Viruddha Ahara

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‘Viruddha’ means incompatible, opposite or unwholesome or which is harmful for the body or dhatu (body-tissue). It possesses opposite qualities compared to dhatu and vitiates them, leading to various diseases or complications. The concept of viruddha is broadly explained in ayurveda. Viruddha ashana (intake of unwholesome food or diet) is mentioned as a causative factor for various diseases, especially skin diseases (kushtha), erysipelas (visarpa), psychiatric diseases like insanity (unmada) etc. In the context of agrya samgraha (collection of definitive and first choice of medication or treatment), in Charak Samhita, intake of viruddha ahara is the foremost causative factor for nindita vyadhi (wretched diseases like kushtha). [Cha. Sa. Sutra Sthana 25/40]
In modern time, knowingly or unknowingly unwholesome combinations of food, faulty diet/junk foods, or processed/packed food are consumed. This produces ill effects on the body, such as allergies, food toxicities, etc. The cases of food incompatibility and food-food interactions, food-drug interactions are increasing. Therefore, a need to understand the concept of viruddha has risen to know measures for preserving health. The dietary guidelines about what to eat and what is to be avoided; what type of food can be combined or taken together and what not; are important to prevent diseases too. Faulty dietary habits can be corrected and incompatibility with ill effects can be prevented by knowing concept of viruddha. This chapter describes concept of viruddha, its practices and its effects on health.

Contributors
Section/Chapter/topic Concepts & Practices/Viruddha Ahara
Authors Dubey M.1,
Deole Y.S.2
Reviewer Basisht G.3,
Editor Basisht G.3
Affiliations 1Charak Samhita Research, Training and Development Centre, I.T.R.A., Jamnagar, India
2Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India
3Rheumatologist, Orlando, Florida, U.S.A.
Correspondence emails dr.manish181@gmail.com,
dryogeshdeole@gmail.com,
carakasamhita@gmail.com
Publisher Charak Samhita Research, Training and Development Centre, I.T.R.A., Jamnagar, India
Date of publication: May 31, 2023
DOI 10.47468/CSNE.2023.e01.s09.140

Etymology

The word ‘viruddha’ is originated from the Panini root word “Rudhir Avarani” by applying the prefix “Vi”. Thus, the word Viruddha means one which specifically obstructs, opposes or resists. The unwholesome or opposite food and practices that are opposite to the normal dhatu or body physiology is ‘viruddha’. Diet which dislodges dosha within the body but does not expel them out of the body are termed as ‘viruddha’ /ahita (unwholesome). [Cha. Sa. Sutra Sthana 26/85] Every dravya (substance/drugs) is ‘viruddha’ which provokes the dosha, but does not eliminate them outside the body. [A. H. Sutra Sthana 7/45-46] Viruddha ahara means the incompatibility of foods / food substances.

Types 

Some food items are unwholesome individually or in combinations for the dosha as well as dhatu of the body. Whereas some of them are unwholesome due to their contradictory qualities. Some by their combination, some by their preparation methods, some by their desha (geographical area or by body type), kala (time), matra (dose) and some by their swabhava (inherent nature). [Cha. Sa. Sutra Sthana 26/81] Mainly, eighteen types of viruddha are mentioned in Charak Samhita as follows: [Cha. Sa. Sutra Sthana 26/86-101]

Table no.1: Types of viruddha
Sr. no. Type of viruddha (incompatibility) Examples
DeshaDesha (region)]] Intake of ruksha (dry) and tikshna (sharp acting) diet in arid region or deserts (jangala desha)

Intake of snigdha (unctuous) and sheeta (cold) substance in anupa desha (marshy land)

2 Kala (time) Intake of sheeta (cold) and ruksha (dry) in winter,  

Intake of katu (pungent) and ushna (hot) substance in summer.

3 Agni

(Power of digestion)

Intake of food opposite to the power of digestion i.e., agni, for example taking heavy food in case of poor digestive capacity (manda agni)  
4 Matra (dose) Ghee and honey (madhu) in equal quantity
5 Satmya (adaptability) Intake of sweet and cold substance by person who is accustomed to katu (pungent) rasa and ushna (hot potency)
6 Dosha

(Regulatory functional factors of the body)

Using food, medicine or procedure having similar qualities with dosha, but at variance with the habit of individual
7 Samskara

(Mode of preparation)

Meat of peacock roasted on a castor spit.
8 Virya (potency) Substance of ushna (hot) virya taking along with sheeta (cold) virya.
9 Koshtha (bowel pattern/nature of gut/ alimentary tract) Administrating mild purgative to krura koshtha (hard bowel) or strong purgative to mrudu koshtha (soft bowel)
10 Avastha

(State of health)

Intake of vata dosha aggravating food by a person after exhaustion, sexual act and exercise.

Intake of kapha dosha aggravating food by a person after sleep or by lazy person.

11 Krama (order of consumption) Taking food without emptying bowel or bladder or when not having an appetite or after hunger has been aggravated
12 Parihar (Contraindication incompatibility) Intake of hot things after taking pork
13 Upachara (treatment) Intake of cold things after taking ghrita (ghee).
14 Paka (cooking method or process) Preparing food with wrong or rotten fuel and undercooking, overcooking, or burning during preparation.
15 Samyoga (combination) Intake of sour things with milk
16 Hrit (palatability) Any substance which is not pleasant to take
17 Sampad (quality) Intake of substances that are unripe, over ripe or putrefied.
18 Vidhi (rules for eating) Not following dietary guidelines (aahara vidhi) 

Common examples of viruddha

Following tables show the common examples practiced in ancient social practices with their consequences on health mentioned in Charak Samhita. [Cha. Sa. Sutra Sthana 26/82-83] Some of these are practiced in the current era, whereas some are not. The additional examples observed in today’s society are given in the table.

Table no. 2: Common examples of viruddha and the consequences
Sr. No.   Different combinations of viruddha Diseases/ Consequences
1   Fish along with milk

especially one should never consume Chilchima fish (a type of marine fish) with milk

Vitiates the blood and obstructs srotasa (channels of the body), causes constipation, diseases of blood (raktaja vyadhi), ama visha and it may cause even death
2 Meat of gramya (domestic), anup (marshy), audakya (aquatic animals) with honey, sesamum seeds, milk, jaggery, masha (Phaseolus radiatus), radish, lotus stalk or germinated grains Deafness, blindness, tremors, loss of intelligence, loss of voice, causing nasal voice and it may cause death.
3 Vegetable of Pushkara (Nelumbo nucifera) and Rohini (Soymida febrifuqa A.) or Katurohini or meat of pigeon fried in mustard oil together with honey and milk Abhishyandi (increase discharges and obstruction of channels), dilatation of blood vessels, epilepsy, shankhaka (a disease of the head characterised by pain in temporal region), galaganda (goitre), rohini (diphtheria) or even death.
4 Milk intake after intake of radish, garlic, krishnagandha (Moringa oleifera), arjaka (Ocimum gratissimum Linn.), surasa (Ocimum sanctum). Kushtha (obstinate skin diseases/leprosy)
5 Jatuka (Ferula narehex Boiss) shaka or ripe fruit of nikucha (Artocarpus lakoocha Roxb.) with honey and milk   Loss of strength, complexion, sterility and other shukra vikara (diseases of reproductive system), and other serious type of diseases leading to death.  
6   Shaka (leaves) of padmauttarika/ kusumbha shaka (Carthamus tinctorius Linn.), sarkara (type of wine), maireya (type of wine) and honey Aggravate the dosha especially vata
7 Meat of haridraka bird fried in mustard oil Aggravate the dosha, especially pitta.
8   Payasa (milk) when taken with mantha Aggravate the dosha, specially kapha
9   Upodika (Basella rubra) prepared with the paste of tila (sesame)   Causes diarrhoea
10 Meat of crane with varuni (a type of wine)   Instantaneous adverse reactions
11 Kulamasha (dish prepared by steam cooked wheat/grams) is unwholesome, again if fried with shukara vasa (boar/wild pig muscle-fat) Instantaneous adverse reactions
12 Meat of peacock roasted on a castor spit, burnt with castor wood as a fuel and mixed with castor oil   Instantaneous adverse reactions
13 Meat of Haridraka (a bird) roasted on a turmeric spit, burnt with turmeric wood as a fuel or when mixed with honey. Instantaneous adverse reactions
14 Pippali (Piper longum) fried with fish oil   Causes death
15 Kakamachi (Solanum nigrum) with honey Causes death
16 Hot honey or intake of honey by person afflicted with heat Causes death

Concept of samyoga viruddha

Samyoga (combination of two or more substances) viruddha means some drugs or food items will act as unwholesome when taken together or mixed. [Cha. Sa. Sutra Sthana 26/82-83] [Su. Sa. Sutra Sthana 20/13]

Table no. 3: Examples of Samyoga Viruddha and the logical reasons behind their incompatibility:
Sr. no.    Examples of samyoga viruddha Logical reasons of incompatibility
1 Ripe fruit of nikucha (Artocarpus lakoocha Roxb.) with soup of masha (Vigna mungo L.), sugar and ghee Mutually contradictory
2 Amla Rasa food items such as amra (Mangifera indica), amrataka (Spondias pinnata), matulunga (Citrus decumana), nikucha (Artocarpus lakoocha Roxb.), karamarda (Carissa carandas), mocha/shalmali (Salmalia malabarica), dantasatha (Citrus medica), badara (Ziziphus jujuba), koshamra (Schleichera oleosa), bhavya (Dillenia indica), jambu (Syzygium cumini), kapittha (Limonia acidissima), tintidi (Ras parviflora) with milk Mutually contradictory
3 Aksoda (Juglans regia Linn.), panasa (Artocarpus heterophyllus), narikela (Cocos nucifera), dadima (Punica granatum), kulathi (Macrotyloma uniflorum), and amalaki (Phyllantus emblica) or meat of paravata (pigeon) with milk Mutually contradictory
4 Kangu/Kangini dhanya) (Setaria italica Beruv.), vanaka (vana kodo), makustha (Phaseolus aconitifolius), kulattha (Dolichos biflorus), masha (Phaseolus radiatus), nishpava (cowpeas) with milk Mutually contradictory
5 Honey and ghee or honey and rain water in equal quantity, honey with seeds of pushkara (Nelumbo nucifera/ blue lotus), intake of hot water after taking honey, Moolaka (radish) with honey All are unwholesome
6 Bhallataka (Semecarpus anacardium) with hot water All are unwholesome
7 Kampillaka (Mallotus phillippensis) boiled with butter milk All are unwholesome
8 Meat of Bhasa (bearded vulture) roasted with the spit or fire All are unwholesome
9 Stale Kakmachi (Solanum nigrum), Kakmachi with jaggery, Kakmachi with Pippali (Piper longum) or Maricha (Piper nigrum). All are unwholesome
10 Fish with jaggery All are unwholesome
11 Varaha mamsa (pork meat) with milk or jaggery All are unwholesome
12 Kadaliphala (Musa paradisiaca Linn.) i.e., banana with milk, curd or buttermilk or lakuch (Artocarpus lakoocha Roxb.) with milk or curd All are unwholesome
13 Sura (beer), krishra (mess), and payasa (milk pudding) not to be consumed together All are unwholesome

Concept of rasa, virya, vipaka viruddha

Unique concept of viruddha combinations based on rasa (taste), virya (potency), vipaka (post digestion effect) explained in Sushruta Samhita which are as follows: [Su. Sa. Sutra Sthana 20/16]

Table no. 4: Examples of viruddha combinations based on rasa, virya and vipaka:
Sr. no.   Examples of viruddha combinations based on rasa, virya and vipaka Combinations of rasa
1 Rasa viruddha Madhura (sweet) and lavana (salty), amla (sour) and lavana, katu (pungent) and tikta (bitter), katu and kashaya (astringent), tikta and kashaya.  
2 Rasa and virya viruddha Madhura and amla.
3 Rasa and vipaka viruddha Madhura and tikta, madhura and kashaya, amla and katu, lavana and katu.
4 Sarvata viruddha Madhura and katu, amla and tikta, amla and kashaya, lavana and tikta, lavana and kashaya.

Diseases caused by viruddha ahara

Viruddha ahara causes toxic effects on the body. These unwholesome food combinations produce toxins within the body, causing various diseases or may prove fatal. Combinations of such viruddha food sometimes produce immediate effects and sometimes act like gara visha, that produces untoward effects afterwards. [A. H. Sutra Sthana 7/29]
Intake of such unwholesome food combinations results in manifestation of many diseases such as sterility, blindness, erysipelas (visarpa), ascites (jalodara), bullae (visphota), insanity (unmada), fistula in anno (bhagandara), syncope (moorcha), intoxication (mada), abdominal distension (adhmana), goitre (galagraha), pandu (anaemia), poisoning due to ama (ama visha), vitiligo (kilasa), skin diseases (kushtha), digestive disorders (grahini gada), oedema (shotha), acid peptic diseases (amlapitta), fever (jwara), rhinitis (peenasa), genetic and hereditary diseases (santana dosha) and even death. [Cha.Sa. Sutra Sthana 26/102-103]
The following table shows examples of disease caused by the intake of viruddha ahara.

Table no.5: Diseases caused by intake of viruddha ahara:
Sr.no. Diseases References
1 Unmada Cha. Sa. Chikitsa Sthana 9/4
2 Visarpa Cha. Sa. Chikitsa Sthana 21/115
3 Kushtha Cha. Sa. Chikitsa Sthana 7/4
4 Krimi Su. Sa. Uttara Sthana 54/3
5 Apasmara Su. Sa. Uttara Sthana.61/4
6 Arsha Su. Sa. Nidana Sthana 2/4(4)
7 Udara roga Su. Sa. Nidana Sthana 2/5(5)
8 Gara visha A. H. Sutra Sthana 7/29
9 Vatarakta A. H. Nidana Sthana 16/1
10 Grahini dosha A. H. Chikitsa Sthana 10/92
11 Ashta mahagada (eight dreaded diseases) A. Sa. Sutra Sthana 9/11

General treatment

Four main measures have been explained viz., vamana (therapeutic emesis), virechana (therapeutic purgation), virodhi dravya sevana (administration of antidotes) and samshamana (prior use of wholesome substance) for the diseases caused by intake of unwholesome food combinations.

Factors deciding effect of viruddha ahara

If a person is habituated to the intake of such unwholesome food combinations or if taken in very little quantity, then there will be no or less adverse effect of viruddha ahara. Deeptagni (good digestive power), taruna avastha (young age), undergone oleation therapy, having strong physique due to exercise are protective factors against viruddha ahara. In presence of these factors, adverse effect of such unwholesome food combinations is not observed. [Cha.Sa. Sutra Sthana 26/104] So, these practices can be promoted to prevent adverse effects of viruddha ahara.

Importance of knowing viruddha in healthcare

Viruddha Ahara i.e., improper dietic regimens or incompatible food habits, plays a major role in the pathogenesis of various diseases. The incompatible mentioned in classics are not very much in practice now a days, so attempt should be made to identify such dietary incompatibilities. The healthy and unhealthy people should be aware about such factors and must avoid them. Nidana parivarjana i.e., avoiding causative factors of disease is the first and prime treatment. For avoidance of incompatibilities the rules and regulations such as ashtavidha ahara visheshayatana (eight specific dietary guidelines), dwadash ashan pravichara (twelve principles of diet), ahara vidhi (dietary guidelines) are mentioned in Ayurveda. The need of the day is to increase awareness among the public about hazards of such incompatible foods.

Current researches

The concept of viruddha ahara mentioned in classical texts is very much relevant in today’s era because of altered life style of fast food or junk food in their daily life. Many studies have found that some dietary constitutes affect transcription of genes. Association between dietary pattern and diseases has always been a field of interest. Frequent intake of combination of incompatible food leads in to the production of toxins i.e., ama further leads to formation of ama visha (product of improper metabolism), and vitiation of rasa dhatu. It spreads to another dhatu and leads to the manifestation of various diseases. The effects of such incompatibles can be understood by following aspects.

  1. Effects on immune system: Incompatible food combinations impart untoward effects on immune system, cellular metabolism, and Dehydroepiandrosterone sulphate (DHEAS).[1] Viruddha ahara if taken regularly, can cause inflammation at a molecular level, by increasing proistaglandin-2 and thromboxane by disturbing the eicosanoid pathway. This inflammatory effect is important for the basic pathologies which create agnimandya (poor digestion) or ama (undigested food metabolites) which in turns leads to number of metabolic diseases.
  2. Release of toxins: A recent study found that toxin called 4-hydroxy-trans-2-nonenal (HNE) forms when oil such as soyabean and sunflower oils are reheated. Consumption of foods prepared with such reheated oils increases the risks of various ailments such as stroke, cardiovascular diseases, Alzheimer’s disease, various liver diseases and even cancer.

Some common examples of today’s widely used food combinations which act as a viruddha

Number of food incompatibilities are mentioned in old Ayurvedic literature, such as Charaka and Sushruta Samhita. We must identify new food incompatibilities of present era which are very common in today’s daily life. New research should be done on food incompatibilities and create awareness in public about its consequences. Topography deals with scientific studies of combination of foods and its consequences. It tells about the various combinations of basic categories of food. As per topographical studies, protiens should not to be taken with starch and carbohydrates together rather than they should be consumed separately. Because consumption of protein and carbohydrates together will delay the absorption of each other. Similarly, consumption of sugars and acidic fruits together should be avoided as they hinder the action of pepsin and ptyalin which reduces the secretion of saliva and further delays digestion. If sufficient amount of amylase is not present in mouth, then starch will not be digested in the stomach. This unwanted effect of such wrong combinations will affect the gastro-intestinal system and also other major systems of the body. Such reactions may be of less importance, but on long term they can prove to be fatal with serious side effects. Let us have some examples of ahara, we are taking now-a-days unknowingly, which are more harmful.[2]

  1. Tea prepared with milk: Tea contains flavonoids that have beneficial effects on heart. But when milk is added to tea then the milk protein i.e., caseins reduce the effect of flavonoids. Therefore, tea prepared with milk should be avoided.
  2. Milk and curd combination: Dishes prepared with milk or by curd should never be taken together as curd will precipitate or curdles up the milk and hinder its digestion. This irritate the stomach and produces gastric disturbances.
  3. Tea along with garlic preparations: Tea possesses anticoagulant compounds. Garlic possesses anticlotting properties. So, when this combination is taken together, the chances of bleeding increases. Therefore, such combinations to be avoided.
  4. Pomegranate juice and grapefruit juice: Both pomegranate juice and grapefruit juice can block the cytochrome P450 3A4 enzyme systems within the intestines and increases blood levels of medications.
  5. Milkshake/ Smoothie/ Fruit salad/ Custard: Milkshake i.e., combination of food and milk together is the example for samyoga viruddha. Combination of milk with fruit aggravates kapha dosha within the body therefore such combination should be avoided especially for kapha prakriti (constitution) persons. Fruits are mostly acidic in nature. Especially the unripen one, so if they are taken along with milk then milk gets curdeled and produces indigestion. Our body needs different types of enzymes for the breakdown of fruits and different types of enzymes for the breakdown of protein present in milk.
  6. Study over kadaliphala (banana) with milk and their incompatibility: Kadaliphala (Musa Paradisiaca Linn.) along with milk is an example of samyoga viruddha (incompatibility of combination of two or more substances). Banana is already kaphakara (one which aggravates kapha dosha) and milk is also kaphakara so, when both of these taken together, they together provoke kapha dosha in body and diminishes the agni (gastric fire) and produces ama (undigested food) which produces toxins within the body and produces gastric disturbances and other diseases like cough, allergic reactions, etc. This study was planned to evaluate the toxicological implication of their combination on wistar rats. Repeated administration of the combination of cow milk with banana showed statistically significant increase in the level of SGOT and urea whereas, statistically significant decrease in the level of creatinine. Also, alterations in the sections of liver, spleen, heart indicating mild toxic effect of combination of cow’s milk with banana. Hence, continuous intake of such incompatibility proves harmful to the body.[3]
  7. Milk and egg/ baked milk and egg bakery products: Milk and egg combination or combination of milk and egg baked bakery products such as bread, cake, muffins are examples of samyoga viruddha. It is widely used in today’s day to day life mostly at a breakfast time. Milk and egg both are rich in proteins, whereas egg is also called as a reference protein. Both this together should never be consumed as it is heavy to digest and produces ama or indigestion resulting in various allergies or incompatibility. [4]
  8. Honey with warm water: Honey with warm water is example of samyoga viruddha is also widely used nowadays assuming that it will helps in detoxification of body and helps in weight loss which is a big misconception. In Ayurveda, it is mentioned one should never consume honey with warm water because it may prove fatal. Therefore, it is to be avoided. Honey is not collected from any particular flower, but it is made from the sap and juices of different flowers and plants which are incompatible with each other in respect to their rasa (taste), guna (virtue), virya (potency), vipaka (post digestion effect). Furthermore, honey being prepared by poisonous bees, it becomes injurious after contact with heat or fire. Accordingly, the use of hot or boiled honey is forbidden. It is also reported that during nectar and pollen forage, honey bees transform phytochemicals from floral nectars of host plants into honey. The diversity of secondary metabolites in plants attributes to the variance in phytochemical profiles in honey composition.[5]
  9. Study over gutkha and their incompatibility: Gutkha, a combination of kattha (Acacia catechu), slaked lime and arecanut, possesses more than 4000 chemicals combination with more than 40 carcinogenic chemicals. It causes non-healing ulcerative lesions in oral cavity, such as cheek, lips, tongue, hard palate. It induces inflammation at a molecular level, leading to prostaglandin-2 and thromboxane.[6]

Contemporary views

The concept of viruddha ahara mentioned in ayurveda easily correlates with the concept of incompatibility, adverse reactions, food and food interactions, food and drug interactions, etc. Observations on antagonistic food is a unique contribution from Ayurveda in order to prevent internal diseases and synergize action of drugs in the management of disorders. In Ayurveda, it is clearly mentioned that certain combinations should be avoided because they hinder the formation of bodily tissue (dhatu), they vitiate the normal homeostasis of dosha within the body and such combinations are termed as viruddha ahara (incompatible diet). The different combinations of food which is cooked by wrong methods, consumed without following dietic regimens, combined with the food having opposite qualities can be described as viruddha ahara.[7] In present era, modern scientists are still working on this aspect. It is important to understand the mechanism of how viruddha ahara is a cause of many metabolic disorders. It is essential to know certain food combinations, which interact with each other and create many systemic disorders. Food-drug interactions, food-food interactions are a very common phenomenon nowadays which is mostly associated with orally administered medicines. It can occur by multiple factors through change in absorption rate or extent, nature of properties of drug, post prandial physiology, route of drug administration, etc. Thus, understanding of such mechanisms is a must while recommending a specific drug with or without food.[8] Following are some citations for the such incompatibility which is as follows:

  1. Food allergies/ incompatibility
    A study shows that food incompatibilities affect approximately 20% of the general population in western countries. The data shows that in 25% of the affected children and 10% of affected adults, the incompatibility is based on an allergy, that is, on an immunologically generated incompatibility reaction. Gastrointestinal symptoms occur in a third of these cases. Food allergies are caused by IgE-dependent or IgE-independent immunologic reactions, which leads to an inflammatory reaction, in which mast cells, eosinophilic granulocytes, and other cells are involved.[9]

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References

  1. Sabnis M. Viruddha Ahara: A critical view. AYU 2012; 33:332-6
  2. Swetha Chalamalasetty, Tatapudi Mahesh Babu, A. Vijayalakshmi, V. Narasimha. Concept of Viruddha Ahara- The Present Scenario. IAMJ 2017; 5 (2)
  3. Shweta K, Sudhakar, Shobha Bhat K. Toxicological evaluation of banana and milk combination as incompatible diet- An experimental exploration of Samyoga Viruddha concept. JAIM, Elsevier. 2021 Jul-Sep; 12 (3): 427-434
  4. Leonard SA, Nowak-Węgrzyn AH. Baked milk and Eggs Diets for Milk and Egg Allergy Management. Europe PMC. 2015 Jan-Feb;3(1):13-23
  5. Amin, Hetal, Kiran S., Deshbhratar, Vivekkumar Mangilal Chayal. Ayurvedic Challenges for recent use of honey with warm substances. Rasamruta. 2019; 11:15.
  6. Sirdeshpande MK, Kashikar VA. Critical review on Samyoga Viruddha (combination incompatibility) with special emphasis on carcinogenic effect of combination of betel quid, areca nut and tobacco. Ayu. 2017 Jul-Dec;38(3-4):97-101. doi: 10.4103/ayu.AYU_71_16. PMID: 30254386; PMCID: PMC6153908.
  7. Swetha Chalamalasetty, Tatapudi Mahesh Babu, A. Vijayalakshmi, V. Narasimha. Concept of Viruddha Ahara- The Present Scenario. IAMJ 2017; 5 (2)
  8. Deng J, Zhu X, Chen Z, Fan CH, Kwan HS, Wong CH, et.al. A Review of Food-Drug Interactions on Oral Drug Absorption. Drugs. 2017 Nov;77(17):1833-1855
  9. Bischoff, S.C. Food allergies. Springer Link. Current Gastroenterology Reports 8, 374–382 (2006). Available from: https://doi.org/10.1007/s11894-006-0022-8