An Observational Study to Evaluate the Relationship Between Prakriti andNutritional Status in Apparently Healthy Subjects

Introduction

The concept of Prakriti is a unique contribution of Ayurveda. Prakriti is defined as ‘Nirvikara doshastithi’ resulting in a group of characters being inherited by an individual from the Shukra and Shonita of the parents depending upon the predominance of doshas prevailing at the time of Garbhavakranti. These characters remain with the individual from birth till death.¹ As a result, each individual is unique and is different from others. Thus, Prakriti refers to the genetically determined anatomical, physiological, and psychological constitution of an individual.² Seven types of Prakriti are described in Ayurveda viz. three of individual doshaVata, Pitta, and Kapha; three of dvandvajadosha - Vatapittaja, Vatakaphaja, and Pittakaphaja; and one of SamaPrakriti. ³

Comprehensive instructions on specific food, dietary schedules, and certain regimen in lifestyle are explained to suit one’s Prakriti. Agnibala⁴ and Ayu⁵ of an individual are also categorized based on Prakriti. Prakriti emphasizes individuality and plays a key role in diagnosis, preventive medicine, and therapeutics. As a result, it is a part of Dashavidha Atura Pareeksha. ²

The condition of health of a person is influenced by the intake and utilization of nutrients. However, when the nutrients provided in the diet are inadequate or not utilized properly, it results in a state of imbalance in the body. This condition is known as malnutrition.⁶ Currently, there is a high prevalence of malnutrition. With the population increasing continuously, there is a need for the establishment of nutrition assessment standards for assessing the nutritional status and to provide appropriate nutrition awareness and intervention.

Aims and Objectives

Aim: This study aimed to study the relationship between Prakriti and nutritional status

Objectives:

1. To study the relationship between prakriti and dietary intake

2. To study the relationship between prakriti and anthropometric measurements

3. To study the relationship between prakriti and laboratory investigations

4. To derive an individual based nutritional education and to reduce economic burden in screening nutritional status and malnourishment.

Materials and Methods

Research Design

The research design followed in this study was Causal Comparative design i.e., the design that seeks to find the relationship between the independent and dependent variables. The variables studied here - Prakriti and Nutritional Status have a cause and effect relationship. Prakriti of an individual is determined at the time of conception and it remains the same throughout their life. Therefore, this is the independent variable that affects the dependent variable i.e., Nutritional Status.

Source of Data

In this study, a group of a homogenous population, that is, apparently healthy subjects of age between 20-30 years, who were willing to give consent were randomly selected from SDM Ayurveda College Girls Hostel, Udupi.

Inclusion Criteria

Apparently healthy female subjects of age 20-30 years and residing in SDM Ayurveda College Girls Hostel, Udupi, were selected.

The nutritional status of a person is affected by diet, age and gender. Following these inclusion criteria, the selected subjects were of the same gender and age group and had a similar diet. Hence, the effect of extraneous variables (diet, age, gender) was reduced, so that a clearer relationship can be established between prakriti and nutritional status.

Method of Collection of Data

Sixty subjects were randomly selected and divided into three groups based on Prakriti with 20 individuals per Prakriti (dominant with Vata, Pitta, and Kapha). Dietary intake assessment and nutritional status tests were carried out on this sample of 60 subjects.

Assessment Criteria

The assessment of Prakriti was done with the help of a standard ‘Prakriti Assessment Questionnaire’ which was derived from the Prakriti Pareeksha of Charaka Vimanasthana. It was designed in a way to know the Prakriti of the people in totality. Thirty factors that included both objective and subjective parameters were broadly grouped into four traits viz. physical, physiological, psychological, and behavioural traits.

The following three methods were used for assessing the factors deciding Prakriti:

(i) The anthropometric factors that can be quantified were measured by an appropriate scale.

(ii) Factors regarding physical appearances like hair colour and skin tone were easily assessed by simple observation.

(iii) Factors of physiological (sleep, BMI, appetite, etc.), psychological (indecisiveness, memory, friendship, etc.), and behavioural traits (brave, forgiving, etc.) were assessed by specific questionnaires.

After assessment using the questionnaire, the total percentage of each dosha was calculated. The highest scoring dosha was considered and the subject was grouped under that particular Prakriti i.e., either Vata, Pitta, or Kapha prakriti.

Methods for Nutritional Assessment

Nutritional assessment was done by two methods: Direct (- deals with individuals and measures the objective principles) and indirect (- use of community health indices that depict nutritional influences). Anthropometric, biochemical, clinical, dietary, emotional, and functional criteria were assessed by these methods. To know the entire picture of an individual’s nutritional status, the use of combination of methods was recommended. Dietary and objective parameters were used in this study.

Here, the dietary parameters were assessed using a standard questionnaire. The anthropometric parameters were measured scientifically with appropriate instruments and the biochemical parameters were assessed by blood samples of the subjects.

Discussion

Discussion on Dietary Habits

The habit of consuming food irrespective of appetite seen in Vata and Kapha prakriti subjects can be attributed to the fact that Vata and Kapha prakriti individuals have Vishamagni and Mandagni respectively. Vata prakriti individuals are said to be having Vishamagni. They also have chanchala guna. ⁷ As a result, Vata prakriti subjects have the habit of eating less than satisfaction. The habit of skipping meals is seen in Kapha prakriti subjects since Kapha prakriti individuals have Mandagni and can tolerate hunger. And the Pitta prakriti individuals are said to be having Teekshnagni. They are also said to Dandashookas. Hence, they cannot tolerate hunger. As a result, Pitta prakriti subjects have the habit of eating in between meals and do not having the habit of skipping meals, fasting, eating less than satisfaction, and suppressing hunger.

Discussion on Objective Parameters

In this study, the height of Kapha prakriti subjects was more than that of Pitta and also of Vata. This variation in height was not statistically significant and none of the subjects were neither too short nor too tall. The weight of Kapha prakriti subjects was more than that of Pitta and Vata and it was highly statistically significant. As per the characteristic feature of Prakriti, Vata prakriti individuals will be ‘apachita’ and Kapha prakriti individuals will be ‘upachita’. As a result, the BMI and weight of Kapha prakriti subjects was more than that of Vata and Pitta prakriti subjects. The greater Mid-Arm Circumference (MAC) of Kapha prakriti subjects can be attributed to the fact that Kapha prakriti individuals have upachita paripoorna sarvanga and sarasamasamhata sthirasharira. Further, since Vata prakriti persons have apachita alpasharira, they have the least MAC. Snigdhanga is the feature of Kapha prakriti individuals and hence they were found to be having higher Triceps Skin Fold Thickness (TSFT). Kapha prakriti subjects had higher levels of visceral proteins which indicates the better synthetic (anabolic) activity of Kapha prakriti subjects. The higher cholesterol levels of Kapha prakriti subjects can be understood as the ‘abhyantara snigdhata’ -which is the characteristic feature of Kapha prakriti. Further, Kapha prakriti individuals are said to be having Manda guna, and hence energy is not utilized much in them. As a result, Acetyl Co-A formed in Kreb’s cycle is diverted towards the synthesis of cholesterol rather than energy. This explains the higher levels of Total Cholesterol (TC) in Kapha prakriti subjects. On the same analogy, Pitta prakriti individuals have Teekshna guna⁷ and they were found to have lower levels of TC. Kapha prakriti subjects had a higher Hb% which was attributed to the better synthetic activity and hemopoiesis in Kapha prakriti individuals.

Clear demarcation in objective parameters between Vata and Pitta prakriti subjects was not observed, which may be because the sample size for this study was small.

The methods of assessing the nutritional status and deficiency include various methods like anthropometrical, biochemical, clinical, dietary, emotional, and functional measurements. Each of these methods has its own advantages and disadvantages. Hence, to get the overall picture of an individual’s nutritional status, utilizing all of these methods becomes necessary.⁸ Further, currently there is no universally accepted gold standard (best method) for the assessment of nutritional status.⁹

Quantification of the exact measure of nutrient deficiency is difficult because most of the clinical signs for nutrient deficiency are nonspecific and require analysis of biochemical factors. The benefit of biochemical investigations is that these are highly accurate and help detect early subtle changes in physiological processes before evident clinical signs are manifested. Further, these are extremely precise and reproducible. The limitations are that these biochemical investigations are time consuming and expensive, and cannot be used on a large scale.⁷

By establishing a relation between prakriti and nutritional status, the overall picture of the nutrition of a person can be interpreted just by examining his prakriti, thereby saving time and money. Further, as observed in this study, the nutritional status of Vata and Pitta prakriti individuals tends to be towards the lower limit and they are prone to suffer from nutritional deficiency in comparison to Kapha prakriti individuals. Hence, concentration must be given to Vata and Pitta prakriti individuals to prevent nutritional deficiency.

Conclusion

It is clearly evident from the results obtained from this study that all the three criteria used for nutritional assessment - dietary habits, anthropometric measurements, and blood biomarkers favoured Kapha prakriti subjects. These observations substantiate the fact that it is Kapha that is responsible for anabolism and as a result, Kapha prakriti subjects have a higher assimilation rate than the others. Hence, it can be clearly stated that Kapha prakriti individuals have a better nutritional status which is quoted as - Balavanta, Vasumanta, Ojaswina, and Ayushmanta gunas attributed to Kapha prakriti. Further, in clinical practice, due concentration must be given to Vata and Pitta prakriti individuals in correcting the poor nutritional status. Thus, Prakriti can be used as a tool to assess nutritional status and also in individual-based nutritional education.

Conflicts of Interest

None.