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\begin{document}


\def\RunningAuthor{Bharat Rathi}
\firstPage{748}
\articleType{Review Article}
\receivedDate{09 Jun 2020}
\acceptedDate{28 Jul 2020}
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\title{The relevance of dietetic approach of Ayurveda from the perspective of COVID-19 pandemic\textbf{\space }}
\author{Swapnali~Khabade\textsuperscript{1},  
            Bharat~Rathi\textsuperscript{*}\textsuperscript{2}, 
            Renu~Rathi\textsuperscript{2}~\\[5pt]{\textsuperscript{1}Department of Rasashastra Bhaishajya Kalpana, Sunil Ramsinh Chunawale Ayurveda Mahavidyalaya, Chikhali, Buldhana (MS), India}~\\{\textsuperscript{2}Department of Rasashastra \& Bhaishajya Kalpana, Mahatma Gandhi Ayurveda College Hospital \& Research Centre, Datta Meghe Institute of Medical Sciences (Deemed to be University), Salod (H), Wardha (MS) - 442001, India}}

\begin{abstract}
A novel, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causes severe acute respiratory syndrome and spread globally from Wuhan, China. In March 2020 the World Health Organization declared the SARS-Cov-2 virus as a COVID- 19, a global pandemic. This pandemic happened to be followed by some restrictions, and specially lockdown playing the leading role for the people to get disassociated with their personal and social schedules. And now the food is the most necessary thing to take care of. It seems the new challenge for the individual is self-isolation to maintain themselves on the health basis and fight against the pandemic situation by boosting their immunity. Food organised by proper diet may maintain the physical and mental health of the individual. Ayurveda aims to promote and preserve the health, strength and the longevity of the healthy person and to cure the disease by properly channelling with and without Ahara. In Ayurveda, diet (Ahara) is considered as one of the critical pillars of life, and Langhana plays an important role too. This article will review the relevance of dietetic approach described in Ayurveda with and without food (Asthavidhi visheshaytana \& Lanhgan) during COVID-19 like a pandemic.
\end{abstract}\def\keywordstitle{Keywords}

\begin{keywords}COVID-19,\newline Aahar,\newline Asthavidhi visheshaytana,\newline Lanhgan
\end{keywords}
\twocolumn[ \maketitle {\printKwdAbsBox}]
\makeatletter{\raggedright\textsuperscript{*}Corresponding Author\par Name:\ Bharat~Rathi~\\ Phone:\  9011058301~\\  Email:\ bharat.rathi@dmimsu.edu.in
        \par}\vspace*{-11pt}\hrulefill\par{\fontsize{12}{14}\selectfont ISSN: 0975-7538}\par% 
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\section{Introduction}
A novel coronavirus has lead to a disease called COVID-19, became a major global human threat that has turned into a pandemic, is one of the major pathogens that mainly target the human respiratory system \unskip~\citep{837189:19865543}. It is a challenging situation because of its prevalence and urging to concentrate on the immunity of the individual to fight back this coronavirus. But the lifestyle also showing the affirmed obesity because of eating, activity, and sleeps behaviours changed in an unfavorable direction during the lockdown. Ayurveda is the system of medicine which maintains the health of a healthy person and prevents the disease of the ill person \unskip~\citep{837189:19865546} . \textit{Ahara} (Diet) the sum of food consumed by a person and often implies the use of specific intake of nutrition for health \unskip~\citep{837189:19865539}. In Ayurveda, there is always a better solution if you have to maintain the diet you have to follow the Asthavidhi\textit{ visheshaytana} having rules about the food and in excess diet or obesity there is the \textit{Lanhgan } a samshaman therapy can develop without the food. 

\textbf{COVID -19 }

Still, there are no specific clinical features that can reliably distinguish COVID-19 from other viral respiratory infections. Few common symptoms are included headaches, sore throat, and rhinorrhea. In addition to respiratory symptoms, gastrointestinal symptoms, e.g., nausea and diarrhoea have also been reported, and in some patients. Respiratory droplet transmission is the main route, and it can also be transmitted through person-to-person contacts by asymptomatic carriers. Some main symptoms associated with the COVID 19 are fever, cough, Dyspnoea, Headache, Sore throat and Rhinorrhea \unskip~\citep{837189:19865547}.These symptoms worsen depending on the age factor, some previous disease like Diabetics, Cardiovascular disorders and immunity \unskip~\citep{837189:19865543}.

\textbf{Lifestyle during COVID- 19}

As the pandemic spreads this interaction between people and the food system is changing at an unimaginable speed and taking on greater importance in everyday life, with strict rules placed on people's movement to limit the spread of COVID-19. Defiantly the junk food consumption has reduced but staying at home increases the chances of excess eating, keeping awake late night, sleeping during the daytime, mental stress, holding the natural urges gave birth to several diseases \unskip~\citep{837189:19865542}. Some studies are positing that the COVID-19 pandemic will exacerbate all of the risk factors for weight gain associated with summer recess. Specifically, children and adolescents with obesity affirmed that eating, activity, and sleep behaviours changed in an unfavourable direction three weeks into their confinement during the national lockdown \unskip~\citep{837189:19865538}. 

Repeated overeating for more extended period results in setting a stage when the person does not receive satisfaction in a reasonable amount of food resulting in overeating and hence obesity. A home where the dinner table is always laden with eatables may also influence obesity. Thus the home environment matters a lot. For a depressed and socially isolated person, food may act as a sedative, and soon he becomes prey to obesity. A decrease in BMR may increase weight \unskip~\citep{837189:19865540}. At the individual level, the common denominator that drives most of the nutrition and dietary recommendations to combat viral infections, including COVID-19, lies within the link between diet and immunity. It has been demonstrated that specific nutrients or nutrient combinations may affect the immune system through the activation of cells, modification in the production of signalling molecules, and gene expression \unskip~\citep{837189:19865541}.

\textbf{Asthavidhi visheshaytana}

A wholesome diet is a primary cause for good health. On the contrary, unwholesome diet is a cause of several diseases\textbf{.} So in Ayurveda diet is having a vital place, but to be a wholesome diet does not mean only the food items, but it includes so many factors, which are called as \textit{``Ahara Vidhi''}, where the law of do's and don'ts about the diet and drinks are mentioned. A wholesome diet requires a lot more than just having nutrients, and \textit{Ayurveda }has laid down particular importance on all aspects of \textit{Ahara }and \textit{Ahara Vidhi}.

\textit{Ahara Vidhi Visesayatana }means the factors responsible for the wholesome and unwholesome effect of the \textit{Ahara }and methods of \textit{Ahara sevana (}Special rule for diet intake).

These \textit{eight }factors should be considered before eating food\textbf{:}


  
  \begin{enumerate}
  \item \relax \textit{Prakriti }
  \item \relax \textit{Karana}
  \item \relax \textit{Samyoga}
  \item \relax \textit{\textit{Rashi}}
  \item \relax \textit{Desha}
  \item \relax \textit{Kala}
  \item \relax \textit{Upyoga- sansatha}
  \item \relax \textit{Upyokta}
  \end{enumerate}
  \textbf{Prakriti} {\textendash} (Natural quality) 

\textit{Prakriti} is an inherent quality of food, eg. \textit{Masha}(black gram) is said to be a guru (heavy) in nature while \textit{Mudgha} (green gram) is said to be \textit{laghu} (light) in nature. \textit{Prkriti } of the food will be helpful to decide according to digestive capacity or as per the \textit{Prakriti} of the person. So it will not lead to any disorder and digest the food properly.

\textbf{Karana} \textit{\space }{\textendash} (\textit{Samskara})

This means the \textit{Samskara, } i.e. processing of food to make good for consuming. \textit{Samskaras} are followed by cleansing, soaking, cooking, grinding, impregnation flavouring, maturing, preservation, and food storage.

\textbf{Samyoga} {\textendash} (Combination of food)

Combination of two or more food, it may lead to being beneficial or dangerous. It should be known which qualities these combinations are inherited if they combined. E.g. Haney and Ghee in equal quantity or fish and milk combination may become lethal for health.

\textbf{Rashi} {\textendash} (Quantity of the food) 

This means the quantity of food. Quantity of food may differ per individual. But the quantity of food should not be excessive or less then the amount desired, both are not good for health. So the food should be taken according to the required quantity depends on persons digestive power.

\textbf{Desha} {\textendash} (Geographical region where the food grows) 

It is the geographical region where the food grows. The food grows in which part is most suitable for the people in those respective regions. So it will be useful to choose the food in the respective region. E.g. the person is in Rajasthan, he can easily digest a higher amount of \textit{Ghrita }and other \textit{Guru Dravyas, }but when the same person has been in south India, he cannot digest the same type of food items. Use of dry and sharp substances in deserts and unctuous in Marshy land is having an antagonistic effect. 

\textbf{Kala} {\textendash} (Time of food consumption) 

It is the time of food consumption. One must also know about the time factor (\textit{Kaala}). \textit{Nityaga} and \textit{Avasthika} are the two types of \textit{Kaala} for the use of \textit{Ahara}. \textit{Nityaga} \textit{Kala} in which \textit{Ahara } is consumed according to the daily regimen differs by seasonal changes. The \textit{avasthika kaala } means the diseased conditions, comes into the role, by intake of food according to the condition of the disease \unskip~\citep{837189:19865549}.

\textbf{Upyoga- sansatha} {\textendash} (Rules to take food) 

Specific Rules have mentioned concerning the intake of food. This is the \textit{upayoga samshta} It merely means the dietetic rules. It contains everything related to diet, how to eat, when to eat, what to eat. Below mentioned rules and regulations of the food intake for both healthy and diseased person.

\textit{Ushnam ashniyat} {\textendash} Eat hot and fresh food

\textit{Snigdham ashniyat} {\textendash} Eat unctuous food

\textit{Matravat ashniyat} {\textendash} Eat an adequate amount of food 

\textit{Jirne ashniyat} {\textendash} Eat after digestion of previously consumed food

\textit{Virya avirudha ashni}yat {\textendash} Eat food which is not contradictory in potency

\textit{Ishta deshe, ishta sarvopkarnam cha ashniyat} {\textendash} Eat in desired place and pleasant atmosphere.

\textit{Na atidrutam ashniyat} {\textendash} Do not eat in a hurry 

\textit{Na ativilambit ash}niyat {\textendash} Do not eat very slow

\textit{Ajalpana, ahasan, tanmana bhunjitam} {\textendash} Eat with concentration without a laugh and talk 

\textit{Aatanam abhisamikshya bhunjitam} -  

\textbf{Upyokta} {\textendash} (One who uses the food)

\textit{Upayokta} is the one who uses the food (\textit{Aharadravya}), and who has the habitual to the food (\textit{Okasatmya} or \textit{sharira satmya}). He is the one who must take into consideration all these facts of \textit{Ahara} and consume food accordingly. By doing so, he gains health. 

According to the above points, it can be concluded that food should be taken according to (\textit{ahara vidhi Vidhan}) dietary guidelines which are truly scientific as mentioned Ayurveda. Many diseases can be prevented merely due to faulty dietary habits. Healthy eating habits may help lower risk for many other health problems\unskip~\citep{837189:19865537}.

\textbf{Lanhgan }

In Ayurveda, \textit{Langhana } is the process which brings lightness and malnutrition in the body. Another meaning is light meals or fasting. \textit{Acharya} Charaka has mentioned ten types of \textit{Langhana c}an be applied for the \textit{Sthoulya} (Obesity) as per the disease and the strength of the patient. 

\textbf{Types of \textit{Langhana,}}

1) \textit{Vamana }

\textit{2) virechana}

\textit{3) Basti}

4) \textit{Nasya}

\textit{5) pipasa}

\textit{6) Maruta}

\textit{7) Atapa}

\textit{8) Pachana}

\textit{9) Upavasa}

\textit{10) Vyayama}

First four are called as \textit{shodhana langhana} therapy, which eliminates the vitiated \textit{doshas} from their respective site from the body. Remaining six types are \textit{Shamana langhana} therapies not do the \textit{shodhna} but it pacifies the vitiated \textit{doshas} and brings them to the equilibrium. Also, the four therapies need the expertise to do them, but the remaining \textit{Shamana} \textit{langhana} therapies can be followed everyone with their capacity without going through any discomfort \unskip~\citep{837189:19865548}.


  
  \begin{enumerate}
  \item \relax Pipasa
  \item \relax Maruta
  \item \relax Atapa
  \item \relax Pachana
  \item \relax Upavasa
  \item \relax Vyayam
  \end{enumerate}
  \textbf{Benefits of Exercise,}
  
  \begin{enumerate}
  \item \relax Increases Metabolic rate and Fat Oxidation
  \item \relax Maintain Muscle tone
  \item \relax Improve Circulation
  \item \relax Increase sense of self-control 
  \item \relax Reduce Depression
  \item \relax Help to sleep well
  \item \relax Prevent from Diabetes, High Blood Pressure and High Cholesterol etc. diseases.
  \end{enumerate}
  
    
\section{\textbf{Results and Discussion}}
The COVID 19 pandemics cause for the lockdown. That implementation in various countries has resulted in sudden changes in the lifestyle of the people, which may cause damage to the people who do not have any specific disease. This lockdown further may respond with the delayed risks to physical health. During a lockdown, people staying at home for imposing social distancing and limiting with human contacts are getting trapped in their houses. This is resulting in people who are having a lack of physical activity, especially exercise. Even if the junk food may have reduced, but the regular homemade food consumption without any physical activity will lead to gain their weight.

Additionally, stress, feeling of emptiness and boredom will be managed with food consumption. This may lead to weight gain and a worsening eating disorder. Because of the difficulties in weight loss, it will further become the increased high risk of a large number of health problems such as Diabetes, Hypertension, CHD, Stroke etc. Physical and mantel health will be encountered due to weight gain during the lockdown \unskip~\citep{837189:19865745,837189:19865545,837189:19865550}.

So this situation can be handled by the Science of Life, i.e. Ayurveda. If followed the two things as reviewed in this article will help the person to eat quantitatively and qualitatively. \textit{Asthavidha Aharavisheshayatana} will help people to stay positive and alter food intake. A person will take the food as per their requirement and will learn to follow it. This will solve the weight gain problem. The second reviewed point is \textit{Langhana}. In case a person starts to gain weight, the \textit{Langhan} will help to lose his weight with the mere simple suitable practice of \textit{langhana, }without seeking any special attention and expertise. These two \textit{Asthavidha Aharavisheshayatana } and \textit{Langhana} will fight against the weight gain and their causative factors and bring the equilibrium and positivity in life during COVID-19 pandemic situation.
    
\section{\textbf{Conclusion}}
 Pandemic lockdown definitely will raise health-related problems in future. People may get encountered physically as well as mentally. But Ayurveda has the solutions for those situations, and it needs to be followed regularly. Maintaining a healthy life and curing the disease is the principle of the Ayurveda. Diet is the primary and leading cause of life. \textit{Asthavidha Aharavisheshayatana'}s applications may help in the maintenance of health as well as in the curative aspect for many diseases. These methods of food preparations and rules of food intake have an important role in the community for a healthy life. These are not outrageous processes but help to keep people healthy and happy.
    
\section{\textbf{Acknowledgement}}
Author would like to thank DMIMSU for motivating and providing all necessary help for writing this article.

\textbf{Funding support}

DMIMS (Deemed to be University) Sawangi (Meghe) Wardha.

\textbf{Conflict of interest }

The authors declare that they have no conflict of interest for this study.
    

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