The Dr. Youn Show Ep 181.5 - A Holistic Approach to Healthier and Happier Kids with Dr. Elisa Song

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Welcome to the Holistic Plastic surgery show. I'm Dr. Anthony Yun, also known as America's Holistic Plastic Surgeon. If you want to look and feel amazing, but ideally don't want to go under the knife to get there, then you my friend, are in the right place.

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American children suffers from a chronic medical condition and this generation of children may be the first one that unfortunately has a shorter lifespan than their parents. So with this in mind, I've invited a good friend of mine, the country's foremost integrative pediatrician, onto this podcast today and she's going to give us very simple changes that you can make in your home to help keep your kids healthy, vibrant and happy well into adulthood. And the key to this is the microbiome. So let me introduce my guest this week. Dr. Elisa Song is a Stanford, NYU and UCSF trained integrative pediatrician and pediatric functional medicine expert and most importantly, she's the mother to two thriving children. She has dedicated her career to helping parents and practitioners bridge the gap between conventional and holistic pediatrics with an evidence based pediatrician backed parent approved approach. Dr. Song has lectured across the country at leading integrative and functional medicine conferences and premier parenting events. And I'm so excited to bring my good friend Dr. Elisa Song to this podcast today to talk all about functional and holistic pediatrics. But before we do that, I'd like to give a quick shout out to. To OceanB5. OceanB5 left a nice review of this podcast on itunes stating. Thank you, Dr. Yoon. I think I found you on YouTube and I'm so happy I did. Well, thank you so much, OceanB5, for this nice review. And if you've been enjoying my podcast, if you could leave a rating or review on itunes or on Spotify, it definitely helps me spread the word. All right, well, let's go ahead and get started with my interview with Dr. Elisa Song. This is one that every parent should listen to. Thank you so much for joining me today, Elisa.

Oh, I'm so excited, Tony. This is. I mean, you're one of my favorite people in the whole wide world. So this is what I was looking forward to.

It's like you're my sister from another Mr. That's right. Always said that. Okay, so you're really quite possibly the country's most prominent holistic pediatrician. And I know you can also describe it as being an integrative pediatrician or a functional pediatrician. So for those people who don't know, what is the difference between being, let's say, a traditional pediatrician and. And an integrative pediatrician?

Yeah, so that's a great question. I am trained very conventionally. I went to UCSF for my pediatrics residency and NYU for my medical school. So very conventional in the sense that, of course, we learn all about the pharmaceutical medications and, you know, all the, all the things that really we need to do to take care of the immediate problem. The problem with that is when we're taking care of the immediate problem, let's say an infection, you know, like a sore throat, right? And we give the antibiotics, great. We want to kill, you know, the bacteria. But then we recognize now that there are these unintended consequences downstream, which we'll dive into to the microbiome. And so from an integrative standpoint and a functional medicine standpoint, I look to see how do we help kids not just recover from their illnesses or whatever is going on with them, but build the foundations of resilience in their microbiomes from the ground up so that, you know, we can mitigate some of the effects of sometimes very necessary medications, or better yet, maybe prevent them from needing them in the first place. So, so there's so many different modalities that can be incorporated and integrated with conventional PEDs. So what I use is herbal medicines, nutritional supplements, diet and lifestyle recommendations, essential oils, homeopathy, acupuncture, and acupressure. There are many others, but I've been doing this for over 20 years now, so that the combination is what I found to be really effective.

So like you or like me, you went through traditional medical training. You know, you went through medical school, you did your residency. Did you do a fellowship?

I did that.

Clinical.

Yes. You did your residency. At what point in your career did you decide to make this shift into going to integrative pediatrics? Did you practice as more of a traditional pediatrician for a while? Or is this something that, you know, earlier on you knew that you wanted to go in this direction?

I went into medicine knowing I was going to go into this direction. It was, you know, I wasn't actually going to go into medicine at all because my mom was an obgyn, and I just. I mean, she was never at home. I mean, she was up all hours of the night delivering her own babies. This is back, you know, 70s, 80s when I grew up. And, you know, and in the 80s, in high school, as I was thinking about my career, I'm like, I don't think I want to do that, you know, but I always knew I want to work with kids. And my initial vision was actually to be a lawyer. I was going to be a civil rights, you know, children's health. Not even health, just children's advocate, lawyer. And so then in college, when I was at 6, Stanford, I remember thinking to myself, you know what? That would be great. I want to advocate for kids, but I'm not going to work with kids. And that, I mean, I love working with kids, you know, every day. And it was then that I stumbled upon this, this flyer, you know, for the American Holistic Medical Association. This was back in the, again the mid-80s. As a junior, I decided to go and I heard from these people that were just starting to get known. And back then, it wasn't even called integrative medicine, it was called alternative medicine. Right. We've kind of shifted away from that. But, you know, folks like Dr. Andrew Weil and Dr. Deepak Chopra, who now are really big names, but I mean, they were just coming out into the medical field. I was hooked. I'm like, oh, my gosh, this is what I want to do, you know, now I can work with kids, but also take more that root cause, like, wow, I can really help kids thrive and practice true prevention.

So you're going through residency like any other resident, where you're learning about how pharmacology. You're learning about how to treat acute illnesses. At that time, was there. Did you do any additional training during your residency, or were you really just focused on traditional pediatrics at that time? And did you share, I guess, some of your inclinations to go more towards the alternative medicine route as well with your attending physicians?

It's a funny thing. I mean, for sure, my fellow residents and my attending physicians, they all knew that I was more interested in this kind of holistic world. But, you know, when I have medical students or residents approach me, contact me and say, you know, I kind of. I'm interested now in a similar route. Or what I tell them is get really good at conventional pediatrics, right? You better be. I mean, that is why you are in residency. It is to be the best traditionally trained pediatrician you can be. Because there are going to be times where you need to make those referrals to specialists. You need to choose certain medications, and then, you know, have in mind, okay, what are the things that are lacking as I'm going through training, and then you fill in the gaps. I mean, you could do that during residency, but I would say, you know, even after residency, so there are more and more opportunities for pediatric integrative training. So. So, yeah, I went through. I wish someone had told me that, you know, when I was in training, because it was kind of this push pull. But I did do my. My second year of residency when I had time for an elective. I actually went to my pediatrics, rheumatology, attending, and I said, hey, can I create my own? Like, I'll be in the clinics and I'll do the rounds and do all the things, but. But I created my own integrative pediatric elective, like, to so many different offices in San Francisco and Marin. I went to chiropractors, acupuncturists, osteopath, herbalists, hypnotist. I mean, I just, like, I want to know what's out there, right? And so I had this opportunity to go and explore, and then I dived into the research. At the time, you know, not that much. It was mostly adult research, but I wrote a primer and I presented to the pediatric medical students, residents and attendings. It was called then a complimentary and alternative approach to Juvenile arthritis. Now, I would call integrative, because alternative makes it sound like, well, if you have arthritis, if your child has arthritis, that means you're not going to do any of the meds. And that's not true. But if we do that, an integrative approach, then we might be able to, like I said, maybe prevent your kids from needing the stronger and stronger immunosuppressant meds, or at least we can help with some of the side effects and really, really get them, you know, as healthy as possible with whatever's going on with them.

And that's one thing I really love about you. I mean, obviously we've known each other for many years. We've talked about our children and our children's health and all of that. And my wife being a pediatrician, it's my. We've had this definite connection. But I think one thing that I really like about you is that unlike some people who are, let's say, in the functional medicine community, the more holistic alternative medicine community, you have one foot firmly planted in conventional medicine. You know, there are people who are friends of ours who are against conventional medicine. And it just doesn't make any sense to me unless you don't really understand it that well yet. Having that knowledge of all these complementary therapies and definitely combining those to treat, to give the treatment that is ideal, which I agree is a true integrative approach, where you combine east and west, you combine alternative with conventional therapy, that makes the most sense. As somebody like myself, who also, you know, was fully trained in conventional medicine, but has his eyes open to the benefits of alternative medicine too. Hundreds, if not thousands of functional medicine physicians out there that treat adults, but there are relatively few that treat children. And I'd love to hear your thoughts on why that is the case. Because you think that as an adult, honestly, you know, I mean, I care a lot about my health, but I care about my kids health more than in some ways I do my own. Why is it you think that there aren't more physicians who are treating patients the way that you are? I feel like there's just a handful of integrative pediatricians, at least that I know of.

Yeah, there's for sure, as you're seeing and as many people will probably see, you know, for adults who go down the functional medicine integrative route for themselves, let's say they have Hashimoto's or they have, you know, something going on with them, chronic fatigue, and they're like, you know, I need to fix these things. And then, then they kind of look and think, well, I want to do the same thing for my kids. You know, maybe my kids have some attention or focus issues or maybe they're starting to develop anxiety, and it's really hard to find. There's more and more, which I'm really grateful for, because when I opened up my practice in 2004, it felt kind of lonely. You know, I was really lucky that I opened up my practice in the San Francisco Bay area, where I still had a lot of my friends from residency. I was kind of a known entity at that point. I wasn't this, like, kooky, you know, who's this pediatrician coming in, showing up kind of alternative things. So I had, you know, the respect from my friends and colleagues and was able to really, you know, grow the practice. But it's tough to find. And frankly, I think it comes down to the availability of training. You know, there are large institutions like the Institute for Functional Medicine, where I did my functional medicine training, and now there's the A4M, the academy for Anti Aging Medicine. Up until very recently, no one has really wanted to spearhead the pediatric integrative functional medicine education arena, which is. Was so frustrating because, you know, when I started out, I had to take the adult literature and then figure out how to apply it. And so then, you know, starting my practice, I would have pediatricians come and say, well, you know, can we shadow you? How do you. How do we do this? Because there's no specifics on pediatric dosing or testing or anything like that. I'm so excited now because a 4M has really now been committed to training family physicians and pediatricians and pediatric practitioners in functional medicine. And I'm the chair of their pediatric education. So I get to bring some of, you know, the folks who have been with me doing this for decades now and really get their expertise and knowledge out there. So there's more coming for sure. It's just. It's been a slow road. And for, you know, for those of you who have kids and you're like, oh, my gosh, when is it going to come? It's coming, you know, but that's part of why. I mean, when you and I first met, it was in this, you know, health entrepreneur group called Mindshare. And I was like, I don't know what I'm doing here, but I know I need to get more information online because parents don't have, you know, a lot of accessibility to an integrated pediatrician. So. And then here I am, you know, years later.

So we're talking about your new book. It's called Healthy Kids, Happy Kids, An Integrative Pediatrician's Guide to Whole Child Resilience. It's a fantastic book, basically a complete guide to keeping your kids healthy using a true integrative approach. So once again using a combination of traditional conventional medicine with all these types of alternative therapies and techniques, ones that are evidence based and scientifically proven. So I'd like to shift gears a little bit and let's talk a bit about that because I think it's so important to realize that there is a completely different way of looking at our kids health than as a parent, what we may have been exposed to throughout our entire lives. So I think it's important today to start with realizing that our kids today face challenges that let's say you and I did not have when we grew up in the 80s and 90s. So they've got this prevalence of ultra processed foods, there's a lack of outside activity, there's all this time spent on screens, there's social media. So given all of the stuff that our kids are being bombarded with that we didn't have to deal with as children, what do you think is the number one, I guess, greatest challenge that our kids face today that maybe we didn't have to deal with as much when we grew up as Gen Xers?

Yeah, I think when we look at, at this trajectory of chronic illness in our kids, we know now that nearly one in two kids in the United States has been actually diagnosed with a chronic health condition. But then you look at the kids who aren't diagnosed, but they're still not totally, you know, thriving. Right. They have the sensory issues or, you know, maybe they're, you know, they're having chronic tummy aches or chronic headaches that, you know, doesn't qualify them for a diagnosis. But, but it's there. Or you know, eczema and asthma sometimes just, you know, little patches that show up here and there. I do think that, you know, in our increasingly complex world, if we can simplify down and really understand that one of the biggest factors in why our kids are marching along towards the same trajectory of chronic disease as adults are, it's really the change in their gut microbiomes that has occurred in the past several decades. And on a scientific level what we can see is, you know, there's been this dramatic loss of a whole, you know, genus of bacteria, good bacteria, called bifidobacteria. So we're losing that. And even in adults we found that this loss of bifidobacteria is making us more susceptible to, you know, allergies and infections and worse outcomes from, you know, from our illnesses. And conditions. And so I think if we take that sort of gut first microbiome centric approach to kids and think about, well, okay, if we know that the gut microbiome is truly the foundation for your kids developing immune system, developing brains, how do we nurture their microbiomes? And also importantly, in our modern world, what are all the forces that are kind of coming together to disrupt their microbiomes? So it's another way to think about it. And as you said as parents. Right. We would do anything for our kids, you know, oftentimes more than what we do for ourselves and at the expense of our self care. Right. Which I don't do that. Right. I mean, take care of yourselves. But at the same time for our kids, when they realize there's this whole ecosystem inside their bellies that are taking care of them, it shifts a little something and it makes it easier for them to think, you know what? It's not just about like what I want to eat, it's about, you know, what am I eating that can help my tiny little buddies in my tummy and also me.

How did you come to the realization that all of this, that you're seeing in your patients, you know, and these are children who have issues ranging from ADHD to like you mentioned, digestive issues to skin issues, to sleep problems and all of that, these kind of chronic types of illnesses that they can get. How did you come to the realization that all of that really comes down to the health of the microbiome? And even now we're even learning that the health of the microbiome when the baby is in utero, of the parents microbiome of the, of the mom's microbiome is a key element too. How did all this come together for you? Because it is a fascinating topic and it's a fascinating conclusion that these types of things, you know, the brain, the skin, the heart, the lungs, all of this is connected to the microbiome?

Yeah. In the literature. And we've kind of, you know, if we look at the evidence. Right. You know, in, in the literature, we, I'm saying, you know, collectively kind of the, the scientific world has known about this connection between children's microbiome disruption and, you know, health consequences like eczema and allergies for decades. I'm talking like almost 40 years. Right. Or over 40 years. What's in the literature? Right. What's in the literature doesn't always translate into clinical practice. As I was going through my functional medicine training and in functional medicine, really one of the Tenets is it goes way back to Hippocrates, credited with saying all disease starts in the gut. And so then I started looking at the children's gut microbiome literature, and some of it was frankly, kind of frightening, right? As a parent, you're like, oh, my gosh, why didn't I know this? There are some studies I'm going to just explain right now. And if your kids don't did receive antibiotics or antacid medications when they're younger, it's okay, right? You know, we, we can. I mean, the reason why I wrote this book was so that we don't just have these fearful statistics, but we have this. Oh, okay, now I know. Okay, now I know maybe what some of the root causes are for my kids. Eczema or their anxiety or their adhd. And now I can move forward because now I know that I have to look at the gut microbiome, right? But there's one really large study, almost 800,000 kids, so it was a military study, and they looked at all these records of these babies who received antibiotics or antac medications in the first six months of life. Now why those medications? Because we know that those directly disrupt the gut microbiome and can kind of get rid of all of your healthy probiotic bacteria and allow these unhealthy microbes to take hold. So those infants who received antibiotics or antacid medications in the first six months of life were found by the time they're four years of age to have an increased risk, sometimes double, of virtually every single allergic disease, including like anaphylactic food allergies, eczema, asthma, hay fever, you know, hives. Another study, so this is in Denmark, where they keep really good study records of their, of their population and looked at kids who received antibiotics whether it was in utero, meaning, like maybe mom had an antibiotic for a UTI or a sinus infection, or, you know, in their early years. And those children, you know, just one round of antibiotics could increase the risk of many, many mental health concerns by the time they were older kids and toddlers. And the highest risk was when they received those antibiotics when they were younger. So it was this kind of alarming, like, wow, okay, so now we know there are factors that can disrupt the gut microbiome. What wasn't really in the literature was, okay, now what do you do about it, right? Like, how do you move from that kind of fear to I want to do something for my kids? And so, you know, with that, then in the functional medicine world, we can See the necessary ingredients to restore your child's microbiome or if they don't have any particular health concerns, how do we keep your child's microbiome at its best so that your children have the best chance in life, you know, as they get older, to, you know, prevent all of the chronic health diseases that are plaguing, you know, our populations? I mean, the World Health Organization has noted that, I mean, worldwide, it's not just the United States. Worldwide, 8 in 10 adults will die of what are called non communicable diseases, which means those are kind of diet and lifestyle related diseases like obesity and diabetes and heart disease. So if we don't want that future for our kids, we need to start now, however old they are. I would say, even for an adult, I mean, no matter what your health condition is, if you work on your microbiome, there's so many other things that will fall into place because of the gut immune connection. Gut brain connection. If you have hormone imbalance, you gotta look at the gut because the gut is intimately connected with hormone health. Even for you, like the skin. I mean, I'm gonna tell you a little plug for your products here for Yoon Beauty, okay, Because you're a hyaluronic and probiotic serum. First of all, I have to fight my teenage daughter for it. And she kind of keeps it in her room because she's noticed, I mean, for her acne, right. As a teenager, it's so great because our skin has a microbiome. And so if we balance out our skin microbiome, whatever you're dealing with, whether it's even adult acne or rosacea or eczema, it's going to improve.

Well, let's talk about some very practical ways then that we can help to improve our children's health. You go over your book, five things that you and your child can do every day for lifelong resilience. We're gonna go over all five of these, but the first one is one I really want to focus on because it has to do with the food that we eat and maybe foods that we eat that maybe we shouldn't eat as many of. And so let's focus on that first. And it's nourish is the number one thing that you can do for your child every day for lifelong resilience. And the first part of the nourish is adding in your microbiome champions. And so we're talking about the microbiome and the fact that, hey, you know, if we can help to encourage our children to have a healthier microbiome, they're going to be healthier from that. First thing is adding in fiber. So how is the lack of fiber a problem in our children?

So you know, one of the things that we want to think about in terms of nourishing our microbiome is what do they need to eat to live? Just like, you know, we need a certain amount of protein and carbohydrates and healthy fats. So what do our microbes, our probiotics, the beneficial bacteria in our microbiome need? They need fiber. Why fiber? Fiber is also, you know, there are many different kinds of fiber, but one of the most important fibers are act as what are called prebiotics. They are, they are prebiotics that feed our probiotics. In fact, we can't really digest these prebiotics. The, the whole, the, you know, this. One of the main benefits is that they get down into our gut and our probiotics are like, hey, I love this fiber. Whether it's from legumes or whole grains or fruits and vegetables. And they start to ferment and digest it. And then what happens in this amazing process, our probiotics, when they digest and eat those prebiotics, they make compounds for us that we need, like different vitamins, different antimicrobial compounds, even anti cancer compounds. They help to detoxify and clear out all of the environmental toxins like these forever chemicals, which are, you know, in the news a lot now, they actually help us to, you know, kind of excrete and eliminate those. And guess what? They also make this whole series of compounds called neurotransmitters. Right. These are our brain chemicals. So the vast majority of serotonin is made by our gut microbiome by very specific microbes that are actually coined psychobiotics because they help make compounds, neurotransmitters that are helpful for our brain. So serotonin, which is implicated in anxiety and depression, Dopamine, which is implicated in kind of adhd, attention and focus and addictions, acetylcholine, gaba, I mean, you name it. So that's why fiber is so important. And we know that. I mean worldwide, the World Health Organization has noted that populations pretty much everywhere has a fiber gap. Now, the fiber gap. In the United states, only about 5% of U.S. kids and adults actually meet their minimum daily fiber requirements. Five percent. Right. Our five hour daily requirements. I mean, let's say the average kid, it depends on age, but let's say it's maybe about 25 grams of added Fiber. There is a traditional hunter gatherer society in Africa that has the most diverse, healthiest microbiomes of any populations in the world. They're called the Hadza people. I mean, they eat on a daily basis an average of maybe 100 to 150 grams of fiber a day. So for us to get in 25 grams doesn't seem like it's that hard, but it is. When we're faced with all of these ultra processed foods, if we don't kind of mindfully think, all right, I need to get in my fiber today.

So one of the things that I learned reading your book was just what you mentioned earlier, and I really want to emphasize that, is that a huge percentage of some of these neurotransmitters like dopamine and serotonin, which really affect our mood. And just like you said, you know, our concentration and all of that is made by the microbiome of our gut. Like, that was something I actually never knew, and I've been doing this for a while. So it makes so much sense when you look at that, that there's a direct correlation then between the health of your gut microbiome and how well your brain is functioning. There's a lot of things that are maybe indirect correlations that you have to kind of see and learn about and understand pharmacology and biochemistry. But this is something that's very direct. And one thing, once again, that I was reading this in your book was like, wow, how did I not know this? And the other thing I thought that was really interesting is throughout your book, you explain with the whole fiber issues that the more processed the food, the less fib. And so you have little tables where you take, let's say, the least processed food and show how much fiber is in that all the way up to the more processed. So let's do that real quickly because you give like, let's say three examples. So like, not processed, kind of moderately processed, and ultra processed. You know, how does it work with, let's say, an apple for an apple?

I mean, let's say a medium apple has about, you know, maybe four grams of fiber. It depends on, you know, how thick the skin is and all. But you want to eat it with the skin, right? Because the skin has all of those beautiful phytonutrients, which is another microbiome champion, the color, right? And also the fiber. So let's say you kind of gnaw in an apple and you have the whole apple. And that's maybe, like I said, maybe 4 grams of fiber. And then let's say, you know, your, your kiddos want some applesauce. So you decide, okay, I'm going to make some applesauce at home, right? You boil them, you kind of smash them. My daughter makes this all the time. It's, it's pretty easy, right? Add a little kind of squeeze of lemon, maybe some cinnamon, right? You really, I mean, the apples are sweet. You really don't need to add the sugar, right? And so then it has a little less fiber. So you've processed it. So this is where we need to step back and say processed in, in and of itself. That's, that's not, that's not what we're talking about. Because even when we like marinate, you know, a rack of ribs for 24 hours and we grill it, that's processing it, right? But it's minimally processed, right? And so if we make our homemade applesauce that's minimally processed, but you know, now you've taken off the skin and you've kind of, you know, boiled it down a little bit. So maybe now it has like 2 grams of fiber in it. Let's take store bought, you know, something like if you take something where you look and especially, you know, if it's, if it's not organic, so then, you know, okay, there is, there's probably apples can be pretty heavily sprayed with glyphosate, which is another, I mean, that's a big microbiome disruptor. But when you're mass producing applesauce, you know, in the factories, you have to take ultra high heat to boil it down and pulverize it into the smooth, smooth, no chunks, right? And when you do that, you strip away virtually all of the fiber. And very often there are added sugars to the applesauce. And then you also have added preservatives, maybe some citric acid. Each of those can also disrupt the gut microbiome in their own ways. But when we're looking specifically at the fiber, we've moved from, you know, this unprocessed whole apple to a minimally processed homemade applesauce to an ultra processed, virtually no fiber product. And so we can see if we stay on the unprocessed to minimally processed side, we're going to get more fiber in our diet. We're also going to get less of the FDA food additives and you know, added sugars that are countering, you know, what we are trying to do in nourishing our microbiome.

So you mentioned phytonutrients this is another big microbiome champion after fiber. So can you explain what phytonutrients are?

Yeah. So phyto means plant, right? So that's, it's from the Latin, you know, term. If any of you took Latin in high school, which I didn't. Right. But phytonutrients means nutrients from plants. You might, you will also see them in the literature as phytochemicals, but I don't like that term as much because nutrients just sound so much more wholesome because they're naturally occurring compounds. Now, these phytonutrients are in part what give plants their color. Every different color represents a different phytonutrient benefit. Now, why are phytonutrients important? Well, they serve as a really great source of antioxidants to reduce inflammation in our bodies. We need antioxidants if we're sick or you don't have anything chronic going on. But really and truly, what's probably the most important role? Because a lot of these phytonutrients fascinatingly do not get absorbed into our bloodstream. We're thinking about these supplements, like, you know, maybe a liposomal curcumin, because curcumin, you know, from, from the turmeric root. Such a great phytonutrient for us. Anti inflammatory. Well, it's probably not, you know, so important how, quote, bioavailable it is and how much it gets absorbed into our system. Because what really uses these phytonutrients are, are our microbes, right? Our microbiome. They take these phytonutrients and convert them into different compounds that influence how our genes work. That's the fascinating thing. Our microbes can determine what's something called epigenetics. So how are our genes? It may be that there's eczema or diabetes that runs in the family. Your genetic destiny is never set in stone. How our microbes interact with the foods we're eating, especially these phytonutrients, can make that risk so so much less. So with the color, we also know we have a color gap. I mean, 8 in 10Americans has a color gap in every single color of the rainbow. Right? They're not eating the rainbow. Right. And Skittles don't count. Right.

We'll talk about that in a second, too. Yeah, So I mean, phytonutrients, I think that's the whole idea of eating the rainbow. And this is something that I have talked about as well. And I think that there's so much that we don't realize, I think just as. As laypeople about the idea of epigenetics. I think there's so many people who go through life thinking, oh, well, my parents had this in their genes, so I'm going to have it. You know, oh, my, my dad died of a heart attack when he was 50, so, you know, I've got heart disease in my family. I'll probably die of it too. But people don't realize that it really is kind of an 80, 20 type of a rule where really 20% of your health is going to be decided by your genes. With the 80. The other 80% is going to be decided by how your genes express themselves. And that's going to be decided by how you live your life, by your lifestyle, by your exposures and what you eat especially. And so I think with their kids, it's even more, I think, something for us to really think about.

Well, and that's what, I mean, that's exactly what you talk about too, in, in your book. I mean, honestly, guys, for all of you listening, I mean, as we get older, you know, there's so much like biohacking and longevity. How do I enhance my lifespan? Right. To be optimal. But so much of that, if we set those foundations, like all the things that you're doing and the programs you're following with Tony, I mean, if you incorporate that, you know, and I mean, my, my book is very similar. Like, you gotta start with the foundations. Right. And it really matters. I mean, I have some kids who say, well, everyone in my family has anxiety. You know, of course I'm gonna end up on a medication or like, you know, like you said, well, everyone has diabetes. Why should I bother eating a different way? Because I'm sure I'm gonna get diabetes when I'm older.

Yeah. And it's just not true. Obviously, it comes down to how you live your life. So the other group of microbiome champions are fermented foods. Followed me. They know I'm a big fan of fermented foods. We're both Korean, so we are, have probably eaten literally metric tons worth of kimchi in our lifetime, which is great. But, you know, I think the challenge with fermented foods, and I have the challenge with my kids as well, is how do you get your kids to eat fermented foods? Because they're sour. You know, they're not. Other than yogurt, which my kids are good with, it's hard. I find it so difficult to get them Eat it. So, you know, we know, you know, if you've been following me, you know, okay, why would you need fermented foods? We're talking all about the microbiome. They're fast, filled with healthy probiotics. So it's just right along everything that we've been talking about on this podcast. But with children. Okay. It's a challenge. What are some of your suggestions for those kids who have been eating a sterile diet all their life? How can you try to bring those fermented foods in?

I love that phrase. A sterile diet. Right. A microbe free diet. Right. Because we're kind of scrubbing all of our produce every. We're not like gardening many of us. Right. And not like you picking tomatoes right off the vine and getting in our, our inoculum.

Yeah. I mean, everything is shrink wrapped and like. Yeah. I mean, how do you get your kids to eat fermented foods? And what do you tell your patients?

Yeah. So, I mean, so we have to recognize that for some kids, I mean, even for some adults. Right. It can take 40 plus times of trying a food to find it acceptable. I mean, I remember, you know, going to med school in New York where we have like an amazing array of pretty much any cuisine you can imagine. The first time I had Thai food, I was like, oh my gosh, I don't like this. Right. The flavor, it was just such a unique flavor. Right. And now it's one of my favorites. Right. So I mean, you just have to keep trying. So first of all, as a parent, don't give up. And then second, maybe not just have like the whole bowl of kimchi or like a huge bowl of sauerkraut in front of them. There's something called flavor learning, which is fascinating and it really works. But you know, let's say my son's. One of his favorite condiments is ketchup. Right. As I'm sure is for many kids. Right. So what you can do when you flavor, learn. So for having, you know, let's say we're having some chicken and he wants some ketchup with it, you can just put in like a tiny little bit of kraut juice into the ketchup. So, you know, it's barely perceptible. And then you just gradually increase the amount because he loves the ketchup and dipping his chicken and whatever it is. Right. So then eventually your kids will get used to that flavor. And it already is paired with a positive association with food because you're pairing it with something that they Already like, so that's one potential. The other thing we want to do is kind of think outside the box of like fermented vegetables, right? Like the sauerkraut and the kimchi, which is so great. I mean just even getting a spoonful of kraut juice or kimchi. I remember as a kid just, you know, like the bottom of the pickled radish called gakdugi, which is similar to kimchi but it's the radish. And we just would like spoon, you know, the sauce over our rice and then we'd have the radish and then like have it with the Korean meat. I mean, so good, right? So even just that spoonful can be helpful. But, but in my book I give some really different ideas on how to get in fermented foods into your diet. And starting with fermented fruits, which we don't often think of, right? I have a recipe for fermented BlackBerry lemonade. You can substitute whatever fruit you want. But it's so easy and tasty. I mean, I made this. I actually developed a six week curriculum for my daughters third and fourth grade class. I mean these are eight to ten year olds, right? And it was six weeks talking. It was called Healthy Belly Happy. You taught them all about the microbiome magic and microbiome mischief makers. And we made fermented lemonade. We also made kombucha. We brewed our own kombucha, which is another yummy way to get, you know, fermented foods into kids. And we made sauerkraut so they could see like you pound, you know, the cabbage, you add the water and the salt brine. And we just watched it ferment in the windowsill over that six weeks, right? So that's tip. Make some fermented foods. They're easier than you think, right? So I give some options in the book. But you know, when your kids help cook, this is even not just fermented foods, anything, right? They're much more likely at least to try a little bit. But the fermented BlackBerry lemonade you can put into. Or fermented fruit, right? You can make that, you can use that as a compote for your waffles on Saturday mornings, right? Or you can, you can add that into your smoothies. You can, I mean you can make popsicles with them. I mean a lot of different, different things that you can do as a way to get in fermented foods that are really way beyond the kind of sour sauerkraut, which I still want kids to like one day. But there are other kind of. We'll ease them into it.

So we've covered some of the microbiome champions, those food and food types that will help to nourish our microbiome. But you also have a category of food and food like products, I guess, ingredients that you call the mischief makers. And I think it's important for people to realize. So first of all, you know, one thing we have mentioned before is kind of this idea of processing your food. And it's not necessarily a bad thing if you process your food because that's really taking anything that's just in its raw form and either cooking it or seasoning it or anything like that. But there are also ultra processed foods, which in general are not good for the microbiome. So can you explain what an ultra processed type of food is and how does it impact our children's microbiomes when they eat it?

Yeah, so the ultra processed foods are, you know, similar to like the ultra processed applesauce that we were talking about earlier. They are a concoction of ingredients that you won't find on your pantry or at the grocery store individually. There are over 3,000 food additives that the FDA has approved to put into packaged food, basically to make them stick so that they don't become like a goopy mess in the package, to make them sweeter, saltier, fattier. And specifically, when we think about it, to get us to want more of it and buy more of it, right? I mean, the ultra processed food industry, it's a business, right? They need to make money off of it, right? And so you bet that there are these mad scientists in the back rooms of these ultra processed food factories to thinking about how to make make the food. They even call it mouth feel. And we know that certain ingredients can light up your dopamine kind of addiction centers in your brain. So they're trying to think, what, how can we combine these ingredients so that this person who's eating it has to have another bite, right? You just crave more and more. And then of course you're thinking about and you buy it, right? So we're not really even in control of our own food cravings, unfortunately. And then the whole psychology of packaging, right? I mean, they've shown that for adults, you know, parents, if there are pictures of like happy kids or smiling faces on the front of the package, parents are more likely to buy that packaged food because it brings to mind my child, a happy child. Right? And so, you know, the problem with many of These food additives is that we've seen, we can see in the literature that so many of them disrupt the gut microbiome, some of them really directly, and some of them will actually preferentially kill your beneficial bacteria at the expense of keeping and preserving your not such good bacteria. When we look at the gut microbiome disruption that is being triggered by some of the packaged foods that you may be inadvertently buying, right? I'm not, you know, and this is, you know, I'm saying even for me as a, as a integrated pediatrician, once I really start to understand all of these ingredients and I truly learned how to read food labels in a microbiome centric way, I was like, oh my gosh, I'm buying these foods that they're quote, healthy. You know, they have whole grains, you know, they're gluten free, they're blahdy blah, right? Recognizing, oh wow, you know, even, even, you know, trying my best, I didn't know. And so part of what I teach in the book that I think every single child and teenager, an adult can learn to do and should learn to do is really learning how to read those food labels. Like a quote, gut hero, right? We're being a hero to our microbiome. And so if we can really suss out all of those mischief makers in our packaged foods, once you learn what to look out for, it gets easy. The first part, when you're learning, you know, these ingredients, but honestly, if you can't pronounce an ingredient and if the ingredient list is like, like 50 ingredients long, it's like that has strayed very far, you know, from a real food. Like let's take, you know, Costco muffins, right? I mean, there's so many, it's so many. If you made blueberry muffins at home, what would you need? You'd need flour, some butter, some sugar, some blueberries, some eggs, maybe some cinnamon or whatever else, right? You don't need the mono and diglycerides and the xanthan gum and the carina and the artificial blue dye number four or whatever it is, right? You don't need that. It's just when it's mass produced like that, you know, it becomes ultra processed and it really, what's interesting, you know, if we're thinking about our children, where we have this epidemic that is just growing, growing, growing of childhood and teenage anxiety, the ultra processed foods have also been found to make direct changes in your child's brain. So, you know, that gut brain connection is going to be really Harmed if your child has a steady diet of ultra processed foods, right. I'm not going to say never, but it's just, you know, if it's not balanced.

One of the things that I didn't know about were some of the issues with the food dyes. Can you share a bit about how, you know, what the problem with our food dyes are and how those truly impact a child's health? Especially you look, you think about certain foods like candy is like you mentioned Skittles, but other ones too, where they've got these vibrant, different colors. And you know, kids love that because, you know, it's like much more fun for them to eat those types of foods. And a brown food or a just a green food. What are truly the dangers in food dyes with our children?

This whole marketing ploy with Eat the Rainbow. I mean, I mentioned Skittles because when I was a kid I remember loving Skittles, right? And it was like, wow, I'm eating the rainbow, right? Not the rainbow that you want to eat, right?

No.

But you know, with, with these artificial dyes. I mean, some of them, like now more and more states, I mean, California kind of led the way, but more and more states are banning red dye 40. Not really so much, I would say, with kids in mind, but because it's been found to be a carcinogen and really can wreak havoc on, you know, your immune health and brain health. And so there are different states are banning red dye 40, which is found in a lot of these, these vibrants, like you said, these neon colored, you know, candies and Gatorades and things like that. But then there's also many, many other food dyes. And in fact there are in Europe, any food that has these artificial food dyes, these artificial dyes and certain preservatives actually have to have a warning label on them that that food can cause behavior and attention problems in your kids. Right. This is not just, you know, even kids who already have adhd, but any kid. And I've seen it. I mean, I've had kids where, you know, they're drinking the blue Gatorade after soccer practice and parents are like, I don't, you know, every time we come home, my child is, it like flies into a rage. Right? But they're not connecting the dots between the Gatorade just yet. Right. And so, and you know, kids who would cut out the dyes and I mean, they're different kids are not so uncomfortable in their bodies. They're not wiggling and aggressive and you Know, having all these behavioral and attention concerns, these artificial dyes, you know, one in three kids who have any sort of attention or behavioral concern has been found to improve significantly simply by removing artificial dyes from their diet. And so, you know, with that, you know, I would say if you have a kiddo who you're thinking, oh my gosh, are they headed towards adhd? Or maybe they have ADHD and they're eating a lot of foods with artificial dyes. That's one of the first swaps that I would make. And you know, you want to have a swap, right? Because it doesn't work to just say, well, you're never having the candy. Right? Yes. They're not going to be as vibrant. But talk to your kids, explain to them, right? I mean, our kids, we want to give them way more credit than we often do, myself included, for understanding and owning, you know, their health. And so, you know, with the dyes, I mean, there are, yes, there are Skittles and quote M and M's, you know, more natural brands that use plant based dyes. So yeah, they're not going to be neon, you know, green, but a more muted green. But they still are going to be able to have, you know, the quote treats that, that don't have the artificial dyes. So finding those swaps or you know, one of the things that I, I just, I, I really wish was banned everywhere is Takis. I mean, Takis has so many artificial ingredients, artificial dyes, msg, I mean, you name it. And that is one of the, I mean, almost every ingredient that I look at there you can see in the literature, wow, this, this harms your kid's brain, this harms their gut microbiome. And if parents knew, they would do something about it, right? So it's just, you know, it's not that I want, you know, people to feel guilty about the choices that, that they've been making. Now it's just now time to. Okay, now we understand, right? Instead of the talkies, now what's your swap gonna be? Right? It's because your kids maybe want something like that. So then Trader Joe's has a better version, right? The rolled tortilla chips or Siete Foods has their fuego chips, which now, I mean, my son loves the Siete fuego chips, so he doesn't even ask for Takis.

Yeah, and I think that that's something that, you know, I find interesting because online there is this trend right now toward, for traditional conventional physicians calling out people who are more integrative, alternative minded, Doctors who are like, who are looking at ingredients in different foods and saying, hey, you know what? This has these, these ingredients, they're not good for you. You know, try to do a swap out. And there are doctors out there who will poo poo this and say, look, they don't know. The research says that this is not harmful in the amounts that you are ingesting them. And that's always the argument. And, and my, my argument with that against that is, is okay, if you eat it once and you're exposed to that level of that emulsifier or that preservative, then yes, maybe it won't be harmful to you at that amount. But when you're having a lifetime of this or in your situation, you've got children and their bodies are developing and they're eating these types of foods every single day, day in and day out. There aren't studies that have looked at that over those types of time periods. You know, I mean, you know, we look at that even with surgery, there are certain procedures that some doctors will do cosmetically and like, whoa, you know, I do the procedure, there's no complication now, but they're not looking at it 10, 20 years from now of what these people have to deal with then. And so I think that's a problem that we're seeing and myself I'm seeing on social media where you have doctors who are doing reactions to videos where people are saying, hey, you know, read these labels, try to stay away from these types of ingredients because they can create issues. Like you said, you know, let's say with your children's hyperactivity and how their brains are functioning. And they're calling them out saying that, no, the studies show that that's not true in those levels, but they're not necessarily taking into account the accumulation of that and all the things that we're being exposed throughout, you know, throughout the whole day.

I mean, you know, I love that you point that out because it is, it's so true. I mean, it's even the same thing. It's the same argument that, you know, some will make for environmental toxins. Well, they're in such small amounts that you get exposed to. Well, here's the thing. Some of those environmental toxins or food additives, yes, maybe if you look at your overall body burden of it, your load of it, it's a tiny little amount. But guess what, like, if you take a medicine like Ritalin used for adhd, that overall, it's a tiny little amount in your child's body has an effect. So why would we think a medication would have an effect at tiny little levels? And, you know, a food additive or an environmental toxin wouldn't, as you mentioned, I mean, our children are facing, you know, from the moment they're born or even in utero, right from the moment they're conceived to the other end of life. I mean, they're, they're exposed to so many other factors that are harming their brains, harming their gut microbiomes, and we don't want to live in fear of all of them. But we also have to recognize, sure, maybe, you know, the forever chemical that's in your drinking water is at a tiny little amount, but we don't know the effect of the combined forever chemical and the food emulsifier and the artificial dyes and the lead in your water. All of these low levels they may be, you know, sure, we can add up all the individual problems with it, but some of them are actually synergistic, meaning that it's not just that each of them causes a little bit of harm. And so the harm of two of them is equal is 2x the harm. It could be that those two create like a 10x harm because of the way they interact. There's never going to be studies like that. Right. Because we're all exposed to a gazillion different combinations of things in our food and our water and in our environment. So I would counter with that, just as you're saying. Right. You know, the idea is let's try to minimize where we can. Right.

So I mentioned earlier in this interview that we're talking about five things that you and your child can do every day for lifelong resilience. The number one thing which we have focused a lot on here is nourish. So it's adding in those microbiome champions and keeping those mischief makers out. Obviously, there's so much more in your book on this that's just absolutely, just fascinating that you really, if you're listening to this interview, you've got to pick up her book and read about this because there's so, so much more. But I'd like to go over the other four things that you can do with your child every day. But I'd like to really move through it because I know we're running out of time, but just so that people can get an idea of this kind of big picture of what you can do each day. So number one was nourish. So we're talking about the food. Number two is breathe. And this Specifically has to do with the vagus nerve. So briefly, can you explain what you mean by that and how this can help to improve a child for lifelong resilience?

Yeah, this is one of my favorite topics and it's actually a whole chapter in my book because I think it's so important. So the vagus nerve, which is kind of having its day, you know, in the science right now, but the vagus nerve is the two way information superhighway between your gut microbiome and your brain. Most of that communication occurs from your gut to your brain. It shows you. Well, you know, when we, when we call our gut the second brain, maybe it should actually be called our first brain. Right. And so, you know, this vagus, what we found in the, and I say we, I mean what we've seen in some of the research is that when our vagus nerve is not working appropriately and the vagus nerve is responsible for what's called the parasympathetic arm of our autonomic nervous system. So it's the part that, you know, helps us rest, digest, heal. It's, you know, the part that when we're in a flow state, like we're on and focused, that's our parasympathetic. When we're calm, you know, or you know, walking in nature, hugging our kids, that's a parasympathetic vagus nerve that's being engaged. That balances out our sympathetic part of our nervous system. That's the fight or flight, you know, oh my gosh, I have a deadline. I'm late to work, I'm. There's friend drama. Oh my gosh, there's social media drama. Right? All of that, right. That, that puts us into this kind of, this alarm state which when you think about it, we and our kids, I mean like every day, like multiple times we're up and down and the sympathetic, most of us, and this calm flow in the zone resting state, we're not in that enough. When we can engage our vagus nerve and improve that parasympathetic. What's fascinating is that they found in children that can improve your child's gut microbiome independent of diet. So even if your kids are, you know, not the widest eaters just yet, and you're thinking, how am I going to get in more fiber into their diet? Well, then work on, on these exercises that we can do every day in a very simple way to engage their vagus nerve and their microbiome will improve. So that's one of the, one of the things, because it's not the reason why I called these the five things from Microbiome Magic is, is because there are five things that we're already doing every day, right? We have to eat every day. We have to breathe, we have to move our bodies, we have to sleep. We have to drink, hopefully water, right? But if we do those in a way that we're really, you know, kind of conscientiously thinking, how am I doing these in a way that is not just beneficial for me, but beneficial for my microbes who are taking care of me, it puts things in a different light, I think.

Very well said. And you did cover the other three things that you and your child can do every day. So that'd be hydrated, move and sleep. And in your book you go through that. So. So well, one thing I want to finish off with which is I think really practical and something I know actually my wife, after you know, reading I think some of your blog posts or something, your book has got so much practical information. I mean, it's got like recipes, but it's got practical information about supplements, about alternative therapies, including like acupressure and homeopathy and even essential oils and all this stuff. But one thing that I found really fascinating is something that we all think about really every fall and winter is what are some ways that we can boost our children's immune system? Because our kids go to school and there are kids just snotting up everywhere and you know, these kids don't cover their mouth and they're sneezing and coughing. And I'm sure you've had it in your family too, where like one child comes home sick and like a week later the freaking whole house is ill. Oh yeah. So we want to ping pong. Oh yeah. We want to try to avoid that. So how can we do that? But there's interesting thing. I mean, some things are kind of common sense y stuff, you know, getting fresh air, getting daily exercise, so important for the kids to boost their immune system. Prioritizing sleep is so important. But there's some interesting things that you put in here, which I thought that people don't know about. And one of the things you have is to clear your nose after exposures with a certain type of spray. Can you explain that?

Yeah, well, that is one of my favorite because it may take a little doing for some kids to convince them to, to spray their nose. But here's the thing. When we're exposed to, I mean, let's say we're traveling or let's say, you know, we're at a birthday party inside, and everyone's grabbing the candy bowl and, like, you know, there's the cake and all of that and sticky fingers and. Yeah, or like, you're at the, like the jungle gym and they're touching everything. They're touching their face. Right. You know all that. Right. If there is a respiratory infection, a virus that's trying to take hold, what happens is, you know, get into your nasal passages, get into the back of your throat, and start to multiply. And that occurs usually about, you know, at, like, for a day or two before you get symptoms. Which is why, you know, after a birthday party, it's not like your kids, like, instantly, as soon as they get home, they're sick. It might be the next morning or maybe that afternoon that they're like, oh, my throat's a little, you know, I don't feel so good. And you're like, oh, it's a birthday party. Right. If we can flush out, like, literally, you know, we're. We're irrigating your nose to. To flush out those viruses before they can take hold in your nasal passages, in your respiratory tract, then we can actually prevent a lot of infections from happening in the first place. And one of the nasal sprays that I use is Xclear X, L, E, A, R. It could be any. I mean, that's what I'd like, because it has a natural sugar called xylitol in it, which has been found to boost one of the arms of our immune system that helps us fight infections. It also has antimicrobial benefits. In fact, there are studies looking at xylitol chewing gum to help prevent ear infections in kids and also cavities in kids and adults, for that matter. So. But you could even use a saline. It's just the matter of, like, you just want to flush it out. Right. If you do that after flying, you could do it every day after school if you wanted to, but certainly after big gatherings and parties, it can go a long way in preventing your kids from getting in the first place and then bringing home, as you said, the thing that then travels around every family member for a couple of weeks. Yeah.

I mean, so very practical things. That thing that you can do when your child has been exposed or even if you've been exposed in an adult, something that you can do as well so that you don't get sick yourself. You also mentioned some supplementation, and this is something that we do with our kids as well. I think a lot of People think supplements and they think, oh, you know, kids don't need it. It's just other than the Flintstone daily vitamin. So the ones that you recommend in your book are omega 3 supplements, vitamin D, C, and zinc, and then also taking a daily probiotic. How do you choose a good probiotic for your child?

That is probably the million dollar question. Because when I first started my practice, I used to say, well, everybody needs a probiotic. But now it's more, you know, the real question is, what are you using it for? Right. What is, what is the goal of your probiotic? And so there are different probiotics that I might recommend, like after you've taken antibiotics to restore your microbiome. When it comes specifically for immune health, there are very specific strains or subspecies of probiotics that have been found in children to improve their immune health, reduce the number of infections through the fall, winter, reduce the number of missed days from school, which is so great as a parent. Right. So I look for those two strains and there's, I mean, I can say them. It's a Lactobacillus acidophilus ncfm. And the other one, I believe is a Bifidobacterium lactus bio 7. But there are, in my book, I list those specific substrains so that. Because they're complicated names. Right. So that you can look and see if, in the probiotic that you're choosing. Oh, okay. I want these two strains. This doesn't have it. Let me look for another one that has it. Especially I'm talking specifically about how do we get our kids through the cold and flu season with minimal strife for themselves and the family.

There's just so much great information in your new book. I'm so glad that you were finally able to get this out because I know you've been working on it for, I think, as long as I've known you, which I've known you for, gosh, eight years, nine years, something like that. The book itself, it's called Healthy Kids Happy An Integrative Pediatrician's Guide to Whole Child Resilience. This book is on sale actually tomorrow when this podcast comes out. This comes out on a Monday and the book goes on sale on a Tuesday. So you've got to check it out. It's available wherever books are sold. You can go to healthykidshappykids.com book and I'm assuming, like so many of us kind of physician authors we have, you have special gifts for people who register, let's say, their purchase through that website.

Yeah, we have some great, great pre order bonuses. So, you know, snag them when you can because they are, they are pretty, pretty cool. And then, and you get to see more of me. You get to ask me a lot more questions in a, in a live workshop.

Oh, cool. Her book, like I said, Healthy Kids, Happy Kids, An Integrative Pediatrician's Guide to Whole Child Resilience. At the end of every interview, I always ask my guests for one final piece of advice. And I would love to hear what you have for this, Elisa, because the book has got so much fantastic information. It's not just about the gut microbiome, but it's about really whole child health and how to keep your children healthy, happy and vibrant and become vibrant, healthy, happy adults. So how do you distill all this into one final piece of advice for the audience? What would that be?

One piece of advice? I would say the most important, really. I think the secret to life is to find joy in whatever you do. Honestly, that joy is going to help your brain, your immune functioning, your gut microbiome. I mean, the ripple effect pretty much in every single system in your body because joy is healing. It's not to be, you know, just simplistic about life, but find the joy, right? Have the joy in your life. That is so important.

I love that. So definitely check out her new book. Every parent should get this book and read this book. And if you aren't a parent yet, then maybe buy it for one of your friends because it's got just so much amazing information. And really, what's the most important thing is keeping our kids nice and healthy and happy. Thank you so much for joining me today, Lisa. This was fun.

Oh, thanks, Tony. I always love chatting with you.

And if you've been enjoying this podcast, if you could leave a rating or review on itunes, it definitely helps me spread the word. Otherwise, thank you so much everyone for listening. My name is Dr. Anthony Yoon. I'm known as America's Holistic Plastic Surgeon, and this is the Holistic Plastic Surgery Show. And as always, remember to eat real food, use clean skin care, and autojuvenate before you operate.