The Role of Physical Exercise and Diet in management of Medoroga (STHAULYA) Reference Novel Coronavirus Covid 19

Nowadays, due to Covid-19 pandemic circumstance, numerous individuals are Staying from home. Understudy is additionally concern with the online class from home, because of which all physical movement of all individual has been stopped. Medoroga is one of the dominating metabolic problems and driving reason for mortality. Numerous patients with Covid infection 2019 (COVID-19) have identi ied with the metabolic disorder during the lockdown. The general wellbeing proposes (Work from Home, requests, gyms, terminations of garden and wellness focuses) to forestall Covid-19 spread can possibly decrease day by day physical movement. Ideas of Agni, Prakriti, strategy for victualing ought to be given equivalent consideration while choosing ones dietary and exercise routine to turn away/control Medoroga (STHAULYA). Organizing of diet is generally important to support insusceptibility. According to numerous investigates to give valuable pabulum which contains Zinc, Vitamin C, Vitamin D and invulnerability. It is practically equivalent to Medoroga referenced in Ayurveda compositions. Strick likeness outwardly inspected in both customary arrangement of medication and Ayurveda while portraying its causative components, outcomes and preventive part of exercise and diet in its administration. Striking is outwardly analyzed in both Traditional arrangements ofmedication and Ayurveda depicting its causative factors, and preventive capacity of movement and diet in its pandemic Covid-19.


INTRODUCTION
The preventions and treatment on it. Interventions by government. Awareness about the disease and pandemic. The data was collected from different websites, news, books and articles. Even after the disease become pandemic, many people are unknown with the facts, the severity of global health outbreaks, precautions to take and importance of intervention by the government as about quarantine and lockdown. This review study reaches up to all the facts regarding COVID-19, and it's pandemic to spread more awareness (Chhapare and Bhutada, 2020). They may be viruses, bacteria or fungi. It may spread through breathing, talking, sneezing, coughing, etc. which generate droplets in the air. Dhoopana Chikitsa (medicinal fumigation) is one of the important faculties in Ayurvedic treatment (Gond and Bhutada, 2020).
A healthy person has adequate resistance to infection. Infection is a successful invasion, establishment and growth of microorganism in the tissue of the host. The ability is hampered by poor nutritional status. Such a person falls an easy prey to infection frequently either in the form of cold, cough, marginal fever, feeling of weakness and other minor complaints. Immunity can use simply Defence mechanism in the body. The body has two types of defence mechanisms speci ic and nonspeci ic. Immunity classi ies two ways Speci ic & Non-Speci ic, There is the vital importance of proper hydration and nutrition. Individuals who eat an even eating regimen will, in general, be a lower danger of constant sicknesses and irresistible infections and are healthier with stronger immune systems. Thus, the diet must incorporate an assortment of new and natural nourishments consistently to get the nutrients, minerals, dietary iber, cancer prevention agents and enough water for hydration and protein .
Creature tests controlling lu and herpes simplex infections 1 (HSV-1) in the respiratory lot have demonstrated that moderate exercise, performed previously (for example preparing) or after disease (for a couple of days before indication beginning), improves grimness and mortality to the contamination Hence physical exercise effect on immune system ight against viral attack. Increase in immunity useful for a ight against viral attack. Nutritional de iciency effects on the ef iciency of immune against infection Vitamins A, B, C, D and supplement are effective to maintain the function of the immune system. Vitamin A is gathering of retinoids including retinol, retinal and retinoic corrosive, and is one of the most signi icant factors in keeping up safe framework work. Nutrient A supplementation has been appeared to lessen bleakness and mortality of measles, pneumonia, the runs, intestinal sickness, and HIV disease. Nutrient A supplementation likewise upgrades insusceptible reaction after immunization for measles and lu. Considering the defensive impact of these nutrients on the viral disease, supplementation with different nutrients is prescribed to diminish COVID-19 danger (Mora et al., 2008;Huang et al., 2018)

Aims and objectives
Modern and Ayurvedic management of obesity with the help diet and exercise in a more effective manner.

De inition of obesity/Medoroga
Medoroga is characterized as unusual amassing of fat typically 20% or more over a person's optimal body weight. This is a numerical value of your weight in relation to your height. A BMI between 18.5 and 25 kg/m 2 indicates a normal weight. A BMI of less than 18.5 kg/m 2 is considered underweight. A BMI between 25 kg/m 2 and 29.9 kg/m 2 is considered overweight. A BMI of 30 kg/m 2 or higher is con-sidered obese (BMI, 2019;Nishida et al., 2004)

Medoroga
As per Ayurveda, a person having the pendulous appearance of Sphika, Udara and Stana due to excess deposition of Meda along with Mamsa Dhatu and also having unequal and abnormal distribution of Meda with reduced zeal towards life is called Obese (Medoroga) /Atisthula. (Gulve et al., 2015;Trikamji, 2011a).

Causative factors of obesity
Indulgence in a sedentary lifestyle, leading to excessive calories consumption rather than its expenditure is the chief cause of obesity. As per Modern sciences, the main etiological factors responsible for Obesity (2020) have been enlisted in Table 1. Ayurveda most of the causes described for Sthaulya/Medoroga comprises of faulty dietary habits. As per Sushrut Samhita treatise, corpulence and leanness (of the body) depend upon Aahaar Rasa. When one constantly takes diet increasing Kapha humour, indulges in eating when the previous meal is undigested, avoids physical exercise and sleeps in the day, the Ahara-Rasa being undigested and more sweet circulating in the body, due to excessive unctuousness, produces fat which causes obesity (Kaviraja, 2003a) Acharya Charaka has categorized causative factors of obesity into eight captions. Along with defective lifestyle patterns, Aacharya Charaka has also include genetic predisposition and the psychic state as a contributory factor for obesity Shows in Table 2 (Trikamji, 2011b).
In luential Factors concerned with obesity in the context of Ayurveda 1. In luence of 'Ashana' (Paradakara, 2011) in obesity Based on the quality of food items consumed and the time of consuming food concept of Ashana (the process of food consumption) has been described in Ayurveda. It is considerably involved and plays a key role in either maintenance of health or causation of disease. Intake of food consisting of wholesome and unwholesome things mixed together is known as 'Samasana' (eating of healthy and unhealthy food together); if food is taken in excess, in small quantity or untimely it is known as 'Visamasana' (irregular eating time); if food is taken during indigestion, it is known as ' Adhyasana' (eating one over the other). Person habitual to one of -these three pattern is also much prone to Obesity (Medoroga). (Ambikadatta, 2003) 2. Relation of Prakriti (bodily and mental constitution) and obesity. (Amin et al., 2019)  Emotional distress: People will, in general, eat more at the point when they are disturbed, restless, under pressure or feeling weariness gorging messes and late evening eating condition 2. Medications: antidepressants, antidiabetic drugs, anticonvulsants, antipsychotic drugs, betablockers and steroid hormones have been considered obesogenic. 3. Excessive utilization of shoddy nourishments and fat-containing nourishments, because of which more fat gets saved in the body causing stoutness.

4.
Nutrition and Pregnancy-one hypothesis expresses that when youngsters are undernourished during their fetal life when they become grown-ups, they, as a rule, create stomach fat even with the ordinary eating routine. This put them at a more serious danger of creating heftiness. 5. Spending additional time staring at the TV and playing PC games. (Walunj et al., 2020). Not doing physical exercise. Not involving in sexual activity. Sleeping during the daytime. (Walunj et al., 2020).  Eat freshly cooked warm food. It will strengthens Agni, digests food better, reduces excess Kapha and Vata Drinking water after meal, excessive drinking of water irrespective of thirst Eat fresh and seasonal vegetables and fruit available in your region. Drinking too cold water and beverages and cold food Eat food, which has enough oil, and is moist enough (not fried). It tastes better, helps Agni (digestion), builds Dhatusi (body constituents), and increases strength Cruciferous vegetables, fried foods and heavy to digest foods Do not eat food with wrong combination. E.g. Honey and ghee (clari ied butter) when combined in equal quantities is poisonous. Mixing sour fruits and milk curdles the milk. Talking or laughing while eating. Eating too fast or while watching TV Eat only when you are hungry, when previous meal is digested. Eat light meals for breakfast and dinner and heavy meal during lunch time, have early dinner between 6:00 p.m. and 7:30 p.m Eat with proper frame of mind -create pleasant environment Eating sequence: First eat carbohydrates or sweet taste, next eat salty, sour, pungent and bitter foods. Finally eat astringent food. (Walunj et al., 2020) Prakriti is one of the fundamental principles led by Ayurveda. It plays an imperative role in the manifestation of the disease, and adopting the personalized approach as per Prakriti can help in assessing the susceptible clinical features of each Prakriti type and may prove supportive to take preventive measure in arresting the far-reaching ominous clinical impacts of the disease. In a crosssectional survey study intend to study Main Manas and Sharira Prakriti (mental and dominant bodily constitution) in Medoroga (obesity) participants, Kapha and Tamas Pradhana participants were found to be more prevalent to Sthaulya as compared to other Prakriti.

Diet regimen in obesity
Modern science has even accepted dietary interventions as the cornerstones in the management of obesity which mainly focus on energy content and macronutrient composition. Medoroga treatment rule gave by the NIH recommend that individuals who are overweight class. I huskiness and who have, at any rate, two danger components should decrease their energy con irmation by 500 kcal/day (Amin et al., 2019). Current proposals for weight the exec-utives accentuate the signi icance of good dieting designs that incorporate an assortment of supplement thick nourishments, limit parts of energy-thick food sources, and reduce energy (Clinical Guidelines, 1998).
Following Four types of diets are usually recommended in the management of obesity (Makris and Foster, 2011).
Low-fat diet: Include of fat to 15-24% in daily of total energy intake 1001-1499 kcal/day Low-carbohydrate diet: The range of carbohydrate between 60 to 150/day) 1001-1499 kcal.
Very low-calorie Diet -50-55 % carbohydrate,200-900 kcal/day, ( Diet contain many iber and have low GI .)<30% fat. Bene its and disadvantages of these diet patterns have been described in Table 3. Studies relating the impact of these eating regimens on stoutness uncovered that all calorie-limited weight control plans bring about equivalent weight reduction independent of the macronutrient syn-thesis and dietary adherence was seen to be a signi icant determinant of weight reduction. In this manner, picking an eating regimen with a macronutrient arrangement dependent regarding a matter's taste preference (individual approach) can accomplish better consistency.

Ayurvedic perspective of diet/ Aahaar in obesity (Medoroga)
Aahaar(diet), the irst pillar of Ayu (life span) means intake of food and refers to the knowledge of proper diet. It provides the irst approach we can take to maintain health and to alleviate the symptoms of illness. While diet will not cure well-established diseases, most of the illnesses can be controlled solely by an adjustment in diet and eating habits. Such a diet is a signi icant aspect of maintaining good health. Notwithstanding appropriate eating routine, Aahaara stresses the part of three segments indispensable to solid gastrointestinal working -Deepan (the support of solid stomach related ire), Paachan (Smooth processing and digestion) and Anulomana (legitimate end of waste materials). People become ill and obese because they have problems in one or more of these areas. Agni (stomach related ire) controls the craving.
A solid craving called Deepan (the support of solid stomach related ire) gives the sign that the stomach related framework is prepared for new food intake(hunger). Paachan or sound absorption guarantees appropriate sustenance of the Dhatu (body constituents). At the point when absorption is impeded, we may encounter corrosiveness, gas, swelling and queasiness just as a sharp or metallic taste on the tongue. These things show that absorption is slow and Ama (undigested segment) is being delivered. On the off chance that you feel that your processing isn't solid yet you actually have some hunger, at that point eat just a modest quantity of effectively edible food. Solid end called Anulomana happens before anything else with the goal that the framework is prepared to acknowledge the day's new food. The inappropriate end shows as unpredictable solid discharges, reliably free guts stoppage, hard or clingy stools. These show that poisons and waste are aggregating and maturing in the colon, making its pH acidic and upsetting retention and end. On the off chance that your insides are not moving, extra food will just build the weight on an effectively drowsy colon. At the point when hunger, assimilation and end are typical, we have plentiful energy, solid bodies, great wellbeing and clear personalities. (Walunj et al., 2020).

Importance of Consumption of Food at the Proper time to manage obesity
In Ayurveda, the ideal time for having meal has been described based on signs produced in body the ideal time for taking meals is after the end of dung and pee, when the psyche is perfect (without feelings), when the Dosha(body Humors) are moving in their regular ways (working ordinarily), when burping is unadulterated without and foul smell or taste when the craving is a well shown when the latus is moving to descend effectively when the stomach related action is sharp when the receptors are clear working when the body is light. Food ought to be devoured, watching the principles and methodology of taking food. (Acharya, 2011c) One should take food only when he feels hungry. The best time for lunch is between 12 .15 p.m and 1.15 p.m.
Because Pitta Dosha responsible for digestion is at the peak in this time interval. The largest meal of the day, maybe lunch. Dinner should be lighter than lunch. As Obesity is a metabolic disorder, therefore the main emphasis is to be given to digestive ire-Agni and the diet regimen of an obese person should be planned according to the state of Agni. An Obese person with low digestive power (Mandagni) should avoid Guru Aahaar Dravya (heavy to digest food)and should take Laghu Aahaar Dravya (quickly digestible food)more frequently. But in an Obese person with high digestive power (Teekshanagni), Guru (hard to digest) as well as Aptarpak(lowcalorie diet) Aahaar should be given. Guru Aaahara (heavy to digest) will produce a sense of satiety and will help to retard the frequent intake while its Aptarpaka (catabolic) quality will help to reduce body weight. Food does not get.

Method of Consuming Food
To facilitate proper nourishment from food consumed, not the only intake of good qualitative food is essential but also a method of consuming food is also equally important. Acharya Charaka has described in detail maneuver of eating as Ashtaaharavidhiayatana-Eight factors need to be taken into consideration while deciding the diet of the person (Fock and Khoo, 2013).

Quantity of food
Quantity of food to be taken varies as per individuals based on Agni, Abhyavarana Shakti (ingestion capacity). By and large 1 /3 of the limit of stomach ought to be loaded up with solids, 1 /3 with luids and rest 1 /3 ought to be saved void for the free developments of body humors. Vata, Pitta and Kapha. The presumption of the capacity of the stomach can be done by ingestion capacity of a person. (Ambikadatta, 2003) Considering the signi icance of all these above-mentioned factors in order to be sound and increment the stomach related force (Agni) while getting thinner, steps ought to be followed have been enrolled in Table 4.

Physical Exercise in Obesity
Weight loss can be achieved in a short time interval by following proper diet regimen, be that as it may, keeping up this weight reduction is generally troublesome and frequently requires physical exercise and a balanced diet to be a permanent part of an individual's lifestyle. In spite of the fact that activity isn't successful for introductory weight reduction, physical action is signi icant for keeping up weight reduction accomplished. (Trikamji, 2011e) As per Ayurveda properly performed, physical exercise/Vyayama is able to nullify the adverse effects of even incompatible food (Miller et al., 1997). Physical Exercises, if done properly stimulates muscle metabolism and increases oxygenation. It also strengthens and improves Mamsa and Meda Dhatu. If done accordingly it brings lightness in the body, increases work power, solidity, tolerance power; decreases Kapha Dosha and increases Jathragni(digestive power) (Kaviraja, 2003b), Aacharya Charaka has mentioned Medadhatu as site of Kapha Dosha (Trikamji, 2011d) Medadhatu is in excess in an obese person. So as Vyaayam leads to decrease in Kapha Dosha, subsequently, Medadhatu is decreased and the person becomes lean and thin.
Aacharya Charaka has also mentioned Vyayaam in the general treatment of Kaphaj diseases (Acharya, 2011b) And then mentioned Atisthaulya(obesity) in 20 Nanatamaj Kapha diseases. (Acharya, 2011a) So Vyayaam is helpful in the treatment of obesity. Several bene its of exercise, including maintenance of a healthy state, have been described in Ayurveda. (Trikamji, 2011c;Kaviraja, 2003d)

Quantity of Physical Exercise (Vyayaam)
Conventional system opines minum up to 301 min/ week of exercise is required in order to maintain weight loss inconsistency. (Kaviraja, 2003c) with dietary modi ications. While determining the amount of exercise again, the individualistic approach has been adopted in Ayurveda. In all seasons day by day exercise ought to be performed by people craving their prosperity by 'Balardha' (half of one's quality) else it hurts. Measures of half of the person's quality have been characterized as when (Prana) Vayu arranged in the heart comes out to mouth while performing exercise, it is the indication of the half of solidarity (Donnelly et al., 2009) Acharya Sushruta has encouraged to do practice in the wake of thinking about age, body, spot, time and diet else one gets beset with the extreme problem, for example, squandering, thirst, anorexia, regurgitating, inherent drain, energy, exhaustion, fever and dyspnoea Physical exercise ought to be dodged by one experiencing characteristic discharge, skinniness, dyspnoea, hack and twisted, subsequent to taking food, squandered because of sex and distressed with thirst and happiness (Reena et al., 2014;Kaviraja, 2003c).

DISCUSSION
In synopsis, albeit unequivocal veri ication for the possible viability of different supplements in lightening destructive impacts of COVID-19 is as yet prospective, supplementation of adequate nutrients and legitimate minor components is prescribed to help forestall lung disease and mitigate COVID-19 manifestation. Critically, all healthful enhancements just diminish the chance of contamination and are just adjuvant treatments, though the main techniques for COVID-19 avoidance and treatment are in the advancement of antibody and medications. (Sun et al., 2020) Medoroga is a peril factor in viral pandemics and tainted patients with bulkiness have a more awful in irmity igure. COVID-19 is no exclusion, and a report has as of late been conveyed by Public Health England on the relationship of excess load with COVID-19 (Kwok et al., 2020;Chua and Zheng, 2020;Excess weight and COVID-19, 2020)

CONCLUSIONS
This examination underlines the function of diet and physical action in the event of weight in the domain of ordinary and Ayurveda line of treatment. Being corpulent is more terrible due to the ineptitude of exercises and being generally in luenced with a few maladies. The two streams concur that without altering the eating routine and exercise the treatment of Obesity is troublesome. It is the need of pandemic circumstance partner the information on diet and appropriate physical exercise with the examination of ixing to forestall or administer in irmities like quality. The individualistic framework must be followed for dietary regular practice and exercise plan for the heads of strength. Contemplations of Prakriti, Agni, strategy for eating should be given equivalent idea while picking ones dietary and exercise routine to ruin/control imposingness. In our clamoring schedule, we have to review the critical bearings laid by Ayurveda for strong life, with the objective that we can remain sickness free. People should be made careful about the criticalness of Diet and Physical Exercise for expectation and the leading body of weight (Medoroga). Substantialness is a danger factor in viral pandemics and contaminated patients with medoroga /obesity have a more disastrous ailment igure. COVID-19 is no clari ication.

ACKNOWLEDGEMENT
Author would like to thank DMIMSU for motivating and providing all necessary help for writing this article.

Con lict of interest
The authors declare that they have no con lict of interest for this study.