How Balanced is "Too Balanced?"

How Balanced is “Too Balanced?”

By: Vanessa Kirkby

Ayurveda is a traditional Hindu form of medicine that uses balance in all forms as its root. When I hear “balance” I imagine a man of the martial arts standing on a narrow beam; one leg in the air, and refusing to give in to gravity, or the wind, or any other outside force. I think of keeping things completely even, and listening to the natural signs of the earth. While all of these things may sound cheesy, this is what I have been conditioned to think of when I think “balance.” On the other hand, when I think of balance in science, I automatically think of homeostasis and equilibrium. As these concepts are applied to my studies of disease and human system processes I begin to connect the mental and emotional world with the physical world of science.

In biochemistry, it is taught that when a body reaches equilibrium life cannot exist. Life is driven by an imbalance, always striving to restore balance to the earth. If all systems were constantly in a state of equilibrium there would be no reason to exchange oxygen, or take in glucose, or create hormones for regulation. In perfect equilibrium, what is there to be regulated? Homeostasis, on the other hand, we are taught is absolutely necessary for life. Once we break outside of homeostasis, we are outside of the conditions required for life. So, what is the difference between equilibrium and homeostasis? How do we find the right amount of balance for optimal life and growth? Studying different diseases of the human body and its diseases can help to show the boundaries set by nature, that must be obeyed.

Diabetes is a disease that affects the human body’s use of glucose. This is the perfect disease to study in terms of balance. As we feed our bodies glucose, insulin is required to let the glucose into the cells to be used for the energy the glucose is intended for. When our cells cannot properly use this glucose, it will begin to build up in the bloodstream. Besides the fact that there is no insulin to provide access into the cell bodies, there is also no feedback to tell our bodies what to do with the glucose, or what hormones are needed to regulate. This imbalance in hormones and glucose causes many problems with those who have the disease. Diabetes presents itself in many forms. The main form of diabetes is “diabetes mellitus,” and it has two types, referred to as Type I and Type II diabetes.

I was very unaware of how prevalent diabetes is in our society until I attended college outside of my home town and met new people, many of which were affected by Type I diabetes. This fascinating illness requires its victims to be very aware of the state of their blood and glucose levels at all hours of the day. Failure to keep up with the status of their blood glucose levels results in things such as passing out, failure of immune system, organs shutting down, and for some, hallucinations and drowsiness. This is crazy! I have never known my blood glucose levels, because my body takes care of that for me. I don’t have to inject anything before I eat, and besides trying not to gain weight, I don’t have to really worry about what/how much I eat in a day. Why do I deserve to be lazy with keeping in touch with my body? As I studied diabetes and pondered these questions, I realized that I do keep in touch with my body. I just don’t have to see the numbers to do that, and many diabetes patients will tell you the same thing. When we make a cognitive effort to listen to the signals our bodies send us, we can know when something is off. This is the first step to finding Ayurveda, or balance in life: Connect the emotional to the physical. Be aware of what your body is telling you.

Diabetes has an especially strong relationship to finding balance when we look at Type II diabetes. Type I is congenital, and cannot be prevented, only treated for a lifetime. Type II, on the other hand, is acquired. Type II diabetes often occurs in people with a sedentary lifestyle or those who are obese. This is a form of diabetes that can be prevented, and can even be reversed. These patients have control! They have a choice. The control lies in lifestyle. Exercise is a mandatory part of caring for our bodies, and will be included in almost any Ayurveda study, or study of a balanced lifestyle. We have all heard it time and time again: we must have a balanced diet, and we must exercise regularly. Believe it or not, these things are all contributing factors to the state of our economy. Billions of dollars a year are contributed towards the healthcare of patients who are unhealthy due to lifestyle. Balance of all things are connected and tightly intertwined.

A balanced diet, a balance in priorities and fitness, a balance in blood sugar. What happens when the driving force for all of these stops? What happens if your form of balance is the same as the man standing on the post, and once you reach your blood glucose/insulin balance you stop eating? Once you reach your balanced diet goals you maintain by never switching it up? Once we feel we are balanced we stop trying? The matter of fact is that we are surrounded by driving forces. Our environment is always changing, and our mental ability speaks to us and reminds us that one time of finding balance is not enough. We must keep trying, continue striving for that equilibrium that is written in our DNA. This is only possible through connecting our minds and our bodies, and finding the balance between controlling our bodies and listening to them. We will continue to research ways to prevent and cure disease, but amongst the research and the studies, we must take time to listen to people. To feel, and think with our human brains, and not our experiments. This is where we will find the perfect amount of balance.

Metabolism and Diabetes

The metabolism is an important process that needs to occur for the body to function properly.  The body, more specifically, cells, are continuously carrying out these reactions by building and breaking down molecules for necessary cellular processes.  All these cellular processes create the metabolism.  Proper metabolism function allows for the body to be healthy and strong.  Without proper metabolism function, the cells will begin to have problems.  These abnormalities could lead to problems for the body like disease or even death.  Explained through Ayurveda, many seem to believe that the cause of disease is the lack of proper cellular function or because of the presence of toxins.  Ayurveda is perspective that can help individuals broaden their perspective when discussing things like disease and the human metabolism.

Diabetes is a disease that occurs when your blood glucose levels are too high.  Your body is no longer able to utilize glucose and control the glucose levels, and too much glucose causes problems for the individual.  In terms of Ayurveda, your body’s balance was interrupted from the increase in glucose levels.  There are two different types of diabetes, Type 1, when the pancreas is not producing insulin and Type 2, when there is an insulin resistance in the body.  The two Types are different from each other from their onset to their prevalence although both affect the glucose levels in the body.

Something that I found interesting when researching metabolism and diabetes was that there are more concerns regarding individuals that have diabetes than just the biology of the disease.  It was interesting that the most common diseases that affected individuals was related to physical inactivity.  Physical inactivity has a very negative, dramatic effect on the body.  The economic cost that diabetes caused was very shocking and surprising.  In “Diabetes Beyond Biology”, it stated that the annual cost of caring for people with diabetes was about 2.3 times higher than other patients.  I was not aware that the cost was that much higher.  The commonness of diabetes also increases the impact of the higher cost. 

The purpose of the research titled, “Economic Cost of Diabetes in the U.S. in 2012” was to update any previous estimates of the cost of diagnosed diabetes cases in 2012.  They looked at diabetes prevalence, epidemiological data, health care cost, and economical data.  The study concluded that the estimated total economic cost of diagnosed diabetes in 2012 was $245 billion.  This was a 41% increase from their previous estimate.  This shows the burden that diabetes imposes on society, the economy, and the healthcare industry. Some other components of burden that were not included in the study could include, pain and suffering, like mental health, re-sources from care provided by nonpaid caregivers, and the burden associated with undiagnosed diabetes.  This research and study show that diabetes does have an impact not only on the biological health of the individual but on the economy as well.

When reading about diabetes and its side effects, I also found it interesting that people with chronic medical conditions have a higher risk of depression.  Through further research, the National Institute of Mental Health stated that this is because they may have difficulty adapting to their chronic illness and an increase in their medical costs.  They wrote about hoe illness-related anxiety and stress can trigger symptoms of depression in some individuals.  The increase in health-related problems caused by disease also shows the imbalance that Ayurveda strives to maintain.

In learning about diabetes and Ayurveda, diabetes could be described as the disorder in the individual’s metabolic pathway.  An individual with healthy glucose levels could be describes as having order within their metabolic system and order within the body as a whole.  When healthcare experts understand the nature and structure behind the disorder, like diabetes, order can be reestablished to the person with the chronic illness. 

Curated Paper 1: Ayurveda and Metabolism

What is Ayurveda

Ayurveda, what is it? Its definition is as follows: The traditional Hindu system of medicine, which is based on the idea of balance in bodily systems and uses diet, herbal treatment, and yogic breathing. In the context of this course, I think Ayurveda is a perspective that can enhance the study of disease. We are only beginning to understand the complexity with which the human body operates. Studying disease with a holistic perspective is helpful, especially for health care providers. Humans are very complex and their health is affected by a multitude of factors. A patient’s stress from their job could be a bigger issue to their overall health than anything going on inside their body.  I am going into health care, specifically, I am going to be attending an osteopathic medical school next fall. One thing that attracted me to osteopathic medicine was the idea of holistic medicine. Behind every disease is a person with stress from family and work life and a lifetime of environmental and genetic factors that have affected them. As a health care provider, you are not only treating the disease but the entire person. 

 Your Gut and Mental Health- A Connection

It is estimated that nearly one-third of primary care physicians(PCPs) patients are mental health patients( Abed et.al 2010). I currently want to go into primary care, and thus am trying to gain a good understanding of mental health and the various diseases within the discipline. I have shadowed several primary care physicians and I can attest to the statistics found in the study listed above, whether it is a middle-aged woman feeling down for prolonged periods of time, for now, reason, or a suicidal teenager, PCPs see many mental health patients every day. I think it is particularly important to look at mental health issues with the perspective of Ayurveda. When I have been in exam rooms and listened to PCPs evaluate mental health patients they try to get a good understanding of all the factors in that person's life that are contributing to the issue. People and their emotions and feelings are very complex and I can think of very few circumstances where an imbalance of these two things are caused by any single factor. 

One factor that can affect mental health is the types and numbers of bacteria living in your gut. Kind of crazy, hu? In a paper titled The microbiome-gut-brain axis: from bowel to behavior by Cryan and O’Mahony, the authors outline the relationship between gut microbiota and behavior. Stress, anxiety, and diseases of the nervous system are all starting to be shown to be connected to imbalances in the microbiome. Mice models are the primary means by which we are conducting studies on the gut microbiome and its relationship to the brain. The conclusion of this paper was that more research needs to be done on the microbiome in order to effectively understand the gut-brain axis, but that this is a very promising and exciting new avenue of understanding human illness. Further studies will help to develop treatments of disorders that are a result of a miscommunication between the gut and the brain. 

New connections are being found every day and new factors are being shown to influence the development and progression of different diseases. The metabolic pathways of the human body are so interconnected and intricate that it is really surprising that new connections are being found every day! As I said in the opening of this post, I truly believe that learning about and treating disease with the perspective of balance is insightful and important! The rest of this post I would like to discuss the microbiome and it’s incredible connections to human health and wellbeing. 

The Microbiome and Its Connections

The microbiome truly is a fascinating phenomenon of the human body. The more research I see that is done on the microbiome, the more fascinated I become. The Microbiome has been linked to mental health (as we discussed above), sleep, the immune system, cardiovascular health, and cancer. First, we will discuss the link between the microbiome and sleep. 

The past year I have worked as a sleep technician conducting studies that were used to treat and diagnose sleep apnea and other sleep disorders. Sleep is such a fascinating phenomenon, I personally like to call it human death rehearsal. One specific study exploring this connection that I found particularly interesting used mice to explore the relationship between Odoribacter and the abundance of sleep(Bubier et al 2020). The study found a correlation of disease-related traits with underlying biomolecular and microbial characteristics. The gene QTL Micab7 on chromosome 7 is associated with the relative abundance of Odoribacter, and this study showed a relation between this gene and sleep as well as obesity. The methods in this study helped me to answer the question of how one would go about testing individual relationships between specific genes, microbes, and phenotypes. 

Another Interesting connection is between the microbiome and weight gain and weight loss.  A study titled Gut Microbiota from Twins Discordant for Obesity Modulate Metabolism in Mice, explored the relationship between weight gain/loss and the microbiome of mice. Groups of germ-free mice were cultured by fecal microbiota from an obese or lean mouse. The mice who were cultured with the microbiota of obese mice had a greater increase in body mass. These findings are extremely interesting. And the implications for medicine are the new use of fecal transplantation therapies being used to treat a wide range of diseases and disorders. 

The last connection we will discuss here is the connection between the immune system and the microbiome.  In the study, Microbiome and the immune system: from a healthy steady-state to allergy associated disruption,  A line in the abstract caught my eye. The authors stated that the microbiome and the immune system are constantly shaping each other. I had never thought about the microbiome in this way, but it is a balance between the immune system allowing certain good bacteria, and killing bad bacteria. The main focus of this paper was to discuss the connection between microbiome and allergies. Allergic diseases have increased in the last half-century. The authors say that many factors contributed to this. The paper outlines and explains many different interactions. One section I found particularly interesting was the connection between the skin microbiome and atopic dermatitis. I have read and researched what can happen when the gut microbiome gets disturbed, but I never thought about what can happen when imbalances of the skin microbiome occur. This paper outlines the specific interactions and imbalances in skin microbiota that can cause disease. I also found the section on allergic diseases of the airways intriguing. This paper mostly focuses on the role of the microbiome in severe asthma. I had never considered that an imbalance in the airway microbiota could cause asthma. This is an intriguing field of study for developing better treatments and maybe even cures for asthma in the future. 

There are many more studies outlining the various connections between the microbiome and the genesis and progression of various diseases and ailments, and new connections are being found every day! Connections have been shown between the microbiome and the heart (Peng et al 2018), brain development in young children (Wang et al 2018), and bowel disorders (Bhattarai et al 2017). The increasing amount of papers published on the microbiome is telling of the scientific communities interested in this idea of balance and connection. I personally am really excited to see more research on the microbiome and to use the information that is gained from this research to help give patients more holistic and effective care. 

 Abed Faghri, N. M., Boisvert, C. M., & Faghri, S. (2010). Understanding the expanding role of primary care physicians (PCPs) to primary psychiatric care physicians (PPCPs): enhancing the assessment and treatment of psychiatric conditions. Mental health in family medicine, 7(1), 17–25.

Bubier, J. A., Philip, V. M., Quince, C., Campbell, J., Zhou, Y., Vishnivetskaya, T., ... & Foster, C. M. (2020). A Microbe Associated with Sleep Revealed by a Novel Systems Genetic Analysis of the Microbiome in Collaborative Cross Mice. Genetics, 214(3), 719-733.

Ridaura VK, Faith JJ, Rey FE, et al. Gut microbiota from twins discordant for obesity modulate metabolism in mice. Science. 2013;341(6150):1241214. doi:10.1126/science.1241214

Peng, J., Xiao, X., Hu, M., & Zhang, X. (2018). Interaction between gut microbiome and cardiovascular disease. Life sciences, 214, 153-157.

Wang, S., Harvey, L., Martin, R., van der Beek, E. M., Knol, J., Cryan, J. F., & Renes, I. B. (2018). Targeting the gut microbiota to influence brain development and function in early life. Neuroscience & Biobehavioral Reviews, 95, 191-201.

Why African Americans are at Risk for Diabetes

Diabetes runs in my family, so I have experience with the illness. My maternal grandmother has diabetes. My mother developed gestational diabetes and had an 11-pound baby as a result, later she developed type 2 diabetes. My paternal grandmother had diabetes and died after having a hypoglycemic event which was treated with more insulin by inexperienced doctors and led to insulin shock.

As a child I was terrified of this illness. I knew it was in my blood and the prevalence of it in my family made me feel like developing the illness was inevitable. I remember measuring out sugar in my tea, restricting how many Sprites™ I could have per day, and the emergency Sweet & Low™ packets my mother would give to me to keep in my backpack. But despite all my efforts I still feel like it is not enough. There is a biological or environmental difference between my peers and I which makes my family and I more susceptible than others. I will explore these differences in this paper.

In the US women and African Americans are at the highest risk for diabetes. I believe that it is because of a culture which promotes overweight women, sugar, and poverty. In a CDC study titled, Do Black Women’s Religious Beliefs About Body Image Influence Their Confidence in Their Ability to Lose Weight?, it is explained that overweight black women in America are the least concerned about their and have the highest self-esteem (pp. 1). In 2018, 50 percent of African Americans were obese, a number that exceeds other races by a small percentage. According to an article titled, “Mechanism Linking Diabetes Mellitus and Obesity,” fat tissue can secret hormones that affect insulin sensitivity. Non-esterified fatty acids (NEFAs) which is an element of fat stores in the body increase in bigger people and that increase is directly linked to an increase in insulin insensitivity. NEFA leads to a loss of function in pancreatic beta cells as explained in this quote, “the continuous exposure to NEFAs is related to significant malfunction in glucose-stimulated insulin secretion pathways and reduced insulin biosynthesis.” If obesity can increase one’s risk of diabetes, then a fatter population who is unwilling to change is more likely to be diabetic.

African Americans are also poorer than their white counterparts in every state. Poverty promotes a sedentary lifestyle coupled with low quality, highly processed foods which results in obesity.  To further support my assertion, Mississippi, the poorest state in the US, also has the highest rates of obesity at 39.5 percent and West Virginia, the second poorest state, is tied with Mississippi with an obesity rate at 39.5 percent. In an article called, Obesity and Poverty Paradox in Developed Countries, the authors explained that obesity in developed nations is because of “…the easy availability and low cost of highly processed foods containing ‘empty calories’ and no nutritional value.” The empty calories being referred to is sugar. Sugar is a cheap ingredient with many benefits to food manufacturing. It absorbs water which reduces microbe activity, preserves colors in frozen foods, adds bulk and texture to baked items, and enhances the taste of low-quality ingredients. Sugar is one of the easiest consumables to produce; table sugar is made by pulverizing sugarcane and then boiling it until crystals form. This process is so simple the average American could do it in their kitchen. Effortless production and multiple uses make sugar a necessity in foods for low income communities. A survey in 2005 called “Interrelationships of Added Sugars Intake,” concluded that a low socioeconomic background was linked to higher added sugar consumption in diet. The random clustered survey of 28,948 participants revealed that African American women and men reported the highest rates of sugar consumption in America. Asian Americans, a group with the highest income, reported the lowest added sugar intake. The assumption to make is quality of food increases with quantity of income.

The questions asked in the 2005 survey pertained to soda and fruit juice because a previous survey in 2001 indicated that these items contributed to the majority of added sugar consumption. Consumption of sugary beverages increases a person’s chances of developing type 2 diabetes by up to 25 percent as shown in a meta-analysis by the Journal of Diabetes Investigation. Table sugar is a disaccharide made of fructose and glucose. When table sugar is consumed, enzymes in our bodies break apart the dimer. Studies show that it is the fructose, not glucose, that leads to type 2 diabetes. A study performed by the Journal of Clinical investigation had subjects consume sugary drinks with just fructose or glucose which composed of 25 percent of their energy intake. Fat in the liver and in the abdomen surrounding organs increased by 10 percent after 10 weeks for those that drank beverages with fructose. Insulin sensitivity also increased in the animals consuming fructose but not with those that consumed glucose. The liver, being the only organ that can break down fructose, can become overworked, turning the fructose into fat. This explains why fatty liver was observed.

 The results of the studies imply diabetes will increase. Sugar is now being replaced with high fructose corn syrup 55 (HFCS), which has a 5 percent high concentration of fructose than sugar. The switch will affect lower income people the most since HFCS is reported to taste sweeter than table sugar. Less HFCS is needed to produce a desired flavor making it cheaper than sugar. A peer reviewed article from the Global Public Health journal in 2012 concluded that type 2 diabetes increased by 20 percent in countries with HFCS widely available.

The economic implications of obesity and diabetes keeps families in a cycle of generational poverty. In the words of James Baldwin “Anyone who has ever struggled with poverty knows how extremely expensive it is to be poor”. In 2012, the annual medical expenditure per person for diabetes was $13,700. The US Department of Health and Human Services states that the US federal poverty line per person is $12,500. If a person who is suffering from diabetes makes $13,000, then they cannot afford diabetes treatments, but they also make too much to be awarded government assistance. They cannot work more to supplement the loss of income due to medical bills since people with chronic illnesses take time away from work when faced with complications of that illness causing them to miss out on much needed income. The American Diabetes Association in 2012 claimed that diabetes resulted in up to 7 percent of workdays missed. If a person works 8 hours a day 5 days a week on minimum wage at $7.25, 7 percent of missed workdays is the equivalent of $1056 removed from their annual salary. Patients may go into medical debt or the unpaid portion of their care can become a burden on the family. The family will have less disposable income, be thrown further into poverty, and increase other family members’ chances of developing type 2 diabetes. One person’s issue becomes a community problem.

In medical anthropology, we are taught that healthcare is not a mechanical process and diseases never affect two people the same way. There is a link between disease vulnerability and social vulnerability and the link between certain groups of people and diabetes is poverty. Diabetes has always been considered a disease of affluence because to overconsume one must overspend. From a global point of view, that is the case as diabetes only affects developed nations. But within those nations diabetes is a disease of impoverishment. Diabetes affects those that cannot afford good quality foods and good quality medical care.

References

Al-Goblan, A. S., Al-Alfi, M. A., & Khan, M. Z. (2014). Mechanism linking diabetes mellitus and obesity. Diabetes, metabolic syndrome and obesity : targets and therapy, 7, 587–591. https://doi.org/10.2147/DMSO.S67400

American Diabetes Association (2013). Economic Costs of Diabetes in the U.S. in 2012. Diabetes Care, 1033-1046.

 

Bauer AG, Berkley-Patton J, Bowe-Thompson C, Ruhland-Petty T, Berman M, Lister S, et al. Do Black Women’s Religious Beliefs About Body Image Influence Their Confidence in Their Ability to Lose Weight? Prev Chronic Dis 2017;14:170153.

Goran, Michael I, Stanley J. Ulijaszek & Emily E. Ventura (2013) High fructose corn syrup and diabetes prevalence: A global perspective, Global Public Health, 8:1, 55-64, DOI: 10.1080/17441692.2012.736257

Institute of Food Technologists (IFT). (2015, August 18). Five reasons why sugar is added to food. ScienceDaily. Retrieved June 4, 2020 from www.sciencedaily.com/releases/2015/08/150818131807.htm

Silverman, Jacob, "How Sugar Works" 30 March 2009.
HowStuffWorks.com. <https://science.howstuffworks.com/innovation/edible-innovations/sugar.htm> 4 June 2020

“Sitagliptin: MedlinePlus Drug Information.” MedlinePlus, U.S. National Library of Medicine, 15 Mar. 2015, medlineplus.gov/druginfo/meds/a606023.html.

Stanhope, K. L., Schwarz, J. M., Keim, N. L., Griffen, S. C., Bremer, A. A., Graham, J. L., Hatcher, B., Cox, C. L., Dyachenko, A., Zhang, W., McGahan, J. P., Seibert, A., Krauss, R. M., Chiu, S., Schaefer, E. J., Ai, M., Otokozawa, S., Nakajima, K., Nakano, T., Beysen, C., … Havel, P. J. (2009). Consuming fructose-sweetened, not glucose-sweetened, beverages increases visceral adiposity and lipids and decreases insulin sensitivity in overweight/obese humans. The Journal of clinical investigation, 119(5), 1322–1334. https://doi.org/10.1172/JCI37385

Thompson, F. E., McNeel, T. S., Dowling, E. C., Midthune, D., Morrissette, M., & Zeruto, C. A. (2009). Interrelationships of added sugars intake, socioeconomic status, and race/ethnicity in adults in the United States: National Health Interview Survey, 2005. Journal of the American Dietetic Association, 109(8), 1376–1383. https://doi.org/10.1016/j.jada.2009.05.002

Wang, M., Yu, M., Fang, L., & Hu, R. Y. (2015). Association between sugar-sweetened beverages and type 2 diabetes: A meta-analysis. Journal of diabetes investigation, 6(3), 360–366. https://doi.org/10.1111/jdi.12309

Wilcox G. (2005). Insulin and insulin resistance. The Clinical biochemist. Reviews, 26(2), 19–39.

Żukiewicz-Sobczak W, Wróblewska P, Zwoliński J, Chmielewska-Badora J, Adamczuk P, Krasowska E, Zagórski J, Oniszczuk, A, Piątek J, Silny W., Obesity and poverty paradox in developed countries. Ann Agric Environ Med. 2014; 21(3): 590–594. doi: 10.5604/12321966.1120608

Curated paper #1 - Ayurveda and Diabetes

Amandine Venisch

Dr. Karpel

BIOL 4500

Metabolism

Ayurveda and Diabetes

Ayurveda is an ancient system of medicine, it originated in India about 6000 years ago and focus on the individual as a whole and the connection between the body and its environment. It embraces the idea of a connection between different parts of the body as well as a connection with our environment. For my research however, I mostly focused on the nutrition/healing part of Ayurveda as more research has been done on this subject comparing to the connectivity mind-body and environment, as it is harder to do a research project on this subject.

The effectiveness of Ayurveda is controversial subject in the scientific community. Many scientific articles claims its efficacy to treat different diseases using different Ayurvedic herbs, for example this article, titled “Clinical efficacy of Ayurveda treatment regimen on Subfertility with poly cystic ovarian syndrome (PCOS)” written by Siriwardene and al., that claims 85% of women with PCOS were cured after this Ayurvedic treatment. On the other hand, multiple article also talks about the problem of regulation of some Ayurveda herbs, as there are a vast amounts of different herbs in Ayurveda, it is difficult these days to confirm the origin and the authenticity of the product that is sold as Ayurvedic treatments. This could also be a problem for scientific studies as it is impossible to prove the effectiveness of these treatments without product regulation. In my opinion, it is a very interesting approach to medicine, and there may be some very effective treatments that we could find from Ayurveda, but we definitely need regulation and more studies on the subject!

The second subject of research was diabetes, a very well known disease that is affecting millions of people worldwide. As we know, diabetes affects the Human body in many ways, from serious damage to the eyes to liver diseases and even death. Before modern medicine, records show that most diabetes patients (about 90%) turned blind without an effective treatment. Today, people affected by diabetes have a normal life and effective treatments are available to treat the disease, but diabetes also have a huge economic impact on someone’s life, as insulin prices tripled in the last ten years, and could be economically devastating for people on limited income.

Prevention and getting children and adults more active has been a big thing in numerous different countries to reduce the rising occurrence of diabetes. In this article, written by Lindström and al. on the prevention of diabetes called “Sustained reduction in the incidence of type 2 diabetes by lifestyle intervention: follow-up of the Finnish Diabetes Prevention Study”, more than 500 men and women were followed for up to 7 years and randomly assigned either diet, exercise, or diet+exercise, and also a control group. Results showed a decrease of type two diabetes by 31%, 46% and 42% respectively. The findings of this study is reinforcing the idea of diet, and exercising being a huge part of reducing the risks for diabetes, and a good hygiene of life, a balanced diet and a moderate amount of exercise can significantly decrease health risks and can overall increase the quality of life. 

Diabetes were discovered in the late 1890, early 1900, this is a very short time and today, we understand diabetes better than ever before, but a lot more research needs to be done to find a lifelong remedy that could maybe prevent or cure both types of diabetes. Until then, a good diet, regular physical exercise and an overall good hygiene of life is essential if we want to reduce the growth of diabetes.

References

Siriwardene, S. D., Karunathilaka, L. A., Kodituwakku, N. D., & Karunarathne, Y. A. U. D. (2010). Clinical efficacy of Ayurveda treatment regimen on Subfertility with poly cystic ovarian syndrome (PCOS). Ayu, 31(1), 24.

Lindström, J., Ilanne-Parikka, P., Peltonen, M., Aunola, S., Eriksson, J. G., Hemiö, K., ... & Louheranta, A. (2006). Sustained reduction in the incidence of type 2 diabetes by lifestyle intervention: follow-up of the Finnish Diabetes Prevention Study. The Lancet, 368(9548), 1673-1679.

Balance as Nature Provided

Sandon Stokes

Curated Paper #1

Balance as Nature Provided

The earth holds an outstanding abundance of diverse ecological systems teaming with millions of different species from microorganisms to the largest of mammals. These ecosystems require a balance of many different factors from the amount of sunlight received each day, precipitation, predator-prey relationships and adequate habitat. When the ecosystems are in balance with vital factors, life flourishes and species thrive. On the other hand when some of those conditions are not met or there is too much of something disorder occurs. For example, if all the top predators are removed from a jungle the prey they once fed upon becomes overabundant with no limit to their reproduction causing damage to underlying food networks. These trophic cascades are intricate and very complex, but one thing is obvious, they require balance. 

Of the most complex organisms on planet Earth is the human body. With 11 different organ systems and over 200 different cell types we are in a sense our own ecological system. Much like the ecosystems in nature, the human body requires optimal conditions to thrive and live. Some of those basic conditions include air, water, food and shelter. It is obvious to us that when these basic conditions are not fulfilled there is disorder and surmountable distress caused even to threaten human life. 

Now, not all of the conditions of the human body are that severe in their consequences. Much like the ecosystem in nature if one piece of the puzzle is missing the system doesn’t automatically collapse, but it does cause an amount of distress to disrupt the natural balance of the community. This is the same way with the human body. When vital conditions are not fulfilled or are over abundant the result is not death but a lesser form called disease. Thus the ecosystem of the human body requires a balance to remain in a stable healthy condition.

Humans evolved from living in hunter gatherer societies that are drastically different from our modern society. In this kind of society they relied on hunting, fishing and foraging for nutritious vegetation as their sources of food. Groups of people travelled many miles to find food and were consistently changing areas where they lived. They also lived in small tight knit communities where everyone played a role and was important for the survival of the group. This way of life is very different from our current culture, we essentially may not fit for our current modern life. The way we now live may be out of balance to how evolution was built for millions of years. Thus, as we see that an ecosystem without balance leads to disorder and chaos and the same may be true for the human race. 

In our modern society one of the fastest increasing diseases is Obesity. According to the National Institute of Health 1 in 3 adults are reported to be obese and and this rate has been steadily increasing over the last 50 years. Obesity is defined by a person having a body mass index (BMI) greater than 30 with excess amount of body fat. Obesity is a disease that has been generally referenced to people who have a lack of willpower and discipline when it comes to diet, but there are actually a lot more factors that play into the disease. Some of those factors include, nutritional content of food, stress and the microbiome of the digestive tract.

A common misconception of the nutrition field is that all calories are created equal, but current academic research has shown otherwise. Diets high in fat, moderate protein and low carbohydrate have shown to be more effective in fat loss than standard diets while both are maintaining the same caloric load. Diets like this are similar to what our hunter gatherer ancestors would have found available to eat travelling place to place. This finding is hypothesized that eating this way has more nutritional value than standard diets and allows for better uptake of minerals and vitamins which allow the body to work more efficiently. Nutrition plays into the balance of the human body, when the body has the correct nutrients available it functions better.

Another factor that contributes to obesity is the amount of stress in daily life. While stress responses are natural for the human body during times of immediate danger, like getting chased by a lion, but if that response is left on too long those stress hormones can wreak havoc. One symptom of chronic stress is weight gain. This is caused by stress hormones stimulating hunger signals constantly leading to overconsuming nutrients even though the body has more than enough. 

The last factor to note is how the microbiome in the digestive tract can influence metabolism. The microbiome is heavily influenced by the diet and environment which surround us. Within the microbiome there are many different bacteria that communicate and work with the human body in intricate mechanisms. Scientific research is just barely starting to understand how it influences disease like obesity and other metabolic syndromes. One interesting new finding is that people who are obese have very different microbiomes than those people who are normal weight. Researchers even went a step further into testing to see if transplanting the microbiome of a lean person into an obese person would have an effect. This this process know as a Fecal Microbiota Transplant (FMT) showed that obese patients who recieved the transplant lost a significant amount of weight than those who had a placebo while neither group changed diet or activity levels. This is a preliminary new finding, but quite interesting to see how the microbiome influences the metabolic processes as welll.

Another imbalance that is the seventh leading cause of death in the United States is Diabetes. This disease is characterized by the human body’s inability to utilize glucose in the body. This is caused by the pancreas not producing insulin (Type 1) or by insulin resistance (Type 2). Both are denoted by high blood sugar levels and can lead to neuropathy, cardiovascular disease and even Alzheimer's disease. In type 2 diabetes, there is an excess amount of glucose in the blood, more than the body can handle at a time. When the blood sugar is out of balance, damaging inflammation is triggered leading to a cascade of other maladies. Because our modern way of eating is drastically different then our evolutionary diet, the body is essentially not made to handle such levels of sugar in the common diet. The majority of sugar found by our ancestors would have been in fruit which wasn’t always in season. Cheesecake and ice cream were not something they were able to forage for or hunt down so thus the modern nutritional intake may not be in balance from which evolution granted. 

Treatments of diabetes include a number of prescriptions that lower blood sugar and allow the body to use glucose more efficiently. With these medical treatments though, there are a multitude of side effects ranging from weight gain to liver disease. New diet and exercise therapies are being researched to control diabetes without medication. One such diet of interest is the Ketogenic Diet with less than 10% of the energy obtained come from carbohydrates. Carbohydrates are our main source of sugars and energy in the diet but if not kept in check could lead to high blood sugar. Research has shown that this diet lowers blood glucose levels in diabetes patients better than medication in some cases without the side effects. This may be because the way of eating closely resembles to how people ate for thousands of years prior to industrialization and the rise of agriculture.

Exercise as well as shown promising effects on slowing the progression of diabetes. Some forms of exercise that have shown the greatest effect are strength training and aerobic exercises. Exercise allows the body to use glucose more efficiently, decrease stress and improve quality of life overall. Again, exercise reflects more of our ancestral history and what we are adapted to be doing. Lifting weights and running mimics the lifestyle once had for thousands of years travelling and hunting.

Hunter gatherer communities still exist today in some isolated parts of the world and some scientists say they are the model of health and wellness. Cardiovascular disease, diabetes and other metabolic syndromes are a rarity and even life expectancy rivals that of industrialized nations without modern medicine. In these communities daily exercise time is much higher than the common sedentary lifestyle in developed nations. Their diets as well are much more rich in nutrients that are lacking in modern diets. In a sense these societies may be living in a balance that evolution has provided.

From ethnographic studies on hunter gatherer societies we know much about the health and lack of disease in these communities. Modern society is nothing like this and is rampant with cardiovascular and metabolic disorder. It may seem unrealistic to return to living in hunter gatherer societies, but there are some things we can do to return to balance. Exercise, adequate nutrition, and stress management may be differences between modern society and our hunter gatherer society. By improving on these aspects we may be able prevent disease and increase quality of life. By doing so we may be able to live in harmony with which nature has provided. 

Ayurveda and Diabetes

Daniela Cozzi

Capstone: Biology of Disease

Dr. Jonathan Karpel 

Ayurveda and Diabetes

One of the oldest medical practices is known as Ayurveda. The idea behind this practice is a balance within and throughout the body. Ayurveda allows you to find the balance for your unique body. 
When the foundation of the system is not balanced, the chances for that structure to fall are much higher and is an unreliable structure. General medicine for different types of diseases, illnesses or symptoms are made for the general public. 
Different types of medicines are made for millions of Americans every day. How can a medicines made for everyone help unique symptoms of that person's body? Medicines are used mostly to hide symptoms or a quick fix but they don’t resolve the problem. Everyone’s bodies are unique and don’t react the same way to different methods of medicine. In some cases, medicine is an essential to live a better life and technology is an amazing advantage for many 
parts of the medical field and will continue to help many people all around the world. Ayurveda represents a much older medicine and more like a traditional health care. It’s based more on natural remedies like positive thinking, diet, and uses of herbs. 
Our bodies go through constant interactions between order and disorders but we are all unique in finding our own balance. Factors like internal and external can impact our bodies and Ayurveda focuses on those factors to balance your body again. 

In 2018, around 34.2 million Americans had diabetes according to the American Diabetes Association. It has become a common disease among Americans and one of the leading causes of death in the states. Its total cost to the American health care was around 327 billion dollars. Diabetes is considered when your glucose levels are too high. We receive glucose from the food that we consume on a daily basis. We also produce a hormone called insulin that helps glucose to give your cells energy. There are different types of diabetes but the most 
common is Type 1 and Type 2 diabetes. Type 1 diabetes is when your body does not produce the hormone insulin because the body destroyed the insulin producing cells in the pancreas. Type 2 is when your body does not produce or doesn’t use it properly. This diabetes causes an unbalance in the body, which increases the risk of problems on your overall health. Some effects are damage to the eyes, kidneys and nerves according to the U.S National Library of medicine. Before you are diagnosed with diabetes, you go through a stage known as pre-diabetes. This stage is where your glucose levels are very high before you have diabetes. Around more than half the people who are diagnosed with pre-diabetes go to develop type 2 diabetes. When you are in the stages of pre-diabetes, the big question is, are there any steps
that can be taken to reduce the risk of diabetes. 

In 2015, Dr. Sarah Hallberg gave a ted talk about ignoring the ADA guidelines as the beginning of reversing type 2 diabetes. She explains cycles and shows how medicine for type 2 diabetes makes it worse. Diabetes is a state of Carbohydrates toxicity. It’s when the glucose can not get into the cell. The medicine allows you to eat carbs but then makes you consume more because your blood sugar level might get too low. She talks about how in most cases and better seen earlier can be reversed. We actually don’t need carbs, we need essential amino acids and fatty acids. We actually make glucose all the time, it’s known as gluconeogenesis. She believes in a low carb diet based on patients she had in the past. It’s not cured but it’s a way to maintain your glucose blood level in a good range. Low carb diet does not mean no carb or high protein diet. She recommends to increase healthy fats which help keep our glucose and insulin levels low. People that don’t have diabetes are recommended to follow this diet to reduce other diseases and have an overall balance in our bodies.

Type 1 diabetes is more concerning because it’s more than just eating healthier to help with many symptoms. In June 2016, there was a therapy that has given some hope for people who struggle with type 1 diabetes. The experimental therapy transplanted insulin producing cells to patients with very serious type 1 diabetes. They used pancreatic islets from donors to treat 1 type diabetes. Even though more experiments and tests need to be taken, it shows 
good improvements in patients of the treatment. Almost 88 percent of patients were having normal control glucose levels in their blood, and were also able to notice when their glucose levels were too low.  Also people who have type 1 diabetes can’t notice when their blood sugar is too low and that becomes dangerous.

Management plan is a treatment plan for people who struggle with type 1 diabetes. Everyone has a different plan just like in the Ayurveda medicine and diet. Even though the disease has very similar characteristics in the body, everyone responds differently with treatment. According to Ayurveda medicine, diabetes is the reaction of the body getting out of balance. There are factors in genes that can’t be reversed but adding lifestyle changes will allow people who struggle to find a plan for their unique body. That plan will allow the person to find and live their best life with a condition they have or a condition they can try to reduce. There are cases like type 1 diabetes that can only try to improve their life but sadly we don’t have a cure. 

The medicine behind the Ayurveda system is not to fight disease but promote good health. Having a good healthy body decreases the chances to get diseases. Some products that are used in Ayurveda medicine contain different herbs like turmeric. Turmeric has many benefits behind it especially helping to promote good health. It’s known to prevent heart diseases, Alzheimer and cancer. It’s a herb that helps decrease inflammation and is an antioxidant. Another herb used in Ayurveda medicine is Indian Gooseberry. It has many benefits for high cholesterol, diabetes, eye problems and much more. It’s also used to kill germs and reduce pain. Looking through the herbs used in this medicine has opened my interest in practicing a more natural way of medicine. The overall goal of this practice is finding a balance in your body. Using more natural approaches before taking a medicine. This type of medicine is a powerful way but used more for prevention and preparing your body not to take stronger medication.  Combining the Ayurveda medicine and treating overall balance can help improve and reduce diseases that are becoming more common in your society.