Ayurvedic preventive medicine, which stresses nutritional and herbal recommendations for individual body types, offers a potentially effective and inexpensive complementary treatment for patients with respiratory illnesses.

 Ayurveda is a system of wellness that includes a wide range of practices and recommendations. Relatively new in Western culture, Ayurveda is well known in India, with more than 300,000 doctors in the All Indian Ayurvedic Congress. In the United States, some medical doctors already use Ayurvedic techniques—which include physical observation, documenting personal and family history, and measuring palpation—to supplement modern diagnostic methods. Ayurvedic preventive medicine emphasizes creating and maintaining a lifestyle in harmony with the changing cycles of nature and the environment; its physicians emphasize prevention and development of natural disease resistance by correcting imbalances. Removal of symptoms is merely a side benefit to a larger, holistic definition of healing. The word Ayurveda comes from the Indian Sanskrit words ayus, which means life, and veda, which means knowledge. Thus, it is literally “the science of life.”

Nutritional recommendations are among the most interesting and immediately useful aspects of Ayurvedic knowledge. It is reasonable for respiratory therapists to have some understanding of Ayurveda for several reasons. Some Ayurvedic recommendations have direct applicability to respiratory disease. The Ayurvedic tradition of medicine, which dates back 5,000 years or more, was possibly the first system to use inhaled substances for managing asthma.1 Some of our patients might already be using Ayurveda as complementary medicine for treatment of their conditions.1 While Western medicine offers specific dietary recommendations for people with heart disease and diabetes, such nutritional guidance often is lacking for lung diseases and other conditions. Ayurveda provides general seasonal suggestions that apply to everyone and specific suggestions for balancing the effects of body types and disease states. When asked for a recommendation that would apply to a patient with asthma, for example, an Ayurvedic physician might say, “he should favor apples and avoid bananas.”

Ayurvedic nutritional recommendations might also be worthy of serious consideration by health care professionals who find their work environment stressful and out of balance. Ayurveda emphasizes that living in harmony with the environment is essential to spiritual, mental, and physical well-being, and offers specific suggestions for identifying imbalances and correcting them.

Increasing Studies
In addition to dietary advice, Ayurvedic recommendations might include an array of herbal supplements and is arguably the primary source of current interest in that burgeoning market. Many supplements are beginning to be evaluated by the scientific process. For example, a 1998 6-week, double-blind, placebo-controlled study of 80 individuals with relatively mild asthma found that treatment with Boswellia at a dose of 300 mg three times daily for 6 weeks reduced the frequency of asthma attacks and improved FEV1, peak expiratory flow rate, and forced vital capacity and decreased eosinophil counts.2 In animal studies, Boswellia has been found to inhibit 5-lipo-oxygenase and leukotriene B4 production, which cause bronchoconstriction, chemotaxis, and increased vascular permeability.

More randomized, controlled studies are needed to properly assess the efficacy of complementary medicines in general and Ayurvedic herbal recommendations in particular. Current knowledge of drug-herb interactions is limited, and clinicians should closely monitor patients who elect to add herbs to their conventional treatment.

Complementary medicines increasingly are offered in US medical schools, and Ayurvedic medicine has begun to influence western medical practice.3 Deepak Chopra, MD, author of Perfect Health and Quantum Healing, has successfully combined his impeccable credentials as a practicing endocrinologist with an exploration of what he calls mind-body medicine. He has dramatically influenced many in traditional medical circles and helped to bring the benefits of Ayurvedic medicine to the general public’s attention. Andrew Weil, MD, founder and director of the University of Arizona’s Program in Integrative Medicine, uses Ayurveda and other aspects of integrative medicine to combine the best ideas and practices of both conventional and alternative medicine into cost-effective treatments that aim to stimulate the human body’s natural healing potentials.

Three Seasons
Ayurvedic physicians recognize three basic seasons, called Kapha (“earth/water”), Pitta (“fire”), and Vata (“air”), which correspond to the fundamental governing principles of spring, summer, and winter. These qualities also are applied to daily activity cycles. Night shifts and continuously changing cycles of rest and activity are perhaps the ultimate examples of upsetting this balance, and working such schedules can manifest itself in health problems. The seasonal concept is also applied to body types, not unlike the endomorph, ectomorph, and mesomorph described in Western science. John Douillard, DC, a nationally recognized consultant who practices Ayurvedic and chiropractic sports medicine, describes the three growing seasons and harvests in The 3-Season Diet:

Ayurvedic Body Types and Nutritional Recommendations
SPRING
Body Type:
This person has a solid, heavy build, is characteristically calm, and has superior physical endurance. Individuals dominated by spring characteristics may be prone to exercise-induced asthma and need to limit mucus-producing foods. He has an aversion to damp, cold weather. The dietary recommendations for spring weather are extended for this mind-body type.

Should Eat: A low-fat diet featuring salads and leafy vegetables, beans, berries, and spouts. Dried fruits, apples, blueberries, alfalfa sprouts, corn, peas, lentils, and black pepper are favored.

SUMMER
Body Type:
This person is strong, with a moderate build, and tends to be athletic. She may be quick to anger and impatient, with an aversion to hot weather. The dietary recommendations for summer weather are extended for this mind-body type.

Should Eat: A high-carbohydrate diet featuring increased fruits and vegetables. Apricots, cherries, asparagus, sunflower seeds, milk, and chamomile are favored.

WINTER
Body Type:
This person is slender and mentally quick, and often has dry skin, brittle hair, and cold hands. He may have difficulty sleeping without interruption, and has an aversion to cold weather. The dietary recommendations for winter weather are extended for this mind-body type.

Should Eat: A high-protein diet, including animal fats, nuts, and grains. Bananas, grapes, carrots, chilies, sweet potatoes, oats, almonds, peanuts, meats, and ginger are favored.

The first harvest to come is spring, and consists mainly of roots, sprouts, and bitter greens that burst from the ground, aided by spring rains and melting winter snow. Summer provides a much more plentiful and longer-lasting harvest of fruits and vegetables that are picked continually during its extended growing season. Finally comes the fall harvest that precedes winter, gathering the last growths of vegetation along with the nuts and grains that will see us through the long winter months. This is when the grapes are harvested and crushed to make wine, when people traditionally put up preserves and gather hay into barns. I refer to this season as winter, because although the foods are harvested in the fall, they serve us all through the long cold winter months. These three harvest seasons translate easily into the three diets as I describe them: low-fat, low-calorie in the spring, high-carb in summer, and high-protein in winter.5

According to the Ayurvedic system, we should eat the foods traditionally available during the appropriate season. Modern technology makes fruits, vegetables, grains, dairy products, and meats from around the world readily available throughout the year. This has eliminated our natural relationship with the seasons and the foods that correspond with them. Douillard asserts that the reason so many dieting plans fail is that they are appropriate for only one of the seasons, and consequently create imbalance during the other two.

Although we can select the same menu items at a grocery store, the hospital cafeteria, or a restaurant throughout the year, Ayurveda recommends favoring and avoiding specific foods depending on the season. During the summer, when days are longer and warmer, our bodies need energy from high-carbohydrate fruits and vegetables. In the spring, when food supplies have traditionally diminished, a low-fat, low-calorie diet is normal. In the winter, when facing shorter, colder days, we should consume a high-protein diet. This naturally requires choosing foods according to the season. The system is easy to learn, and proponents suggest that weight normalization, improved health, and consistent energy levels will ensue.

Scheduled Meals
Perhaps even more important than what we eat, Ayurveda stresses the importance of when and how we eat. Meals should be consumed in a relaxed atmosphere that offers the experience of seeing, smelling, tasting, and enjoying the meal, as free of distractions as possible. Breakfast is a light meal, just enough to break the fasting that naturally occurs at night. Lunch is the most substantial meal of the day, and is preferably followed by 10 minutes of rest. It provides the calories and energy needed to get us through the rest of the day and into the evening. People who follow the regime find a light dinner that is easy to digest (ie, soup) is all that is required in the evening. Many seniors and people with chronic obstructive pulmonary disease might already have gravitated to a similar regime, with plenty of time for a substantial mid-day meal and a brief rest after eating.

The typical health care professional must make a concerted effort to get nutritious food and take the time to consume it in a relaxed atmosphere. We often have a decidedly substandard lunch “on the fly,” and by mid afternoon are “treating” our complete lack of energy with colas, candy, or coffee. We may be famished by evening, and have actually forgotten what we ate for lunch. Consequently, we consume a huge meal at exactly the wrong time. When the body should be winding down, we are stressing our physiology by loading up with calories that cannot be burned. It is possible to follow an Ayurvedic regime even when working in a busy medical center, but it does require planning and a reasonable commitment.

Body Types
Ayurvedic science describes “summer” and “winter” types in great detail. Because the characteristics of body types also apply to thought processes, the Ayurvedic types have been described as “mind-body” types. Most people exhibit characteristics of two or all three types, but an understanding of the three classic examples offers insight into the concept. Not surprisingly, Ayurveda also offers dietary suggestions and herbal advice for each body type. The goal is to balance the characteristics of that body type with the most appropriate foods and seasonings.

Conclusion
Traditional Ayurvedic medicine does not offer an alternative to established Western medical practice, but it does provide a vast area for potential research and represents a cornerstone of the current interest in complementary and alternative medicine. Used in conjunction with competent health and medical advice, Ayurvedic dietary and nutritional recommendations are relatively easy to understand, inexpensive, and inherently safe. They provide an effective guide to weight management and a system that offers to restore balance, improve health, and increase energy.

John A. Wolfe, RRT, CPFT, is a contributing writer for RT magazine.

References
1. Ganedvia B. Historical review of the use of parasympatholytic agents in the treatment of respiratory disorders. Postgrad Med J. 1975;51(7 Suppl):13-20.
2. Ernst E. Complementary/alternative medicine for asthma. Chest. 1999;115:1-3.
3. Eisenberg DM, Kessler RC, Foster C, Norlock FE, Calkins DR, Delbanco TL. Unconventional medicine in the United States. Prevalence, costs, and patterns of use. N Engl J Med. 1993;328:246-52.
4. Wetzel MS, Eisenberg DM, Kaptchuk TJ. Courses involving complementary and alternative medicine at US medical schools. JAMA. 1998;280:784-7.
5. Douillard J. The 3-Season Diet. New York : Three Rivers Press; 2000:9-10.