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 Table of Contents  
ORIGINAL ARTICLE
Year : 2019  |  Volume : 7  |  Issue : 2  |  Page : 39-47

Role of Pradhana Sharira and Manas Prakriti (bodily and mental constitution) in the manifestation of sthaulya (obesity): A cross-sectional survey study


1 Regional Ayurveda Research Institute for Skin Disorders, CCRAS, Ministry of AYUSH, Government of India, Ahmedabad, Gujarat, India
2 Department of Basic Principles, I.P.G.T. and R.A., Gujarat Ayurved University, Jamnagar, Gujarat, India
3 Department of Basic Principles, All India Institute of Ayurved, New Delhi, India

Date of Submission14-May-2019
Date of Acceptance21-Aug-2019
Date of Web Publication17-Oct-2019

Correspondence Address:
Dr. Hetalben Amin
Regional Ayurveda Research Institute for Skin Disorders, CCRAS, Ministry of AYUSH, Government of India, Ahmedabad, Gujarat
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijny.ijoyppp_8_19

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  Abstract 


Background and Aim: Lifestyle diseases such as obesity, hypertension, and diabetes mellitus are the major risk factors for the development of cardiovascular disease. Concept of Prakriti (human constitution) can be applied for manifestation and prognosis of diseases. Therefore, in this study, we intend to study Pradhana Sharira and Manas Prakriti (dominant bodily and mental constitution) in Sthaulya (obesity) participants. Materials and Methods: A total of 106 Sthaulya participants who had no confirmed mental illness to participate were selected without any bar of age, sex, caste, and religion. The diagnosis was mainly based on the sign and symptoms of Sthaulya as mentioned in Ayurvedic and Allopathic literature. Participants aged between 20 and 60 years and with body mass index (BMI) >25 (BMI = weight in kg/height in m2) considered as obese were included in the study. Participants of Sthaulya were assessed as per Prakriti assessment pro forma. Vata-, Pitta-, and Kapha Dosha (bodily humors)-dominant Prakriti were analyzed according to the characteristics found in participants. Same protocol was done in assessing the Manas Prakriti, i.e., Sattva Pradhana Prakriti, Rajas Pradhana Prakriti, and Tamas Pradhana Prakriti. Results: 56.60% Kapha-dominant Prakriti participants and 47.17% Tamas Pradhana Prakriti were found in Sthaulya. Conclusion: Dominant Kapha and Tamas Prakriti have influence on manifestation of that Dosha-dominant disease obesity.

Keywords: Manas, obesity, Prakriti, Sharira, Sthaulya


How to cite this article:
Amin H, Vyas H, Vyas M. Role of Pradhana Sharira and Manas Prakriti (bodily and mental constitution) in the manifestation of sthaulya (obesity): A cross-sectional survey study. Int J Yoga - Philosop Psychol Parapsychol 2019;7:39-47

How to cite this URL:
Amin H, Vyas H, Vyas M. Role of Pradhana Sharira and Manas Prakriti (bodily and mental constitution) in the manifestation of sthaulya (obesity): A cross-sectional survey study. Int J Yoga - Philosop Psychol Parapsychol [serial online] 2019 [cited 2019 Nov 20];7:39-47. Available from: http://www.ijoyppp.org/text.asp?2019/7/2/39/269480




  Introduction Top


Sthaulya (~obesity) is one of the most profound public health problems today. Significance of Sthaulya as a pathological condition has changed over years from the time of Charaka Samhita (ancient Ayurvedic treatise) to the later authors. Understanding this disease from Ayurvedic perspective is the most important need of the present era as it has reached the pandemic levels and has a great influence on morbidity and mortality. Chronic diet-related diseases are on rise around the world due to new lifestyles and eating habits. Therefore, studies about health promotion and its related factors certainly need to be conducted. Change in the lifestyle is becoming major strategy for the prevention of noncommunicable diseases[1] and promotion of health. Most of these noncommunicable diseases share common preventable risk factors, such as tobacco use, high alcohol consumption, anxiety, raised cholesterol level, and sedentary lifestyle. Lifestyle diseases such as hypertension, diabetes mellitus, and obesity are the major risk factors for the development of cardiovascular diseases (CVDs).[2] Obesity is psychosomatic and much common in Jamnagar city; therefore, they are selected. Medovriddhi is Kapha and Tamas Pradhana. Therefore, this disease is selected to assess the Pradhana Sharira and Manas Prakriti of patients of Sthaulya.

Sharira and Manas Prakriti have an important role in Hetu Skandha (causative factors), Linga Skandha (symptomatic factors), and Aushadha Skandha (treatment factor). Many works have been done on Sharira Prakriti, but researches on Manas and Sharira prakriti with relation to Vyadhi Utpatti are very few or not available. For Sharira Prakriti, it is said that “Vataladya Sadatura.”[3] Keeping this particular view in the mindan attempt was made to assess the role of Prakriti in Sthaulya manifestation. On the basis of manifestation of sign and symptoms and current evidence, obesity can be equated to Sthaulya and is of Kapha and Tamas Pradhana.[4]


  Materials and Methods Top


Selection of participants

A cross-sectional survey study was conducted on 106 Sthaulya participants, attending outpatient department (OPD) and inpatient department of Institute for Postgraduate Teaching and Research in Ayurveda (IPGT and RA), Gujarat Ayurved University, Jamnagar, Gujarat, India, from December 1, 2013, to February 28, 2014, after obtaining approval from the institutional ethics committee. The participants were selected using simple random sampling and written informed consent was taken as per the Declaration of Helsinki after offering sufficient explanations about the study and its aims. All participants were interviewed in the local language by a single person.

Inclusion criteria

Obese participants who had no confirmed mental illness to participate were selected without any bar of age, sex, caste, and religion. The diagnosis was mainly based on the signs and symptoms of Sthaulya as mentioned in Ayurvedic and Allopathic literature. Participants aged between 20 and 60 years and with body mass index (BMI) >25 (BMI = weight in kg/height in m2) considered as Sthaulya were included in the study.

Exclusion criteria

Participants aged <20 and >60 years, obesity associated with CVD, hemiplegic, diabetes, and severe hypertension were excluded from the study. Females with a history of pregnancy and lactation were also excluded.

Assessment of Prakriti

Prakriti determination pro forma was prepared having Vatika, Paitika, and Kaphaja characters with reference to anatomical, physiological, and sociological characters, by following Briha Trayi (Charaka, Sushruta, and Ashtanga Hridaya). Assessment was made by analyzing obtained data from filled questionnaire and physical examination of the participants. All anatomical characteristics were assessed by visual and tactile examination. Vata, Pitta, and Kapha Pradhana Prakriti were analyzed with pro forma according to character found in individuals. Maximum characteristic of any Dosha indicates Pradhana Dosha Prakriti of that individual. All calculations and statistics were done with The statistical analysis of data was performed using (IBM SPSS) statistics software version 22.0. India. After assessing Prakriti, participants were further divided into three categories, i.e., Vata Pradhana, Pitta Pradhana, and Kapha Pradhana Prakriti. The same protocol was done in assessing the Manas Prakriti, i.e., Sattva Pradhana Prakriti, Rajas Pradhana Prakriti, and Tamas Pradhana Prakriti.

Procedures

A volume of 5 ml fasting blood of participants were taken from for the estimation of biochemical investigations, such as hemoglobin, erythrocyte sedimentation rate, serum cholesterol, serum triglyceride, serum high-density lipoprotein (HDL), low-density lipoprotein (LDL), very LDL (VLDL), serum urea, serum creatinine, alkaline phosphate, serum glutamic pyruvate transaminase, serum glutamic oxaloacetic transaminase, serum protein, serum albumin, and serum globulin. Anthropometric parameters such as height, weight, BMI, circumference of neck, mid arm, fore arm, chest, abdomen, hip, mid-thigh, and mid-calf were recorded. The body fat was assessed by measuring the skin fold thickness by vernier caliper (Lange's skinfold vernier caliper [Lange 85300, Texas, USA]). Skinfold thickness of the middle portion of the biceps muscle and triceps muscle, inferior portion of the scapula, thickness of the abdomen, and middle portion of the supra iliac region was also recorded. The skinfold measurement was carried out bilaterally after exposing the skin properly in the above-mentioned region. Skinfold was measured by placing two points of vernier calipers at Superficial skin along with subcutaneous fat (except muscles). For all the regions, the mean values of both sides of the body have been recorded.

For survey study

A cross-sectional survey study was conducted on 106 Sthaulya participants, attending OPD and inpatient department of IPGT and RA, Gujarat Ayurved University, Jamnagar, Gujarat, India, from December 1, 2013, to February 28, 2014, after obtaining approval from the institutional ethics committee. The participants were selected using simple random sampling and written informed consent was taken as per the Declaration of Helsinki after offering sufficient explanations about the study and its aims. All participants were interviewed in the local language by a single person. A short clinical pro forma was prepared which included the present and medical history of first-degree relatives, medications, diet pattern, and lifestyle of patients in the light of etiological factors explained for Sthaulya in Ayurvedic classics. Ethical clearance was obtained from the institutional ethics committee of the IPGT and RA, Gujarat Ayurved University, Jamnagar; vide Ref. PGT/7-A/Ethics/2012–2032/3552 dated 25/02/2013. This study is registered in Clinical Trial Registry of India (CTRI) vide CTRI/2013/06/003775. The study period was May 2013–June 2014.


  Results Top


Demographic distribution of 106 patients of Sthaulya is mentioned in [Table 1]. Sharira–Manas prakriti-wise distribution of Sthaulya patients is summarized in [Table 2] and factors related to Sharira prakriti of Sthaulya patients are depicted in [Table 3]. Manasika Prakriti-wise distribution of 106 patients of Sthaulya is presented in [Table 4]. Biochemical, anthropometric, and skinfold thickness profile of patients are mentioned in [Table 5].
Table 1: Demographic distribution of 106 patients of Sthaulya

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Table 2: Sharira Manas Prakriti-wise distribution of Sthaulya patients

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Table 3: Factors related to Sharira Prakriti of Sthaulya patients

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Table 4: Manasika Prakriti-wise distribution of 106 patients of Sthaulya

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Table 5: Bio-chemical, anthropometric and skin fold thickness profile of patients

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  Discussion Top


A total of 106 participants (female: 57, male: 49) of Sthaulya were studied. Kapha-dominant Prakriti participants were found to be more prevalent (56.60%) whereas Vata-dominant and Pitta-dominant Prakriti participants were 18.87% and 24.53% respectively. Prakriti plays an important role to predict the susceptibility of the manifestation of disease, and it is also possible to predict the probable clinical features of each Prakriti type. This would give us an opportunity to predict clinical features and will be helpful in taking preventive measures on how they should be avoided and cured.[5]

Majority of the patients were in the age group of 20–35 years. Young group occurrence was most common, which signifies the increasing trend of sedentary lifestyle and changing food habits in Indian youth. Recent reports also support the increasing prevalence of obesity in adolescent age,[6] which is an alarming signal for modern society. According to Ayurveda, in the middle age, all body tissues (~Dhatu) reach to completeness (~Paripurnata). In the current lifestyle, in the middle age, the professional and social stress is being common occurrence, resulting in increment in mental worries, and the people could not concentrate on what and how much they eat and follow disorderly eating habits, which ultimately lead to the Sthaulya.

More prevalence was found in female gender, which shows their more susceptibility; this might be due to faulty dietary and lifestyle habits, hormonal variations (postpartal or menopausal), and more vulnerability to diseases in female gender.[7],[8],[9]

Maximum patients of this study are married. A study reported that the spousal concordance of poor health (including obesity) among married couples is primarily a phenomenon occurring among households of low socioeconomic status (SES), whereas high SES couples are relatively untouched. Even as increases in life expectancy can be thought of as a leveling of lifetime health, marital sorting undermines those leveling trends.[10]

In the present study, maximum patients had sitting type of occupation. Sitting type of work is related with light nature of work with advancement of new techniques; tools are the causative factors for reduced activity. Low physical activity at work is a significant risk factor for total and central obesity in middle-aged workers.[11] Their energy expenditure is less than energy intake, which may lead to Sthaulya. Maximum patients were primary level educated. Low educational status may be associated with ignorance toward healthy food as well as daily requirement of body which may trigger the manifestation of disease. There is at least some evidence that over longer periods of time, more educated individuals have been less likely to be become obese than their less educated counterparts, suggesting that education produces its influence on obesity only in the long term.[12]

The study shows that maximum numbers of patients were from lower-middle class. There is a clear inverse relationship between SES and obesity. Within some affluent countries, however, obesity has been found to be more common in the lower socioeconomic groups. In developing countries, it can occur only in the prosperous elite. After so many surveys, it is observed that the increased prevalence of obesity is seen in middle and lower and upper socioeconomic classes, respectively.[13]

Maximum patients of Sthaulya have Kapha Pradhana Prakriti which indicates that Kapha is the predominant factor for Sthaulya and it is also included by Charaka in Nanatmaja Vyadhi of Kapha Dosha.[14] More prevalence of Sthaulya in patients having Kapha-predominant Prakriti pointed toward involvement of Kapha Dosha in the pathophysiology of Sthaulya. Properties attributed to Kapha and Meda are almost similar. People having Kapha-predominant Prakriti have stout physique, so they are more prone to obesity.

Tamas Pradhana Prakriti was found in maximum number in patients of Sthaulya. Bhavaprakasha has considered increased Tamo Guna and declined Sattva Guna for occurrence of Sthaulya. Bhavaprakasha has advocated Sattva, Audraya, and Tamo Jaya as a line of treatment for Sthaulya.[15] In practice, it is also observed that Rajas–Tamas Prakriti peoples are more inclined toward enjoyment of eating and worldly pleasures.

In patients of Sthaulya, Kapha Prakriti Lakshana, viz., Snigdha Anga (unctuous body), Sukumara Gatra (soft body), Avadata Varna (fair skin), Snigdha Nakha (unctuous nails), Sthira Sharira Sandhi Mansa (stable joint and muscles), Sushlishta Sandhi Bandhana (normal joints), Prasanna Mukha (happy face), Swara (voice), Darshana (face), and Alpa Trishna (low thirst), was found in maximum number of patients because of Snigdha (unctuous), Mridu (soft), Accha (clear), and Shita Guna (cold quality) of Kapha Dosha.[16]

In patients of Sthaulya, Kapha Prakriti Lakshana, viz., Manda Cheshta (slow activity), Ashighra Karya (slow work), Sara Adhisthita Gati (stable gait), Adhika Nidra (more sleep), Toyada Swapna (water dreams), and Alpa Trasa/Raga/Viraga (low tension/anger/depression), was found maximum. It is because of Manda (slow), Sthira (stable), and Guru Guna (heaviness quality) of Kapha.

It shows that excessive sleep plays an important role in developing obesity.[17]Acharya Charaka has quoted that Harsha Nityatva (jolly nature) is one of the important causative factors for Sthaulya.[18] Emotional disturbances are deeply involved in the etiology of obesity. Kapha Prakriti people take excessive quantity of Snigdha, Guru, Shita, etc. Kapha Guna-dominant diet and lifestyle increase Kapha and further leads to Sthaulya. Excessive consumption of similar substance (Dravya Samanya), viz., Meda Pradhana Ahara, similar quality (Guna Samanya), viz., Guru and Snigdha, or similar in action (Karma Samanya), viz., sitting occupation, Diwaswapna results in the over production of Dhatu. This may be the reason for Sthaulya. All the Nidana ultimately decreased physical activity, which aggravates Kapha and leads to Medovriddhi (excessive fat). Viharatmaka Nidana (lifestyle-related causative factors) such as Diwaswapna (day sleep) having Abhishyandi (crate blockage of channels) property leads to blockage of the microchannels of the body, specifically in Medovaha Srotas.[19] Due to obstruction of Srotas by Meda, the Vata moving mainly into stomach, whips up the Agni, and absorbs the food. The corpulent man digests food speedily and craves for food exceedingly. Excessive eating produces more production of Rasa which causes over growth of Meda Dhatu, leading to Sthaulya.[20] Therefore, it is rightly said by Sushruta.[21] In obesity, there is excessive water content in the body which in turn leads to the increase in weight because of Udakavaha Srotas Dushti. In maximum number of patients, Kapha Prakriti Lakshana, viz., Madhura-Amla Rasa and Shita Aharaguna Sevana, was found.[22]

Excessive Madhura-Amla Rasa is Kapha aggravating factors and Kapha vitiation plays a key role in the Samprapti of Sthaulya. According to modern point of view, Madhura, Amla Rasa dominant diet is always high calorie value and excessive indulgence in high calorie diet is a well-established cause of obesity.[23]Shita Ahara Guna Sevana leads to Medovriddhi, and if it continuously taken by people, then it leads to vitiation of Kapha and Meda and became cause of Sthaulya. Significant numbers of patients were found to have affliction to Shita Guna -ominant diet, i.e., cold drinks, ice creams, packed food, freeze food. Starchy foods that providing bulk of the cheap meals and fast food, oily foods, alcohol, junk foods in the form of pizza, burgers, hot dogs, noodles, drinking soda, and sweets are causes of obesity.[24] Moreover, the findings of biochemical and anthropometric variables of patients suggest a strong association of noninsulin-dependent diabetes mellitus with the dominant Prakriti.[25] Serum cholesterol, serum triglyceride, HDL, LDL, and VLDL were in the normal upper limit of in Kapha-dominant Prakriti participants of Sthaulya.[26]Kapha-dominant Prakriti subjects were found to be more prevalent (56.60%) to Sthaulya as compared to Vata- and Pitta-dominant Prakriti. Serum cholesterol, serum triglyceride, HDL, LDL, and VLDL were in the upper limit of normal in Kapha-dominant Prakriti subjects. Hence, it is evident that the prevalence of obesity is not related with quantum of money, but it depends upon faulty eating habits and lifestyle.


  Conclusion Top


Kapha and Tamas Pradhana participants were found to be more prevalent to Sthaulya as compared to other Prakriti. Prakriti plays an imperative role in manifestation of disease, and adopting personalized approach as per Prakriti can help in assessing the susceptible clinical features of each Prakriti type and may prove supportive to take preventive measure in arresting the far-reaching ominous clinical impacts of disease. To sum up, the present study is preliminary, but it accentuates the knowledge of Prakriti to explore a new dimension of scientific research in diagnosis, selection of the drug or therapy, and prognosis of the disease.

Financial support and sponsorship

IPGT and RA, Jamnagar, supported the study.

Conflicts of interest

There are no conflicts of interest.



 
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  [Full text]  



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5]



 

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