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|keywords=santarpana (over-nutrition), apatarpana (under-nutrition), management of over-nutrition induced disorders, nutrition deficiency disorders, charak samhita, obesity, dislipidemia, hypercholesterolemia, Ayurveda, Indian system of medicine, charak samhita.  

|keywords=santarpana (over-nutrition), apatarpana (under-nutrition), management of over-nutrition induced disorders, nutrition deficiency disorders, charak samhita, obesity, dislipidemia, hypercholesterolemia, Ayurveda, Indian system of medicine, charak samhita.  

|description=Sutra Sthana Chapter 23. Over-nutrition, under-nutrition and its disorders

|description=Sutra Sthana Chapter 23. Over-nutrition, under-nutrition and its disorders

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|image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg

|image_alt=carak samhita

|image_alt=carak samhita

|type=article

|type=article

|label7 = Reviewer  

|label7 = Reviewer  

|data7  = Byadgi P.S.

|data7  = Byadgi P.S.

|label8 = Editor

|label8 = Editors

|data8  = Dwivedi R.B.

|data8  = Dwivedi R.B., Deole Y.S., Basisht G.

|label9 = Date of publication  

|label9 = Year of publication  

|data9 = December 17, 2018

|data9 = 2020

|label10 = DOI

|label10 = Publisher

|data10  =  

|data10 = [[Charak Samhita Research, Training and Skill Development Centre]]

|label11 = DOI

}}

}}

Unctuous (''snigdha''), sweet (''madhura''), heavy to digest (''guru''), and slimy (''pichhilla'') foods predominantly have ''prithvi'' and ''apa mahabhutas'', leading to an increase in ''kapha'' and ''rasa dhatu''.  

Unctuous (''snigdha''), sweet (''madhura''), heavy to digest (''guru''), and slimy (''pichhilla'') foods predominantly have ''prithvi'' and ''apa mahabhutas'', leading to an increase in ''kapha'' and ''rasa dhatu''.  

The functional trait of such food articles is ''snigdha'' (oily) ''guna'' is ''sneha'' (unctuousness), ''mriduta'' (softness), and ''ardrata'' (malleability, fluidity)<ref> Gothecha Mohanlal., Dr., editor. Guna Parijnana. Jamnagar: Post Graduate Training Center in [[Ayurveda]]; 1958. pp. 19–20. </ref>  <ref> Acharya Vaidya Jadavaji Trikamaji, Aachrya Narayana Rama. Sutra Sthana Dalhana. 8 edition. 49. Vol. 1. Chaukhamba Orientalia; 2005. Susruta, ‘Susruta Samhita’ with ‘Nibandha Sangrha’ commentary by Dallhanacharya; p. 12 </ref>. ''Snigdha'' food articles include those derived from lipids and fat molecules. Similarly, ''madhura'' (sweetness) is a property of food substances that possess predominantly sweet taste - not just perceived at the tongue, but also in many parts/tissues along our digestive system. ''Guru'' is the primary property that indicates “heaviness” of a food item, and a ''guru'' food article is heavy to digest and increases bulkiness of the tissues. ''Guru'' is the opposite of ''agni'' and hence delays digestion and metabolism and is used, therefore, in therapies that require nourishment, enhancement of physical strength, etc (''brimhana, agnimaandyakara, upalepa, bala, upachaya'' and ''tarpana''). Finally, ''picchilla'' is sliminess and stickiness, and indicates food items that vitiate ''kapha'' and ''mamsa-meda dhatu'' particularly.  

The functional trait of such food articles is ''snigdha'' (oily) ''guna'' is ''sneha'' (unctuousness), ''mriduta'' (softness), and ''ardrata'' (malleability, fluidity)<ref> Gothecha Mohanlal., Dr., editor. Guna Parijnana. Jamnagar: Post Graduate Training Center in [[Ayurveda]]; 1958. pp. 19–20. </ref>  <ref> Sushruta. Sutra Sthana, Cha.41 Dravyavisheshavinjaniya Adhyaya verse 11. In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 8th ed. Varanasi: Chaukhambha Orientalia;2005. </ref>. ''Snigdha'' food articles include those derived from lipids and fat molecules. Similarly, ''madhura'' (sweetness) is a property of food substances that possess predominantly sweet taste - not just perceived at the tongue, but also in many parts/tissues along our digestive system. ''Guru'' is the primary property that indicates “heaviness” of a food item, and a ''guru'' food article is heavy to digest and increases bulkiness of the tissues. ''Guru'' is the opposite of ''agni'' and hence delays digestion and metabolism and is used, therefore, in therapies that require nourishment, enhancement of physical strength, etc (''brimhana, agnimaandyakara, upalepa, bala, upachaya'' and ''tarpana''). Finally, ''picchilla'' is sliminess and stickiness, and indicates food items that vitiate ''kapha'' and ''mamsa-meda dhatu'' particularly.  

Today’s research is consistent with the above findings of [[Ayurveda]]. Researchers acknowledge that taste receptors exist in the upper gastrointestinal tract as well. These receptors are “primarily located in the intestinal brush and enteroendocrine cells, and recognize sugars, D-amino acids, sweet proteins, and artificial sweeteners<ref>Greenfield Jerry R.,  Chisholm Donald J.  How Sweet It Is: Intestinal Sweet Taste Receptors in Type 2 Diabetes. Diabetes. 2013 Oct; 62(10): 3336–3337.</ref>”, per their research. Peptide YY (PYY) exerts its action through NPY receptors by inhibiting gastric motility and increasing water and electrolyte absorption in the colon<ref> Liu C, Aloia T, Adrian T, Newton T, Bilchik A, Zinner M, Ashley S, McFadden D (1996). "Peptide YY: a potential proabsorptive hormone for the treatment of malabsorptive disorders". Am Surg 62 (3): 232–6.Charak Samhita Sutra Sthana 27/309 </ref>.  PYY may also suppress pancreatic secretion, as it is secreted by neuro-endocrine cells in the ileum and colon in response to a meal, and has been shown to reduce appetite. It works by slowing the gastric emptying, thereby increasing the efficiency of digestion and nutrient absorption after a meal. Considering the effects of sweet food substances, PYY, in certain quantities, helps induce satiety in a person and thus in excess, inhibits appetite. This study clearly suggests the impact of ''madhura rasa'' and ''snigdha'' food substances in creating ''santarpaniya vyadhi'' or increased anabolism. Like GLP -1, GIP is related to metabolism and inflammation.  

Today’s research is consistent with the above findings of [[Ayurveda]]. Researchers acknowledge that taste receptors exist in the upper gastrointestinal tract as well. These receptors are “primarily located in the intestinal brush and enteroendocrine cells, and recognize sugars, D-amino acids, sweet proteins, and artificial sweeteners<ref>Greenfield Jerry R.,  Chisholm Donald J.  How Sweet It Is: Intestinal Sweet Taste Receptors in Type 2 Diabetes. Diabetes. 2013 Oct; 62(10): 3336–3337.</ref>”, per their research. Peptide YY (PYY) exerts its action through NPY receptors by inhibiting gastric motility and increasing water and electrolyte absorption in the colon<ref> Liu C, Aloia T, Adrian T, Newton T, Bilchik A, Zinner M, Ashley S, McFadden D (1996). "Peptide YY: a potential proabsorptive hormone for the treatment of malabsorptive disorders". Am Surg 62 (3): 232–6.Charak Samhita Sutra Sthana 27/309 </ref>.  PYY may also suppress pancreatic secretion, as it is secreted by neuro-endocrine cells in the ileum and colon in response to a meal, and has been shown to reduce appetite. It works by slowing the gastric emptying, thereby increasing the efficiency of digestion and nutrient absorption after a meal. Considering the effects of sweet food substances, PYY, in certain quantities, helps induce satiety in a person and thus in excess, inhibits appetite. This study clearly suggests the impact of ''madhura rasa'' and ''snigdha'' food substances in creating ''santarpaniya vyadhi'' or increased anabolism. Like GLP -1, GIP is related to metabolism and inflammation.  

=== II. Impact of age on grains and grain-based food products ===

=== II. Impact of age on grains and grain-based food products ===

The age of food grains helps determine the quality as well as digestibility of food. ''Shuka dhanya'' (monocotyledons) and ''shami dhanya'' (dicotyledons) that are old /aged are easy to digest and are dry in property as compared to new ones [Cha.Sa.Sutra Sthana 27/309]. ''Nava anna'', or fresh, non-aged rice, millet, etc. increase ''kapha'' and are heavier than old grains. Charak notes that all new and fresh grains are heavy and induce ''santarpana'', while aged grains are lighter to digest.

The age of food grains helps determine the quality as well as digestibility of food. ''Shuka dhanya'' (monocotyledons) and ''shami dhanya'' (dicotyledons) that are old /aged are easy to digest and are dry in property as compared to new ones. [Cha.Sa.[[Sutra Sthana]] 27/309] ''Nava anna'', or fresh, non-aged rice, millet, etc. increase ''kapha'' and are heavier than old grains. Charak notes that all new and fresh grains are heavy and induce ''santarpana'', while aged grains are lighter to digest.

Sharangdhara in Purva Khanda also talks of new and old grains and recommends six to twelve month-old grains to be used. Biochemical changes that help in digestion may be occurring after certain aging of grains. Per researchers (Seguchi, 1993), aging of flour and grains does enhance their functionality as ingredients for cakes and batter. Cereals can be stored for long periods without microbial spoilage. However, biochemical changes also occur during aging. There is great possibility that certain amino acids and phyto chemicals get stabilized in the grain which make them safe for consumption. Eventually, the grain respires, dry matter is lost and functional and nutritional aspects of the grain are altered. Age related changes have great influence on the viscosity of any batter made out of wheat-flour and the water-binding ability of the wheat flour (Shelke et al, 1992). In addition, the starch granule surface protein is found to increase up to three to four times with aging. However, prolonged aging is not recommended (Pomeranz et al, 1968). The moisture content of grains, the storage temperature and relative humidity have been shown to exert dramatic changes in the acidity, pH, free amino nitrogen, crude protein, and protein quality. Significant changes in soluble sugars and amylase contents of the grains have also been reported during storage at elevated temperature<ref> Zia-Ur Rehman, W.H. Shah. Biochemical changes in wheat during storage at three temperatures. Plant Foods for Human Nutrition 54: 109–117, 1999. </ref>.   

Sharangdhara in Purva Khanda also talks of new and old grains and recommends six to twelve month-old grains to be used. Biochemical changes that help in digestion may be occurring after certain aging of grains. Per researchers (Seguchi, 1993), aging of flour and grains does enhance their functionality as ingredients for cakes and batter. Cereals can be stored for long periods without microbial spoilage. However, biochemical changes also occur during aging. There is great possibility that certain amino acids and phyto chemicals get stabilized in the grain which make them safe for consumption. Eventually, the grain respires, dry matter is lost and functional and nutritional aspects of the grain are altered. Age related changes have great influence on the viscosity of any batter made out of wheat-flour and the water-binding ability of the wheat flour (Shelke et al, 1992). In addition, the starch granule surface protein is found to increase up to three to four times with aging. However, prolonged aging is not recommended (Pomeranz et al, 1968). The moisture content of grains, the storage temperature and relative humidity have been shown to exert dramatic changes in the acidity, pH, free amino nitrogen, crude protein, and protein quality. Significant changes in soluble sugars and amylase contents of the grains have also been reported during storage at elevated temperature<ref> Zia-Ur Rehman, W.H. Shah. Biochemical changes in wheat during storage at three temperatures. Plant Foods for Human Nutrition 54: 109–117, 1999. </ref>.   

'''''Kushtha''''': There are many skin diseases which are related to anabolism. Anabolism leads to discoloration and hyperpigmentation of skin. Majority of obese people show severe hyperpigmentation, which is called as acanthosis nigricans. Simple acne can also be the result of ''santarpanajanya vyadhis''.  Some of the studies<ref> Downing D, Strauss J, Pochi P. Changes in skin surface lipid composition induced by severe caloric restriction in man. Am J Clin Nutr. 1972;25:365–367</ref> had reported, how caloric restriction can change sebum composition. Another study <ref> Adebamowo CA, Spiegelman D, Berkey CS, et al. Milk consumption and acne in teenaged boys. J Am Acad Dermatol. 2008;58:787–793. </ref>linked acne to the consumption of milk.  

'''''Kushtha''''': There are many skin diseases which are related to anabolism. Anabolism leads to discoloration and hyperpigmentation of skin. Majority of obese people show severe hyperpigmentation, which is called as acanthosis nigricans. Simple acne can also be the result of ''santarpanajanya vyadhis''.  Some of the studies<ref> Downing D, Strauss J, Pochi P. Changes in skin surface lipid composition induced by severe caloric restriction in man. Am J Clin Nutr. 1972;25:365–367</ref> had reported, how caloric restriction can change sebum composition. Another study <ref> Adebamowo CA, Spiegelman D, Berkey CS, et al. Milk consumption and acne in teenaged boys. J Am Acad Dermatol. 2008;58:787–793. </ref>linked acne to the consumption of milk.  

'''''Klaibya''''': A person who is unable to have proper sexual intercourse either due to erectile dysfunction or early ejaculation is termed as ''klaibya'' in [[Ayurveda]].''Klaibya'' is described in detail in [[Chikitsa Sthana]] (Chikitsa 30/155) and is mentioned as a complication of either obesity, diabetes or hypertension. While elaborating the properties of ''lashuna'' (garlic) Charak has explained that ''lashuna'' is important herb in cardiac disorders as well and is useful in ''klaibya''. Looking at its properties on microvessels, ''garlic'' is proven to be a herb which regulates nitric oxide synthesis in the arteries and keeps the lumen of the arteries dilated. Per studies, in cases of hypertensive erectile dysfunction in rats, it has been observed that nitric oxide synthesis in penile artery is lowered<ref> Penson DF et al. Adrenal Control of erectile function and nitric oxide synthase in the rat penis 138(9):3925-32 1997 </ref>. Garlic has positive impact on regulating nitric oxide synthesis<ref> Peyman et al.  Therapeutic Uses and Pharmacological Properties of Garlic, Shallot, and Their Biologically Active Compounds 16(10):1031-1048 2013 </ref>.

'''''Klaibya''''': A person who is unable to have proper sexual intercourse either due to erectile dysfunction or early ejaculation is termed as ''klaibya'' in [[Ayurveda]].''Klaibya'' is described in detail in [[Chikitsa Sthana]] [Cha.Sa.[[Chikitsa Sthana]] 30/155] and is mentioned as a complication of either obesity, diabetes or hypertension. While elaborating the properties of ''lashuna'' (garlic) Charak has explained that ''lashuna'' is important herb in cardiac disorders as well and is useful in ''klaibya''. Looking at its properties on microvessels, ''garlic'' is proven to be a herb which regulates nitric oxide synthesis in the arteries and keeps the lumen of the arteries dilated. Per studies, in cases of hypertensive erectile dysfunction in rats, it has been observed that nitric oxide synthesis in penile artery is lowered<ref> Penson DF et al. Adrenal Control of erectile function and nitric oxide synthase in the rat penis 138(9):3925-32 1997 </ref>. Garlic has positive impact on regulating nitric oxide synthesis<ref> Peyman et al.  Therapeutic Uses and Pharmacological Properties of Garlic, Shallot, and Their Biologically Active Compounds 16(10):1031-1048 2013 </ref>.

   

   

The direct effect of obesity on increased risk of erectile dysfunction is well researched, and is often attributable to hormonal imbalance, endothelial dysfunction and insulin resistance.  

The direct effect of obesity on increased risk of erectile dysfunction is well researched, and is often attributable to hormonal imbalance, endothelial dysfunction and insulin resistance.  

Apart from its diuretic properties, ''pashanabheda'' exhibits good anti-diabetic properties. The 80% ethanolic extract of ''pashanabheda'' rhizome was fractionated to investigate for a-glucosidase or anti-diabetic properties. Sample solution were evaluated at dose levels of 5.0, 0.5, 0.05 mg/ml to obtain dose response. The ethyl acetate extract exhibited an inhibitory effect of a-glucosidase properties<ref> Youshikawa M, Nishida N, Shimoda H, Takada M, Kawahara Y, Matsuda. Polyphenol constituents from Salacia species: quantitative analysis of mangiiferin with alpha- glucosidase and aldose reductase inhibitory activities. Yakugaku Zasshi, 1231, 2001, 371-378. </ref>.  

Apart from its diuretic properties, ''pashanabheda'' exhibits good anti-diabetic properties. The 80% ethanolic extract of ''pashanabheda'' rhizome was fractionated to investigate for a-glucosidase or anti-diabetic properties. Sample solution were evaluated at dose levels of 5.0, 0.5, 0.05 mg/ml to obtain dose response. The ethyl acetate extract exhibited an inhibitory effect of a-glucosidase properties<ref> Youshikawa M, Nishida N, Shimoda H, Takada M, Kawahara Y, Matsuda. Polyphenol constituents from Salacia species: quantitative analysis of mangiiferin with alpha- glucosidase and aldose reductase inhibitory activities. Yakugaku Zasshi, 1231, 2001, 371-378. </ref>.  

'''''Takra''''' (butter milk) is used to relieve ''santarpanajanya vyadhis''. It has prime importance in diet and is supposed to be improve appetite. Its properties and medicinal qualities are described in (Ashtanga Hridaya [[Sutra Sthana]] chapter 5).  

'''''Takra''''' (butter milk) is used to relieve ''santarpanajanya vyadhis''. It has prime importance in diet and is supposed to be improve appetite. Its properties and medicinal qualities are described in Ashtanga Hridaya Sutra Sthana chapter 5.  

'''''Trikatu''''': is combination of equal parts of ''sunthi, maricha'' and ''pippali''. ''Trikatu'' is regarded as an anti-obesity formulation and has been widely used in anabolic disorders. It is widely used to lower cholesterol and triglycerides and is known to increase HDL levels. In one of the studies it is found that ''trikatu'', by virtue of its ability to reduce triglycerides and LDL cholesterol, increases HDL cholesterol to reduce the risk of hyperlipidaemia and atherosclerosis.<ref> Effect of an indigenous herbal compound preparation ‘Trikatu’ on the lipid profiles of atherogenic diet and standard diet fed Rattus norvegicus Valsala Sivakumar1,Phytotherapy Research Volume 18, Issue 12, pages 976–981, December 2004. </ref> ''Trikatu'' is also known to have immune modulatory properties<ref> Trikatu, an herbal compound as immunomodulatory and anti-inflammatory agent in the treatment of rheumatoid arthritis-an experimental study Vachana Murunikkara, MahaboobKhan RasoolCellular ImmunologyAvailable online 18 December 2013 </ref>  and is known to be a good bioavailability enhancer<ref> Effect of trikatu (PIPERINE) on the pharmacokinetic profile of isoniazid in rabbitsRS Karan, VK Bhargava, SK Garg Year : 1998  , Volume : 30 ,,  Issue : 4  ,  Page : 254-256. </ref>.  

'''''Trikatu''''': is combination of equal parts of ''sunthi, maricha'' and ''pippali''. ''Trikatu'' is regarded as an anti-obesity formulation and has been widely used in anabolic disorders. It is widely used to lower cholesterol and triglycerides and is known to increase HDL levels. In one of the studies it is found that ''trikatu'', by virtue of its ability to reduce triglycerides and LDL cholesterol, increases HDL cholesterol to reduce the risk of hyperlipidaemia and atherosclerosis.<ref> Effect of an indigenous herbal compound preparation ‘Trikatu’ on the lipid profiles of atherogenic diet and standard diet fed Rattus norvegicus Valsala Sivakumar1,Phytotherapy Research Volume 18, Issue 12, pages 976–981, December 2004. </ref> ''Trikatu'' is also known to have immune modulatory properties<ref> Trikatu, an herbal compound as immunomodulatory and anti-inflammatory agent in the treatment of rheumatoid arthritis-an experimental study Vachana Murunikkara, MahaboobKhan RasoolCellular ImmunologyAvailable online 18 December 2013 </ref>  and is known to be a good bioavailability enhancer<ref> Effect of trikatu (PIPERINE) on the pharmacokinetic profile of isoniazid in rabbitsRS Karan, VK Bhargava, SK Garg Year : 1998  , Volume : 30 ,,  Issue : 4  ,  Page : 254-256. </ref>.