Ayurvedic Dietary Guidelines for Diabetes Management & Reversal

-

Introduction

One of the biggest non-communicable diseases, diabetes mellitus, especially Type-2, is becoming more common worldwide. Diabetes type 2 is brought on by either decreased pancreatic insulin production or peripheral resistance to insulin. A range of consequences, such as heart disease, stroke, renal disease, blindness, neuropathies, leg and foot amputations, and even death, can result from poorly managed diabetes. Genetic predisposition, environmental variables, a sedentary lifestyle, and a poor diet are major contributory factors to diabetes, which are themselves fueled by increasing urbanization and economic expansion. Diabetes can be prevented or reversed with the help of food. The onset of Type-2 diabetes often occurs in middle age, but small dietary and lifestyle adjustments can significantly lower the risk of developing the condition. After adjusting for multiple characteristics, higher diet adherence and modest physical activity were linked to lower probabilities of having diabetes.

Similar to that, when managing diabetes, an individualized diet is essential to improving glycemic control and avoiding complications. Limiting refined sugars and foods with a high glycemic index is a key component of the conventional diabetic treatment strategy.   The diet may contain an unhealthy amount of other nutrients like fat and protein if carbs are controlled. Similar to this, attempts to follow the typical “diabetic diet” food measures frequently lead to severe limitations, overindulgence, or repetitious intake of particular food items. A few recent research also revealed that excessive diet restrictions may worsen diabetic symptoms. Additionally, contemporary dietetics employ a reductionist approach when designing the diet regimen, placing an emphasis on the macro and micronutrients in the food while ignoring the unique needs of the consumer. Ayurveda, the traditional medical system of India, has a comprehensive approach to health and disease that can help in this situation. Its nutritional recommendations include meals that are recommended and discouraged for a particular person, as well as timings and mindful eating techniques. It also emphasizes the importance of tailoring each person’s diet depending on their prakriti (body composition), dosha (body humours), and agni (energy) (digestive power). On the basis of the person’s desa (place of residence), kla (age and season), and sathmya (homogeneity), necessary alterations are also suggested. A meal plan created using these concepts is thought to be advantageous for maintaining a healthy metabolic state and preventing diseases like diabetes. Patients with and without obesity receive different ayurvedic approaches to managing their diabetes, and as a result, they require different diets.   When preparing the nutrition plan for patients, the aforementioned elements, such as prakriti, are also taken into account. Reexamining the fundamentals of ayurvedic dietetics and therapeutic techniques should give researchers and practitioners new insights into the prevention and management of diabetes mellitus, especially in light of recent trials on dietary regimens’ positive results.

The fundamentals of Ayurveda in terms of diet

To comprehend Ayurveda’s dietary concepts and their practical application, it is essential to gain a general understanding of the discipline’s fundamental ideas. Despite being a medical system, Ayurveda—a name that means “the knowledge of life” or “the science of life”—is also a way of life that teaches people how to live normal, healthy lives in all aspects. Ayurveda has two viewpoints on health: the first is preventative, which attempts to keep people healthy, and the second is curative, which aims to treat disorders that have already developed. Diet has been given top priority in each of these areas since, according to Ayurveda, both the human body and diseases are a product of what people consume.

Tridosha idea

According to Ayurveda, the five fundamental elements—Prithwi (Earth), Apa (Water), Teja (Fire), Vayu (Air), and Akasha (Ether)—combine to form all substances in the universe, whether they be life or nonliving. The human body is made up of seven structural components called Sapthadhatu, three waste products called Trimala, and three basic functional units called Tridosha (three biological humours). The influence of nutrition on these fundamental parts of the body is explained based on the panchamahabhoota composition of the food consumed. All of these have amalgamations of the panchamahabhoota in varying ratios. 8 In essence, ayurveda dietetics focuses on the energetics of food as a way to balance the tridosha, with each food item having either an aggravating, pacifying, or balancing effect on the tridosha. Food items are first categorised for this purpose based on their rasa (taste) and guna (attributes), from which their pharmacological characteristics and activities are elaborated. Six varieties of rasa—madhura (sweet), amla (sour), lavana (salty), katu (pungent), tikta (bitter), and kasaya—have been identified as the whole sensory experience involving the nose, tongue, and throat (Astringent). The six tastes are always included in a well-balanced Ayurvedic diet, which in turn helps maintain homeostasis. Consuming too much of either rasa can tip the balance and cause health issues. For instance, consuming too many sweet foods can cause obesity, whereas eating too many savoury foods can cause acidity. Guna is a property or trait of a substance that is determined by its physical properties or the changes it causes in the body. 10 Twenty different kinds of guna exist, with characteristics like guru (heavy), snigdha (unctuous), ushna (hot), etc.

Prakriti: A Personalization Manual

Each person is different in their health and illness, and they need individualized care based on their unique Prakriti (body constitution). An individual’s prakriti, a collection of physical, physiological, and psychological characteristics, can be seen as a phenotypic phenomenon resulting from a certain genotype. Humans are divided into seven different Prakriti kinds according to characteristics of the tridosha in their bodies. Recent research has confirmed that this classification is genetically based, with each constitutional type showing distinct variances in terms of biochemical and haematological markers as well as levels of expression across the entire genome.

Agni, the power of digestion

In addition to the tridosha, Agni, or the digestive power, is another significant element said to be crucial to preserving health.

Agni can be understood as the force that propels metabolic activity throughout the body, including in the intestines, tissues, and elements. An appropriate dietary plan helps to support healthy living, which is ensured by the agni’s normal operation.

Understanding of diabetes in Ayurveda

Under the idea of Prameha, ancient Ayurvedic texts make mention of an illness called madhumeha that is confirmed to be diabetes mellitus. Urinary volume and turbidity are both raised in the illness known as prameha. Numerous etiological factors have been identified, including sedentary lifestyle and prolonged ingestion of sugar and its derivatives, freshly produced cereals, meat from marshland animals, etc. These factors are still significant in the modern period. Overeating and an erratic diet lead to agni dysfunction, which promotes the development of ama (partially digested/toxic chemicals), which is thought to be the primary cause of many metabolic illnesses, including prameha. 16 Evidence gained from investigations on the involvement of gut dysfunction in the aetiology of diabetes has recently supported this idea of an abnormality in the digestive process. Ayurveda’s general dietary recommendations have a crucial role to play in keeping agni normal and halting the development of metabolic disorders.

Ayurvedic dietetics fundamentals

Ahara(food)

One of the three pillars that supports life is “food,” which is signified by the name “Ahara.” The other two pillars are nidra (sleep) and brahmacharya (measured celibacy). Ayurveda lays more emphasis on the quality, quantity, processing, compatibility, and norms of consumption than the traditional Western approach. To describe the acceptance and adaptability of a specific cuisine in a given situation, the terms pathya (compatible) and apathya (incompatible) are used. 18 Following these guidelines daily will help to avoid ama production, prevent agni dysfunction, and preserve tridosha balance. Three criteria can be used to categorise ayurvedic dietetics: rules of consumption, timing of food (when to eat), and choice of food (what to eat) (How to eat).

Choice of food Numerous variables affect how food is customised, but Prakriti, Guna (attributes), Samskara (processing), Sathmya (homogeneity), Vaya (age), Desa (habitat), and Kala are crucial ones (Seasons).

Prakriti-based food selection

As previously said, dietary, lifestyle, and medication advice varies depending on one’s prakriti. People with a Kapha-predominant prakriti have slow metabolisms, can handle hunger and thirst, need little food, and take longer to digest. They have a high propensity for obesity and may gain weight even when eating tiny amounts of food. Therefore, it is suggested that they periodically fast and eat modest meals, especially those that have spicy, bitter, and astringent flavours. Additionally, they can be instructed to take hot beverages and season their diet with spices.

Pitha prakriti people have quick metabolisms, can digest dense foods, and need significant amounts of food frequently. They are prone to acid peptic illnesses and cannot endure hunger or thirst. They might be told to consume foods and drinks that are preferred cooling, more sweet and astringent tasting, and should limit acidity. They must stay away from foods with strong, salty, and sour flavours and excessive amounts of spices.

People with a vatha-predominant prakriti have irregular metabolic patterns, eat quickly, and consume less food. Even with continuous nourishing therapy, they will not gain much weight and are more susceptible to degenerative disorders. They are encouraged to eat foods with more fat, such as clarified butter, edible oils, meat, etc., as well as hot foods and drinks. Foods that have a sweet, salty, or sour flavor are preferred; pungent, spicy, and astringent flavors should be avoided.

People with kapha-predominant prakriti are more likely to develop diabetes than those with other types of prakriti, which is just one of several characteristics that predispose a person to specific diseases. Therefore, altering the diet in a prakriti with a kapha predominance could delay or avoid the onset of diabetes.

Food choice based on guna and rasa

Food products are chosen based on their guna (attributes), which considers prakriti, vikriti (state of disease), seasonal fluctuations, and agni. Food products have been categorised based on their inherent qualities, such as guru and laghu (heavy to digest) (light to digest). For instance, whereas green lentils are light and simple to stomach, black gramme is hefty and tough to digest. In the case of the earlier prakriti description, application of the thisguna concept is important in determining the food items for each prakriti. For instance, in a person with a kapha type of prakriti, diet with similar qualities might aggravate kapha, leading to diseases of its imbalance because kapha is guru (heavy) and snigdha (unctuous). To keep the balance of the doshas, food should have properties that counterbalance kapha. Similar circumstances exist when a person is in vikriti (a diseased state), when pacifying the illness by giving them food that has attributes opposite to the aggravated dosha is possible. Additionally, it is crucial to evaluate the agni, or digestive force. A person with low agni will not be able to effectively digest foods that are guru (heavy), snigdha (unctuous), and sheetha (cool), whereas a person with good agni may do so. Along with guna, the idea of rasa (taste) is also important when choosing a diet because each rasa has an impact on a person’s tridosha and agni. The basic recommendation for diabetes prevention is to avoid excessive intake of foods that are high in guru, snigdha, madhura, and amla, as these flavours stimulate kapha while pacifying vatha.

Food selection based on samskara

Another significant component to take into account while selecting food is samskara, or processing dietary items to change its properties for enhanced palatability or preservation. The same food can be prepared in a variety of ways, and depending on how it is treated, it can produce distinct guna. As an illustration, puffed rice is easier to digest than flaked rice. Similar to how boiling milk with dry ginger for asthma sufferers had positive results, processing can have negative results, such as atherogenesis from deep frying. To avoid the onset of diabetes, it is best to refrain from regularly consuming processed meat, dairy products, and foods high in sugar and fat.

The idea of virudha

Virudha, or incompatibility, is a key idea in ayurvedic dietetics. When eaten together, several foods are considered unsafe to eat. A case in point is the inappropriate pairing of fruits and milk. This idea was recently supported by a study on milk and blueberries, which showed that the antioxidant capabilities of blueberries are diminished when consumed combined. This is because there are 18 different forms of virudha that, when ingested over an extended period of time, can cause severe systemic and metabolic illnesses. As in the instance of curd when consumed with green lentils, combining dietary items can also be advantageous. The rapidly developing area of trophology may soon shed light on the positive and negative consequences of such pairings, as described in traditional ayurveda texts.

Food selection depending on age

Due to the differing metabolic requirements for each age group and the dosha predominance in each age group, age plays a crucial role in determining an individual’s diet. In childhood, kapha dosha predominates, followed by pitha in middle life and vatha in old age. In order to prevent diseases, the diet should be adjusted for each age group so as to prevent the vitiation of the appropriate dosha. Following a diet that does not disrupt kapha in childhood may postpone the onset of diabetes, particularly in those who are prone to it.

Ayurveda recommends consuming food grown in the appropriate habitats since it is more hospitable for persons, hence it is necessary to choose food based on the desa Desa, or environment, where the food is produced and consumed. Seasonal differences must also be taken into account when modifying the diet to balance out the variances in tridosha that occur in various climates. Seasonal diet changes are also justified by changes in the chemical composition of food, the body’s metabolic needs, and physical activity.

Amount of food

The appropriate amount of food varies on a number of variables, including the person’s needs, the type of food, and their agni (digestive capacity). Regarding the type of food, foods that are considered difficult to digest should be consumed in half the quantity that results in fullness, while foods that are easily digestible should be consumed in a number that does not result in over satiety. Ayurveda also recommends the “three portions” method, which divides the stomach’s capacity into three sections, one of which should be filled with solid food, one with liquid, and the third should be left empty. As a result, ama development is prevented and the digestive system is able to work properly.

Concerns for timing

The timing of meals should be set based on each person’s unique requirements, which varies. Ayurveda generally suggests only eating twice a day, preferably in the morning and evening. The indications of appropriate digestion of previously consumed food and the onset of excellent hunger are two significant aspects to take into account when determining the timing of meal intake. Even though it is not practical to recommend eating twice a day in the current situation, the important variables in achieving hunger and indicators of digestion of the preceding food should constantly be highlighted. Feelings of hunger and thirst, eructation without the flavour of the previous meal, a lightness in the abdomen and body, and adequate faeces and urine evacuation are signs that the previous meal was properly digested. Adhyasana, the act of eating before the preceding meal has been completely digested, causes ama to build and eventually results in sickness.

Other consumption guidelines

Speed of food consumption is equally as important as timing, with slow eating promoting better digestion, higher enjoyment, and better weight loss or maintenance. Eating with awareness encourages optimum digestion and is thought to enhance glycemic management. Emotions that are too strong during eating and digesting can cause an abnormal and erratic digestive function.

Diabetes control through diet

In controlling illnesses, especially ones that have a protracted course like diabetes mellitus, maintaining a healthy diet is just as crucial as taking prescription medications. The current medical nutritional therapy attempts to reach and maintain body weight goals, meet specific glycemic, blood pressure, and lipid targets, and postpone, prevent, or treat diabetes consequences. It is designed to be administered by a licensed nutritional therapist, and patients with type 1 diabetes and those with type 2 diabetes who adhere to this therapy have A1C levels drop by 0.3–1% and 0.5–2%, respectively. The methods utilized, such as carbohydrate counting and exchange lists, are too complex for the average person to understand and follow. Additionally, patients’ problems with arithmetic and reading may make them less likely to follow a carefully planned diet. Additionally, several elements discussed earlier in ayurvedic dietetics, such as prakriti, seasons, or the status of the agni, are not taken into account by this dietary plan. The Ayurvedic method to manage diabetes patients is distinctive in that it customizes the diet while taking into account the prakriti, agni, and dosha condition as well as co-existing indications of diabetes. It also advises making the required adjustments based on seasonal differences and eating a certain amount of food at a set time each day. Before beginning treatment, Ayurveda further divides diabetic patients into obese and lean types since the two require different therapeutic approaches. Diets for fat people are designed to cause nutrient depletion in bodily tissues, which is made easier by recommending foods that are hard to digest and low in nutritional content. Foods that are healthy and simple to digest are used in the lean kind. 

The recommendations made by Ayurveda are based on the dosha condition rather than the strict prohibition of any food substances. The substantial usage of different oils has been described, for instance, in diabetic individuals with vatha predominant symptoms.

The recommendation of numerous little meals goes against ayurvedic principles yet again in current dietetics. A recent randomised crossover research indicated that eating six small meals per day is less beneficial than two larger meals per day (breakfast and lunch) for patients with type 2 diabetes on a reduced-energy diet. Frequent food consumption impedes the digestive process.

Table 1. Examples of generally recommended food items in diabetes mellitus

    Nutrient    Sources
    Carbohydrate    • Whole grains –          • One year old rice           • Buckwheat, Barley, Wheat, Pearl millet, Wild rice, Maize    • Unripen banana flour
    Protein sources    • Beans such as moth beans, mung beans, lima beans, soy beans    • Green gram, fenu greek    • Grilled meat
    Fat sources    • Clarified butter    • Butter milk    • Mustard oil
    Vitamin and other    micronutrients    • Vegetables like bitter gourd etc with astringent and bitter taste    • Leafy vegetables
Generally Recommended Food items in Diabetes Mellitus

Treatment-related diets

Ayurveda employs a medicated diet, in which food is prepared with medicinal herbs to have therapeutic benefits on the body. Dashamoola yavagu is one instance; it is a rice gruel that has been treated with the roots of ten different medicinal plants. The effectiveness of this in bringing about glycemic control and reducing complications from diabetes is currently being researched.

Conclusion

Health, food, and nutrition beliefs and practices according to Ayurveda differ significantly from those of biomedicine and contemporary nutrition. Our ongoing systematic research has revealed fresh understandings of nutritional sciences to offer solutions in modern healthcare, such as how to modify diet and lifestyle to suit one’s prakriti, age, and season. Additionally, rather than employing a universal approach, prevention and control of lifestyle disorders like diabetes can only be accomplished by customizing the measures to match individual needs.

Share this article

Recent posts

Google search engine

Popular categories

Recent comments