99: Gut Health & Chronic Disease in Children with Dr. Elisa Song, Holistic Pediatrician

Welcome to the Joyous Health Podcast hosted by me, Joy McCarthy. I'm a holistic nutritionist, founder of Joyous Health Mama and best selling cookbook author. Join me for great conversations with people who are passionate about what they do and are making the world a better place. I hope this episode brings a dose of joy to your day.

Hey everyone, if you are a parent or a caregiver, a grandma, a grandpa, this is an episode where you're going to want to take some notes. So take a minute to get a pen and a journal or a piece of paper because Dr. Elisa Song is so knowledgeable and she dives right into talking about the importance of a child's gut microbiome, the connection between the gut and the brain. Why is gut health so important for our children? Because supporting gut health now while they're young is going to benefit them as an adult. So Dr. Song is a Stanford NYU UCSF trained holistic pediatrician. So there's not many people out there like her. With her sort of expertise and also just knowledge in natural health, she founded Whole Family Wellness which is an integrative pediatric practice in Belmont, California and one of the first and most highly regarded holistic pediatric practices in the country. In her holistic practice, she has helped thousands of kids get to the root causes of their health concerns and help their parents understand how to heal their children from the inside out using an integrative pediatric approach. So these health concerns have ranged from frequent colds, ear infections, asthma, eczema, even to more serious conditions like autism, adhd, anxiety, depression, autoimmune. She has created Healthy Kids Happy Kids which is a space dedicated to empowering parents to take charge of their kids health naturally. I definitely recommend in the show notes we'll link this up that you go and follow her on Instagram because she has lots of easily digested information. If you're a parent, she's someone you want to be following. So before we get to our chat, if you never wanna miss an episode, make sure you subscribe to hi.joyoushealth.com and then on a weekly basis you'll get an email which is called our Dose of Joy. You'll get all the latest episodes and all the latest and greatest on joyoushealth.com to help you live a joyous, healthy life. So here is my chat with Dr. Song.

Hi Alisa, welcome. I'm so thrilled to have you here.

How are you?

I'm doing great. You know this is such an honor to be on your podcast and I'm super excited to share what I can with your listeners.

Amazing. Well, it's an honor to have you because I found you through Instagram and I started following you because I am also a mom. I know you're a mom of two, I'm a mom of one. And you know what, your posts and the information you share just. I take a deep breath because it's just always like a sigh of relief. I'm like, okay, I got this. We're doing things right. Yeah. So I really appreciate your perspective of combining like, the best of Western medicine with the best of traditional medicine. And you call yourself a holistic pediatrician. Can you talk about what that means to you?

Yeah. So, you know, really what I would consider myself is a holistic and an integrated pediatrician. And you know, really, as pediatricians, we should all be holistic. I mean, bottom line, right? We should all take our children in the context of their families and their friends and their communities and their schools. And when you take a holistic and an integrative approach, what that means is really being able to integrate the best of what conventional pediatrics has to offer and understand the shortcomings and be able to integrate some other natural modalities. So we know that there is a time and a place for almost everything in conventional medicine. Conventional medicine is amazing at putting out fires, amazing at treating emergency emergencies and really the acute injuries and even life threatening things that can occur. On the other hand, I mean, let's take antibiotics for instance. Antibiotics are considered one of the greatest inventions of the 20th century. We're not in the 20th century anymore. We're really now in this place where, wow, kids are dying not so much from infectious diseases, but from the downstream effects of what we're doing. And so we have to understand that we're going to dive into that today on gut health, but knowing that you take the best of what we can from conventional pediatrics. And I was trained very conventionally at NYU Medical School and at Stanford and ucsf. I mean, super conventional. But then we can integrate acupuncture and holistic nutrition and functional medicine and herbal medicine and homeopathy to really help kids thrive from the inside out. Right. Not just putting out fires, but really building up that foundation of true health so that no matter what comes their way, we trust and understand that they can stay well and be well for the rest of their lives and prevent disease.

I'm sure so much of what you do is about prevention too. How did that. So when you were studying to become a pediatrician, did you go into it Already holistic minded? Or was it when you fit, like, how did that all come together?

That's a great question. Because a lot of physicians who find functional medicine or integrative medicine, it's because maybe they have had a health concern or a family member has had a health concern that conventional medicine didn't have all the answers for. And that's not really my story. I mean, thankfully. Right. I'm so grateful that that hasn't been my. And it really was from the beginning that I was really interested in this. I remember at Stanford as an undergraduate, I mean, here I am, this, you know, 19, 20 year old kid, and I'm walking around campus and I wasn't even going to go into medicine. I was going to be. I always wanted to work with children, be a children's advocate. I was going to be a lawyer, work on Capitol Hill, do children's civil rights and policy, and work for the Children's Defense Fund. I mean, I had it all mapped out. Yeah. And I even took the LSATs. Right. I was well on my way and then I saw this flyer that caught my eye. And it was a flyer for a convention just in Santa Clara for the American Holistic Medical Association. And I was like, what's holistic medicine? You know, because my mom was an obgyn, I was grounded in conventional medicine growing up. And so something, you know, got into me. And as a junior, I'm like, well, I'm going to check it out. So I made myself, made my way to this conference and it was fascinating. They were folks. Now I'm dating myself. I mean, this is back in the late 80s, very early 90s, and there were folks who were just getting known in this health and wellness space. Andrew Weil, Deepak Chopra, Right. Joan Borisenko. And my mind was blown. I mean, I couldn't believe it. I'm like, oh my gosh, what is this thing they're talking about? Medicine can do this. And so I remember at that point I told my mom, I think I want to do this. And I actually got applications from Basseer Naturopathic College. I'm like, I'm going to be a naturopathic doctor. You know. But back then, I mean, that was a long time ago. Now, you know, most everyone has heard of naturopathy and naturopathic medicine, but back then people did not. And so, you know, my mom said, well, you can do whatever you want. I'm going to support you.

That was going to, I was going to ask you that, actually. Did you have the support? Because Your mom conventionally trained. That's amazing that she was very supportive.

I want you to be happy and follow your dreams. I mean, she was so great.

Oh, that's fantastic.

But she gave me some really good advice that I am glad this is the path that I took, because she said, you know what? Why don't you go to medical school first? Because that's what people know. And then you can incorporate. You can always learn the integrative. It wasn't even called integrative then. Right. It was called alternative. And so. Right. There was an office of alternative medicine at the nih. And so she said, you can learn all that, and if you want to do that with that foundation of conventional medicine, that might be the way to go. And I'm so glad.

That I went this route. It was painful. I'm not gonna lie. I mean, I didn't like anything about medical school and residency. I'm like, oh, my gosh, is this really what I want to do with my life? And it wasn't right. I didn't see anything in residency that I really wanted to do for the rest of my life. But it set that foundation so that I know when medicines are truly needed. I know when referrals to specialists are needed. And yet I also know how to thankfully mop up some of the unintended consequences of the medications we're prescribing. I know how to, when a kid shows up with a chronic health concern, to try to find the root causes so that we can really embrace the idea that just because the disease is, quote, chronic, it doesn't mean that it's forever. Right. And I've been really trying to move away from the word chronic because that kind of strikes fear into people's hearts. Right. As a mom, if you're told your kid has chronic asthma, chronic anxiety, you're like, oh, my gosh. Okay. So basically, they have this for the rest of their life, and even if they get better, they're always still going to have it. They're just, you know, it's just under the surface. So moving more towards thinking of these as persistent health problems. So, yeah, they're persistent. They might be stubborn, they might be hard to really get to the root cause of, but they're not forever. And that's where integrative pediatrics has the true hope for our kids. Well, and frankly, for us as adults. Right.

I like that as a mindset change, thinking of persistent health problems versus chronic. Because when you hear the word chronic, it just makes you feel that your child is Going to have this forever. I imagine when you've seen children with chronic asthma, has it been. Have you seen success? Has there been success helping children move beyond that?

Absolutely. And, you know, we really, with an integrative approach, I mean, I've been. I mean, I've been doing this for a long time. I started my practice back in 2004 as an integrative functional medicine pediatric practice. So, I mean, that's almost 20 years now. So through the years, I've been really blessed to be able to, you know, find those roadmaps that. To help children and their families recover completely. And even if they don't, I mean, I'm not going to say it's 100%, but children who have lost their autism diagnosis or kids who really no longer have asthma and we're not concerned at all that they're going to wheeze with their next cold, or kids who have had autoimmune diseases, diagnosed rheumatoid arthritis, or Crohn's disease, and are not just in remission, but they are 100% great. Right. So that's what we want. I mean, we really, you know, that's the hope we want to move towards. And you know, this, that it is so true. Joy, that mindset shift is so important for us as parents and as physicians. Really important.

Yeah. And I appreciate that you shared all that and that you help your patients realize because I imagine it's a, you know, teaching. They're coming to you as a holistic pediatrician. But I imagine for a lot of parents, if they've been given that diagnosis, they're just kind of like, oh, this is what it is. And you can help them change their mindset around that.

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It does seem though that kids.

Are getting sicker and sicker. It seems autoimmune disease is on the rise. Mental health, especially the last couple of years. Some of the stats I'm not as I'm sure it's very similar in America, but in Canada it's pretty awful what our kids are going through. So can you share? Like what are some of the current numbers in terms of chronic disease or persistent disease mental health?

What's going on you know, it's startling, and it was. The statistics were startling even before the pandemic. But, you know, as you've mentioned, these past few years have thrown curve balls that we never could have imagined and not for the better in terms of, you know, mental health for our kids and in terms of these, you know, persistent chronic health concerns. So even before the pandemic, the estimates were that a little over one in two kids, maybe around 55% of kids, had some sort of a, quote, chronic diagnosis. And it runs a gamut, you know, from things like eczema to asthma to anxiety to autoimmunity. So a broad spectrum of concerns, some not, quote, serious. Right. And others much more.

Grave potentially. And even before the pandemic, if you looked at the graph and the trajectory, the estimates were that by 2025, which is right around the corner, we may up to eight in 10 children with a chronic concern. And now I'm thinking way back in 2005, this is again, I mean, 18 years ago. Now I have to do the Math. This is 2005. Yeah, I guess that's 18 years ago. Almost 20 years ago, there was an article in the New England Journal of Medicine that said that for the very first time ever in history, our children are expected to have a shorter lifespan than us, their parents.

That is sad.

With all of the medical advances that we have, right? It is so sad. You know, with all the technology, all the things that we should be able to accomplish with modern medicine, our kids are not going to live longer than us. And it's almost all due to lifestyle related, what are called NC cds, non communicable diseases. Now the pandemic shined a really big light on that, right. We know across the world, I mean, the World Health Organization said non communicable diseases are the highest risk factor besides age, for severe Covid, things like diabetes, heart disease, chronic lung disease. So it should have been a wake up call back then. It needs to be a wake up call right now. And I really, you know, it's, it's.

You sharing these messages out with the world with your podcast. You know, really all of us, you know, in this health and wellness space, sounding the alarm bell. And not just sounding the alarm bell because that just instills fear, right? But saying that we have this huge red flag, right? The bell is, you know, the siren call is here. We need to now move forward with hope because we have a lot of the answers at our fingertips. We need to put this into action. And when it comes to mental health, our Kids can't wait. I mean, they really can't. You know, mental health was declared a state of emergency in children during the pandemic in the United States, as I'm sure in Canada, similar in Australia, similar around the world. And we know that by the time kids are 18, one in two kids in the United States is going to be diagnosed with the. Some sort of a mental health disorder. I mean, that's, that's 50%. Right? I mean, that could be. I mean, I have two kids. It could be one of them. Right. And so, and then this, this autoimmunity, autoimmunity has been skyrocketing. And this is really where you might think as a parent or as a teenager. Well, you know, my grandma had Hashimoto's, my mom has Hashimoto's. Well, you know, my aunt has Hashimoto's. So I'm definitely gonna have it. Why bother really trying to prevent it? We know now the power of epigenetics. We know that we can make our genes work for us or against us. Nothing is ever set in stone. Our genetic destiny is not set in stone. We have the power to influence that, and we need to step in and teach our kids that. Because autoimmunity, there's a marker called an ana, an antinuclear antibody. It's a very general autoimmune marker. And so there was one study that just last year that has been following since the 80s, the different age groups and how rapidly the rate of ANA positivity is occurring. And what they found is that in every single age group, there are more and more people with positive ANAs. So the rate is increasing, but the rate is increasing the most rapidly in teenagers, 12 to 18 year olds. And since the mid to late 80s, that number has almost quadrupled. Whoa, quadrupled, Right. And so this is, this is a huge. You know, you talk about the canary in the coal mine. Well, this is that. Because when you have a positive ana, it doesn't tell you that you necessarily have a particular autoimmune disease, because you can have this antibody present for decades before an autoimmune disease actually develops. But it tells us, look, we have this opportunity now. We know that this child is tipping over into autoimmunity. How do we flip the switch? Right? And that's where really taking that integrative approach and that preventive and that thriving approach is so important.

So what do you think is going on? I know you talk a lot about the gut microbiome and why gut health is so important for our children is that part of the puzzle piece of what's going on, why there is so much chronic disease?

That is a huge part and I would say, really the foundational piece that I want parents to understand and that practitioners need to. Need to understand as well. Because unfortunately, when you look back, you know, over at the research on, and we'll talk about, you know, leaky gut in just a moment. But when you look at the research in, on PubMed, which is the, you know, national database of research, you know, scientific papers, there are papers on the association with leaky gut and eczema, let's say, you know, from back, way back into the 80s, 1980s. Right. And yet how many dermatologists and how many pediatricians are talking about this with their, with their kids? Right. We've known about the connection between leaky gut and, you know, asthma and autoimmune disease in kids. It's there in the literature. And I've, you know, I've combed the literature, but there aren't many studies, but they're there. And so we should have taken that and run and said, well, what's going on here? Right. And so why is gut health so important for children? You know, when children are born, babies are born out into this world.

Their gut is fairly, quote, sterile. Now, there is controversy over that. You know, we know that mom's gut microbiome and vaginal microbiome play a huge role even, even in utero. Right. In shaping what that baby's gut microbiome will look like. But for the most part, they don't really have many bacteria in their gut, many microorganisms, and they rely on the mode of delivery. If they're born vaginally, they come out and they're exposed to mom's vaginal bacteria. And mom's gut bacteria, if they're born by cesarean section, they're more exposed to skin bacteria. Now, the way that a baby's gut microbiome develops in that fat first, in utero, all the way to about three years of age is a really key foundation for how their brain and how their immune system develops. Your gut microbiome. I mean, there are 70 to 100 trillion microorganisms in our gut. And so those get into our baby's gut and they colonize and they flourish. And, you know, when Hippocrates said that all disease starts in the gut and we have to flip it and say, well, then all health must also start in the gut. And the gut microbiome lays the communication as the gut microbiome in your baby in those first several years of life, and then there's another stage in their younger years and another stage of development, their teenage years. That gut microbiome development parallels brain development and immune system development. It's fascinating. And then we think, well, you know, is it a chicken or an egg thing? What comes first? And we know, you know, that imbalance in the gut microbiome for children and for adults for that matter, is linked with virtually every persistent pediatric health concern. Right. And not just gut problems. We're talking immune problems like eczema and asthma that we mentioned. We're talking about brain concerns like ADHD and anxiety and, you know, all sorts of neuropsychiatric concerns. So when we have a health concern for a child, we always want to go back to the gut and understand how is their gut microbiome informing the way that your child's brain and immune systems are developing.

So is there any way, like, as a holistic pediatrician, how do you assess the health of someone's gut, the health of a child's gut microbiome? Do you have tools to do that, or is it more symptomatology, finding out what's going on?

Yeah, so there are clues. Right? So, you know, when a patient comes already with maybe some little patches of eczema on their skin, or maybe they have, you know, as an infant, they have reflux and they have a lot of GI symptoms, bloating, and, you know, they're really, really fussy as infants or, you know, as toddlers, they have some behavioral concerns that are starting to show up in preschool. Those are all signs to me that their. That their gut is pretty probably imbalanced. And I want to take a look. So in those cases, I will start with what's called a comprehensive stool analysis. This is a specialized functional medicine stool analysis that can look at not just are there lots of majorly bad bugs like salmonella or shigella, and those can happen, but aren't as common as subtle imbalances in your gut microbiota community. Right. Imbalance is in the different kinds of bacteria that are present, or parasites or viruses or yeast. We have all of these present in our gut, but they should be in healthy balance. And so when there's an imbalance, that is called gut dysbiosis. And so these functional stool analyses can assess all the different kinds of microbes that are in your gut. Now, we don't yet have great tests for all the different viruses that live in our gut. We know about Probiotics, the bacteria. But we have whole communities of microorganisms that we are just in the infancy of learning about. And that's going to open up another huge avenue for potential therapeutic possibilities for our kids. And then also we can look at, through a comprehensive stool analysis, how your kids are digesting and absorbing their nutrients. Because it doesn't matter if you're pouring in all the most nutritious foods and supplements that you think are really going to be helpful if they're not absorbing them. Right. And we can look at inflammation. So I might do that. Now, not everyone has a functional medicine pediatrician nearby and may not have access to some of the functional medicine labs or testing that I might do in the office. So there are then, I mean, like I said, these are clinical clues. If your child has a persistent health concern, yes. Look at their gut. And then there are some things that you can do presumptively that, you know, different supplements you can try, different things you can do with diet and lifestyle that can really make a difference, even if you don't have the test to start with. And then when you get stuck, you know, if you have. If you move forward and you're like, oh, okay, my child's getting better, behavior is improving, sleep is improving, skin is improving, whatever it is, then you can try to find, you know, and you get stuck, then you can try to find a practitioner who can guide you even deeper along the process. And then, you know, if your child does not have any persistent health concerns, if they have ever had a round of antibiotics, right? And I'm talking even if it was antibiotics that they were exposed to in your womb when you were pregnant, that still counts. That's still an antibiotic exposure for your baby. If they've ever had other medications that we know can disrupt the gut microbiome. Microbiome, like antacid medications or your teenager who's on the birth control pill or a variety of different medications, or they're eating in a way, or living in a way, as many of our children do in our modern world, that directly causes disruption to your gut microbiome and your gut lining. Then we know, all right, let's do some cleanup. Let's just try. Let's do some cleanup. Let's mop up the gut microbiome. Let's restore and recover a really healthy gut microbiome at any age and see what happens. Because it can be amazing, even if you didn't think your child had any health concerns, how much more vibrant they can be and feel when you do that cleanup. It's just like with adults, Right. You think, well, I feel fine. Right. But we shouldn't just live feeling fine.

I agree.

We should live feeling fine, vibrant and amazing and energetic. Right. Which a lot of us sadly don't live on a day to day basis that way.

Yeah. So I want to talk about in.

A bit, I want to talk about.

Like some of the solutions you recommend, whether it's supplements or changes to lifestyle or diet. But before we get to that, I want to dig a little deeper and ask you about the gut brain connection and, you know, what's going on there and why is the gut called the second brain?

So I love this question because the gut brain connection to me is really holds for me, holds the answer to so many of the concerns that we have with our children. The gut and the brain communicate via this two way information superhighway called the vagus nerve, which many listeners are familiar with or at least have heard of. It's the longest nerve in our body. And the gut is called the second brain for a couple of different reasons. The gut actually has its own nervous system. It's like a mini brain in our gut. What's really fascinating is that our gut's nervous system can live without our brain, but our brain can't live without our gut's nervous system. So who really has more, quote, control in this relationship? Right? And what most people don't, don't fully realize is that the vast majority of all of our brain chemicals called neurotransmitters are actually made in our gut and made by our gut microbes. These microbes in particular that make these neurotransmitters are called psychobiotics because they have a psychological impact.

Something like 80 to 90% of all the serotonin in our body is made by our gut microbiome. Microbiome. And serotonin is what helps us feel good and relax and manage stress and helps us with sleep more. Melatonin is made in our gut than anywhere else in our body. And we have other neurotransmitters like dopamine, which is important for attention and focus, and acetylcholine, which is really important for processing and implicated in neurodegenerative diseases like Alzheimer's. So even then, we always want to look back to the gut. Now, the real reason I think that we really need to call the gut our primary brain, right, Our more. Not the second brain, not the second brain, but really our main brain is that when you look at the vagus nerve, most of the communication, 80 to 90% of the communication in the vagus nerve, this information highway occurs from the gut to the brain. And only about 10% goes back from the brain back to our gut. So how our gut microbiome is functioning and shaped really informs how our brain is going to communicate then with the rest of our body and with the rest of our organ systems. And so really supporting your child's gut is going to have so many downstream effects on their mood and their focus and attention, their relationships, you know, their sleep. And we know that the health of the vagus nerve, which we can measure by something called heart rate variability. And many adults now wear things like oura rings, right?

Oh, you have an aura ring too?

That's right, yeah. Where oura rings or other wearable devices that measure heart rate variability. Now heart rate variability is a measure of vagus nerve function and is a measure, is a best predictors of optimal health and performance and all of the things that we want for ourselves and for our kids. And when we engage our vagus nerve and by optimizing our gut microbiome, optimizing that communication, and practicing engaging our vagus nerve on a daily basis, we strengthen that gut brain connection and we strengthen the resilience of our gut to stay healthy no matter what happens in life. And we strengthen the resilience of our child's brain to remain resilient no matter the psychological stressors that occur. So I mean, the vagus nerve, if we could really teach our children how to strengthen, you know, give their vagus nerve muscles every single day, that that could be really the key for lifelong health for them.

And how do we, how do we do that?

So there are different ways. There are. If your children are, you know, do have some, you know, more persistent health concerns, then you might do things like acupuncture, which can engage your vagus nerve. It's a great way to engage your parasympathetic, you know, rest and digest and heal arm of your autonomic nervous system to quickly get out of the competing sympathetic fight or flight state. Right. There are things like Heart Math, which is an app that engages, that uses biofeedback. It's lots of amazing studies on vagus nerve optimization. And there are things like EFT tapping emotional freedom technique that I love. That is a simple, easy tool for kids to learn to tap their way out of that alarm sympathetic state into that vagus nerve, that parasympathetic state. And then there are things we can do every single day. You could tap every day Tap all you want, right?

You know what?

I.

You're. I wish I had like, my pen and paper writing because, like, I'm benefiting from this so much with my own daughter. But I'm thinking, yeah, wow. Like, I think of all those things for myself, but with my daughter, why not? Why am I not taking her for acupuncture?

Yeah.

Like, I assume. I assume with your two kids, do you do all these holistic modalities? Like, have they done acupuncture?

They for sure have done acupuncture. And so as a little aside, because some parents are probably listening and like, well, my kids aren't gonna sit on a massage table for 30 minutes and just lay there with Zen music. So acupuncture with kids, we don't keep the needles in. And I don't call them acupuncture needles. I call them acupuncture sticks. Or I ask kids what they wanna call them. I use these tiny little Japanese. They're called, quote, painless needles and they have different colors. I use ones that maybe have a red tip or turquoise tip. Can choose. And literally a session could be like two minutes and we're on the floor, we're on the couch, or wherever they want to go. And you just go in and out. Sometimes I'll keep the needles in for a little longer, especially if they're having tummy aches or with constipation or if they have an asthma flare. And then you can also use acupressure on these same spots. So, I mean, for instance, I just had a mom yesterday call and their child has a cough. So I showed her over the phone. I told her where acupressure spots were for fever and for cough, so that she can massage those spots directly for therapeutic benefit. But absolutely, I mean, it's acupuncture for kids. It is amazing because they don't have all of the energetic blocks and all of the garbage that we have as adults. They were respond so quickly, it's amazing. So I would encourage parents to consider that a modality for their children, especially if you're doing it for yourself and you see the benefits, because it definitely can benefit your kids. Right. And if you do tap for yourself, have your kids tap with you. Right. There's an app, the tapping solution app has some free tapping.

Okay, I'll check that out.

That are they even have a kids section and some for teens so that they can learn how to tap on their own. And that's something too. If they're stressed out in school and they have, you know, they're getting worked up over a test, they can just excuse themselves, go to the bathroom for a little bit, you know, tap for a couple of minutes and come back and, you know, be in a calm state. Now, what I love to teach, though, is.

Our different tools for kids. And these are going to resonate with different kids and families. So choose what works best for you. But the one thing that is really important to learn is how to breathe in the right way that engages the vagus nerve and keeps you in a parasympathetic state. And most of us breathe in a way that's very shallow. And we lift our shoulders up and we suck in our bellies. So we're breathing with the upper half of our chest. And when you do that, I mean, if you're sitting here listening to this just for a moment, put your shoulders up to your ears and breathe really shallow, and you start to feel a little anxious. I mean, you just start to feel, I'm not relaxed right now. I'm tense. I'm waiting for something bad to happen. Right? And so if you keep your shoulders down and for kids, you can. There actually is a very cute YouTube video with Elmo and singer Colby Kelly and rapper Common, and it's all about belly breathing. I've shown it to, you know, I did. I taught a gut health, gut, brain, gut you class, a six week class for my kids, third and fourth grade class. And we played the Elmo video. Super cute. So many of us as adults have forgotten how to breathe with our diaphragms. And we don't fully, fully inhale and fully exhale. And so we're not getting all the oxygen we need. We're not blowing out all the carbon dioxide that we should be getting rid of. And so you place your hand on your belly and you just keep your shoulder. You can even put one hand on your shoulders. Some people like to lay down so that their shoulders don't move. And you could put a little book on your child's belly so that they can see as they breathe in and inhale slowly. The hand on their belly should be lifting. Chest stays still. And they're expanding that balloon. Hold it at the top for a little bit, and then as the exhale, the balloon in their belly deflates and you hold at the bottom. The longer you can hold it at the bottom, slow your exhale. That's when you engage your vagus nerve and your heart rate variability really, really starts to flow. And you can assess this. You can actually see if you find Your pulse on your neck or your wrist and you take a quick breath in, you'll notice that your heart rate speeds up. And then as you exhale slowly, your heart rate slows down and that is normal. Good heart rate variability when you're stressed. Do this the next time you're in your car driving to work, late for whatever, and you've had a hours of couple a cup of coffee to try to wake up in the morning. And your heart rate, no matter how slowly you exhale and inhale, your heart rate's just fast and steady, one beat, right. There's no variability. Okay. That's where the heart variability comes in. And so.

Okay, that's a good way of explaining it.

Yeah. And this one thing, you know, we breathe every day. We have to, right? So why not learn how to breathe in the right way? And you know this, we know meditation can improve heart rate variability, but that's a little bit of a longer game for kids, right? I mean, they have to learn how to do that and practice it. And it takes more time and kids should practice that. I guarantee it's going to be one of the greatest gifts that you can give to your kids and to yourself. But last, I think two weeks ago, a study, as we're recording this, a study just came out looking at breathing techniques versus meditation and breathing actually.

Improved mood and different physiologic signs of anxiety better than meditation.

So I can see that. Because you know what? When if I'm doing a guided meditation and the guidance is guiding me along how to breathe, I have a better, more relaxing experience than if I'm just doing a guided meditation. And there's no talk about the breath. So that makes a lot of sense to me, 100%.

And again, it's on that exhale, right? When we breathe in, your heart rate should speed up. When we exhale, your heart rate should slow down. And it's in the exhale when you're slowing down, that that makes a huge difference. And then, you know, every moment that we can, every day, incorporating a mindfulness technique, and there's lots of different ones and they don't have to take a lot of time, but that is another instance, instant way to help your child just stop in the moment and engage your vagus nerve. And this ability to stop and regulate yourself and then move on, that is one of the keys to success in life, right? You know, when, when we're stressed and anxious, if we could just stop, I mean, just get out of that state, take a look around at what's happening around us and also inside of us, and then move on. And so different, different mindfulness tools. One of them is a loving kindness meditation, a gratitude exercise that you can do anytime. And kids can do it in their heads. But if they're feeling really worked up or maybe angry about something, you can say, you know what, why don't we just sit? I know you have this big feeling inside, but let's just sit for a moment and extend some kindness to those around us. And you just repeat four simple sentences. Give loving kindness to yourself first, then to whomever else you want. And you tell yourself, and you tell others. May you feel safe, may you feel healthy, may you feel happy, may you live with ease. And you just go through that exercise with as many people as you want to. And in that moment, you will be engaging your vagus nerve. And you can't help but feel just a little more grounded. And then you can talk about that big feeling. And oftentimes that big feeling is, is a little less big, right? A little more manageable and kids can talk through it better. And then another favorite one, which you can do when you're walking your kids to school or if you're maybe you're hanging out on vacation on a beach somewhere, you can say, hey, let's just, let's. And I call it stop, look and listen. But it's really a five senses meditation, right? And so you can say, hey, let's just stop, look and listen for a moment. And you just stop. The stop part is literally stopping what you're doing and giving yourself permission to take these few mindful moments with yourself or with your child. And then you look with all of your senses. But the first thing you do is close your eyes. Because our visual sense, our sight, is the one we engage all the time, every single day. And it's our strongest, so it tends to overpower our other senses. So you close your eyes and you just ask your child to notice the for a moment, what do you hear in this moment? And then you pause and you say, wow. Do you hear the waves crashing? Do you notice that the seagull chirping in the sky? Did you hear that car going by? Then you move on to smell. Notice everything you're smelling. Is it the salt air or is it the fire from the chimney? Because it's a brisk morning. What do you taste? You know, is it the toothbrush that you. Toothpaste that you just used to brush your teeth, hopefully, Right? Is it the right. What do you feel on your skin? Do you feel the weight of your backpack on your shoulders. Do you feel the wind rustling your hair? And then finally we open our eyes and what do you see? And oftentimes in that moment, you are going to see things that even if it's the same walk you do every single day, you know, every day of the year that you have never noticed before. And then we listen. And the listen part is where you integrate this and you just tune in and you listen to how your body and your brain are feeling in that moment. And that's your mindful moment right there. And it doesn't take a long time. But just by giving your kids these tools and showing them that they can stop and they can reflect and they can be mindful before they go back to the busyness of their day is so powerful. And they can use that at any time.

I love all of those strategies. I'm totally going to do the one you just mentioned. Can you tell me again?

It's stop, stop, look and listen.

Stop, look and listen.

Okay, stop what you're doing.

We're going to do that one right?

Then look with all of your five senses. And then you listen and integrate with what's going on inside your body and your brain.

I am a fan of that. We also, I'm a big fan of meditation. I got Vienna, our daughter, meditating at a very like I would do. She would see me doing it all the time when she was a baby. So then when she was a toddler, we would do it together. And now, you know, it's been a while since she's had, you've been really upset or had like a major meltdown. But when that did happen, it became a habit that she would say, mommy, can I, can you put on a meditation for me? And of course I said, yeah. I used to use Calm kids a lot. Calm kids isn't. It's the calm app story. And then they have a calm kids section. So we would use that with her. But I mean, obviously that you just go into YouTube and find great free meditations for kids. So I'm a huge fan of that. And to your point, it's not, you know, if you have like a 12 year old who's never done meditation before, perhaps that's not for them. But I feel like the younger you can start them on that, the better. And also I was thinking as you were talking about mindfulness, something that we do at dinner, and it just kind of occurred to me that it's actually a mindfulness exercise is we do the rose bud Thorn. So I don't know if you've heard of that before. Yeah. So like what went amazing today, what didn't really go your way? What are you looking forward to? And I feel like it always, it helps all three of us become sort of more, more mindful in the moment, even though you might be thinking about what you're looking forward to. But I just loved all those strategies that you shared and also all the stuff you talked about when you talk about different apps with the Heart math app and the tapping.

We'll make sure that we link that up for everyone in the show notes. And now for a short break. I've always been obsessed with skincare products, but because of my sensitive skin, I have to be super careful about what I use. That's one reason I was inspired to create my own line of all natural products that are gentle but effective to use on all skin types called hello Joyous. We crafted our line to include powerful botanicals from nature like certified organic rosehip, comfrey root, golden jojoba, calendula flowers, chamomile and more. It was also so important to me that our products be made locally with natural organic ingredients that have functional benefits that include everything from anti inflammatory action, super hydration and antioxidant power to prevent premature wrinkling. Every single ingredient has a purpose, so you won't find a single filler in our products. And when it comes to creating a safe all natural skincare line, what we put in is just as important as what we leave out. The conventional beauty industry is the furthest thing from clean. In fact, according to the David Suzuki foundation, up to 80% of conventional personal care products contain the toxic 10 ingredients. These include everything from parabens to coal tar derived colors to formaldehyde releasing agents and hormone disrupting ingredients such as artificial fragrances that contain fence phthalates. Unlike conventional products, our hello Joyous skincare line is free from all these harsh chemicals making it completely safe and non toxic for you and the planet. From cleansing to balancing to hydrating and exfoliating, we have something for all your skincare needs. Crafted from nature with organic ingredients formulated to bring you and your skin joy. Check out our cleanser, toner serums and exfoliating mask. Visit hello joyous.com and use code podcast to save 15%. That's hello joyous.com h l l o J-O-Y-O u s.com and use the code podcast to save 15%. And now back to my guest when.

Are there area one to talk about in Regards to gut health. And I know parents are probably wondering, this too, is like, how the gut and the immune system are connected. And then I'd love to talk about how can parents keep their gut microbiome healthy.

Okay, Love that. Because we want, we want actionable items, right? Especially, you know, Joy and I, we're, we're mamas. We don't want fluff, we want actionable items.

Exactly, exactly. What can we do right now? Well, you gave us tons of actionable items. Thank you so much, by the way. To support the vagus nerve. Yeah, I mean, so those are all.

Fantastic, but it doesn't help if there's nothing you can do with it. So the gut immune system connection is really key. So, you know, when we think about our gut, well, our bodies, we are basically one big tube, you know, from our mouth all the way down to the bottom where the poop comes out. We're a hollow tube, right? And so our gut is our largest interface with our outside world. If you think about it, all the food we eat, any pathogens, you know, viruses or bacteria that we're exposed to, they're going to make their way down into our gut as well, right? It's not like we just breathe them in and they stop there, you know, go to our lungs. They also travel down to our gut. Any environmental toxins that we're exposed to are going to travel down into our gut. And so, yes, our skin is a large organ, but our gut is, is our most important interface with the outside world. 70% of our immune system lies in our gut. If you think, you know, your kids have, you know, most kids have tonsils still, not all adults have tonsils. But, you know, these tonsil like patches line our entire GI tract. And our gut microbiome communicates with those tonsil like patches. And anything that comes through our gut, whether it's a food particle or a virus or a bacteria, our gut microbes decide they have a role in saying, is this something friendly? Do I just want to have a pass and get into my bloodstream, absorbed into my bloodstream and not make a big deal about it? Or is it foe? Is this something that I should be fighting? If you're eating, let's say, some apples, there's no reason your immune system should have an immune response to that. You chew, you digest, you absorb those pieces of apple. Your gut microbes say, this is fine, this is, this is friend to me. And your immune system stays calm. If it's something like, let's say, a virus or a pathogenic, bacteria that passes through your immune system, your gut can sense that as well. And then tells your immune system, you know what? This is no good, this is faux, let's attack. And tells your systemic immune system to create inflammation, to fight this thing, right? That shouldn't be in your body or passing through. So that in the ideal situation, that inflammation comes and it goes when the fight is done. Now, what can happen when your gut microbiome is disrupted and dysregulated is a couple of different things. When things pass through, your gut might tell your immune system to create inflammation, but not turn off. Okay, so that's when we then have too much inflammation for too prolonged a period and we get chronic inflammation, which occurs in virtually every persistent health concern. There's chronic inflammation, right? What happens then on another front, what can happen is your gut microbiome says, oh, I don't like this, we should attack this. This is faux. But tells your immune system to start attacking the wrong thing. So in attacking this particle or this bacteria, your immune system mistakenly attacks a part of you, and that's when autoimmunity occurs. So the way that our microbiota and our microbiome communicates with our immune system informs our systemic immune system whether to have the right amount of inflammation, too much inflammation, or the wrong kind of inflammation and immune response. So as our child's immune system, our gut microbiome is developing in those first key periods of life. You know that 0 to 3 year ish age range, that the information that your gut microbiome is sending your immune system sets the stage for their developing immune response. So in that way, we know that disruption early on, for instance, antibiotics or antacid medications, if given in that first six months of life, without the proper knowledge of how to restore a healthy gut microbiome in studies have been shown to increase the risk of virtually every single allergic disease like eczema, asthma, hay fever, anaphylactic food allergies by the time Your kids are 4 years of age because of the shaping that has occurred. Now, if your child has eczema, asthma, food allergies, whatever it is, it's not too late to recover and restore your baby's gut microbiome. But it's so much easier to start from the beginning. If your child needs those antibiotics or need those medications that we know disrupt the gut microbiome, let's take those necessary medications first, let's make sure they are necessary, then let's take them if they're necessary and know how to recover your microbiome so that it can maintain a healthy state.

That always seems crazy to me though when you hear that a baby is being given an antacid. Like, how are babies producing? Is that like fairly. I remember like, I don't know, several years ago someone told me that they were giving their baby an antacid. And I was, I was just so shocked because I was like, I did not know that that could be given to babies. So is that like fairly common?

Unfortunately, yes.

For colicky babies, I guess, yeah.

Wow.

Yeah, it is. And you know, it's interesting because back in, so 2003, when, before I started the practice, my practice in 2000, 2004, I, you know, we actually know this must have been, I mean the time all melts. It probably was 2002 where my husband and I decided to travel around the world. Right. We're going to take a break, we're going to travel, we're going to. Mostly we want to go to all the dive sites possible because we knew.

Oh, cool.

Yeah. So I mean we had some amazing adventures and it was because we knew when we, when we came back that, that I was going to, we were going to start an integrated pediatric practice. And we also wanted to.

Is your husband a pediatrician as well?

He's the tech, you know, everything, you know, office guru.

So we knew, oh, amazing, that's great. You work together.

And we also knew that we wanted to have children and that this was going to be a golden opportunity before the time and the pressures of owning a business and having kids to do that. Before I left on this year long trip, antacids were not approved for children. We never gave antacid medications to infants who were fussy and colicky. And all of a sudden I came back and I worked part time temporarily as we were getting grounded and starting up the practice in my, one of my friends pediatric practices. And all of a sudden every baby was being put on antacid medications. Oh, your baby's fussy. They must have reflux. Here's an antacid medication. Oh, it's spinning up a lot. Let's give them an anti acid medication. Instead of stepping back and saying, why are they so fussy? Why are they having this colic or reflux? All babies have reflux. Okay. Every single baby. Reflux just means that the food comes back. Right? So.

Right.

And babies, you know, their esophageal gastroesophageal sphincter. Right. That little sphincter muscle between the esophagus and the stomach. Just like all the Rest of the muscles is kind of floppy when they're born. Right. It's not that strong. So any milk goes into their stomach, it's going to slosh back up and easily. And the milk, you know, they'll have a little spit up or a little, lot of spit up.

Now is it normal if a baby doesn't have any spit up? I'm asking for myself because when my daughter was a baby, she never had spit up.

And people would always be like, why.

You'Re not like burping your baby? I'm like, because she doesn't have spit up. I don't know. Is there something wrong here? Am I doing something wrong? That being said, if she like once in a while she goes to a birthday party and has like a cupcake. Oftentimes when she has a lot of refined sugar, she'll tell me that, she says, mommy, I have throw up in my mouth. Like it comes right up.

Wow.

So she's experiencing it? Yeah, as a child, As a seven year old now. But yeah, she never.

That's so funny.

I don't know, it's so weird.

It's totally normal too.

Okay, good.

Your breast milk probably just was so digestible. It passed right through, right?

Oh, well, it's my amazing breast milk. What can I say?

That is too kind of blessings. I mean my, my daughter, oh my gosh, she was the spit up queen. I never went, oh yeah, anywhere without, you know, 20 burp rags and you know, five changes.

Oh my gosh.

So funny. Changes of clothing for me, so. But she was a happy, happy spitter. Right. And I would not call her reflux disease or ever consider her. Right now there are some babies who are really fussy and they're arching their back, really, you know, they're spinning up and they're so uncomfortable that it's hard for them to feed. And yes, that needs to be managed. I will tell you.

There are some probiotics that have been studied to really help be helpful for infants who have, you know, reflux problems. Acupuncture on infants, amazing for reflux and digestive issues. And then we have to look at the foods they're eating. They are reacting in a way to something going into their gut. So how do we manage that? And one thing that we don't think about is mama's stress. Our mamas are not supported today in the way they should be.

It's so true.

And when we have a lot of adrenaline in our system as adults. If you've ever had a time where you were Completely stressed and wired. We know that reflux kicks in because adrenaline weakens your lower esophageal sphincter. And so a lot of people, when they have times of high stress, they have heartburn and they're popping the tub. And I've done that. I have had moments where, oh, my gosh, deadlines and whatever it is. So if as a mama, you are not being supported, you don't have the time to rest, maybe you have another toddler at home and, you know, or you're a single mom or you're still trying to manage everything and you have to go back to work in a month and you're like, what do I do? All that adrenaline goes through the breast milk, too, Right? And when we have a wired and tired mom, we're going to have most likely a wired, you know, and tired baby who is going to have more spit up and more reflux than they otherwise would. So really supporting the mother infant dyad in all of this is really important, too.

That's so important. I couldn't agree more because I feel like when you have a baby, there's so much you're just trying to keep this thing alive and you really aren't thinking about yourself. So I'm glad that you, you shared that. So how do you have any tips or tools just to kind of wrap things up, how parents can keep their kids? I know we've talked a little bit back and forth about this, but what are some things that we can do to keep our kids microbiome happy and healthy?

Yeah. So this is great. This is a great place to kind of put some of these pieces together. So I don't know if you just knew, but I just turned in my manuscript for my book and this is all what this is about, right?

Congratulations. Oh, my gosh, that's huge.

Because you're an author and, you know. Oh, my goodness. Right? Yeah.

Yeah. Meeting those deadlines. Yeah. That's great. Oh, that's so exciting.

But I'll tell you, it's all about creating microbiome magic for your kids, because that's what we need. So I talk about the five microbiome champions, okay. And we think if we break it up, because we always want to think, well, how do we think about this in our head? And so the first one, and these five things are things that you do every single day, your kids do every day. So now we just want to think about them in how do we do them? In a gut, friendly way, in a way that is really championing their Microbiome. And so the first thing is nourishing your gut microbiome. So what can we do to really nourish that gut microbiome? And there are three.

Fs to focus on, right? And this is, none of this is rocket science. All of you listeners, you know this, right? Because Joy talks about this all the time, all of these things. It's not rocket science. But when we understand the importance to your gut microbiome, it's easier to make it a priority and it's easier to talk to your kids about why it's so important for them, you know, and really shifting the language and making it relevant for them. Because most kids, they could care less about, oh, you're going to be healthier, that's very nebulous to them, right? But if it's going to help them run faster down the soccer field, if it's going to help clear their skin up, if it's going to help them fall asleep easier and have good dreams, that to a kid, that's relevant and important for them and guaranteed, whatever their goals are, if you support their gut, it's gonna improve, right? And the three three Fs to focus on in eating fiber, fiber, fiber, fiber, right? Get in your plant based foods, fermented foods. If you can start young, a spoonful of kraut juice is gonna go a much longer way in repopulating and restoring your child's gut microbiome than any probiotic pill. Although probiotics can be, supplements can be important and also interestingly, maybe even more important than fiber. A Stanford study showed that they gave college kids, you know, they're, they're little guinea pigs right, at your disposal there. And I did some, I participated in some studies as a Stanford student too. They're kind of fun, but, you know, they, they divided the groups up in students who ate more fiber or students who incorporated more fermented foods into their diet. And what they found was that gut micro microbial diversity and numbers improved more in the fermented foods group than in the fiber group.

Interesting.

The fiber is still super important. The fiber group, they, they had more markers of healthy gut microbiome functioning like higher levels of butyrate. So it wasn't so much the microbial diversity and quantity, it was more the functioning. So they're both really important, right? But fermented foods, every different, every culture has a fermented foods at your disposal. And it doesn't have to be sauerkraut. You can look up, look up, you know how to make fermented lemonade or fermented blueberries. I mean there's so many different.

Yeah, so true.

And the phytonutrients, what is that? Those are the plant chemicals, phytochemicals that give you the plants color. Okay. So all the different colors gives a different benefit for different organ systems, for different, you know, for your gut microbiome. So, so each color counts. So even if your kids aren't the most varied eaters yet, one thing you can do is a lot of vegetables nowadays come in different colors naturally. Right. So if your kid is really into carrots, then get the white carrots, get the orange carrots, get the purple carrots because it's a carrot. But each of the colors has a different phytonutrient.

That's a great tip.

Broccoli comes in purple. I mean there's lots of different colors. So that's how we nourish our gut microbiome. We already talked about the vagus nerve and the breathing that we do every day. And the three other things are really how we live. So how we exercise, the quality of our sleep and staying hydrated. And so what's really important. So let's take exercise and sleep for instance. We know those are important. We pay lip service to them. Right. But with exercise and we, with sleep, we know that the gut microbiome for sleep makes a lot of melatonin and serotonin. So a healthy gut microbiome can help you have a healthy sleep and a healthy gut microbiome can enhance your exercise performance. But what's fascinating is the flip is true. When you exercise and when you get restorative sleep, that helps your gut microbiome to be healthier and happier independent of diet. Okay. Same thing with the vagus nerve. If you optimize the vagus nerve and optimize your heart rate variability, that is going to support a healthy gut microbiome independent of diet. Now why do I say that? Because for some families and parents thinking my kids are so picky right now, I'm not going to get them to eat more vegetables. Right?

Yeah.

Okay. Focus on the other things. Because even if you focus on mindfulness, or let's work on just moving our bodies as a family every day, or let's work on, you know, moving up our bedtime, all of us as a family, that is also going to impact your child's gut microbiome in a positive way, even if they're not eating the healthiest foods just yet. Now, if your kids are eating mostly processed or ultra Processed foods, which, you know, we all, we all, I mean, all of you listeners who you would be listening to Joy, right now if you're not, you know, trying to have a healthier mindset for your family and trying to move away from ultra processed foods. But this is the way of our world right now, especially for our children. And if you can really think about making healthier swaps within those packaged foods, that is going to make a huge difference for your child. So learning how to read those food labels in a way that champions your gut microbiome. And I teach kids how to read food labels like a gut hero, because the label counts. Right. Understanding that FDA approved food additives are some of the biggest disruptors to your child's gut microbiome. And so if we can swap out packaged foods for healthier packaged foods without those food additives, you're not. Your child can still enjoy that pack of chips, but without the microbiome disruptors. And so what's an example? I always give the example of this chip called Takis, which I don't even. Your child, your daughter, probably never heard of Takis yet, thankfully. But once they're older and they go out into the world and they can, you know, go to the store by themselves.

Yep.

These Takis are these rolled corn tortilla chips with chili lime flavor that has FDA, you know, red dye 40, you know, FD and C yellow. Oh, it's got, you know, all of the art. It says literally, artificial chili lime flavor in it. Right. You should run away if it has any added food additives, like artificial colors and anything that says artificial in it. But my son's kids love them and he wants them. Right?

Yeah. So what do you do as a mom?

Yeah. So how do we help our kids live in this world without feeling alienated from their friends, without feeling deprived? And so then we look and see, well, what's a substitute? What can we do? So Trader Joe's has rolled corn tortilla chips that are chili lime flavor, that are better, that don't have artificial flavors, don't have artificial colors. Right. Still has, you know, there's a couple of ingredients that maybe aren't amazing, but it's a better swap. And then there's another brand called Pocky's which has, you know, they're not roll, but they're chili lime, you know, chips, and they're much cleaner. So you can move from, you know, the worst packaged food to a better swap to an even better swap. And so even if your child is not loving salads yet or you know, wants a three bean salad, that's fine. Just make sure that when you're buying those packaged foods that you're really looking at those foods to make sure that they don't have microbiome disruptors in them.

Appreciate all that.

So much great information you shared, so many great tools and resources. I thank you so much. Everyone needs to go and follow you on Instagram. Where else can people find you? Can you share with us and is there anything that you want people to know about? You mentioned you have a book coming out if you want to share about that.

Yeah. So you can find me on Instagram. And I love following Joy. I mean just, it's, it's so fun. A fascinating world, right, where you get to meet people virtually first. Yeah, totally. And then I have my, my website, healthykidshappykids.com where I post blogs and articles and more resources. If you are on Facebook, I am still on Facebook too. People kind of.

Oh, great move.

One or the other, right? Yeah. And, and then, you know, the book is coming out. Not quite yet, so I'll let you know, Joy. I'll give you an advance copy.

Yeah, I know it's a few years when you're submitting your manuscript, it's like, okay, yeah, see you in March 24th.

So March 2024.

Okay, so that'll be here before we know it. That's not bad.

Right? But in the meantime, I'm gonna share all of these tips, you know, with all of you guys because it's so important. I mean, like I said in the beginning, our kids can't wait. We need to start moving the needle in the right direction for our kids health now. And there are so many things we can do. You know, we have, we can be empowered to make changes in our kids lives. And so, you know, that's what I'm all about is just one step at a time. Doesn't have to be huge steps, but as long as we keep moving forward, we're going to help our kids thrive.

Amazing. Thank you so much. This is a really inspiring conversation. I really enjoyed it.

Thank you.

Thanks for having me. I loved being on. Thank you.

What an awesome convo. I love the conversations we have here on the Joyous Health podcast. And you know, I feel so fortunate that I get to chat with amazing individuals who are experts in their field and super passionate about what they do. You know, if you enjoy this as much as I did, please share this with others so that they may benefit from this info. Just take a screenshot and share it on Instagram. Tag me and tag the guest we had or send this link. Link to your friend, your relative, or your neighbor. The more people who know about the Joyous Health podcast, the more people we can help live healthy, joyous lives. And of course, subscribe to the podcast as well. Thanks so much and have a joyous day.