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== General treatment ==
 
== General treatment ==
<p style="text-align:justify;">Four main measures have been explained viz., vamana (therapeutic emesis), virechana (therapeutic purgation), virodhi dravya sevana (administration of antidotes) and samshamana (prior use of wholesome substance) for the [[Vyadhi|diseases]] caused by intake of unwholesome food combinations. </p>
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<p style="text-align:justify;">Four main measures have been explained viz., [[Vamana|vamana (therapeutic emesis)]], [[Virechana|virechana (therapeutic purgation)]], virodhi dravya sevana (administration of antidotes) and samshamana (prior use of wholesome substance) for the [[Vyadhi|diseases]] caused by intake of unwholesome food combinations. </p>
    
== Factors deciding effect of viruddha ahara ==
 
== Factors deciding effect of viruddha ahara ==
<p style="text-align:justify;">If a person is habituated to the intake of such unwholesome food combinations or if taken in very little quantity, then there will be no or less adverse effect of viruddha ahara. Deeptagni (good digestive power), taruna avastha (young age), undergone oleation therapy, having strong physique due to exercise are protective factors against viruddha ahara. In presence of these factors, adverse effect of such unwholesome food combinations is not observed. [Cha.Sa. [[Sutra Sthana|Sutra Sthana]] 26/104] So, these practices can be promoted to prevent adverse effects of viruddha ahara.</p>
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<p style="text-align:justify;">If a person is habituated to the intake of such unwholesome food combinations or if taken in very little quantity, then there will be no or less adverse effect of viruddha ahara. Deeptagni (good digestive power), taruna avastha (young age), undergone [[Snehana (unction therapy)|oleation therapy]], having strong physique due to exercise are protective factors against viruddha ahara. In presence of these factors, adverse effect of such unwholesome food combinations is not observed. [Cha.Sa. [[Sutra Sthana|Sutra Sthana]] 26/104] So, these practices can be promoted to prevent adverse effects of viruddha ahara.</p>
    
== Importance of knowing viruddha in healthcare ==
 
== Importance of knowing viruddha in healthcare ==
<p style="text-align:justify;">Viruddha Ahara i.e., improper dietic regimens or incompatible food habits, plays a major role in the pathogenesis of various [[Vyadhi|diseases]]. The incompatible mentioned in classics are not very much in practice now a days, so attempt should be made to identify such dietary incompatibilities. The healthy and unhealthy people should be aware about such factors and must avoid them. Nidana parivarjana i.e., avoiding causative factors of disease is the first and prime treatment. For avoidance of incompatibilities the rules and regulations such as ashtavidha ahara visheshayatana (eight specific [[Ahara vidhi|dietary guidelines]]), dwadash ashan pravichara (twelve principles of diet), [[Ahara vidhi|ahara vidhi (dietary guidelines)]] are mentioned in [[Ayurveda|Ayurveda]]. The need of the day is to increase awareness among the public about hazards of such incompatible foods.  </p>
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<p style="text-align:justify;">Viruddha Ahara i.e., improper dietic regimens or incompatible food habits, plays a major role in the pathogenesis of various [[Vyadhi|diseases]]. The incompatible mentioned in classics are not very much in practice now a days, so attempt should be made to identify such dietary incompatibilities. The healthy and unhealthy people should be aware about such factors and must avoid them. [[Nidana Parivarjana|Nidana parivarjana]] i.e., avoiding causative factors of [[Vyadhi|disease]] is the first and prime treatment. For avoidance of incompatibilities the rules and regulations such as ashtavidha ahara visheshayatana (eight specific [[Ahara vidhi|dietary guidelines]]), dwadash ashan pravichara (twelve principles of diet), [[Ahara vidhi|ahara vidhi (dietary guidelines)]] are mentioned in [[Ayurveda|Ayurveda]]. The need of the day is to increase awareness among the public about hazards of such incompatible foods.  </p>
    
== Current researches ==
 
== Current researches ==
<p style="text-align:justify;">The concept of viruddha ahara mentioned in classical texts is very much relevant in today’s era because of  altered life style of fast food or junk food in their daily life. Many studies have found that some dietary constitutes affect transcription of genes. Association between dietary pattern and [[Vyadhi|diseases]] has always been a field of interest. Frequent intake of combination of incompatible food leads in to the production of toxins i.e., ama further leads to formation of ama [[Visha Chikitsa|visha]] (product of improper metabolism), and vitiation of [[Rasa dhatu|rasa dhatu]]. It spreads to another [[Dhatu|dhatu]] and leads to the manifestation of various [[Vyadhi|diseases]]. The effects of such incompatibles can be understood by following aspects. </p>
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<p style="text-align:justify;">The concept of viruddha ahara mentioned in classical texts is very much relevant in today’s era because of  altered life style of fast food or junk food in their daily life. Many studies have found that some dietary constitutes affect transcription of genes. Association between dietary pattern and [[Vyadhi|diseases]] has always been a field of interest. Frequent intake of combination of incompatible food leads in to the production of toxins i.e., [[Ama|ama]] further leads to formation of [[Ama|ama]] [[Visha Chikitsa|visha]] (product of improper metabolism), and vitiation of [[Rasa dhatu|rasa dhatu]]. It spreads to another [[Dhatu|dhatu]] and leads to the manifestation of various [[Vyadhi|diseases]]. The effects of such incompatibles can be understood by following aspects. </p>
<ol type="A" style="text-align:justify;"><li style="font-weight:bold">Effects on immune system: <span style="font-weight:normal">Incompatible food combinations impart untoward effects on immune system, cellular metabolism, and Dehydroepiandrosterone sulphate (DHEAS).<ref name="ref1">Sabnis M. Viruddha Ahara: A critical view. AYU 2012; 33:332-6</ref> Viruddha ahara if taken regularly, can cause inflammation at a molecular level, by increasing proistaglandin-2 and thromboxane by disturbing the eicosanoid pathway. This inflammatory effect is important for the basic pathologies which create agnimandya (poor digestion) or ama (undigested food metabolites) which in turns leads to number of metabolic [[Vyadhi|diseases]]. </span></li>
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<ol type="A" style="text-align:justify;"><li style="font-weight:bold">Effects on immune system: <span style="font-weight:normal">Incompatible food combinations impart untoward effects on immune system, cellular metabolism, and Dehydroepiandrosterone sulphate (DHEAS).<ref name="ref1">Sabnis M. Viruddha Ahara: A critical view. AYU 2012; 33:332-6</ref> Viruddha ahara if taken regularly, can cause inflammation at a molecular level, by increasing proistaglandin-2 and thromboxane by disturbing the eicosanoid pathway. This inflammatory effect is important for the basic pathologies which create agnimandya (poor digestion) or [[Ama|ama]] (undigested food metabolites) which in turns leads to number of metabolic [[Vyadhi|diseases]]. </span></li>
<li style="font-weight:bold">Release of toxins: <span style="font-weight:normal">A recent study found that toxin called 4-hydroxy-trans-2-nonenal (HNE) forms when oil such as soyabean and sunflower oils are reheated. Consumption of foods prepared with such reheated oils increases the risks of various ailments such as stroke, cardiovascular [[Vyadhi|diseases]], Alzheimer’s disease, various liver [[Vyadhi|diseases]] and even cancer.</span></li></ol>
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<li style="font-weight:bold">Release of toxins: <span style="font-weight:normal">A recent study found that toxin called 4-hydroxy-trans-2-nonenal (HNE) forms when oil such as soyabean and sunflower oils are reheated. Consumption of foods prepared with such reheated oils increases the risks of various ailments such as stroke, cardiovascular [[Vyadhi|diseases]], Alzheimer’s disease, various liver [[Vyadhi|diseases]] and even [[Cancer|cancer]].</span></li></ol>
    
== Some common examples of today’s widely used food combinations which act as a viruddha ==
 
== Some common examples of today’s widely used food combinations which act as a viruddha ==
<p style="text-align:justify;">Number of food incompatibilities are mentioned in old Ayurvedic literature, such as Charaka and Sushruta Samhita. We must identify new food incompatibilities of present era which are very common in today’s daily life. New research should be done on food incompatibilities and create awareness in public about its consequences. Topography deals with scientific studies of combination of foods and its consequences. It tells about the various combinations of basic categories of food. As per topographical studies, protiens should not to be taken with starch and carbohydrates together rather than they should be consumed separately. Because consumption of protein and carbohydrates together will delay the absorption of each other. Similarly, consumption of sugars and acidic fruits together should be avoided as they hinder the action of pepsin and ptyalin which reduces the secretion of saliva and further delays digestion. If sufficient amount of amylase is not present in mouth, then starch will not be digested in the stomach. This unwanted effect of such wrong combinations will affect the gastro-intestinal system and also other major systems of the [[Sharira|body]]. Such reactions may be of less importance, but on long term they can prove to be fatal with serious side effects. Let us have some examples of ahara, we are taking now-a-days unknowingly, which are more harmful.<ref name="ref2">Swetha Chalamalasetty, Tatapudi Mahesh Babu, A. Vijayalakshmi, V. Narasimha. Concept of Viruddha Ahara- The Present Scenario. IAMJ 2017; 5 (2)</ref></p>
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<p style="text-align:justify;">Number of food incompatibilities are mentioned in old Ayurvedic literature, such as [[Charak Samhita New Edition|Charaka]] and Sushruta Samhita. We must identify new food incompatibilities of present era which are very common in today’s daily life. New research should be done on food incompatibilities and create awareness in public about its consequences. Topography deals with scientific studies of combination of foods and its consequences. It tells about the various combinations of basic categories of food. As per topographical studies, protiens should not to be taken with starch and carbohydrates together rather than they should be consumed separately. Because consumption of protein and carbohydrates together will delay the absorption of each other. Similarly, consumption of sugars and acidic fruits together should be avoided as they hinder the action of pepsin and ptyalin which reduces the secretion of saliva and further delays digestion. If sufficient amount of amylase is not present in mouth, then starch will not be digested in the stomach. This unwanted effect of such wrong combinations will affect the gastro-intestinal system and also other major systems of the [[Sharira|body]]. Such reactions may be of less importance, but on long term they can prove to be fatal with serious side effects. Let us have some examples of ahara, we are taking now-a-days unknowingly, which are more harmful.<ref name="ref2">Swetha Chalamalasetty, Tatapudi Mahesh Babu, A. Vijayalakshmi, V. Narasimha. Concept of Viruddha Ahara- The Present Scenario. IAMJ 2017; 5 (2)</ref></p>
 
<ol type="A" style="text-align:justify;"><li style="font-weight:bold">Tea prepared with milk: <span style="font-weight:normal">Tea contains flavonoids that have beneficial effects on heart. But when milk is added to tea then the milk protein i.e., caseins reduce the effect of flavonoids. Therefore, tea prepared with milk should be avoided.</span></li>
 
<ol type="A" style="text-align:justify;"><li style="font-weight:bold">Tea prepared with milk: <span style="font-weight:normal">Tea contains flavonoids that have beneficial effects on heart. But when milk is added to tea then the milk protein i.e., caseins reduce the effect of flavonoids. Therefore, tea prepared with milk should be avoided.</span></li>
 
<li style="font-weight:bold">Milk and curd combination: <span style="font-weight:normal">Dishes prepared with milk or by curd should never be taken together as curd will precipitate or curdles up the milk and hinder its digestion. This irritate the stomach and produces gastric disturbances.</span></li>
 
<li style="font-weight:bold">Milk and curd combination: <span style="font-weight:normal">Dishes prepared with milk or by curd should never be taken together as curd will precipitate or curdles up the milk and hinder its digestion. This irritate the stomach and produces gastric disturbances.</span></li>
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== Contemporary views ==
 
== Contemporary views ==
<p style="text-align:justify;">The concept of viruddha ahara mentioned in [[Ayurveda|ayurveda]] easily correlates with the concept of incompatibility, adverse reactions, food and food interactions, food and drug interactions, etc. Observations on antagonistic food is a unique contribution from [[Ayurveda|Ayurveda]] in order to prevent internal diseases and synergize action of drugs in the management of disorders. In [[Ayurveda|Ayurveda]], it is clearly mentioned that certain combinations should be avoided because they hinder the formation of bodily tissue ([[Dhatu|dhatu]]), they vitiate the normal homeostasis of [[Dosha|dosha]] within the [[Sharira|body]] and such combinations are termed as viruddha ahara (incompatible diet). The different combinations of food which is cooked by wrong methods, consumed without following dietic regimens, combined with the food having opposite qualities can be described as viruddha ahara.<ref name="ref7">Swetha Chalamalasetty, Tatapudi Mahesh Babu, A. Vijayalakshmi, V. Narasimha. Concept of Viruddha Ahara- The Present Scenario. IAMJ 2017; 5 (2) </ref> In present era, modern scientists are still working on this aspect. It is important to understand the mechanism of how viruddha ahara is a cause of many metabolic disorders. It is essential to know certain food combinations, which interact with each other and create many systemic disorders. Food-drug interactions, food-food interactions are a very common phenomenon nowadays which is mostly associated with orally administered medicines. It can occur by multiple factors through change in absorption rate or extent, nature of properties of drug, post prandial physiology, route of drug administration, etc. Thus, understanding of such mechanisms is a must while recommending a specific drug with or without food.<ref name="ref8">Deng J, Zhu X, Chen Z, Fan CH, Kwan HS, Wong CH, et.al. A Review of Food-Drug Interactions on Oral Drug Absorption. Drugs. 2017 Nov;77(17):1833-1855</ref> Following are some citations for the such incompatibility which is as follows: </p>
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<p style="text-align:justify;">The concept of viruddha ahara mentioned in [[Ayurveda|ayurveda]] easily correlates with the concept of incompatibility, adverse reactions, food and food interactions, food and drug interactions, etc. Observations on antagonistic food is a unique contribution from [[Ayurveda|Ayurveda]] in order to prevent internal [[Vyadhi|diseases]] and synergize action of drugs in the management of disorders. In [[Ayurveda|Ayurveda]], it is clearly mentioned that certain combinations should be avoided because they hinder the formation of bodily tissue ([[Dhatu|dhatu]]), they vitiate the normal homeostasis of [[Dosha|dosha]] within the [[Sharira|body]] and such combinations are termed as viruddha ahara (incompatible diet). The different combinations of food which is cooked by wrong methods, consumed without following dietic regimens, combined with the food having opposite qualities can be described as viruddha ahara.<ref name="ref7">Swetha Chalamalasetty, Tatapudi Mahesh Babu, A. Vijayalakshmi, V. Narasimha. Concept of Viruddha Ahara- The Present Scenario. IAMJ 2017; 5 (2) </ref> In present era, modern scientists are still working on this aspect. It is important to understand the mechanism of how viruddha ahara is a cause of many metabolic disorders. It is essential to know certain food combinations, which interact with each other and create many systemic disorders. Food-drug interactions, food-food interactions are a very common phenomenon nowadays which is mostly associated with orally administered medicines. It can occur by multiple factors through change in absorption rate or extent, nature of properties of drug, post prandial physiology, route of drug administration, etc. Thus, understanding of such mechanisms is a must while recommending a specific drug with or without food.<ref name="ref8">Deng J, Zhu X, Chen Z, Fan CH, Kwan HS, Wong CH, et.al. A Review of Food-Drug Interactions on Oral Drug Absorption. Drugs. 2017 Nov;77(17):1833-1855</ref> Following are some citations for the such incompatibility which is as follows: </p>
 
<ol><li style="font-weight:bold">Food allergies/ incompatibility <br/><span style="font-weight:normal">A study shows that food incompatibilities affect approximately 20% of the general population in western countries. The data shows that in 25% of the affected children and 10% of affected adults, the incompatibility is based on an allergy, that is, on an immunologically generated incompatibility reaction. Gastrointestinal symptoms occur in a third of these cases. Food allergies are caused by IgE-dependent or IgE-independent immunologic reactions, which leads to an inflammatory reaction, in which mast cells, eosinophilic granulocytes, and other cells are involved.<ref name="ref9">Bischoff, S.C. Food allergies. Springer Link. Current Gastroenterology Reports 8, 374–382 (2006).   
 
<ol><li style="font-weight:bold">Food allergies/ incompatibility <br/><span style="font-weight:normal">A study shows that food incompatibilities affect approximately 20% of the general population in western countries. The data shows that in 25% of the affected children and 10% of affected adults, the incompatibility is based on an allergy, that is, on an immunologically generated incompatibility reaction. Gastrointestinal symptoms occur in a third of these cases. Food allergies are caused by IgE-dependent or IgE-independent immunologic reactions, which leads to an inflammatory reaction, in which mast cells, eosinophilic granulocytes, and other cells are involved.<ref name="ref9">Bischoff, S.C. Food allergies. Springer Link. Current Gastroenterology Reports 8, 374–382 (2006).