Exercise From the Perspective of Iranian Traditional Medicine

Abstract

Exercise, in Iranian traditional medicine, is 1 of the 6 principles recommended for maintaining good health. There are some considerations that must be taken into account before, during, and after exercise. Exercise has different terms in different individuals, seasons, and ages. According to these principles, the interval between exercise and eating food is very important. Exercise after eating is inappropriate, and it is recommended that the best time for exercise is after food has been completely digested and before the next meal. According to the opinion of traditional medicine philosophers, exercise should be done after the complete digestion of food. Exercise may be more effective if it is done according to traditional medicine view at appropriate times and conditions with sufficient intensity and duration.

From the perspective of Iranian traditional medicine, the purpose of medicine is to maintain and restore good health under conditions of disease. Findings have shown that maintenance of good health and prevention of disease is based on 6 principles known as the Sette Zaroriye, which include air and everything related to it; food and drink; sleeping and walking; physical activity and rest; emotional conditions and preserving what should remain in the body; and excretion of waste from the body.^1,2

Exercise, is the fourth component of these 6 essential principles. From the perspective of Avicenna, the most important principle is exercise (riazat), then food, and after that sleep. Exercise is the voluntary movements that lead to deepening and rapid breathing and increased pulse rate; he believed that if anyone does exercise in a proper way, appropriate to his or her temper and at the right time, he does not develop any disease.²

Hippocrates also prioritizes exercise stating that physical activity, eating, sleeping, and walking should all be done carefully and in a natural order.³

For implying the movements and the physical response of the body, physicians have proposed doing exercise, and Avicenna has found it to be superior to other activities.⁴ Jorjani stated that “the distinct heat which reaches the entire body will be diminished after some time and should be replaced and only heat which results from the body, called abstinence, can replace it.”⁵

Traditional medicine philosophers have stated that humans need to eat food to survive, grow, and replace the energy lost from the body. All of the food that is eaten is never fully absorbed, and the waste that remains in the body should be emitted through natural ways such as in urine and stool, but the human body is not always able to excrete accumulated waste taken step by step from each food intake, and the best way, according to traditional medicine philosophers, is by warming up the body to excrete the waste through sweat or steam.^1,2,6 Exercise, in addition to excreting the waste materials, also strengthens the body. Philosophers believed that exercise has a positive effect on the cardiorespiratory, digestive, musculoskeletal, and nervous systems and induces exhilaration in the body, which increases sweating and improves blood flow and prevents the onset of chronic diseases.^1,2,5

In order for the exercise to be the most beneficial for the body, recognition of the right exercise for each person and the considerations before, during, and after exercise is essential. In this article, we have tried to do a variety of sports and considerations from the view of Iranian traditional medicine.

Method

This article is a review of the valid resources of Iranian traditional medicine in different centuries, such as The Canon of Medicine, Kholasato-Al-Hekmah, Sharhe nafis, Zakhire Kharazmshahi, Fi Tabiat Ensan; also, exercise title and the related terms have been searched in the books and were classified.

Results

Considerations Before Exercise

Some principles should be considered if exercise is to have a desirable effect on the body. These principles include appropriate timing of exercise and eating food. The time for taking exercise is when previously consumed food has been digested in the stomach and when the urine becomes stronger in its color. Exercise is recommended after urine color has changed. After doing exercise, an individual can eat food but must never do exercise before the urine has become stronger in its color because that may lead to poor food digestion.^1,2,5–7

Exercise Before Food

The main recommendations for maintaining good health are exercising and taking shower before a meal and sleeping and resting after the meal. Exercise before a meal leads to better digestion of food and facilitates excretion of waste from the body.^2,7

Galen in the book Al-Gheza stated that anyone who does exercise before eating does not require respecting many considerations about the food.³ It is beneficial for everyone to exercise before eating a meal to his or her strength. Those who are obese and suffer from hunger and thirst need to do exercise before a meal, but lean individuals with a hot temperament, and those who have headache and nausea at the time of hunger, do not need to do exercise before a meal or do much exercise for being healthier.⁷

How to Do Exercise

Exercise before a meal should be quick so that heat reaches the internal visceral organs and deepens breathing and increases the heart rate.⁷

Exercise after a meal is extremely harmful for health. If exercise after a meal is quick and tiring, it can contribute to stomach bloating and diarrhea, and if it is slow and is done long before food has been completely digested, it can cause excretion of incompletely digested food from the stomach, and sometimes doing hard exercise after a meal can cause skin diseases.⁷ Avicenna in The Canon of Medicine mentions that hard exercise is one of the barriers to food digestion. Doing hard exercise after a meal impairs digestion. Thus, severe body movements can enhance the movement of food before it has been completely digested causing disruption in the stomach and the process of digestion that results in sour belching and regurgitation and can cause digestive disorders and disease of the joints. Hard exercise is defined as heavy physical work and fast and intense running. Soft and light walking after a meal for those who want to sleep after a meal is not harmful and is suitable for individuals suffering from poor digestion. If one has to move after a meal, it should be done slowly and quietly so as not to increase the pulse rate and breathing and not to create shortness of breath. For those who should eat during movement, or immediately after eating, it is recommended that they not drink or drink only very little after a meal.^2,7

Second, exercise should be done when the bladder and intestines are empty. Philosophers have stated that body heat produced during exercise leads to dilution of waste in the body and causes reabsorption; on the other hand, waste matter becomes more concentrated and excretion will be more difficult.^2,7 Recent studies have reported that prevention of urination can cause high blood pressure and other problems such as anxiety.⁸

Third, exercise should be done after adequate sleep and rest and the best time for it is in the morning.^6,8

Fourth is examining the most appropriate times of exercise for different seasons: the best time for exercise is when the temperature is moderate. Doing exercise in extreme heat or extreme cold is not recommended. Spring is the best season for exercise, and the most appropriate time of the day is close to noon, and in this season, it is recommended to eat a snack first and then do exercise.^1,2

In summer and at times of intense heat, doing exercise is not recommended and it is better to rest more in this season, and the best exercise recommended for this season is a long walk.⁵

Exercise should be done before noon in autumn and its management is like in spring, and the type of exercise that may cause sweating and body stiffness is not recommended.⁵

In winter, it is recommended that exercise is done during the hottest time of the day, and intense and heavy exercise such as running fast and wrestling are also recommended.¹

Philosophers have stated that doing exercise warms up the body’s internal organs; thus, the heat produced in the body during exercise in cold winter weather improves digestion, especially in obese individuals to whom winter exercise with more intensity is recommended.^1,2

Another important point is consideration of a person’s habits and occupation. For those who work hard and sweat a lot during the day, it could be damaging if they did light exercise.¹

One should choose the right exercise according to age. For example, in the works of traditional medicine philosophers, the best exercise for children who are not able to exercise alone, riding rocking in the cradle is the best exercise. For the elderly, morning massages and mild walking recommendation is consistent with recent studies.^5,9–11

Traditional Medicine philosophers had a category of exercises based on body parts. Some exercises that caused mobility in all parts of the body, such as walking, were called general or public sports and were known to be more suitable than other exercises for the elderly. Some other sports that are more effective on particular organs were named as special sports, such as shooting or shot put or polo to strengthen hand muscles. According to the conditions of each individual, general or specific sports were recommended.^2,13,14

Considerations During Exercise

Moderation has been recommended as an important consideration when taking up exercise. Philosophers have stated that each person has his or her own ideal exercise regime. In today’s science, this subject is presented in this way that individuals’ capability for doing exercise is different as the ratios of muscle fibers in different persons differ because of genetics.¹⁵ Some criteria have been proposed in traditional medicine for appropriate levels of exercise: body color, body state during movement, normal breathing, antigravity, and previous heaviness and appetite stimulation. In terms of body color, it is generally known that the body becomes red during exercise, but if the face turns into yellow color, then exercise should be discontinued.^1,2

Body state during exercise is important. If happiness and a feeling of lightness is created in the body during exercise, then exercise can be continued, but it should be discontinued if a person experiences fatigue or weakness.^1,2,5,6

Considering sweating, a moderate level of sweating is recommended. If sweating is heavy, it can cause weakness and in that case exercise should be stopped.^1,2,5,6

Also, if breathing becomes deep and fast and causes gasping, then the exercise is considered harmful to the body and should be discontinued. Feeling hungry and appetite stimulation are the reasons for complete digestion of the previous meal and doing exercise is useful at this time.⁵

Discussion

This issue has been addressed in traditional medicine. According to philosophers’ opinions, the most appropriate time for exercise is after food has been completely digested and before the next meal. This phase is approximately 2 hours after a meal when the stomach is completely empty, and in clinical terms it is when the urine becomes concentrated and is strong in its color. Exercise at other times may cause undigested food to enter the digestion phase causing digestive disorders and other digestion problems. For those who are aiming to lose weight, exercise is recommended when the stomach is empty. According to the findings of this study, some causes of digestive disorders have been overlooked in current modern medicine, and considering these findings gives a deeper understanding of digestive disorders that may be useful in preventing such disorders as essential considerations before exercising, like type of food eaten, adequate rest, and an appropriate interval between eating and exercise, which have been examined from different aspects by researchers in recent researches.

Thus, according to conflicting reports on the effects of exercise on health, it is recommended that if exercise is taken at the right time with adequate intensity and duration, from the perspective of traditional medicine philosophers, it can help improve digestive function.