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Trividhakukshiya Vimana (view source)
Revision as of 07:53, 27 October 2020
, 07:53, 27 October 2020→Vidhi Vimarsha (Applied Inferences)
The proper quantity of food depends on the strength of [[agni]] ( factors responsible for digestion and metabolism). The strength of [[agni]] varies according to season, age and other factors. Thus the amount of food will also vary as per the power of [[agni]]. The suitable variation in quantity of food helps maintaining proper digestion and metabolism. The quantity further subjects to heavy to digest (gurutva) and light to digest (laghutva) nature of food.
The proper quantity of food depends on the strength of [[agni]] ( factors responsible for digestion and metabolism). The strength of [[agni]] varies according to season, age and other factors. Thus the amount of food will also vary as per the power of [[agni]]. The suitable variation in quantity of food helps maintaining proper digestion and metabolism. The quantity further subjects to heavy to digest (gurutva) and light to digest (laghutva) nature of food.
=== Assessment of [[Agni]] (digestion and metabolism) ===
Nourishing benefits of diet is subjected to the status of [[agni]].Thus [[agni]] is an important facilitator between health and food. Assessment of the status of [[agni]] is an essential component in maintenance of health as well as while treating diseased conditions. Singh A, Patwardhan K. et. al. developed and validated a self-assessment tool to estimate strength of [[agni]]. The study also evaluates the practical utility of developed tool by recording serum lipid parameters. Lipid parameters vary significantly according to the status of [agni]]. <ref>Singh A, Singh G, Patwardhan K, Gehlot S. Development, Validation and Verification of a Self-Assessment Tool to Estimate Agnibala (Digestive Strength). J Evid Based Complementary Altern Med. 2017 Jan;22(1):134-140. doi: 10.1177/2156587216656117. Epub 2016 Jul 4.</ref>
Eswaran H T et al have prepared an agni assessment scale with total 64 questions to evaluate the four types of [[agni]]. The study has validated a scale for internal consistency. <ref>Eswaran HT, Kavita MB, Tripaty TB, and Shivakumar. Formation and validation of questionnaire to assess Jāṭharāgni. Anc Sci Life.2015 Apr-Jun; 34(4): 203–209.</ref>
Patil VC, Baghel MS et. al. have developed formulae for assessment of the digestive functions ([[agni]]) in during administration of [[snehana]] (internal oleation). <ref>Patil VC, Baghel MS, Thakar AB. Assessment of [[agni]] (digestive process) and [[koshtha]] (bowel movement with special reference to abhyantara [[snehana]] (internal oleation). Ancient Sci. Life. 2008; 28:26-28</ref>
[[Agni]] performs various functions of digestion, metabolism and assimilation. Gastric secretions is a digestive fluid, formed in the stomach and contain numerous compounds including hydrochloric acid (HCL), pepsin, lipase, mucin. Kulatunga et al assessed the status of [[agni]] in the patients of [[pandu]] (anemia and blood deficiency disorders) and find out its relationship with the acidity of gastric secretions by use of fractional test meal examination. Their study concluded that HCL reduction in patients of anemia seriously affects the protein and iron absorption; thus Hypochlorhydria (found in 72.8% of the patients) indicates hypofunction of [[agni]].<ref>Kulatunga R D H, Rai N P, Ali Z. Status of Agni in Pandu Roga (anemia) and its association with the acidity of gastric secretions-A Clinical Study. IAMJ: Volume 7, Issue 1, January – 2019.</ref>
==== Proper quantity of food ====
==== Proper quantity of food ====
Satiety is one of the subjective parameters to assess the ingestion capacity of a person. The maximum ingestion capacity of a person should be divided into three parts. One-third part of food intake should be consumed in solid form and one third part as liquid diet, remaining one third part of total capacity should be kept empty for movement of [[vata]], [[pitta]] and [[kapha]]. This is the indicator of satiety. This means once the two third part of stomach will be filled, a person will have the feeling of satisfaction [Cha.Sa.[[Sutra Sthana]]25/40]. At this point the person should stop eating. If this limit is crossed, the excess food stuff will occupy the third part of stomach which interrupts the process of digestion, causing extra burden on [[agni]] (digestive power) and may result indigestion. The divisions of stomach (amashaya) are not in equal proportion, but it is in accordance with user’s suitability and the adaptive pattern of food consumption [Chakrapani on Cha.Sa.[[Vimana Sthana]]2/3]. Power of ingestion (abhyavaharana shakti) is different for every individual and it depends upon the strength of digestive capacity (jatharagni). The proper quantity of food (ahara matra) to be consumed is subjected to power of ingestion and consistency of food articles i.e. solid and liquid.
Satiety is one of the subjective parameters to assess the ingestion capacity of a person. The maximum ingestion capacity of a person should be divided into three parts. One-third part of food intake should be consumed in solid form and one third part as liquid diet, remaining one third part of total capacity should be kept empty for movement of [[vata]], [[pitta]] and [[kapha]]. This is the indicator of satiety. This means once the two third part of stomach will be filled, a person will have the feeling of satisfaction [Cha.Sa.[[Sutra Sthana]]25/40]. At this point the person should stop eating. If this limit is crossed, the excess food stuff will occupy the third part of stomach which interrupts the process of digestion, causing extra burden on [[agni]] (digestive power) and may result indigestion. The divisions of stomach (amashaya) are not in equal proportion, but it is in accordance with user’s suitability and the adaptive pattern of food consumption [Chakrapani on Cha.Sa.[[Vimana Sthana]]2/3]. Power of ingestion (abhyavaharana shakti) is different for every individual and it depends upon the strength of digestive capacity (jatharagni). The proper quantity of food (ahara matra) to be consumed is subjected to power of ingestion and consistency of food articles i.e. solid and liquid.
Some Ayurveda scholars have divided ingestion capacity of amashaya in four parts and advised to take two parts with solid food, one part with liquids and rest one fourth part to be left empty for [[dosha]] (as a normal physiology of digestion). [A.Hr.[[Sutra Sthana]]8/46-47]<ref name="A. Hridaya">Vagbhata. Ashtanga Hridayam. Edited by Harishastri Paradkar Vaidya. 1st ed. Varanasi: Krishnadas Academy;2000.</ref> Arundatta, commentator of Vagbhata has considered this capacity of amashaya as the measurement of satiety.
Some Ayurveda scholars have divided ingestion capacity of amashaya in four parts and advised to take two parts with solid food, one part with liquids and rest one fourth part to be left empty for [[dosha]] (as a normal physiology of digestion). [A.Hr.[[Sutra Sthana]]8/46-47]<ref name="A. Hridaya">Vagbhata. Ashtanga Hridayam. Edited by Harishastri Paradkar Vaidya. 1st ed. Varanasi: Krishnadas Academy;2000.</ref> Arundatta, commentator of Vagbhata has considered this capacity of [[amashaya]] as the measurement of satiety.
==== Understanding proper quantity of food (sauhitya matra) and physiological mechanism of satiation====
==== Understanding proper quantity of food (sauhitya matra) and physiological mechanism of satiation====
'''Low satiety phenotype:''' ‘Low satiety phenotype’ is associated with specific behavioral and metabolic profiles that could explain their susceptibility to overeating. These individuals do not recognize their appetite sensation before and after meal. This is considered as an important step in individualized obesity treatment.<ref>DrapeauV, Gallant A. The low satiety phenotype. In: Blundell JE, Bellisle F, ed. Satiation, Satiety and the Control of Food Intake: Woodhead Publishing Series in Food Science, Technology and Nutrition; 2013:Pages 273–297. https://doi.org/10.1533/9780857098719.5.273</ref>
'''Low satiety phenotype:''' ‘Low satiety phenotype’ is associated with specific behavioral and metabolic profiles that could explain their susceptibility to overeating. These individuals do not recognize their appetite sensation before and after meal. This is considered as an important step in individualized obesity treatment.<ref>DrapeauV, Gallant A. The low satiety phenotype. In: Blundell JE, Bellisle F, ed. Satiation, Satiety and the Control of Food Intake: Woodhead Publishing Series in Food Science, Technology and Nutrition; 2013:Pages 273–297. https://doi.org/10.1533/9780857098719.5.273</ref>
==== [[Amashaya]]- Site of digestion ====
Amashaya is a site of digestion of all types of food. After complete digestion, the digested essence of food reaches all the body organs through vessels. Amashaya is a seat of [[pitta dosha]] and [[kapha dosha]] [Cha. Sa.[[Sutra Sthana]] 20/8] and the disorders originated from [[amashaya]] are specifically grouped as the disorders having a predominance of these two [[dosha]]. [Cha.Sa.[[Vimana Sthana]] 6/3] The Pachaka pitta and kledaka kapha play important role in digestion. Surface anatomy describes [[amashaya]] as the organ situated between the umbilicus and the breast. Stomach can be considered as upper segment of [[amashaya]]. Small intestine along with liver and pancreas can be considered as the lower segment of [[amashaya]].
=== Classification of food ===
Depending on the consistency, the food articles are classified into four categories: drinkable, likable, eatable, and chewable. These four types are further abbreviated under two classes as liquid foods and solid foods respectively. Thus both type of food shall be consumed till half of it satiety or till feeling of satiety. This quantity will definitely be digested in due time, without disturbing [[dosha]] physiology ([[prakriti]]), thus indicates proper quantity (aahara matra). Subjective parameters shall be observed carefully to decide the proper quantity of food. [Cha. Sa.[[Vimana Sthana]] 2/6] Food consumed in the appropriate quantity enhances strength, complexion, and nourishment of tissues.
There are other six types of food patterns described depending upon the consistency of food viz.
# Suckables(chushya) e.g. sugarcane
# Drinkable(peya) e.g. water, milk etc.
# Lickables (lehya) e.g. rasala (curd mixed with sugar and spices) and kadhi (a traditional Indian dish consisting mainly of yogurt and gram floor)
# Bhojya (soft eatables) e.g. dal Rice
# Bhakshya (hard eatables) e.g. laddu, modak (kind of sweet meal),
# Charvya (chewables) e.g. poha, roasted horse gram.
These food articles are heavy for digestion in ascending order. [B.P. Prathama Khanda 4/142-143]<ref>Bhavamishra. Bhavaprakasha -Volume I. Translated from Sanskrit by K.R. Srikantha Murthy. 1st ed. Varanasi: Krishnadas academy;2000.</ref>
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==== Effects of deficient quantity of food ====
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A deficient and excessive quantity of food both are detrimental to human health. The deficient quantity of food reduces strength, complexion, and nourishment of body tissues and makes the person a home for various disorders of [[vata dosha]]. The quantity of food is one of the major factors which decide the wholesome and unwholesome effect of food on body tissues. [Cha.Sa.[[Sutra Sthana]] 25/32]
Under eating or intake of food in reduced quantity (pramitashanam) is mentioned as the principal cause of emaciation (karshaniyanam) [Cha.Sa.[[Sutra Sthana]]25/40]. Fasting or over eating does not kindle digestive fire, as like fire in environment is extinguished if there is no fuel supply or if excessive fuel covers the fire. [Cha.Sa.[[Chikitsa Sthana]] 15/211] Taking wholesome food in appropriate quantity after complete digestion of previously eaten food helps to continue good health for long duration.[Cha.Sa.[[Chikitsa Sthana]] 15/214] It is observed that deficient quantity of food deteriorate the digestive capacity of [[agni]] and in absence of sufficient nutrients leads to malnourishment disorders and poor health status.
There are two ways to measure the quantity of food:
# Total quantity of food to be consumed in a meal (sarvagraha)
# Quantity of each food article in a meal (parigraha).
The inclusion of different food articles in a meal is to ascertain all the six rasas (tastes) in the required proportion. The nutritional requirement of everybody tissue is different. Proportionate quantity of six [[rasa]] will ensure the tissue requirement. The balanced diet concept of [[Ayurveda]] is essentially based of this principle. Imbalanced diet concerning six [[rasa]] leads to improper nourishment of body tissues, which further leads to depletion of body tissues ([[dhatu]]) [Cha. Sa.[[Sutra Sthana]] 5/4-Chakrapani]. Long-term exposure of imbalanced diet triggers wear and tear mechanism of tissues and may result in early senility.
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==== Insufficient/deficient quantity of food ====
==== Insufficient/deficient quantity of food ====
* Adopt interdisciplinary approach like inclusion of Yoga techniques to improve mental health.<ref>Baldwin C, Kimber KL, Gibbs M, Weekes CE. Supportive interventions for enhancing dietary intake in malnourished or nutritionally at-risk adults. Cochrane Database Syst Rev. 2016;12(12):CD009840. Published 2016 Dec 20. doi:10.1002/14651858.CD009840.pub2.</ref>
* Adopt interdisciplinary approach like inclusion of Yoga techniques to improve mental health.<ref>Baldwin C, Kimber KL, Gibbs M, Weekes CE. Supportive interventions for enhancing dietary intake in malnourished or nutritionally at-risk adults. Cochrane Database Syst Rev. 2016;12(12):CD009840. Published 2016 Dec 20. doi:10.1002/14651858.CD009840.pub2.</ref>
==== Effects of excessive quantity of food ====
=====Research tools to assess digestive processes (Jatharagni) =====
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Excessive food triggers all three [[dosha]] vitiation as there is no space left for [[dosha]] functioning. [[Dosha]] are the main functional unit of human physiology. [[Dosha]] also govern the physiology of digestion. Samana [[vayu]] functions nearby the abode of digestive fire (jatharagni), kindles [[agni]]. Prana [[vayu]] and apana [[vayu]] supports the functions of [[agni]]. Pachaka [[pitta]] when devoid of its liquid property, functions as digestive fire.[A. Hr. Sutra Sthana 12/10-11]<ref name="A. Hridaya"/> Kledaka [[kapha]] is responsible to moisten the ingested food. Thus the process of digestion is driven by [[dosha]]. Factors responsible for complete transformation and absorption of food(ahara parinamakara bhava) explain this phenomenon in-depth. [Cha.Sa.[[Sharira Sthana]]6/14],[Cha.Sa.[[Chikitsa Sthana]] 15/6-8]. The vitiated [[dosha]] leads to the formation of [[ama]].
Excessive eating is one of the etiological factors for non-communicable diseases like obesity and diabetes mellitus which are more prevalent in society. Excess intake of calorie food which is not processed properly by digestive power (jatharagni) and further utilized by dhatvagni (type of [[agni]] present at tissue level) leads to obesity and related disorders.
==== Understanding links between mental health and gastrointestinal tract mediated through gut microbiota ====
==== Understanding links between mental health and gastrointestinal tract mediated through gut microbiota ====
Research validates the important role of brain and mental health in digestion and metabolism. Mental health is closely linked with gastrointestinal health. Emotions like stress, anxiety, mood swings may trigger stomach problems and gastrointestinal disturbances affect mental health.<ref>Park AJ, Collins J, Blennerhassett PA, Ghia JE, Verdu EF, Bercik P, Collins SM. Altered colonic function and microbiota profile in a mouse model of chronic depression. Neurogastroenterol Motil. 2013 Sep;25(9):733-e575. doi: 10.1111/nmo.12153. Epub 2013 Jun 17. PMID: 23773726; PMCID: PMC3912902.</ref> <ref>Washabau, R. J. (2013). Chapter 41 - Antispasmodic Agents (R. J. Washabau & M. J. B. T.-C. and F. G. Day (eds.); pp. 481–485). W.B. Saunders. https://doi.org/https://doi.org/10.1016/B978-1-4160-3661-6.00041-9
Research validates the important role of brain and mental health in digestion and metabolism. Mental health is closely linked with gastrointestinal health. Emotions like stress, anxiety, mood swings may trigger stomach problems and gastrointestinal disturbances affect mental health.<ref>Park AJ, Collins J, Blennerhassett PA, Ghia JE, Verdu EF, Bercik P, Collins SM. Altered colonic function and microbiota profile in a mouse model of chronic depression. Neurogastroenterol Motil. 2013 Sep;25(9):733-e575. doi: 10.1111/nmo.12153. Epub 2013 Jun 17. PMID: 23773726; PMCID: PMC3912902.</ref> <ref>Washabau, R. J. (2013). Chapter 41 - Antispasmodic Agents (R. J. Washabau & M. J. B. T.-C. and F. G. Day (eds.); pp. 481–485). W.B. Saunders. https://doi.org/https://doi.org/10.1016/B978-1-4160-3661-6.00041-9
https://www.sciencedirect.com/topics/immunology-and-microbiology/gut-brain-axis</ref> Probiotic consumption also has been reported to reduce self-reported feelings of sadness and aggressive thoughts.<ref>Steenbergen L, Sellaro R, van Hemert S, Bosch JA, Colzato LS. A randomized controlled trial to test the effect of multispecies probiotics on cognitive reactivity to sad mood. Brain Behav Immun. 2015 Aug;48:258-64. doi: 10.1016/j.bbi.2015.04.003. Epub 2015 Apr 7. PMID: 25862297.</ref> Study of Sudo et al supports that the hyypothalamic–pituitary–adrenal (HPA) reaction to stress is influenced greatly by gut microbiota.<ref>Sudo N, Chida Y, Aiba Y, Sonoda J, Oyama N, Yu XN, Kubo C, Koga Y. Postnatal microbial colonization programs the hypothalamic-pituitary-adrenal system for stress response in mice. J Physiol. 2004 Jul 1;558(Pt 1):263-75. doi: 10.1113/jphysiol.2004.063388. Epub 2004 May 7. PMID: 15133062; PMCID: PMC1664925.</ref> <ref>Bowey E, Adlercreutz H, Rowland I. Metabolism of isoflavones and lignans by the gut microflora: a study in germ-free and human flora associated rats. Food Chem Toxicol. 2003 May;41(5):631-6. doi: 10.1016/s0278-6915(02)00324-1. PMID: 12659715.</ref> <ref>Pinto-Sanchez MI, Hall GB, Ghajar K, Nardelli A, Bolino C, Lau JT, Martin FP, Cominetti O, Welsh C, Rieder A, Traynor J, Gregory C, De Palma G, Pigrau M, Ford AC, Macri J, Berger B, Bergonzelli G, Surette MG, Collins SM, Moayyedi P, Bercik P. Probiotic Bifidobacterium longum NCC3001 Reduces Depression Scores and Alters Brain Activity: A Pilot Study in Patients With Irritable Bowel Syndrome. Gastroenterology. 2017 Aug;153(2):448-459.e8. doi: 10.1053/j.gastro.2017.05.003. Epub 2017 May 5. PMID: 28483500.</ref>Based on extensive preclinical evidence and clinical observations showing bidirectional signaling pathways of BGM axis, Mayer et al proposed a systems biological model of bidirectional BGM interactions, which revalidate the impact of mental health on gastrointestinal health and vice versa.<ref>Mayer EA, Labus JS, Tillisch K, Cole SW, Baldi P. Towards a systems view of IBS. Nat Rev Gastroenterol Hepatol. 2015 Oct;12(10):592-605. doi: 10.1038/nrgastro.2015.121. Epub 2015 Aug 25. PMID: 26303675; PMCID: PMC5001844.</ref>
https://www.sciencedirect.com/topics/immunology-and-microbiology/gut-brain-axis</ref> Probiotic consumption also has been reported to reduce self-reported feelings of sadness and aggressive thoughts.<ref>Steenbergen L, Sellaro R, van Hemert S, Bosch JA, Colzato LS. A randomized controlled trial to test the effect of multispecies probiotics on cognitive reactivity to sad mood. Brain Behav Immun. 2015 Aug;48:258-64. doi: 10.1016/j.bbi.2015.04.003. Epub 2015 Apr 7. PMID: 25862297.</ref> Study of Sudo et al supports that the hyypothalamic–pituitary–adrenal (HPA) reaction to stress is influenced greatly by gut microbiota.<ref>Sudo N, Chida Y, Aiba Y, Sonoda J, Oyama N, Yu XN, Kubo C, Koga Y. Postnatal microbial colonization programs the hypothalamic-pituitary-adrenal system for stress response in mice. J Physiol. 2004 Jul 1;558(Pt 1):263-75. doi: 10.1113/jphysiol.2004.063388. Epub 2004 May 7. PMID: 15133062; PMCID: PMC1664925.</ref> <ref>Bowey E, Adlercreutz H, Rowland I. Metabolism of isoflavones and lignans by the gut microflora: a study in germ-free and human flora associated rats. Food Chem Toxicol. 2003 May;41(5):631-6. doi: 10.1016/s0278-6915(02)00324-1. PMID: 12659715.</ref> <ref>Pinto-Sanchez MI, Hall GB, Ghajar K, Nardelli A, Bolino C, Lau JT, Martin FP, Cominetti O, Welsh C, Rieder A, Traynor J, Gregory C, De Palma G, Pigrau M, Ford AC, Macri J, Berger B, Bergonzelli G, Surette MG, Collins SM, Moayyedi P, Bercik P. Probiotic Bifidobacterium longum NCC3001 Reduces Depression Scores and Alters Brain Activity: A Pilot Study in Patients With Irritable Bowel Syndrome. Gastroenterology. 2017 Aug;153(2):448-459.e8. doi: 10.1053/j.gastro.2017.05.003. Epub 2017 May 5. PMID: 28483500.</ref>Based on extensive preclinical evidence and clinical observations showing bidirectional signaling pathways of BGM axis, Mayer et al proposed a systems biological model of bidirectional BGM interactions, which revalidate the impact of mental health on gastrointestinal health and vice versa.<ref>Mayer EA, Labus JS, Tillisch K, Cole SW, Baldi P. Towards a systems view of IBS. Nat Rev Gastroenterol Hepatol. 2015 Oct;12(10):592-605. doi: 10.1038/nrgastro.2015.121. Epub 2015 Aug 25. PMID: 26303675; PMCID: PMC5001844.</ref>
=== Concept of [[ama]] ===
=== Concept of [[ama]] ===
[[Ama]] formation occurs due to the accumulation of toxic or intermediate product of metabolism in the body termed as mala. These intermediate products are formed due to defect in the metabolism of protein, carbohydrate or lipid. Excessive uric acid is formed due to improper metabolism of protein which is hazardous to body tissue and joint structure. Lactic acid, acetone and ketone bodies are formed due to improper metabolism of carbohydrate and fats. Lack of insulin activity defunct carbohydrate metabolism and leads to formation of intermediate products in the body. This intermediate products act as [[ama]] and leads to many disease conditions.
[[Ama]] formation occurs due to the accumulation of toxic or intermediate product of metabolism in the body termed as mala. These intermediate products are formed due to defect in the metabolism of protein, carbohydrate or lipid. Excessive uric acid is formed due to improper metabolism of protein which is hazardous to body tissue and joint structure. Lactic acid, acetone and ketone bodies are formed due to improper metabolism of carbohydrate and fats. Lack of insulin activity defunct carbohydrate metabolism and leads to formation of intermediate products in the body. This intermediate products act as [[ama]] and leads to many disease conditions.
'''Metabolic waste functions as [[ama]]''': Tissue nutrients after action of metabolism (dhatvagni) nourishes body tissues and part is formed as excretory product ([[mala]]). Accumulation of this metabolic waste beyond certain limits disrupts the [[dosha]] hemostasis, leads to formation of [[ama]]. Depending on the type of metabolic waste and predominance of doshas exhibits many diseases.
'''Metabolic waste functions as [[ama]]''': Tissue nutrients after action of metabolism (dhatvagni) nourishes body tissues and part is formed as excretory product ([[mala]]). Accumulation of this metabolic waste beyond certain limits disrupts the [[dosha]] hemostasis, leads to formation of [[ama]]. Depending on the type of metabolic waste and predominance of [[dosha]] exhibits many diseases.
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=== Research theses done (M.D./Ph.D.(Ayurveda) reserach works) ===
=== Research theses done (M.D./Ph.D.(Ayurveda) research works) ===
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#Badeka B.P.(1964 ) : Aam vivechan. Institute for Post Graduate Teaching & Research in Ayurveda, Gujarat Ayurved University, Jamnagar.
#Badeka B.P.(1964 ) : Aam vivechan. Institute for Post Graduate Teaching & Research in Ayurveda, Gujarat Ayurved University, Jamnagar.