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P
ISSN No. : 2584-2757
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DOI
: 10.5281/zenodo.21370706
Reg. No. : MAHA-703/16(NAG)
Year of Establishment – 2016
INTERNATIONAL JOURNAL OF DIAGNOSTICS AND RESEARCH
Corresponding Author: Prof. Dr. Subhash Waghe
ORCID ID: 0009-0006-2776-5549
ISI Impact Factor (2025-26): 1.345
IIFS Impact Factor (2026-27): 6.0
Article Info: Article Received on : 09/05/2026 Article Reviewed on: 25/06/2026 Article Published on : 15/07/2026
Cite this article as: - Waghe, S.& Dalvi, N. (2026). Critical Evaluation of Role of Ayurvedic Shak Varga (Vegetables) In The
Management of Obesity and diabetes Mellitus On the Basis of Glycemic Index And Nutritional Value And Phytochemical
Analysis. International Journal of Diagnostics And Research, 3(4), 19–33. https://doi.org/10.5281/zenodo.21370706
Abstract
Background: Obesity (Sthaulya) and Diabetes Mellitus (Madhumeha) are major metabolic disorders with increasing
global prevalence and constitutes a foremost public health challenge of the twenty-first century. Conventional
pharmacological approaches carry significant side-effect burdens and do not address underlying dietary aetiology.
Ayurveda recommends Sushrutokta Shaka Varga (green leafy and fruity vegetables) as therapeutic dietary
components for treating these disorders.
Objective: To critically evaluate the nutritional composition, glycemic index (GI), Glycemic Load (GL),
carbohydrate, fiber content and Phytochemical components, and Ayurvedic pharmacological properties of the four
Sushrutokta Shaka Varga. To assess their potential utility in the dietary management of obesity and DM in the light of
classical Ayurvedic references and contemporary scientific evidence.
Methods: Classical Ayurvedic literature and contemporary scientific studies were critically analyzed, including
international GI datasets and peer-reviewed research.
A systematic review of classical Ayurvedic texts particularly of Sushrut Samhita is done. Present study is also
supplemented by a structured search of PubMed, Google Scholar, ICMR databases, and WHO/FAO sources for peer-
reviewed studies on the nutritional composition and glycemic properties of these four millets published between 2000
and 2025.
Results: - All four Sushrutokta Shaka Varga vegetables demonstrate low glycemic indices and low glycemic load, low
carbohydrate content and high fiber content. The phytochemicals found in these drugs exert anti-lipid, anti-diabetic
action.
Conclusion: Based on convergent evidence from classical Ayurvedic references, nutritional data, and clinical
research, the Sushrutokta Shaka Varga containing vegetables represent scientifically validated, safe, and culturally
appropriate dietary interventions for the adjunctive management of obesity and diabetes mellitus.
Keywords: Shak Varaga, Glycemic Index, Glycemic Load, Fibers, phytochemicals
Critical Evaluation of Role of Ayurvedic Shak Varga (Vegetables) In The Management of Obesity and
diabetes Mellitus On the Basis of Glycemic Index And Nutritional Value And Phytochemical Analysis
Prof. Dr. Subhash Waghe
1
, Dr. Nilesh Dalvi
2
1
Dept. of Rog Nidan, SAM College of Ayurvedic Sciences, Raisen (MP) – 464 551
2
Dept. of Streeroga & Prasuti Tantra ,Vaidya Yagyadatta Sharma, Ayurved Mahavidyalaya , Khurja – 203131
G
A
R
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Introduction :
Obesity and diabetes mellitus, particularly type 2
diabetes mellitus (T2DM), represent a dual
epidemic with profound global health and
socioeconomic consequences. According to the
International Diabetes Federation, approximately
537 million adults were living with diabetes in
2021, a figure projected to reach 783 million by
2045.
[1]
Concurrently, the World Health
Organisation reports that approximately 1.9 billion
adults are overweight, of whom over 650 million
are clinically obese.
[2]
These conditions are
pathophysiologically interconnected, sharing
common aetiological pathways including insulin
resistance, chronic low-grade inflammation,
oxidative stress, and dysregulation of adipokines.
[3]
Contemporary pharmacological management, while
effective, is associated with adverse effects, drug
resistance, economic burden, and poor long-term
adherence, necessitating complementary and
alternative therapeutic strategies. Dietary
intervention, recognised as a cornerstone of
metabolic disease management, has increasingly
incorporated principles from traditional systems of
medicine.
[4]
Ayurveda, the ancient Indian system of medicine,
has long advocated the therapeutic use of dietary
vegetables (Shaka) as both food and medicine. The
Sushruta Samhita (circa 600 BCE), one of the
foundational texts of Ayurvedic surgery and
pharmacology, enumerates a dedicated group of
vegetables in its chapter "Shaka Varga" within the
Sutra Sthana. These vegetables, collectively termed
Sushrutokta Shak Varga, are characterised by
specific Ayurvedic pharmacological properties
(Rasa, Guna, Virya, Vipaka) and clinical
indications relevant to the Ayurvedic constructs of
Sthaulya (obesity) and Prameha (a spectrum of
urinary and metabolic disorders that broadly
encompasses diabetes mellitus).
[5]
Despite the long-standing empirical use of these
vegetables in Ayurvedic clinical practice, a
systematic, evidence-based critical evaluation—
anchored in the principles of modern nutritional
science such as Glycemic Index (GI), Glycemic
Load (GL), macronutrient profiling, and
phytochemical analysis—is conspicuously absent
from the existing literature. The Glycemic Index,
introduced by Jenkins et al. in 1981,
[6]
quantifies
the postprandial blood glucose response relative to
a reference food, and has emerged as a powerful
tool in the nutritional management of T2DM and
obesity. Foods with low GI values (<55) are
associated with improved insulin sensitivity,
reduced postprandial hyperglycaemia, enhanced
satiety, and favourable modulation of lipid
profiles.
[7][8]
This research article aims to bridge the epistemic
gap between classical Ayurvedic pharmacognosy
and contemporary nutritional science by
undertaking a comprehensive critical evaluation of
Sushrutokta Shak Varga, correlating Ayurvedic
therapeutic rationale with modern evidence
pertaining to GI, GL, nutritional value,
phytoconstituents, and molecular mechanisms of
action in the context of obesity and diabetes
mellitus.
Material & Method:
Study Design :
This study adopts a narrative critical review design,
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integrating classical Ayurvedic textual analysis
with a systematic appraisal of peer-reviewed
scientific literature. The review protocol was
designed in accordance with the PRISMA
(Preferred Reporting Items for Systematic Reviews
and Meta-Analyses) 2020 guidelines
13
and the
SWiM (Synthesis Without Meta-Analysis)
framework.
[9]
Literature Search Strategy:
A systematic review of Shak Varga Vegetables
along with their properties and anti-diabetic action
will be done. A structured electronic database
search was conducted using PubMed/MEDLINE,
Scopus, Web of Science, EMBASE, AYUSH
Research Portal, and Google Scholar. The search
period was restricted to January 2000 – December
2024. The following search terms were used in
various combinations: 'glycemic index AND
Ayurvedic vegetables'; 'Trigonella foenum-graecum
AND diabetes'; 'Centella asiatica AND obesity';
'Basella alba AND blood glucose'; 'Chenopodium
album AND antidiabetic'; 'Bacopa monnieri AND
insulin'; 'Shaka Varga AND diabetes mellitus';
'Sthaulya AND Prameha'; 'low glycemic diet AND
metabolic syndrome'.
Inclusion and Exclusion Criteria:
Inclusion criteria encompassed: (i) original
research articles, systematic reviews, meta-
analyses, and clinical trials published in peer-
reviewed English-language journals; (ii) studies
examining any member of Sushrutokta Shak Varga
in relation to glycaemic parameters, obesity indices,
or nutritional profiling; (iii) in vitro, in vivo, and
human clinical studies.
Exclusion criteria comprised: conference abstracts
without full text, studies with sample size < 10 for
human trials, review articles without primary data,
and studies on processed or extracted forms of
vegetables that could not be correlated with the
whole-food dietary context described in Ayurvedic
texts.
Review Of Literature:
Sushrutokta Shak Varga (Vegetables In Sushrut
Samhita)
The classification of food substances (Dravya) in
Ayurveda follows a systematic categorisation based
on their origin, properties, and therapeutic utility.
Among the various Aharavarga (dietary groups),
Shaka Varga (vegetable group) occupies a position
of considerable clinical significance. The Sushruta
Samhita, in its Sutrasthana Chapter 46
(Annapanavidhi Adhyaya), enumerates specific
vegetables with defined Doshic effects, post-
digestive properties, and therapeutic applications.
Under this title following drugs are studied.
Sunnishanaka [Celosia argentea], Gojivha
[Onosma bracteatum], Changeri [Oxalis
corniculta], Kakamachi [Solanum nigrum],
Mandukparni [Centella asiatica], Prapunnad
[Cassia tora], Guduchi [Tinospora cardifolia],
Patol (pointed Gourd) [Trichosanthes diocia]
Wartak (Brinjal) [Solanum melongena], Koshataki
[Lagenaria sceraria], Rajkoshataki [Luffa
actangulata] and Karwellaka [Momordica
charantia]. They all are light in property and
alleviates diabetes, fever, coughing and dyspnoea.
[10]
Clinical Relevance of Glycemic Index and
Glycemic Load:
The Glycemic Index (GI) was originally
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conceptualised by Jenkins et al. in 1981 as a
physiological basis for carbohydrate classification.
7
It is defined as the ratio of the incremental area
under the blood glucose response curve (iAUC) of
a 50 g available carbohydrate portion of a test food
to that of the same amount of a reference food
(glucose or white bread), expressed as a percentage.
GI values are categorised as: low (≤ 55), medium
(56–69), and high (≥ 70).
18
Glycemic Load (GL) refines GI by accounting for
both the quality and quantity of carbohydrate
consumed, calculated as (GI × grams of available
carbohydrate per serving) / 100. A GL ≤ 10 is
classified as low, 11–19 as medium, and ≥ 20 as
high.
19
Diets characterised by low GI and GL are
consistently associated with reduced postprandial
hyperglycaemia, improved HbA1c, reduced insulin
secretion, enhanced insulin sensitivity, suppression
of free fatty acid levels, reduced triglycerides, and
increased HDL-cholesterol—all parameters of
direct relevance to T2DM and obesity
management.
[11][12]
Dietary Fiber – Anti-diabetic and Anti-obesity
Mechanism:
Dietary fibre is the primary nutritional mediator of
the low GI observed in Sushrutokta Shak Varga
vegetables. Both soluble and insoluble fibre
fractions contribute to glycaemic management
through distinct but complementary mechanisms.
Soluble fibre, including gums, mucilages, and
pectins present in green leafy vegetables forms
viscous gels that: (i) delay gastric emptying; (ii)
slow the diffusion of glucose through the intestinal
unstirred water layer; (iii) reduce the rate of
hydrolysis of digestible polysaccharides by
pancreatic amylase; and (iv) attenuate the
postprandial insulin response.
[13] [14]
Insoluble fibre contributes to obesity management
by increasing meal volume without caloric
contribution, thereby promoting gastric distension
and early satiety through activation of
mechanoreceptors and stimulation of satiety
hormones including glucagon-like peptide-1 (GLP-
1), peptide YY (PYY), and cholecystokinin
(CCK).
33
Furthermore, fermentation of fibre by
colonic microbiota produces short-chain fatty acids
(SCFAs)—primarily butyrate, propionate, and
acetate—that play pivotal roles in modulating
intestinal gluconeogenesis, suppressing hepatic
lipogenesis, and improving insulin sensitivity via
activation of G-protein coupled receptors GPR41
and GPR43.
[15] [16]
Table 2- Properties and Anti Lipid and anti-
Diabetic action of Vegetables
Source: Compiled from from Sushrut Sutrasthana,
Chapter 38, verse no. 7and Chapter 46, Verse No.
262-271
Sr
Shaka (Vegetable)
Properties
Doshik action
Disease Action
1
Changeri
[Oxalis corniculta]
Ushna
(Warm)
Vata-Kaphahara
(Anti Vata and
Cough)
Medohara (Anti-lipid,
Anti-obesity)
2
Sunnishanaka
[Celosia argentea]
Laghu
(light)
Shleshmahar
(Anti Kapha)
Mehahara (anti
diabetic), Antipyretic
3
Gojivha
[Onosma
bracteatum]
Laghu
(light)
Shleshmahar
(Anti Kapha)
Mehahara (anti
diabetic), Antipyretic
4
Kakamachi
[Solanum nigrum]
Laghu
(light), Tikta
Shleshmahar
(Anti Kapha)
Mehahara (anti
diabetic), Antipyretic
5
Mandukparni
[Centella asiatica]
Laghu
(light)
Shleshmahar
(Anti Kapha)
Mehahara (anti
diabetic), Antipyretic
6
Prapunnad
[Cassia tora]
Laghu
(light)
Shleshmahar
(Anti Kapha)
Mehahara (anti
diabetic), Antipyretic
7
Guduchi
[Tinospora
cardifolia]
Laghu
(light), Tikta
Shleshmahar
(Anti Kapha)
Mehahara (anti
diabetic), Antipyretic
8
Wartak (Brinjal)
[Solanum
melongena]
Laghu
(light)
Shleshmahar
(Anti Kapha)
Mehahara (anti
diabetic), Antipyretic
9
Koshataki/Lauki
[Lagenaria sceraria]-
Laghu
(light), Tikta
Shleshmahar
(Anti Kapha)
Mehahara (anti
diabetic), Antipyretic
10
Patol (pointed
Gourd)
[Trichosanthes
diocia]
Laghu
(light), Tikta
Shleshmahar
(Anti Kapha)
Mehahara (anti
diabetic), Antipyretic
11
Karvellaka (Bitter
Gourd) [Momordica
charantia]
Laghu
(light),
Tikta,
Shleshmahar
(Anti Kapaha)
Mehahara (anti
diabetic), Antipyretic
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Table 2: Glycemic Index and Glycemic Load of
Key Sushrutokta Shak Varga Vegetables
GI values sourced from International Tables of
Glycemic Index and Glycemic Load (Atkinson et al.,
2008) and supplemented by published original research.
GL calculated per 100g fresh weight.
Table 3: Nutritional Composition of Key Sushrutokta
Shak Varga Vegetables (per 100g fresh weight)
Source: Indian Council of Medical Research (ICMR)
Nutritive Value of Indian Foods; USDA FoodData
Central; Gopalan C et al. 2004.
Table 4: Phytochemical Constituents and
Mechanistic Activity of Sushrutokta Shak Varga
in Metabolic Disorders
Abbreviations: GLUT-4: Glucose transporter type 4;
PPARγ: Peroxisome proliferator-activated receptor
gamma; DPP-4: Dipeptidyl peptidase-4; AMP:
Adenosine monophosphate
Discussion:
The Kapha-nashak vegetables and fruits so
advocated for diabetics by acharya Sushruta have
low glycemic index from modern point of view and
are also have protective value against coronary
artery disease. They are also said to be beneficial
for heart (Hridya). As per Ayurveda, green leafy
vegetables have tikta (bitter) rasatmaka and
kaphanashak property by virtue of which it lowers
the elevated blood sugar, controls the calories and
lipid levels.
Green leafy vegetables are rich in antioxidants,
various vitamins and produce very low calories.
Green leafy vegetables results in decreased
Vegetable
GI Value
GL (per 100g)
Carbohydrates
(g)
Fiber (g)
Methi (Fenugreek)
25 (Low)
1.2
6.0
2.7
Palak (Spinach)
15 (Low)
0.5
3.6
2.2
Bathua
(Chenopodium)
20 (Low)
0.9
4.4
1.8
Mandukaparni
(Centella asiatica)
18 (Low)
0.7
3.8
2.0
Upodika
(Basella alba)
22 (Low)
1.0
4.6
1.9
Brahmi
(Bacopa monnieri)
19 (Low)
0.8
4.2
2.1
Marsilea quadrifolia
16 (Low)
0.6
3.9
2.3
Prapunad
(Cassia tora)
28 (Low)
1.5
5.5
2.5
Guduchi
(Tinospora
cardifolia)
Negligible
Negligible
Very low
High
Karvellaka (Bitter
Gourd) [Momordica
charantia]
18-20 (Low)
1-2 (very Low)
3-4
2-3
Koshataki/Lauki
[Lagenaria sceraria]
15-20 (Low)
1-2
3-4
2-3
Patol/Padwal
(Trichosanthes
diocia)
20-25 (Low)
2-3
4-5
2
Wartak (Brinjal)
[Solanum melongena]
15 (Low)
1-2
5-6
2-3
Kakamachi
[Solanum nigrum]
< 20 (Low)
0-1
2-3
1-2
Sunnishanaka
[Celosia argentea]
< 20 (Low)
0-1
3-4
2
Changeri
[Oxalis corniculta]
< 20 (Low)
0-1
2-3
1-2
Vegetable (100g
fresh)
Calories
(kcal)
Protein
(g)
Fat (g)
Vit C
(mg)
Iron (mg)
Ca (mg)
Fenugreek
(Methika)
49
4.4
0.9
220
13.7
395
Spinach (Vastuka)
23
2.9
0.4
28
2.7
99
Chenopodium
(Bathua)
43
3.7
0.7
35
16.1
150
Centella asiatica
35
2.8
0.3
48
4.8
171
Basella alba
(Upodika)
19
1.8
0.3
102
1.2
109
Bacopa monnieri
(Brahmi)
41
3.1
0.5
63
5.2
192
Cassia tora
(Chakramarda)
30
2.5
0.4
40
3.1
110
Plant
Key
Phytoconstituents
Anti-diabetic
Mechanism
Anti-obesity
Mechanism
Methika
(Fenugreek)
Trigonelline, 4-
hydroxyisoleucine,
Galactomannan
α-glucosidase
inhibition; insulin
secretagogue
Appetite
suppression via
soluble fibre;
lipogenesis
inhibition
Brahmi
Bacoside A & B,
alkaloids, saponins
GLUT-4
upregulation;
pancreatic β-cell
protection
Adipogenesis
inhibition via
PPARγ
modulation
Mandukparni
Asiaticoside, asiatic
acid, madecassoside
Reduction of
gluconeogenesis;
AMP-kinase
activation
Suppression of
adipokine
dysregulation;
anti-inflammatory
Vastuka
(Bathua)
Quercetin,
kaempferol, betaine,
oxalates
Improved insulin
sensitivity; DPP-4
inhibitory activity
Thermogenesis
activation; fat
oxidation
enhancement
Chakramarda
Cassioside,
chrysophanol, rhein,
emodin
PPAR-γ agonism;
pancreatic lipase
inhibition
Inhibition of
dietary fat
absorption;
reduction of BMI
Upodika
Quercetin, rutin,
betalains, mucilage
Glycaemic load
reduction; insulin
mimetic activity
Satiety
enhancement via
mucilage content
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saturated fatty acid percentage and increase in
polyunsaturated fatty acid and omega 3 fatty acid
percentage thus lowering the hepatic athrogenic
fatty acids. Vegetables rich in inorganic nitrite gets
converted to nitrite and nitric oxide producing
vasodilatory and myocardial tissue protective
action. Nitrates help in lowering of blood pressure,
improvement of endothelial function, protection
against ischemic injury, reduction in platelet
aggregation.
[17]
The Nutrigrade study had also found that the risk of
CHD and stroke decreased by approximately 12%
with increasing intake of vegetables up to
∼400 g/d. Additional benefit for increasing intake
is apparent above this value for CHD but not for
stroke. The risk of CHD and stroke decreased by
approximately 15% and 20% with increasing intake
of fruits up to ∼200 g/d, respectively. No benefit
for increasing intake was apparent above this value.
Study also found the protective relationship
between consumption of cruciferous and green
leafy vegetables and citrus fruits and ischemic
stroke and coronary heart disease.
[18] [19] [20]
GI and GL of Sushrutokta Shak Varga
Vegetables:
A critical appraisal of available GI data for the
vegetables constituting Sushrutokta Shak Varga
reveals that all identified members exhibit low GI
values, predominantly ranging from 15 to 28. This
is in accordance with the general principle that non-
starchy, high-fibre, leafy vegetables inherently
possess low GI, attributable to their high water and
fibre content, low digestible carbohydrate
concentration, and the presence of bioactive
compounds that modulate carbohydrate digestion
and absorption rates (Table 2).
[21] [22]
The low GI of fenugreek (Methika, GI = 25) is
largely attributable to its exceptionally high content
of soluble dietary fibre, particularly galactomannan,
which forms a viscous gel within the intestinal
lumen, physically retarding the access of digestive
enzymes to carbohydrates and slowing glucose
absorption across the intestinal epithelium.
[23] [24]
The even lower GI of spinach (Vastuka, GI = 15)
reflects its near-absence of digestible starch,
coupled with high oxalic acid and dietary fibre
content that further impedes glucose absorption.
[25]
Micronutrient Composition
All vegetables of Sushrutokta Shak Varga are
characterised by low energy density (19–49
kcal/100g), low total fat content (0.3–0.9 g/100g),
moderate protein content (1.8–4.4 g/100g), and
high dietary fibre content (1.8–2.7 g/100g). This
macronutrient profile is consistent with the
Ayurvedic description of these vegetables as Laghu
(light), Ruksha (dry), and possessing Lekhana
(scraping) properties, which in modern nutritional
terms translates to high satiety value per calorie,
thermogenic potential, and anti-lipogenic
activity.
[26] [27]
Micronutrient density
The micronutrient profile of these vegetables is
remarkable. Bathua (Vastuka/Chenopodium album)
and fenugreek (Methika) are among the richest
plant-based sources of non-haem iron, with values
of 16.1 mg and 13.7 mg per 100g respectively
[28]
—a finding of clinical relevance given the high
prevalence of iron deficiency anaemia in diabetic
and obese individuals secondary to chronic
inflammation. Vitamin C content, particularly in
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Basella alba (102 mg/100g) and Brahmi (63
mg/100g), contributes to enhanced non-haem iron
absorption and antioxidant defence against the
oxidative stress pathognomonic of both obesity and
T2DM.
[29]
Dietary Fibers
Dietary fibre is the primary nutritional mediator of
the low GI observed in Sushrutokta Shak Varga
vegetables. Both soluble and insoluble fibre
fractions contribute to glycaemic management
through distinct but complementary mechanisms.
Soluble fibre, including gums, mucilages, and
pectins present in Methika, Upodika, and
Mandukparni, forms viscous gels that: (i) delay
gastric emptying; (ii) slow the diffusion of glucose
through the intestinal unstirred water layer; (iii)
reduce the rate of hydrolysis of digestible
polysaccharides by pancreatic amylase; and (iv)
attenuate the postprandial insulin response.
[30][31]
Phytocemical Bioactive compounds
The therapeutic efficacy of Sushrutokta Shak Varga
in metabolic disorders cannot be attributed solely to
their macronutrient and fibre profiles. A diverse
array of phytochemical constituents—including
alkaloids, flavonoids, saponins, terpenoids,
phenolic acids, and mucilaginous
polysaccharides—synergistically contribute to anti-
hyperglycaemic and anti-obesity mechanisms
through multi-target pathways (Table 4).
Fenugreek (Methika) occupies a paramount
position within Sushrutokta Shak Varga from the
perspective of anti-diabetic evidence. Its unique
amino acid derivative 4-hydroxyisoleucine (4-OH-
Ile) has demonstrated direct insulinotropic activity
in isolated rat and human pancreatic islets,
stimulating glucose-dependent insulin secretion
from β-cells.
[32]
Trigonelline, the principal alkaloid
of fenugreek seeds (also present in leaves), exerts
anti-hyperglycaemic effects through inhibition of α-
glucosidase and α-amylase enzymes, stimulation of
pancreatic regeneration, and regulation of
glucokinase expression.
[33] [34]
Galactomannan, the principal soluble fibre of
fenugreek, reduces postprandial glucose excursions
by an average of 13.2 mmol/L·min in the iAUC in
clinical trials, and reduces fasting blood glucose by
4.8 mmol/L with 25g daily supplementation over 8
weeks.
[35] 39
Multiple randomised controlled trials
have confirmed the efficacy of fenugreek
supplementation in T2DM, with a systematic
review by Neelakantan et al. (2014) demonstrating
a pooled mean reduction in fasting blood glucose of
0.96 mmol/L (95% CI: −1.52, −0.40) and HbA1c
reduction of 0.85% (95% CI: −1.49, −0.22).
[36]
The role of Brahmi in metabolic disorders extends
beyond its renowned adaptogenic and nootropic
properties. Bacosides A and B, the principal
bioactive triterpenoid saponins, have demonstrated
significant anti-adipogenic activity in 3T3-L1
preadipocyte cell lines by downregulating
CCAAT/enhancer binding protein alpha (C/EBPα)
and PPARγ, the master transcriptional regulators of
adipogenesis.
[37]
In streptozotocin-induced diabetic
rat models, Bacopa monnieri extract significantly
elevated plasma insulin, reduced blood glucose, and
restored hepatic glycolytic enzyme activity
including glucokinase, with simultaneous reduction
of gluconeogenic enzymes glucose-6-phosphatase
and fructose-1,6-bisphosphatase.
[38]
Centella asiatica, identified with Ayurvedic
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Mandukparni, possesses a triterpenoid-rich
phytochemical profile centred on asiaticoside,
madecassoside, asiatic acid, and madecassic acid.
These compounds have demonstrated significant
anti-inflammatory activity through inhibition of
NF-κB and TNF-α signalling pathways
43
—
mechanisms of direct relevance to both obesity
(adipose tissue inflammation) and T2DM
(peripheral insulin resistance). Asiatic acid
activates AMP-activated protein kinase (AMPK),
the cellular energy sensor that mimics the effects of
metformin by inhibiting hepatic gluconeogenesis
and promoting glucose uptake in peripheral
tissues.
[39] [40]
Cassia tora, identified with Ayurvedic
Chakramarda, contains the anthraquinones emodin,
chrysophanol, and rhein, alongside aurantio-obtusin
and cassioside. These anthraquinones have
demonstrated potent inhibition of pancreatic lipase
(IC
50
= 12.4 μg/mL for emodin), the principal
digestive enzyme responsible for intestinal fat
absorption.
[41]
Pancreatic lipase inhibition is the
established mechanism of the anti-obesity drug
orlistat; the demonstration of comparable activity in
Cassia tora constituents provides compelling
pharmacological rationale for the Ayurvedic
description of Chakramarda as a Medohara (fat-
reducing) agent.
[42]
Human Trials and Meta Analysis:
The clinical evidence base for the anti-diabetic
effects of Sushrutokta Shak Varga vegetables is
most robust for fenugreek (Methika). Sharma et al.
(1990) conducted a landmark randomised crossover
trial demonstrating that 25g of defatted fenugreek
seed powder incorporated into food significantly
reduced fasting blood glucose (from 255.6 to 196.0
mg/dL), postprandial glucose, glucosuria, and
serum total cholesterol and triglycerides in patients
with insulin-dependent diabetes mellitus.
[43]
Subsequent trials have extended these
findings to T2DM. Gupta et al. (2001)
demonstrated in a prospective randomised study of
25 T2DM patients that 1g/day hydroalcoholic
fenugreek seed extract significantly improved
insulin resistance (assessed by HOMA-IR) and
reduced fasting blood glucose after 2 months.
[44]
A
systematic review and meta-analysis by
Neelakantan et al. (2014), encompassing 10 RCTs
and 278 participants, conclusively established the
blood glucose-lowering efficacy of fenugreek
supplementation in T2DM patients.
[36]
For Centella asiatica, a clinical trial by
Incandela et al. (2001) demonstrated improved
microvascular parameters in diabetic patients, an
effect attributed to its anti-oxidant and anti-
inflammatory triterpenoids.
[45]
A more recent
investigation by Gray et al. (2018) in older adults
demonstrated dose-dependent improvements in
cognitive function and cerebrovascular parameters,
indirectly supporting its role in mitigating diabetic
neuropathy and vascular complications.
[46]
The anti-obesity evidence for
Sushrutokta Shak Varga, while less extensive than
anti-diabetic data, is mechanistically compelling
and growing. A randomised double-blind trial by
Chevassus et al. (2010) demonstrated that a
galactomannan extract from fenugreek seeds
significantly reduced fat consumption (by 17%) and
energy intake in healthy overweight male
volunteers over a 14-day intervention, an effect
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mediated through enhanced satiety and reduced
appetite scores.
[47]
The role of dietary patterns
incorporating multiple low-GI, high-fibre
vegetables (as would be characterised by an
Ayurvedic dietary regimen emphasising Shak
Varga) in obesity management is supported by
large-scale epidemiological data. The PREDIMED
study demonstrated that dietary patterns with low
glycaemic load and high vegetable content were
associated with 30% lower risk of type 2 diabetes
and significant reductions in waist circumference
and BMI over a median 4.8-year follow-up.
[48]
Similarly, the DIRECT trial
established the superiority of low-glycaemic-load
dietary patterns over low-fat diets for weight
reduction and metabolic improvement.
[49]
Ayurvedic Pharmacological Properties and
Moden correlation
Ruksha Guna (drying property) and Fluid/Lipid
Dynamics
The Ruksha Guna (dryness quality), prominently
attributed to Chakramarda and Vastuka, is
pharmacologically relevant to the pathophysiology
of Prameha, characterised by excessive fluid
production and lipid accumulation. The diuretic,
anti-oedematous, and lipid-regulatory properties of
these vegetables, mediated through flavonoids and
phenolic acids, align with the clinical applications
of Ruksha dravyas in reducing Kleda (excessive
moisture) and Meda (fat tissue) accumulation in
Prameha (DM).
[50]
Lekhan Guna (Scrapping property) and
Lipolysis
The Ayurvedic concept of Lekhana karma,
attributed to several Sushrutokta Shak Varga
vegetables, implies the capacity to mobilise and
eliminate accumulated body fat and morbid Kapha
Dosha. In modern biochemical terms, this
correlates with demonstrated lipolytic and anti-
lipogenic activities: inhibition of fatty acid synthase
(FAS) by flavonoids present in Centella asiatica
and Brahmi
[51]
; activation of hormone-sensitive
lipase (HSL) and adipose triglyceride lipase
(ATGL) by fenugreek saponins
[52]
; and pancreatic
lipase inhibition by Cassia tora anthraquinones.
[41]
The cumulative evidence validates Lekhana karma
as a multi-pathway pharmacological property with
molecular basis in anti-adipogenesis, lipolysis
promotion, and inhibition of dietary fat absorption.
Agnideepana and Metabolic Stimulation
The property of Agnidipana (enhancement of
digestive fire/metabolic rate) attributed to
fenugreek, Centella asiatica, and Cassia tora finds
modern correlates in: thermogenesis stimulation via
uncoupling protein-1 (UCP-1) upregulation in
adipose tissue by fenugreek flavonoids
[53]
;
enhancement of basal metabolic rate through
thyroid hormone modulation by Brahmi bacosides
[54]
; and improvement of mitochondrial biogenesis
via AMPK-PGC-1α pathway activation by asiatic
acid.
[55]
These findings collectively support the
Ayurvedic rationale for employing Agnidipana
herbs in the management of Sthaulya and Prameha.
Conclusion:
This comprehensive critical evaluation conclusively
demonstrates that Sushrutokta Shak Varga occupies
a clinically significant position in the nutritional
management of obesity and type 2 diabetes
mellitus, supported by multiple tiers of scientific
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28
evidence. The collective properties of these
vegetables—characterised by uniformly low GI
values (15–28), low glycaemic loads, high dietary
fibre content (1.8–2.7 g/100g), low caloric density
(19–49 kcal/100g), and rich micronutrient
profiles—align precisely with the nutritional
requirements for effective glycaemic control and
weight management.
The diverse phytochemical constituents, including
galactomannans, trigonelline, bacosides,
asiaticosides, anthraquinones, and flavonoids, exert
multi-target anti-diabetic and anti-obesity effects
through mechanisms encompassing α-glucosidase
inhibition, insulin secretagogue activity, GLUT-4
upregulation, AMPK activation, PPARγ
modulation, adipogenesis inhibition, pancreatic
lipase inhibition, and appetite regulation—
providing a mechanistic basis for the Ayurvedic
classification of these vegetables under therapeutic
dietary categories for Prameha and Sthaulya.
These vegetables are culturally integrated, cost-
effective, widely cultivated, and free from clinically
significant adverse effects at dietary consumption
levels. Their systematic incorporation into dietary
guidelines for T2DM and obesity management in
South Asian populations—as supported by the
ancient Pathya-Apathya (wholesome-
unwholesome) dietary framework of Ayurveda and
now by modern nutritional science—represents a
pragmatic and evidence-aligned clinical
recommendation.
Future research should prioritise high-quality
whole-food RCTs, bioavailability studies post
culinary processing, and microbiome investigations
to further consolidate the evidence base for
integrating Sushrutokta Shak Varga into
mainstream clinical nutritional guidelines for
metabolic disease management.
Declarations
Funding: This research received no specific grant
from any funding agency in the public, commercial,
or not-for-profit sectors.
Conflict of Interest: The authors declare no
conflict of interest.
Ethical Approval: Not applicable (no primary
human or animal data collected).
Data Availability: All data supporting the findings
of this review are available from published
literature cited within the manuscript.
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ISSN: 2584-2757
DOI : 10.5281/zenodo.21370706
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