Using Traditional Typologies to Understand Posture Movement and Cognitive Performance - A cross sectional study

CONTEXT

We employed two classification methods that characterize psycho-somatotype categorization to understand motor and cognitive performance. The Trunk Index produces three somatotypes/body type categories: ectomorphs, mesomorphs, and endomorphs, and Prakriti classifications categorizes people into three categories: Vata, Pitta, and Kapha. Comparing these two categorization methods offers insights into anthropometric measures that combine psychological and physical characteristics to account for motor and cognitive behavior.

AIMS

The present study examined variations in cognitive and motor performances using the two typologies - prakriti and somato body types using cross-sectional study design.

SUBJECTS AND METHODS

The study employed fifty-eight healthy young adults, classified into prakriti (vata, pitta, kapha) and ecto-, meso-, endo-morph body types, to examine their cognitive performance (reaction time [RT] and accuracy), and motor performance (posture stability and posture accuracy) in standing yoga postures.

STATISTICAL ANALYSIS USED

Analysis of covariance was performed to compare the cognitive and postural performance across the three somato and prakriti types after adjusting for age and gender as covariates. Post-hoc analysis of Bonferroni was performed with the consideration of Levene's test. Partial correlations were employed to investigate the correlation between postural stability and cognitive performance measures for each of the prakriti- and somato-body types as well as between the prakriti typology (scores) and trunk index values (adjusting the effects of age and gender as control variables). A P < 0.05 was selected at the statistical significance level. SPSS 26.0 version was used for the analysis.

RESULTS

Cognitive performance was observed to vary in terms of RT across somato- and prakriti body types (P < 0.05). Postural stability and cognitive performance are positively connected only for ectomorph body types (P < 0.05). Variations in motor performance were not significant. Barring ectomorph type, no other somato- and prakriti body types showed significant relationships between postural stability and cognitive performance. Likewise, the association between the features used for prakriti classification, and the trunk index scores showed marginal significance, only for a small subset of physical features of prakriti assessment (P = 0.055) (P1).

CONCLUSIONS

Comparing classifications that use psychophysical attributes might offer insights into understanding variations in measures of motor and cognitive performance in a sample of healthy individuals.

Modulation of gut microbiota with Ayurveda diet and lifestyle: A review on its possible way to treat type 2 diabetes

Background

The prevalence of type 2 diabetes (T2D) has increased substantially in the past few decades throughout the world. In India, the epidemic of diabetes continues to increase irrespective of area, status, and age. Despite various scientific societies involved in the treatment of diabetes, still, the burden of diabetes keeps growing.

Aims

The aim of this work is to explore the Ayurvedic concept of a personalized diet to modulate the gut microbiota for the treatment of T2D.

Material and methods

A thorough study of literature from online scientific databases including Web of Science, PubMed, Scopus, and Google Scholar as well as from classical texts of Ayurveda was done. A careful compilation was done to extract the valuable output of the personalized diet to modulate the gut microbiota.

Results

There are various diets used to control blood glucose levels, and their effects are also being studied on the transcriptome or epigenome despite 99.9% genomic similarity among human beings. However, microbiomes have only 10% similarity. Ayurvedic diet is given on the basis of Prakriti (body constitution), therefore, it is also called personalized diet.

Conclusion

The diets prescribed for T2D in Ayurveda are high in fibers, polyphenols, and complex carbohydrates which enrich butyrate-producing bacteria and decrease lipopolysaccharide-producing bacteria. Hence, there is a need to have a personalized diet to manage the glucose level by enriching beneficial gut microbiota. The approach of a personalized diet associated with gut microbiota can be helpful in maintaining blood sugar in T2D patients.

Development of a reliable Dosha self-assessment questionnaire

INTRODUCTION

The Ayurvedic theory of Tri-Dosha offers a unique framework for understanding human differences in health and disease. The Doshas could be readily applied in clinical studies to control for such differences the same way sex, age, height and weight are routinely used except that clinical evaluation is required and methods vary. No open-source questionnaire has been shown to be reliable for self-assessment. Therefore, we undertook this study to develop a reliable Dosha self-assessment questionnaire with characteristics suitable for use in clinical research.

METHODS

A review of published questionnaires and translations of classic Ayurvedic texts along with an analysis of item-total correlations and ANOVAs by Dosha for 735 responses to a 37-item ipsative questionnaire from an Ayurveda products company served as the basis for generating 108 Dosha-specific test items featuring a 7-point Likert scale. We used item-total and inter-item correlations from a convenience sample of 176 individuals to identify the best performing items. We then solicited repeat responses to the resultant 39-item questionnaire (13 for each Dosha) from these and other website visitors and calculated test-retest reliability as the intraclass correlation coefficient for absolute agreement (ICC 2,1) for each Dosha.

RESULTS

The final questionnaire gives normally distributed results. Among 76 self-selected adults, the test-retest reliabilities for Vata, Pitta and Kapha Dosha scores are all above 0.8.

CONCLUSIONS

This study demonstrates that it is possible to quantify the three Doshas with adequate reliability for most clinical studies.

Correlation of body composition parameters and anthropometric somatotypes with Prakriti body types among the Meitei adults of Manipur, India

BACKGROUND

Body composition and types are often considered essential health indicators for lifestyle-related disease. Assessment of body type based on tridosha is regarded as a prerequisite in Ayurveda.

AIM

To correlate body compositions and somatotypes with Prakriti body types.

SUBJECTS AND METHODS

A cross-sectional study on 463 adult individuals was done. Anthropometric and body composition parameters were measured. Heath-Carter somatotypes and Prakriti body types were also determined. Tests of association were calculated. Correlation and concordance analysis was also done to infer the correlation between body composition parameters and Prakriti body types.

RESULTS

Kapha Prakriti have significantly higher body weight, body mass index (BMI), body fat percentage and body fat mass. Vata have the lowest mean values in all body composition parameters with Pitta in the intermediate position compared to the other Prakriti types. There is a strong and positive statistical association between Prakriti body types and body composition parameters, except height. Cohen's Kappa analysis reveals there is a fair concordance between Prakriti body types and somatotype.

CONCLUSIONS

Prakriti assessment can explain an individual's fatness as it correlates with body composition parameters and could be used to predict risk susceptibility to various complex disorders.

Correlation of prakriti diagnosis using AyuSoft prakriti diagnostic tool with clinician rating in patients with psychiatric disorders

Assessment of individual constitution (prakriti) has been an important basic construct of the Ayurveda system of medicine. The AyuSoft prakriti diagnostic tool has been extensively used in Ayurveda research. However, we could not find any literature regarding reliability of a prakriti diagnostic tool in patients with psychiatric conditions. One hundred and twelve patients (M = 70) suffering from various psychiatric disorders as per ICD-10 criteria were recruited (Depression = 31; Schizophrenia = 30, Anxiety disorders = 27; OCD = 9; BPAD = 15). The AyuSoft tool (developed by C-DAC, Pune, India) was applied to determine their prakriti after obtaining written informed consent. Two Ayurveda physicians independently assessed prakriti of the same patients through clinical examination. Inter-rater reliability was assessed between prakriti scores obtained from AyuSoft and those from the Ayurveda physicians by determining Cohen’s Kappa intra-class correlation coefficient (ICC). ICC estimates and their 95% confidence intervals were calculated using SPSS statistical package (version 24.0) based on a mean-rating (k = 2), consistency and two-way mixed-effects model. We observed that there was a significant correlation between dosha scores obtained through AyuSoft and those from the two Ayurveda physicians (for all three doshas: p < 0.01). Inter-rater reliability was moderately strong for vata (ICC = 0.72; Cronbach’s alpha = 0.83), good for pitta (ICC = 0.58; Cronbach’s alpha = 0.62) and comparatively weak for kaphadosha (ICC = 0.44; Cronbach’s alpha = 0.51) respectively. Prakriti diagnosis by AyuSoft was feasible in stabilized psychiatric patients and was found comparable to clinical diagnosis of prakriti by Ayurveda physicians in patients with psychiatric disorders.

Effectiveness of Ayurveda treatment in Urdhwaga Amlapitta: A clinical evaluation

Background

Dyspepsia (Amlapitta) is the commonest ailment found in the present time. Nowadays due to unawareness about Prakriti (psychosomatic constitution) people are practising inappropriate diet and lifestyle which leads to disturbances in digestive system. Due to this pitta is imbalanced and common consequences are Amlapitta. If this pitta takes an upward course, then it is called Urdhwaga Amlapitta.

Objective

This study was conducted to assess the effectiveness of Ayurveda treatment for UrdhwagaAmlapitta in terms of improvement in symptoms, cure rate, satisfaction and side effects if any.

Material and methods

This was a single-arm exploratory open-label clinical trial. Patient with symptom of Urdhwaga Amlapitta were diagnosed as per Rome IV criteria and were further assessed as per eligibility criteria. Thirty patients were enrolled. They were given different herbo-mineral preparation as per ones Prakriti. These drugs were given for 28 days and patients were followed weekly in OPD for assessment of their symptom severity scores.

Result

Tiktamlodgar (acid eructation) and Gurukoshthatva (heaviness in abdomen) was the most commonly occurring symptom in 93% (n = 28) of participants. Seventy Percent (n = 21) of participants had Avipak severity of grade 2 or 3 followed by Gaurav in 50%. The patient was symptomatically relieved by all the symptoms of Urdhwaga Amlapitta by 3rd visit (21st day) and the difference in score was statistically significant. All participants express willingness take Ayurveda medicine in future.

Conclusion

Combination of Ayurveda drugs as per ones Prakriti and severity of symptoms, given to the patient of Urdhwaga Amlapitta was found to effectively cure patients within 28 days. These drugs were found to be well-tolerated, safe and acceptable.

Ayurveda and Epigenetics

Ayurveda is a comprehensive, natural health care system that originated in the ancient Vedic times of India. Epigenetics refers to the external modification of DNA that turns genes on and off, affecting gene expression. This occurs without changes in the basic structure of the DNA. This gene expression can have transgenerational effects. The major factors that cause epigenetic changes are lifestyle and behavior, diet and digestion, stress, and environmental factors. Ayurveda addresses these factors, thereby affecting the Deha (body) Prakriti (psychophysiological constitution), which corresponds to the phenotype, and indirectly the Janma (birth) Prakriti, which corresponds to the genotype. Thus, it is proposed that epigenetics is an important mechanism of Ayurveda. This correlation and understanding will lead to better communication and understanding with the current medical system, and lead to better integration of both sciences in the management of optimal health. In addition, research on Ayurvedic modalities affecting gene expression will further increase correlation and understanding between the current medical system and Ayurveda.

An Approach to Screen Genotoxic-Susceptible Diabetic Population of Various Prakriti Groups for Personalized Disease Management

Background: Ayurveda classifies human populations into three predominant groups as Vata, Pitta, and Kapha based on their "Prakriti'. Any disturbance in the equilibrium of Prakriti can cause various diseases. Objectives: The aim of the study was to link genotoxic variation among the three Prakriti having type 2 diabetes. Design: Type 2 diabetic patients and healthy individuals belonging to three predominant Prakriti were selected through the Prakriti Questionnaire screening as per the guidelines of the CSIR-TRISUTRA unit modified for type 2 diabetes disease. Settings/Location: Sixty individuals from three predominant Prakriti, each consisting of 10 diabetic patients and 10 healthy individuals, were chosen. Subjects: Clinically diagnosed outdoor patients of JBRMCH suffering from type 2 diabetes for 5 years (fasting blood glucose >140 mg/dL; HbA1C > 7.0) and healthy individuals were the subjects for study. Inclusion Criteria: Age limit: 30-70 years, Sex: Both, Habitant: Participants residing in West Bengal for the last five generations, Religion: Unspecified, Social entity: Both urban and rural, Education: High school to college, Economic status: Lower middle to middle classes. Exclusion Criteria: Participants were nonsmokers and nonalcoholics. An individual having a medical history of long-term illness or dwandaja Prakriti type was excluded here. Outcome Measures: Reactive oxygen species (ROS) generation, blood DNA content, DNA damage, apoptosis of blood cells, and interaction of DNA with various carcinogens were observed. Results: The yield of ROS and total cell damage were significantly higher in the diabetic Vata (p < 0.001) group compared with other Prakriti Decreased DNA content and increased DNA damage were observed in type 2 diabetic patients who belonged to Vata (p < 0.01) Prakriti. DNA of Vata Prakriti was more prone to lead and arsenic. Conclusions: The diabetic Vata Prakriti is a genetically susceptible group as it has a tendency to get affected by increased DNA damage, which could help in creating personalized management of diabetes among individual Prakriti.

Comparative gut microbiome analysis of the Prakriti and Sasang systems reveals functional level similarities in constitutionally similar classes

The traditional medicinal systems (TMS) of India (Prakriti) and Korea (Sasang) classify human individuals based on their constitution determined by the physiological and psychological traits of individuals. Similarities in the constitutions are already found between the classes of Prakriti (Vata, Pitta, and Kapha) and Sasang (TE: Taeeumin, SE: Soeumin, and SY: Soyangin) systems. Gut health is an important aspect of this constitution based classification in TMS. To determine the role of gut microbes in such classifications, we have analyzed the gut microbiome (taxa and imputed functions) in the constitutionally similar Prakriti and Sasang classes. An enrichment of Bacteroides and Prevotella enterotypes is observed in the Sasang and Prakriti samples, respectively. The impact of the constitution is found to be more prominent with respect to the taxa and predicted-functions within the Prakriti classes. Gut microbiome functional-level similarities are found to correlate well with the host phenotypes of the constitutionally similar Prakriti and Sasang classes. An enrichment of carbohydrate and amino-acid metabolism is observed in the Vata and SE classes which may be responsible for meeting with their high energy demands and lean phenotype. The Pitta and SY classes exhibit the high capacity to metabolize toxins. An enrichment of functions responsible for predisposition to obesity and high drug metabolism is observed in the Kapha and TE classes. The contribution of gut adaptive functions is found to correlate with the constitution-based classification in both Prakriti and Sasang systems. The TE class harboured the highest number of biofilm-forming and stress-tolerant microbes thus exhibiting the maximum tolerance of environmental stress. Similarities in the gut microbiota and the resulting disease predisposition patterns are found to exist between the constitutionally matching Prakriti and Sasang classes.

Prakriti phenotypes as a stratifier of gut microbiome: A new frontier in personalized medicine?

Ayurveda has a rich history and its significance woven deeply in the Indian culture. The concept of prakriti (a person’s “nature” or constitutional type determined by the proportion of three doshas, namely - vata, pitta and kapha) in Ayurveda is deeply rooted in personalized health management. While the attributes of prakriti has been established to have a genomic basis, there is dearth of elaborate evidences linking prakriti with manifestation of diseases. Next generation sequencing studies have provided a causal link between variation in the gut microbiome and its effect on an individual’s fitness. Separately, reports have identified gut microbial patterns associated with several host variables such as geography, age, diet and extreme prakriti phenotypes. Recently, few reports have identified a “core gut microbiome” consisting of Bacteroides, Faecalibacterium, Prevotella and Ruminococcus prevalent across the Indian population; however, a few bacterial genera were specifically enriched in certain prakritis. Hence, in this review we aim to analyse the role of prakriti variations on dysbiosis of the gut microbiome and concomitantly its effect on human health. We suggest that prakriti phenotyping can function as a potential stratifier of the gut microbiome in a given population and may provide evidence for the conceptual framework of personalized medicine in Ayurvedic system of medicine.

Ayurveda Body-Mind Constitutional Types and Role of Yoga Intervention Among Type 2 Diabetes Mellitus Population of Chandigarh and Panchkula Regions

Background:

Type 2 diabetes needs a better understanding of etiological factors and management strategies based on lifestyle and constitutional factors, given its high association rate with many cardiovascular, neurological disorders, and COVID-19 infection.

Purpose:

The present study was undertaken to investigate the effect of Diabetes-specific integrated Yoga lifestyle Protocol (DYP) on glycemic control and lipid profiles of diabetic adults. Along with the DYP intervention, the individuals residing in Chandigarh and Panchkula union territories in the northern part of India were assessed for Ayurveda-based body–mind constitutional type. Ayurveda describes body–mind constitution as “prakriti,” which has been discussed from two angles, namely physiological and psychological as body and mind are correlated.

Methods:

Cluster sampling of waitlist control study subjects was used as the sampling method for the study. A total of 1,215 registered subjects (81 diabetic) responded in randomly selected clusters in Chandigarh and Panchkula. Ayurveda physicians did Ayurveda body–mind constitutional assessment called prakriti assessment (physiological body–mind constitution assessment) in 35 participants (23 diabetic, 12 prediabetic) as a part of the study.

Results:

A group of 50 subjects was randomly selected for yoga intervention out of 81 diabetes mellitus adults, and 31 subjects were enrolled as waitlist controls. A significant decrease in the glycosylated hemoglobin levels from 8.49 ± 1.94% to 7.97 ± 2.20% in the intervention group was noticed. The lipid profiles of the DYP intervention and control groups were monitored. Three-month follow-up results of lipid profile diagnostic tests in intervention and control groups showed a significant difference between the two groups (P < 0.05). Most diabetic and prediabetic individuals were found to have pitta dosha (pitta controls all heat, metabolism, and transformation in the mind and body) as dominant constitution type.

Conclusion:

The study results demonstrated significant positive effects of yoga in diabetic individuals. This study has indicated the evidence for the safety and efficacy of the validated DYP for community-level interventions to prevent maladies like brain damage and stroke.

A cross-sectional study on the role of stress in hyperglycemia and the effect of Mahatiktaka Kashaya (an Ayurvedic formulation) in its management

Background:

Stress is a potential contributer to chronic hyperglycemia. PittaPrakriti (body constitution) individuals are more prone to stress and the prevalence of type 2 diabetes in stressed out individuals is much more. Aim of study was to evaluate the role of stress in hyperglycemia in individuals of Pitta predominant constitution and to assess the effectiveness of MahatiktakaKashaya in stress-induced hyperglycemia.

Methodology:

A cross-sectional study was carried out in 100 Pitta predominant patients having fasting blood sugar level greater than 140 mg/dl, to find the association of stress and hyperglycemia, using International Stress Management Association questionnaire followed by open lebelled clinical trial with MahatiktakaKashaya (Decoction). Trial drug was administered at a dose of 15 ml twice daily for 14 days. Assessment was done before and after the treatment.

Observation and Analysis:

80% of Pitta predominant individuals have reported stress-associated hyperglycemia. Overall effect of MahatiktakaKashaya in major domains of Stress Assessment Questionnaire, i.e., symptoms, stability and strategies was significant. Furthermore, the trial drug showed significant improvement in biochemical parameters of diabetes.

Conclusion:

The study concludes that there is significant association between stress and hyperglycemia in the individuals of Pitta constitution. MahatiktakaKashaya is found to be highly significant in stress-associated hyperglycemia in the above said group.

Effect of mindfulness meditation protocol in subjects with various psychometric characteristics at high altitude

INTRODUCTION

Incidence of high altitude-related sickness is increasing due to more number of people visiting the areas of high altitude which may result in life-threatening conditions including acute mountain sickness (AMS), high altitude pulmonary edema (HAPE), high altitude cerebral edema (HACE), and High-altitude pulmonary hypertension (HAPH). We hypothesized that an advanced yoga regimen may be beneficial in dealing with the physiology of acclimatization.

METHODS

Anthropometric, Biochemical, and Psychological assessments were carried out in 48 participants before and after the advance meditation program (AMP) in the experimental group. Individuals with an age range of 20-65 years with no comorbidities were included in the study. Participants were exposed to AMP for 4 days. All assessments were carried out at the baseline and after the course. Prakriti was constituted for all participants using a standard questionnaire. The study was carried out after obtaining the written informed consent as per the guidelines outlined by the Institute Ethics Committee.

RESULTS

Po2 and glucose levels were found significantly reduced along with changes in the Happiness index, anxiety, and mental well-being. However, participants with lowered Po2, after 4 days of mindfulness intervention, showed a positive outcome measured by the established scales of anxiety, happiness, and information processing. Psychometric or Prakriti wise analysis revealed that subject with "Pitta" constitution exposed to high altitude and advance meditation showed changes in more parameters than "Vatta" or "Kapha" Constitution.

CONCLUSIONS

Advance meditation in the high altitude zone confers biochemical and neuro-cognitive benefits. Molecular studies may require to understand the role of hypoxic condition in improving the disease state.

Functional signature analysis of extreme Prakriti endophenotypes in gut microbiome of western Indian rural population

Ayurveda is practiced in India from ancient times and stratifies the individuals based on their Prakriti constitution. Advancements in modern science have led to the association of Prakriti with molecular, biochemical, genomic and other entities. We have recently explored the gut microbiome composition and microbial signatures in healthy extreme Prakriti endo-phenotypes. However, their functional potentials are still lacking. The present study includes 63 females (29 Vata, 11 Pitta, and 23 Kapha) and 50 males (13 Vata, 18 Pitta, and 19 Kapha) samples. The predictive functional profiling and organism level functional traits of the human gut microbiome have been carried out in Prakriti groups using imputed metagenomic approach. A higher functional level redundancy is found than the taxonomy across the Prakriti groups, however the dominant taxa contributing to the functional profiles are found to be different. A high number of functional signatures specific to the Prakriti groups were identified in female datasets. Some of the functional signatures were found to be gender specific. For example, a higher abundance of microbes contributing potential pathogenic and stress tolerance related functions was found in Kapha in female and Pitta in male. The functional signatures correlated well with phenotypes and disease predisposition of Prakriti groups.

Concepts of body constitution in traditional Siddha texts: A literature review

Analysis of body constitution has been in practice in most complementary and alternative systems of medicine. Siddha system of medicine practiced in South India consists of fundamental classical literature that stress on the importance of tri-humoral makeup of individuals. Guidance has been given in the classics for identifying specific types of body constitution, various dietary recommendations and disease susceptibility. In validating such important traditional fundamental aspects, analytical systematic literature framework is the first robust step. The present study has been conducted to provide an updated integrative framework of information about body constitution given in various Siddha literatures in quantitative systematic method by using Whittemore and Knafl's five stage approach. This descriptive account may be useful to construct a suitable questionnaire for Siddha based udaliyal assessment.

Western Indian Rural Gut Microbial Diversity in Extreme Prakriti Endo-Phenotypes Reveals Signature Microbes

Heterogeneity amidst healthy individuals at genomic level is being widely acknowledged. This, in turn, is modulated by differential response to environmental cues and treatment regimens, necessitating the need for stratified/personalized therapy. We intend to understand the molecular determinants of Ayurvedic way (ancient Indian system of medicine) of endo-phenotyping individuals into distinct constitution types termed “Prakriti,” which forms the basis of personalized treatment. In this study, we explored and analyzed the healthy human gut microbiome structure within three predominant Prakriti groups from a genetically homogenous cohort to discover differentially abundant taxa, using 16S rRNA gene based microbial community profiling. We found Bacteroidetes and Firmicutes as major gut microbial components in varying composition, albeit with similar trend across Prakriti. Multiple species of the core microbiome showed differential abundance within Prakriti types, with gender specific signature taxons. Our study reveals that despite overall uniform composition of gut microbial community, healthy individuals belonging to different Prakriti groups have enrichment of specific bacteria. It highlights the importance of Prakriti based endo-phenotypes to explain the variability amongst healthy individuals in gut microbial flora that have important consequences for an individual's health, disease and treatment.

Association of Kaphaja and Kapha-Pittaja Prakriti and methylenetetrahydrofolate reductase C677T allele with type 2 diabetes

Background and Objectives:

Type 2 diabetes is a multifactorial disorder that results from the interaction between genetic predisposition and environmental factors. Different Prakriti (body constitution) individuals have different susceptibility for the diseases, and this Prakriti is determined by both genetic and environmental factor. This study was undertaken to determine the association status of Methylenetetrahydrofolate reductase (MTHFR) C677T and A1298C with type 2 diabetes and Prakriti.

Materials and Methods:

After informed consent, 54 patients with type 2 diabetes and 56 individuals as normal controls were analyzed. Their constitution and pathological data were collected and MTHFR C677T and A1298C genotypes were determined.

Results:

Kapha/Kapha-Pittaja Prakriti were associated and found to be strong risk factors (Chi-square test = 39.67, P < 0.00001, odds ratio [OR] = 16.133, 95% confidence interval [CI] = 6.32–41.20) for type 2 diabetes. MTHFR C677T was associated (Chi-square test = 7.743, P = 0.02) with type 2 diabetes where the major CC genotype was found to be a risk for type 2 diabetes (OR = 3.78, 95% CI = 1.14–12.45). A1298C was not associated with type 2 diabetes (Chi-square test = 2.264, P = 0.322). None of the Prakriti was associated with C677T and A1298C variants.

Interpretation and Conclusion:

In the present study, an extremely strong association between Prakriti (Kaphaja/Kapha-Pittaja) and type 2 diabetes (P < 0.00001) was detected. The present study gives a strong clue for the association of Prakriti (body constitutional) and clinical phenotype.

Variation in skin hydration on the basis of Deha Prakriti (body constitution): A cross-sectional observational study

Background:

Prakriti (body constitution) is an important concept of Ayurveda which is decided at the time of birth. It shows differences in physical, physiological and psychological characteristics of an individual. Variation in skin characteristics is found as per Prakriti.

Aim:

The aim of the present work was to study hydration of skin over volar forearm in people with different Prakriti with the help of skin diagnostic SD 27 instrument.

Subjects and Methods:

This was a cross-sectional study conducted at Cosmetic Technology Department in unmarried healthy female students of (18–30 years). A total of 904 volunteers were screened, of which 621 volunteers were further examined for Deha Prakriti for screening of single Dosha dominant Prakriti. 58 Vata, 70 Pitta and 61 Kapha dominant Prakriti were eligible for further study, but on actual day of skin examination, 50 volunteers in each group completed the study. Skin hydration was measured by skin diagnostic SD 27 instrument.

Results:

It was found that maximum people with Vata (92%) and Pitta dominant Prakriti (70%) had less hydration while (48%) Kapha dominant Prakriti volunteers had normal to dehydrated skin. Chi-square test was used for analysis. The Chi-square value is 45.9 and P = 0.0001, which is highly significant.

Conclusion:

The skin of Vata and Pitta dominant Prakriti had less hydration while hydration was well maintained in Kapha dominant Prakriti than that of Vata and Pitta Prakriti people.

A Pilot Study of Correlation between Intelligence Quotient, Social Quotient, and Ayurveda Parameters in Children

BACKGROUND

Intelligence quotient (IQ) and social quotient (SQ) are comparable in predicting intelligence status. The latter is assessed whenever IQ testing is not possible. According to Ayurveda, Buddhi (intelligence) is affected by Prakriti (body constitution) which depends on the predominance of Tridosha and Triguna. There is a paucity of studies to examine their association. The study was designed to examine correlation among IQ, SQ, performance quotient (PQ) and maladaptive behaviour; and to find out their relationship with primary (Anubandhya) and secondary (Anubandha) doshas with intelligence in children with mild to moderate intellectual disability.

METHODOLOGY

Children (n = 120) were recruited from outpatient department of a tertiary care hospital as part of a clinical trial of a novel Ayurveda formulation. Stanford Binet Scale, Vineland Social Maturity Scale, Seguin Form Board Test, and Maladaptive Behavior Schedule-II were administered. Ayurvedic parameters were assessed clinically by Ayurveda practitioner. Separate regression analyses were carried out to look for associations.

RESULTS

IQ and SQ were positively correlated (P = 0.01). Maladaptive behavior and SQ were negatively correlated (0.05). SQ was associated with secondary dosha (P = 0.002) and stage of disease (Roga Kriyakala) (P = 0.015). IQ was also associated with secondary dosha (P = 0.008).

CONCLUSION

SQ and IQ are positively correlated. The correlation of Anubandha (secondary) dosha was high on IQ and SQ.

Plasma metabolomics reveal the correlation of metabolic pathways and Prakritis of humans

BACKGROUND

Ayurveda, an ancient Indian medicinal system, has categorized human body constitutions in three broad constitutional types (prakritis) i.e. Vata, Pitta and Kapha.

OBJECTIVES

Analysis of plasma metabolites and related pathways to classify Prakriti specific dominant marker metabolites and metabolic pathways.

MATERIALS AND METHODS

38 healthy male individuals were assessed for dominant Prakritis and their fasting blood samples were collected. The processed plasma samples were subjected to rapid resolution liquid chromatography-electrospray ionization-quadrupole time of flight mass spectrometry (RRLC-ESI-QTOFMS). Mass profiles were aligned and subjected to multivariate analysis.

RESULTS

Partial least square discriminant analysis (PLS-DA) model showed 97.87% recognition capability. List of PLS-DA metabolites was subjected to permutative Benjamini-Hochberg false discovery rate (FDR) correction and final list of 76 metabolites with p < 0.05 and fold-change > 2.0 was identified. Pathway analysis using metascape and JEPETTO plugins in Cytoscape revealed that steroidal hormone biosynthesis, amino acid, and arachidonic acid metabolism are major pathways varying with different constitution. Biological Go processes analysis showed that aromatic amino acids, sphingolipids, and pyrimidine nucleotides metabolic processes were dominant in kapha type of body constitution. Fat soluble vitamins, cellular amino acid, and androgen biosynthesis process along with branched chain amino acid and glycerolipid catabolic processes were dominant in pitta type individuals. Vata Prakriti was found to have dominant catecholamine, arachidonic acid and hydrogen peroxide metabolomics processes.

CONCLUSION

The neurotransmission and oxidative stress in vata, BCAA catabolic, androgen, xenobiotics metabolic processes in pitta, and aromatic amino acids, sphingolipid, and pyrimidine metabolic process in kapha Prakriti were the dominant marker pathways.

Wipeout period of spinal anesthesia in hemorrhoidectomy in relation to Prakriti: An observational study

Background:

A maximum number of hemorrhoidectomies are performed under spinal anesthesia. However, the effect of spinal anesthesia varies from person to person due to difference in their physical and psychological properties, which is well explained in Ayurveda as Prakriti (physiology of an individual). In this study, we have tried to establish a relation between wipeout period of spinal anesthesia and different Prakriti.

Objectives:

To observe wipeout period of spinal anesthesia in hemorrhoidectomy in relation to different Prakriti.

Materials and Methods:

A total of 30 individuals who underwent hemorrhoidectomy under spinal anesthesia were selected for the study and their Prakriti was assessed as per the standard Prakriti assessment chart before surgery. Apart from demographic data, pain assessment was also recorded by following visual analog scale. Postoperative follow-up was done until the wipeout effect of spinal anesthesia was observed. GraphPad Prism software was used to analyze the data; P < 0.05 was considered statistically significant.

Results:

Male predominance was observed in hemorrhoidectomy cases. Majority of the patients were 20–25 years of age with body weight between 61 and 70 kg. Distribution of Prakriti was observed to be highest in Vata-Pitta Prakriti (36.6%). A significant difference was observed in the wipeout period among Prakriti where the duration of wipeout period was more in the Kapha Prakriti individuals (P < 0.0001).

Conclusion:

Kapha involvement increases the wipeout period in posthemorrhoidectomy; however, in Pitta and Vata Prakriti individuals, the wipeout period is less. Future studies could include a larger sample size and various other factors to analyze the involvement of Kapha.

Ayurgenomics for stratified medicine: TRISUTRA consortium initiative across ethnically and geographically diverse Indian populations

BACKGROUND

Genetic differences in the target proteins, metabolizing enzymes and transporters that contribute to inter-individual differences in drug response are not integrated in contemporary drug development programs. Ayurveda, that has propelled many drug discovery programs albeit for the search of new chemical entities incorporates inter-individual variability "Prakriti" in development and administration of drug in an individualized manner. Prakriti of an individual largely determines responsiveness to external environment including drugs as well as susceptibility to diseases. Prakriti has also been shown to have molecular and genomic correlates. We highlight how integration of Prakriti concepts can augment the efficiency of drug discovery and development programs through a unique initiative of Ayurgenomics TRISUTRA consortium.

METHODS

Five aspects that have been carried out are (1) analysis of variability in FDA approved pharmacogenomics genes/SNPs in exomes of 72 healthy individuals including predominant Prakriti types and matched controls from a North Indian Indo-European cohort (2) establishment of a consortium network and development of five genetically homogeneous cohorts from diverse ethnic and geo-climatic background (3) identification of parameters and development of uniform standard protocols for objective assessment of Prakriti types (4) development of protocols for Prakriti evaluation and its application in more than 7500 individuals in the five cohorts (5) Development of data and sample repository and integrative omics pipelines for identification of genomic correlates.

RESULTS

Highlight of the study are (1) Exome sequencing revealed significant differences between Prakriti types in 28 SNPs of 11 FDA approved genes of pharmacogenomics relevance viz. CYP2C19, CYP2B6, ESR1, F2, PGR, HLA-B, HLA-DQA1, HLA-DRB1, LDLR, CFTR, CPS1. These variations are polymorphic in diverse Indian and world populations included in 1000 genomes project. (2) Based on the phenotypic attributes of Prakriti we identified anthropometry for anatomical features, biophysical parameters for skin types, HRV for autonomic function tests, spirometry for vital capacity and gustometry for taste thresholds as objective parameters. (3) Comparison of Prakriti phenotypes across different ethnic, age and gender groups led to identification of invariant features as well as some that require weighted considerations across the cohorts.

CONCLUSION

Considering the molecular and genomics differences underlying Prakriti and relevance in disease pharmacogenomics studies, this novel integrative platform would help in identification of differently susceptible and drug responsive population. Additionally, integrated analysis of phenomic and genomic variations would not only allow identification of clinical and genomic markers of Prakriti for application in personalized medicine but also its integration in drug discovery and development programs.

Effect of yoga training on lipid metabolism in industrial workers with reference to body constitution (Prakriti)

INTRODUCTION

The progressive increase in dyslipidemia and physical inactivity are considered to be major risk factors for the onset of non communicable diseases. Awareness of body constitution plays a vital role to regularise optimum health. The present study was planned to evaluate the effect of yoga practices on lipid metabolism with reference to specific body constitution (Prakriti).

METHODS

A self-as-control study was conducted on 36 male healthy volunteers between age group of 30-58 years. Their prakriti analysis was done using standardized, validated questionnaire and were divided into Vata-Pitta (n = 16) and Pitta-Kapha (n = 20) groups. The assessment of lipid profile was done in fasting blood samples before and after 12 weeks of yoga training. Data were analyzed using paired t-test and independent t-test.

RESULTS

After yoga intervention, the result of within group comparison revealed that in Vata-Pitta (V-P) group, significant decrease in the levels of TC, LDL (p < 0.001) and significant increase in HDL (p < 0.01) was observed. While, Pitta-Kapha (P-K) group showed significant decrease in TC (p < 0.001), TG (p < 0.01), LDL (p < 0.001) and VLDL (p < 0.05) levels. Further, the results between groups revealed that P-K group has significantly higher baseline levels of TC, TG and VLDL as compared to V-P group (p < 0.05).

CONCLUSION

The study concludes that yoga practices can effectively regulate lipid metabolism and total body energy expenditure with reference to specific constitutional type (Prakriti) that may act as a tool to assess magnitude of metabolic functions.

Development and initial standardization of Ayurveda child personality inventory

Background:

Ayurveda inventories for prakriti (constitution) have been developed and validated for adults. Children, however, require different categories of quarter and questions, for example, to assess the intelligence, the questions can be related to their scholastic performances.

Objective:

To develop and standardize an inventory to assess the prakriti of the children, and to compare with Child Personality Questionnaire (CPQ).

Materials and Methods:

A 135-item Ayurveda child personality inventory (ACPI) scale was developed on the basis of translation of Sanskrit verses describing vataja (A), pittaja (B), and kaphaja prakriti (C) characteristics and by taking the opinions of experts (ten Ayurveda experts and three psychologists). Study was carried out in Maxwell public school, Bangalore. The scale was administered on parents of children of the age group 6-12 years. CPQ was administered on children of the age group 8-12 years.

Results:

The ACPI was associated with excellent internal consistency. The Cronbach's alpha for A, B, and C scales were 0.77, 0.55, and 0.84, respectively, and the Split-half reliability scores were 0.66.0.39 and 0.84, respectively. Factor validity coefficient scores on each items was above 0.5. Scores on vataja, pittaja and kaphaja scales were inversely correlated. Items of V, P, and K scales showed significant correlation (values ranging from 0.39 to 0.84) with subscales of CPQ, which indicates that Eastern and Western psychology concept have good correspondence.

Conclusions:

The prakrti of the children can be measured consistently by this instrument. Scores on V and P scale showed good correlation with the anxiety primary scale of CPQ.

Determinants of prakriti, the human constitution types of Indian traditional medicine and its correlation with contemporary science

Background:

Constitutional type of an individual or prakriti is the basic clinical denominator in Ayurveda, which defines physical, physiological, and psychological traits of an individual and is the template for individualized diet, lifestyle counseling, and treatment. The large number of phenotype description by prakriti determination is based on the knowledge and experience of the assessor, and hence subject to inherent variations and interpretations.

Objective:

In this study we have attempted to relate dominant prakriti attribute to body mass index (BMI) of individuals by assessing an acceptable tool to provide the quantitative measure to the currently qualitative ayurvedic prakriti determination.

Materials and Methods:

The study is cross sectional, multicentered, and prakriti assessment of a total of 3416 subjects was undertaken. Healthy male, nonsmoking, nonalcoholic volunteers between the age group of 20-30 were screened for their prakriti after obtaining written consent to participate in the study. The prakriti was determined on the phenotype description of ayurvedic texts and simultaneously by the use of a computer-aided prakriti assessment tool. Kappa statistical analysis was employed to validate the prakriti assessment and Chi-square, Cramer's V test to determine the relatedness in the dominant prakriti to various attributes.

Results:

We found 80% concordance between ayurvedic physician and software in predicting the prakriti of an individual. The kappa value of 0.77 showed moderate agreement in prakriti assessment. We observed a significant correlations of dominant prakriti to place of birth and BMI with Chi-square, P < 0.01 (Cramer's V-value of 0.156 and 0.368, respectively).

Conclusion:

The present study attempts to integrate knowledge of traditional ayurvedic concepts with the contemporary science. We have demonstrated analysis of prakriti classification and its association with BMI and place of birth with the implications to one of the ways for human classification.

Impact of season and constitution on lipid parameters

Ayurveda prescribes daily and seasonal regimen in maintaining good health. Measures in the preservation of health have been described considering one's own Prakriti, Satva, Vayas, Bala, Agni, Ojus, season, and so on. Depending on the relative predominance of Doshas in various constitutions and seasons, certain regimens have been prescribed. The present study was done to assess the lipid profile in 54 healthy volunteers. It was observed from the present data that winter month is one of the potential risk factors for cardiovascular diseases because more lipid profile level was observed during winter. Among the constitutions, Kapha and Pitta Prakriti are more vulnerable for cardiovascular diseases because more lipid profile level is observed in these constitutions during winter.

Development and validation of a Prototype Prakriti Analysis Tool (PPAT): Inferences from a pilot study

Prakriti, for its tangible impacts upon decision making in Ayurvedic clinical practice, requires a thorough and fool-proof method of examination. Conventional methods adopted for Prakriti examination are found inconsistent with huge inter- and intra-rater inference variability. By observing the gaps in the field, the present study aims to develop a prototype Prakriti analysis tool and its evaluation on inter-rater validity grounds. The study observes that Vata and Pitta constructs of Prakriti identification in Ayurveda have a significant inter-rater correlation (P ` 0.001 and P ` 0.01), whereas Kapha has less (P ` 0.02) correlation. It is inferred that for less correlated variables like those of Kapha, a better understanding is required to reach a better consensus.

Applicability and importance of Caraka's concept of Aaturaparijnana Hetawah in understanding a patient

Many concepts in Ayurveda are untouched or unexplored till date. One of such concepts to understand the healthy and unhealthy persons is that of the Aaturaparijnana Hetawah (APH), which is only mentioned in Caraka Samhita. The descriptions about Dushya, Desha, Bala, Kala, Prakriti, etc. are mentioned very briefly in all the classics. But no standard figure or pattern is maintained while considering them. It is only in the description of Aaturaparijnana Hetawah mentioned in Vimana Sthana that all the factors are pre-arranged in a chronological order to understand an individual according to one’s Desha as from birth till grown up stage, and also to understand about the illness and most common disorders. In this article, it is aimed at presenting an in-depth evaluation about description of Aaturaparijnana Hetawah in Ayurveda. For this study, the references of Aturaparijnana Hetu have been collected through the Ayurvedic texts along with their commentaries. By making use of 14 factors described in Aaturaparijnana Hetawah, it is possible to have an in depth understanding about the patient’s nature and factors that may be contributing to his health and illness. Aaturaparijnana Hetawah helps in an in-depth understanding of a patient’s disease and heath status. More in-depth evaluation studies and application in the modern medical science should be done in order to avail the benefits of this approach.

Effect of walking (aerobic isotonic exercise) on physiological variants with special reference to Prameha (diabetes mellitus) as per Prakriti

Walking is an isotonic aerobic exercise and has been associated with reduced blood sugar level in diabetic patients and other physiological changes in observational studies. A study was conducted to determine the effect of isotonic aerobic exercise (walking) on blood sugar level and other important physiological parameters as per Prakriti. This study was carried out in Department of Kriya Sharira and Kayachikita, S. S. Hospital; Faculty of Ayurveda, IMS, BHU and some cases were enrolled from Kashi Mumukshu Bhawan, Assi, Varanasi. A total 83 (32 diabetic control and 51 diabetic exercise) diabetic cases were included with age ranging from 35 to 65 years during January 2009 to January 2011. Control cases enrolled in this study had not performed any exercise. The results of the study revealed that, there is a strong association in between Prakriti, Blood pressure and certain other Biochemical parameters.

Understanding personality from Ayurvedic perspective for psychological assessment: A case

The study of personality has fascinated psychologists since a long time. Personality as an area of study has grown so much that a wealth of literature is available. On the other hand, the socio-ethnic dynamics of human race in the emerging global village context provoking psychologists to develop a personality theory which can treat certain basic components of personality as invariants, so that irrespective of culture, race, and nativity could still be able to study personality which will have universal applicability and relevance, is still far away. In the above emerging backdrop, "Ayurveda" has perhaps an important role to play as it can enable providing a theoretical and empirical base of personality traits and types. These Ayurvedic concepts are applicable to all human beings irrespective of caste, color, sex or race. Therefore, it is interesting to build on the Ayurvedic knowledge which has already given us so much since time immemorial, and validate some of these issues related to personality from psychological perspective. There are already certain efforts in understanding Sattva, Rajas, and Tamas Gunas. It can be furthered so that a comprehensive personality picture can be generated, which can have implications for health, career, education and many other dimensions of life. The present paper is a theoretical attempt in developing such a personality proposition which can be validated. Thus, the present paper only builds a theoretical framework for their possible empirical validity.