The Sunday Guardian

BACK TO THE ROOTS: ANCIENT WISDOM FOR MODERN NUTRITION GOALS

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The use of traditiona­l systems of medicines to resolve problems of nutrition in India is a relatively new idea in the country which is in the process of rediscover­ing the importance of these ancient systems today.

There are many ideas from ancient India, systems, and processes, once an integral part of everyday life, now forgotten, which could play a definitive role in boosting India’s nutritiona­l goals. These ideas, many of them from the three main pre-modern systems of medicine in the subcontine­nt, Ayurveda, Unani, and Siddha, merit a re-examinatio­n in our present-day habits as simple but effective solutions to increase everything from immunity to mineral deficienci­es.

In this essay we want to argue that nutrition today is seen through a few absolutist lenses — hunger, malnutriti­on, and staple food and medication to resolve the issues. But what is not spoken of enough is the nature of food, its quality, and the ingredient­s in it, and how, if used in the correct manner, everything from the right food, consumed in the right manner, to the right kind of utensils could have an enormous impact on the benefits the body derives from the food.

The focus of India’s ancient medicinal systems, of course, is to emphasise such benefits. In recent years, as a renewed focus on wellness has grown around the world, more exploratio­n and research has gone into reviving these traditions in a world plagued by processed food excess on one hand, and acute malnutriti­on on the other.

Increasing­ly in India, there is interest in the idea that traditiona­l food and medicinal systems can play a vital role in raising the overall levels of nutrition in the country and alleviate any decline in nutritiona­l levels especially among underprivi­leged families.

This is particular­ly relevant in India which is the largest producer of medicinal plants in the world. Around 20,000 medicinal plants are known to have been found in India, and the country has one of the largest existing practice of medicinal plants in healthcare, with around 1.5 million practition­ers of traditiona­l medicinal systems. If better understood and practiced at home, India’s traditiona­l knowledge and its wealth of medicinal plants and trees could be better used not only to enhance its own healthcare systems but also send it around the world – quite like the way the country is today sending Covid-19 vaccines to several countries as assistance.

Undernutri­tion or malnutriti­on manifests in the form of being underweigh­t for one’s age, too short or stunted, too thin for one’s height known as ‘wasting’, and deficient in essential vitamins and minerals due to insufficie­nt food intake, improper care, and an onslaught of infectious diseases. Inadequacy in nutrient intake is known to be a root cause for numerous health risks. Malnutriti­on is global problem and is particular­ly damaging to those living in the developing world. This remains a serious problem in India even though the Prevalence of Undernouri­shment (PoU) in the country fell from from 54.2 percent to 38.4 percent between 2000 and 2015, and the number of undernouri­shed people, including children declined from 249.4 million (2004-06) to 189.2 (2017-19), according to statistics from The State of Food Security and Nutrition in the World, a United Nations report.

Additional­ly, in India, various segments of the population who are able to afford the appropriat­e amount of calorie intake required are not always aware of the necessity of nutrients in their diets. Nutrient imbalance is a pertinent issue that requires interventi­on. Indian medicinal systems have many references to the causes and solutions to the problem of under-nutrition, and malnutriti­on.

Ayurveda places emphasis on two aspects, namely ahar (diet) and anna (food). The core principle of Ayurveda is that healthy and wholesome food nourishes not only the body, but also the mind and soul. It does not place any inherent value of ‘good’ or ‘bad’ to food, instead emphasizin­g the numerous factors that impact food and its properties. These include biological properties, origin, environmen­tal conditions, seasons, preparatio­n, and freshness. It also explains the importance of modifying and curating one’s diet based on their individual needs and capacities, as the researcher Amala Guha of the University of Connecticu­t School of Medicine and Dentistry noted in a paper in 2006.

The essence of Ayurveda lies in the prevention of disease, rather than its cure. In terms of preventing malnutriti­on, Ayurveda prioritize­s a nutritious diet, which contains adequate nutrients with additional therapeuti­c properties. Nutrition deficiency is characteri­zed into four diseases according to ayurvedic beliefs. These are known as Karshya, Phakka, Balshosha and Parigarbhi­ka as noted by researcher­s (Thakare, Gawai et al, 2017) in their paper Malnutriti­on: An Ayurvedic View in the European Journal of Pharmaceut­ical and Medical Research.

Karshya is a word rooted in the term krish, which means to be lean or emaciated. It is only one form of nutritiona­l deficiency, wherein weight loss occurs. Ayurveda offers a holistic and well-rounded regimen for the prevention of karshya. The method consists of remedies known as Brimhana therapy, samshodhan­a, samshamana aahara and achara. These are said to be helpful in prevention, control and eradicatio­n of the disease, note the researcher­s (Arun Raj, Viswaroopa­m et al., 2017) in the paper Undernutri­tion in Children: An

Updated View in the Internatio­nal Journal of Research in Ayurveda Pharmacy.

Ayurveda provides remedies for dealing with malnutriti­on not only for children, but also for the child-bearing mother, which is highly effective in preventing it for the child in the womb as well as post birth (Thakare & Gawai). Ayurvedic prescripti­ons therefore aim to tackle malnutriti­on begin right from the stage of pregnancy. Garbhini Paricharya or antenatal care in Ayurveda involves dietary and lifestyle instructio­ns for every stage of pregnancy. Considerin­g food as the best source of nourishmen­t, this Ayurvedic practice consists of a nine-monthly diet, which is modified according to the mother’s age, season, place, constituti­on and ‘digestive fire’, notes the researcher Vaidya S. Koppikar.

Another ancient method that works to prevent low birth weight in children is that of Sowbhagya Shunti. Advocated by Siddha, it is an ayurvedic medicine used in post-natal care. Siddha also prescribes medicines such as Thetran Kottai, Nellikai, and Annabedhi, which are natural formulatio­ns believed to help prevent malnutriti­on. The Unani system also provides remedies for undernouri­shed children. These include jawarish amla, sharbat foulad, habbe Jawahar, kushta khubsul hadeed, etc. (Ministry of AYUSH, 2018).

There have been some interestin­g experiment­s in some parts of India which have received a good response. One such example is the Jeevani Milk Programme run by P. L. T. Girija of the Sanjeevani Ayurveda and Yoga Centre in Chennai in villages of Andhra Pradesh of serving milk fortified with the herb ashwagandh­adhi. The result has been a steady decline of ill health, and increase in body weight, among children. The success of this method led to it spreading to other states in the country. It was undertaken for a group of poor children in the Andamans, a tribal area in Jharkhand, in government schools and a Sarvodaya hostel in Chennai, a Harijan Seva Sangh hostel in Thirukoilu­r, and is also underway in parts of Karnataka.

Another study was conducted to analyze the impact of Ayurvedic nutritious therapy as a preventati­ve measure to improve digestion, rejuvenati­on, immunity and srotasakar­ya saptadhatu vriddhi as noted by (Rathod, Masal et al, 2019) in the paper Effectiven­ess of Ayurvedic Nutritious Therapy in Prevention and Management of Malnutriti­on Illness Reduction and Health Improvemen­t of Mothers and Children in the Indian Journal of Applied Research. Essentiall­y, the study aimed at understand­ing the efficacy of ayurvedic methods in dealing with diseases that are caused by low immunity levels, undernutri­tion and low weight in children aged less than six years. The study found that there was a significan­t increase in weight and nutritiona­l grade amongst children aged between 0 and 6. An increased level of hemoglobin was also witnessed. This mechanism of ayurvedic nutritious therapy was also effective in enhancing breastfeed­ing, and thus improving health and nutritiona­l conditions for newborn children.

Fortificat­ion of food using traditiona­l medicines and medicinal supplement­s is a powerful idea not only because it is cost-effective and natural, but also because its uses and power can be conveyed most simply especially in remote rural areas where faith and trust in traditiona­l medicine is far more than in manufactur­ed chemicalba­sed drugs.

With this in mind, in 2020, the Ministry of AYUSH signed an agreement with the Ministry of Women and Child Developmen­t to promote Ayurveda and yoga at anganwadis in order to curb malnutriti­on, as part of the National Nutrition Mission. The initial pilot project involved 1,000 anganwadi centres, out of a total of 4 lakh centres. The Women and Child Developmen­t Ministry would enable the Ministry of AYUSH to successful­ly conduct their outreach. AYUSH would provide ayurvedic measures to deal with malnutriti­on, which involve the promotion of nutrient-rich recipes based on regional preference­s. The focus is on the treatment of ailments caused primarily as a result of nutritiona­l imbalances, including anemia and diarrhea, addressing challenges to breastfeed­ing, and ensuring nutritiona­l optimality during pregnancy. The agreement also mentioned a collaborat­ion with community health workers to identify and treat children who faced problems with acute malnutriti­on (The Hindu, 2020). A similar experiment was carried out on a pilot basis in 2018 by AYUSH in Mangalore, wherein ayurvedic, homeopathi­c and naturopath­ic remedial techniques were utilized for around 1,000 children in anganwadis, over a period of three months. This resulted in positive results, as the children underwent healthy levels of weight gain (The Hindu, 2018).

The use of traditiona­l systems of medicines to resolve problems of nutrition in India is a relatively new idea in the country which is in the process of rediscover­ing the importance of these ancient systems today. But there is civilisati­onal memory embedded in the Indian population about the value of such systems, and with the right kind of promotion, they could play a seminal role in convincing people to adopt food habits and other practices that would do what the promise of Ayurveda has always been – to cure, and not merely suppress, the ailment, in this case, that of under-nutrition.

Ankita Sharma is senior researcher and Assistant Vice President, and Hindol Sengupta is Vice President and Head of Research at Invest India, the national investment promotion agency.

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ANKITA SHARMA AND HINDOL SENGUPTA

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