Curated Paper 1: Metabolism, Microbiome, and Ayurveda: The Big Picture

        For millennia, health and medicine have rested on the idea that parts of the body constantly communicate with each other and the environment. This perspective is central to Ayurveda, “The science of life,” and contemporary research likewise recognizes the connections between biological systems. As I continued my research on Ayurveda, one important tenet I came across was Agni (fire), which represents the biological or metabolic fire. Agni drives metabolic processes and, ultimately, health and vitality. This idea started to sound similar to what we know about the microbiome. In Ayurvedic philosophies, Agni governs distinct mechanisms such as ingestion, digestion, absorption, and assimilation. Ayurveda emphasizes that proper digestion is vital to preventing disease, so when Agni becomes imbalanced, it can lead to Ama, a toxic, undigested byproduct. My first impression came as I read about the disruptions of these processes in my microbiology class and our discussion of dysbiosis. Perhaps even more significant than recognizing the interconnected nature of these processes is the idea of utilizing our modern understanding and investigative tools to improve overall individual health. Through my journaling, I noticed that observations and experiences I have had in my own life fit nicely within both the Ayurveda framework and the study of pathology and disease lifecycles.

Which comes first…the chicken or the egg?

At first, you might think this sounds like an opening line to a comedy act, but practitioners of Ayurvedic medicine would argue this is no laughing matter. This paradox is very similar to what we know about the microbiome. I started to wonder whether certain diseases lead to an imbalance in the microbiome, or whether the imbalance in the microbiome leads to the disease.  Research shows that when the microbiome is in a state of equilibrium, it performs essential processes that improve metabolism, immunity, cardiovascular health, and brain health. Conversely, when the microbiome is out of balance, dysbiosis can occur and may contribute to inflammatory and gastrointestinal issues. Growing up on a farm, my parents often credited being around animals and outside with making us so healthy. I didn’t care much about the idea at the time, but as we started our discussion of the microbiome, it made me curious if my childhood environment had any significant influence on my microbiome. For instance,  I come from a long line of farmers, and riding horses and playing in the feedlot were weekly activities. My cousins, however, did not grow up on a farm, and when they would visit, they struggled with hay fever and other allergies. This didn’t make much sense to me at the time, but recent studies refer to this phenomenon as the “farm effect.” An article from Pediatr Allergy Immunol discusses how lipopolysaccharides (LPS), which are bacterial components found in rural environments and farm animals, get tracked into the house and accumulate on bedding. Notably, higher levels of LPS were associated with reduced risk of allergies and asthma. The researchers found more microbial diversity in the children on the farm when compared to children not on a farm. The repeated exposure to bacterial microbes may help train the body's immune system not to overreact to everyday allergens. Notably, the influence of these microbes is particularly influential during early development. 

The idea that there are beneficial bacteria from nature and animals seemed counterintuitive, especially considering the importance these microbes have in early childhood. This raised the question: why is early exposure important for development? Interestingly, beneficial bacteria can be passed through the mother's breast milk to her newborn and can help shape the infant's gut microbiome. When infants digest their mother's breast milk, their gut microbes produce compounds that may influence serotonin signaling, which is important in healthy brain development. What I found most interesting from this connection was that early disruptions of these processes may influence the risk of neurodevelopmental disorders. This research helped me understand how breast milk can greatly influence the development of a healthy gut microbiome and overall health of a growing child. However, I wasn’t sure if these same levers could be pulled when disease has already set in. 

As we began our study of metabolism, I was shocked to learn that one of the most economically and socially devastating metabolic diseases is diabetes. Diabetes is often thought of in terms of type 1, type 2, blood glucose, insulin, and other complications when metabolism is imbalanced. In endocrinology, we learned that removal of the pancreas in animals led to what we know as diabetes, highlighting the pancreas’s role in regulating blood glucose. Before insulin was available, type 1 diabetes was essentially fatal. The discovery of insulin was lifesaving, but as time went on, the cost of insulin started to increase. Recent research emphasizes how the increased cost of insulin has created a barrier to treatment for many individuals with diabetes. An article in Endocrinology and Metabolism Clinics of North America reported that about 25-30% of Americans skip or ration insulin because of its cost. Not only is it a cost concern, but rationing medication increases the risk of complications and developing other diseases. This shows how diabetes is much more than managing a disease, but a debilitating financial obligation. Beyond the individual financial burdens, population studies on diabetes found that glucose-lowering medications and supplies were 17% of the total direct medical costs attributable to diabetes, suggesting most costs came from other diabetes-related healthcare expenses. As a college student, I recognize how even little inconveniences or unexpected financial events alter my budget for necessities. It’s difficult to imagine how different my life would be if managing a chronic illness and its costs weren’t an option. This understanding of diabetes helped me recognize that improving the lives of others requires more than just insulin and other medications. It requires addressing broader socioeconomic barriers and manageable healthcare costs. 

Connection to Ayurveda

        As I thought about these physical and economic imbalances, I started to consider the idea that these burdens may have psychological effects. Chronic psychological stress can significantly influence the gut microbiome, contributing to gastrointestinal and immunological issues. These processes are mediated by what is referred to as the gut-brain axis, through which the brain and gut can communicate through bidirectional signaling. As I investigated the relationship between stress and metabolic health, I found a study that analyzed changes in the microbiome resulting from psychological stress in healthcare workers during COVID-19. This helped me see another angle to metabolic diseases, as they found that severe psychological stress was associated with persistent depletion of some beneficial bacteria. The deficiency of these bacterial species is similar to the gut dysbiosis in inflammatory bowel disease (IBD). Notably, while the psychological symptoms fluctuated, they found that changes in the gut microbiome persisted for six months. Although this study doesn’t investigate individuals with diabetes directly, it made me consider the additional effects of stress and how it connects to broader aspects of health. I found this connection between the gut microbiome and the brain interesting, as this interaction reflects principles rooted in Ayurveda. 

    

        As I studied different areas of the body, I began to see how diet, exercise, socioeconomic factors, and the environment are all connected. I’ve come to learn that Ayurveda goes beyond disease and offers a framework for health and well-being. Blended with modern scientific wisdom, some Ayurvedic practices support restoring balance between metabolic and other biological systems to improve health.