The Role of Asbāb Sitta Ḍarūriyya in the Pathogenesis of Metabolic Disorders: Classical and Contemporary Perspectives

Asbāb Sitta Ḍarūriyya (the Six Essential Factors) constitute the foundational principles for maintaining health and preventing disease in Unani medicine. These factors- Hawā (Air), Maʾkul wa Mashrub (Diet and Drink), Harkat wa Sukūn-e-Badanī (Physical Activity and Rest), Harkat wa Sukūn-e-Nafsānī (Mental Activity and Repose), Naum wa Yaqzah (Sleep and Wakefulness), and Iḥtibās wa Istifrāgh (Retention and Evacuation)-are considered indispensable for preserving Mizāj (temperament) and equilibrium of Akhlāṭ (humours). Classical Unani texts emphasize that disturbance or imbalance in these factors disrupts the Mizāj, leading to Sū’-i-Mizāj (derangement of temperament) and ultimately to disease. In contemporary times, sedentary lifestyle, unhealthy dietary habits, irregular sleep patterns, chronic stress, and environmental pollutants have emerged as major disruptors of these essential factors, significantly contributing to the rising prevalence of metabolic disorders such as obesity, type 2 diabetes mellitus, metabolic syndrome, dyslipidemia, and non-alcoholic fatty liver disease. This paper examines the pathogenesis of these disorders through the unani framework- detailing the role of humoral imbalance, impaired Quwwat-e-Mudabbira (regulatory faculty), and progressive organ dysfunction- as well as the contemporary biomedical understanding involving insulin resistance, chronic low-grade inflammation, oxidative stress, and hormonal dysregulation. By integrating classical unani perspectives with modern scientific evidence, this review highlights the enduring relevance of Asbāb Sitta Ḍarūriyya in preventive and therapeutic strategies for metabolic disorders. Such a multidisciplinary approach not only validates unani principles in the light of modern research but also offers a holistic framework for lifestyle modification, early intervention and long-term health preservation.