Preventive Healthcare, An

Ayurvedic Perspective
Dr. Pratibha Shah
MD (Ay.)
 The Spectrum

Diet Rat Race

Lifestyle Fast Pace
Meditation STRESS
HEALTH DISEASE

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Diseases of the new world

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 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

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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

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 Goals of Ayurved

Broadly speaking, Ayurved states two main

goals namely:
• ‘Swasthasya swasthya rakshanam’
• ‘Aturasya vikaar prashamanam ch’

(Ch.Su.30/26)

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Tenets of Preventive
Healthcare in Ayurved

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 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

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 Factors affecting immunity at
conception…..cont’d

• Maternal factors cont’d

- Mental health of the mother
during pregnancy
- Influencing external factors during
pregnancy

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 Factors affecting immunity at
conception….cont’d

• Paternal factors
- Health of the male sex cell

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 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

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 ‘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.

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 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.

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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)

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 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.

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 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)

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 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.

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 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.

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 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

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 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

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 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.

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 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

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 The three upstambh (pillars) of
health

• Aahaar (Diet)
• Nidra (Sleep)
• Brahmacharya (Controlled celibacy)

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 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)

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 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)

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 Importance of hitaahaar
(conducive diet)
• It is only hitaahaar that is solely responsible for
shareer vriddhi (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)

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 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)

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 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)

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 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)

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 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)

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 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)

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 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)

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 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)

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 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.

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 Fundamentals and rules of Aahaar
(cont’d)
Rule for optimum serving:
• According to one’s agni (digestive fire)
• Conducive to one’s doshic prakruti (body type
according to dosha)
• That which gets digested in time

(Ch. Soo. 5/1-4)

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 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) – moong daal (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)

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 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)

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 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)

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 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)

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 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
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 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)

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 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)

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 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)

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 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)

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 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)

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 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)

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 Diet recommended for frequent use

• Shashtik rice(ripens in 60 days), shali rice

• Moong daal (Green Gram)
• Saindhav lavan (rock salt)
• Amalaki (Gooseberry)
• Millet flour
• Cow milk
• Lean meat
• Honey
• Aakaash jal (rain water collected at strategic
high points)
(Ch. Soo. 5/12)

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 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)

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 Diet to be always avoided

Vairodhik aahaar (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)

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THANK YOU