Curated Paper 1 GD

 In the last several weeks, after learning about Ayurveda, metabolic pathways, diabetes, and the microbiome in humans has most definitely changed the way I think about health and disease. Now, as a biology undergraduate student, I have spent a rather large sum of time studying the different systems of the human body. Often I’ve focused on individual organs, cellular processes, and biochemical pathways. However, the unification of these topics has helped me to recognize that our bodies are very interconnected. If you affect one system, it can have consequences throughout the entire body, whether that means you changed something in glucose regulation, or the microorganisms that live in our digestive tract, or even our environment and lifestyle. I think one of the most interesting connections that I've found while learning these topics is how they relate to the philosophy of Ayurveda. In particular, the emphasis it has on balance and the relationship that the body, mind, and environment have on one another. Now, the traditional explanations that ayurveda has aren’t necessarily supported by our modern science, but I think it still has some particularly interesting similarities between its overall perspective on health and what we actually know about physiological homeostasis. And looking at these topics side by side has helped me to develop new ideas about what balance, as taught by ayurveda, actually means, as well as how different biological systems can influence each other, and how understanding disease requires more than being able to identify one disrupted process.

What is Ayurveda? A traditional system of medicine that originated from India several thousand years ago. Its main philosophy puts emphasis on maintaining balance between the mind, body, and spirit. It also recognizes that lifestyle and environmental factors can impact health. In Ayurveda, people are believed to have different combinations of 3 doshas. They are called vata, pitta, and kapha, and they believe that disease is a disruption of their balance. Now, doshas haven’t been established as biological mechanisms in modern scientific research, but the more broad concept that different bodily systems influence one another is something that I find rather reasonable. In my physiology class, we are always learning about homeostasis and how the body maintains these internal conditions through coordination of multiple organ systems. The nervous, endocrine, immune, and digestive systems are in constant communication with one another, and a disruption in one can most definitely influence the function of several others. I think an interesting comparison between ayurveda and modern biology can be made here without having to necessarily say they are scientifically equivalent. This also made me question a lot about whether health should be understood as just maintaining one specific internal condition or as the body’s ability to constantly and continuously adapt to different circumstances. 

I think one of the best examples of this kind of interconnectedness is metabolism. Even more so when looking at diabetes. During all of my substantial quantity of general biology, physiology, chemistry, and biochemistry classes, I've spent yet an even larger substantial quantity of time learning about glycolysis, gluconeogenesis, glycogenolysis, and the citric acid cycle. Now, when I first learned these, the pathways seemed to me like separate processes that I just needed to understand for my exams. However, while learning about diabetes, it helped me to appreciate how important they are for maintaining normal physiological functions. The body is constantly regulating glucose availability, energy production, and nutrient storage. And hormones such as insulin and glucagon are so critically important to coordinating these processes. In type 1 diabetes, autoimmune attack on pancreatic beta cells makes it so the body produces little, or no insulin. Type 2 diabetes is similar, although insulin can be made, cells become less responsive to insulin, and the pancreas can eventually struggle to make enough insulin to maintain normal blood glucose levels. A disruption such as this can affect multiple metabolic pathways and even eventually impact the cardiovascular, nervous, renal, and several other systems. I think something that stands out a lot to me is how something that involves the regulation of one molecule, glucose, can have such a widespread effect on the body. I think this helps me to recognize that even though we study each metabolic pathway individually, they are all working together to maintain homeostasis.

After learning about all of these metabolic pathways, it made me reflect about my own lifestyle. As a college student, I am constantly juggling classes, studying, work, exercise, and getting sufficient sleep. Finding a balance between these things is difficult. On some particularly busy days, it is often tempting to choose to eat whatever food is quickest or most convenient to make, rather than something that has better nutritional value to me. I think that before I studied metabolism in greater detail, I never really thought about how those decisions influenced the biological processes happening inside my body. I think now, I spend much more time and careful consideration on how nutrition, physical activity, and sleep are affecting my energy regulation and long-term health. I think that even though type 2 diabetes has loads of contributing factors, including genetics, and other circumstances that are outside of a person's control, it is important to maintain healthy habits that can help reduce its risk. I think this ties in nicely with ayurveda’s emphasis on lifestyle and maintaining that balance, since each of the perspectives, ayurvedic and biological, encourage each of us to consider how our everyday choices, behaviors and such influence our health over time. Now, something that I did begin to realize from some of the other topics that we covered is that lifestyle choices are only a part of maintaining health. There are many more biological and environmental influences that we don't always have complete control over.

Another topic that I found interesting was the human microbiome. In many of my biology and immunology classes, we spend a lot of time talking about pathogenic microorganisms, antibiotics, and how the immune system works and how it protects the body from infections. I think that learning about the microbiome challenged this perspective, since it highlights how dependent we are on microorganisms for our normal bodily functions. We have trillions of microorganisms that live on and inside the human body. Many of them contribute to digestion, metabolism, immune regulation, and protection against pathogens. In my immunology class, we talked about how microorganisms can have mutualistic, commensalistic, or pathogenic relationships with their hosts. Some of our beneficial bacteria help break down some otherwise indigestible food components and then make useful metabolites. Others occupy space and compete with potentially harmful organisms. I think learning about this definitely helped me to recognize that maintaining health isn’t just about destroying bad microorganisms, but also about maintaining relationships with the good ones that allow our bodies to function properly. I think its super interesting that organisms that we might normally link with disease are actually essential contributors to our health.

I think something that I found most interesting about the microbiomes is that two different people can have two very different microbial communities. Genetics, diet, medications, age, environment, and lifestyle can all influence what microorganisms we have in our bodies. What this can mean is that there isn’t a ‘gold standard’ for microbiomes that everyone should have, but it's more so that health can depend partly on how well a person's microbial ecosystem is doing within a person's body. If there were to be a significant disruption of this, also called dysbiosis, have been linked to several diseases. I think this made me think a lot about the concept of balance with ayurveda. Initially, I was thinking that the balance of the body was just functioning in a particular healthy state, but my understanding was reformed. If two healthy people can have vastly different microbiomes, then maintaining health certainly means that it does not require that they have identical microbiomes. I think it's much more that biological balance is about someone being able to regulate themselves and adapt to changing circumstances. I think that thinking about it this way makes a much stronger comparison between ayurveda and modern biology, more than just saying they both emphasize balance. 

While I was thinking about how the microbiome changes I was reminded about my experience of moving to Portugal. When I moved there I noticed a lot of differences in how my digestive system felt, and in the moment, I chalked these changes up to mostly stress, sleep schedule differences, or just getting used to a new environment. After we talked about the microbiome, I realized that the changes in my diet and the foods i was eating was influencing my gut microorganisms. Different microbes metabolize different nutrients, which means dietary changes can change the environment in which they live. Although I can't directly state that my microbiome was the culprit for the digestive changes I felt, I can certainly realize how complicated the relationship between diet, environment, and physiology can be. I think this also made me realize that things like antibiotics can also sometimes disrupt beneficial microbial populations in their quest to eliminate the harmful ones. I think that when I look back on my experience I think it is very possible that multiple factors went into my digestive changes rather than just one. 

I think that after reflecting and reviewing these topics from my undergraduate experience has helped me to gain a much broader understanding of what imbalance actually means. Ayurveda has helped me to think more critically throughout this whole process, and I think that revisiting my journals has helped me to appreciate how much more complex health is than simply just the lack of disease. I find that I am thinking more about the relationships between all the different bodily systems. Diabetes shows the importance of metabolic homeostasis, and the microbiome helps us understand our dependence on microbiota. I think that by combining these ideas, it helps realize that metabolism is influenced by microorganisms, and that chronic disease and stress can influence one another, and that biological balance doesn't always look the same for everyone. I think that my personal experience of moving to Portugal, being a college student balancing my responsibilities, and knowing people who live with diabetes has helped me to see these concepts in more real life situations. I would say that by far the biggest lesson that I've taken from these topics is that understanding disease is much more than being able to identify what biological process has gone wrong. It also is about recognizing how the disruption affects the rest of the body, affecting mental well-being, and their ability to function in a society. I think that as I continue to study biology and prepare for med school, i think keeping this broader perspective can help me understand my patients as individuals rather than just a collection of symptoms or medical conditions.