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 Table of Contents  
ORIGINAL ARTICLE
Year : 2022  |  Volume : 16  |  Issue : 3  |  Page : 207-212

An observational study to find out the etiological factors of Medoroga: A Nidanatmaka survey


1 Department of Roga Nidana Evam Vikriti Vigyan, Chandrashekhar Singh Ayurved Sansthan, Kaushambi, U.P, India
2 Medical Officer, State Ayurvedic Hospital, Pachhara, Mathura, India
3 Technical Officer, W.H.O., SEARO, New Delhi, India

Date of Submission15-Apr-2021
Date of Decision10-Aug-2021
Date of Acceptance14-Aug-2021
Date of Web Publication28-Sep-2022

Correspondence Address:
Balendra Singh
Department of Roga Nidana Evam Vikriti Vigyan, Chandrashekhar Singh Ayurved Sansthan, Koilaha, Puramufti, Kaushambi - 212 213, Uttar Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/joa.joa_111_21

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  Abstract 


Introduction: With the advancements in the area of science and technology, today's people are living sedentary life style which emerges as a cause for life-threatening metabolic disorders such as obesity, hypertension, diabetes mellitus, atherosclerosis, and dyslipidemia. These metabolic diseases are the consequence of various etiological factors such as excessive food intake, day sleep, sedentary life style, excessive happy state of mind, and hereditary involvements. These metabolic disorders can be correlated with Medoroga, the diseases of Medovaha Srotasa in Ayurveda. Abnormal accumulation of Meda Dhatu in the body is known as Medodushti which includes several numbers of other Medovikara, collectively known as Medoroga. Methods: A Nidanatmaka survey was done among 500 subjects of Medoroga visiting outpatient and inpatient department of institute from January 2018 to March 2019. A structured questionnaire was given to each patient to collect data on sociodemographic profile, Ahara-satmya (dietary pattern), Vihara, and other Ayurvediya variables. Results: Maximum subjects of Medoroga were of age group 18–30 years (45.4%), male (67.6%), Hindu (88.6%), married (66.8%), graduates (69.8%), and belonged to upper middle class (74.6%) and Jangala Desha (95.8%). 57.2% subjects were vegetarians and gave the history of Akalabhojana (33.6%). Among total 500 subjects, 50.8% had Mandagni and were taking Madhura dominant Rasa in diet (49.6%). Nearly 56.8% of subjects were following sedentary lifestyle. It was also found that maximum subjects had body mass index in between 25 and 27.9 kg/m2 (36.4%) and waist/hip ratio in between 0.96 and 1.05 (95.2%). Conclusions: In the study, it was found that the person indulged in Ati-bhojana Sevana, Ati-gurvadi Sevana, Ati-madhura, Ati-sheeta-snigdhadi Ahara, and excessive intake of junk food, beverages like tea/coffee are more susceptible to Medoroga. Vihara such as Asyasukha, Avyayama, Diva-svapna, Achinta, and Nitya-harsha were also proved to be etiological factors of Medoroga.

Keywords: Medoroga, Medovikara, Nidanatmaka Survey


How to cite this article:
Singh B, Verma R, Godatwar P. An observational study to find out the etiological factors of Medoroga: A Nidanatmaka survey. J Ayurveda 2022;16:207-12

How to cite this URL:
Singh B, Verma R, Godatwar P. An observational study to find out the etiological factors of Medoroga: A Nidanatmaka survey. J Ayurveda [serial online] 2022 [cited 2022 Nov 29];16:207-12. Available from: http://www.journayu.in/text.asp?2022/16/3/207/357291




  Introduction Top


Nidana refers to the causative factors of a disease.[1] Nidanatmaka study describes the distribution and magnitude of health and disease, identify etiological factors, and provide the data essential for the prevention and treatment of disease in human population, which is the basic aim of Ayurveda.[2] Since the prevention of occurrence of disease is easier than treating the disease, a survey study was done to bring out etiological factors of Medoroga into light, with the help of a questionnaire. Survey study is very useful tool to gather information about various perspectives of disease.

Medoroga means a disease, in which Meda Dhatu is deranged. It is a disease of Medovaha Srotasa which involves Meda Dhatu. Vrikka and Vapa-vahana are considered as Medovaha Srotomoola as per Acharya Charaka.[3] Acharya Sushruta considers Kati and Vrikka as Srotomoola.[4] Diseases pertaining to Meda Dhatu can be found as Dhatu Pradhoshaja Vikara in classics.[5] Abnormal accumulation of Meda Dhatu in the body is known as Medodushti which includes several numbers of other Medovikara, collectively known as Medoroga. Most of the Acharya have stressed upon the role of an unbalanced diet combined with sedentary lifestyles as the important cause of Medoroga.[6]

Here, an attempt has been made to revalidate the wordings of our Acharya in perspective of changing environment.

Aim and objective

  • To conduct Nidanatmaka survey to find out the etiological factors of Medoroga.



  Materials and Methods Top


  • Participants and study design: Total 500 subjects of Medoroga of age group 18–60 years of either sex, reporting to outpatient and inpatient department of institute from January 2018 to March 2019 were randomly selected and included in the Nidanatmaka study. This study was approved by Institutional Ethics Committee, National Institute of Ayurveda, vide letter no. IEC/ACA/2017/59, dated April 26, 2017.
  • Site of selection of participants: The participants were selected from the pool of the subjects reporting to OPD/IPD/Laboratory of National Institute of Ayurveda, SSBH Kishanpole, and Satellite Hospital Jawahar Nagar, Jaipur, and various camps organized by National Institute of Ayurveda, Jaipur.
  • Methodology of survey study


The following steps were involved for the collection of data

  1. Questionnaire
  2. Physical measurements


    • Questionnaire: A structured questionnaire was administered to each subject of Nidanatmaka survey to collect data on sociodemographic profile, Ahara-Satmya (DietaryPattern), Vihara and other Ayurvediya variables
    • Physical measurements (anthropometry): Anthropometric measurements were taken by standard methodology, using Omron Body Fat monitor, and unstretchabale measuring tape. The following parameters were measured for this study: height, weight body mass index (BMI), body fat percentage, waist circumference, hip circumference, and waist/hip ratio.


Inclusion criteria

  1. Subjects of age group 18–60 years
  2. Subjects of either sex
  3. Subjects found to be suffering with Medoroga on the basis of parameters such as adiposopathy, dyslipidemia and anthropometric measurements as well as the Ayurveda parameters
  4. Subjects with BMI >23 kg/m2.


Exclusion criteria

  1. Subjects having age <18 years and more than 60 years
  2. Pregnant women
  3. Patients not complying with the directions of the physician
  4. Patient with major complications and in requirement of emergency treatment.



  Observations Top


Observation enables the researcher to gather information or data needed to describe the various aspects of variables being studied. Hereby, all the observations made during the study are being presented in the tabular form [Table 1],[Table 2],[Table 3],[Table 4],[Table 5].
Table 1: Distribution of subjects according to sociodemographic profile

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Table 2: Distribution of subjects according to dietary pattern

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Table 3: Distribution of Subjects according to Aharaja Nidana

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Table 4: Distribution of subjects according to ViharajaNidana

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Table 5: Distribution of subjects according to anthropometry (physical measurements)

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  Discussion Top


Total 500 subjects of Medoroga of age group 18–60 years of either sex were randomly selected and included in the Nidanatmaka study. The interpretation of the various observations which were made during this survey study is presented here as follows:

Discussion on socio-demographic profile

Age

The maximum numbers of subjects, i.e., 45.4% were found in the age group of 18–30 years, followed by 35.8% belonged to 31–40 years. 13% and 5.8% individuals belonged to age group of 41–50 years and 51–60 years, respectively. It is observed that young age group is prone to obesity and overweight probably due to excess intake of junk, oily food, sedentary lifestyle, peer pressure, and academic stress. Obesity in working age group is mainly due to desk job. According to the survey in the United States, the prevalence of obesity increases progressively from 20 to 60 years of age and decreases after 60 years [Table 2].[7]

Gender

The maximum 67.6% subjects were male. Rest 32.4% subjects were female. It was observed that prevalence of Medoroga was more in males. Actual data may vary by considering larger sample size in further studies.

Religion

The maximum number of patients, i. e., 88.6% were Hindu and 11% were Muslims, rest others. These data may be found due to geographical dominance of Hindu people in the study region.

Marital status

The maximum 66.8% were married, while remaining 31.2% were unmarried. Incidence of Medoroga in married people may be due to workload stress because of more responsibilities.

Education

Incidence of Medoroga was found to be higher in graduate people (69.8%) followed by 9.4% were postgraduate, 7.8% and 6.2% were educated to higher secondary and high school. Remaining 5.8% were illiterate. Graduates are found more susceptible due to less physical activity and having more stress while competing with others. Furthermore, the prevalence of overweight/obesity was highest among participants with higher education.[8]

Occupation

The study of occupation-wise distribution of patients shows that maximum 52% subjects were doing private job, followed by 26.0% were students. It may be due to more stress of work.

Socioeconomic status

The maximum numbers of subjects, i. e., 74.6% belonged to upper middle class, followed by 23% belonged to lower middle class. Overeating and sedentary lifestyle could be the reason of upper middle class and urban habitat to be prone to Medoroga.

Desha

Incidence of Medoroga was higher, i.e., 95.8% in Jangala Desha. It may be due to the study site being Jangala Desha.

Habitat

Medoroga was found to be higher in urban population (75.2%), rest 24.8% belonged to rural area. Incidence is due to less physical activity in urban area.

Discussion on dietary pattern

Diet type

Medoroga was found to be higher in vegetarians (57.2%), followed by 42.8% who were taking mixed diet. It is due to dominance of vegetarians in this geographical area. Excessive intake of vegetarian food also results in Sthaulya.[6]

Dietary habits

Nearly 40.4% of subjects gave the history of Kalabhojana (meals on time), 33.6% gave the history of Akalabhojana (mealsnot on time), and 10.6% gave the history of Viṣamashana (meals not in proper quantity), Samashana (wholesome and unwholesome food mixed) and Adhyashana (taking meals without digestion of previous meal) were found in 9.2% and 6.2% of patients, respectively. Improper diet habit causes Agni Dushti, leading to the formation of Ama which results in Srotorodha and Medadushti.[9],[10] Furthermore, according to Acharya Sushruta, Vishamashana, Viruddhashana, Adhyashana, and Samashana are responsible for creating Agnimandya.[11] According to Acharya Charaka, not only excessive diet but also Guru, Sheeta, Ruksha, Vidahi etc. Ahara and Kama, Krodha, Bhaya, Moha etc. Vihara are also responsible for Aagnidushti and formation of ama.[12] Hence, these type of Ahara and Vihara taken in proper time can also cause Agnimandya.

Agni

Maximum 50.80% patients had Mandagni, followed by 23% were having Vishamagni. Due to Nidana Sevana, Jatharagni gets disturbed (due to Samana Vata Dushti) in the initial stages of Medoroga forming Ama. In the later stages, Dhatvagni also gets involved leading to improper formation of Medo dhatu (Abaddha Meda).[13] As mentioned in Ayurveda classics, the excessive intake of Nidana causes Kapha Vriddhi as almost all Nidana are Kapha Vriddhikara.[14],[15] Due to Ashraya-Ashrayee relational between Kapha-Medas,[16] Meda Vriddhi occurs which cause Avarana of Vata Dosha, results in its aggravation. The aggravated Vata moves mainly into Koshtha and increases the Jaṭharagni. The increased Jaṭharagni results in increased appetite, quicker digestion, and absorption of the food. The next hunger reflex occurs quickly and person craves for more food. This excessive eating produces more production of Ahara Rasa which causes over growth of Meda Dhatu leading to Medoroga.[10]

Dominant Rasa in diet

Majority of subjects, i.e., 49.6% were habituated to Madhura Rasa, 22.8% to Lavaṇa Rasa, and 19.2% were consuming Amla Rasa.

Discussion on Aharaja nidana

In the Nidanatmaka survey of 500 subjects of Medoroga, it was found that 58.2% subjects were taking breakfast sometimes, 62.8% individuals were indulged in Ati-bhojana sometimes. 43.2% and 28.4% were found to do Ati-gurvadi Sevana sometimes and often, respectively, 52.6% and 16.4% were found to take Ati-madhuradi Dravya in their diet sometimes and often, respectively. 71.8% were found to take Ati-sheeta Ahara Sevana sometimes while 12.8% were often consumers, 54.4% were found to take Ati-snigdhadi Ahara sometimes while 24.2% were often consumers followed by 6.6% of daily intakers. 55.0% subjects were found to take Ati-ksheera Sevana sometimes. 52.8% and 24% were found to do Ati-dadhi Sevana sometimes and often respectively. 62% were found to have Ati-sarpi Sevana sometimes. Nearly 52.4% and 24% were found to take excessive junk food sometimes and often respectively. 60.2% and 28.8% were found habituated to take excessive Tea/Coffee sometimes and often, respectively.

Discussion on Viharaja Nidana

Nearly 54.6% of subjects of Medoroga were found habit of Ati-asyasukham sometimes, while 41% were found to do it often, 54.6% were found habit of doing Vyayama sometimes, and 56.8% were busy in sedentary work. Nearly 50.4% and 12.8% were found habituated to Diva-svapna sometimes and often respectively. Around 71.2% and 16.8% were found to have Achinta sometimes and often respectively, 37.6% and 35.2% were found to have Nitya-harsha often and sometime respectively. 61.4% subjects were not found family history of obesity, while 38.6% were had it. It is found that people with obesity have multiple genes that predispose them to gain excess weight.[17]

Discussion on Anthropometry (physical measurements)

  1. BMI: 36.4% were found BMI between 25-27.9 kg/m2, 23.6% were found between 23 and 24.9 kg/m2. It is also found in a survey study that maximum number of subjects were having BMI in between 25–29.9 kg/m2 (34%) and 30–34.9 kg/m2 (45.6%)[17]
  2. Body fat percentage: Majority of the subjects, i.e., 50.2% were found with body fat percentage >30 and 49.8% were found between 25% and 30%
  3. Waist circumference: Majority of the subjects, i.e., 66.6% were found with waist circumference between 85 and 95 cm, 33.4% were found between 96 and 105 cm
  4. Waist/hip ratio: The maximum subjects, i.e., 95.2% were found with waist/hip ratio between 0.96% and 1.05, 4.8% were found between 0.85 and 0.95.



  Conclusions Top


In the study, it was found that the subjects of Medoroga were belonging to young age group (18–30 years), male, unmarried, Hindu, upper and lower middle class living in urban area and Jangala Desha. The persons indulged in Ati-bhojana Sevana (excessive food intake), Ati-guru Sevana (intake of heavy food), Ati-madhura (excessive sweet food intake), Ati-sheeta-snigdhadi Ahara (excessive cold and fatty food) like Ksheera (milk), Dadhi (curd), Sarpi (ghrita) and excessive intake of junk food, beverages like tea/coffee are more susceptible to Medoroga. Vihara such as Ati-asyasukha (continuous sitting), Avyayama (lack of exercise), Diva-svapna (day sleep), Achinta (absence of thoughts), and Nitya-harsha (continuous cheerfulness) also proved to be etiological factors of medoroga. For further study, multicentric methodology may be adopted for survey to avoid regional bias.

Financial support and sponsorship

National Institute of Ayurveda.

Conflicts of interest

There are no conflicts of interest.





 
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