Integrative Approaches for Health

Biomedical Research, Ayurveda and Yoga

Bhushan Patwardhan, Gururaj Mutalik, Girish Tillu

• Publisher: Academic Press
• Year: 2015
• ISBN:
  9780128014349
• Topic: Tecnología e ingeniería
• Subtopic: Ciencia de los alimentos

Despite spectacular advances, modern medicine faces formidable global challenges in several key areas—notably the persistence of major killer diseases such as malaria, tuberculosis, leprosy, and newer threats including HIV/AIDS, resistant infections, and Ebola. As such, modern medicine has not led to a significant decrease in chronic diseases like diabetes, obesity, and other degenerative and autoimmune diseases. The authors believe that modern medicine needs to experience a paradigm shift, an integration of traditions—in particular from the ancient systems like Ayurveda and Yoga.

Integrative Approaches for Health: Biomedical Research, Ayurveda and Yoga brings together the basic principles of interdisciplinary systems approach for an evolving construct of future medicine. Such an approach is already emerging at the cutting edge of current research in omics, bioinformatics, computational and systems biology. Several leading institutions of medicine have adopted Yoga and complementary medicine to widen their reach, and deepen effectiveness in therapeutic practices. The amalgam of modern medicine, with its strengths in scientific rigor, blended with the basic principles of life drawn from Ayurveda and Yoga might evolve into a medicine of tomorrow. Integrative approaches are no longer alternative, perhaps taking these approaches is the only possible way to heal our sick planet. This book introduces important trends and tools for biomedical researchers and physicians alike, to innovate the practice of medicine for the better.

• Contains a harmonious confluence of ancient and modern concepts, historical perspectives, philosophical underpinnings, and a relevant review of literature supported by worldwide case studies.
• Provides a critical analysis of ancient wisdom, pointing to potential areas for future research, which provide food for thought for public debate on integrative health care for the twenty-first century.
• Explains Ayurveda knowledge, and its relevance to drug discovery, nutrition, genomics, epigenetics, regenerative biology, longevity and personalized medicine.
• Shares Yoga knowledge insights, and explains its relevance to body–mind complex relationships, psychology, neurobiology, immunoendocrinology, bioenergetics, consciousness, and cognitive sciences.
• Offers illustrations and logic diagrams for enhanced understanding of the concepts presented.

Chapter 1

Advocacy for Integration

Abstract

This chapter begins within the context of advocacy for integrative approaches, followed by a review of the global health status. The diversity of challenges in different parts of the world gives few glimpses of the seriousness and magnitude of the health care crisis. The authors discuss the evolution of health care systems, with medical care as a component, and suggest that the present focus is more on treatment of diseases than on health protection. Despite spectacular advances in biomedical sciences, the developing world has not been able to eliminate age-old diseases; in the developed world, newer diseases attributable to lifestyles have sprung up. These unresolved challenges call for a close look at today’s health care solutions, and new, imaginative approaches in health and medicine. In exploring their complementary roles in health care, we survey important advancements in biomedical sciences, and basic concepts from Ayurveda and Yoga. The authors suggest a possible meeting ground for the integration of diverse systems such as Ayurveda, Yoga, and other traditional and complementary medicines (T&CM), with modern medicine. Issues related to medical pluralism, and definitions of T&CM practices are discussed to indicate possible meeting grounds. Discussed in this chapter are the rationales, and constructs of integrative approaches, and their relevance and importance to learning, in light of biomedical sciences, Ayurveda, and Yoga. While making the advocacy, authors do not take any sides—be it modern medicine, Ayurveda, or Yoga but try to strike a balance between the two seemingly diverse yet complementary philosophies.

Keywords

Advocacy; Biomedical sciences complementary; Global health scenario; Health care system; Holistic; Integration; Integrative approach; Medical pluralism; Nonpharmacological approach; Scientific advances; Traditional

He who does not trust enough, will not be trusted

Lao Tzu

Background

Before we begin this chapter “Advocacy for Integration,” we recognize that, on a global level, the importance of an integrative approach for health and medicine, in general, has been accepted. Indeed, there is no need to convince professionals, governments, and people. However, there is not enough clarity and consensus about what constitutes integration. To build advocacy, a critical review of ostensibly different knowledge domains that broadly represent modern and traditional knowledge systems, biomedical sciences, Ayurveda, and Yoga is needed. Interestingly, although these knowledge systems differ epistemologically, their underlying philosophies are similar.

The domain of modern knowledge systems is represented by biomedical science, which integrates biology and medicine. Biological sciences are represented by physiology, biochemistry, biophysics, microbiology, and similar basic sciences. Medicine is represented by pharmacology, pathology, therapeutics, and similar applied sciences. We prefer to call the medical component as modern medicine, which is also known as conventional medicine, orthodox medicine, Western biomedicine, or more popularly as allopathy. New variants of modern medicine such as molecular medicine emphasize cellular- and molecular-based interventions beyond the conceptual and observational focus on patients and their organs. Personalized medicine brings understanding of individual genomic variations to design specific treatments most suitable for a particular person.

All systems, practices, or forms, and therapies other than modern medicine are contained in the traditional and complementary medicines (T&CM) category. The domain of traditional knowledge systems is represented by Ayurveda and Yoga. Ayurveda deals with health promotion, disease prevention, and personalized treatments with the help of natural medicines. Yoga is a nonpharmacological approach that focuses on mind/body/spirit through exercise, relaxation, and meditation.

In general, modern science is often regarded as reductionist, while Ayurveda and Yoga are considered to be holistic. We feel that modern and traditional knowledge domains share some similar basic principles. Historically, while there have been some detours, the basic philosophy, doctrines, ethos, and approaches remain the same, even today. In the post-Aristotelian period, modern science has rigorously followed the reductionist approach—imparting a much deeper understanding to the parts. After William Harvey, the understanding of physiology became more precise. After Robert Koch, Louis Pasteur, and Joseph Lister, the understanding of diseases and causative factors became clearer. After Ronald Ross and Alexander Fleming, the magic bullet era began. After Paul Erlich and Linus Pauling, medicinal chemistry became much more precise. Frederick Sanger, James Watson, and Francis Crick advanced knowledge of genetics and genomics. Now the high-throughput technologies are helping us to move toward personalized treatments.

The emergence of systems biology is an indication that even though biomedical sciences have taken the reductionist path, there is a growing recognition of the importance of a holistic approach. New fields like quantum mechanics, robotics, and artificial intelligence are indicative of a convergence toward holistic approaches—going back to basics, but with much more clarity and strength. We feel that both modern medicine, and Ayurveda and Yoga have complementary strengths to evolve into integrative medicine of tomorrow. It is true that in practice, they do not seem to be so. The present biomedical science has compartmentalized itself into several superspecialities, and has become more linear, mechanical, and protocol-driven. Ayurveda and Yoga have remained frozen traditions. However, at the core, both in their own rights are logical, evidence-based, patient-centered, and personalized.

Today, hoping to attain health and wellness, the world is facing incurable diseases and illnesses. Despite powerful drugs, diagnostics, surgical advances, and sophisticated technologies, people continue to suffer. To note, this is not to undermine the power of modern medicine; on the contrary, modern medicine has done wonders to eradicate many infectious diseases, and improve quality of life and longevity. However, limitations of modern medicine exist—especially in the treatment of chronic, psychosomatic, and lifestyle diseases.

In this day and age, medical science knows more about disease and illness than health and wellness. Biomedical sciences may have understood complexity of body and mind to some extent, but a holistic view that takes into account body/mind/spirit is still missing. Until now, the fact of the importance of positive health and wellness has been neglected by the scientific community. The curative approach—with an excessive focus on diseases, diagnostics, and drugs—has overshadowed any holistic methodology of health promotion and prevention. The patient as a person is usually undermined in the process of clinical diagnosis and treatment. The clinical process has become more scientific and evidence-based, but at the same time it has become protocol-driven, algorithmic, and mechanical. Experience-based systems like Ayurveda and Yoga might be useful in overcoming the present limitations of medical therapy. We recommend the integration of the best resources and practices from biomedical sciences, Ayurveda, and Yoga as a smart strategy and practical approach.

In our advocacy, we do not take any extreme positions regarding either Western reductive modern medicine or Eastern traditional holistic medicine. Both these systems have strengths and weaknesses. We hypothesize that a synergistic confluence of these seemingly diverse systems may be possible through appropriate integrative approaches. In this book, we try to build a case in support of our hypothesis. In order to provide a philosophical underpinning for our case, we also discuss the evolution of medicine, and concepts of health and disease. We critically review the importance of holistic approaches and their similarities with the emerging science of systems biology. We review the advances in biomedical sciences leading to the development of modern pathology, diagnostics, and drug discovery; and the journey of modern medicine from clinical acumen to scientific evidence-based medicine. We discuss the importance of food, nutrition, and lifestyle management for health, wellness, healthy aging, and longevity. Finally, we attempt convergence of personalized and integrative approaches to imagine the contours of future medicine.

Global Health Scenario

In attempting an advocacy for integrative approaches, it is necessary to review the global health scenario. Of interest is the juxtaposition of the evolution of the health care system against the backdrop of advances in biomedical sciences, including the unmet needs and unresolved challenges in this sector. In the following sections, we sketch this background before discussing the need for integrative approaches.

Historically, health has been a natural and integral part in most of the cultures and traditions. Now, however, peoples’ active participation in seeking and maintaining health is overshadowed by their passive dependence on treatments. The basic objective of any health care system is to provide better physical and mental health across the communities through effective interventions. Good health care systems also attempt to improve individuals’ satisfaction by respecting their dignity. Health is an element of common good, and a central part of economic and social development. Health is now considered an important human right, crucial to individual dignity, and should be accessible and affordable for all individuals.

As this book is being written, the world has reached a population of approximately 7.2 billion. Out of these, about 80% of the population live in the developing countries. According to the World Health Organization (WHO), about 36 million people have died of HIV so far. Globally, 35.3 million people were living with HIV at the end of 2012. Sub-Saharan Africa remains most severely affected, with nearly 1 in every 20 adults living with HIV and accounting for 71% of the people living with HIV worldwide. Globally, there are at least 300 million acute cases of malaria each year, resulting in more than a million deaths. Around 90% of these deaths occur in Africa, and are mostly young children; malaria is virtually nonexistent in the developed world. The number of people who suffer from tuberculosis is over 532 per 100,000 in Africa and Southeast Asia. Spending on pharmaceuticals accounts for about 15% of the total amount spent on health worldwide; the average per capita spending on pharmaceuticals in high-income countries is over 400 dollars, and barely over 4 dollars in low-income countries. A WHO statistics showed that the density of modern medicine physicians per one hundred thousand persons in some countries is very low: Rwanda, 1.87; Ethiopia, 2.85; Uganda, 4.70; India, 51.25; and China, 164.24. In stark contrast is the numbers for Australia and the United States: 249.13 and 548.91, respectively.

Over 1 billion people exist on less than 1 dollar a day. Over 2.5 billion people lack sanitation. Over 1.5 billion people do not have safe drinking water, and some 3 million people—mostly women and children—die every year from diarrheal diseases directly related to these deficiencies. There is little cause for optimism in these areas as available evidence suggests that the drinking water resource in the poor world is likely to diminish over the next several decades.

According to the WHO, in 2012, there were 56 million deaths worldwide from all causes. The epidemiological transition from communicable to noncommunicable diseases (NCDs) is apparent in the second decade of the twenty-first century. NCDs were found to be responsible for over 68% of all deaths globally; a near 10% increase from 2000. The four main NCDs are diabetes, cardiovascular disease, cancer, and chronic lung disease. Among these, cardiovascular disease tops the list with 30% of deaths. On a global level, collectively, communicable diseases, poor prenatal, natal, postnatal and neonatal care, and poor nutrition, were responsible for 23% of deaths. Globally, 9% of all deaths were the result of injury. Earlier in the twentieth century, the rich and developed countries ranked higher in NCDs, while poor countries were contending with communicable diseases. However, over the past few decades, the epidemiological transition is clearly visible where poor and developing countries are confronted with the double burden of both communicable diseases and NCDs.

Successful elimination of many infectious diseases, substantial reduction in childhood mortality, and the improvement of life expectancy and longevity has occurred in the rich and developed world. Ironically, the contrasting...

Table of contents

• Cover image
• Title page
• Table of Contents
• Dedication
• Copyright
• About the Authors
• Foreword
• Preface
• Acknowledgments
• About the Cover
• Chapter 1. Advocacy for Integration
• Chapter 2. Evolution of Medicine
• Chapter 3. Concepts of Health and Disease
• Chapter 4. Evidence-Based Medicine and Ayurveda
• Chapter 5. Systems Biology and Holistic Concepts
• Chapter 6. Lifestyle and Behavior
• Chapter 7. Food and Diet
• Chapter 8. Health Supplements
• Chapter 9. Drug Discovery and Ayurveda
• Chapter 10. Longevity, Rejuvenation, and Rasayana
• Chapter 11. Personalized Approaches for Health
• Chapter 12. Integrative Approaches for the Future
• Ayurveda and Yoga—Primer
• Index