ISSN 0976 - 0075
Ayurveda is stream of knowledge coming down from generation to generation. Now Ayurveda is treatise of universal importance which sets up physical and mental health. For the treatment purpose physician needs some parameters which decide normal and abnormal state of constitutional elements. One of the parameter is pramaan pariksha which includes anguli (finger) pramaan (measurement) of body. It explains anthropometrical measurement in terms of swaanguli pramaan (self finger measurement) for describing anatomical position, size and shapes of organ in the form of aayam (height), vistaar (arm span) and parinaah (circumference). Samsharir (proportionate body) is described as body having height and arm span 84 angul (fingers) each. Now a day's obesity and malnutrition creates various uncontrolled disorders. In modern science extra fat is calculated by various methods out of which Body Mass Index (BMI) is widely used by physicians. Though it is widely used, World health Organization (WHO) has promoted to evaluate most scientific method for assessing health and nutritional status. So in this direction we put forth the concept of anguli pramaan. The aim of proposed study was to evaluate correlation between the anguli pramaan and BMI and to establish the practical utility of anguli pramaan. On the basis of data obtained it was concluded that BMI has a moderately negative correlation with height and arm span. Arm span is the best predictor of height in the calculation of BMI .This denotes the importance of anguli pramaan for determination of person's physical health.
Keywords : Anguli pramaan, Obesity, BMI
Introduction :
Now a day's India suffers from two major health problem, obesity and malnutrition. These major problems arise because of nutritional crises and drastic change in life style of individuals.[1][2] In Modern Science BMI (Body Mass Index) is widely used to rule out obesity and malnutrition.[3] WHO has promoted to evaluate the most scientific method for assessing health and nutritional status. BMI can be misleading in terms of a person's body fat as it solely depends on the net weight and height of a person. It ignores the distribution of muscle and bone mass.[4] The medical fraternity has identified and acknowledged limitations of BMI. BMI calculation is solely dependent on the net weight and height of the individual and does not consider the distribution of muscle and bone mass. BMI also does not differentiate between body fat and muscle mass. This may often result in misleading information with regard to the amount of fat in an individual. There is a potential risk of overestimating 'fatness' in individuals with high muscle mass, such as body-builders, and underestimating the fat deposit in those with less lean body mass, such as the elders. The argument against BMI is so intense in some quarters that its use as a tool to evaluate health risks in individual is strongly disfavored.[5] BMI overestimates the fat and the risks to health in the body builders and athletes. BMI can underestimate the amount of body fat in elderly people, muscle wasting problems, anorexia nervosa and morbid obesity.[6][7]
In Ayurveda anguli pramaan is used to measure the body proportion in the form of height and arm span. It is said that height and arm span should be equal, which is 84 fingers. Thus body having height and arm span 84 finger each is described as proportionate body.[8] The concept of anguli pramaan mentioned in Ayurveda and BMI of modern science, these two methods are different from each other but their utility is to assess health of person. Thus this study was carried out to assess health and nutritional status in diseases of civilization. The aim of proposed study was to evaluate if there is any correlation between the anguli pramaan and BMI and to establish the practical utility of anguli pramaan.
Material And Methods
For the study, 300 volunteers were randomly selected according to selection criteria. Persons from different religion, diet habits, habitats, socioeconomic groups, professions, and life style were selected. 162 male and 138 female of the age group 25 to 55 year were selected. Persons having congenital anomalies, polio were excluded. Person suffering from endocrinal diseases like Hypothyroidism, Hyperthyroidism were excluded. Person undergone major surgeries like amputation, had loss of body part due to road traffic accident were also excluded. Vernier caliper, measuring tape, weight machine and long scale were used to measure the study variables .[9]
Method of taking swanguli pramaan
Swanguli pramaan (self finger measurement) was taken for each subject with the help of Vernier caliper. For measuring one anguli pramaan we asked the examinee to remove his / her finger ornaments firstly and to keep both hands on flat surface (e.g. table) in such a way that index, middle, ring, and little fingers are closely related to each other and thumb is slightly away from index finger. Now Vernier caliper was kept at place of parvasandhi and panital joint (joint between the lower phalanges and metacarpals) of right hand not too tight or too loose. Vernier caliper should be perpendicular to the flat surface in such a way that both ends must touch the flat surface. Now Vernier caliper was removed and reading of Right hand was noted on paper in centimeters. In same way reading of left hand was taken. For calculation of one anguli pramaan following formula is used.[10][11]
Self finger Breadth of joint between the lower phalanges and metacarpals of both hands Measurement = 8
Following precautions were taken while measuring with Vernier caliper. Both hands were ensured be on flat surface. Subjects were asked to make fingers free from ornaments. Use of Vernier caliper should was done very carefully not too loose nor too tight (Figure 1 and 2).
Measurement of Height and Arm span.
Acharya Jyotishchandra saraswati describes the ayama as measurement from padtala (sole) to shirsha (head), [12] and according to modern anthropometry height is an assessment of maximum vertical size or the vertical dimensions of body. Hence we can say that Aayaam is the height.[13] Acharya Jyotishchandra mentioned vistar as "Samprasarita Hasta" that is extending hands laterally and horizontally. Aacharya chakrapani says "Vistrut bahu dvaya" (both hands extended laterally and horizontally).[14] According to anthropometry arm span is measurement of finger tip to finger tip of middle finger of both hands. Hence we can say that arm span is the vistaar of body.[15] Measurement of height and arm span was done simultaneously on long scale (Figure 3). For this we asked subject to stand on wooden base with heels of both feet together and toes pointed slightly outward at approximately 60 angle. We made sure that body weight is evenly distributed and both feet are flat on wooden base. Position of heels, buttocks, shoulders blade and back of head was contacted with vertical scale. Simultaneously subject was asked to extend his hands laterally away from body. Height and arm span was recorded in centimeters and then convert it into anguli pramaan with all precaution.
Calculation of BMI:
To calculate BMI, weight of subject was taken with help of weighing machine. Already measured height in centimeter was converted in meter. BMI was then calculated using following formula.
BMI was classified as following [16]
| BMI | Category |
| <18.50 | Under weight |
| 18.50-24.90 | Normal |
| >25.00 | Over weight |
In this way measurement of Swanguli pramaan, height, arm span and BMI was taken with all precautions for 300 subjects. All these readings were recorded in master chart.
Result:
Table 1: mean values for height and arm span in anguli pramaan.
| Variable | Sample size (N) | Mean (± sd) | Min | Max |
| Height (Aayaam) | 300 | 85.17 (± 4.76) | 72.85 | 104.37 |
| Arm span (Vistaar) | 300 | 86.49 (± 5.41) | 72.51 | 108.82 |
Table 2: Mean of height and arm span according to classification of BMI.
| BMI Classification | Category | Sample size (Percentage) |
Mean of height | Mean of arm span |
| <18.50 | Under weight | 81 (27%) | 86.31 ± 4.75 | 86.83 ± 5.16 |
| 18.50-24.90 | Normal | 187 (62.33%) | 85.23 ± 4.63 | 86.96 ± 5.42 |
| >25.00 | Over weight | 32 (10.67%) | 81.94 ± 4.25 | 82.94 ± 4.76 |
Table 3: Showing correlation of BMI with height and arm span.
| Variable | ‘r’ value | ‘p’ value |
| Height Arm span |
- 0.3047 - 0.2224 |
<0.001 |
Table 4: Differences between mean of BMI Calculated using Height and Arm span
|
|
Sample |
Mean |
Difference |
P.Value* |
|
BMI From Height |
300 |
20.69 |
0.01 |
<0.001 |
|
BMI from arm span |
300 |
20.68 |
* Significance calculated using Independent sample t test
Table 5: Mean of swanguli pramaan (self finger measurement).
| Sample size | Mean | Std Dev. | Min | Max |
| 300 | 1.9002 | .1619 | 1.08 | 2.8 |
Discussion
On the basis of data obtained mean of the height was 85.17 fingers where as mean of arm span was 86.49 fingers which are more than 84 fingers. According to Ayurveda proportionate body must have the height and arm span equal that is 84 fingers, but here we found that arm span of the person is slightly greater than that of person's height (Table 1). This may be due to change in genetics, diet and impact of environment.[17] The subjects in underweight category ( BMI < 18.50) were having mean height of 86.31 ± 4.75swangulipramaan and mean arm span of 86.83 ± 5.7swanguli pramaan. The subjects in overweight category ( BMI greater than 25.00 )had mean height of 81.94 ± 4.25 swanguli Pramaan and mean arm span of 82.94 ± 4.76swanguli Pramaan. From this results we can say that if the height or arm span in fingers is increase, person is going toward underweight category and vice versa (Table 2). Since this finding is based on a weak negative correlation we advice to exercise caution in reaching a conclusion in this regard. Also there is a need to conduct further studies with homogenous and larger sample size to evaluate this relationship.
Correlation coefficient (r) of BMI with height was -0.3047 and of that with arm span was -0.2224, which shows the weak negative correlation of height and arm span with BMI (Table 3and Fig 1 and 2). Predicted mean of BMI from height was 20.69 and predicted mean BMI from arm span was 20.68 (Graph 3), which showed highly positive correlation (Fig 4). Hence in case of unavailability of height of person we can put arm span of that person in the calculation of the BMI, It means arm span is the best predictor of height in calculation of BMI. [18][19] Regression equations were derived to calculate the BMI. If we know the person height or arm span in fingers, we can calculate the BMI of that person by using the following regression equations.
BMI from given Aayaam (height) in fingers.
BMI = 37.81 + [ (-0.2010) X Aayaam in fingers]
BMI from given Vistaar (arm span) in fingers.
BMI = 31.87 + [(-0.1293) X Vistaar in fingers. ]
Conclusion:
As per definition of Healthy body mentioned in Ayurveda texts the height of a person should be equal to Arm span. But in our study we found that Height was not exactly equal to arm span, but arm span was slightly greater than height. This study also denotes that swaanguli pramaan is a good indicator of Body type in determining Obesity. It can be considered that if height and arm span increases in anguli pramaan (measurement in fingers), we can say that person is going towards underweight category and vice versa. Arm span can be considered as best predictor of height in calculating BMI. Prediction of BMI from anguli pramaan may be possible with the help of regression equations generated from this study.
Acknowledgement:
We acknowledge Dr. B. I. Goswami and Dr. M. Yusuf Sheikh of Government Ayurved College, Nagpur.
*Asst. Professor, Department of Rachana Sharir, Shri Ayurved Mahavidyalaya, Nagpur
**Asst. Professor, Department of Kriya Sharir, Shri Ayurved Mahavidyalaya, Nagpur
References :
