Globally, over half a billion adults aged 20-79 are estimated to have diabetes. An additional half a billion adults have impaired glucose tolerance, which places them at high risk for developing type 2 diabetes in the future.
Research has shown that the metabolic dysregulation associated with diabetes is a major cause of kidney failure, heart attacks, stroke, peripheral neuropathy, lower limb amputation, and blindness. It is well-known that diet and lifestyle factors strongly contribute to the development of type 2 diabetes. As such, Ayurveda, the indigenous medical practice of India that emphasizes optimal lifestyle habits, should be considered as an adjunctive therapy in the management and prevention of type 2 diabetes, as well as other modern health challenges.
Ayurveda’s complementary approach to diabetes management uses food as medicine to help manage disease. This involves selecting the right type of foods for your body, properly implementing medicinal herbs and spices, and following a lifestyle that will optimize the function of circadian rhythms.
Foundations of Ayurvedic Medicine
Ayurveda is known as the “science of life” and is the indigenous medical system of India that has been practiced for thousands of years. Ayurveda considers all beings to be part of nature, and so what happens in nature is also happening in us. It addresses the root causes of imbalances by considering how we interact with nature and how we are designed to function naturally from a mind-body-spirit perspective.
The basics of Ayurvedic principles emphasize that the qualities of the elements fire, water, earth, air, and ether are present in varying quantities in all things. Everything we see has some mix of these qualities. The way in which these qualities interact and combine is defined by the three doshas.
Space and air qualities create the vata dosha, water and earth qualities create the kapha dosha, and fire and water qualities create the pitta dosha. Each dosha is associated with several functions and energetic forces that are responsible for the physiology of the body. Ayurveda uses the three doshas as a map to understand how your body and mind work. When the doshas are in balance, they support well-being. An imbalanced dosha creates disorder.
A basic principle in Ayurveda is bio-individuality. Our genetic blueprint is known as Prakriti, and in this state, all three doshas exist in a proportion that is optimal for our individual body-mind. Lifestyle and environmental influences impact our doshic balance, and we exist in a new state known as Vikruti. This is where dysfunction and disease can occur. However, by following the principles of Ayurveda related to lifestyle, we can restore the appropriate proportions of the doshas that will keep us feeling vibrant and healthy.
Understanding Diabetes Through The Ayurvedic Lens
The Ayurvedic perspective on diabetes characterizes it in the class of disorders titled prameha, which means “those that result in excess urination.” A subset of prameha is madhumeha, “sugar in the urine,” which is characteristic of diabetes. Although diabetes is a condition where an imbalance of all three doshas can occur, it is primarily a disorder of excess kapha dosha, which is characterized by the qualities of heavy, oily, and dullness or slowness. Secondarily, pitta irregularities can occur, which further lead to irregular blood sugar due to inconsistent metabolism.
Ayurvedic Dietary Recommendations for Diabetes
In general, Ayurveda views food as medicine and emphasizes the importance of diet in maintaining harmony among the doshas. The concept of digestive fire is known as agni, and this is the ability to transform the food you eat into the nutrients the body needs. The purpose of food is to maintain a strong agni.
Nutritional recommendations are personalized based on the individual’s current constitution, but general recommendations emphasize the consumption of whole foods, mostly plants, that are grown locally and appropriate for the season, when possible. Avoiding processed foods and excessive sugar is beneficial. Ayurveda recommends adjusting the diet for the season to accommodate for changes in the doshas. Universal recommendations include mindful eating without distraction, eating the heaviest meal at lunchtime, and having an early dinner before sunset.
Spices are added to help with ease of digestion, boost the metabolism, and add physiologic benefits. It is recommended to avoid excessive sweets, cold foods, and processed items, as these foods diminish agni. Healing foods in Ayurveda tend to include those that are warm, moist, and semi-digested (such as steamed vegetables), as these gently support the digestive strength of the individual. Warming spices and warm water are also beneficial. Avoiding snacks is also advised to allow for full digestion of the food between meals, which will prevent accumulation of ama, or harmful food byproducts. More specifically, knowing your individual constitution is very helpful in choosing foods to balance your current state of Vikruti.
One way to classify foods in Ayurveda is based on six tastes. The six major tastes are sweet, sour, salty, pungent, bitter, and astringent. Each of these tastes can increase or decrease the effect of the doshas. Incorporating all six tastes into the diet is beneficial for overall health, but specific tastes will be emphasized when managing an imbalance of doshas.
Ayurvedic dietary recommendations for diabetes emphasize using foods that will counteract the elevated kapha dosha. Using foods with bitter and astringent qualities will balance the elevated sticky and oily quality of the kapha dosha. This would include lentils such as toor dal and vegetables such as bitter gourd, drum stick, unripe bananas, and garlic. Choosing foods that are slow to digest but light, such as low glycemic index foods, is advised. This would include lentils and millet. Avoiding sweet, heavy, oily foods, which tend to further aggravate the kapha dosha, is recommended. This would include dairy products, red meat, and foods with excessive or refined sugars.
Role of Spices and Herbs
Utilizing herbs and spices with bitter and astringent tastes can also help with the management of type 2 diabetes. Ayurvedic herbs for diabetes include those with bitter and astringent qualities. These include Gymnema sylvestre, Trigonella foenum (fenugreek), and Ocimum sanctum (holy basil, Tulasi) as some of the most commonly used.
Spices for blood sugar regulation include cinnamon, ginger, turmeric, and cumin, as these have been shown to have bioactive compounds that have anti-diabetic, antioxidant, and anti-inflammatory properties.
Importance of Meal Timing and Routines
Just as important as what you eat is when you eat it. Ayurveda discusses the components of the ideal lifestyle as an ideal daily regimen, “Dinacharya.” Following Dinacharya allows you to capitalize on the natural ebbs and flows in the physiologic functions of your body. In modern biochemistry, we know this as circadian rhythms.
Circadian rhythms are biological clocks present in all cells that influence many important physiologic functions, including metabolism. Under normal conditions, they are synchronized to the environment in order to function optimally. These clocks allow for physiologic functions to be performed efficiently. Additionally, recent research has suggested an influence of glucose metabolism on circadian cycles and also a disruption of circadian rhythms in patients with type 2 diabetes.
By having regular meal timings, the ability to anticipate a regular rhythm promotes optimal performance of bodily functions. The body will be primed and prepared to accept food and to efficiently digest, metabolize, and utilize nutrients.
The Synergy of Ayurveda and Modern Medicine
Ayurveda is an ancient medical system proven to be relevant in modern times. The science has been developed via astute and continuous observation of how humans and nature ideally interact. Ayurveda takes a truly holistic approach to health and the treatment of disease by focusing on the individual’s unique physiology. In addition, emphasis on emotional, spiritual, and physical health is recommended for true wellness. By modifying lifestyle factors and using natural remedies from food and herbs, Ayurveda’s principal aim is to restore the balance within each person and among people and their external environment.
Allopathic medicine often focuses on the elimination of the bothersome symptom or disease state using standardized treatment guidelines and pharmaceutical treatments. Both Ayurveda and allopathic medicine can be complementary to each other, and utilizing treatment approaches from both systems is likely to maximize the best individual patient outcomes.
Integrating Ayurveda and modern diabetes treatments can address the unmet need for individualized lifestyle assessment in patients with diabetes. Approaching the disease of diabetes from an imbalanced dosha perspective will allow an individual to design a lifestyle to restore balance – this will include personalized changes to diet, exercise, sleep, and stress management. This can be very synergistic with anti-diabetic medications recommended in allopathy and will allow the patient to have a root cause approach to treatment.
Embracing Ayurvedic nutrition for diabetes can empower patients to deeply know themselves and how lifestyle can impact their individual physiologic function. By continuing to learn from and integrate this traditional wisdom with modern science, we can learn to tap into the body’s incredible capability for self-healing and apply it to treatment approaches in modern medicine.
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