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Why taking 5 to 10 minutes to eat out of your busy schedule is so important! The risk of developing Gastroparesis from undereating

May 1, 2023

Imagine that you’re a Georgia Tech student. Your day starts at 8:25 AM, with your first class, Systems Physiology, which you know you have a weekly quiz in. You wake up at 8:05 AM, and by the time you finish brushing your teeth and changing into your clothes, you see that is 8:10 AM. Your class is not nearby. These are not the times of virtual classes after all! You have to make it all the way across campus, and you have barely any time to do so. You can’t take the bus because the bus is running late. So, you are unfortunately left with only one choice, to run quickly to class and skip breakfast, or eat breakfast, miss your quiz, and hurt your grade. Which do you pick? The answer that many students at Georgia Tech would pick would be to skip breakfast. After all, your stomach can wait right? Your hunger can wait? So what that you don’t eat for a few hours, what is really the worst that can happen? Eventually, skipping breakfast leads to skipping lunch because you are too busy throughout the day to eat lunch, and eventually, next thing you know, you’re skipping dinner because there’s no time to eat any dinner. You have that test to study for that’s happening in the morning that you need to ace, and you can’t even waste a second taking a break to eat. This is unfortunately the reality for many Tech students, and college students, in general, and I hope to tell you today why this reality is so dangerous and the significant harm that it can cause.

Sure, one or two days of late eating or skipping meals may not harm you. Heck, even if you do it for a few months, nothing might happen. However, what I am here to tell you and what I hope to instill in your minds today is that this is not something that you will get away with over the longer term. Contrary to what you may have been told, your digestive system is not ironclad. Just like other parts of your body, your digestive system is prone to diseases and issues. You just don’t realize it because, well, how could you? When your digestion is working as it should, you are less inclined to pay attention to it because you are not in a constant state of pain or distress. It is only when things go wrong that you start to realize how truly important eating properly is, and the impacts of not eating properly. Over time, not eating properly can wreak havoc, not just on your digestive tract, but ultimately your entire body. In fact, not eating properly can be a risk factor for many chronic diseases in the digestive tract and throughout the body that can ultimately increase the risk for cancers, autoimmune conditions, tissue damage, etc. if they continue long enough.

Perhaps, one of the most devastating consequences of chronically undereating, caused by skipping meals is the development of a condition called Gastroparesis. Gastroparesis is a condition that is caused, when the stomach empties significantly more slowly than it should. Think of it this way, normally when you eat something like a sandwich, over 90% or so of that sandwich should be gone from your stomach within 4 hours. Put another way, if someone were to take a look in your stomach after four hours, they should see almost none of the sandwich there. Contrast that to someone with Gastroparesis, where, even after 3 to 4 hours, a noticeable amount of that sandwich may still be remaining in that person’s stomach (perhaps, even as much as 40% to 50% of the meal, or, in some cases, even more). Now, you might think, surely it’s not that big of a deal that your stomach takes longer to empty? What’s the worst that’s going to happen? You’re going to feel a little more full for a little more time, so what? Unfortunately, the symptoms are usually much more severe than this and most people feel much more uncomfortable than just feeling full for a longer period of time. When the stomach does not empty as it should, many people can feel nauseous, have stomach pain, feel like their stomach is overly stretched for long periods of time, etc. (Gastroparesis).

Additionally, the discomfort of Gastroparesis does not just stop with the symptoms of the disease itself. Many people who have Gastroparesis are at risk of developing a significant complication known as a Bezoar. This is when undigested food matter essentially forms a large clump in your stomach or your intestines and effectively blocks the flow/passage of other food or fluid (Palchaudhuri 26). One example is a Phytobezoar, which is made up of matter from cellulose and other cruciferous vegetables that are poorly digested in those with impaired gut motility. There are other types of Bezoars, but the key theme with all of them is that they can be life threatening if not addressed immediately because they can prevent the delivery of nutrients to your tissues. Gastroparesis can also affect your blood sugar levels. You may not think about it, but, usually, when you eat, your stomach moves food to your small intestine throughout the day, keeping rises and falls in your blood glucose levels extremely stable. However, for someone with Gastroparesis, when food that is stuck in the stomach for so many hours suddenly moves to the small intestine all at once, all that sudden absorption of large quantities of food can cause such a significant and rapid increase in Blood Glucose levels. This can have extreme complications, such as causing Ketoacidosis, and causing rapid cell shrinkage, due to a person’s blood becoming significantly more concentrated than it was before(Shakil and Church 1699).

So now that you have heard so much about Gastroparesis, you are probably wondering, how does skipping meals cause Gastroparesis? How does my stomach suddenly lose its ability to digest food properly, just because I skip meals? Well, it turns out that the answer is actually much more logical than you might think. Just like other muscles in your body, the muscles and nerves in your stomach need to be used periodically in order to effectively work. Just like other muscles and nerves in other parts of the body, the muscles and nerves in the stomach atrophy or weaken when they are not being effectively used. For example, have you ever seen the movies about children who were in wheelchairs all their life, and then suddenly tried to walk? Did you notice how it took these children a very very long time to learn how to walk afterwards? Similarly, have you noticed how when you lift weights at the gym, you build muscle, but after a period of time, when you stop working out, you end up losing all that muscle? This is a natural consequence of muscle atrophy. Believe it or not, the same thing happens in your stomach. Moving food is essentially the work out for the muscles in your stomach, and if they stop getting this work out, they get weaker and weaker (Santonicola and Gaglidari 10). To an extent, these muscles can become stronger again by being used again, through eating properly, but it is a slow and difficult process and it is one that I don’t think anyone should have to go through, especially for something this preventable.

So why did I tell you all this information about a random health condition? Well, my intention was not to scare you, but rather just to convey that taking care of your physical health is just as important as success and grades. These days, so much stress is put on our age group to meet certain expectations that I think we forget the importance of taking care of ourselves sometimes, and that is really a significant problem in and of itself. The incidence of many diseases in young people are rising, especially in the western world, and one significant factor is that, these days, young adults are so stressed out that they do not take the time to put as much effort into their health or their physical and mental well being, as they do their success. So, I hope with this post, I have emphasized that not taking care of your health can have significant consequences and is just as important as being successful in school and other facets of life.

Citations:

Chawla, Rajeev. “Gastrointestinal Complications of Diabetes.” Complications of Diabetes, 2012, pp. 100–100., https://doi.org/10.5005/jp/books/11685_10.

“Gastroparesis.” Cleveland Clinic, https://my.clevelandclinic.org/health/diseases/15522-gastroparesis.

Palchaudhuri, Sonali, and Carlos Rees Parrish . “Bezoars: Recognizing and Managing These Stubborn, Sometimes Hairy, Roadblocks of the Gastrointestinal Tract.” University of Virginia Journal of Medicine, 2021.

Santonicola, Antonella, et al. “Eating Disorders and Gastrointestinal Diseases.” Nutrients, vol. 11, no. 12, 2019, p. 3038., https://doi.org/10.3390/nu11123038.

 

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4th year Biomedical Engineering Student at Georgia Tech, looking to go into the Premed track.

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  Timothy Durham was convicted of rape when a test showed his DNA genotype matched the DNA recovered from the crime scene. Eye witnesses testified that Durham was in a different state at the time of the incident, but he wasn’t exonerated from his 3000 year sentence until follow up DNA analysis showed that the preliminary forensic analysis used in the trial was misinterpreted (Thomas et al.). DNA testing serves an invaluable part in our criminal justice system, but it comes with complications and bias that can lead to wrongful convictions and misinformed juries.  

Background:

Forensic genetics aims to identify the origin of a biological sample. It can be traced back to Karl Landsteiner who discovered human ABO blood groups. With blood groups, suspects could be eliminated based on their blood type. For example, if a suspect had type A blood and there was type B blood left at the scene by the perpetrator, the investigators could rule out the suspect. Unfortunately, the reverse didn’t work. If the suspect and perpetrator both had the same blood type, it can’t be concluded that the suspect was guilty. Blood identifiers evolved into 8 distinct categories which improved the ability to eliminate suspects, but could only conclude that (if the system matched) it might be the perpetrator or this person might be related to the perpetrator (Jobling and Gill). The field evolved in the 1980s with the discovery of Minisatellites, lines of repetitive DNA that don’t encode proteins. Minisatellite patterns in DNA create what we know today as the DNA fingerprint, and it has a much higher accuracy rate than previous methods (Augustyn et al.). Around the same time, a breakthrough for victims of sexual assault was discovered. In the case of assault, bodily fluids of both the victim and the assaulter can get mixed. A process called differential lysis was created which could selectively increase the concentration of sperm in a fluid sample thereby allowing for accurate DNA testing (Jobling and Gill). Forensics evolved to use single-locus probe testing after several years because of its ease of interpretation. It looked at specific minisatellites that had high variability between subjects. This was the first DNA-based method to be used in a criminal investigation. Two murder homicides from several years apart were connected using DNA evidence. The evidence was then used to exonerate an innocent man, and the guilty party was found when he tried to evade mandatory DNA testing for all men in the small town. His guilt was then reinforced when the DNA profiles matched, and he gave a confession (Jobling and Gill). Finding DNA at a crime scene doesn’t guarantee that you’ll find a murderer. There are issues with non-pure samples and limited samples that make DNA work difficult, and accreditation of facilities and new techniques and take time (Jobling and Gill).  

Subjectivity of DNA Interpretation:

In a 2009 publication, the National Academy of Science discusses the possibility for subjective influence in lab based forensics. The interpretation bias happens in complex cases where, for example, there could be a mixture of DNA. A study published in 2011 looked specifically at this issue. A gang rape happened in Georgia, and the mixture in DNA from the case was used to prosecute one suspect after another suspect took a plea bargain to testify against him. With DNA mixtures, there are three possible conclusions: suspect excluded, suspect cannot be excluded, and inconclusive. If the suspect is excluded, it means that there’s little to no possibility that his DNA is part of the sample. If the suspect cannot be excluded, it means that there’s a possibility that his DNA is part of the sample. In the trial, the DNA examiners who knew the context of the case concluded that the suspect being prosecuted could not be excluded. The 2011 study gave the DNA evidence from this case and the DNA profiles of the suspects to 17 forensic examiners. These examiners had no context of the case, and they all worked independently. Of the 17, only 1 came to the same conclusion (suspect cannot be excluded) as the examiners who knew the context of the case. Twelve of the 17 concluded that the suspect who was prosecuted and convicted had no relation to the DNA found in the sample. Not only does this show that subjectivity occurs due to the context of the case, but the 17 examiners came up with different findings based on their past experiences meaning that not all DNA analysis is objective. Some organizations like the Scientific Working Group on DNA Analysis Methods say that quantitative statistical evidence should be presented with every categorical conclusion, but the US doesn’t require this (Dror and Hampikian).

False Positives:

There are two categories that cause wrongful identification in a DNA report: coincidental matches and false positives. Coincidental matches are DNA matches between two unrelated people. The probability of these matches is about 1 to 500,000 for white individuals and about 1 to 350,000 for black individuals. This small probability of coincidental matches makes people feel confident in DNA evidence. False positives, on the other hand, are matches between DNA and test DNA that result from issues in the forensics lab. There have been multiple cases of forensics labs accidentally switching victim and suspected rapist DNA which lead to convictions that were later overturned when the lab realized the error. There are also cases of misreading or misunderstanding a sample. In a case from 1993, a man was convicted of rape because someone interpreted a mixed sample of victim and perpetrator DNA as an individual sample. The conviction was again overturned. To prevent false convictions, retesting DNA is allowed, but it’s not an efficient solution. Many people are pushing for statistical information on the probability of false positives, so that the jurors can make accurate judgements based on DNA evidence (Thomas et al.).  

Conclusion:

DNA analysis is a useful tool for the criminal justice system, but subjectivity can be an issue in forensic testing. To combat wrongful convictions, there are organizations like The Innocence Project who use DNA testing to free the innocent, but reformed forensic testing standards should be put in place to prevent subjectivity and to ensure juries are correctly informed during trials. https://www.innocenceproject.org/    

Citation:

Augustyn , Adam, et al. “DNA Finerprinting.” Encyclopedia Britannica , 26 Apr. 2018, www.britannica.com/science/DNA-fingerprinting#ref153186. Dror, Itiel E., and Greg Hampikian. “Subjectivity and Bias in Forensic DNA Mixture Interpretation.” Science & Justice, vol. 51, no. 4, 2011, pp. 204–208., doi:10.1016/j.scijus.2011.08.004. Jobling, Mark A., and Peter Gill. “Encoded Evidence: DNA in Forensic Analysis.” Nature Reviews: Genetics, vol. 5, no. 10, Oct. 2004, pp. 739–751., doi:10.1038/nrg1455. Thompson, William C, et al. “How the Probability of a False Positive Affects the Value of DNA Evidence.” Journal of Forensic Sciences, vol. 48, no. 1, Jan. 2003, pp. 1–8., doi:10.1520/jfs2001171.