Understanding Clinical Nutrition of Skin Disease through the Lens of Ayurveda

Aharaja Nidana [6]

• Excessive intake of salty and sour foods (Ati Lavana, Ati Amla Rasa Sevana)
• Incompatible foods (Viruddhahara): consumption of milk after fish, consuming Milk and Lavana Padarthas together, Gramya and Anoopa Mamsa along with milk etc.
• Excessive heavy, oily and liquid foods (Guru-Snigdha- Atidrava Annapana)
• Unwholesome foods (Asatmya Ahara)
• Consumption of food before the digestion of previous meal (Ajeernaahara)
• Consumption of hot and cold food together (Sheeta- Ushna Akrama Sevana)
• Excessive consumption of honey (Madhu)-jaggery (Phanita)-fish (Matsya)- sour fruits (Lakucha)-curd (Dadhi)-black grams (Masha)-raddish (Mulaka)-protein- carbohydrate rich food (Pishtanna) -sesame seeds (Tila)-Alcoholic preparations (Madyapana)-green leafy vegetables (Harita Shaka)-putrefied food (Praklinna Anna)-dairy products like paneer etc (kurchika and Kilata).

Viharaja Nidana [7]

• Suppressing the urge of vomiting
• Irregular or improper practice of Panchakarma procedures
• Entering into cold or drinking cold water after one is exposed to fear, exhaustion and grief
• Habit of day sleeping
• Sinful activities (Papakarma) Hence, Kusta can be triggered by multiple factors which can primarily initiate Agni Vaishamya and Raktadushti thus leading to the involvement of deeper Dhatus.

Ahara Vidhi Vidhana [10]

As per Acharya Vagbhata

• Eating at the proper time (Kale Bhojana)
• Eating what is suitable for oneself (Satmya Bhojana)
• Eating in accordance with one’s Prakriti (Hita Bhojana)
• Food cooked in a hygienic manner (Shuchi Bhojana)
• Consumption of spicy, delectable, and easily digestible food (Ushna-Snigdha-Laghu Bhojana).
• Eat whenever there is a desire for food, paying attention to both the food and the act of eating (Tanmana Bhunjita), and consume foods that share all the Rasas.
• Eating while calm and not moving too quickly or slowly (natidruta-vilambita);
• Eating after taking a bath (Snatah).
• Only eating when one is sufficiently hungry (Kshudhavan)
• Before eating, one should wash their hands, feet, and faces properly (Dhaatha kara-pada-anana).
• After offering prayers and paying to Gods and forefathers (Pitru-devata Tarpana)
• After offering food to guests, teachers and children (Athiti-Bala-Guru Tarpana)
• Without disgracing food (Anindana Bhojana)
• Silently (Mouna)

Astavidha Ahara Vidhi Vishesha Ayatana [11]

Ayurveda mentioned 8 specific food conventions that include compatibility of dietary articles which are determinant factor for maintained health.

• Prakriti-Nature of qualitative factors of the food
• Karana-Proper processing of the food
• Samyoga-Mixing/combination of food items with other items
• Rashi-Quantity of food consumed as a whole and as an individual
• Desha-Natural habitat of person
• Kala-Time and seasonal variation
• Upayoga samstha-Variable digestibility of different food articles
• Upayokta-The person who consumes food Skin conditions are primarily brought on by poor dietary habits and practices in addition to being contagious diseases. Therefore, all areas of food planning for the treatment of illnesses and the preservation of health should be given the careful thought as recommended by ayurveda.

When it comes to dietetics, Ayurveda has given careful consideration to kitchen and tool use. The kitchen should be tidy, roomy, open, and free of dust and debris. Food that has been prepared should be adequately covered and thoroughly protected from insects, animals, dirt, and dust. Ahara Matra [12]

The amount of food and nourishment needed depends on the individual’s Agni, Sharira Prakriti, Vaya and other conditions. According to Sushruta and Vagbhata, if the stomach’s capacity were hypothetically divided into four equal parts based on how full it was, one should eat two portions of solid food, one portion of liquid food, and one portion should be left empty to allow for simple Vata Dosha movement.

Viruddha Ahara-Incompatible Diet [13]

Foods with contradictory or incompatible properties have a harmful effect on the body, aggravating the Tridosha and causing a host of illnesses, including allergic dermatitis, eczema, abscesses, and other skin conditions. Along with loss of power, vitality, memory, immunity, etc. (A. H Su 7/44) Few incompatible food items that can lead to skin diseases are:

• Fish or its soup along with milk
• Milk or milk products along with salty/sour food items like milk with Namkeen, milk after having citrus fruits
• Processed food/cereals with milk as they contain high level of salt in them
• Consuming Ushna and Sheeta items together etc.

Wholesome and Unwholesome Diet in Skin Diseases [14]

Nutritional Psychiatry in Skin Disease [15]

Diet and mental health are intimately intertwined. Our diet has a significant impact on maintaining a healthy mind, and this allows for the classification of food into;

• Satvic diet is the ideal diet, consisting of vegetarian, non-oily, non-spicy, sweet foods that are good for the body and the mind.
• Rajasika diet is overly hot, sour, salty, and spicy; stimulates the mind.
• Tamasika diet is too much oil and heavy meals; lowers mental acuity.

Disease Specific Diet

Psoriasis: A chronic condition affecting skin that causes spontaneous regression followed by relapses. In addition to immunological mechanisms, genetic and environmental variables also contribute to the disease’s etiology. Unfortunately, there are currently no well-established nutritional therapy regimens for psoriasis in contemporary medicine. Saturated fatty acids, which are found in fatty meats and animal fats like butter and cream, and trans fats, which are found in highly processed foods and confectionery products, are to be limited. Omega 3 fatty acids, which are found in marine fish at the highest concentrations, are to be increased. Consumption of uncooked fruit and vegetables are advised and is not recommended to drink alcohol.

Ayurveda explains nidana parivarjana as the main treatment modality and avoiding incompatible food items (viruddha ahara) can be considered as first step in treating the skin disease. Old wheat, old barley, pulses like moong or green gram, masoor or red lentils, split pigeon peas, honey, Luffa cylindrical, a vegetable from the gourd family also known as snake gourd, Neem (leaf), garlic, Purana Ghrita (Old ghee), and Tikta Rasa (herbs and food with a bitter taste), it is better to avoid dairy products and nuts are all included in the recommended diet. Additionally, Triphala-a dried and powdered mixture of the three fruits Amalaki (Phyllanthus Emblica), Haritaki (Terminalia chebula), and Bibhitaki (Terminalia bellirica)-is crucial.

Vitiligo: Mango, cashew, pistaschio, oak, cassava, areca nut, red chillies, cherry, raspberry, cranberry, blackberry and tea contain naturally occurring plant phenol and polyphenolic compounds (tannins), which may aggravate vitiligo. Eczema: Tomatoes, olive oil, green leafy vegetables, such as spinach, kale, and collards nuts like almonds and walnuts, fatty fish like salmon, mackerel, tuna, and sardines, fruits such as strawberries, blueberries, cherries, and oranges. Fungal infection: Cane sugar, honey, maple syrup to be avoided. Fruits like bananas, grapes, mangoes to be avoided. Wheat, rye, barley to be avoided. Potato, carrots to be also lessened.