Throughout the last month many different topics have been explored in class, mainly we have talked about Ayurveda, metabolism and the microbiome. All of these topic felt as its own module until I started seeing how they just build onto each other. Ayurveda is mostly an holistic idea where we can see balance and connection in the mind and body axis. Further research about it, lead me to found out that Ayurveda is a traditional system of medicine that comes from India, it’s meant to approach health and disease while looking at the body as a whole rather than treating each part separately. The most interesting part is that the main idea is centered around health depending on keeping a balance within the individual, and that the environment and lifestyle can affect it. This leads to the idea that instead of treating everyone the same way, it is expected that we all have our differences and will respond in different ways towards health and diseases. Looking forward to my future after graduation, I am planning to attend medical school and become a Doctor of Osteopathic Medicine (DO). It was particularly interesting to find a deep connection between the idea of Ayurveda and the principles of osteopathic medicine. Both emphasize the importance of looking at the person as a whole, and encourage us to think how different parts of the body interact, and how those relationships can influence health. This also brings me back to anatomy, throughout my course I have seen multiple times how hard it is to separate each body system, because they all end up interacting and affecting one another. As an anatomy TA, I always suggest the new students, to not treat each lab separately, but rather let them build on one another, because of how connected everything tends to be. I don’t necessarily believe that every explanation or treatment from Ayurveda is scientifically proven, but I think it’s really valuable to recognize the broader idea of not focusing only where symptoms appear, but rather on what leads there. The idea of interconnection between the different things of the body became more relevant as we started talking about metabolism, and got a first impression on how complex it is. While Ayurveda was able to introduce the importance of looking at health from different and broader prospectives, talking about metabolism gave me a concrete connection from a biological and cellular level. Before discussing this topic, I had always thought about metabolism as how fast or slow someone’s burn calories, but I had never tried or thought about making that deeper research to discover all the reactions and processes involved in it. It has been fascinating to learn about the thousands of reactions that happen in our bodies and inside our cells everyday. Mainly, we looked at two types of metabolic pathways: anabolic and catabolic, and we looked more into each to understand the differences between the two. Essentially anabolic pathways require energy to build larger molecules, while catabolic pathways break things down and release usable energy by the body. If I think about everyday life, I can relate catabolic processes to digestion, where the nutrients we consume get processed and broken down to help provide energy, while others might be stored or used to build other molecules. We also mentioned many pathways like glycolysis, the Krebs cycle, and oxidative phosphorylation. The most interesting thing is how different each pathway is, and the many different roles they perform. Our metabolism is made up of so many pathways reaction, that when something goes wrong in one pathway, it can end up affecting many others. One of the most significant example of how disruptions can affect the entire body is diabetes. In simple words, diabetes occurs when the body is unable to properly control and regulate blood glucose levels. This definition is, of course, a simplification of what diabetes actually is. There are many types of diabetes, each with different causes and effects, and they all affect millions of people every day in several ways. Many organs are actually involved in keeping blood glucose at a normal range, for example, when we are fasting, the liver can release glucose into the bloodstream, while after eating, glucose becomes available through digestion and absorption of food. Other organs and systems involved in glucose regulation include the pancreas, muscles, kidneys, brain, intestines, and immune system, as well as the microbiome. This is the main reason why it is such a complicated disease, because it involves many pathways and loosing regulation on one side can have effects on the all body. This brings me back to the idea of Ayurveda and anatomy, which demonstrates why understanding a disease requires looking at many systems rather than focusing on one in specific. It was interesting to have many people in class share their story about diabetes and its different forms. I wasn’t really aware of gestational diabetes, and how it can just develop during pregnancy and go away after giving birth. I really loved the part where we opened our conversation outside biology, and looked at how these diseases impact society and the economy. These aspects are often overlooked, but things like education, transportation, workplace, healthcare, or just the environment that we live in can influence our physical activity, and our possibilities of an overall healthy lifestyle. One of the major challenges behind diabetes is physical inactivity in most people, and non healthy behaviors, but social and environmental factors can also make the prevention and management more difficult. The economic cost of diabetes was one of the biggest surprises, as someone who comes from a country with mostly free healthcare, it is really hard to imagine that while dealing with any kind of disease, you also have to worry about how you are going to afford the treatments that are going to keep you alive. The paper provided to us, estimated that diagnosed diabetes cost the US $412.9 billion in 2022, while people with diagnosed diabetes had in average about 20 thousand dollars of annual medical expense. It was really hard realizing how economy is such a big part of someone’s health, and I had never considered diabetes, or any other disease, under this prospective. If we look at everything together, diabetes also affects your life and your family, because it can have long term consequences on your daily life activities, financial stability, and overall quality of life. Another topic that increased my understanding about the complexity of our bodies was the microbiome, this added another perspective to how different biological processes interact and influence our health. First of all, I feel like I have always been thinking about bacteria in our body too simply, without realizing how complex and organized these microbial communities are. In the lecture we talked about how the microbiome is this big community of microorganisms living in and on our bodies, and that many are actually beneficial for us. I feel like it’s really easy nowadays to associate bacteria with something negative, because we always think about infections or antibiotics or something bad in general, and we tend to forget how there are many bacteria that are really important for our bodies. These organisms help us digest food, protect us from some other harmful microorganisms in the body, interact with the immune system, and produce molecules that our cells can use. In some ways, it is almost like an additional organ, but it’s alive and it’s frequently changing with our diet, the environment, and our habits. One of the things that surprised me the most was learning how even choosing the way we deliver a baby can end up influencing its microbiome in early development. There are many things that can affect, starting from delivery, our microbiomes. If we go in order, the baby’s first exposure, the way the baby is fed, the mother’s microbiome, the environment, and the baby’s diet can all influence its development. This continues also into adolescence, and adulthood, every decision or change in our life can affect our microbiome. During this conversation in class, we talked about how traveling to other countries can expose us to different microorganisms through water and food, and ultimately affect our microbiomes. Another connection I made was between the microbiome and what I have been learning in biochemistry. Microbiomes actually expand what our bodies can metabolize, because our enzymes can’t digest everything we eat, and some bacterial enzyme can ferment fibers and produce short chain fatty acid that our bodies can use. This relates back to our discussion about anabolic and catabolic pathways, because microorganisms can contribute to the metabolic process happening in our bodies. Throughout the whole discussion diet felt like one of the most relevant factors, as it can directly affect our microbiome. It is really important to have a diet with a lot of variety, that includes plants, fruits, vegetables and fiber rich foods, which can support microbial communities.. It was really surprising to see how many aspects of health are connected to the microbiome, so sleep, obesity, diabetes, cardiovascular diseases, brain development, and many more things all take part and are linked to our microbiomes. Honestly, this topic made me go back to one of our first discussions about Ayurveda. During that discussion, we talked about the importance of balance and the relationship how between the mind and body axis, and this is probably one of the best examples to explain how different aspects of health can be interconnected. Thinking about factors such as diet, daily routine, stress as one whole thing instead of different systems, is critical when thinking about maintaining a healthy microbiome, and a balanced lifestyle. If we keep imbalance in our life, our microbiome will be affected as well, which can lead to inflammations and diseases, later on, and ultimately it might have an effect on our metabolism, and more in general in our bodies. Looking back at everything that has been discussed, the main take away is how interconnected our health is between many different factors. Ayurveda introduced the more general idea of looking at the person as a whole, metabolism helped me understand how many different reactions and pathways work together inside our bodies, and the microbiome added another layer of complexity, by showing how many different decisions and lifestyle can ultimately influence the microorganisms community in us.
Friday, October 9, 2026
Curated Paper 1 - Jace Rowley
Throughout my undergraduate studies and learning experiences the human body has been presented as a fascinating combination of complex cellular interactions, chemical reactions that lead to function, and an immune system that is capable of identifying harmful bacterial and viral infections and fighting against them. While these things are vital to understanding health and the protection from diseases these lectures sometimes miss on the fact that all of these functions and networks are all interconnected. This gap was filled when I explored the idea of Ayurveda, which is an ancient holistic framework that allows one to view organisms not as organs and bodily fluids, but rather as a dynamic network that depends on other parts to function properly. A proper balance of Ayurveda allows the human body to function properly, but this is thrown off when there are imbalances or disruptions of the harmony of these systems, or as taught in ayurveda these doshas. Some of these disruptions in the body’s doshas cause a whole host of issues pertaining to overall health. This principle of harmony is mirrored by our modern, western understanding of physiology and is exemplified in our cellular metabolism and the human microbiome. In these systems, the breakdown of fuel and microbial diversity can be affected by these imbalances that Ayurveda warns against. When our metabolic pathways become overwhelmed by excess fuel and our internal ecosystems are disrupted, balance collapses and gives rise to complications that will have lasting effects. By pairing a holistic and relationship based model with modern medicine it will expand the possibility to better understand and even sometimes treat root causes of these imbalances rather than just managing downstream symptoms.
Charaka, an ancient physician and scholar accredited to being one of the founders of Ayurveda taught, “Life is the combination of body, senses, mind and reincarnating soul. Ayurveda is the most sacred science of life, beneficial to humans both in this world and the world beyond.” A holistic approach on the interconnectedness of our bodies, minds and physical senses dictates the limits of the health of that same body and mind. In Ayurveda each system of our bodies is described as a dosha, an energy, these energies when working properly flow into the system and create a balance. But when one doshas becomes out of balance, it tips the metaphorical scale and throws off the entire system. Ayurveda searches for a way to return these doshas to balance and to restore the overall health and harmony of the system. These can be obtained through regular exercise, a balanced and healthy diet, the betterment of mental health and uses of natural herbs and meditation. While this might not cure the downstream effects of these imbalances Ayurveda teaches that it can help stop the causes of these diseases. Two core principles that are heavily affected by imbalances in the body are Agni and Ama. Agni is the body’s metabolic fire driven by digestion and contributes to the absorption of nutrients and physical vitality. Ama is the toxic metabolic residue that accumulates when the Agni falters which leads to problems in the microbiome and in our metabolic pathways.
The body fueling itself and the dosha of Agni comes from our metabolism and its pathways. Metabolism is the chemical and physical processes in living cells that will convert food and drink into the energy bodies need to sustain life. There is an apparent flux of fuel in the metabolism that stems from the catabolic breakdown and anabolic synthesis; this is a mirror of the Ayurvedic concept of Agni, the fire that digests food and turns it into energy. When the catabolic and anabolic pathways work together and there is a balance it allows the fuel to move smoothly through our cells. Sometimes when the cells don’t need more nutrition but it keeps being produced, it leads to congestion and the body enters a state of overflow where cells are saturated and lose their capacity to remove byproducts. This is when Ama is present and a backup of toxic material doesn’t allow the metabolism to function as normal. An example of this build up is seen in Metabolic Dysfunction Associated Steatotic Liver Disease or MASLD. When someone develops MASLD, adipose tissue develops a resistance and continuously leaks fatty acid into the bloodstream. While this happens, there are high levels of glucose and insulin circulating in the system that will eventually signal the liver to synthesize even more fat cells which leads to hepatic overload and lipotoxicity. In Ayurveda this uncontrolled storage and overnutrition smothers the Agni and throws the entire body out of balance.
When this damage occurs it leads to consequences of the lack of metabolic breakdown. One of the most damaging conditions to patients when metabolism is hindered is diabetes, and not only physically. According to a 2022 report by the American Diabetes Association, the total economic burden of diabetes per year is estimated to be 412.9 billion dollars. When broken down, the study claims that 306.6 billion stemmed from direct medical expenses which means that almost one in every four dollars spent in the country goes to the care of someone with diabetes. Individuals diagnosed with diabetes face nearly twenty thousand dollars a year in medical expenses. The real catch is that these dollars go to management of downstream symptoms without actually treating the root cause of the issues developing. Ayurvedic therapies, if implemented early, could actually treat the cause of these diseases. Restoring metabolic balance requires consistent daily movement, unrefined whole food, and routine fasting to clear cellular waste, and rekindle the Agni.
Along with the metabolic flux, the human body is also an interconnected habitat for microbiomes that influence overall health. The human body is covered and lined with microbiomes, they make us who we are. Our skin, oral cavity, gastrointestinal tract, along with other microbiomes dictate how our bodies react to our diets and interaction with our environments. One example is our mouths, these microbiomes have a rich oral flora that regulates acidity, breaks down food via amylase and protects hard tissues structures. However diets that are not in good balance, that contain sugars and lots of acidity, disrupt the microbiome and poor unhealthy bacteria will begin to outcompete beneficial commensal bacteria. This can be treated with modern remedies, but our microbiome is vital to our health and is a life long process.
Even as we begin our lives we begin to start developing a microbiome, this starts as early as the womb and through which process a baby is delivered. A baseline is established early and carried into our adulthood. Newborns that are delivered vaginally are able to use the maternal bacteria to begin creating their microbiomes, while babies who are born via Cesarean section acquire a differing version of bacteria to jump start their microbiomes. After birth this process continues based upon whether or not a child is breastfed or formula fed. A breastfed infant will receive certain oligosaccharides that cannot be exactly replicated by synthetic formulas, which will lead to a development of differentiating microbiomes. This early microbial education aligns with the hygiene hypothesis that investigates the idea that immune competence requires direct environmental exposure to a diverse collection of harmless microbes. Shielding a child from ordinary dirt and microbial challenges deprives the developing immune system of necessary training, which could lead to dysregulation of immune disorders.
Arguably one of the most important microbiomes for our health and ayurvedic balance is the gut microbiome. The gut microbiome is in constant conversation with the metabolism and a connection with the mind. This affects energy shaping and the storage of tissues. Animal studies have shown evidence of this connection. A study involving mice and a fecal transplant showed that skinny and healthy mice, when implanted with feces of obese mice, began to change their calorie extraction and increased adipose tissue storage without any change in diet. Gut microbiomes are vital to more than we think but they are susceptible to modern intervention more than most of these microbiomes. Overuse of antibiotics and frequent regimens can wipe out the healthy bacterial communities and even permanently remove bacteria that has been developing our entire lives. This disruption has even been linked to increased adiposity and altered caloric output.
Bringing these systems together shows that human health is an interconnected network where cellular biochemistry, a microbial ecology, and lifestyle influence one another. The microbiomes, a healthy metabolism and other bodily functions serve as the biological engines of an ayurvedic balance. Working together they drive nutrient breakdown, metabolic flux, and control fueling and protect the body from imbalances which lead to diseases. Recognition and implementing practices of Ayurveda like consumption of whole foods, regular exercise, and mindful thought practices can protect lifelong microbial flora and metabolic pathways. Modern medicine excels at pinpointing molecular mechanisms and Ayurveda provides the perspective that is needed to see how relationships can govern long term health. Pairing a holistic model with modern medicine expands the possibilities to understand and treat root causes and best help entire populations to avoid diseases.
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.
Curated Paper 1_Kihyun Yu
Connecting Ayurveda, Metabolism, Diabetes, and the Microbiome
When I first researched Ayurveda, I learned that it is a traditional medical system from India that looks at the body, mind, lifestyle, and environment as connected. Health, according to Ayurveda, is dependent on the balance of three doshas, which include Vata, Pitta, and Kapha, whereas health disorders result from an imbalance of the above doshas. Nonetheless, I found there was little scientific proof to demonstrate that the three doshas were responsible for causing diseases. Therefore, I concluded that all elements of Ayurveda could not be scientifically accepted as a whole.
My first draft on Ayurveda made use of stress as an example. Apart from affecting one's mental state, stress can affect other bodily functions such as sleep and digestion. Diet, exercise, sleep, and environment were mentioned to play a role in determining a person's health status as well. This is one of the reasons why I think there is scientific validity in the broader concept of Ayurveda. I came up with a hypothesis where stressed individuals will have more issues concerning their sleep and digestive function than non-stressed individuals.
At that point, I mostly understood the idea of balance in a very general way. After learning about metabolism and diabetes, I started to understand balance in the body in a more specific way. One of the key things that made me rethink my previous ideas was the discovery that metabolism goes beyond burning of calories. Metabolism is a series of chemical reactions that facilitate the body in using nutrients to produce energy and maintain homeostasis. The concepts of glycolysis, Krebs cycle, oxidative phosphorylation, and gluconeogenesis were also introduced to us.
One part that caught my attention the most is the regulation of blood glucose levels. Insulin and glucagon have opposing effects, but together they regulate the level of glucose in the blood. Insulin reduces blood glucose levels through decreasing the formation of glucose in the liver and taking up the glucose from the blood by muscles and fats. Glucagon increases blood glucose levels when the body requires additional energy. Diabetes develops when the regulation of glucose levels starts failing. When there is insufficient insulin production, or the cells do not react to it properly, the glucose does not go inside the cells as it should and remains in the bloodstream, resulting in hyperglycemia. At the same time, glucagon will release glucose in the blood, causing even bigger imbalance. One point that I found very interesting is that the blood could be full of glucose and at the same time the cells could not utilize it.
The study of diabetes also made me view diseases in general differently. Before this module, my view of diabetes was mainly focused on the elevated blood glucose level. However, after further understanding, I realized that diabetes does not only have impacts on the blood glucose level but can affect various organs including the liver, muscles, fats, kidneys, the brain, the immune system, the stomach and the gut microbiome. Diabetes also causes oxidative stress as a result of the long period of hyperglycemia.
The next component that helped me develop my ideas was an explanation of diabetes from a sociological perspective. The information provided in “Diabetes: Beyond Biology” talked about low income, unemployment, low education level, and bad living conditions. This information may influence one’s access to proper nutrition, physical activity, and healthcare services. For this reason, I wrote that it is far too simplistic to assume that type 2 diabetes is solely associated with unhealthy decisions made by the individual. Diet and exercise are important, but so is the environment.
Considering this idea in hindsight, I believe that it ties in with an earlier idea of mine that I had on Ayurveda. When writing my paper on Ayurveda, I believed that one’s lifestyle and surroundings influence his or her state of health. This idea was later developed in a more concrete manner when I was reading about diabetes. An individual might be aware of the importance of proper nutrition, exercise, and medical care, yet factors such as income level, occupation, education, and other living conditions may influence the accessibility of these necessities. However, this does not prove my earlier hypothesis regarding Ayurveda; rather, it helped me see the connection between the two papers.
This was emphasized by the economics of the disease. According to the Economic Costs of Diabetes in the U.S. in 2022 paper, the cost of diagnosed diabetes in the United States was estimated at approximately $412.9 billion in 2022. Direct medical costs amounted to $306.6 billion, while indirect costs were valued at $106.3 billion. Individuals with diagnosed diabetes had annual medical expenditures of approximately $19,736, while the medical expenditure was 2.6 times higher compared to those who did not have diabetes. Approximately $12,022 was attributed to diabetes per person annually.
Indirect costs consisted of loss in productivity, disabilities, and early deaths. The statistics revealed to me that diabetes impacts more than the patient who is suffering from the disease. The disease may impact a person’s family members, workplace, and even the larger society. For this reason, prevention and early intervention became an important aspect for me. As noted in my journal, physical activities can help in preventing diabetes, although prevention also requires access to low-cost health care services, good nutrition, knowledge about diabetes, testing, and exercising grounds.
There was also an additional tie to the topic brought out in the journal on the microbiome. Prior to reading this journal article, while I was aware that bacteria existed in the gut, my association with them was only with digestion. The journal showed me how the microbiome is able to have connections with other parts of the body as well.
This immediately brought back Ayurveda to mind as Ayurveda stresses digestion, diet, lifestyle, and balancing of body. While writing about the microbiome in my microbiome journal, I did not want to claim that the study of microbiome validates Ayurveda, instead I noted that the study of microbiome indicates that diet impacts gut bacteria and some specific diets are linked to some specific types of gut bacteria. For me, this was yet another instance where something related to lifestyle also connects to biology of the body.
I also learned that a disruption in the microbiome may be harmful to health. Gut bacteria help with digestion, generates helpful compounds like short-chain fatty acids, and interacts with the immune system. In class, we also found out that an unbalanced or bad microbiome is linked to illnesses like obesity, diabetes, cardiovascular diseases, allergies, and IBD. The fact that we saw diabetes in the list of conditions related to a poor microbiome was fascinating for me because I had studied it previously as a metabolic condition.
Gut-brain axis was definitely the most shocking fact from the chapter on the microbiome. It was fascinating that the gut and the brain can exchange information using such mechanisms as the nervous system, hormones, and the immune system, and changes in gut bacteria influence stress and behavior. Moreover, this information brought back the topic of my research on Ayurveda. The example that I used in that paper was that long-term stress can influence both sleep and digestion. Then, with the help of the microbiome information, I got an additional perspective on the issue of stress and the gut. Nevertheless, I do not think that it proves Ayurveda to be scientifically correct, but it explained to me the reasons for my findings.
Combining all three of these journals helped me look at the term “balance” in a completely new light. At first, while researching Ayurveda, the concept of balance seemed very general and abstract. Metabolism taught me more about homeostasis through insulin, glucagon, and blood glucose regulation. Diabetes revealed what happens when such processes start breaking down, how they affect one’s body overall, and that one’s state of health depends on one’s social surroundings and resource availability. Finally, the microbiome provided me with yet another link between one’s diet, digestion, metabolism, immune system, and even brain function.
I do not think Ayurvedic balance and biological homeostasis are the same thing, and I still agree with what I wrote in my first paper: some parts of Ayurveda need more scientific evidence. I also wrote in my microbiome journal that there is still a lot we do not fully understand about what a “healthy” microbiome actually looks like. Because of this, I think it is important not to take similarities between these topics too far.
However, when reading these articles together, my perception of the field of health care changed somewhat. Previously, I considered individual diseases and body systems in isolation. Diabetes was a blood sugar problem; the microbiome was digestive; and Ayurveda was an entirely separate medical tradition. Now that I’ve reviewed these journals again, it makes more sense why the theme of interconnectedness kept popping up in all three.
In summary, the most significant concept which I have learned as a result of connecting these topics to each other is the fact that health is a product of interaction between many factors at once. Metabolism introduced me to the concepts of regulation within our bodies. Diabetes taught me how one metabolic problem may influence the whole body, as well as create social and economic issues. The topic of microbiome made me realize that digestion goes beyond our consumption of food. Ayurveda became the first topic which made me realize that the body, lifestyle, and environment should be viewed as interconnected entities, although I still think that not all of its concepts require any scientific proof.
Reference
Parker, E. D., et al. (2024). Economic costs of diabetes in the U.S. in 2022. Diabetes Care, 47, 26–43.
Curated Paper 1 - Yun Chung
Curated Paper 1
Health and illness are the result of the relationships that exist between various parts of the body and a person's everyday life. When I previously considered Ayurveda, I accepted its broad idea that the body, the mind, one's way of life, and the environment are all connected. Looking at metabolism, diabetes, and the microbiome has provided me with more particular methods for looking at these connections. At the same time, these subjects have led me to doubt whether the concept of 'balance' is a clear enough description of health. Precisely what needs to be balanced and how can we tell when that balance has in fact been reached? After bringing my thoughts together, I conclude that an interconnected approach to health is helpful, but it must be backed by specific biological mechanisms and by consideration of individual circumstances.
I was interested in the holistic approach of Ayurveda since I had always held the view that physical and mental health affect one another. Severe stress may lead to physical issues and a physical illness can in turn affect a person's mental state. To me, taking these interrelationships into account is reasonable. Yet, the fact that there is a connection between the mind and the body does not imply that all diseases can be accounted for by emotional distress or by lifestyle choices. It is possible for a person to be mentally healthy yet still have metabolic problems, some of which may be due to genetic factors. Although connections are important, their role may vary from person to person.
That is the reason why, to me, the term "balance" now seems too vague when used alone. It doesn't clearly show which processes are working correctly and which have altered. The aspects of a person's mental health, glucose regulation, and microbial function cannot all be regarded as belonging to a single condition. The issue I have is not with evaluating these factors together, but with supposing that a general statement can account for the details. It is exactly the complexity of disease that appeals to me. Various mechanisms can interact, and in order to understand them a close examination from several different points of view is required.
In the reflection I wrote on Ayurveda, I also separated its general approach from the particular treatments it offers. I can see the value of the emphasis it places on lifestyle and the individual as a whole, even though I remain wary of the idea that natural treatments are always superior. It is possible for someone to put their trust solely in natural cures and thus postpone essential medical treatment. The fact that this point resonated with my later journal entries helped me to realise that a wide-ranging view of health and a careful assessment of the evidence should go hand in hand. Looking at more aspects of a patient's life does not take away the need to decide whether a treatment is effective.
Metabolism served as a clear illustration of the importance of certain mechanisms. Catabolic pathways involve the breakdown of molecules to release energy that can be used, whereas anabolic pathways consume energy in order to build molecules. Glycolysis, the Krebs cycle, oxidative phosphorylation, and gluconeogenesis are examples of pathways that help to show how the body breaks down nutrients and provides fuel. Because of these processes the concept of internal regulation became more specific; rather than just saying the body is balanced or unbalanced, I could begin to ask how energy is obtained, how glucose is regulated, and what occurs when those processes fail to work properly and effectively.
It was diabetes that gave these questions significance. When a person has eaten, insulin causes the tissues to take up glucose and at the same time reduces the amount of glucose that the liver produces. Moreover, insulin signalling causes GLUT4 transporters to be brought to the membranes of muscle and fat cells. While fasting, the liver releases glucose in order to keep blood glucose levels stable. Type 1 diabetes involves the autoimmune destruction of the pancreatic beta cells, while type 2 diabetes involves insulin resistance and a decrease in insulin secretion. The fact that there are these differences shows that diabetes is far more complex than just having an excess of sugar in the blood; it is important to know what specific disruption is present since a general remark about an imbalance does not explain how the disease develops.
The microbiome contributes another aspect to this situation. When I was keeping a microbiome journal, I discovered that microorganisms aid in digestion, metabolism, immune function, and communication between the gut and the brain. The effect of food on the body can be seen both in the nutrients we take in and in the actions of our microbes. For instance, microbial fermentation leads to the production of short-chain fatty acids such as butyrate, which provides energy for the intestinal epithelial cells. As a result, I was able to see a more concrete way of linking nutrition with the notion that health relies on the interactions between various systems.
At the same time, the microbiome helped me to focus on individual differences. Not everyone has the same microbial communities and it doesn't follow that variation must mean someone has a disease. Just as important as the kinds of organisms present is the function of the microbes. Although it is interesting to find associations between microbial differences and conditions like obesity or insulin resistance, such an association does not prove whether those differences cause disease, are a result of disease, or interact with other factors. In a similar way, the findings from germ-free animals cannot be simply transferred to humans. Because of these limitations, I am careful not to assume that one microbial pattern or intervention will mean the same thing to all people.
The fact that the gut-and-brain connection was discussed also provided a biological basis for the mind-body connection which interested me in Ayurveda. The communication between the gut and the brain takes place via neural, hormonal, and immunological pathways. While this reinforces the idea of looking at physical and mental health as a pair, it does not prove that Ayurvedic ideas or any specific treatments have been scientifically validated. As a result of bringing these two areas together, I gained a more specific understanding of what a holistic approach entails: it should prompt us to look at the connections in question while at the same time being careful about what the evidence actually shows.
My metabolism journaling also broadened my view outside biological processes. Parker et al. (2024) estimated that the cost of diagnosed diabetes to the United States in 2022 was $412.9 billion, this amount comprising $306.6 billion in direct medical expenses and $106.3 billion in indirect costs. The indirect costs involved losses due to disability, reduced productivity, and early death. This demonstrated that the effects of diabetes extend to families, workplaces, and society as well as to the individual body. The study also posed a question which I had not before given any serious thought to: what occurs when a person needs treatment but their situation makes it hard to get or keep that treatment?
When I was growing up in South Korea, I never regarded treatment costs as a major obstacle in the same way. That view was due to my familiarity with the Korean health insurance system, even though my own experience doesn't prove that everybody can get medical care without difficulty. It became clearer to me through the nutrition classes and this capstone course in the United States that financial situations can be another barrier to managing a disease. It was disappointing to realize that knowing what would be helpful doesn't mean that a person can afford it or that they can fit it into their daily routine. This realization also made me interested in the roles that different health professionals and community services play in helping to ensure access to care.
Combining this social viewpoint with metabolism and the microbiome has altered the way I consider nutritional advice. Although diet has a biological impact, a person's choice of food also depends on their income, work schedule, the circumstances of their household, and the resources that are available to them. If someone is unable to adhere to a recommended eating pattern they should not be seen as lacking motivation. Knowing what food does within the body is only one aspect of the question; we must also take into account what the individual can actually obtain and prepare.
Since I intend to become a physician, I would like to look at a patient's nutritional state in conjunction with their economic situation and their daily routine. To do this, I would find out what they usually eat, how their schedule influences their meals, and what kind of home circumstances they have. From these answers I could work out the conditions under which a treatment plan would have to function. In the case of difficulties caused by cost or access, I would aim at arranging community support, identifying any available assistance, and finding more affordable ways of making dietary changes. I have also come across such possibilities in my nutrition classes, and this shows how scientific knowledge can be combined with practical support.
To sum up, these reflections have served to deepen my interest in the complexity of disease. Ayurveda enabled me to think about health in a connected way, metabolism explained the importance of particular physiological mechanisms, and the microbiome caused me to discover more relationships and uncertainties. When I learned about the costs of diabetes, this broadened my perspective to include the conditions that affect a person's ability to manage their illness. I realised that in order to take a holistic view of a person it is necessary to have both a detailed knowledge of the biology and an understanding of practical matters. Instead of merely stopping with the idea of 'balance', I now wish to find out what is actually happening, identify which factors are relevant for this individual, and determine what sort of support would make care possible.
Nicholas Davis - Curated Paper 1
Ayurveda is a system of traditional holistic medicine that originated in India. This system looks at the relationship between body, mind, and spirit. This is an official system of medicine in many places that supports a more modern medicine system. I think the interconnectedness of our body and all its processes is fascinating. I think that it makes a lot of sense that the concept of ayurveda has existed for so long.
Most diseases are due to some kind of imbalance in the body, whether that’s among the different levels of substances in your body or between your body and another organism. Microbes, for example, are an essential part of our bodies. The number of microbes in our body outnumbers our own cells by a significant amount. Some people call the relationship between our genome, epigenetics, and the microbiome the hologenome. The microbiome is an essential part of large organisms and is often required for an individual to survive. There are more than 160 different species of bacteria in any given individual. Populations of microbes differ based on location in the body and shift based on different conditions like diet or other factors. Even the placenta is exposed somewhat to bacteria and other microbes, but exposure to most bacteria will occur at birth and after. As we’ve learned more about the balances between our body and other organisms, we understand more about why disease occurs and we could consider it to be a kind of modern ayurveda. This knowledge gives us a more holistic approach to disease treatment.
Another example of this, and one that is especially interesting, is the connection between your gut microbiome and your mental health. They’ve found that various mental health issues can be improved somewhat on the basis of improving gut microbiome health. The microbiome can affect brain function via signal promotion or interference. The population in your gut can contribute to things like depression, anxiety, and even possibly something like Parkinson’s if it becomes unbalanced.
The microbiome can produce byproducts that can interfere with other signals in the body and create problems like insulin resistance, chronic inflammation, and a lack of satiety. Antibiotics are an example of something besides diet that can completely change the makeup of your microbiome. Some people can see improvements in certain problems with their microbiota when using antibiotics. Genetics can also play a part in diseases relating to the microbiome of the gut. The immune system maintains a homeostasis with the gut microbiome and when the immune system reacts improperly, it can lead to gastrointestinal diseases.
As development continues from birth, the body can grow with different microbes that can have very different effects. The body uses various signals, chemicals, and conditions to select for microbes normally found in the microbiome. One example is that the intestinal lining uses a lot of oxygen which makes an anoxic environment, which is one of the ideal conditions for normal gut bacteria. The milk of a mother is essential for the development of a baby’s microbiome and immune system. If the microbiome doesn’t develop properly, it can lead to things like malnutrition and disease. Probiotics can help to restore normal function to your microbiome when it’s been put off balance.
The microbiome has major impacts on many different systems in the body. They have found that obesity can be caused by the microbiome. They took mice that were obese and performed a fecal transplant on mice that didn’t have a microbiome and those mice became obese. Diet is a major determinant for the composition of your microbiome. Certain diets can promote the growth of bacteria that can contribute to many different diseases like atherosclerosis, obesity, and others.
Another major factor in diseases like obesity is metabolism, which is where imbalances within our own body come in. Metabolism is the conversion of energy from ingested material into a usable form for the body. This energy and other molecules associated with the process of metabolism are used to maintain homeostasis and allow for growth and survival of the body. This is accomplished through a combination of catabolic and anabolic processes. Metabolic diseases most commonly have to do with molecules that tend to be less essential for survival, since organisms with metabolic diseases that affect the main processes typically don’t live for very long if they live at all.
Metabolic diseases can arise in three primary ways, genetics, acquired, or dysfunction. One of the most well known metabolic diseases is diabetes, which can be either from genetics, type 1, or acquired, type 2. Treatments for metabolic diseases include dietary restrictions, enzyme replacement therapy, and there are gene therapies emerging that can even cure certain metabolic diseases. Examples other than diabetes of metabolic diseases are galactosemia, phenylketonuria, and Gaucher disease.
Metabolic diseases are all about a loss of balance in the body. Thinking about them through the lens of ayurveda is interesting here because it is the loss of balance caused by whatever metabolic deficiency that causes disease. Metabolism is all about maintaining homeostasis in the body, so when there is a process that doesn’t work like it should, like being unable to properly metabolize phenylalanine for example, then it can throw off the balance the body typically maintains and it causes bad side effects that lead to disease. Diabetes is another great example of a balance of things that are all supposed to be there being thrown off and causing disease.
My sister has had type 1 diabetes since she was around 3 or 4 years old and one of the biggest things I’ve noticed is how inconvenient it is. She had to get used to needles when she was very little because she had it before they had any good insulin pumps, so injections were the only way for her. It’s become much more convenient for her since she can now use a pump, but there are still expenses tied with that. One thing I haven’t noticed, at least lately, is her being unable to do something because she has diabetes, which is good.
My dad and one of my other sisters have prediabetes, which would become type 2 diabetes without management. Their situation is not as inconvenient, but they do use medication to help manage their blood sugar levels. My dad has successfully implemented lifestyle changes that have helped effectively manage his prediabetes as well as some other issues like kidney stones. I’m not sure if his kidney stone issue is a metabolic one, but I do know that he makes two different kinds of kidney stones that each come with their own dietary restrictions to manage them.
Society is often a big contributor to the risk of people in a population developing a metabolic disease like diabetes. Things like city planning, economic status, and other factors of accessibility to healthy lifestyles. Diabetes also has a significant impact on society, especially in terms of cost. Well managed diabetes is very costly to individuals due to insulin costs and a healthy lifestyle is often more expensive for many people. Poorly managed diabetes is even more costly for individuals as well as society itself.
Diabetes can result in major health issues including complications that can lead to loss of eyesight and amputation of limbs. This is expensive for the person going through it, but it also costs society a lot in things like loss of productivity and payments for the disabilities that result from these conditions. Social determinants tend to lock people into cycles of unhealthy lifestyles that can be very difficult to break. It can be difficult for these patients as well due to stigmas surrounding things like obesity.
Looking at recent figures on the cost of diabetes, diabetes accounts for about 1 in every 4 dollars spent on health care. People with diabetes spend around 4,000 dollars a year out of pocket just for this condition. Numbers tied with diabetes can get somewhat messy as well because of the number of other conditions it can cause. Adding complications like kidney disease, hypertension, and other conditions resulting from diabetes makes those medical bills stack up quickly.
An article called Economic Costs of Diabetes in the U.S. in 2022 from Diabetes Care gives some crazy statistics for just how big of a deal diabetes is on an economic level. Diabetes costs an estimated $412.9 billion with $306.6 billion being direct costs. Indirect costs come from loss of productivity due to disability and premature deaths along with other factors that come with diabetes. On average, people with diabetes pay 2.6 times more money on medical expenses than someone without the disease. They conclude that the cost is an incredible burden on society as a whole. This is a big reason why more effective treatments for diabetes are sought after and why it’s worth spending money to try to fix the problem.
Diabetes has some really interesting and terrible effects on the body. Diabetes can lead to a decrease in flexibility in the walls of arteries and veins, which leads to higher blood pressure because the heart has to work harder to do its job. It can also cause impairment to the immune system’s ability for phagocytosis, which makes fighting diseases more difficult. Proteins can become glucosylated, which can change the shape of the protein and impair its normal function. Blood clotting is more likely to occur, which can lead to deep vein thrombosis, pulmonary embolism, stroke, or heart attack.
These issues and imbalances are just a couple examples among many about why the core idea of ayurveda is so important in health. There are many options that people can take advantage of to improve their health, many of them being lifestyle changes that have proven to be sustainable for those who participate. Focusing on proper diet and physical activity can do a lot to reduce the likelihood of throwing off the many delicate balances your body maintains. My family has benefited from some of these lifestyle changes in their health struggles and the science shows that anyone can.
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.