Introduction

Metabolism is the foundation of life-sustaining chemical reactions within the human body, enabling the conversion of nutrients into energy and supporting essential bodily functions, such as growth, repair, and regulation. When the metabolic processes are balanced, the body functions optimally. However, disruptions in this balance, which are often influenced by modern lifestyles, can lead to various health-related issues. One of the most concerning outcomes of metabolic imbalance is metabolic syndrome, a condition characterized by a group of risk factors including abdominal obesity, high blood pressure, elevated blood sugar, and abnormal cholesterol or triglyceride levels. Lifestyle choices are fundamentally linked to the underlying causes of metabolic syndrome. Metabolic syndrome significantly increases the risk of developing various noncommunicable diseases, including type 2 diabetes and cardiovascular diseases. The kinds of food we consume, the way we manage stress, the amount of sleep we get, and our level of physical activity all influence how susceptible we are to non-communicable diseases (NCDs).^[1] These factors not only put stress on the body’s metabolic functions but also encourage insulin resistance and fat buildup, worsening the condition. The occurrence of metabolic syndrome (MetS) in India has been reported to range between 11% and 41%, reflecting the country's wide diversity in socioeconomic and cultural backgrounds.^[2] According to statistics, between 25% and 33% of India's urban population is affected by metabolic syndrome.^[3] It is estimated that individuals with Metabolic Syndrome (MetS) face a two-fold increased risk of developing cardiovascular disease (CVD) within the next 5–10 years compared to those without MetS. This risk is believed to be significantly greater over a lifetime. Furthermore, MetS increases the risk of developing type 2 diabetes five-fold. Research also suggests that over 20 years, people with MetS have a 30% to 40% higher chance of developing either type 2 diabetes, cardiovascular disease, or both.^[4] Ayurveda’s comprehensive approach holds significant promise in managing the prevalence of lifestyle-related non-communicable diseases, such as metabolic syndrome.^[5] Addressing metabolic syndrome has thus become a public health priority in India, requiring comprehensive strategies focused on awareness, prevention, lifestyle modification, and medical intervention.

In context of metabolic syndrome, abnormal Meda deposited in subcutaneous tissues manifests clinically as obesity. Similarly, when unprocessed Meda (Abaddha Meda) accumulates in bladder (Basti), it contributes to symptoms of Prameha.^[12] Furthermore, when it is abnormally deposited in arterial walls, it increases peripheral resistance (Dhamanipratichaya or arteriosclerosis)^[13], result-ing in symptoms of hypertension. Additionally, presence of this abnormal Meda in Rakta Vaha Srotas (channels carrying blood) leads to elevated levels of unhealthy fats, resulting in hypercho-lesterolemia.^[14] Currently, many diseases are classified as Santharpanajanya disorders, primarily resulting from a sedentary, stressful lifestyle, and unhealthy dietary habits. These factors exacerbate Kapha Dosha along with Mamsa and Meda dhatus, contributing to development of metabolic disorders such as Prameha (diabetes), Atisthoulya (obesity), Sopha (inflammatory conditions), and Dhamani Pratichaya (atherosclerosis).^[15] These conditions are often linked to metabolic syndrome, highlighting a significant connection between metabolic syndrome and Santarpanajanya diseases.^[16] In Charaka Samhita, lack of physical activity and unhealthy eating habits, which are the causes of lifestyle diseases, are mentioned.^[17] As per the Acharya Charaka, emotional disturbances such as excessive thinking, sorrow, fear, and anger can disrupt the digestive process. This disruption results in weakened digestive fire (Agnimandya) and indigestion (Ajeerna). If this condition persists, it may progress to impaired tissue metabolism (Dhatvagnimandya) and the accumulation of waste products in tissues (Dhathumalasanchaya).^[18] An increase in qualities such as heaviness (Guru), slowness (Mandha), stability (Sthira), and stickiness (Abhisyanthi) can lead to an imbalance in kapha and further weaken digestion, ultimately resulting in formation of harmful metabolic waste. Ama, which possesses sticky and heavy qualities (Picchila and Guru), has potential to obstruct body's channels (Srothorodha).^[19]

In Metabolic Syndrome (MetS), modern pathology identifies insulin resistance as the primary cause, which primarily results from elevated levels of free fatty acids in the bloodstream, often due to excessive intake of high-calorie foods.^[20] Insulin resistance may be interpreted as Srothorodha (obstruction of bodily channels) caused by Bahudrava Kapha, Kleda, and other Dooshyas.

Pungent (Katu), bitter (Tikta), and astringent (Kashaya) tastes offer valuable benefits. They possess properties such as enhanced digestion (Deepana), promotion of metabolic activity (Pachana), and reduction of excess fat and moisture (Lekhana and Meda-Kleda Upashoshana). These actions support the digestion of Ama, help restore impaired digestive fire (Agni Vaishamya), and clear blockages in the bodily channels (Srothorodha), as well as correct imbalances related to Kapha and Meda.^[23] Dietary guidelines rooted in Ahara Vidhi and the incorporation of Dinacharya and Ritucharya enhanced long-term compliance and disease management.

Discussion

Metabolic Syndrome (MetS) is a cluster of lifestyle-related disorders with complex etiopathogenesis, strongly aligned with the Ayurvedic concept of Medopradoshaja Vikara, in which the vitiation of Medo Dhatu plays a central role. The accumulation and abnormal distribution of Meda in various tissues contribute to clinical conditions, such as obesity, diabetes (Prameha), hypertension, and hypercholesterolemia, mirroring modern MetS manifestations. Ayurveda attributes these conditions largely to Santharpanajanya (over-nourishment) disorders triggered by sedentary habits, improper diet, and mental stress. These causative factors disturb Kapha, Meda, and other Dooshya, leading to Srothorodha (channel obstruction), Agni Vaishamya (digestive imbalance), and Mala Sanchaya (toxic accumulation). Ayurveda addresses these foundational issues rather than merely managing symptoms, and offers a personalized and comprehensive therapeutic approach. Treatment strategies involve both curative and preventive approaches. Samshodhana (purificatory therapies) are employed to eliminate deep-seated toxins and restore the natural functioning of digestive and metabolic processes. Samshamana, an Ayurvedic therapy designed to maintain balance in the body by managing doshas without purging them, including the use of specific herbs and dietary modifications, further aids in correcting Dosha imbalance and improving lipid and glucose metabolism. Lifestyle guidance rooted in Ayurvedic routines (Dinacharya) and seasonal practices (Ritucharya), along with the removal of causative factors (Nidana Parivarjana), enhances long-term disease control. Holistic nature of Ayurveda also emphasizes mental well-being,