‘FAT CAUTION’ for Bone Health: Ayurveda and Modern perspectives

Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa S, B.A.M.S

Medas vis-à-vis fat tissue occupies the midpoint of the seven tissues mentioned by Ayurveda. Like other tissues, even fat tissue undergoes pathological increase and decrease and is subject to be contaminated by the circulating vitiated doshas. It is an abode of kapha dosha. When in a state of balance it serves important body functions, mainly snehana i.e. provides unctuousness and lubrication to the body parts and cells.

When fat tissue builds up abnormally in the body it becomes dangerous. It is a tissue which tends to cause blocks and clogs in the srotas – channels of the body. This causes base for many systemic and metabolic disorders to crop up.

Accumulation and build up of bad fats beyond desired proportions would cause imbalances in all the other tissues of the body, including the bone tissue. Increased fat is responsible for the damage and disorders related to all other tissues, organs and organ systems.

To understand this, we need to understand the relationship between fat and bone tissues from Ayurveda perspective.

Ayurveda has explained the process of formation of tissues from the essence of food that has undergone digestion in the gut i.e. ahara rasa. The first tissue formed form ahara rasa is the rasa dhatu i.e. plasma / lymph. Following this, rakta dhatu – blood tissue, mamsa dhatu – muscle tissue, meda dhatu – fat tissue, asthi dhatu – bone tissue, majja dhatu – bone marrow tissue and shukra dhatu – semen tissue is formed in that chronological order.

In this chronology, we can see that the bone tissue is formed from and after the fat tissue. This consequential formation of tissues depends on the nature and strength of each and other dhatu agni – tissue fire. This tissue fire is dependent on the strength of the fire which controls them i.e. jathara agni i.e. the main core-central digestive fire.

Coming to the contextual discussion of meda and asthi dhatus – If medo dhatvagni i.e. tissue fire of fat tissue is good and balanced, the fat tissue is formed in balanced proportions. Not only that, the successive tissue i.e. precursors of bone tissue are also formed in proper and balanced quantity. If this fire is less, more of fat tissue is formed. This is not healthy. This increased fat causes obstruction of the channels which are responsible for the formation of other tissues and lead to their depletion. Thus, increased fat can also cause depletion of bone tissue.

Similarly, if the fat-tissue fire is increased, it causes depletion of fat tissue. This further leads to deficit formation of bone tissue.

Abnormally increased Medo dhatu and its influence on bone tissue and BMD

As already discussed, if the fat tissue is formed properly and the agni at its level is working in a state of serene balance, then the bone tissue is formed to its optimum best.

In the context of ‘medo roga’ i.e. disorders caused due to errors in fat metabolism, it is said ‘medasavrita margatvat pushyanti anye na dhatavah’. It means to tell that – ‘When the fat builds up in the body without any control, it causes blocks in all the channels. This would consequently lead to inadequate nourishment of all the other tissues of the body’.

On the other hand, ‘only fat’ will be nourished from the rasa i.e. the nutritive part of the essence of digestion. The other tissues will eventually be deprived of nutrition since the fat tissue takes the lion’s share. This leads to inadequate formation of all tissues and excessive formation, less conversion and abundant storage of fat tissue in the body. This causes a burden on the other body tissues and causes conditions like ‘being overweight’ or obesity. This predisposes the body to wide array of diseases.

Consequences on bone tissue – The consequences of these pathological and damaging events also lead to and includes inadequate formation of bone tissue also. Consequentially the BMD values will be disturbed. There is a fall in the bone mass density. These events also lead to manifestation of osteopenia and osteoporosis. Therefore, it is essential that there is a balance between formation and conversion of fat tissue. Therefore, it is essential for people to keep a check on their body weight and BMI.

Recent researches also show that obesity has an effect on bone density and obese people have a lower bone density in relation to their body weight and also an increased risk of fractures.

Related Research –

A study showed the association between overweight and obesity on bone mineral density in 12 to 15 years old adolescents in China.

Obesity – a condition of abnormal fat increase – might prove a risk factor for fractures independently of BMD. Thus, adipose tissue may negatively impact bone health. More specifically, visceral adipose tissue may potentially prove detrimental.

Decrease of body fat and painful joint disorders

Bony joints are said to be the upadhatus – sub-tissues of fat tissue. Osteoporosis or osteopenia are first manifested in the form of joint pains in majority of the people. Pain and weakness in one or more joints are the chief complaints of people with these conditions. Doctors are tempted to diagnose and treat these conditions as one or the other type of arthritis. A ‘BMD’ evaluation is generally missed in patients having painful joints.

Interestingly, sandhi sphutana – cracking pain in the joints is one of the symptoms of ‘meda kshaya’ i.e. pathological reduction in fat tissue.

So, decrease in fat → leads to improper formation of asthi and sandhi (bones and joints) → leads to reduction in bone mass density → leads to osteopenia or osteoporosis.

Study – A 10% weight loss results in ~1-2% bone loss at various bone sites. There is greater bone loss (>1%) with weight loss in normal-weight (less than ~60kg) compared with overweight or obese individuals (<1% bone loss) – Nguyen at el. Therefore, unplanned and excessive weight loss than is desired and in sync with BMI is not desired.

There are evidences that weight loss by caloric restriction decreases bone mass in overweight and obese older adults and also in nonobese (including normal weight) younger adults.

Excessive weight loss and in overtly thin or emaciated individuals, there will be less BMI and less BMD and these people are prone to pathological bone fractures due to osteoporosis.

Low BMI increases fracture risk. This is possibly because low BMI is associated with low BMD (bone mass density), less soft tissue and muscle weakness. However, the relationship between high BMI and fracture risk is complex.

Summary

According to Ayurveda, the fat and bone health are interrelated. If one is balanced, the other tissue too is balanced and is healthy, usually in a chronological pathway keeping fat and bone in that order. On the other hand, an increase or decrease of fat tissue is shown to have negative impact on the bone, bone mass and bone and joint health.

Reduced bone mineral density, osteopenia, osteoporosis, pathological fractures of bones, bone and joint pains are some of the bone issues faced in people having imbalanced fat metabolism or errors of fat metabolism in the body.

So, abnormal increase or decrease of fat tissue will lead to painful bones and joints which might indicate need of BMD evaluation.

So, one needs to keep a strict check on their fat numbers and try to bring it to balance as it ascends or descends the ladder of the graph.

Strict, guided and monitored foods, lifestyle changes, essential medicines and therapies, good exercise and stress free life as recommended and monitored by specialists of concerned areas will be the key for balancing fat and bone health in the body and also to maintain and manage their mutual chemistry in a good and positive way.