Distinct from traditional ayurveda, it emphasizes the role of consciousness, and gives importance to positive emotions. A 1991 article in the Journal of the American Medical Association found that promoters of MVAH failed to disclose financial incentives when they submitted a letter for publication and that their marketing practices were misleading. A 2008 study published in JAMA reported that two of the 19 Maharishi Ayurveda products tested contained heavy metals.