Its Time To Be a Nutrition Geek! The Biochemistry of Your Encounter With Food

We're learning about the endocrine system now (the collection of organs responsible for producing your hormones), and specifically, a lot about diabetes and obesity. I love it when my education brings biochemistry alive by making it relevant to our life today.

The way your biochemistry responds to an encounter with food, is down-right elegant. Many who are interested in nutrition, or have experience with low-carb diets, or who know something about diabetes have heard about insulin. Insulin is what we call a "storage hormone". As soon as you eat, and your body absorbs all of the sugars and starches that have been broken down, your body secretes insulin to signal to your muscle and liver cells to soak up all the sugar from the blood. This is so that the body can prevent damage to blood vessels and blood cells from sugars attaching to them. Now, insulin has been made out to be the bad guy by some people, because it favors the formation of body fuel stores, like fat and others. We'll leave this for another day. Whats important to know for our purposes now, is that in Diabetes, we've bombarded the body with refined carbs for so long, that the insulin producing machinery starts to conk out. This causes you to have high glucose levels, and so you have diabetic complications, like diabetic neuropathy (destruction of nerve endings in the feet), blindness (due to sugars attaching to the retina), and high blood pressure (due to sugars attaching to the lining of the blood vessels, making them harden).

So what does this have to do with how you eat? Well, it turns out, that insulin isn't JUST sensitive to the levels of carbs in your blood. Insulin levels are also mediated by a hormone called GLP1. The more GLP1, the more insulin, and the more glucose is taken out of your circulation. Now stay with me, because we are getting to the cool part. It turns out that GLP1 is secreted by the body in response to your anticipating food! Thats right, when you have that beautiful plate of say, your mom's home cooking in front of you, when you start salivating in anticipation of that scrumptious meal, your brain says to the body "OK, send out some GLP1, because we're going to have a shipment of glucose coming in, and we need insulin to make sure its not circulating all over the body wreaking havoc!" If you did not have GLP1, the insulin response isn't going to be high enough, and you end up with a situation thats similar to what a person with diabetes experiences - hyperglycemia, or high blood sugar. So why is this a big deal? Because it means that you need to be aware of your food when you eat, so that your body can utilize the food effectively. It's a beautiful illustration of how the way we live effects our well-being directly. Of course, there are tons of other reasons you should slow down and savor your meal. Digestions starts in the mouth. When you chew properly, you are giving your saliva a chance to break down your food, and make it more accessible to the stomach. The body also responds to your experience of the food by secreting the kinds of enzymes you need to digest it. Still think eating on the go is a good idea?

So back to GLP1. It turns out that my favorite hormone of the day also slows the emptying of food from the stomach into the intestine, helping you feel full and satiated, therefore preventing you from eating more! So besides helping to prevent all of those awful diabetic complications, GLP1 also helps you lose weight!

Well, if I haven't exhausted you, and you are hungry for more, here's another mind-body morsel (give me a break, sometimes bad puns are fun!). Epinephrine, better known as adrenaline also has some weight loss implications. Adrenaline is commonly known as the "fight or flight" hormone, because its what your body pumps out when you are trying to flee from danger (whether that be running from a bear, or trying not to fail an exam!). Adrenaline's effects are to increase your heart rate, increase sweating, making you nervous AND (drum-roll) excessive hunger! We know this, because when people are hypoglycemic(have low blood sugar), they have what are called "adrenergic symptoms" or symptoms that are because of adrenaline. These include all of the above. The excessive hunger in this case is your body responding to a lack of fuel. However, when the adrenaline in your system is because you are freaking out about a deadline, the effect on your body is still the same! Thats why some people eat when they are stressed. This is speculation on my part (Sorry, I wish I had the time to check this out!) but I would posit that its also why you get hungry after a meal of refined carbohydrates - like white bread, candy or sugary drinks. You generate a pretty big insulin response because your body is scrambling to catch up with the heavy load of carbs thats coming into the blood stream very quickly. This then causes you to crash and become hypoglycemic, and presto! You've got more adrenaline in your system and you are hungry all over again!

So in conclusion, next time you sit down to eat, make sure you savor your food. Its one of the biggest pleasures of life anyway, so you might as well enjoy it!

From Perfectionism to Sportsmanship

Medical school has been a bit of a growth process for me. I grew up very insecure with my own abilities. Like many in medical school who won't admit it, I am a perfectionist. The yard-stick by which I measured myself was always far too long. I looked at my achievements and especially at my failures, and I always compared them to the person who was the absolute best at whatever it was I was doing. I always said "they can do it, why can't I?", and so it went. The cycle in which I would beat myself up until I got things absolutely perfect, and kept challenging myself further and further until I would inevitably fall. I would take a semester of classes in college that was for me, a realistic load, and do amazingly well. Then the next semester, I would challenge myself to something I thought was a little impossible because I thought achieving the impossible was the way to prove to myself that I was worthy of the title "smart." I would spend the days that were close to my exam terrified of failure because of course, my identity as "smart" hinged on success. I would then proceed to fall on my ass. Yes, my ass. Now ashamed of myself, I would then pick myself up and start all over again.

Basically the admissions committee in medical school wants to know if you can weather mental and physical abuse for about 7 years of your life, maybe more, and come out alive. Apparently I met the criteria. However, needless to say that while my attitude got me into medical school, it was not healthy. Especially in medical school, where everyone was either as good as me, or better at jumping through those hoops to get where we all are now. I was already feeling worn-out when I started medical school (a story for another day) due to circumstances in my life. This coupled with my way of coping with challenges destined me for burn-out in my first year.

So here I am, after a year off of school in the middle of my second year, after having learned many, many lessons. The reason the title of this post is called "From Perfectionism to Sportsmanship" is because I have noticed a few common themes that run through my insights about success in medical school, or in any other challenging situation that constantly tests your limits, and one of them is the attitude that athletes take.

Athletes often have to imagine that they can do the impossible. They are constantly trying to overcome limitations, and achieve more with their natural ability than they could envision before. They can't afford to get down on themselves, because that means loss of valuable practice time. They have to use limited resources and limited time to achieve all this. Given such conditions, they have got to have the healthiest attitude towards failure than anyone else. I know that the world of athletics has its share of problems, but you have to admit, there are lots of similarities. When I do badly on an exam now, its painful, yes, but I say to myself "you have to lose if you want to be a winner." Med-students commonly say that "medical school is a marathon, not a race." I dont know about you, but I think we sound a lot like athletes.

I think approaching medical school from the perspective of athletics also has taught me something about intelligence. When training for a sport, you have to budget your energy, and your resources so they last you as long as possible. You have to use the time you have to get as much as possible from it. Therefore, problem solving becomes very important. Now, when people told me I was smart in college, I would always say "academic achievement isn't about how smart you are. Its about how lucky you are, and its about how motivated you are." and I concluded so because I knew a lot of people who were smarter than me that weren't making grades like mine because try as they could, they couldn't prioritize school to the degree that college course-work demanded. Some were even floundering because of circumstances in their life. However, circumstances or not, society would allow their grades to place them in the "smart" or "not smart" category. I still believe such thinking is quite silly, and I still agree with my previous conclusions about academic success to a degree, but with some caveats. Yes, its true that your grades are not an adequate barometer for measuring your ability to digest difficult to understand material that is presented to you. But, your grades, to a degree, do measure another kind of intelligence, and that is the problem-solving ability I alluded to earlier. I've realized that successful students are amazingly good at, in a time-crunched situation, organizing themselves, or coming up with ways to use the resources they have effectively so they can glean as much from them as possible in the given amount of time. Or, they are really great at getting in the teacher's head and looking at materials and figuring out what it is they are supposed to emphasize in their studies. Some are really great at getting tips or ideas from peers or professors. Its kind of like being able to create a good training regimen, and being able to fine-tune it as you go along for maximal results.

So anyway, wish me luck world, as I put my heart and soul into training for this marathon. I'll meet you at the finish-line, and hopefully when I'm done, I'll be a better person, and a better doctor than I ever could imagine.

Hello World, Its Me!

I'm a wife, a daughter, a daughter-in-law, a sister, a friend. I'm a Woman

I'm Distractable, Passionate, Talkative, Always Learning, a Student Leader. I'm a Medical student.

I'm Indian, American, ABCD (American Born Confused Desi, Desi meaning of our country), South-Asian American, Brown... still looking for a label!

I'm a liberal, wannabe Hippie, not-so-successful-at-it crunchy granola health-nut.

There are so many roles that I fulfill and so many things that make me who I am. This blog is half journal and half hackneyed, amateurish attempt at writing. I hope you enjoy my writing, and I hope you gain catharsis from my experiences. Please feel free to critique my writing, give me suggestions on how to improve myself or show me ways to to be better at what I do.

(Haha, and I swear, this will get less corney)