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Preventive Healthcare, An Ayurvedic Perspective

Preventive Healthcare, An Ayurvedic Perspective. Dr. Pratibha Shah MD (Ay.). The Spectrum. Diet Rat Race Lifestyle Fast Pace Meditation STRESS HEALTH DISEASE. Diseases of the new world.

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Preventive Healthcare, An Ayurvedic Perspective

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  1. Preventive Healthcare, An Ayurvedic Perspective Dr. Pratibha Shah MD (Ay.)

  2. The Spectrum Diet Rat Race Lifestyle Fast Pace MeditationSTRESS HEALTH DISEASE Consulate General of India 2010

  3. Diseases of the new world Consulate General of India 2010

  4. Why do we need Prevention? • Health is a fundamental human right • To improve the quality of life • To bring down the cost of healthcare • To decrease DALYs • To increase QALYs Consulate General of India 2010

  5. WHO Constitution: "the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being..." http://www.who.int/hhr/en/ Declaration of Alma-Ata: International Conference on Primary Health Care, Alma-Ata, USSR, 6-12 September, 1978 The Conference strongly reaffirms that health, which is a state of complete physical, mental and social wellbeing, and not merely the absence of disease or infirmity, is a fundamental human right and that the attainment of the highest possible level of health is a most important world-wide social goal……… http://www.searo.who.int/LinkFiles/Health_Systems_declaration_almaata.pdf Consulate General of India 2010

  6. Goals of Ayurved Broadly speaking, Ayurved states two main goals namely: • ‘Swasthasya swasthya rakshanam’ • ‘Aturasya vikaar prashamanam ch’ (Ch.Su.30/26) Consulate General of India 2010

  7. Tenets of Preventive Healthcare in Ayurved Consulate General of India 2010

  8. Factors affecting immunity at conception, and in the prenatal period • Maternal factors - Health of the female sex cell - Health of the Uterus - Regimen followed during pregnancy, including diet Consulate General of India 2010

  9. Factors affecting immunity at conception…..cont’d • Maternal factors cont’d - Mental health of the mother during pregnancy - Influencing external factors during pregnancy Consulate General of India 2010

  10. Factors affecting immunity at conception….cont’d • Paternal factors - Health of the male sex cell Consulate General of India 2010

  11. Activities performed immediately after birth - Fontanelle are covered with a piece of cotton soaked in ghee - Baby is administered ‘saindhav lavan’ (rock salt) mixed with ghee orally, for cleansing - A lot of anti-septic procedures are performed, including fumigation Consulate General of India 2010

  12. ‘Sanskaras’ (rituals) performed in childhood Out of the 13 – 40 ‘sanskaras’ or rituals that are advised in the childhood period, the most mentionable, from a health point of view is the ‘karnvedhana sansakara’ or piercing of the ears. It is supposed to confer immunity against respiratory and certain other disorders. Consulate General of India 2010

  13. Daily regimen - Waking up early - Attending to nature’s calls - Cleaning teeth and tongue with any of the prescribed herb twigs - Doing ‘gandoosh’ or ‘kaval dharan’ for multiple health benefits - Eye care with ‘anjan’, ‘tarpan’, ‘putpaak’, ‘sek’, etc. Consulate General of India 2010

  14. Dr. Mary Martha Stevens, Chairperson of the Dental Hygiene Department of Wichita State University, found that people who gargled with sesame oil daily had significantly lower (p<0.001) bacteria colony types in sub-gingival probe specimens (“The effects of a sesame oil mouth rinse on the number of oral bacteria colony types.”) (Presented at the 11th International Symposium on Dental Hygiene, Ottawa, Canada, June 1989) Consulate General of India 2010

  15. Daily regimen cont’d - Nasal cavity and sinus care with ‘nasya’. - Ear care - Whole body and specific body part massage - Exercise - Others – shaving, cutting nails, etc. Consulate General of India 2010

  16. Studies on benefits of massage Significant benefits from massaging newborns, such as enhanced weight gain and responsiveness (Field T, Scafidi F, Schanberg S 1987 Massage of pre term newborns to improve growth and development. Pediatric Nursing 13:385-387) (Rice R 1977 Neurophysiological development in premature infants following stimulation, Developmental Psychology 13:69-76) Consulate General of India 2010

  17. Seasonal regimen There are 6 ‘ritus’ or seasons according to Ayurved, namely – ‘Hemant’, ‘Shishir’ (Winter), ‘Vasant’ (Spring), ‘Greeshm’ (Summer), ‘Varsha’ (Monsoon), ‘Sharad’ (Fall). Characteristics and the dos and don’ts of each of these seasons, including diet and regimen are described in great detail. Consulate General of India 2010

  18. Giving heed to factors like ‘bala’, ‘kala’, ‘sattva’, etc. Every individual has a different level of ‘bala’, ‘sattva’ and other individual attributes. Also, there are factors like ‘kala’, etc. which need to be taken into consideration before undertaking any activity. Consulate General of India 2010

  19. Knowing your body type and eating and living accordingly • Based on dosha predominance, there are 7 body types • Each body type characteristics are listed with fine details and therefore it is possible to identify every individual’s body type. • If the individual follows the diet, regimen and lifestyle according to one’s body type, he or she can keep diseases at bay Consulate General of India 2010

  20. Taking care of mental health • Mental health is an important component of one’s health • Mind and mental attributes have been described in great detail in Ayurvedic texts • Various means of maintaining mental health like meditation, chantings, charity, etc. have been listed Consulate General of India 2010

  21. Recognizing prodromal symptoms • This is one of the strongest areas of Ayurved. • Prodromal symptoms for virtually every disease have been elaborately described. • Recognizing prodromal symptoms and starting preventive care at that stage, is a major tool to prevent a full blown disease. Consulate General of India 2010

  22. Others • A lot of other instructional gems are found throughout the ancient Ayurvedic texts. • Some pertain to diet – various types of diets, diet categories, seasonal diets, unhealthy/contradictory food combinations, rules to be followed while eating, etc. are found in elaborate detail • Some pertain to Public Health issues Consulate General of India 2010

  23. The three upstambh (pillars) of health • Aahaar (Diet) • Nidra (Sleep) • Brahmacharya (Controlled celibacy) Consulate General of India 2010

  24. Importance of Aahaar (diet) • Of the three pillars of health, aahaar or diet is the most important, and that is why it is mentioned first • Of all the factors that are responsible for the growth and development of the human body, diet is the most important. (Ch. Sh. 6/12) Consulate General of India 2010

  25. Hitaahaar (Beneficial or conducive diet) Hitaahaar: • Is panchbhautik (made up of 5 components – Earth, Water, Fire, Air, Space), because every individual is panchbhautik • Has shadras (6 tastes), or has all or most of them or has rasas according to prakruti (body type) • Is liked by the one eating • Is clean and pure • Not very hot • Has been freshly prepared (Ch. Soo. 25/33)(Su. Soo. 46/465) Consulate General of India 2010

  26. Importance of hitaahaar (conducive diet) • It is only hitaahaar that is solely responsible for shareervriddhi (growth and development of the body) and maintenance of health. On the contrary, ahitaahaar (inconducive diet) is responsible for disease development. • Although there are other factors in the development of the body, aahaar is the most important (Ch. Soo. 25/33) Consulate General of India 2010

  27. Fundamentals and rules of Aahaar • Food should be prepared and served by well wishing people or aids. • The kitchen/cooking area should be clean and not congested • For kings, testing for poisoning should be done before food is served. (Su. Soo. 46/451-453) Consulate General of India 2010

  28. Fundamentals and rules of Aahaar (cont’d) Rules for vessels or containers: • Ghee should be served in cast iron bowls • Drinks like water to be served in silver containers, clay glasses, glasses made up of alum or glass; or boiled and cooled water can be stored and served in brass containers. • Drinks like alcohol or cold drinks should be served in containers made up of clay, glass or alum. (Su. Soo. 46/454-455) Consulate General of India 2010

  29. Fundamentals and rules of Aahaar (cont’d) • Fruit juices, soups and liquid food should be served in silver containers. • Dry accompaniments to the food, and food processed with yogurt should be served in containers made of gold. • Food and fruits to be served on clean leaves of banana, palash (Butea monosperma), etc. (Su. Soo. 46/456) Consulate General of India 2010

  30. Fundamentals and rules of Aahaar (cont’d) Rules for serving: • The one being served should be seated on even, clean ground. • The serving area should be pleasant, not a thorough fare, and should be fragrance, flowers and other things that are pleasant to the senses, around him. (Su. Soo.46/457) Consulate General of India 2010

  31. Fundamentals and rules of Aahaar (cont’d) • Fruits, solids and other dry edibles like paapad (cracker), etc. should be placed on the right side of the plate. • All liquids like water, fruit juice, soup, alcohol, etc. should be placed on the left side of the plate. (Su. Soo. 46/458) Consulate General of India 2010

  32. Fundamentals and rules of Aahaar (cont’d) • Sweets and jaggery preparations should be placed towards the front portion of the plate. • After having placed all these accompaniments, the server should carefully and respectfully serve the main dishes in the center of the plate. • Dishes should be served in order of liking, starting with the least favorite dish and ending with the most favorite. (Su. Soo. 46/459) Consulate General of India 2010

  33. Fundamentals and rules of Aahaar (cont’d) Rules for the one eating: • Should be hungry • Should sit straight on a slightly elevated seat • Should eat in silence focusing on the food • Should eat not too fast, nor too slow, chewing many times before swallowing • Should rinse mouth when changing rasa • Should drink sips of water in between meals • Should floss with herb twig or silver/brass wire, after meals (Su. Soo. 46/471, 489) Consulate General of India 2010

  34. Fundamentals and rules of Aahaar (cont’d) Rules for the one eating: Do not eat – • Before or after meal time • Less or more • Contaminated, uncovered, spoilt, burnt food. • Left over food • Food that you do not like, or that which tastes and smells bad • Food that has not been cooked properly • Food that has been reheated, was cooked long time back or is very cold. Consulate General of India 2010

  35. Fundamentals and rules of Aahaar (cont’d) Rule for optimum serving: • According to one’s agni (digestive fire) • Conducive to one’s doshicprakruti (body type according to dosha) • That which gets digested in time (Ch. Soo. 5/1-4) Consulate General of India 2010

  36. Fundamentals and rules of Aahaar (cont’d) Qualitative assessment: • Assessing the gurutva/laghutva of the diet: - One must evaluate whether the food is guru (heavy) (milk products like curd, cream, etc., red meat, meat of animals of marshy or wetlands, sesame seeds, etc.) in terms of digestion, - Or laghu (light) – moongdaal (green gram), red rice, bird meat, deer meat, etc. • Assessing the rasas of the diet: - A shadras diet is highly advocated. (Ch. Soo. 5/5-6) Consulate General of India 2010

  37. Fundamentals and rules of Aahaar (cont’d) Quantitative assessment: • Fill the first 1/2 of stomach with solid diet, guru diet taken first, followed by laghu diet; but if diet is very heavy, fill only 1/3rd of the stomach with solids • Fill the next quarter or third with anupaan (adjuvant). • Leave the rest quarter or one third space for action of different doshas (Ch. Soo. 5/7)(Ch. Vi. 2/4)(As. Hr. Soo. 8/46) Consulate General of India 2010

  38. Fundamentals and rules of Aahaar (cont’d) Other Rules: • Eat solids first • Eat the highly beneficial amalaki (gooseberries) in the beginning, middle and end of meal • Eat salad in the beginning of the meal • Meals should be taken in a timely manner or when hungry. • Meals should be taken in the right amount, neither too much nor too less. (Su. Soo. 46/468-470) Consulate General of India 2010

  39. Fundamentals and rules of Aahaar (cont’d) • One should take into account the characteristics of the season, one’s body type, time of the day and other factors, before selecting their diet. (Su. Soo. 46/468-470) Consulate General of India 2010

  40. Fundamentals and rules of Aahaar (cont’d) After Meals Regimen: • Sit straight for 5-10 minutes, waiting for food to settle down • At this time, smoke herbal cigars or hookah and/or chew beetle leaf or other mouth fresheners • After that, take a stroll (about 100 steps) • After dinner, do the above and then lie down on your left side. • Surround oneself with pleasantness Consulate General of India 2010

  41. Fundamentals and rules of Aahaar (cont’d) Avoid after meals: • Sleep or sit for a long time • Laugh or talk excessively • Avoid unpleasant sensory exposure • Consume large amount of fluids • Excessive physical activity like swimming, horse riding, etc. (Su. Soo. 46/495-496) Consulate General of India 2010

  42. Anupaan (Adjutant) Anu means that which follows. Paan means a drink. Therefore Anupaan means a drink that follows or in the context of, a drink that follows meals or is taken along with it. Anupaan that is opposite in properties to the meal that has been taken, but is not contrary to it, is the best. (Ch. Soo. 27/320-330)(As. Hr. Soo. 8/47-51)(Su. Soo. 46/424-436) Consulate General of India 2010

  43. Benefits of Anupaan A well selected Anupaan confers the following benefits: • Softening of food • Good digestion and absorption • Satiation • Energy • Nourishment (Ch. Soo. 27/320-330)(As. Hr. Soo. 8/47-51)(Su. Soo. 46/424-436) Consulate General of India 2010

  44. A few common Anupaan • Water – This is a universal Anupaan; can be taken with any type of food. • Milk – This is considered the best Anupaan, especially for the weak, tired, infants and aged, people who have fasted, traveled or done excess physical labor, or have undergone excess of any kind. • Honey + Water – For the obese (Ch. Soo. 27/320-330)(As. Hr. Soo. 8/47-51)(Su. Soo. 46/424-436) Consulate General of India 2010

  45. A few common Anupaan • Herbal alcohols – for the lean, insomnia, fear, etc. • Meat soups – for the emaciated • Warm water – after any oily preparation • Kanji (a type of vinegar) - after a particularly or buttermilk heavy meal For the diseased, the Anupaan should be opposite to properties of the dosha involved. (Ch. Soo. 27/320-330)(As. Hr. Soo. 8/47-51)(Su. Soo. 46/424-436) Consulate General of India 2010

  46. Benefits of disciplined eating • Strength • Stamina • Good complexion • Good health • Happiness • Long life • Vitality It is rightly said that the jathraagni or the digestive fire, needs fuel in the form of diet, to sustain itself. (Ch. Soo. 5/8)(Ch. Soo. 27/342) Consulate General of India 2010

  47. Diet recommended for frequent use • Shashtik rice(ripens in 60 days), shali rice • Moong daal (Green Gram) • Saindhavlavan (rock salt) • Amalaki (Gooseberry) • Millet flour • Cow milk • Lean meat • Honey • Aakaash jal (rain water collected at strategic high points) (Ch. Soo. 5/12) Consulate General of India 2010

  48. Diet recommended for infrequent use • Dried flesh • Dried plants • Lotus stem • Pippali (long pepper), Kshaar (alkalis), Lavan (salt) • Meat of pig, cow, buffalo; fish • Curd • Bengal gram (Ch. Soo. 5/10-11) Consulate General of India 2010

  49. Diet to be always avoided Vairodhikaahaar (diet which is harmful due to processing, combination or other factors): - Heated honey - Milk with sour things - Milk with fish - Curd taken at night - Ghee and honey mixed in equal amounts (Ch. Soo. 26/80-111) Consulate General of India 2010

  50. THANK YOU

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