Upavasa

Upavasa is an exercise of restraining all activities. The word upavasa is widely applied for therapeutic fasting. However, practicing upavasa includes many other abstaining measures. Upavasa is one of the spiritual therapies and a type of langhana (that which produces lightness of the body) therapy[Cha.Sa. SutraSthana 22/18]. Upavasa is a religious and spiritual practice in many countries of South East Asia region. Greek physician Hippocrates has said “Continuous intake of food without the elimination of waste materials from the body is deleterious to one’s health and fasting is the best natural remedy.”.Indian sages practiced upavasa to gain more spiritual powers. ‘Ekadashi (Eleventh day after full moon and new moon)’ Upavasa, Shivaratri Upavasa, Chatpuja Upavasa etc. are traditionally followed as religious practices. There are different type of upavasa that may be compared with calorie restriction. It includes lowering 30-40 percent of usual calorie consumption, while maintaining all the necessary nutrients and vitamins to support life. This article describes the concepts and practices of upavasa in detail.

Contributors

Section/Chapter/topic	Concepts& Practices /Upavasa
Authors	Bhojani M. K. 1, AcharyaRashmi Rekha 1 Deepankar Rahul1
Reviewer	Basisht G.2,
Editor	Deole Y.S.3
Affiliations	1 Department of Sharir Kriya, All India Institute of Ayurveda, New Delhi, India 2Rheumatologist, Orlando, Florida, U.S.A. 3Department ofKayachikitsa, G.J.Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India
Correspondence emails	meera.samhita@aiia.gov.in, carakasamhita@gmail.com
Publisher	Charak Samhita Research, Training and Development Centre, I.T.R.A., Jamnagar, India
Date of publication:	November 29, 2022
DOI	10.47468/CSNE.2022.e01.s09.119

Etymology

The Sanskrit word ‘Upavasa’ is derived from verb ‘vasa’ (dhatu meaning to dwell or to stay) and ‘ghnya’ pratyaya. It starts with prefix ‘Upa’ (upa+vas+ghnya), meaning towards, near to, by the side of.Thus, the word ‘upavasa’ means to abide by a state of abstinence and abstain from food.
Upavasa means “to sit or stay near (the God or divinity)”, to maintain God in close proximity to your heart and mind. Upavasa has an inbuilt orientation of divine therapy. In a therapeutic sense, it can be considered as staying near oneself or giving rest to the agni(GodVaishwanara).

Definition

• Ahoratrabhojanaabhava: Lack of food for the whole day and night.
• Sarvabhogavivarjana: Abstaining from every single delight of senses, mind, and body.
• In general, upavasa denotes abiding in a state of abstinence and one should refrain from food and other psychological tendencies like desires(ichcha), anger(krodha), grief(shoka), greed(lobha), fascination(moha) etc.

Synonyms

• Upavasa
• Upasa
• Aupavasa
• Anasana
• Laghubhojana
• Bhojanaparityaga
• Upavastam
• Uposhitam
• Uposhanam
• Auopavratam
• Vrata
• Vratopavasa

Types

• Generally: Two types are described based on oral intake.
1. Nirahara: without taking any food
• Sajala: with water
• Nirjala: without consumption of water
2. Phalahara: Taking fruits only
• In naturopathy practices: Three types
1. Laghuupavasa (1-3 days)
2. Madhyamupavasa (4-6 days)
3. Dirghaupavasa (7 to 30-40 days)
• According to Vachaspatyam: two types [Vachaspatyam-1322]
1. Vaidha or lawful fasting
2. Avaidha or lawless fasting
• According to Jainism:
1. Ekashana: Having a single meal a day.
2. Aayambil: Having one meal per day and boiled water along with restrictions for some particular food items like milk, curd, cheese, sugar, oil, tea, coffee, sour, spicy food
3. Biyashana: Having two meals per day
4. Unodara: Consuming smaller portions than desired and avoiding hunger.
5. VruttiSankshep: restricting the amount of food consumed.
6. Rasa parityag: renunciation of one's favourite meals.
7. ChauviharUpavasa: From the preceding dusk till the dawn of the third day, any sort of food and liquid is prohibited.
8. TriviharUpavasa: From the previous evening's sundown through the next morning's sunrise, all food and liquids are prohibited.
9. Aathai: Foreight days without meals, just boiled water is consumed.
10. Navai: For nine days without meals, just boiled water is consumed.
11. Solbhatu: For sixteen days without meals, just boiled water is consumed.
12. Maaskshaman: To abstain from food for a full month.
13. Varshitap: Individual consumes only on alternate days between dawn and dusk.
• According to some other acharya
1. Kalikaupavasa: Fasting for a specific time duration in a day.
2. Dugdhakalpa: When only milk is permissible for drinking during fasting.
3. Rasoupavasa:When an individual restricts oneself to a specific taste.

Upavasavis-à-vis pratyahara

‘Pratyahara’ means control of ahara. It is the fifth step among the eight steps described by sage Patanjali in the book Yoga sutra. As yoga shastra describes three levels of food:

Nourishment of every individual is carried out by the help of earth, water, fire, air and ether which is present in physical form of food. For the nourishment of mind, subtle elements together constitute smell, taste, sight, touch and the sensation of sound.
One should refrain from junk food, wrong consortium etc. and should emphasize on correct food eating habits, right consortium etc. These are the two folds known by the term ‘Pratyahara’.

1. Physical food: Every meal comprises of five elements which are essential for the nourishment, growth and overall development of the body.
2. Impressions : Our mind retains all the things perceived through our five senses.
Associations: Our food habit also has impact on our mind and they are inter related to each other as stated in Bhagvat Gita about sattvik, rajasik and tamasik food which affect sattva, rajas and tamas guna of our mind.

By this, upavasa(fasting) touches all the virtues of the tripod of human life.

Prerequisite

Following factors should be considered before practicing upavasa.

• Prakriti (constitution)
• vaya (age)
• rogibala (strength of the patient)
• vyadhibala (strength of the disease)
• kala (time period)
• satmya (habit)
• agni (digestive capacity)
• desha (habitat)

Method of withdrawal from fast

Favorable outcome of a fast depends on how it is broken.

The following day of the fast, after evacuation of bowel and bladder properly, one should consume unctuous, sweet, soft, tasty and sattvik food. Do not overindulge oneself in over eating, abstain from quick eating and food should be chewed properly and thoroughly, gradual changes in normal diet should be made after few days.

Therapeutically, this is depicted in the sansarjana krama (post purification measures) after purification (shodhana) therapy; wherein it starts with peya– a low calorie intake and ends with krutamamsa rasa – a high calorie intake. This gradual withdrawal and adaptation enhances the digestive capacity and helps the body become accustomed to regular food again.

Indication of upavasa

Following disorders with mild intensity are treated with upavasa.
Vami (vomiting), atisara (diarrhoea), gaurav (heaviness), hrudrog (heart-related disorder), acute intestinal irritation (cholera), alasaka (delayed emptying of stomach or sluggish bowels), jwara (fever), arochaka (anorexia), kapha-pittaroga (disorders due to kapha and pitta predominance). [Cha.Sa. Sutra Sthana 22/20]

Contraindications

1. Patients with disease from elevated vata dosha should abstain oneself from fasting and those who have unrestrained thirst and hunger, aged and children, pregnant lady and sick person should avoid fasting.
2. As stated by acharya Charak, pregnant woman with aggravated vata who practice frequent fasting develop retardation of fetus. This underdevelopment stays for long without any other signs, known as ‘Nagodara’. [Ch.Sa. Shareerasthana 8/26]
3. Fasting is contraindicated in vataja diseases, chronic diseases and fever, along with this, in people with anger, jealousy and psychological disorders. [Ch.Sa. Chikitsasthana 3/140]

Physiology of fasting

• Glycogen, a polymer of glucose, is stored in the liver and during non- availability of food, certain enzymes break it down into glucose, which provides energy to the body. If one never fasts, this enzyme system that breaks glycogen into glucose may not remain effective. Therefore, periodical fasting is considered beneficial to the body. Once the glycogen reserve is exhausted, the adipose tissue comes to the rescue of the fasting person.
• During fasting, firstly, blood glucose is used for energy. Next to that, glycogen stored in hepatocytes is utilized. This increases the breakdown of adipose tissues which is stated as lipolysis. As a result of which, more fatty acids and glycerol are formed and released into blood.
  Ketones are produced in our body. Fatty acids are transported to hepatocytes, then get metabolized to produce Beta-hydroxybutyrate (3-OHB) and acetoacetate. This induces mitochondrial biogenesis. Ketones are carried into cells with high metabolic activities like neurons, muscles etc., converted into acetyl coenzyme A. It enters into Tricarboxylic acid cycle where ATP are generated. Glucose is primary source of energy, but it gets shifted to fatty acids and ketones during fasting.
• Prolonged fasting is not advisable, as fasting for extended periods makes the fat cells pathological. Further, during fasting the cell membrane lining the intestine undergoes a reorientation program to achieve maximum efficiency. The membrane cholesterol level goes down; hence, the membrane becomes free and absorbs more during fasting.
• Fasting also has an inhibitory effect on cell proliferation and eliminates pre-neoplastic cells.

Probable mode of action of upavasa

• Upavasa makes the body light by relieving heaviness and clears the channels. So, during fasting, our body, as well as mind, feels light. Heaviness is the characteristic of kapha. Kapha creates a blockage in the channels of our body.
• During Upavasa, Agni, previously busy with digestion, becomes free; hence it digests the undigested food already present in the body. Then it digests the samadosha, dhatu and mala.
• The atmospheric air and the heat dry up the small water bodies on the earth's surface. Similarly, fasting increases vayu and agnimahabhuta (the air and fire components) in the body. This in turn dries up the mildly vitiated dosha. [Cha.Sa. Vimana Sthana 03/44]

Applied aspect of upavasa(fasting)

1. Diagnosis of disease:
   The desire to fast may be used as a diagnostic criterion forvataocclusion by excessive kapha dosha. [Cha.Sa.ChikitsaSthana 28/63]
2. In management of disease:
• Fever (jwararoga) [Cha.Sa.ChikitsaSthana 3/139],
• Blood vitiation (raktajaroga) [Cha.Sa. Sutra Sthana 24/18]
• Diseases originating from the stomach (amashaya) can be treated through fasting. [Cha.Sa. NidanaSthana 8/31]
• Bleeding disorders (raktapitta) especially urdhwajaraktapitta through the upper orifices (eyes, mouth, and nose) [Cha.Sa.ChikitsaSthana 4/30],
• Noninfectious gastroenteritis (visuchika). [Cha.Sa.VimanaSthana 2/13],
• Mild aggravate dosha can be managed by fasting therapy in case of diarrhea (Atisara) [Cha.Sa.ChikitsaSthana 19/19],
• In all disorders of nutritive fluid (rasa dhatu) [Cha.Sa.SutraSthana 28/25] and the conditions affecting mouth and oral cavity. [Cha.Sa. ChikitsaSthana 12/80]
• Disorders due to over-nutrition (santarpanjanyavikara) [Cha.Sa. Sutra Sthana 23/8]
• In the prodromal stage of all varieties of erysipelas (visarpa) [Cha.Sa.ChikitsaSthan 21/44]
• Indigestion caused due to ama (amajeerna). [Su.Sa. SutraSthana. 46/505]
• Fissure in ano associated with ama. [Cha.Sa. SiddhiSthana 6/63]
• Grahaniroga[Cha.Sa. ChikitsaSthan 15/65]
• Akshiroga, Udararoga, Pratishyaya, Vrana
• Fasting can improve or even cure diseases related to cardiovascular system, circulatory system, digestive system, locomotor system (ex. rheumatism), respiratory system (ex. asthma)
3. In the preservation of health:
• To maintain equilibrium of dosha in body, wintertime is favorable for fasting (hemanta and shishira). [Cha.Sa. Sutra Sthana 22/24]
• Upavasa should be practiced on a regular interval in obese people to remove toxic metabolic products (ama).
4. It is a kind of spiritual therapy (daivyavyapashayachikitsa). So, in prajnaparadhajanyavyadhi which may be compared with life style disorder, the upavasa procedure can be very helpful.
5. Upavasa can make the body light by relieving heaviness. Heaviness is generally caused by kapha dosha, similarly obstruction of the body channel also occurs because of kapha dosha. So upavasa helps in all the kapha and kapha associated with pitta diseases.
6. It removes toxins (ama): The fire intensity is reduced by the remaining ash particles on it and hampers the burning process. Similarly, in the human body, the vitiated dosha lessen the power and disable the digestive capacity. It causes stomach related debilitation, and produces ama. These ama get accumulated in our body and block the minute channels which leads to diseases. During fasting, digestive process gets ignited and destroys metabolic toxins, and clears the blockages of channels.
7. Reducing fat: Fasting dissolves all unnecessary and unnatural fat deposits all over the body.
8. Our senses become more active during fasting.
9. Excellent remedy for physical, mental, and spiritual upliftment.
10. The physiological effect: lowering of blood sugar, lowering of cholesterol, lowering of systolic blood pressure
11. Restoring youthfulness and longevity: Fasting hastens the destruction of the body's decaying tissues through hunger and then builds new tissues through nutrition. Therefore, fasting is regarded as an effective means of restoring youthfulness and longevity.
12. Several physicians advise patients to skip meals, sometimes for a few days, before prescribing them a controlled diet.
13. Fasting is helpful in reducing the symptoms in some psychological disorders like depression, anxiety, schizophrenia etc.
14. Upavasa(fasting) during pandemic: The importance of fasting is described in janapadoddhvamsaneeya vimana adhyaya. Regular practice of fasting was very helpful for COVID-19 patients.Fasting has an added effect to vaccination which strengthen our immune system during the pandemic and after the pandemic also.

Myths and misconceptions related to fasting

• Fasting vis-a-vis starvation: People think food is the only energy source for our body. If they fast, they will starve their body, but fasting and starvation are different.
• Fasting can be used for underweight people: Fasting can be judiciously used in the person who cannot gain weight. As metabolism is improved through fasting,the body regains the capability to assimilate proteins, fats, carbohydrates, starches, sugars, minerals, vitamins, and all other essential nutrients necessary because all organs work appropriately after fasting.
• Weakness: In the clinical features of appropriate langhana therapy, lightness of the body, lack of drowsiness, exertion or fatigue, and many other symptoms are mentioned.These indicate positive physiology. Thus, weakness is not the outcome mentioned for langhananeither it is expected. Only after the Shodhana kind of Langhana this maybe found.

Autophagy vis-a-visupavasa

• Autophagy (self-eating) is a metabolic process in which the cell eliminates non-essential components via a lysosome-dependent, regulatory mechanism. It transforms cellulardetritus into survival-essential energy.
• Autophagy occurs in our body primarily during the energy deprivation phase, such as fasting. Fasting destroys metabolic toxins, ignites the digestive fire and clears all the blockage in our body's channels, which ultimately provides good health. Fasting is a ubiquitous religious and cultural practice that is found, in varying forms, across the world.
• Fasting stimulate autophagy,it helps in the cell renewal process and it also help in declining the aging process.

Researches on fasting and its effect on physiology

1. Fasting and the brain:
   Fontan-Lozano A, Saez-Cassanelli JL, Inda MC, de losSantosArteaga M, Sierra-Dominguez SA, Lopez-Lluch G, DelgadoGarcia JM, Carrion AM. Caloric restriction increases learning consolidation and facilitates synaptic plasticity through mechanisms dependent on NR2B subunits of the NMDA receptor. J Neurosci. 2007; 27:10185–10195
2. Fasting and factors implicated in aging:
   Guevara-Aguirre J, Balasubramanian P, Guevara-Aguirre M, Wei M, Madia F, Cheng CW, Hwang D, Martin-Montalvo A, Saavedra J, Ingles S, de Cabo R, Cohen P, Longo VD. Growth hormone receptor deficiency is associated with a major reduction in pro-aging signaling, cancer, and diabetes in humans. SciTransl Med. 2011;16;3(70):70ra13.
3. Fasting and cancer:
   Longo VD, Mattson MP. Fasting: molecular mechanisms and clinical applications. Cell Metab. 2014;19(2):181-92.
4. Fasting and inflammation and hypertension:
   Goldhamer AC, Lisle DJ, Sultana P, Anderson SV, Parpia B, Hughes B, Campbell TC. Medically supervised water-only fasting in the treatment of borderline hypertension. J Altern Complement Med. 2002; 8:643–650.
5. Fasting and metabolic syndrome:
   Klempel MC, Kroeger CM, Varady KA. Alternate day fasting (ADF) with a high-fat diet produces similar weight loss and cardio-protection as ADF with a low-fat diet. Metabolism: clinical and experimental. 2013; 62:137–143.
6. Fasting and self-control:
   The findings of a famous psychology experiment termed the Stanford marshmallow experiment, are closely related to the traditional reason behind fasting. In the experiment, children were left in a room alone for 15 minutes and given a candy. They were given a promise that if the child did not eat the candy at the end of the 15 minutes, he/she would get two candies. Children who could control the temptation for 15 minutes to get the reward were later tracked in life. After 2 decades, they became way more successful than the kids who got tempted to eat the candy as soon as they were given it. Fifty years post the experiment, the researcher talks about self-controlas a muscle that must be exercised and built.
7. Fasting and autophagy:
   The controlled digestion of internal cell components is called autophagy.Basically, when we give fuel to mitochondria, when they don’t need them, they release a large number of electrons, giving rise to reactive oxygen species that act as free radicals. These free radicals damage not only mitochondria, but also nuclear DNA. Yoshinori Ohsumi a cellular biologist from Japan, was awarded a Nobel Prize in 2016 in physiology and medicine for discovering the importance of autophagy for many physiological processes such as adaption to fasting and the Mechanism of Autophagy.

Theses and research works done

1. Ami Rajani, Mahesh Kumar Vyas, Hitesh A. Vyas(2009): Comparative study of Upavasa and Upavasa with Pachana in the management of Agnisada. Department of basic principles. I.P.G.T.R.A, Jamnagar
2. Mehta M. J. (1991) :ApatarpanaChikitsaSiddhantagataLaghuPachanaChikitsaKa SaiddhantikaevamPrayogikaManikeekarana. Department of basic principles. I.P.G.T.R.A, Jamnagar
3. A Study on DashavidhaLanghana in perspective of Autophagy to assess the role of Paachana modality to cause Autophagy in patients of MedoDushti(Dyslipidaemia) Dr. Anita Choudhary,Prof. Mahesh Vyas,Dr. Meera K. Bhojani(AIIA) (2021)

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