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.
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