Abstract

Background Ayurveda describes Kshudha (hunger) among the naturally occurring physiological urges that should not be voluntarily suppressed (Adharaniya Vega). Classical texts associate suppression of an arisen hunger urge (Kshudha Vega Dharana) with manifestations including Karshya (emaciation), Daurbalya (weakness), Vaivarnya (alteration in normal complexion), Angamarda (bodily discomfort or aching), Aruchi (aversion towards food) and Bhrama (giddiness). Contemporary lifestyles frequently involve postponement of meals because of occupational schedules, commuting, shift work and weight-control practices. At the same time, structured fasting and time-restricted eating (TRE) have emerged as areas of metabolic research, making it necessary to distinguish deliberate fasting from habitual suppression of physiological hunger. Objective To critically reassess the Ayurvedic concept of Kshudha Adharaniya Vega in relation to contemporary evidence concerning hunger physiology, meal omission, meal timing, chrononutrition and structured fasting, while avoiding direct equivalence between Ayurvedic constructs and individual biomedical mechanisms. Methods A critical narrative review was conducted using verse-level examination of relevant passages from Charaka Samhita, Sushruta Samhita and Ashtanga Hridaya. Contemporary biomedical literature was examined through PubMed/MEDLINE and bibliographic verification from journal sources up to 17 August 2026. Search concepts included hunger, appetite regulation, ghrelin, meal skipping, breakfast omission, delayed eating, meal timing, chrononutrition, circadian eating, intermittent fasting and time-restricted eating. Human randomized controlled trials, systematic reviews and meta- analyses were prioritized. Studies of planned fasting were treated as comparative evidence rather than direct tests of Kshudha Vega Dharana. Results Classical Ayurvedic sources consistently regard hunger as a physiologically meaningful urge whose inappropriate suppression may produce adverse symptoms, although descriptions vary among texts. Modern physiology confirms that subjective hunger emerges from integrated neural, gastrointestinal, endocrine, metabolic and learned signals; preprandial ghrelin elevation is one measurable component but cannot be considered equivalent to Kshudha. Controlled studies indicate that meal omission and late eating can modify glucose regulation, appetiteand energy metabolism, but findings are context- dependent. Randomized evidence does not establish that every skipped meal is harmful. Similarly, TRE trials are heterogeneous: some early-TRE interventions have improved selected metabolic outcomes, whereas other randomized trials have not demonstrated clinically important superiority over conventional meal timing. Recent meta-analyses suggest that timing—particularly earlier rather than later eating—may influence metabolic outcomes. Conclusion Current biomedical evidence does not directly validate the classical doctrine of Kshudha Vega Dharana, because modern studies rarely measure deliberate suppression of an already manifested hunger urge. Nevertheless, contemporary hunger physiology and chrononutrition provide biologically plausible domains in which the classical observation can be investigated. Kshudha Vega Dharana should not be regarded as synonymous with planned fasting or TRE. Its contemporary relevance may instead lie in avoiding habitual, contextually inappropriate disregard of genuine physiological hunger and chronically disordered meal timing. Prospective studies using a validated operational definition of hunger suppression are required.