Curated Paper 1- Balance in All Things

 Balance in All Things

“Calm mind brings inner strength and self-confidence, so that's very important for good health.” - Dalai Lama

Just as the Dalai Lama’s words suggest, the mind and body are very closely linked, and problems with one can seriously impact the other. This idea of interconnectedness is not new. Ayurveda, a traditional medicinal system used in India, has promoted a long and healthy life for generations. It involves using natural elements to battle the root cause of diseases, primarily through restoring balance to the body and creating a healthy lifestyle to ensure this balance is maintained. It aims to maintain harmony and balance in all disciplines of life, including the body, mind, and spirit, through the use of holistic approaches such as changes in diet, use of herbs and spices, meditation, yoga, and more to prevent and treat disease. While holistic practices may not be enough to treat every disease, Western medicine is essential for treating specific diseases. However, only understanding the body through structural or biochemical analysis can sometimes limit our view of health. Studying various topics from metabolism to the microbiome to diabetes, I kept finding the same lesson: the systems of the body and the environment around us are all connected, and our health is dependent on ensuring balance among them.

Our metabolism is a good example of this. It recycles and builds energy through pathways such as glycolysis, pyruvate oxidation, and the Krebs cycle. During a biochemistry class I took over the summer, we went into depth about each of these cycles and how they work together to create homeostasis within multiple systems. There are major detriments that can happen when these cycles don’t function or aren’t regulated properly. A few diseases that occur from enzyme dysregulations are G6PD deficiency, PEPCK deficiency, von Gierke disease, or complex II mutations. Diving deeper into one of these disorders, I was able to learn more about von Gierke disease. Edgar von Gierke, the namesake, was the first to describe the excess glycogen storage in the liver. Von Gierke disease is an autosomal recessive glycogen storage disease resulting in abnormal amounts of glycogen. It is caused by a deficiency of glucose-6-phosphatase activity, mainly in the kidney and liver, leading to hepatomegaly, hypoglycemia, and other long-term conditions. There is no cure, but strict diet and medical treatment can manage it. As we can see, one enzyme malfunctioning causes a domino effect through our whole system, and diet can help to restore the “balance”. This is exactly the kind of approach that Ayurveda emphasizes. 

The same interconnection appears between the immune system, thyroid, and blood sugar. The major histocompatibility complex (MHC) is the major genetic contributor to autoimmune disease susceptibility, and accounts for a large part of genetic risk in conditions like type 1 diabetes and rheumatoid arthritis. The primary function of MHC molecules is to defend against pathogens, but variation on the MHC gene locus on 6p21 is closely connected to autoimmune thyroid disease, including Hashimoto’s thyroiditis, which I have. Thyroid disorders impact metabolic functions including circulating insulin levels, absorption of glucose, and glucose uptake. Hyperthyroidism is linked to glucose intolerance, while hypothyroidism is associated with insulin resistance. Autoimmune thyroid diseases are more common in people with type 1 diabetes, reflecting shared genetic susceptibility. Seemingly separate diseases turn out to be deeply intertwined. 

These conditions can also come with emotional and financial burdens. Between 1990 and 2010 cases of those living with diabetes tripled, and the number of new cases annually doubled. Those adults with diabetes have a 50% higher risk of death than those without, not accounting for the myriad of complications associated with diabetes. In 2022, the American Diabetes Association’s most recent comprehensive US economic analysis found that those with diabetes had an average annual medical expenditure of $19,736, about 2.6 times higher than those without diabetes. This can include payment for insulin, glucose monitors, A1C checks and lab testing, treatment of additional health complications, time away from work, and other costs. These can all create financial hardships for patients and families. The CDC reported approximately $640 billion is used annually for diabetes related costs and accounts for one-quarter of the US health-care spending. We can use this information to better the lives of those around us by investing more in prevention and early intervention, including making insulin and healthy lifestyles more affordable. One of the cheapest ways to deal with diabetes is to prevent it during the pre-diabetic stage. This is where Ayurveda’s message and modern medicine meet: put the body into balance before it becomes severely unbalanced. 

The microbiome may be one of the most important pieces of that balance. A person's microbiome begins developing very early in life. We live with enormous amounts of microorganisms, and scientists are still learning what a “normal” or “healthy” microbiome actually looks like. As I read about this alongside metabolism and diabetes, I began to wonder: if gut microbes influence metabolism and immune function, could microbiome imbalances lead to these chronic conditions? We know that the gut is connected to many different systems in the body, including the immune system and metabolism, and there is also evidence of communication between the gut and the brain. Gut microbiome imbalances have been associated with many health conditions. In addition, Westernized industrialized populations tend to have less diverse gut microbiomes than those in rural settings, and exposure to soil, animals, and other microbes appears to be a contributing factor. Evidence has been found that children who grow up with dogs can have differences in their gut microbiome and may have a lower risk of developing certain allergic diseases. Modern lifestyles have perhaps shifted our relationship with microorganisms in ways we are only beginning to understand. This is where Ayurveda and microbiology, in different ways, point us in the same direction. If a diverse, healthy microbiome helps to prevent metabolic and autoimmune disease, then the preventive lifestyle that Ayurveda promotes may deserve further research.  

The mind is also an essential piece of the puzzle. One paper I found discussed how high subjective well-being can promote better health and longevity, and that positive emotions were related to lower pain and a greater tolerance for pain. This fits into the idea of balance between the mind, spirit, and body. In another class, we discussed physician Ronald Epstein’s observation that when we are less anxious, defensive, and rigid, curiosity flourishes. This promotes the idea that a calm mind can not only improve health but also our learning. It is interesting to me that something as simple as our outlook on life or our situation can make such a difference in our health. I saw a real example of this when I was vacationing in California over the summer; I happened upon a group doing Tai Chi. The instructor explained how he now works with a hospital to help people connect their mind to their body to have a positive effect on their health. Meditation techniques may help to improve this relationship between having a “calm mind” and “good health”. Western medicine is still the default for treatment because of its supporting evidence and research; however, it remains clear that there are many obstacles to overcome in order to deliver the best care for each patient. Ayurveda-based and other holistic approaches can support prevention and patient well-being. 

In the end, our outlook on health should expand to include the mind alongside the body’s systems. Just as balance is an integral part of Ayurveda, there is also balance in how we use it: drawing on the strengths of both Western and holistic approaches can help prevent disease before it begins. 

Curated Paper 1 - Craig Whittaker

  Journaling every day has helped me connect concepts from biology with broader approaches to understanding health. Over the past few weeks, I’ve journaled about ayurveda, metabolism, diabetes, and socioeconomic influences on health. Revisiting these entries has allowed me to recognize connections I had not initially considered. Integrating these topics has given me a more comprehensive understanding of health and disease. It has made me realize that the key to health is the balance between the mind and body. 

To begin with, let’s understand what ayurveda actually is. Ayurveda is an ancient traditional form of medicine whose central dogma is the balance between the body and mind. One of the main principles of ayurveda is the three doshas: Vata, Pitta, and Kapha. The three doshas represent biological energies which must be in balance. It is thought that illness arises when the doshas fall out of balance. Key values of ayurveda are diet and digestion, lifestyle and prevention, and overall balance. We will see how these values relate closely with diabetes, metabolism, and socioeconomic influences on health. 

Ayurveda’s holistic perspective offers a useful way to think about interactions between body systems. Modern healthcare is designed to focus narrowly on individual organ systems or sometimes even just organs. Clinicians often specialize in a specific organ system and often don’t take other organ systems into full account when treating. This can cause serious side effects when the rest of the body is not considered. While we can train clinicians to have a more holistic approach, the problem is deeply rooted in how our healthcare system works. I don’t think that putting the full responsibility on training clinicians will be effective. This issue would have to be solved through a complete restructure.

Ayurveda has changed how I think about balance and the interconnectedness of the body. I always knew that the body is always wanting to reach homeostasis across many processes from studying biochemistry, but I never considered the interconnectedness of the mind and body. A person’s outlook on life has a significant impact on their health. For example, someone with depression might find it difficult to get outside and be active, and if that were to go on for an extended period of time, it could lead to serious health problems such as obesity or diabetes. Not to mention, those problems could cause more depression. Another example could be anxiety. We know that anxiety can cause a myriad of issues, such as hypertension, gastrointestinal distress, irritable bowel syndrome, shortness of breath, a weakened immune system, and much more. All to say, the mind and body are entirely connected.

Now let's bring in metabolism and diabetes. Let’s first dive into metabolism and explore the relationships between anabolism, catabolism, and metabolism. Metabolism is the sum of all reactions that sustain life. Anabolism takes energy from simple molecules to build complex molecules. Catabolism breaks down complex molecules into simpler ones. These processes work together to maintain and sustain the body. When metabolism dysfunctions, a possible outcome is hyperglycemia. Hyperglycemia can damage the endothelium of blood vessels, which can affect blood flow, blood pressure, clotting, and inflammation. Excess glucose can do this through oxidative stress, which is when reactive oxygen species oxidize proteins, lipids, and DNA, affecting blood vessels. Oxidative stress can also reduce nitric oxide availability. Nitric oxide helps blood vessels relax; without it, blood flow can be impaired. Another way is through advanced glycation end products (AGEs). AGEs are formed when glucose attaches to proteins and lipids without enzymatic control in a process called glycation. Over time, AGEs can build up in vessel walls, causing inflammatory signals. One last way hyperglycemia affects blood vessels is simply by thickening and stiffening vessel walls via chronic inflammation and damage to the extracellular matrix.

To explain how one becomes hyperglycemic, we first need to understand how insulin and glucagon work together to balance glucose levels. Insulin works to lower blood glucose by anabolic processes of storing nutrients and constructing large molecules. Glucagon raises blood glucose by extracting stored energy, usually in times of fasting. When the system malfunctions, hyperglycemia, type 1 diabetes, and type 2 diabetes can occur. 

Let’s talk about type 2 diabetes and how genetic predispositions and lifestyle factors play a role. Genetic predisposition can cause someone to have impaired insulin production or insulin resistance. This alone doesn’t guarantee someone will develop diabetes, but rather it means they are more susceptible to diabetes. Lifestyle factors are what can take those genetic predispositions and cause type 2 diabetes to occur. Diet, physical inactivity, excess body fat, poor sleep, stress, and environmental factors can all affect someone's likelihood of developing diabetes. Many of these factors can be out of someone's control and are baked into society. Food access and opportunities for physical activity are huge factors that we ought to take more seriously as a society.

To bring all these ideas back to ayurveda, the key to avoiding these conditions is balance. There needs to be balance metabolically, in diet, in exercise, and in sleep. We can see that when systems fall out of balance, disease occurs. This trend expands across organ systems. We have been using diabetes as an example to demonstrate this, but there are many different ailments that all derive from a lack of balance between systems.

Researching ayurveda, diabetes, and environmental factors for diabetes has made me realize that type 2 diabetes is preventable and the blame should not be placed on the people who are afflicted with it. In society, there is often a stigma around type 2 diabetes, and people are quick to blame the afflicted person, but there are so many factors outside of their control that blame is not fair. This research has solidified my stance that we need to address type 2 diabetes on the social level and not the individual. The system we live in is built to put those at risk in danger.

To expand on the system, let’s dive into the socioeconomics of it all. It is no coincidence that people with type 2 diabetes often are in the lower socioeconomic classes. We have found strong inverse relationships between household income and type 2 diabetes. One of the major reasons for this is disadvantaged environments. Immediate access to fresh food is often limited, and safe spaces for outdoor activity are non-existent. Chronic financial stress causes inflammatory proteins and cortisol in the blood, triggering insulin resistance. Barriers to healthcare are enormous. When it is difficult to put food on the table and pay rent, going in for a check-up is not even in the picture. This causes treatment to be delayed until hospitalization. These delayed treatments cause severe complications that can be fatal. Not to mention, if you are trying to get a job as a person with type 2 diabetes, your odds are much lower. There has been research done on biases towards people with type 2 diabetes. People with type 2 diabetes have lower odds of getting jobs and being promoted. This makes getting out of the lower class and into a safer environment much harder. These biases also make adults conceal their diabetes. This concealment might even make them take their diabetes less seriously because they are in denial that it even exists! There is a quote by W. Edwards Deming: “Every system is perfectly designed to get the results it gets.” In this context, we could say that diabetes being the problem it is today is no accident. This system we live in was designed to keep the lower class down.  We have to address the system to solve these issues. We have to correct these conditions that people in lower socioeconomic classes live in. Diabetes is among the leaders in death causing diseases and has to be taken seriously.

To conclude, ayurveda ties the ideas of holistic health care and balance in the mind and body to prevent diseases. We can use these ideas to build a healthcare system that is better designed to treat the whole body. We can also see connections of balance in how our metabolism works. We can see biologically what goes wrong when systems fall out of balance. Using diabetes as an example, we see that when insulin and glucagon become unbalanced, glucose levels rise or fall, causing a myriad of issues, including type 2 diabetes. We learned that type 2 diabetes requires a genetic predisposition as well as environmental and lifestyle factors. Finally, we learned about how socioeconomic class affects one’s likelihood of developing type 2 diabetes.

Curated Paper 1

 Curated paper 1: Ayurveda, Metabolism, and the Way We Understand Health

“You are what you eat.” I never really understood how true that is. I always knew that food was important for our health, but I didn’t think much about what happens inside our body after we eat. The food we consume provides the energy and nutrients our bodies need to function, but our bodies process and use those nutrients in ways that are much more complex than I realized.

Through the journaling assignments, I started noticing connections between metabolism, diabetes, diet, society, and even how different medical systems understand health. The concept of Ayurveda especially made me think about metabolism differently. Ayurveda looks at the body as a system of relationships rather than as separate organs or processes, and when I put this idea together with what I learned about metabolism and metabolic diseases, I started to see health as something influenced by many connected factors instead of one simple cause.

One of the first things that made metabolism feel more connected to everyday life was paying attention to food. For example, when I go to Dutch Bros to get a sweet drink, I notice the calories, and I’d probably just think about whether I want the drink or not, but now I look at the calories and it makes me think about how often we make these small decisions without thinking about their effect on the body. A single drink does not determine someone's health, but many drinks can become part of a person's overall diet. It made me realize that metabolism is not something that only matters when someone has a disease, it is always happening as the body processes the food we eat and uses the energy we get from it.

It is too simple to say that someone's metabolic health is only the result of their choices; the process is much more complicated. I started thinking more about the environment we live in. People might not realize it, but what we buy and consume is affected by price, convenience, time, advertising, and what is available. Someone who has very little time to prepare food may rely more on “ready-to-eat” options than someone who has more time and resources to make meals from scratch. This means that talking about metabolic health only in terms of personal responsibility leaves out an important part of the situation. People make choices, yes, but those choices are influenced by the society around them. Eating is not just about satisfying hunger or counting calories, but is also about providing the body with the materials it needs to function.

These everyday choices can become especially important when we look at conditions such as diabetes. Diabetes is often discussed in a way that makes it sound like it is simply caused by eating too much sugar or having an unhealthy lifestyle, however, the body is much more complicated than that. Glucose is an important source of energy, and hormones like insulin regulate the amount of glucose in the blood. When blood glucose regulation is disrupted, glucose levels can become too high and contribute to health complications over time. These changes in the body's normal processes can affect a person's overall health. It shows why metabolism is important beyond topics such as weight loss or nutrition. Metabolic processes are essential for keeping the body functioning; they affect not only the individual but also families, healthcare systems, and society through medical costs and long-term care.

Patwardhan et al. (2004), in their article Ayurveda and Natural Products Drug Discovery, discuss how traditional Ayurvedic knowledge may contribute to modern medicine, including the discovery and development of drugs from natural products. Metabolism can be studied through individual biochemical pathways, but these pathways are part of a larger biological system. Ayurveda's holistic perspective encouraged me to think about how the different parts of health relate to one another. The authors explain that traditional knowledge can provide ideas for scientific investigation, while also emphasizing the importance of evaluating treatments through modern research. Modern biology gives us ways to understand the specific mechanisms happening inside the body; we can study enzymes, metabolic pathways, hormones, glucose, and other measurable processes. Ayurveda approaches health from a different perspective by focusing more on the person as a whole and on the relationships between different aspects of health. These approaches are different, but I do not think that necessarily means that one has to completely replace the other; they can lead to different questions about the same person. Modern biology can help explain what is happening inside the body, while a more holistic perspective can encourage us to think about what else may be influencing those processes.

This connection made me realize that understanding a disease involves asking different kinds of questions. Biochemistry helps explain the mechanisms behind a condition, while a holistic perspective encourages us to consider how those mechanisms relate to the person's overall health. Looking at social factors helps us understand the circumstances that may influence their health. Together, these perspectives helped me see that understanding disease requires both scientific knowledge and a broader view of the individual. 

If a person has a metabolic disorder, it is easy to focus only on the biological problem; however, their diet, activity, stress, sleep, environment, and access to healthcare may also be connected to their health. This does not mean that every disease can be solved simply by changing someone's lifestyle, it means that understanding the biological process is only one part of understanding the person's experience with disease.

Ayurveda's idea of the body as a system of relationships gave me another way of thinking about health. Health can be understood at multiple levels at the same time. At the smallest level, we can look at molecules and biochemical reactions; at the next, we can look at organs and body systems. Then we can look at a person's habits, environment, relationships, and access to resources. None of these levels necessarily gives us the complete picture by itself, but looking at them all together gives us a better understanding of why health and diseases can be so complicated.

Maintaining health involves personal choices, but it is also influenced by factors that are not always within a person's control. It is easy to say that people should simply eat better, exercise more, or make healthier choices. Those things can be important, but a person's health is affected by their biology, as well as by their circumstances. Health is not only about treating a disease once it appears, it also involves paying attention to patterns in everyday life and how different parts of life affect one another.

Overall, these topics made me think about metabolism as much more than calories or the speed at which someone burns energy. Metabolism is a biological process, but it is also connected to the way people eat, live, and experience their environment. Diabetes and other metabolic disorders show what can happen when these biological processes are disrupted, while Ayurveda provides a different perspective that emphasizes the relationships between different parts of a person's health. By connecting these ideas, I came to see that understanding disease requires more than understanding one biological pathway. It also requires thinking about the whole person and the different factors that influence their health. This was probably the most important change in my thinking throughout these topics: instead of seeing metabolism, diet, disease, and lifestyle as separate subjects, I now see them as different parts of the same larger picture of health.

Citations

Patwardhan, B., Vaidya, A. D. B., & Chorghade, M. (2004). Ayurveda and natural products drug discovery. Current Science, 86(6), 789–799.

Curated Paper 1

So I have diabetes, which is a metabolic disorder, I was just thinking about how I hope I can learn more about diabetes, because while I do have the disease, I haven’t used what I have learned in my undergraduate degree in order to further understand it more, so I think that would be pretty cool if we just dive into it literally at the very end of my undergrad degree. I asked a question about where the glycogen is stored and it seems it is stored in muscles, I just think that is cool because whenever I exercise, my blood sugar just absolutely drops so I am sure there is some sort of connection there, pretty cool. Recently, my blood sugar has been having a mind of its own due to the stress of having a dental school interview, so I could absolutely relate that to what we are talking about when it comes to ayurveda. My body is absolutely out of balance, so when I inevitably inject too much insulin, that throws my body out of balance but the other way. The topic we discussed in class made me ask myself who in my family has diabetes, and the answer is absolutely nobody so I think T1D would classify as an “acquired disease.”

When we actually talked about diabetes itself. I have heard of beta cells, I believe these are the cells that are generally my issue or at least that is what I’ve heard online. If these cells are antagonistic, that should be self regulating, I don’t know what happened to my beta cells, they must just be dead as well. We also talked about endocrine disruptors which, and that topic was kind of scary, lots of stuff can disrupt people’s hormones. I think it's crazy that we don’t really know what some disruptors actually do, and I think it is even crazier that we don’t know if stuff is even a disruptor in the first place.  I remember asking why high blood glucose levels inevitably cause high blood pressure so I did some research. I have heard this so I knew it was probably true. I initially thought that since high blood sugar can cause stiff blood vessels, that stiffness could potentially not let blood vessels do stuff that blood vessels do like expand and contract. I found that that idea I had was actually correct so that was pretty cool, there was another pathway BP can rise due to blood sugar, and it is through just having more sodium.

I was curious if a person can get both types of diabetes, I remember “researching” this subject when I was younger and less educated in biology. From what I can understand I don’t think we can get insulin resistance from insulin we don’t even produce ourselves, I know that would be terrible. After researching it, apparently we can get literally both types of diabetes. So our body wouldn’t produce insulin in the first place, then when injected, it wouldn’t be effective. This would not be a very good situation for people, but insulin resistance is kind of a spectrum, it doesn’t just start and suddenly you’re unable to utilize all insulin. But I am very glad this isn’t as common of a problem as just either type of diabetes by themselves. 

So, concerning the economics of diabetes, I can definitely personally relate to this. What I can put into this conversation is type 1 diabetes is not optimal if you do not have insurance. Constant glucose monitors help make diabetes much more manageable, but it costs about 300 dollars for a month’s supply of constant glucose monitors. Without insurance that is totally unaffordable, at least for me it is. I need diabetic supplies, insulin, and insulin pump application units cost money unfortunately, these companies do need to “keep the lights on” but there is no way a couple pieces of plastic are a couple hundred dollars, of course that’s just my opinion. It just feels like I am kind of trapped unless I am making a stupid amount of money to just buy these supplies out of pocket, because if insurance isn’t paying for this stuff then I am literally just going to have to buy it or I have to go without a pump, which is still absolutely doable. 

I have learned that physical activity is down as of late, and I believe this is absolutely a factor of health in the general public. From what I have seen, exercise is one of the most important factors of health. Before, my view of exercise was limited, I would normally say that everyone has time to exercise even if it is for 10 minutes a day. But for someone who has a serious health problem in this ever increasingly expensive world, trying to add exercise to that mix sounds like some tough tasks to balance. Not even to mention that food is generally worse for people than it used to be, in my opinion. To test this, just take a trip to Walmart and see how much some chicken or beef is, some protein is extremely expensive, but kraft mac and cheese is like one dollar. This absolutely affects the general population’s health, as economic factors are getting worse, since 2007, the cost of diabetes in the US has risen by 41%. At the same time, we are also seeing that people’s general health is also getting worse. No wonder why the leading case of death is heart disease. I think exercise is basically this same conversation as well. The common question arises, “Do we have a chance without exercise?” I personally think we as human beings need exercise, I know I have talked about how it can be difficult for some people to exercise. Unfortunately, I believe that no matter how difficult it is to get some activity in, not exercising will be detrimental to anyone’s health. 

So why haven’t we improved health if we know more than ever now? There have actually been scientific papers written on the subject that state that technology has made tasks that were once more difficult, less difficult and time consuming. And I think this applies to health as well because I don’t think people are getting up and moving as much, but apparently according to science “it is not laziness.” So then why is diabetes getting more prevalent? A quick trip down google scholar will tell you that yes in fact, both type 1 and 2 diabetes are becoming more prevalent, but why? The National Institutes of Health released a paper stating that environmental factors are increasing, but they don’t know exactly what those factors are. This is where I can take my guess, I believe it is our ever decreasingly nutritional diet. That, and the fact that I think type 1 diabetics are able to get more access to care than before, and having children is becoming more viable than before to type 1 diabetics.

I am currently taking immunology and that class emphasizes the fact that our immune system does not simply attack everything that is not our own body. If that were true, then the first thing everyone in that class thinks of, is our gut microbiome, without our biome we would have some serious struggles trying to digest literally anything. If people figured out all the way back in 1875 that the microbiome existed and functions, then it was probably pretty important and prominent. Whether or not we think the microbiome is important, it is absolutely prominent, as our microbiome outnumber our own cells. But everything kind of points to it being important, such as vitamin K production. From day 0 we are exposed to outside pathogens, we have just recently found that the placenta is actually not sterile. So starting from the very beginning, the decisions our parents make as we are literally infants change what our microbiome will be like. Even the method at which we are born into the world changes something as important as our microbiome, which really does promote the fact that our body really is in a balancing act. And our microbiome can change stuff like what we are allergic to, or even our risk of heart disease. Formula is missing some sort of components that mothers milk has, so human milk basically selects for a particular type of bacteria, which suggests our microbiome is kind of picked out on purpose, it's not just randomly assigned to us. 

When you just simply change the bacteria in the microbiome, it has direct connections to the nervous system, and even direct connections to the immune system. So basically any change to the microbiome could possibly change lots of different things in the body. This relates back to ayurveda, which essentially says that the body is always in a balance. We can see that the gut microbiome can affect the rest of our body, even in the mind. The gut-brain axis is a communication from our digestive system, and it directly links brain function to the function of our digestive system, also pointing to the fact that we are always in a balance. They literally took the microbiome from a fat mouse, then put it into a sterile thin mouse and it would make thin mouse fat. I wanted to dig into this study and it did in fact happen which is crazy because we do not learn anything about our gut microbiome in a class like biochemistry. I did not know it had such an important impact in the overall metabolism process. I initially thought that maybe it increased the amount of food that the mouse would want to eat, but apparently they ate the exact same diet, with the exact amount of food. Essentially, what they think happened was the mice did not break the laws of thermodynamics, but instead, the new microbiome just forced the mouse to use pathways that stored more calories. Research suggests that 10 percent of the total increased risk of heart disease associated with eating red meat come from the microbial change. I also found it interesting that poultry and fish do not change our microbiome as red meats do, and they also are not as strongly linked to atherosclerosis. One would think that our gut microbiome is completely separate from something like atherosclerosis, but apparently it is not. This really goes to show that we truly are always in a balance. All of this makes me wonder why we haven’t done a lot of other research on how to change our gut microbiome for the better. 

Curated paper 1

Alex Judd 

Ayurveda is a sanskrit word and sanskrit is a south asia language from thousands of years ago and the word can be split in two, ayur and veda. Ayur means life and veda means science or knowledge. The similar word that I thought of once I read the definition is holistic, and as a CNA this is a part of what we learned in our classes. Not all diseases and problems can be solved with medicine alone. The mind often needs to be heard as well as spoken with and in doing so can heal wounds far better than any drug or remedy could. This type of care also sounds very similar to how some medical schools work, they take the whole person into account not just their disease or sickness. Ayurveda takes a more natural approach to healing sick people and also considers that disease or sickness can come from any imbalance in your life. So lifestyle changes are one way to restore the imbalances of your life. I think this approach can be very healthy because you're not just looking for medicine to cure you but looking inward to find imbalances and then looking to improve and fix those imbalances in your life. Then combined with medicine it provides a fantastic way to improve health and fight disease. It is very interesting that India uses this medical approach much like we use our standard medicine here in the US. There are also providers that are trained to teach how to administer this ayurveda way of medicine. I believe that implementing aspects of ayurveda into the medical field would be very beneficial as we already see with the holistic way of caring for patients in the US. I found that ayurvedic medicine, when compared to western medicine, looked to examine the body as a whole and find the imbalances of the body. They focus more on a qualitative analysis of the person rather than a quantitative analysis like is done in modern medicine. The hope of the paper is to combine the two practices to get a more whole examination of the person, especially when dealing with neurological disorders. It seemed to me that ayurvedic medicine definitely has its place when there are limited resources and technology, however I found modern medicine to be a better way to find the imbalances that ayurvedic medicine looks for. Modern medicine just gives you more information on why and where the imbalance is stemming from. All in all I didn't find ayurvedic medicine to be super helpful in this situation because modern medicine could more accurately find the imbalances present in the body. While ayurveda focuses on the balance of mind, body and spirit modern medicine finds the chemical imbalances in the body like is evident with people with diabetes.  

Type 1 diabetes is an autoimmune disease that attacks the beta cells in the pancreas that produce insulin essentially destroying the key that allows for glucose uptake into the cell. And then in type 2 diabetes there are multiple types but the type that i read about was insulin resistance. This occurs when your body becomes numb to insulin in your body and the cells aren't as receptive and this requires your pancreas to work harder to produce more insulin until eventually the sugar levels are too high in the blood stream and they spike to high levels. Type 1 and type 2 diabetes are great examples of imbalances that may arise within our body and utilizing an ayurvedic approach along with modern medicine is imperative to restore balance. Diving into the microscopic view of diabetes mechanisms the type of cell that is responsible for insulin release is the beta cell. They are endocrine cells which means they secrete insulin into the blood stream and this quickly signals to the body to intake glucose. Increased ATP levels after glycolysis occurs create a charge difference in the beta cells thus promoting the departure of insulin into the blood stream. When these processes do not function properly it may result in diabetes, and when people have episodes of hyperglycemia the body "remembers" these events, which cause negative outcomes later on in life. Starting people with diabetes on a strict and rigid care plan for their diabetes is attributed to better health later on in life. A study was done by two groups one with normal care for diabetes and another group with intensive care for diabetes and the group that had intensive care was seeing better results thus emphasizing the importance of prevention and early regulation of blood sugars. What is interesting is that even after someone has established good stable control of their diabetes and blood sugar levels the body will still remember the hyperglycemic event(s) and problems can still arise even though the control is much better. The hard part about early aggressive diabetes treatment is when people are pre diabetic and do not yet have type 2 diabetes. Finding the “right time” to start treatment would be very important, however there are other economical and lifestyle consequences to an early aggressive treatment that may not be needed for some time. This highlights one aspect that may be overlooked especially from a medical and disease point of view is the cost and financial strain that comes with the disease. 

I had previously never really paid too much attention to how a disease like this could cause so much financial burden. In my mind the medical world and the financial world are two separate entities, but the more I learn about medicine and administration from working in a medical environment and shadowing doctors I have learned that finances are an integral part of medical decisions. Now reading the paper on the cost of diabetes has opened my eyes to another side of disease that I truly did not fully grasp. Other than the initial expense of doctors visits and paying for the medicine, in this case insulin, I also found it interesting that there is a productivity cost that plays a part in the financial burden. Not only do you have to pay all the essentials but you are taking a cut out of your paycheck potential due to lower productivity and less days worked due to complications with this disease. Not to mention those that have type 2 diabetes already have the potential struggle of obesity. It was a good eye opener to realize that there is much more at play than just medicine when we talk about diseases, there are so many factors that can complicate life to great extremes. Another one of these factors is our microbiome. 

The microbiome has a great effect on the body as a whole especially when talking about ayurveda. When discussing the drug making process pharmacologists now must consider how the microbiome affects the drugs efficiency in the body. For example some microbes may interact with the drug making it ineffective because the drug doesn't make it out of the gut and into the blood stream where it can then travel to the rest of the body. There may also be harmful interactions between certain drugs and the microbiome which poses another obstacle for pharmacologists. I find this very interesting because certain drugs may not have the same effects on different people and this is due to a difference in microbiome which not too long ago we didn't pay much attention to our gut and its effects on our bodies. 

The gut brain axis has gained a lot of traction for scientists studying diseases. Since 2019 there have been over 25,000 journals written on the microbiota and brain axis. We can easily see that our body is more connected than we ever thought. And changes in our diet and lifestyle have a clear effect on our brain and mental well being. It has been known for a long time that healthy eating and exercising are required for a good healthy life, however I feel that it is recently (since 2019) that we have started to discover how exercise and healthy eating directly and indirectly affect our brain's health. Contributing to the factor that living a life the ayurveda way is greatly important. Keeping our body healthy and free from mental illness requires complete balance throughout our whole body. This balance can be altered by things from our environment that may not have been thought to be so dangerous, like an unhealthy diet. My original thinking about a bad diet was just getting fat and not being able to move around as much and that causes someone to be depressed or sad. However there are real physical processes between the gut and the brain that are causing these symptoms and it's not primarily an outward perception having an inward effect. But an inward imbalance having an inward effect which can be magnified by our outward perception. 

Having balance in our lives is very difficult and a process that takes years and years to become comfortable with and even then many people will fail to truly find balance in all aspects of their lives. More importantly, how we deal with imbalances can greatly change whether we are moving towards or away from balance and equilibrium. There are many processes biologically that require imbalances to function properly so finding ways to utilize our imbalances to create an overall balance may be necessary. People with type 1 diabetes or even type 2 diabetes can no longer change the fact that they have an imbalance, however they must work with their imbalances to make their lives whole. Striving to be balanced may be the closest anyone will ever get to true equilibrium and it is in that striving that we feel complete. 

Curated Paper 1

Throughout the past few weeks, I have gained valuable insight into the mechanisms unique to specific aspects of the human body. Before learning about Ayurveda, the gut microbiome, and metabolism/diabetes, I did not realize how interconnected they are. I used to view diseases as isolated events that primarily impacted a certain area or organ, but now I understand that one medical issue can permeate all of the body’s other systems. Furthermore, such topics also provided me with an insight into the effect that various external and internal factors such as lifestyle choices, genes, and access to healthcare services can have on people’s health.

The topic of Ayurveda was particularly interesting to me since it is a comprehensive system that holistically approaches the human body and mind. Being aware of how the body reacts to the food we eat, the sleep schedule we keep, and the stress levels we experience is important, but I find it difficult to single out one factor that can considerably improve one’s wellbeing. In fact, Ayurveda and modern medicine tackle the topic of health from a different angle, yet both suggest that a person should not approach their health issues from a narrow and one-dimensional perspective. I believe it is crucial to not only examine the subject scientifically as researchers do to acknowledge the validity of alternative medicine.

The topics of the gut microbiome and the brain were also interesting to me. Microbiome is a collective term that encompasses all the organisms that reside in the digestive tract and affect its proper work. Researchers have found that the microbiome can impact one’s mental health, as the experiment with mice demonstrated. I find such findings very intriguing, as they showcase the sheer complexity of the human body and its inner connections. I also find these topics to be very relevant to my life, as I often experience stress as a result of irregular routines, especially when traveling. After returning from a trip, my wife and I tend to fall into the frequent junk food consumption and irregular sleeping patterns since we could not do much during our travel. While I cannot say with a degree of certainty that such an irregular schedule has impacted our microbiome, these are the factors that I will consider in the future.

I also find the connection between Ayurveda and microbiome very interesting, as they both emphasize the role of an average person’s lifestyle and the detrimental effects that smoking, lack of sleep, and poor nutrition can have on health. Ayurveda approaches the topic from a holistic point of view, while the scientific community actively works on isolating the specific impact that various factors may have on the body. Reading about these connections allowed me to better understand the research process and the importance of clinical trials, but I find value in alternative medicine as well. It is fascinating to observe how different areas of science can intersect and give a more in-depth understanding of the causes of certain diseases rather than merely focusing on their symptoms.

I also find that what I have learned about metabolism and diabetes can be connected to other topics. The human body is a complex system that requires thorough care, and metabolic disorders are often the result of lifestyle choices and genes. Researchers have found that people with diabetes often experience higher chances of developing other diseases as well. Type 1 diabetes used to be referred to as juvenile diabetes because it usually affects children and adolescents. When the body cannot produce enough insulin on its own, doctors prescribe external insulin injections to the patients. On the other hand, type 2 diabetes used to be known as adult-onset diabetes because it rarely occurs in children and teenagers. However, recent research has shown that due to poor lifestyle choices and extreme obesity rates among young people, there is a higher risk of developing type 2 diabetes at an early age.

I believe that what I have learned about diabetes and disorders of the endocrine system are also relevant in everyday life. People with diabetes must be particularly mindful of their health, as high blood sugar levels can tremendously affect their wellbeing. Poor nutrition and lack of physical activity can profoundly impact the human body, and I find this topic relevant to my life as well. However, it is not always within the power of a person with diabetes to make healthy lifestyle choices because of economic reasons. I think that it is necessary to educate people about nutrition and an active lifestyle, but I also believe that a comprehensive approach requires addressing the issue of food accessibility as well. It is not uncommon to see people with diabetes being criticized for not following the strict diet that is recommended for people with glucose tolerance issues. I find this approach counterproductive because the challenges that people with diabetes face are not seasonal or situational.

Furthermore, people with endocrine system disorders often have to make radical changes to their routines and lifestyles. Such a dramatic step is challenging for everybody, and it is natural for a person to seek support from family and friends. Speaking of support, one of the topics that resonated with me on a personal level is the social dimension of chronic disease. I have epilepsy, and I take a dose of medication twice a day to prevent seizures. Seizure can be very dangerous, especially if they occur suddenly and without warning. Due to the nature of my condition, it is impossible for me to change the medication on my own, since it can have severe consequences. Taking this medication is a part of my daily life, but it is something that I seldom like to talk about because it is a very sensitive topic for me. I think that seeing a person with a chronic disease is not the sole indicator of their quality of life. In my opinion, a lot of people are quick to judge others without knowing their situation, and I believe that being compassionate and supportive is a better way to approach such situations.

In conclusion, I find that all of these topics are very interesting, and I have gained valuable insight into the health issues that people encounter on a daily basis. Ayurveda, gut microbiome, and human metabolism are very different subjects, but, as I have mentioned earlier, they are connected in more ways than one. The mechanisms of the human body are truly fascinating, and I find the variety of approaches that scientists take particularly interesting. Diabetes is a devastating diagnosis, and I respect the resilience of the people who have to deal with it on a daily basis. My own experiences with medication are also relevant to the topic, as my epilepsy medication severely impacts my metabolism and, consequently, my weight. I find it to be a very sensitive topic, and I respect people with diabetes to make their own choices regarding their health. In my opinion, chronic disease and a poor physical and mental state should not define a person, and I think that learning about the science behind them allows us to be more emphatic and compassionate towards others.

 CAMERON DELANGE

Curated Paper

After looking more and more into the concept of what Ayurveda is, I have been able to reflect a lot on what that actually means to me. I have looked at what I have accomplished so far in my undergrad and I feel like I have had a few topics and ideas covered from other classes I have taken here at SUU that have changed my perspective. Up until this point, I have felt that most of my classes at SUU have been overly specific and on a “high zoom setting” . I took organic chemistry, and we would usually spend weeks of the semester memorizing specific reaction mechanisms and atomic scale properties. Later, I took an endocrinology class in which we were able to look at much more of a macroscopic view. Now, as I'm currently in microbiology, we focus heavily on individual microbial phyla, as well as common chemical and morphological structures. That approach is very useful and I feel that it has allowed me to understand how complex these systems can be, however I feel that it can make it easy to forget how these systems interact in a living person. That is where the Ayurvedic perspective clicked for me. The Ayurvedic approach doesn't so much look at the human body as a machine made of isolated parts, but more so as an open ecosystem that is constantly reacting to its surroundings. As we have been looking at metabolic disease through both the molecular and this more holistic framework, I believe that it illustrates that health isn't just a baseline you maintain but really it is an ongoing balance between the environment, cellular chemistry, and our internal microbiome.

Once I was able to grasp what Ayurveda was, I felt that this connection between external surroundings and internal biology became really clear after I continued to look at the topics I studied in genetics. In the lecture, we were introduced to the idea of epigenetics. We were able to  look at environmental stressors such as  psychological pressure, the nutrient availability, and even the odd example of how light cycles can trigger DNA methylation and even histone modifications. The resultant epigenetic tags don't necessarily change the underlying genetic code, but they can completely affect how cells express their genes. This is where I believe the Ayurvedic approach operates. Ayurveda teaches us that our bodies are more of a dynamic network that is constantly taking external cues from its environment. Another example is if you look at seasonal shifts or daily routines through this lens, you realize that our daily habits act as direct signals to our cells.

A super interesting example of Ayurveda is the body's digestive capability. This is often framed as internal metabolic strength, and is considered one of the core foundations of overall systemic health. In class when we were discussing the gut-brain axis, we saw how localized metabolic activity in the intestines can influence systemic inflammation, immune cell training, and even mental health. I think we as a society should not only be taking what we can measure for caloric intake as well as balancing different vitamins and other important nutritional markers, but we should be combining it with the Ayurvedic emphasis on daily maintenance that gives us a much better model for healthcare. Instead of having to wait for tissue damage to occur and treating symptoms clinically, we are equally focused on maintaining the internal ecosystem before breakdown happens.

Once  we shifted gears to studying the metabolic pathways, I was reviewing the same material to be tutoring students in BIO 1610 as well as studying enzyme kinetics for my own MCAT prep. It is interesting to see how tightly regulated these pathways are and it was a reminder to me of how precise cellular chemistry has to be. Enzyme activity, substrate concentrations, and negative feedback loops all keep energy balanced across tissues. When a chronic stressor is introduced into that balance, it might disrupt a rate limiting step or alter enzyme efficiency, and that tiny error doesn't stay in the local environment. These types of minor shifts in one cellular reaction may eventually ripple through other connected pathways, causing more of a systemic manifestation 

We see this exact cascade when mapping out the cellular mechanisms behind insulin resistance and Type 2 Diabetes. In my endocrinology and pathophysiology classes, we discussed how insulin signaling is mapped as a step-by-step sequence: insulin binds its membrane receptor, causing autophosphorylation, recruiting insulin receptor substrates like IRS-1 and IRS-2, activating the PI3K-Akt pathway, and finally moving GLUT4 transporters to the cell membrane so glucose can enter. If that pathway were to fail, the body's inability to pull sugar out of the bloodstream causes multi-organ strain over time. In the liver, unsuppressed gluconeogenesis continues pumping glucose into the blood even when blood sugar is already high. In adipose tissue, unchecked lipolysis floods the circulatory system with free fatty acids, adding to the increasing cellular stress. What originated as a signaling failure at a single receptor interface turns into systemic tissue damage across multiple organ systems.

In that perspective, it shows us how this pathophysiology builds up over time and puts the human and financial cost of diabetes into account. As I was listening to my classmates talk about managing Type 1 diabetes and their constant worry over insulin pumps and daily glucose monitoring. I think that this helps pinpoint how much psychological stress can come with managing such a chronic condition. On top of that, the economic impact is significant. I did some of my own research, and looking through the American Diabetes Association cost report, the total diabetes expenses in the U.S. is $412.9 billion in 2022, with the direct medical costs reaching $306.6 billion. On the individual level, someone with diabetes has an average annual healthcare expenses of $19,736, about 2.6 times higher than someone without diabetes.

What makes those financial stats so frustrating is how recombinant modern DNA technology works. In my summer semester of  biochemistry, we covered how you can take the human insulin gene, insert it into an E. coli plasmid, then reintroduce that plasmid into the bacteria, and culture them in large fermenters to yield pure human insulin. The actual manufacturing cost for a vial of basic human insulin is only a few dollars. Yet, retail prices for modern analog insulins remain anywhere from $50 to $300 a vial. 

To get a full picture of metabolic health, I think that you have to look beyond human cells and consider the bacteria in the gastrointestinal tract. For a  microbiology assignment earlier in the semester, we looked at the Shi et al. (2025) paper, which used Mendelian randomization to demonstrate bidirectional causal links between gut microbiota composition and central nervous system outcomes like insomnia. I felt that this tied directly to what we had on our latest immunology exam, regarding "microbial shift disease" and dysbiosis, where disease isn't caused by an invading pathogen, but by a shift in the balance of native bacteria. Healthy gut bacteria produce short-chain fatty acids like butyrate, which serve as the primary fuel source for colonic epithelial cells and keep the tight junction proteins intact.

In that unit, we discuss that when dietary stressors, and antibiotics eliminate those beneficial bacterial phyla, which then leaves open niches for opportunistic microbes. This breakdown triggers endotoxemia. When the epithelial barrier fails, lipopolysaccharides (LPS) from Gram-negative bacterial walls leak through a compromised gut lining into the bloodstream and bind to TLR4 receptors on immune cells. This triggers the NF-κB pathway and releases pro-inflammatory cytokines like TNF-α and IL-6, which phosphorylate serine residues on IRS-1 and directly blunt insulin signaling in muscle and liver tissue.

Doing some more research on my own revealed some interesting results. This host microbe connection extends directly into neurochemistry. As it turns out, about 90% of the body's serotonin is produced in the gut by enterochromaffin cells. If the body is under conditions of stress or inflammation, immune signals upregulate specific enzymes. What happens is this diverts tryptophan away from the serotonin pathway and down the kynurenine pathway. This detour affects the neurotransmitter levels and provides a direct mechanism for how gut dysbiosis drives systemic inflammation, fatigue, and sleep disruptions.

Pulling all of these topics over my undergraduate has made the idea that health isn't something you can reduce to a single gene, a broken receptor, or an isolated medication. Isolating diseases like Type 2 Diabetes to single metabolic steps ignores the macroperspective and environmental, microbial, and economic factors that dictate how our bodies function day to day. Bridging our Ayurvedic focus on dynamic balance with mechanisms of epigenetics, signal transduction, and gut microbiology, I think it gives a much clearer framework for health. By recognizing how daily habits, environmental inputs, and microbial communities influence cellular signaling gives us the tools to prevent metabolic breakdown before it starts.