Let us understand how an automobile works. An automobile’s chief purpose is to help us get from point A to B in a safe, comfortable, and quick way. It has various parts playing unique roles to enable this transportation. An engine that produces the energy, a tank that stores the fuel. A gearbox and transmission that transfers the energy to various parts intelligently based on the need. The wheels that help move us and the brakes that help us stop. The various electronic components that provide us with feedback about the journey and keep us connected and entertained. The steering that keeps us in the right direction. The suspension, the radiator, the condenser, the coolant, the exhaust system, the windows, and various purposes each one of them serves etc. you get the picture.
Now, think of the human body. It has trillions of such body engines which produce the power the entire body needs to run. These cells can also reproduce, which makes them distinctly different from an automobile. Also, these engines can die just like how an automobile’s engine could die. Besides, our cells can also commit suicide if they believe they are not functionally adding value. Other than these key differences, which we can appreciate, an analogy of an automobile could help us understand how our body works but also what and how things could go wrong.
If we think about metabolism as the energy production and consumption cycle, our metabolism literally powers our life. It involves various parts of the body playing different complicated functions just to get the fuel into our cells. This fuel comprises nutrients and oxygen that get used by each cell to generate power. The circulatory system, with our blood being the medium, is what carries the nutrients to every cell in our body. It makes all the nutrients available through the complex set of systems and processes that involve the entire gastrointestinal (GI) tract, the mouth, the esophagus, the stomach, the small intestine, and the large intestine. Once the nutrients are extracted from the food we eat, the liver and pancreas play a critical role in orchestrating various hormonal activities to help us process the various nutrients and transport them to every cell.
Our body gives certain nutrients priority over others. Extra nutrients get stored to be used later. The measurement of the effectiveness of this orchestration across various organs and body components, regulating it so that no overheating or malfunction happens, etc. is controlled and coordinated by the central nervous system that comprises our brain and spine. Similarly, the lungs play a critical role in ensuring oxygen availability and supply to the body. Blood functions to supply nutrients and oxygen to all the cells, while brings back the by-products of metabolism, waste products and toxins etc. from the cells to be removed from the body. As important as getting the nutrients and oxygen into the cells is, getting the waste products and toxins out of the body is also equally important. This is where the kidneys, large intestine, sweat glands, and lungs again play a crucial role. A buildup of these in the body would lead to malfunction and disease.
Any imbalance in the above process is what we will be calling Metabolic Imbalance.
Cellular Health & Function
The coming together of cells form tissues and organs etc. the brain, lungs, heart, liver and kidney etc. are examples of cells coming together and specializing in a set of tasks needed to keep the body healthy and functioning. Cellular membranes and other membranes within a cell-like those surrounding the mitochondria and the nucleus play an important role in ensuring cellular health and function. As the nutrients and oxygen get absorbed into the cell through the membrane, based on the functioning of gates, receptors, hormonal or electrical communication channels, the cell generates power. This happens in the mitochondria. While different nutrients get processed in different ways to produce energy with varying levels of efficiency, the typical path is Oxidative Phosphorylation. The outcome of each energy production process is ATP (Adenosine Tri Phosphate) – the currency of energy in our body. A by-product of this cycle is ROS (Reactive Oxygen Species). The ROS, while essential to regulate certain cellular processes, when produced in greater numbers play havoc in the cellular system. They are the primary cause of a process called “Inflammation” which in some sense is like rusting within the human body. Chronic inflammation is a precursor and key component in leading to most lifestyle disorders and needs to be managed and controlled.
Various proteins, enzymes and other materials are needed by the cell; eventually, the body and the knowledge of how to process these are encoded in our DNA. We have DNA in the nuclei of the cells and also in the mitochondria. The body also has the ability to assess and measure cellular health and the efficiency of its function from within the cell itself. The body monitors and maintains this throughout life. Should there be a drop in cellular health and function, either the concerned cells are killed and recycled in a process called autophagy or programmed cells’ death is invoked by the cells itself and is called apoptosis, more like suicide by the cells in the larger interest of the body? The cells typically produce the power and play the role they specialize in – be it cells in the kidney as nephrons, or in the brain as neurons or in the heart and so on. The cells replicate, copy, and reproduce more of their ilk when the time and environment are favourable. And when this replication happens, while the genome remains intact, certain loss infidelity might occur in the epigenome. This leads to loss of functional mutation in the DNA. It is important to take the right actions to maintain the sanctity of our DNA, to the extent possible.
Any weakening in the above impact cellular health and function and that in turn impacts the overall human health. We have looked at the success path of metabolism and cellular health, let us also recognize that multiple things can go wrong. And the beauty of the being we have evolved to be is that the body has a host of specialized mechanisms to help us ward off threats and remain healthy. Some of the key defence mechanisms are our Immune System, Stem Cells, DNA Sanctity, Gut Microbiome and Angiogenesis. Our immune system helps us identify and fight against pathogens (bacteria and viruses) as well as various toxins. Our stem cells are progenitor cells of the body that has the capability to produce and reproduce most of the cells of the body including immune cells. They help repair damage of various key organs. Our Epigenome plays a critical role in maintaining the sanctity of our DNA. We have various helpful bacteria inside our body, primarily in our gut or the large intestine that play critical protective roles and ensure better metabolic function as well as emotional stability. Our circulatory system is itself a defence mechanism as to how it grows determines the quality of the supply lines to each cell.
How well is each of our key defence mechanisms primed and functional determines our state of health? The more functional they are, the less likely we will get impacted with diseases and as a converse, the weaker our defence mechanisms, the more chances and susceptibility we have to different ailments and disorders.
And why and when do things go wrong…
As we are born, assuming we have no manufacturing defect, we are like an automobile getting off the factory’s conveyor belt. We are same as the next car and the next. However, each car ends up with a different owner. And each owner uses (and abuses) their car differently. And so, over time, depending on the usage and level and type of abuse, each car starts working differently. The state of health and function of various parts is different. The fuel efficiency one gets is different. The maintenance requirements for each are different. The choices that we make impact the state of our health and are what we will call- Lifestyle and Lifestyle choices. We are not going to be considering pathogen driven diseases in this context. If we use impure or wrong kind of fuel, our engine’s performance and energy efficiency and overall life get impacted. It could also result in deposits of chemical residues in the system impacting and clogging the flow. Overheating could be the result. Higher wear and tear might happen. Over or under inflation that leads to reduced tire life. Ineffective lubrication and cooling could impact function. Again, you get the picture.
The same thing happens to the human body. When we make one or more wrong choices and sustain those over some time, our body’s state of health gets impacted. Hormonal imbalances start. Chronic Inflammation results. Mitochondrial damage occurs. Our DNA mutates to what our body may be prepared for. Cellular maintenance gets impacted. We lose beneficial bacteria from our gut and harbour harmful ones instead. Our immunity reduces and the levels of stem cells also decrease. Some or all of these could happen. Each is a vicious cycle that can get worse over time. And given the interconnectedness and complexity of our body’s biological systems, one of these triggers the other and each one gets independently worse and makes the other bad as well. Over time, this cascades as a snowball and reaches proportions that impact overall health and well-being – both physical and mental. And once certain parameters breach medically acceptable thresholds one gets diagnosed with one or the other lifestyle diseases like obesity, PCOD, Type 2 Diabetes, hypertension, cardiovascular diseases etc. Let us understand, each one may or may not be an independent disease but a symptom of an imbalanced metabolism, of degraded cellular health and function and of weakened defence mechanisms – which are the root causes for lifestyle conditions. We understand that the above does not happen instantly. It’s not like the ignition or switch being turned on or off. These are time-dependent and they magnify over years and it takes about 10-12-15 years for these to breach thresholds that qualify them as a disease. In some unfortunate cases sooner while in others, later.
And what happens, when one of these, say Diabetes gets diagnosed. You get on a regime of lifelong medication that needs to be upward calibrated every few years as the effectiveness keeps going down. Eventually, you transition to injecting insulin till even that becomes ineffective. And by then, the underlying condition which you might have assumed is getting better with the medication, has actually gotten worse. Then the irreversible impact on various organs and body systems is such that one or the other gives up and one stares at end game. Similar is the case with other lifestyle conditions as well.
And why does this happen? Because the focus of medicine is typically symptomatic. It is working to suppress/magnify a specific parameter – say blood glucose. However, it is not addressing the underlying root cause.
So, what is the solution? Is there a fix for this?
Absolutely! And only if the approach is shifted to focusing on the root causes from being focused on managing symptoms.
Let us appreciate the fact that this is a time-dependent disease. The sooner we identify that we are on this path, the easier and faster it is for us to fix this.
The root cause of these set of conditions is metabolic imbalances, impaired cellular health and function and weakened defence mechanisms driven by bad/wrong lifestyle choices. And the only way to solve for the root cause and swing the pendulum from one end of disease towards improved health is to make counterbalancing lifestyle choices that rebalance Metabolism, the Improve Cellular health and function and that strengthen the body’s defence mechanisms. The solution has to include – Improved Nutrition, Increased Physical Activity, Better Stress Management, Alignment with Circadian Rhythm, High-quality Sleep and Predictive Diagnostics amongst others.