Holistic Pediatrician Reveals Top Reasons Why Kids Are Sicker Than Ever Before And How To Raise Resilient and Healthy Kids With Dr. Elisa Song

The kids are not okay. Kids are sicker than ever, and the trend is getting worse and worse. Can you give us some stats? Big picture?

Yeah. Well, you know, let's go way back to 2005. And this is where I remember starting out as an integrated pediatrician. I opened up my practice in 2004 as a functional medicine doc. And I remember reading this article in the New England Journal of Medicine that said that for the very first time in history, our kids are expected to have shorter lifespans than us, their parents. And I thought, oh, my God, we need to. What's going on here? Right? With all of these medical advances now, Fast forward almost 20 years, and I would say that we're, I mean, we're certainly not in any better shape, and we're probably in worse because we have almost one in two kids diagnosed with a chronic health concern and then forget about an actual diagnosis. I mean, so many kids have, have health concerns that are not quite yet diagnosed. But we do know that, you know, 1 in 5 kids has eczem, 1 in 10 has asthma, 1 in 10 has ADHD. The number of kids with autoimmunity is on the rise. And the age group with the fastest rise in autoimmunity are teenagers out of any other age group, the 12 to 19 year olds. And then when we look at anxiety, mental health concerns, which, as we know in the functional medicine world, we cannot separate out from the rest of what's going on with our gut, our brains, our immune systems. So by the time kids are 18, one in two is gonna be diagnosed with a mental health disorder. And when we look at our teen girls, I mean, we know that through the pandemic, this mental health emergency has really been, you know, the alarm has been raised for kids and teenagers. We had that long before the pandemic. But now we know that one in three teenage girls will seriously think about suicide in their adolescent years. And 1 in 4 has actually thought of a plan, and 1 in 10 has tried. And so that's someone that you know. Right. If you're a parent or a grandparent or a teacher or whatever it is, you are going to know someone in your life that is suffering. A child who has a chronic disease or a chronic mental health concern. And so we need to, if we don't want this trend to continue, the time is now. We can't wait.

You know, one of the ones that you didn't mention inside of there, but that you mentioned inside of your book is also autism. Yeah, the autism rates that I was looking at they're nuts in a sense that they should be mind blowing. I think that they, I mean, you may know the rates better than me. I don't have them offhand here, but I think that they've increased almost like doubled since like the begin. Beginning of like just even the early 2000s.

Yep. Well, you know, so I finished my residency at UCSF in 2000. And I remember as we're kind of being left off to the great wide world and think, you know, opening up our practices, I remember being told that if I saw a handful of kids in my career with autism, it would be a lot. That was 2,000 in a matter of years. I opened up the practice in 2004. Within the first year, I was flooded with kids, parents who were saying, my kids have been just diagnosed. I'm worried they have autism. What can we do? And now the latest numbers are 1 in 36 kids is on the autism spectrum. Now, is some of that better diagnosis? Are we capturing more kids? I think that's some of it. But there are certainly more kids who, who are on the autism spectrum who really need our support, need our help in feeling comfortable in their bodies, in their brains, understanding some of the underlying pathophysiology with the neuroinflammation, the immune dysregulation, the gut dysbiosis that we know underlies a lot of the concerning behaviors and symptoms that kids with autism have and that their parents really want to support them with.

You mentioned gut. That's a big through line inside of your book. Talk about that a little bit more.

So what I really want to do in my book is lay this story for practitioners who may not know as much. And it's not that. It's not that practitioners, many people listening, I mean, everyone I would say listening to this podcast has heard of the gut microbiome, the gut brain connection, the gut immune system connection. What I really want with my books are for parents, practitioners, grandparents, educators to understand the profound importance for this, for our children. So we know that the developing gut microbiome takes shape from maybe a little in utero, but really from the moment kids are born, there's this critical window, this first two and a half to three years of, of life, this first thousand days. And the way that that microbiome forms and develops, informs the way that their immune system develops, the way that their brain develops. In fact, some of the studies, and, you know, I couch these studies in the sense that a lot of parents listening will think, oh, my God, that's my kid. That happened to my kid. They have eczema now. They have anxiety now. I wish I had known. And there are a lot of things that a lot of us wish we had known. We only were doing our best at the time that we had. And some of the studies, there's this large study, nearly 800,000 children, and they looked at antibiotic use or antacid use in the first six months of life and found that for those children who received those antibiotics or antacid medications in the first six months of life, they had a significantly increased risk of virtually every single disease, allergic disease, by the time there were four.

Wow.

Every single one, including asthma, allergies, eczema, anaphylactic food allergies, and hives.

They're giving antacids to babies.

Well, you know, there's this trend there which I think is. I don't know if it's going down because my practice is integrative and I rarely use antacid medications in children. But I remember traveling around the world with my husband back in 19. Let's see, back in 2002 with the idea that I would open up my own practice when I came back now in 2000, when I graduated from residency, babies were not getting antacid medications. Zantac or Ranitidine was not authorized for children and infants. When I came back and I started working as a pediatrician, all of a sudden all these babies were getting put on Zantac because suddenly it was authorized for babies with reflux. Now, what we have to understand is that all babies have some amount of reflux, right? Right. Their lower esophageal sphincter is not very strong, and the food from their stomach sloshes back up and down their esophagus really easily. That doesn't mean they have reflux disease. And so when we have this. This fussy baby who happens to be spitting up, I think a lot of babies were mistakenly diagnosed with reflux disease and put on Zantac. And it's become this persistent problem. Now, why antacid medications in this study? Why were they looked at with antibiotics? Well, they both can disrupt the gut microbiome and the way the gut microbiome develops in babies pretty immediately. We also know the same thing is true for mental health concerns later. So there's another study, Denmark actually can study their populations really well. They have these amazing databases. And so they followed this enormous number of mother infant pairs and looked at antibiotic use from in utero through childhood and found that even just one round of antibiotics could increase the risk of that child developing mental health concerns by the time they were older kids or teenagers. And the risk was highest when those antibiotics were received before they were six months of age. And so that when we understand the importance of foundation of the gut microbiome and how it informs that brain development or how it informs the immune system development, we want to do everything we can to preserve and optimize gut microbiome development in babies and also through their lifetime. Because it doesn't change. I should back up and say it's not that it doesn't change, but our children's brains and immune systems continue to develop. And that same fascinating explosion of synapses in our children's brain, infants brains, is happening in their preteen and teenage years. And it's mirroring this change in their composition and diversity of their gut microbiome. And so we have these points of intervention. And that's where as a parent, if you're looking and thinking, oh my gosh, my child has eczema, they got antibiotics when they were four months of age, that's okay, it's, it's fluid. And we have times that we can intervene and it's never too late, it might get a little harder. I mean, that's why as an adult, if you have got dysbiosis or, you know, yeast overgrowth or whatever it is, it may take a lot longer than for a three year old to restore the microbiome. But it's not impossible. I mean, that's why we do the work that we do as functional medicine docs. And so it's just now being aware of all the different factors in our modern world that is, that are, are changing our children's microbiomes and they have changed. I mean, when we look back a hundred years ago, there was a pathologist, a microbiologist in Scotland who happened to be measuring the microbiomes of formula fed babies versus breastfed babies at the time, 100 years ago. A hundred years ago.

And how are they, they were, how are they doing that?

Just like through culturing. Culturing. And so with this pathologists found in Scotland was that the breastfed babies had almost exclusively bifidobacteria species in their microbiomes. Right. Formula for babies had different microbiomes. We know that from our studies today, formula for babies and breastfed babies do have different microbiomes in our modern world. What's fascinating is though that the breastfed baby of today looks much more like the microbiome of the formula fed babies from 100 years ago.

Wow.

Our infants are losing their very important bifidobacteria, which is so important for supporting butyrate producing species, which is so important for supporting their brain development and immune tolerance to things like food allergens. And this loss of bifidobacteria is fascinating. There were some studies during COVID that found that a reduction in bifidobacteria species also correlated with increased risk for more severe Covid. So bifidobacteria is really protective and our infants and our children are losing it at pretty rapid rates.

Wow, that's mind blowing. You know, as you're painting today's story that we are continuing to tease out, you know, connecting the dots for our listeners right now, and also doing it for myself too, as, knock on wood, a future parent one day, you know, kids are not okay. They're getting sicker every year. Chronic disease is exploding and it's leading to all sorts of challenges. Ultra processed food consumption amongst young people continues to go up and we are in this sort of emergency state. And this diet now that we have here in the west is being exported all around the world. It's not a good look for the future of our species and the health of our species. And a big part of that comes back to our gut health, not just for adults, but of course, kids. And it starts with how our gut health is as kids. And there's a lot of things that are going on in this modern world that are making our guts as kids, or if you're a parent, you have a kid, they're making their guts, say ouch, by damaging it. You identified one of the main ones which is overuse or early use or improper use of antibiotics for children. What are some other things that you have also found from both your research and being a pediatrician that are also damaging the guts of kids today?

Yeah. So the single biggest acute disruptor are antibiotics. Right. And as you said, it's really, you know, it's the inappropriate use, but also the overuse. And so that's where as parents and practitioners, we just have to be really good stewards of antibiotics. There are some estimates that by 2050, which is really right around the corner, antibiotic resistance is going to become a leading cause of death worldwide. That is frightening.

That's crazy.

Right. And so. And in some studies, they found that up to 70% of antibiotics for children are inappropriately prescribed. So prescribed for things like viral infections.

For which it is sick. It has nothing to do with bacterial.

Yep.

You just give them an antibiotic which that Happened to you and I when we were growing up.

We were just talking offline and my mom was an OB gyn. I grew up in a very conventional medical household. I mean, I remember taking antibiotics like they were candy for every little thing. Oh, you have a stuffy nose. Here's some antibiotics right now. At the same time, I mean, I think you and I, you know, coming from immigrant families, we had, I had the barley tea that my grandma would make and she would make, you know, different kinds of soups with who knows what was in it, you know, when we were sick. And so it was this interesting, interesting blend. But now, I mean, you touched upon the ultra processed foods. Children today are exposed to so much more than we were exposed to in terms of, quote, foods, right? These fake foods that are directly disrupting their microbiomes. And it's not just a matter of, oh, let them be kids. Well, yeah, we had some of that when we were kids. But now at least two thirds of our children's and teenagers diets on average are from ultra processed foods. And when you take a look at Americans, American kids, on any given day, 1 in 3 kids doesn't have a single item of fruit and 1 in 2 kids doesn't have a single vegetable. And so our, our diets, our palates are shifting. And what I tell kids and teenagers, because of course, what do teenagers want? They want control, right? They want, they want to be independent. They want to make their own decisions, right? Well, those mad scientists in the food industry, they are making sure that you are not in control of your decisions, right? I mean, hijacking your kids, they're hijacking, they're hijacking our brains, right? I mean, they are, they know exactly how to make the food more addictive. You know, really get that mouth feel that makes you just need more. It's not just want more. And so we, we've lost control too. And when it causes gut dysbiosis, the microbes in our gut can also inform what we want to eat. I mean, think about yeast dysbiosis and sugar cravings. I mean, that's one classic example where the yeast will feed on sugar and tell our brain that it wants more and more sugar. But they've even found different microbial patterns can actually impact our taste buds and what we want to eat. And so when we're thinking about, hmm, what do we want to eat? I don't think the food scientists were necessarily thinking, oh, we're going to change their microbiomes. But that's what's happening. And these micro, the, the microbial composition that we have today is really leading us also to want more and more of these foods that are, that are serving our addictions. And so the studies around ultra processed foods and kids is really frightening when you look at it. I mean when I look at the brain studies, right, A steady diet of ultra processed foods for children has been found to shrink parts of their brains that are responsible for emotions, decision making, rational thought processes can smooth out their brains. So I mean kids, all kids have seen models of brains, right? They see all these folds in the brains, these gyri. And so ultra processed foods make kids, brains lose some of that gyrification. That's frightening. And a steady diet of ultra processed foods when kids are four is much is significantly correlated with behavioral problems and neurodevelopmental concerns by the time they're seven. So, and this is the thing, you know, for, for folks who are listening to your podcast, they're not running out saying I'm going to buy ultra processed foods for my kids. I mean that's not who is, who is listening right now. But here's the thing. Until I really dug into the science and started really teaching not just my own kids, but the kids in my practice and parents in my practice how to be really savvy about the packages they were buying and, and really read labels to understand what these modern day microbiome mischief makers are. I was buying packages of food that I thought were just fine, right? And so that I thought were quote, healthy, right? Because the front of the box says oh, healthy, gluten free. You know, all the things like whole grain, I mean all the things that, that we might be looking for. But I would say one of the most ubiquitous food additives that, that I want people to know about and to put right back on the shelf if they see it, There are these, these category food additives and, and you know, the kind of, it's kind of funny, but not really funny. The FDA actually has a database, it's called Everything put into food in the United States, right? It's its database of over 3,000 food additives. I mean who would think we need 3,000 food additives to make our food actually taste, taste good, right? I mean it's, it's all that, that kind of mad science behind the scenes. But there's a particular category of food additives called emulsifiers. They're the things that keep our food together, keep them from make, making this goopy mess. They're found in some protein bars that our kids are gravitating towards. They're found in ice creams, they're found in ready to feed infant formulas, even at levels that are known higher than what are known to be harmful. So we need to be savvy about this because these emulsifiers, many of them have been found to directly cause gut dysbiosis and preferentially preserve the pathogenic bacteria while killing the beneficial probiotic bacteria. And some of these have been found to directly increase intestinal permeability. So directly cause leaky gut. In fact, the rise, this huge rise of food emulsifiers in our packaged foods in some countries can be seen to kind of directly correlate with the rapid rise in autoimmunity that we're seeing in our populations. And so the package isn't going to say food emulsifiers, it's going to say things like mono and diglycerides, carrageenan, carboxymethyl cellulose or CMC polysorbate 80, xanthan gum. So there are some things that we just want to be on the lookout for. Now, the gums like xanthan gum or, or guar gum, um, acacia gum, some of them actually can be beneficial for our microbiome. So we just have to be savvy. But that's, that's where if all kids could learn how to choose their package, packaged foods or chips or their drinks or their whatever it is, so that they can sit with their friends and yeah, have their friends can have the prime and the takis, they can choose maybe the CT chips and the liquid death, you know, hydration that the drinks, then they can sit with their friends, have fun, you know, be kids, but not have the disruption to their gut microbiomes. And there's simple swaps like that. So that's what I want every parent, grandparent child to understand.

If you had to rank on the topic of food, and we'll go to a few other categories that are these sort of mischief makers, right? Things that can disrupt the gut microbiome, antibiotics being a big classification. But sticking to foods for a second, if you had to rank what is harming kids gut health the most, just based on what you've come across, there's no definitive research that's out there that maybe it's one thing or another outside of maybe you pointing to antibiotics outside of food, how would you rank that? Because you hear a lot of arguments on different sides. Some people say it's the presence of too much sugar in the diet. Some people will say that it's things like emulsifiers like Carriage gn, which is in a lot of, you know, products that, that are even in like Whole Foods and Trader Joe's that people are shopping in. Some people will say that it's too much of something. People will say it's not enough of something. What are your thoughts?

So I think, you know, there's this, there's this sort of what do we want to try to get in versus what do we want to try to keep out. And I mean they're both important. What I have parents and kids think about is what's going to be the easiest for them. Because yes, you need that foundation. We need to feed and nourish our microbiome. Our microbiome is not just the bugs in our gut, it's a whole ecosystem and it's our genes. And so if we want to nourish that ecosystem inside our gut, which is really our largest ecosystem, right. I mean all kids learn, oh, we want to, you know, save the world. You know, save the world. It's Earth day. We want to, you know, reduce, reuse, recycle, reuse, all of that. Right. We want to think about our gut microbiome's ecosystem in the same way it's, it needs to be protected. Because if we don't protect our gut microbiome, we are not going to have the resilience to withstand whatever comes our way. Right. Whether it's, you know, I mean we'll talk about psychological stress because in terms of food, I think there are some key hitters. I think though that one of the most disruptive factors to our kids microbiomes today is chronic unmanageable psychological stress. I think that is something that, you know, is very different than how we grew up, our parents grew up. There are so many forces that are really playing into making psychological stress an unnecessary harm to our kids brains and to the microbiomes. But as far as the foods go, when we think about nourishing our gut microbiome, I'd say that the biggest things to keep out are, I mean, how do I rank them? I mean the added sugars are way up there, right? I mean at least 50% of added sugars in adult diets now is coming from sugar sweetened beverages. I mean think the Boba and the Starbucks. For our kids, it's some of them, it's almost every day that they're having these bobas or these frappuccinos that have upwards of, you know, 35 to 50 grams of added sugar. When kids should really have no more than 25 grams of added sugar in a day. And I'm seeing it in kids blood work. I mean, what's startling is as an integrated pediatrician, I do more blood work on kids than I would say the general pediatrician because I really want to understand what's going on underneath. How do we take the data to really fine tune our kids health? And even these slim, fit, athletic, you know, young middle schoolers and high schoolers who are not anywhere near the picture of what most people think of as having type 2 diabetes. When I check their fasting blood sugar and their fasting insulins and their hemoglobin A1Cs, they are reaching pre diabetic ranges and they're certainly not optimal ranges. So I think that's the sugar. And we know that poor glycemic control and the resulting inflammation is one of the biggest factors in chronic disease. I mean, when we saw Covid. Right. I mean one of the, one of the biggest risk factors really was that underlying poor glycemic control. And so, you know, that's, that's one thing that kids just need to be aware of. Right? Yeah, sure, they can have the Boba, but maybe not an everyday thing, you know, or if they're going to have the Boba, maybe they decide not to have, you know, the ice cream for dessert after dinner. Right.

Comprehing. Just a little quick tangent and I always share this with, you know, folks, anytime your name comes up, I so I've always respected you and your work as early as I found out about your work and I send you as a resource to everybody that I know who's dealing with any kind of thing about fevers or should I give my kid Motrin or this. That like you have so many incredible resources and I send so many of your articles to people. And then when the COVID 19 pandemic happened and we started having a lot of early conversations about vaccines and that started these early conversations even before the vaccines were out about sort of mandates and we need to protect, you know, vulnerable and kids were getting lumped into that conversation that we need to get the kids protected. And even before the vaccines were out for kids, the COVID 19 vaccine, there was this real drumbeat and sort of march to, I would say from the outside, it really felt like we, it felt like a campaign to kind of bulldoze parents. And this just needs to be a massive tidal wave so that we don't have anybody questioning whether or not kids should or shouldn't. We're just going to give you the science and this is it. And you were one of the first mainstream pediatricians who has your foot both in the integrative world and the functional world, who is, you know, well educated, well respected on both sides that came out and said, hey, hang on one second. Let's have an honest conversation about this, right? And I really respect you for that. You came on my podcast quite early still, and we were even debating about, do we do this topic. You were talking a little bit about it on social media. And I believe at the time, even some of your own posts got flagged, right, For. For potential misinformation, which everything was getting flagged at that time. Anybody who was discussing anything that was different than the typical narrative. And I really want to acknowledge you because after, you know, you came out and talked about so many of the nuances that are there and how kids are not a vulnerable population for COVID 19, how we're misunderstanding a lot of the breakdown of the science, how there's actually very little research on the vaccines that were done for kids, how it's okay to have questions as parents. I saw so many of my friends that would be typically not very open to the conversation, all of a sudden have a much more open mind because you weren't trying to convince them. You were just saying, I'm going to walk you through the science. Let me show you how many kids have actually died in, you know, from COVID 19 that didn't have a comorbidity that, you know, I believe one of the studies you referenced was in Germany. Not one child had died from, like, COVID 19. Yeah, out of, like. Out of like, like the last year or something like that. Anyways, you went into all the detail, and I just want to say that probably at the time took a lot of courage to be able to do that and present this voice to parents who were just looking to get answers. So I want to acknowledge you for doing that, because you open it up. And now if we look at it, not to make this about the COVID 19 vaccine or pandemic or anything else, but it's really the larger topic that's there is there were a lot of individuals that didn't really want to have the full conversation. And you look at it today, I think even when the vaccines were fully out there, less than like, 5% of, you know, parents, like, got the vaccine for their kids because people were ultimately making the risk benefit analysis and saying that, hey, listen, maybe this isn't the intervention that's needed. Sure, there could be other interventions that are needed, but this particular intervention is not, is not needed. And how I feel that's tied to today's conversation is that a couple of things. Number one, we're not talking about how bad the state of health is for kids today and it's getting worse every year. And if we don't see it as a national emergency, that is multifaceted. Sure, I'm sure. Devices play a role into this. Food plays a role. The health of parents, especially the health of the mother plays a role. Environmental factors play a role. I'm sure the vaccine schedule plays a role. There's so many different things that play a role. But if we're not willing to talk about how bad it is, we're never going to end up getting to the right solution. So that's part of the reason why I wanted to make this acknowledgement on the podcast in this moment for this conversation.

Yeah. Well, thank you. I mean, you know, this is where I mean clearly what we're doing in conventional medicine and pediatric for our children, I'm not going to say it's not working. It's working in a sense, but it's not working to end chronic disease in children. And if anything, we're just seeing a higher and higher trajectory. So we need to understand the value of the conventional approach because there is, is and yet we also need to understand for let's say something like antibiotics, all of the downstream unintended consequences that may be putting our kids for longer term harm than the initial infection itself.

Risk, reward.

Right. And so, you know, when we think about all of these factors, you know, it is interesting you mentioned. Yes, yes, devices have a role. In fact, what's fascinating is screen time use and gamers, when they look at the microbiomes of children and kids, I think this month, even for adults too, they have different microbiomes than people who spend less time on their phones. Well, there could be a number of reasons. I don't know if it's the emf, but what do you do when you're on your phone, you're not exercising. We know that exercisers have different microbiomes and people who don't exercise. And then you think about the environmental toxicity. I mean we have to worry about these people forever chemicals that, I mean, some of them have a half life of 25 years. They're not leaving your kid's system very quickly. And so these forever chemicals and many of these endocrine disruptors directly harm our kids microbiomes too. And so when we understand that foundation. I mean, here's the thing. We can think about all the things that we shouldn't do. That's a hard way to live, right?

Overwhelming.

Right. And so, yes, there are some things that we want to focus on and choose what's going to be easiest. If your kid is addicted to screens, I'm not going to tell you tomorrow, get rid of it. I mean, we need to work on that. But if, if your kid loves exercise or loves other things, let's think about what is going to be doable in the moment because all of those will make a difference each little step. And so, I mean, yes, there's so many different factors, I would say for kids and their microbiomes. When we think about the biggest mischief makers, it's going to be, you know, these, the ultra processed foods which include the added sugars. I mean, that's part of it. Psychological stress way up there. And then all the things that, because of the different lifestyle factors, they're not doing to support their microbiomes. And so it's kind of a combination of, okay, what are the things that we can take out that are easy to make swaps with and what are the things that we can add in to their diet and their lifestyles that are going to create that foundation of resilience in their microbial ecosystem so that the next time they have the Boba or the next time, you know, they have the, the Takis with the artificial ingredients and the MSG and all that, their microbiomes can bounce back. Right. I mean, that, that's, I mean, the whole conversation around Covid. I mean, this word resilience kept coming up over and over again. It's not about avoiding everything. Right? You can't do that. And for our kids, I don't, we don't want to do that. We don't want to put them into lonely little bubbles where they don't do anything except, you know, eat at home and, and don' with their friends in any way. That is really, you know, the way kids interact. I mean, I look at my son and my daughter and going downtown with their friends now independently, and, you know, they need to learn how to make these choices without living in a bubble. And so when we build that foundation of resilience, microbiome resilience, immune resilience, brain resilience, then they can withstand a lot of these stressors. It's understanding what these stressors are and then giving them the tools to build that resilience that really will help them for lifelong health.

You know, One of the things that I often hear just in listening to conversations, and sometimes it'll come from individuals that I would call that might be in like the grandparents stage of their life right now and they have kids and their kids are having kids right now, and their grandparents, they'll often be the sentiment of like, you guys are doing like so many different things and you're trying to have your kids live in this bubble by protecting them. When we were young, we just ate whatever and we didn't have eczema, peanut allergies, we didn't have all this stuff. We were fine. And you know, you go through a phase as kids. You eat your Lucky Charms or your whatever processed cereal that they ate at the time, maybe Wheaties, and you kind of, you know, grow out of that and you start to learn how to like your vegetables later on. And, you know, we didn't have any of those issues that you see that kids are having today. What do you say to the people who say things like that as, as the explanation for what's uniquely going on today, that kids seem to have a lot more things comparatively? Is it simply primarily because of the introduction and the overuse of antibiotics? Is it the biggest culprit? Is there something else that's there?

I think that probably, you know, the introduction of antibiotics is, is one of the biggest culprits. I mean, that's the change in the number of prescriptions that's been written. But you know what's interesting too, we think about antibiotics as being the biggest acute microbiome disruptor that we have. But when we look at the studies, what's really alarming to me is the number of other medications that can disrupt the gut microbiome pretty much as significantly as antibiotics. They include things like, well, we already talked about reflux medicines, but NSAID medications like ibuprofen, right. Motrin or Advil, antihistamines like Zyrtec or Claritin, ssri, antidepressant and anti anxiety medicines, the birth control pill, steroids. I mean, think about when I think about what's going on with our teenagers today. Think about how many teenage girls are on birth control pills for their horrible period cramps, they're on low dose doxycycline for their acne, they may be on a steroid inhaler for their asthma, they're on an SSRI because they have anxiety. Right. And when they get their period cramps, they pop the ibuprofen. Right? I mean, all of those things that if we're not supporting Their microbiomes, they're going to continue to get more and more disrupted. So it's sort of this, you know, this synergistic effect. And, and we need to step back and help understand. I'm not telling kids. You know, when kids come to me and they. And teenage girls and they come to me and, you know, they want to consider being in an SSRI or they want to, you know, be on the birth control pill before they go off to college. That's a common one, right? I mean, I've been in practice now 20 years. I had a whole bunch of kids going off to college during the pandemic. And last year was a big, you know, graduation for a lot of my kids. And it is common. A lot of girls want to be on the pill when they go off to college. I don't say never know. What I say is, look, let's understand. Just like when you buy your first car, you are most likely going to do your due diligence and do all the research, look at multiple different car options, decide which one is best for you. We want to do the same thing with any medication that's recommended. And so when it comes to the pill. Okay, let's look at it. Well, birth control. Yes. We also want to make sure we're protected against std. So that's not going to be the pill. Birth control. We know the pill will disrupt the gut microbiome. Let's make sure if you're, if you want to take this medication and make responsible decisions as a young adult, understand how to nourish your gut microbiome so that the pill doesn't cause so much disruption. We know that the pill also depletes certain nutrients like methyl B12 and folate, which, when those are impacted, methylation is going to be disrupted. Your neurotransmitters are going to be disrupted, which is why I think in the first two years of starting the pill, we know that many women and young girls will suffer from depression, you know, mental health concerns directly related to beginning the Pill. Well, our young woman teenagers to the early 20s in their first two years of starting the pill have a significantly increased rate of suicidality and er and suicide attempts. And if we can support their methylation, support the nutrients that are depleted, we could probably mitigate a lot of those. So it's just knowing the information and not just blindly saying, I'm here, I'm going to take this prescription. All right, I'd like this prescription. And what are the side effects? How do I support myself from the side effects. Are there any other options? I mean, it's the same thing when, you know, a doc prescribes antibiotics. I have a list of questions that I suggest that parents ask the doc, the prescribing doctor, not to be controversial or not to be challenging, you know, but to really have that open discussion of, hey, I'd like to make this informed decision. Can you help me make this for. For myself if you're, you know, an adolescent or for my child, if you're a parent with a younger kid.

There was this big article that just came out we'll link to in the show Notes in the Washington Post. I don't know if you saw it at all. It was all over Tick Tock and Instagram. But it was basically talking about this explosion of women online who have been talking about some of the challenges that they experienced with.

With the pill.

With the pill. And it was talking about a few different influencers who. That's been a big part of their brand. Or they maybe written a book or they have online courses. And then they were interviewing a lot of, you know, quote unquote, experts in this space who are, you know, scientifically have a background in it. But we're largely saying, like any of these conversations about the downsides, it was in a way, blanketly sort of saying, these are unscientific. They're trying to come at women's rights. And largely there was an undertone there because it was the Washington Post, that this is all part of this sort of right movement, this conservative movement of women's health being under attack. They were connecting it to sort of going after abortion rights for women, Roe versus Wade, and a bunch of other stuff that was completely unrelated to the story. And it brought up a lot of feelings for people that are in this space. You know, I'm sure you saw a little bit I did about that.

I don't do too much social media, even though, I mean, I love Instagram, but. But I did see. And I thought that is really so interesting. Right. I mean, because we have to have this conversation and women should be allowed to have this conversation.

Right. They were almost attacking women and they were saying if you ask any questions about the pill, they're basically saying, you are against Roe versus Wade and you are a deep MAGA supporter.

Yeah.

It's like, what, we can't have an honest conversation about something that happened to our bodies?

Yeah.

You know, obviously that's the women talking about who went through that. And a lot of the women did speak up and ultimately, like all things I think people understand. Legacy media is one perspective, and individuals are going to come in with their own slant, just like our podcast is going to have its own bias. It's going to come. And it led to a lot of just healthy conversation, you know, online. But what was really interesting to hear from a physician standpoint is that, hey, you have seen that again, it's not a blanket thing that the pill is going to be an immediate solution. First of all, a lot of people get placed on it, like my wife did when she was very young, because they have very painful periods. Well, there is a lot of factors that go into a reason why a woman might have a very painful period. And the worse off your metabolic health is, the less fiber you have in your diet, the less active you are. All those things that would be making you healthier overall if you were doing them would also be things that would help mitigate how painful a period would traditionally end up being. So if you're just giving somebody a pill, you're not having a conversation about root cause medicine that's there. And everybody else also acknowledges that, you know, the pill has done so much for women's rights and their choice of when they, you know, their reproductive cycle, when to have a baby, when not to have a baby. That's been a huge part of that. And just because something has been a huge part of things doesn't mean that we can't question it along the way to make better and more informed choices for the individuals that end up taking it.

Yeah, I mean, that. That's exactly right. I mean, that's. I mean, we need to be able to question the existing status quo in order to be able to make things better and better. And so, you know, this is. It's the same thing as you've said, you know, with the vaccine issue with kids, we weren't necessarily allowed to say anything. It's like, well, why not? We just want the best for our kids. You know, even, you know, when parents are being prescribed antibiotics, the first question I recommend asking the doctors, well, hey, doc, is this really necessary?

Right.

Simple question, simple question. But what that does is it opens up the doctor's mind to the idea that, oh, you're not the parent who necessarily came in here just to get a prescription. Right, Right. Because some studies have found that doctors are twice as likely to prescribe an antibiotic you. Even if they think it's not going to be beneficial if they think the person wants a prescription. Right. I mean, it's just the way it is. Right. And I get it. You know, you're in this er, you're seeing like, you know, one patient every five minutes, and you're just, go, go, go. But if someone stops and says, hey, you know, do I really. Is this really necessary? Is there anything else I could do? It does make the doc pause and say, hmm, all right, well, you know, I don't know whether you have a sinus or a bacterial, you know, a viral or bacterial sinus infection. You know, you could hold on to this for a little bit and just wait and see what happens.

Right.

Right. Now, what would be amazing would be if that doc also had maybe some other tools. Like, hey, why don't you try Neti Pod and, you know, how about some thyme essential oil to break up that mucus and, you know, all the other things. But, you know, sometimes just the doc saying, hey, look, it's okay. You can. You can wait it out. We know a lot of things are going to resolve on their own. I mean, that could make a huge difference in saving that child's or your microbiome in that one moment. Right. From an unnecessary antibiotic. Also, just from a public health standpoint, reducing the risk of antibiotic resistance even.

Further, which is a huge problem. I'm not sure if you saw this. I'll link to in the show notes a lot of articles to link to Tyson Foods, one of the largest manufacturers of meats, especially chicken, packaged chicken. They recently, along with one other large processor came out, and I got to dig into this a little bit more. But they said that we, for a long time, because a lot of people have been very worried, mainstream, you know, medicine scientists about antibiotic resistance. It's a very real issue. They was enough pressure to tell these large poultry and chicken and hog manufacturers and harvesters and slaughterhouses, hey, you're overusing antibiotics in the way that you're treating things. So they all pulled back, and now two of the largest ones just said that, hey, we're going to start using them again in the feed. And primarily because I think that animals are continuing to get sicker and some of the solutions have been more expensive. But they did say, we are going to work together with public health officials to sort of narrow the sort of antibiotics. We're going to try to keep it away from things that are similar to stuff that's being used on humans. But I think ultimately it was from what I understood from the outside, I got to dig into it a little more. It was a cost thing, right? It was a cost thing. Which.

Yeah.

Which A lot of things are, yeah, right.

I mean, yeah. I mean we even know, I mean that, that unless these animals are raised in a, you know, ethical, regenerative, sustainable way, you know, a lot of farmers will, will feed their chickens arsenic, same thing because it's antimicrobial. And so I mean if, if we are eating poultry that isn't organically, you know, raised and free range and pastured and all the things we could be getting, our kids could be getting a dose of arsenic simply by eating those chicken tenders, you know, that are, that is not organic. And so I mean it's all these things that really the food producers don't have to disclose.

Sure.

And so it's really the food industry and the regulations have to change. I mean, you know, the fact that, you know, lead is found in infant formula and infant foods, I mean that's, that's astonishing. Even, even organic, I think it was. I don't want to throw anyone under the bus, but there were some organic brands too that were found to have levels of lead in their baby food products that were unacceptably high. And these are foods that consumers, as a parent, you're choosing, oh, I'm buying the organic, slightly more expensive baby food for my child because I want something better. And sure, I would love to home cook and home puree all of their foods, but you know, this is on the go. It's easy. Right. And it's a necessary thing. I mean I gave my kids a squeezy things and you know, a lot of the jarred foods and we're trusting, right, we're trusting that, that these food manufacturers and the FDA is going to make sure that our baby food is safe for our babies. And it's not, unfortunately not. I mean, you know, there are some brands that are, are better, but when it's a profit driven company, we have to really be aware consumers and not just aware consumers. We need to, once we have that awareness, be able to vote with our dollars so that we can demand better. It's going to come down to our dollars whether the manufacturers are going to change or not.

You know, to add to that, one of the big takeaways that I got really from your book and following your work is that. But there are a million things that are wrong with this world. There's going to be all sorts of stuff, things that we can't control, air pollutants, other things. But if you can make your gut resilient, if you can go from not dealing with leaky gut, which we're going to talk about in a second to actually having a healthy gut. And there's multi. It's not just about food and it's not just about avoiding antibiotics. It's about working out and getting the right things and fiber and other stuff, doing.

You're.

If you can do that, you are so much more resilient. And then you can't control everything else. And there's gonna be plenty of times where you're gonna wanna partake in things that may not be the healthiest choice. But you're a human being and that's natural, and we all do that. But you're not gonna be that, you know, kid who's sick all the time as a kid and now sick all the time as an adult. You're gonna be somebody who's resilient in this world. So we're gonna talk about what it looks like to be resilient in a second. But I wanna touch on this idea because gut health is really the central theme in the idea that you're talking about today is that as much as this idea of leaky gut sounds new, we've actually known about the connection between leaky gut and chronic disease for quite some time. Can you chat about that for a second?

Well, you know, as I was doing the research and trying to think about, oh, gosh, how long, I mean, how long have we known about leaking gut and children, you know, when in the literature was this first cited? Because it's not this, this new concept, and it's just still not something that's taught in medical school. It's not something I learned about in residency. It's something I had to learn, you know, years after finishing residency, as I was embarking on this functional medicine journey to. To figure out, oh, my gosh, this thing called the microbiome, which we didn't learn about in med school, Right. This thing called leaky gut could actually be one of the underlying causes for virtually everything that's going on in our kids now. There's a different journey to gut dysbiosis and leaky gut for every person, but that as an underlying factor that if we can support a child's gut microbiome, either to first prevent a chronic health concern from happening in the first place, or if they do have a chronic health concern, to be able to reverse that. And I do mean reverse that. I mean, I have a kiddo that I talk about in the book who, you know, as a teenager, older sister, had rheumatoid juvenile arthritis and Crohn's Disease. And we were able to finally, after doing all the things like elimination diets and anti inflammatory supplements and you know, all the things, the one thing that flipped the switch and put her into remission for good was treating her klebsiella gut dysbiosis.

Wow.

Same thing happened to her brother. Her younger brother got rheumatoid arthritis. His was a little harder to manage because he was more, it was a little harder for him to keep away from those mischief makers in his, in his diet. And so sugar additives.

Sugar.

And he loved, he loved, you know, his corn chips and you know, loved the, like the, the Gatorade. At that time there wasn't prime. Didn't exist back then, you know, but, but yeah, and so a little bit more of an uphill battle, but eventually, once he learned how to, you know, really kind of get in the foods that are going to keep his microbiome healthy and make some of those swaps, when we treated his klebsiella gut dysbiosis, that also flipped the switch. So it can be, I mean, that seems like such a simple thing. Oh, treat the dysbiosis. But we know that there are many dysbiotic organisms in the gut that can predispose and even trigger autoimmunity. And some of those, I mean, for instance, let's say glyphosate will preferentially. I mean, many people know glyphosate as Roundup, you know, an herbicide. Some people will know that glyphosate was originally patented as an antibiotic. Well, glyphosate can trigger leaky gut, you know, just on its own. Glyphosate kills your lactobacillus and bifidobacteria. So it kills the beneficial probiotics in your gut and can preferentially keep these dysbiotic organisms, especially things like proteus or Klebsiella. These organisms that we know are more closely linked with autoimmunity. And so, you know, that's, you know, that's where we just want to kind of unravel that story and help parents understand. Okay. One of the foundations, if your kid comes to me or you know, develops a persistent health concern, we always want to look at their gut, even if they're not have any, quote, classic gut symptoms. Right. They could have the perfect looking poops and still have gut dysbiosis and leaky gut going on.

The gut is really that through line. It's the, it's the really the first place that the immune system gets Built for the entire rest of the body.

Yep. Yeah.

For the parents that are listening at home and the grandparents too.

Right.

Because everybody cares about the future of kids on the planet. What is the first step in now that we understand a little bit more about the problem and we understand how bad it is and that there's a problem even in the, you know, half, half the problem is just understanding there is a problem.

Yes.

Right now, you know, all these different inputs that are there that can lead to the situation. Some of these mischief makers. How do we begin to unwind and actually create kids that are happy and healthy?

So, you know, the, the. One of the things that I want to make sure when I wrote the book was that parents didn't feel the overwhelm, that grandparents didn't feel the overwhelm. And I've had grandparents read the book and in fact, I mean, gotta love the grandparents, God bless them. Right? But oftentimes I'll have parents saying, you know, it's. They cringe when they go to grandma and grandpa's house because, you know, grandma and grandpa think that, you know, going to McDonald's and, you know, stocking the freezer with all sorts of, I mean, treats yet treats, quote, unquote, treats is the, Is the way to love their kids. Right? And I remember, I mean, this was, this was me too, right. When, when Kenzie was first born. And I remember my sisters pulling me aside and saying, look, you got to like tone it down because like, mom, she gets nervous when you come around because she doesn't know what to feed the kids. Right. And I was like, oh my gosh, that's the last thing I want to do is have my mom feel nervous about, you know, what's in the fridge. Because I used to, you know, anyhow, yes, we have to kind of step back and understand this about building that resilience. But, you know, I've had one grandparent in particular. She, she reached out to me and she's like, you know what? I totally get it now. And I had a conversation with my husband. We clean out the pantry, we're getting totally different snacks for our kids. And I was like, that's what we want to happen. Right? And she was so upbeat about it. She's like, this is, this makes total sense. It's. I. Now, now that's the answer. I don't feel like I'm depriving my grandkids because they're not getting that, you know, artificial whatever. I'm going to, I'm going to call out my My stepdad, the bunny tracks ice cream that he loves to get the kids, right? He, they. They now know, okay, we're going to buy this particular ice cream that doesn't have the artificial colors. And, you know, I tell my kids, you know what, like, mint ice cream shouldn't be fluorescent green, right? It should be like this natural color. So, but, but where do we start? It's really like you said, with the foundations of knowledge. Like, what are the things that can contribute to disruption to your child's gut microbiome? And then we step back and we let go of the overwhelm, right? Because I had one mom. I remember she was pregnant and she came to me and she just. Her health was not good and she was. She was pregnant with the second sibling. And I'm like, what is going on? You could see that she was just so wired and anxious and she just read, you know, all the horrible things about water, right? All the horrible things about, like, oh, my gosh, I can't have water that's in plastic. And if I had this water, what if it's contaminated with X, Y and Z? And I don't know what purifier used? She was so paralyzed, she stopped drinking water. I mean, literally, like, we cannot have that. That is not the way to build resilience. You should be able to have water in a plastic bottle, right? And be able to bounce back, right? Sure. I'd love it if you had water in a glass bottle all the time, right? I mean, whatever it is, right? But that I'm like, wow, I never, ever want to instill that kind of fear in a parent or child or grandparent or whomever so that they feel like, I can't live in this world. Right? We can live in this world and thrive if we know the biggest needle movers for us, right? And so, you know, one of the biggest needle movers that I said mentioned before was really, if we can learn how to manage our psychological stress a little bit more reasonably, right?

For the parents, for the kids, for both.

Everyone, right? Everyone, right? Who doesn't say, oh, my gosh, I'm so stressed, me.

But I'm the only person that I know that doesn't say that.

I've stopped saying it. You know, the other thing I've. I've taken out of my vocabulary. I've stopped saying, I'm so busy.

Yeah, that's a good one.

Who's not busy now? Right? Of course, everybody. And so it's really. We have to shift this mindset, but if we don't teach our kids how to do that. And, and we often have to start with the parents because parents have not learned that. Right.

Yeah.

But when we can improve our mindsets, what does that do? I don't call it mindset mindfulness meditation. I do in the book. But really when I talk to kids face to face, I teach them about our vagus nerve, I teach them about their gut brain connection and I teach them that when we do our vagus nerve work, just like, you know, we should exercise our bodies every day, we need to exercise our vagus nerves every day. And guess what? You're going to be able to manage stress better and your gut microbiome is going to improve even if you don't change your diet. I mean, that's what one of the studies showed, that kids who engage in activities that improve their heart rate variability as a proxy for vagus nerve function, their microbiome diversity and function improved independent of diet. So for a lot of parents, changing the diet is one of the most daunting things. Right. And so, you know, if their kids are addicted to the, the artificial this and that and the too much sugar in the msg, okay, we're going to work on that. Because being addicted is hard and it's hard to get rid of those. We're going to work on that. Right. But if we can work on your child's vagus nerve and they can work on it and be engaged with it, not only are they going to have tools to build emotional psychological resilience for the rest of their lives, they are going to improve their microbiome which then with, with which then with the gut brain connection will improve their mental health resilience. So it's this kind of, it's this two way street and it becomes a positive cycle. Right. Instead of a negative cycle where psychological stress that we can't manage releases zonulin within an hour, directly triggers leaky gut, causes gut imbalance and gut dysbiosis, which then we don't have the microbes to manufacture our serotonin and dopamine, then we can manage stress less well and kind of the cycle goes on and on. We want to build this positive cycle forward. So if we start with the vagus nerve work, which there are some simple, easy ways that kids can do that, I think that foundation of, of microbiome resilience will be so much easier to.

Attain some of those simple and easy ways. Do you want to just name a couple that offhand?

Yeah.

And how much of it is also kind of removing the stimulus that's constantly around that's putting us in this sort of fight or flight. Like, you know, I actually think one of the most stressful things for kids is how much advertising they're exposed to. Like, I would much rather have. And I'm not a parent right now. Sure, I get it. Kids are going to be on their iPad, they're going to do stuff. But when I look around, it's interesting. I see a lot of kids, like the amount of ads they get on YouTube, the amount of ads that they get on these free games, on apps. Like, and these ads are like, they're, they're jarring. Like, they're designed to like, grab your attention. This, like. And they're different voices. They're this. They're. It's like they're. There's so much stimulus. I'd rather just love. I'd rather pay for my kid to have like a PlayStation where there's no ads or like, unfortunately, I try to buy YouTube Premium for my nephew and niece for their Gmail account because it's under, you know, YouTube and, and you. And YouTube was like, oh, you cannot have. Google was like, you cannot have kids. It was something about like, they're not old enough.

Right.

You have to be above the age of 14 or whatever because they're like tracking or whatever. I was like, I'm trying to have these kids, like, not watch ads by getting them YouTube Premium. And like, YouTube is not allowing me to do it.

Yeah, yeah.

Anyway, so the question was how much of this is sort of remove, reducing stimulus and how much of this is sort of adding in activities which we know are important, you know, like working out or being active, not even working out for kids, but just being active.

Yeah, I mean, I think to the, to the extent possible in the moment, removing that stimulus is really important. I mean, we know that of course, video games too. I mean, those video game scientists, I mean, you bet they're trying to make that as addictive as the food scientists are. Right. And so all of these, these things. And so again, I mean, video addiction is real and you know, screen time addiction for kids. And so it may take some time to undo that, but that is critical. If your kids are, you know, really and truly addicted to their screens and constantly looking, there's some work that has to be done. And so which it seems like kind.

Of every parent is kind of going through that right now, is what I've just been noticing, especially for my friends. Their kids are sort of at the age of like 7, 8, now they're becoming like 9, 10, 11. It's a, it's a tough thing I feel for and I'm sure I'm gonna go through the same situation. Everybody's trying to deal with it and trying to figure out what is their unique form of sort of carrot and stick or boundaries that make sense. But I do feel like the kids need boundaries. And the ones, my friends, who's my, My friends who are parents who have those boundaries with the kids that make sense for their own family, which may not make sense for another family, those kids are, you know, genuinely less anxious is what I feel.

Yeah, yeah. Well. And you know, during the pandemic for boys, especially video games and communicating on discord was really the way they could stay connected with their friends. And for girls it was texting. Right. One thing that, you know, I, I am all for educating kids and teenagers and, you know, in an age appropriate way. But what they're, they can be pretty savvy and they can understand a lot of the science when you explain it to them. And so, you know, when kids are even before, hopefully they get their phones or they get that first video game console to have a discussion about how addictive they can be, how they can drain their neurotransmitters. And I talk to kids about neurotransmitters, your brain chemicals that, you know, affect your mood and your cravings and how you interact with other people, how you slee and all of that. And so, you know, having that conversation about how addictive they are or if they've already had it, you know, if they already have their devices, talking them about how addictive they. They are in the moment. Right. And letting them know, look, if, if there is a time, you know, because of course, when you ask someone if they're addicted, they'll say no.

Even adults, right. A lot of adults are addicted themselves.

Yep. And say, of course I can, I can get off anytime. Right. So I let kids know and teenagers know. Look, if you feel like, you know, when mom's called you ten times to come down to dinner and you just have to do that one more thing on your device, right. That's addiction. Right. And you're not in control of your brain. Right. Those video game manufacturers are. So think about that and let's figure out how to get you to have control over your playing time. Right? And so really talking to kids about, about that and all the other forces that can make that addiction harder. But it is true. I mean, it's so hard for parents it's so hard for kids. I talk to kids about social media before they get social media and let them know that some of the size of fam. I mean, there can be some benefits. I'm not saying that screen time is all bad. And in fact, in one large study, they did find that there was an increased rate of depression and suicidal thinking. And the higher the number of. Of hours on social media and screen time, the higher the risk. I mean, any, you know, five hours and up was significantly higher. And so I will have parents and kids pull out their phones in the office and look at their screen time usage because, you know, a lot of kids are like, there's no way I'm using that much screen time. I mean, and parents too. And then they look and they're like, oh, my gosh, I have like eight hours today. Right? I mean, it adds up because that little scroll while you're in line at the cafeteria or the, you know, in the car ride 10 minutes away to your soccer game and you're kind of looking, I mean, all adds up, right? So five hours or more was significantly increased risk. Now, when they looked at protective factors too, because it can't just be about, oh, my gosh, this is doom and gloom and it's all fear. Protective factors, they included playing on a sports team. Right. Whether that's a community or whether that's physical exercise. It included reading print media. I mean, who. Who reads a newspaper now? But. But, you know, it was print media.

Shout out to my older sister Herschel, who helps me with the podcast she makes. She not makes, but she reads the. Reads the newspaper with her kids.

The paper that is so that you can tell Herschel, that was a protective factor. The number one protective factor was face to face, in person, communication with your friends. Yeah, number one. And not just sitting, you know, sitting on the sidewalk, all on your phones together. Right. It's like interacting. And so that was the most protective. So even if your kids are on screens, right. You can mitigate a lot of that by getting them playing sports, having them be in person with their friends.

Counterbalance.

Yes.

Yeah. So how much of this is the problem with screen time? Which obviously screen time's not going anywhere and not just having other options, because I've generally seen from kids of all ages, if there's something to do that's fun, like playing a sport, going and doing something, you know, obviously every kid and I had this too. I'm sure you had that. You know, when you're younger, you don't. You naturally Especially in your teens, you don't want to like spend a lot of time with your parents. You want to be independent, you want.

To do your own thing that my kids are almost teenagers but, you know.

You'Ll hang out with like an uncle or, you know, this or like whatever makes somebody who's making something fun or cool. Like kids want to do stuff.

Yeah.

They want to go do something.

Right.

And if there, there just has to be options that are available, which I know is, you know, obviously every family has to figure that out and, and see what that is or find out what activities to be enrolled into. But there just has to be counterbalances that are there.

Well, and you know what, they're taking cues from, from their parents too, right. I mean, I, you know, I have some families who are amazing and really doing the best they can. And yet I, you know, and, and my practice as a functionality, pediatric, integrated pediatric practice. Parents select. I mean, they choose to come to me because they want a more integrative approach.

Right.

And that, you know, by virtue tends to be a little bit more of a natural, quote, healthier approach. Right. And yet I still have parents come in and, and saying, gosh, is screen time really that bad for my kids? You know, spending hours on the weekend playing video games together, great, if that's a family bonding thing. But then put show model that you can put time limits around that, you know, that, that, you know, we do this and we balance it with, you know, going for, you know, a hike in the canyon or going for a family bike ride after dinner. So we want to model that, that we can also temper our own use and that it's a balance. And you know, I have kids coming to me. You know, kids, they, they do have, you know, when they have Internet access, right. I mean, they're going to look up all sorts of things. You know, one thing that kids and ask, which I'm so grateful they do. I mean, for my patients, I talk to them, you know, if, if they're looking at a different supplement or a thing that they're interested in, just shoot me a message, pick up the phone, right. I'm happy to go over, you know, what it is, right. Because I've had some coaches recommend certain protein shakes or, you know, whatever, muscle building things, and I look at the ingredients and I go through each of them, you know, with the kids and say, okay, what are your goals? Why do you want to take this?

Right?

Is this the right thing for you? Could we reach your goals in other ways? If you take this, what are some additive things that we can help to reach your goals? But one of the things that a patient found was this. You know, one of the, one of the markets in the supplement industry that is one of the fastest growing is the gamer's market, right? These nootropics for gamers, right? How do you stay on longer and be sharper when you're playing your games? So there's this one that's, it's really popular and so a patient brought it to me and he wasn't really interested in gaming. But you know, he's super smart, he's into robotics and he just wanted his brain to be more focused so he could do all the things that he wants to do. And I'm looking at this, I'm like, oh my gosh, like the, it says artificial everything on it, right? I mean it's like dyed this like lemon lime fluorescent green. I'm like, let's find a different one. But of course he wanted that one, right? So I, you know, we, we went through and we tried, we found some other, other supplements that had similar ingredients, not necessarily marketed to the gamer, but would help him achieve the goals that he wanted to. So. Yeah, but you talk to your kids, I mean even kids younger, you know, when they're younger. When I taught, I, I created this, one of my favorite things I've ever done, ever. It was these group of 8 to 10 year olds in my daughter's 3rd and 4th grade combined class and I created a 6 week curriculum talking, teaching them all about their microbiome. We didn't call them their microbiome, we call them their tiny little friends in their tummies, right? And, and you know, they learned about, you know, how their microbiome is so important for their brains. And you know, if you can't sit still in class, you have trouble falling asleep or it's hard to get along with your friends or you're, you're tired of getting sick all the time and missing, you know, parties, right? And so they, in those six weeks learned how to read labels and count sugar. We made kombucha, we made sauerkraut. And you know, they were, they were going home telling their, their parents about this. I mean that's how we get the change. And they were 8 to 10 year olds and, and these parents were, were calling me like, I can't believe they just picked up a box of like this unicorn thing they normally would have wanted. And they looked at the ingredients like now let's choose something different, right? I Mean that's how we empower the.

Next generation, personalizing it to the kids goals. If I, I mean I ate like when I was a kid. Yeah, I, I grew up primarily vegetarian and I ate that meant that I basically ate anything that just wasn't meat. So that was a lot of Gatorade and chips and honey buns. Yeah, I wasn't eating like they didn't really have like healthy vegetarian food at my school. So I'm just eating like whatever the processed food, snacks are that are there. And then at home my parents would make a good dinner and everything like that healthy dinner, you know, for what they knew at the time. And it wasn't until I had really bad acne when I was in high school get going into my senior year and then, and then when I got into university I was like very motivated. I was like asking questions like what is driving my acne? Because I tried all these different gels and creams and nothing was working. And then that's when I started doing a little bit of like digging around and I went to this, like I went to this lecture at this conference that I was at actually it was like a, like a religious convention that I went to from my background in the Jain community. And I heard a speaker over there talking about how for some people, for some especially teens, dairy can make their acne worse, worse off. And I was like, I had never heard that. And as a vegetarian, so much of my diet was dairy. And I was like, you want me to give up dairy too? That's like the only thing that I could eat. Like that's why I go to Taco Bell. So then I, I tried it and I was drinking a lot of milk and having a lot of cheese and I saw a huge difference. In about a month and a half my acne cleared up. You know, that was my situation. I'm not saying that's for everybody. And that got me sort of motivated. So it's like what are your kids goals? Whether it's being more focused, having more energy, how do you tie it into them? And just realizing that every kid is pushing back in the beginning.

Right.

Like everybody does. I'm sure you did in your own version and own way.

Oh yeah.

But bringing it back to something that you shared earlier, I was asking you like, how do we begin the process of unwinding this? And you were saying, you know, starting off with the vagus nerve and starting off with having these resilience activities that lower and have us have a counterbalance to psychological stressors. So great. And that can be done through a multitude of things that you talked about and more that's outlined inside of the book. Then where do we want to go from. From there?

Well, so, you know, we start with. With setting the foundations. And then sometimes despite that, there's still some embarrassment. Balance. Right. And so then we have to do a little bit more of the work of healing a disrupted gut microbiome, which unfortunately, many of us have. Right.

Most people probably.

And so there might be some cleanup that you have to do. And this is, you know, even for kids who don't have a particular diagnosis, you know, if they're just. If they're more sensory, you know, when I was in med school and residency, there was no such diagnosis as sensory processing disorder. And I mean, that term didn't even exist. And then when I started my practice, I'm like, sensory issues? What are sensory issues? Of course, sensory issues are when kids don't feel comfortable in their own skin. Right. But now so many kids are sitting there and they don't like the tags on their shirts and, you know, the seams on their socks or certain. Certain food textures or they cover their ears. You know, when the vacuum is going or the blender, which, which, I mean, as a one off, that's okay. You can live like that. But if it's everything, every single day, it's really hard to live in this world. Absolutely. And so, you know, so many kids now have, you know, multiple sensory issues that are just making it impossible to sit still in class or, you know, be calm. And so, I mean, part of that, part of this is just trying to figure out how do we support our kids even if they don't have a diagnosis, if they're showing signs that. That something is happening, that they're not thriving. Right. You know, we've come to accept that it's normal for kids to wiggle in their chairs or, you know, have huge worries and huge meltdowns or have sensory issues. Well, they don't have to.

And if that's happening, that's a gut brain issue.

Gut brain or gut immune. You know, we've cut. I mean, kids should have, you know, babies. Some babies have that, that buttery, soft skin that you just, you know, want to touch. And it's so silky smooth. And, you know, babies should have smooth skin. It shouldn't be accepted that babies have eczema on their cheeks. And, oh, that's. Every baby has eczema. Right? Or, oh, every baby's colicky. It doesn't have to be but we've just, we've sort of created this world now where we've normalized a lot of these things and we've forgotten what it really means for a kid to thrive in their whole body and in their whole mind. And so, you know, then when we look back and see, okay, we know the foundations. We have to, we have to get back to the foundations of, you know, nourishing your gut microbiome. And I talk about your microbiome champions, too. I mean, these are the fiber, the phytonutrients, and fermented foods, which may be, in some, in one Stanford study, even more important than fiber at improving gut microbial diversity. Right. But apart from that, if your child already has a dysbiotic gut or they have a leaky gut, we need to do some of that cleanup up, too.

Yeah. They might have too much of the wrong type of bacteria. That has to be addressed. That could be done through, you know, supplemental intervention, food intervention, in some cases, maybe some targeted antibiotics.

Yeah, yeah, yeah. Well, so, you know, the, the kiddos I was mentioning earlier with the klebsiella, I did use antibiotics, right? I used a prescription because I wanted to make sure I was getting this klebsiella out. And in the particular stew city I used, I could see what antibiotic was going to work, you know, what the sensitivities were. So I chose that one so that I knew I'm going to kill the klebsiella. And then we did all of that gut restoration to make sure that we could replenish the microbiome. And that's not just, you know, a lot of people now think, well, I'll just throw tons and tons and tons of probiotics at your gut microbiome. And that's all I need to do. Right? I mean, that's kind of. It's a, it's a. This very Western American phenomena. More is better, but it's not necessarily more. It's really about the right strains and about feeding and nourishing those strains. You know what I tell kids? It's not like Jack's magic beanstalks. You can't just throw some probiotics into your gut and expect this whole ecosystem of microbes to want to grow and stay. You have to nurture. And that's where, I mean, that is going back to the foundations of making sure that we're not inadvertently preventing those microbes from wanting to stay because we're eating ultra processed foods or too much sugar, making sure that we're feeding them what they need to grow, like the fiber, the phytonutrients and the fermented foods.

For anybody who is a parent and is in this sort of world of integrative and functional medicine, or anybody who is just even looking for somebody who's like a more open minded clinician, one of the things that they've seen for their kids, right, or for a family member that is a child, nephew, niece, grandkids, whatever it might be, there's just not that many integrative and functional pediatricians that are out there. Right. And, and sure, there's probably a few more open minded individuals, even if they don't use that classification that seems to be growing every year, but it's still a tiny little bit. How much of sort of this GUT reset for kids who are regularly sick, have eczema, all these food allergies, sensory issues, all the stuff that we see today that 20 years ago would be very abnormal, but today is like super normal. Pretty much, you know, one out of every three kids, maybe one out every two kids, is dealing with some version of that. How much of this is things that parents can kind of do at home themselves with using like a book like yours as a little bit of a guidebook. And how much of it would you say, percentage wise, for, you know, the population that's out there is parents having to really find a clinician to help guide them through some of the more personalized recommendations?

That's a great question. I mean, because in the ideal world all practitioners would practice this way, right? And the second your child develops like a little patch of eczema, we'd say, oh, let's work on their gut. Let's, you know, look at X, Y and Z factors. So, and you're right that there are more and more. And you know, I'm, I'm, I'm really, really, you know, putting a lot of focus in these next years to work on training more pediatric practitioners. But our kids can't necessarily wait until that time. Which is part of the reason I wrote this book for parents who don't have a guide just yet, so that they can understand the steps of the gut reset program and do a lot of it on their own. And then also for practitioners, I've had practitioners read the book and say, oh my gosh, this is so great. I mean, so many different things that I hadn't thought of. Even if they're already practicing functional medicine or if they're pediatricians, and I still have a lot of very conventional pediatric friends and colleagues who are like, this is so great. I can't wait to, you know, incorporate this or, you know, at least, you know, be able to refer to some of my functional medicine colleagues. But at least now I know. Right, Right. Because, I mean, pediatricians, they go. I mean, we go into this because we love kids. Right. It's not because we want to do harm. It's. But the knowledge isn't always there. And so, you know, really, the, the start is knowledge even for practitioners. Right. Who have that open mind, who and when. When it's driven by the data, it's so much easier to say, oh, okay, I want to do this for my kids now. Right. There are some things that are going to be more challenging to do without a practitioner. Now. There are some general herbs that you can use that can target a lot of the organisms that might be dysbiotic that can be safe to use for kids. And that's why I give suggestions and even suggested dosages based on age in the back of the book. Because, I mean, that's actually one of the most common questions I get from practitioners too, are starting at, well, how do I dose for kids?

Right, Right. We know this is healthy, but they're younger. How much should we actually give?

Yeah. And so you can do that. Now, what we won't know without a gut microbiome test is what are some specific bacteria, parasites, yeast that we're not necessarily getting with those herbs. Is there maybe a time for pharmaceuticals? Does your child have any underlying, maybe inflammation in the gut that, that we're not aware of that also needs to be addressed? So there are some things on a stool test that can be really helpful to know, but starting out, we don't necessarily have to know them. The other thing that's a little bit more of an, of an uphill climb if we don't know, is many kids, kids, especially if they have underlying chronic health concerns, they, they are, can develop certain nutrient deficiencies or insufficiencies. But frankly, I see so many, quote, healthy kids who are low in vitamin D, low in zinc, you know, who need more iron or need more magnesium. But if we don't address these nutrient deficiencies or insufficiencies, even if they're in the, quote, normal range, but they're not at optimal levels. It can be harder to heal a leaky gut lining if you don't have enough zinc. It can be hard to reverse autoimmunity if you don't have enough vitamin D. It can be really hard to manage your child's anxiety. Or constipation if they don't have enough magnesium. So. So some of these things, if we know blood levels, we can optimize those levels, and then it makes it so much easier for the other things to fall into place. Now, you know, for. For parents who don't have practitioners to order the lab work, I do give some suggested lab work to say, hey, doc, do you think we can order these for my kids?

Or they can go to their regular pediatrician and say, hey, here's the reason why I want to order this.

That's right. And they're very. They are. They're blood tests that you can easily get at a conventional lab. Or, you know, I also have graphs of each nutrient that's a common nutrient deficiency in kids. And some of the clinical signs, like what you might see, how do you suspect that my child has iron deficiency or, you know, zinc deficiency? Some of the clinical clues. So that if you read the list and you're like, oh, my gosh, my kid has like 10 of these. Oh, maybe they need more zinc. Right. So you can kind of, you know, have an approximation that they. That they need a little bit more.

No, that's great. The book is fantastic resource with all those different things in the back. It's kind of like you're getting some signs at least to know what questions to ask next.

Yes.

Right. Because even sometimes when you have a practitioner that you like, a lot of this is parents having to do a little bit of the digging to even know kind of what to bring up, what questions to ask. And I think you have a lot of material inside the book that can kind of point people in the right direction. You know, there's an important quote that you have from the book, and I think it's one dimension, especially for kids who are getting a little bit older, who have been sick for years. And the quote, I'll paraphrase, is like, it's never too late to start to heal the gut.

Yeah, right.

For a gut that's been challenged, that's been a child that's been dealing with leaky gut, It's. It's never too late to turn things around. Can you talk about that for a second?

Yeah. Well, and that's where, you know, I always want to lead with hope because there. There are so many. I mean, you just go on social media and it can be overwhelming. All. All of the X, Y and Z toxins that are making you sick.

You know, that glyphosate, microplastics, this antibiotics, all this stuff you're done. Don't even try.

It's true. And. And you're just like, oh, my gosh, what do I do? Crawl under a rock? And so you just. You have to leave with hope and with solutions. So I never want to say, okay, these things are things that are. Are harmful without giving solutions. And it is true that. I mean, it really is never too late to restore a disrupted gut microbiome. And we can do that. We have the tools. We have the knowledge. Now, here's the thing, though, for. For many people, and. And this is for functional medicine practitioners, if you have the experience that, you know, you've gotten your patient into remission or their gut is restored, you do another stool test, and, oh, my gosh, look, the dysbiosis is gone. Right. And three months later, some symptoms start trickling back. You know, six months later, they're almost back to where they started from. Not quite, but they're turning the corner for the worse again. Right. It's not lasting. Right. And when it's not lasting, it's because we haven't necessarily. And I say we, like even me. Right. This is. Was. Has been my experience that we haven't laid the foundations of how to build that resilience to begin with. Right. It's just, okay, kill the gut dysbiosis, seal and heal the leaky gut, and now you're good. It's like, well, yeah, but if they go back to, you know, not getting optimal sleep, Sleep deprivation can disrupt your gut microbiome within 48 hours. It takes seven days to repair the damage that was done. Right. So if we don't make sure, as we're working on the leaky gut, patients know, okay, this is really important. It's not just so you're well rested and feel better in the morning. It's so that your microbiome can stay healed. Right. So just kind of imparting all the things that build that foundation, and it really and truly is never too late. It may take, like I said earlier, it can take a little bit longer if it's been long standing, but we can get there. And for the babies, like, for the little kids, you know, the reason one of the things that is so rewarding as an integrated pediatrician is how quickly kids can respond.

Yeah.

And when you start, you know, the foundation's young, it sticks with them. I mean, sure, the pushback, you know, when they're tweens and teens, but they have those foundations to take with them. And I'm just. I. You know, like I said, I Have a bunch of kids who have gone off to college, and it's just. It, like, is so good for my heart to have them call me when they're at school saying, hey, Doc, you know, you know, I'm having X, Y and Z symptoms. What do you think it could be? And, like, like trying to do some digging and, you know, saying, oh, I, you know, I know I had, like, I had too many drinks this night, but I'm working on it and I'm gonna, you know, and they know about their gut health. They know about the gut brain connection. So. So they're learning how to adult in a way that's really optimal for their microbiomes and for their brains and for their health. And that's what we want as parents. I mean, they're going to push back at times, but if we have those foundations, they can go off and we can trust. Okay. They know how to make those good decisions. They're going to get back to it, and then they're going to make those good decisions for our grandkids. Right. And it goes on and on. So. So, you know, we really want to. That's what we want. We just want to pay it forward to our next generations.

Well, one of the positive things about social media that I definitely feel like I'm seeing, and sure, there's a little bit of a coastal bias because, you know, I live in California. You're also on the west coast as well. But I see that it's actually cool for kids to, like, take care of themselves.

Yes. Right. Yeah.

Even though, sure, there's a lot of extremes that still exist in this world. People combining alcohol and caffeine and these crazy drinks that, you know, are having kids end up in the hospital. But in general, there's this trend towards, you know, even, like, a lot of my friends who have teenage boys, like, boys are really into, like, taking care of their skin.

Yes.

It's, like, now really cool to, like, for all kids to, like, want to work out.

Right.

Like, there's a lot of themes that are kind of creeping in, and it's like, it's, It's. It's. It's cool to want to take care of yourself.

Yeah.

Where I don't think that that was always the. The case back in the day. And sure, that can have some positives, it can have some negatives, but I think that there's a big cultural shift and people are realizing the importance of. Of. Of wanting to, you know, take care of your. Your temple in a way. And I think that's a lot of the credit goes to, you know, this previous generation that was there before that's been advocating and putting out information that's kind of trickled down. The kids call it crunchy moms and dads on social media, right? They make fun of the parents for all their healthy choices, their granola parents, their crunchy parents. But hey, one way or another, the message is getting out there.

That's true. And Birkenstocks are cool again.

Birkenstocks are cool. That's true. Tell us a little bit more about the book. The title, when people can get it, where people can get it.

So the book is called Healthy Kids, Happy Kids, An Integrated Pediatrician's Guide to Whole Child Resilience. And the book is really about the everyday things that we can do to foster microbiome resilience, to foster whole child resilience. And I really wanted to make sure it was simple things that people can do every single day, not an add on. Right? These are the ways that we can live as kids, as teenagers, as families, to set the habits for life. Right? Because, you know, we can be weekend warriors as, as adults and be sedentary all week and then like, you know, go out and, you know, bike like 50 miles on the weekends. But it's the things that we do every day that that make the biggest difference. And so, you know, we want to teach our kids those everyday things in a way that really, you know, have some excited about nourishing themselves and nourishing their microbiomes. So the book comes out May 14, and it's available pretty much anywhere where you can buy books, support your indie bookstores, please, if you can. But yeah, it's available anywhere.

That's fantastic. I know one thing that you're always great at is you do a ton of online education. You have E courses, you do just even a ton of free content on Instagram. I'm always sending your reels. I think there was a reel that you made a few days ago or a week ago. It was about Tamiflu and how it really doesn't work the way that people think. And I had a friend just asking about this, like this past winter when all the kids were getting sick and stuff. And I sent them the reel. I said this, save this for this upcoming winter season. Any other places that you want to send our audience to?

So Instagram is the social media that I'm most active on. And then my website, healthy kids, happy kids dot com.

Have you made the. The jump into TikTok knowing that a lot of your own patients are probably there right now.

Oh yeah, they are there. I actually, it's so funny. I started and then I stopped. But I do have some videos on TikTok and my friends, my kids friends are like, your mom's on TikTok. And I mean it's hilarious. So I have not, I have not jumped yet, but that is probably the next thing.

Well, we'll have the link to the book as well as your Instagram and all the other great courses that you've developed over a period of a few years in the show notes below. And also if there's any practitioners that are listening, how do they raise their hand for maybe one day when you are doing more training or shadowing or something like that? If they want to reach out to you, how do they reach out to you?

I love that question. So right now I am chair of pediatric education for a 4M. And so we are this our is third year of hosting a pediatric symposium to provide pediatric functional medicine training. So that would be the best place that happens online.

Or is that in their, their Vegas conference?

Actually. So it's not there. It's their fall conference and this year it's going to be in LA at the LA Live. Yeah, in September. So we're trying to hop back and forth, but, but they're committed to bringing pediatric functional medicine out to practitioners. And, and you can just reach out to me. I love, you know, chatting with practitioners and you know, when I started in, in integrated pediatrics, I mean, this was back in 2004, I opened the practice, there weren't really a lot of colleagues for me to chat with. Not at all. And kind of go through this journey together. So I'm always happy to give some of my tips that I've learned through.

The years to practitioners, audience, grandparents, existing parents, future parents like myself. Pick up a copy of this book, give it to somebody you love. Dr. Elisa Song. Thank you for coming on the podcast.

Oh, thanks for having me, Drew.

Hi everyone. Drew here. Two quick things. Number one, thank you so much for listening to this podcast. If you haven't already subscribe, just hit the subscribe button on your favorite podcast app. And by the way, if you love this episode, it would mean the world to me. And it's the number one thing that you can do to support this podcast is share with a friend. Share with a friend who would benefit from listening. Number two, before I go, I just had to tell you about something that I've been working on that I'm super excited about. It's my weekly newsletter and it's called Try this Every Friday. Yes, every Friday, 52 weeks a year, I send out an easy to digest protocol of simple steps that you or anyone you love can follow to optimize your own health. We cover everything from nutrition to mindset to metabolic health, sleep, community, longevity, and so much more. If you want to get on this email list, which is by the way, free, and get my weekly step by step protocols for whole body health and optimization, click the link in the show notes that's called Try this. Or just go to drew pirouet.com that's D H R U P U R-O-H I-t.com and click on the tab that says Try this.