Translating Ayurveda's Dosha-Prakriti into objective parameters.

Ayurveda considers each human being to have a unique physical, physiological, and mental constitution, which in turn, requires the correspondingly unique treatment regime. In Ayurvedic philosophy, three Doshas, viz., Vata, Pitta, and Kapha, of the body are believed to determine the unique combination of physical, physiological, and psychological features of an individual. The Prakriti of a person is a consequence of the relative proportions of the three Doshas. The dominant Dosha of a person is believed to be determined at birth, which is further modulated by the diet and lifestyle of mother, age of the parents, and the environment in which the person grows to generate the unique Dosha-Prakriti of the individual. The classical texts of Ayurveda provide detailed parameters by which the trained Ayurvedic practitioner identifies the Prakriti of the person and correspondingly defines the treatment regime. However, in the absence of clearly defined contemporary biological correlates of the traditional Dosha-Prakriti features, such classifications have not been taken seriously in the context of modern medicine. It is interesting, nevertheless, to note that the determinants of Dosha-Prakriti of a person, as defined in classical Ayurvedic texts, are very similar to those believed to determine the phenotype in modern biology. Thus, the current genetic paradigms believe that the phenotype of individual results from interaction between genotype (established at fertilization) and the environment, which includes epigenetic changes resulting from parental age, diet, lifestyle, and other environmental factors. Can we then define the Dosha-Prakriti features in terms of contemporary biological parameters? An interesting study by Rotti et al. in this issue attempts to establish correlates of Dosha-Prakriti with features that are commonly used in contemporary medicine[1].

Rotti et al. examined a large number of individuals in three different populations and classified them into the different Prakriti classes based on the conventional examination by experienced Ayurvedic practitioners and independently, by software developed for the purpose. Significantly, they found ~ 80% concordance between the Prakriti classification obtained by the two parameters. Such high concordance, although expected because the software would depend upon the same parameters that the Ayurvedic practitioner would rely upon, shows that Prakriti of an individual can indeed be determined objectively. The observed good correlation between the traditional description of each Dosha-Prakriti and the body mass index suggest that the Ayurvedic classification of Dosha-Prakriti indeed has a biological basis. Since populations of three different geographical regions were examined independently, authors also used the data to ask if there is a correlation between the geographical location (and consequent environmental variability) and Dosha type, as has been claimed in traditional Ayurvedic texts. Interestingly, a significant correlation was indeed obtained. It is notable that no correlation was found between certain other genetically determined phenotypes like the blood groups and Prakriti types. Although, the blood group may not influence the Dosha-Prakriti of an individual, geographical location, and therefore the environment, seems to modulate the frequencies of different Dosha-Prakriti types in a population.

Ayurveda and other traditional health-care systems across the world have suffered because very few studies have actually attempted to understand the traditional age-old descriptions in contemporary vocabulary. Some recent studies, including that of Rotti et al. in this issue, seem to reduce this void. Further studies, using larger and more diverse population samples in conjunction with other physiological and genomic parameters are expected to provide better and rational understanding of the “traditional wisdom”.