite evident that there is a prevalence of plant remedies used for gastrointestinal complaints. In a comparison between indigenous and biomedical pharmacopoeias cited by Balick and Cox, and summarized data referring to 15 different geographical areas, it was shown that “indigenous plant remedies are focused more on gastrointestinal disorders then western Pharmacopoeas”. In fact, the main indication for plant-based remedies was gastrointestinal disturbances (accounting for 15% of the total), equal only to dermatological complaints.[1]

These data are confirmed by more recent research.
In the now famous paper by Etkin and Ross on Hausa folk medicinal knowledge, of the 781 recipes registered, 184 (23.5%) were used for gastrointestinal complaints. Limiting the analysis to the naturalistic maladies, the percentage rises to 32%.[2]
Amongst the most cited uses of the remedies of the Masai in Kenya, gastrointestinal indications play a major role: stomachache is cited 100% of the time, loss of appetite 92% and indigestion 45%.[3] In more recent study on Kenyan ethnobotany, plant remedies for stomach problems were cited 20% of the times.[4]
Very similar percentages are found in other African areas. The proportion of remedies used for treatment of gastrointestinal related disease are for instance high in most studies conducted in Ethiopia, going from 23%[5] to 35%.[6]

In a comparison of Mediterranean folk pharmacopoeias, the percentage of plants used for gastrointestinal complaints went from 31.2 in Uzbekistan, to 21.68 in Turkey, to 16.93 in Greece, to 10.6 in Italy.[7]
In an ethnobotanical survey of the western Pyrenees the plants were used primarily for gastrointestinal or RT disorders,[8] and a survey done in a Peruvian clinic showed that gastrointestinal problems were the second most important reason for patients to use plants.[9]
In the ethnobotany of the South West of the US, around 23.6% of the remedies are used for gastrointestinal disorders.[10]

According to two papers on Brazilian ethnomedicine, 22 to 30% of the medicinal plants were used for digestive disorders, the second most frequent use of all.⁠[11]
A very similar percentage is apparent in a study on Mexican ethnobotany, where roughly 30% of all plants were used to treat colics and stomachaches.[12]
According to Volpato and coworkers, almost 50% of the remedies used by Haitian immigrant to Cuba are intended to treat general gastrointestinal disorders, and about 20% are used as digestive and carminative.[13]
In Perù, 20.3% of the 402 medicinal plant species were used to treat gastrointestinal disturbances, the second most important indication of all,[14] and 6,68% of all plant mixtures (the highest percentage of all uses) was used to treat colic and intestinal problems.[15]
The use of medicinal plants for the treatment of gastrointestinal disorders has a high prevalence in other Andean societies as well.[16]

Many papers have recorded the very high percentage of plants used for gastrointestinal disorders in India, usually the most frequent use af all. The data vary between 25,3% for indigestion,[17] to 30% for stomach related disorders,[18] to 51,2% for generic gastrointestinal disorders.[19] Even when the indications are not the most important, the percentages are still very relevant, as in two recent studies reporting percentages of 9 and 18% for gastrointestional uses.[20]
In a review of remedies used in Pakistan, 16% of the plants were used for gastric problems.[21]
In a recent paper on Nepali remedies, 14,3% of plant species were taken for indigestion, and 10,7% were used as appetite stimulants.[22]
In East Timor the digestive uses were 4th by frequency, adding uo to 6,7%.[23]
⁠In an ethnobotanical study based in China, 40,52% of plants were used to treat gastrointestinal disorders.[24]

These data refer to medicinal plants but, even when selecting only those remedies that can be ascribed to the food-medicine continuum, this trend remains evident.[25] In a study in Mediterranean Spain, the functional or medicinal foods were used in great prevalence for gastrointestinal disorders (up to 20.4%),[26] and the same was true in a study in northwest Patagonia, where a great number of edible medicinal plants were used for gastrointestinal disorders.[27]

In Cuba viandas (starchy roots and tuber crops) and fruits, typical foods used also as medicinal resources, are particularly important for gastrointestinal distress. Viandas are usually boiled in water or milk and eaten as mashed vegetables (Xanthosoma spp., given as a stomachic, for gastritis and stomach ulcers), or grated and sun dried and eaten with milk (Maranta arundinacea, given to kids as a digestive).[28] Fruits are used as simple remedies to improve digestion (Carica papaya, Mangifera indica, Citrus sinensis for example), to prevent colic and “stomach congestion” in kids.[29]

Various reasons have been proposed to explain the prevalence of use for gastrointestinal disorders. Balick and Cox put forward reasons of saliency and of danger perception: the gastrointestinal ailments were, according to the authors, easily identifiable, contrariwise to, for example, tumors; and in traditional societies or in ancient periods of our history the main risks for people were infective diarrheas, gastrointestinal parasitic diseases, alimentary intoxications, etc., much more than cardiovascular diseases, CNS disturbances or neoplastic diseases.[30] Traditional pharmacopoeias are also probably quite conservative and tend to favor gastrointestinal remedies even when the prevalence of diseases has changed.[31]

This prevalence would also be partly explained by the ancient, pre-cultural link between plants and humans. Herbal remedies were (and still are) mainly used per os, thus human beings have “explored” the secondary metabolites sphere mainly through the gastrointestinal tract, which then has a pivotal role as a first diaphragm between the external world and its dangers (xenobiotics) and the internal physiology, and had to “measure itself” against plant constituents: those constituents that represented at the same time a health risk and a pharmacological opportunity.

If the thesis that man had to live in a world rich in alimentary toxins, and at times had to adapt and “learn” to use the same toxins to his own advantage; it is possible that he developed systems of detection, management and defense and that these systems are mainly present in the same gastrointestinal tract.[32]

In fact, according to Johns, the effects of wild foods on the gastrointestinal tract has probably been one of the primary factors in the evolution of medicine and of the use of medicinal foods. Because taste has always been the messenger of many chemical messages, it has been interpreted in many contextualized manners, so that even bitter and pungent tastes could be accepted or even desired.[33]

—————————————————————————————————————-
Notes
[1] Balick, M., Cox, L. (1996) Plants, people, and culture: the science of ethnobotany. New York: Scientific American Library
[2] Etkin NL, e Ross PJ (1994) “Pharmacological implications of “wild” plants in Hausa diet”. In NL Etkin (ed.) Eating on the wild side: The pharmacological, ecological, and social implications of using noncultigens. Arizona University Press
[3] Kiringe, John Warui (2006) “A Survey of Traditional Health Remedies Used by the Maasai of Southern Kaijiado District, Kenya”. Ethnobotany Research & Applications; 4:061-073
[4] Bussmann, R. W. (2006) “Ethnobotany of the Samburu of Mt. Nyiru, South Turkana, Kenya”. Journal of ethnobiology and ethnomedicine, 2, 35. doi: 10.1186/1746-4269-2-35.
[5] Teklehaymanot, T., & Giday, M. (2007) “Ethnobotanical study of medicinal plants used by people in Zegie Peninsula, Northwestern Ethiopia.” Journal of ethnobiology and ethnomedicine, 3, 12. doi: 10.1186/1746-4269-3-12.
[6] Tessema T, Giday M, Aklilu N (2001) “Stacking and information on the medicinal plants of Ethiopia”. In National Biodiversity strategy and action plan project Medicinal plant Team, Addis Ababa: IBDA; 2001.
[7] Everest, A and Ozturk, E (2005) “Focusing on the ethnobotanical uses of plants in Mersin and Adana provinces (Turkey)”. Journal of Ethnobiology and Ethnomedicine, 1:6
[8] Akerreta, S, Cavero, RY, Calvo, MI (2007) “First comprehensive contribution to medical ethnobotany of Western Pyrenees” Journal of Ethnobiology and Ethnomedicine; 3:26
[9] Bussmann, RW, Sharon D, Lopez A (2007) “Blending traditional and western medicine: medicinal plant use among patients at the Clinica Anticona in El Porvenir, Peru”. Ethnobotany Research and Applications; 5:185-199
[10] Curtin, L.S.M. (1997) Healing herbs of the upper rio grande: Traditional Medicine of the South West. Revised and edited by Michael Moore. Western Edge Press
[11] Almeida, C. D. F. C. B. R., Amorim, E. L. C. de, Albuquerque, U. P. de, & Maia, M. B. S. (2006). “Medicinal plants popularly used in the Xingó region – a semi-arid location in Northeastern Brazil”. Journal of ethnobiology and ethnomedicine, 2, 15. doi: 10.1186/1746-4269-2-15; Albuquerque, U. P. de. (2006) “Re-examining hypotheses concerning the use and knowledge of medicinal plants: a study in the Caatinga vegetation of NE Brazil”. Journal of ethnobiology and ethnomedicine, 2, 30. doi: 10.1186/1746-4269-2-30.
[12] Estrada, E., Villarreal, J. a, Cantú, C., Cabral, I., Scott, L., & Yen, C. (2007) “Ethnobotany in the Cumbres de Monterrey National Park, Nuevo León, México”. Journal of ethnobiology and ethnomedicine, 3, 8. doi: 10.1186/1746-4269-3-8
[13] Volpato, G., Godínez, D., Beyra, A., & Barreto, A. (2009) “Uses of medicinal plants by Haitian immigrants and their descendants in the Province of Camagüey, Cuba”. Journal of ethnobiology and ethnomedicine, 5, 16. doi: 10.1186/1746-4269-5-16.
[14] Luziatelli, G., Sørensen, M., Theilade, I., & Mølgaard, P. (2010) “Asháninka medicinal plants: a case study from the native community of Bajo Quimiriki, Junín, Peru”. Journal of ethnobiology and ethnomedicine, 6(1), 21. doi: 10.1186/1746-4269-6-21.
[15] Bussmann, R. W., Glenn, A., Meyer, K., Kuhlman, A., & Townesmith, A. (2010) “Herbal mixtures in traditional medicine in Northern Peru”. Journal of ethnobiology and ethnomedicine, 6, 10. doi: 10.1186/1746-4269-6-10.
[16] Bussmann, R. W., & Sharon, D. (2006) “Traditional medicinal plant use in Loja province, Southern Ecuador”. Journal of ethnobiology and ethnomedicine, 2, 44. doi: 10.1186/1746-4269-2-44; Alexiades MN, Lacaze D. (1996) “FENAMADs program in traditional medicine: an integrated approach to health care in the Peru- vian Amazon”. In Balick MJ, Elisabetsky E, Laird SA (eds.) Medicinal Resources of the Tropical Forest Columbia University Press, New York:341-365; Arrázola S, Atahuachi M, Saravia E, Lopez A. (2002) “Diversidad floristica medicinal y potencial etnofarmacólogico de las plantas de los valles secos de Cochabamba Bolivia”. Revista Boliviana de Ecología y Conservación Ambiental; 12:53-85; Bastien J (1987) Healers of the Andes: Kallawaya Herbalists and Their Medicinal Plants University of Utah Press, Salt Lake City; Bastien J (1992) Drum and Stethoscope: Integrating Ethnomedicine and Biomedicine in Bolivia University of Utah Press, Salt Lake City
[17] Kala, C. P. (2005) “Ethnomedicinal botany of the Apatani in the Eastern Himalayan region of India”. Journal of ethnobiology and ethnomedicine, 1, 11. doi: 10.1186/1746-4269-1-11.
[18] Pradhan, B. K., & Badola, H. K. (2008) “Ethnomedicinal plant use by Lepcha tribe of Dzongu valley, bordering Khangchendzonga Biosphere Reserve, in North Sikkim, India”. Journal of ethnobiology and ethnomedicine, 4, 22. doi: 10.1186/1746-4269-4-22.
[19] Sajem, A. L., & Gosai, K. (2006) “Traditional use of medicinal plants by the Jaintia tribes in North Cachar Hills district of Assam, northeast India”. Journal of ethnobiology and ethnomedicine, 2, 33. doi: 10.1186/1746-4269-2-33.
[20] Ragupathy, S., & Newmaster, S. G. (2009) “Valorizing the “Irulas” traditional knowledge of medicinal plants in the Kodiakkarai Reserve Forest, India”. Journal of ethnobiology and ethnomedicine, 5, 10. doi: 10.1186/1746-4269-5-10; Ragupathy, S., Steven, N. G., Maruthakkutti, M., Velusamy, B., & Ul-Huda, M. M. (2008) “Consensus of the “Malasars” traditional aboriginal knowledge of medicinal plants in the Velliangiri holy hills, India”. Journal of ethnobiology and ethnomedicine, 4, 8. doi: 10.1186/1746-4269-4-8.
[21] Hayat, M. Q., Khan, M. A., Ahmad, M., Shaheen, N., Yasmin, G., & Akhter, S. (2008) “Ethnotaxonomical approach in the identification of useful medicinal flora of tehsil Pindigheb (District Attock) Pakistan”. Ethnobotany Research & Applications, 6, 035-062
[22] Kunwar, R. M., Nepal, B. K., Kshhetri, H. B., Rai, S. K., & Bussmann, R. W. (2006) “Ethnomedicine in Himalaya: a case study from Dolpa, Humla, Jumla and Mustang districts of Nepal”. Journal of ethnobiology and ethnomedicine, 2, 27. doi: 10.1186/1746-4269-2-27.
[23] Collins, S. W. M., Martins, X., Mitchell, A., Teshome, A., & Arnason, J. T. (2007) “Fataluku medicinal ethnobotany and the East Timorese military resistance”. Journal of ethnobiology and ethnomedicine, 3, 5. doi: 10.1186/1746-4269-3-5.
[24] Long, C., Li, S., Long, B., Shi, Y., & Liu, B. (2009) “Medicinal plants used by the Yi ethnic group: a case study in central Yunnan”. Journal of ethnobiology and ethnomedicine, 5, 13. doi: 10.1186/1746-4269-5-13.
[25] Ruffo, C.K., Birnie, A., Tengnas, B. (2002) Edible wild plants of Tanzania. RELMA, Kenya; Williamson, G.; Yongping Bao; Chen, K.; Bucheli, P. (2004) “Effects of Phytochemicals in Chinese Functional Ingredients on Gut Health” In Choon Nam Ong and B. Halliwell (eds.) Herbal and Traditional Medicine Molecular Aspects of Health. Lester Packer
[26] Rivera-Nunez D., Obion-de-Castro C (1993) “Plant food as medicine in Medittìerranean Spain” In Actes du 2e Colloque Européen d’Ethnophannacologie et de la 1 le Conference internationale d’Ethnomédecine, Heidelberg, 24-27 mars 1993;
[27] Ladio AH (2006) “Gathering of wild plant foods with medicinal use in a Mapuche community of Northwest Patagonia” in Pieroni A, & Price LL Eating and Healing: Traditional Food As Medicine, The Haworth Press.
[28] Volpato G, Godìnez D “Medicinal foods in Cuba: Promoting health in the household”, in Pieroni and Price 2006 Op. Cit.
[29] Volpato, Godinez 2006 Op. Cit.
[30] Balick and Cox 1996 Op. Cit.
[31] Rivera-Nunez, Obon-de-castro, 1993 Op. Cit.
[32] Johns 1990, Op. Cit.
[33] Johns, T (1994) “Ambivalence to the palatability factor in wild food plants”. In NL Etkin (ed.) Eating on the wild side: The pharmacological, ecological, and social implications of using noncultigens. Arizona University Press