The use of traditional systems of medicines to resolve problems of nutrition in India is a relatively new idea in the country which is in the process of rediscovering the importance of these ancient systems today.
There are many ideas from ancient India, systems, and processes, once an integral part of everyday life, now forgotten, which could play a definitive role in boosting India’s nutritional goals. These ideas, many of them from the three main pre-modern systems of medicine in the subcontinent, Ayurveda, Unani, and Siddha, merit a re-examination in our present-day habits as simple but effective solutions to increase everything from immunity to mineral deficiencies.
In this essay we want to argue that nutrition today is seen through a few absolutist lenses — hunger, malnutrition, and staple food and medication to resolve the issues. But what is not spoken of enough is the nature of food, its quality, and the ingredients in it, and how, if used in the correct manner, everything from the right food, consumed in the right manner, to the right kind of utensils could have an enormous impact on the benefits the body derives from the food.
The focus of India’s ancient medicinal systems, of course, is to emphasise such benefits. In recent years, as a renewed focus on wellness has grown around the world, more exploration and research has gone into reviving these traditions in a world plagued by processed food excess on one hand, and acute malnutrition on the other.
Increasingly in India, there is interest in the idea that traditional food and medicinal systems can play a vital role in raising the overall levels of nutrition in the country and alleviate any decline in nutritional levels especially among underprivileged families.
This is particularly relevant in India which is the largest producer of medicinal plants in the world. Around 20,000 medicinal plants are known to have been found in India, and the country has one of the largest existing practice of medicinal plants in healthcare, with around 1.5 million practitioners of traditional medicinal systems. If better understood and practiced at home, India’s traditional knowledge and its wealth of medicinal plants and trees could be better used not only to enhance its own healthcare systems but also send it around the world – quite like the way the country is today sending Covid-19 vaccines to several countries as assistance.
Undernutrition or malnutrition manifests in the form of being underweight for one’s age, too short or stunted, too thin for one’s height known as ‘wasting’, and deficient in essential vitamins and minerals due to insufficient food intake, improper care, and an onslaught of infectious diseases. Inadequacy in nutrient intake is known to be a root cause for numerous health risks. Malnutrition is global problem and is particularly damaging to those living in the developing world. This remains a serious problem in India even though the Prevalence of Undernourishment (PoU) in the country fell from from 54.2 percent to 38.4 percent between 2000 and 2015, and the number of undernourished people, including children declined from 249.4 million (2004-06) to 189.2 (2017-19), according to statistics from The State of Food Security and Nutrition in the World, a United Nations report.
Additionally, in India, various segments of the population who are able to afford the appropriate amount of calorie intake required are not always aware of the necessity of nutrients in their diets. Nutrient imbalance is a pertinent issue that requires intervention. Indian medicinal systems have many references to the causes and solutions to the problem of under-nutrition, and malnutrition.
Ayurveda places emphasis on two aspects, namely ahar (diet) and anna (food). The core principle of Ayurveda is that healthy and wholesome food nourishes not only the body, but also the mind and soul. It does not place any inherent value of ‘good’ or ‘bad’ to food, instead emphasizing the numerous factors that impact food and its properties. These include biological properties, origin, environmental conditions, seasons, preparation, and freshness. It also explains the importance of modifying and curating one’s diet based on their individual needs and capacities, as the researcher Amala Guha of the University of Connecticut School of Medicine and Dentistry noted in a paper in 2006.
The essence of Ayurveda lies in the prevention of disease, rather than its cure. In terms of preventing malnutrition, Ayurveda prioritizes a nutritious diet, which contains adequate nutrients with additional therapeutic properties. Nutrition deficiency is characterized into four diseases according to ayurvedic beliefs. These are known as Karshya, Phakka, Balshosha and Parigarbhika as noted by researchers (Thakare, Gawai et al, 2017) in their paper Malnutrition: An Ayurvedic View in the European Journal of Pharmaceutical and Medical Research.
Karshya is a word rooted in the term krish, which means to be lean or emaciated. It is only one form of nutritional deficiency, wherein weight loss occurs. Ayurveda offers a holistic and well-rounded regimen for the prevention of karshya. The method consists of remedies known as Brimhana therapy, samshodhana, samshamana aahara and achara. These are said to be helpful in prevention, control and eradication of the disease, note the researchers (Arun Raj, Viswaroopam et al., 2017) in the paper Undernutrition in Children: An Updated View in the International Journal of Research in Ayurveda Pharmacy.
Ayurveda provides remedies for dealing with malnutrition not only for children, but also for the child-bearing mother, which is highly effective in preventing it for the child in the womb as well as post birth (Thakare & Gawai). Ayurvedic prescriptions therefore aim to tackle malnutrition begin right from the stage of pregnancy. Garbhini Paricharya or antenatal care in Ayurveda involves dietary and lifestyle instructions for every stage of pregnancy. Considering food as the best source of nourishment, this Ayurvedic practice consists of a nine-monthly diet, which is modified according to the mother’s age, season, place, constitution and ‘digestive fire’, notes the researcher Vaidya S. Koppikar.
Another ancient method that works to prevent low birth weight in children is that of Sowbhagya Shunti. Advocated by Siddha, it is an ayurvedic medicine used in post-natal care. Siddha also prescribes medicines such as Thetran Kottai, Nellikai, and Annabedhi, which are natural formulations believed to help prevent malnutrition. The Unani system also provides remedies for undernourished children. These include jawarish amla, sharbat foulad, habbe Jawahar, kushta khubsul hadeed, etc. (Ministry of AYUSH, 2018).
There have been some interesting experiments in some parts of India which have received a good response. One such example is the Jeevani Milk Programme run by P. L. T. Girija of the Sanjeevani Ayurveda and Yoga Centre in Chennai in villages of Andhra Pradesh of serving milk fortified with the herb ashwagandhadhi. The result has been a steady decline of ill health, and increase in body weight, among children. The success of this method led to it spreading to other states in the country. It was undertaken for a group of poor children in the Andamans, a tribal area in Jharkhand, in government schools and a Sarvodaya hostel in Chennai, a Harijan Seva Sangh hostel in Thirukoilur, and is also underway in parts of Karnataka.
Another study was conducted to analyze the impact of Ayurvedic nutritious therapy as a preventative measure to improve digestion, rejuvenation, immunity and srotasakarya saptadhatu vriddhi as noted by (Rathod, Masal et al, 2019) in the paper Effectiveness of Ayurvedic Nutritious Therapy in Prevention and Management of Malnutrition Illness Reduction and Health Improvement of Mothers and Children in the Indian Journal of Applied Research. Essentially, the study aimed at understanding the efficacy of ayurvedic methods in dealing with diseases that are caused by low immunity levels, undernutrition and low weight in children aged less than six years. The study found that there was a significant increase in weight and nutritional grade amongst children aged between 0 and 6. An increased level of hemoglobin was also witnessed. This mechanism of ayurvedic nutritious therapy was also effective in enhancing breastfeeding, and thus improving health and nutritional conditions for newborn children.
Fortification of food using traditional medicines and medicinal supplements is a powerful idea not only because it is cost-effective and natural, but also because its uses and power can be conveyed most simply especially in remote rural areas where faith and trust in traditional medicine is far more than in manufactured chemical-based drugs.
With this in mind, in 2020, the Ministry of AYUSH signed an agreement with the Ministry of Women and Child Development to promote Ayurveda and yoga at anganwadis in order to curb malnutrition, as part of the National Nutrition Mission. The initial pilot project involved 1,000 anganwadi centres, out of a total of 4 lakh centres. The Women and Child Development Ministry would enable the Ministry of AYUSH to successfully conduct their outreach. AYUSH would provide ayurvedic measures to deal with malnutrition, which involve the promotion of nutrient-rich recipes based on regional preferences. The focus is on the treatment of ailments caused primarily as a result of nutritional imbalances, including anemia and diarrhea, addressing challenges to breastfeeding, and ensuring nutritional optimality during pregnancy. The agreement also mentioned a collaboration with community health workers to identify and treat children who faced problems with acute malnutrition (The Hindu, 2020). A similar experiment was carried out on a pilot basis in 2018 by AYUSH in Mangalore, wherein ayurvedic, homeopathic and naturopathic remedial techniques were utilized for around 1,000 children in anganwadis, over a period of three months. This resulted in positive results, as the children underwent healthy levels of weight gain (The Hindu, 2018).
The use of traditional systems of medicines to resolve problems of nutrition in India is a relatively new idea in the country which is in the process of rediscovering the importance of these ancient systems today. But there is civilisational memory embedded in the Indian population about the value of such systems, and with the right kind of promotion, they could play a seminal role in convincing people to adopt food habits and other practices that would do what the promise of Ayurveda has always been – to cure, and not merely suppress, the ailment, in this case, that of under-nutrition.
Ankita Sharma is senior researcher and Assistant Vice President, and Hindol Sengupta is Vice President and Head of Research at Invest India, the national investment promotion agency.