Avoid These Gut Health Disruptors for Adults and Children, with Dr. Elisa Song

Hello and welcome to the Feel Freaking Amazing podcast. I have one of my friends and colleagues here today. Ed's not here because we couldn't figure out how to get the camera to work just to acknowledge he was available, but we couldn't get the camera to not show anyone but me. And I'm sure there's someone who can unpack that, but I can't. Anyway, Welcome. I have Dr. Elisa Song here today. She's a friend of mine. She is a Stanford, nyu, UCSF trained integrative pediatrician, pediatric functional medicine expert, mom to two thriving kids. And she's on a mission to revolutionize the future of children's health. She's the best selling author of the Healthy Kids Happy Kids, an Integrative Kid. I'm sorry, an integrated pediatrician's guide to whole child resilience. Dr. Song created healthy Kids Happy Kids as an online holistic pediatric resource to help practitioners and parents grow bridge the gap between conventional and integrative pediatrics with an evidence based pediatrician backed, mom approved approach. So, Elisa, welcome. I'm so happy to have you here.

Oh, I'm so excited to be here. I'm sorry to not see Ed, but I love seeing you.

Ditto. I'm sorry he's not here, but we'll figure it out. I guess we gotta reinstall and reinstall the app, so. Okay. So how'd you get into this? I didn't even ask you that.

Into pediatrics and functional medicine or all of it?

All of it. Like, you know, you have a particular focus on gut health and integrative pediatrics and functional. So what was the moment where you were like, okay, the traditional path is not mine. I'm going here.

Yeah. I mean, really from the beginning. Because when I, you know, when I was at Stanford as an undergrad, I had no intention of being a doctor. Like, that was the furthest thing from my mind because my mom was an OB GYN growing up, you know, solo practitioner. She delivered all her own babies like you did back then, which is amazing. But I saw the life that she had. I'm like, I. That's not really for me. And I didn't know any other way. So I thought, I'm not going to do medicine. Medicine. But I love kids and I want to work with kids. So I didn't know what that meant. I thought maybe teacher. And then I landed on, okay, I'm going to be a lawyer. I'm going to be, you know, civil rights lawyer. I'm going to be on Capitol Hill. Advocating for children. And I took the LSATs. And I mean, there you go. I was all set, right? But then, you know, life happens. And I was walking through. Through Stanford campus, and I saw on a flyer, this is back in the late 80s. So I saw a flyer for the American Holistic Medical Association. It was one of the first annual conferences. And I'd never heard that term, like, what is holistic medicine? And I also, at that point, had already started kind of a Mind Body journey reading, like Shakti Gawain and, you know, all these. All these other books on creative visualization and manifestation. So I thought, well, let me check it out. And so I went, and I was. Lord, I'm like, this is amazing. And I heard, you know, people who are just getting known, like Andrew Weil and Deepak Chopra, Joan Borisenko. And I thought, okay, that's. I could do this. I could do this as a. As a doctor. And so I called my mom up, and I was like, guess what? I want to be a naturopathic doctor in the 80s. In the 80s, I want to go to Bastyr. And she's like, what's that? I mean, that was kind of the common refrain. What's that? And nobody said, don't do it. But I also didn't get, yeah, you should do it, right? It was more like, sure, you know, that sounds great, but maybe you want to go to medical school first, right? And so that's how that happened. I mean, I landed there, and I actually wanted to do integrative. I mean, it was called alternative medicine back then, right. And so even through med school, I started an alternative medicine group in medical school. And in residency, I actually was able to create an. Actually, by that point, we were calling it a holistic. So I created a holistic pediatric rotation for myself. So it's been there this whole time, but I didn't know functional medicine. It was just more like, oh, I love all of these other. This really holistic way of caring for kids. And so, same thing. After residency, I'm like, this is not for me. I don't want to be a hospitalist. I don't want to be a neonatologist. I don't want to be in the ER or urgent care. Primary care is like, you know, a patient every 10, 15 minutes. I don't. I can't do that. And so. So then I went back. I went back to get my master's in public policy, and I'm like, you know what? I'm going to. I will now do advocacy. This is this is my path, but I'll do it in children's healthcare. And same thing. I was at UC Berkeley campus, saw a flyer, you know, for the center for Mind Body Medicine, Food as Medicine conference hosted by James Gordon. And I went, and I'm like, what is this concept? Food is medicine, right? What you eat matters. And I heard a very young Mark Hyman, and I was just like, this is what I'm gonna do. And so I started off my practice as a functional medicine pediatrician.

Got it. So you've seen a lot, right? You've really watched trends come and trends go. So what would you say is the state of children's health today?

Well, we know it's not good. And, you know, it's. It's not to paint a picture of doom and gloom. And that's. And that's never me, right? I never want to, you know, just. Just share scary statistics and say, okay, there you have it. You know, we're. We live in a toxic world. There's nothing you can do. I mean, you and I wouldn't be doing this work, right, if. If there was no hope. But. But, you know, the latest statistics from the CDC are that, you know, nearly one in has some sort of a chronic health condition. I imagine it's probably more than that simply because how many kids have health concerns that are chronic and persistent but don't have a, quote, diagnosis, so they're not captured by insurance with the ICD10 codes? Right? And, you know, I just think back to when I was a resident back in the kind of early 90s, right? And this was at UCSF, where we saw a wide range of patients. But when I was at ucsf, I remember I was in my developmental pediatrics rotation, and, you know, we saw. We saw a child with autism. And I was told by the developmental pediatrician attending that, you know, as we were ready to graduate from residency is like, look, if you see a handful of autistic kids in your lifetime, that's going to be a lot. I mean, this was like mid-90s, right? Late-90s. I mean, fast forward. I opened up my practice, and I was like, oh, my gosh, there's so many families in need. And when I was in training for kids with eczema, we were told, never, ever put anything stronger than hydrocortisone 1% on the face. And you never put steroids in the diaper area. And now, I mean, they're getting lathered with stronger and stronger, you know, steroid topicals and being put on, you know, Anti, kind of immunosuppressants, regularly, antimicrobials, I mean, you name it. And so, and I also tell my families in my practice who really can hardly believe it, there was no such thing as sensory processing disorder back then, meaning, like we just never saw it and wasn't diagnosed. And there was no such thing as type 2 diabetes. It was called adult onset diabetes because kids didn't get it. So this, that's not, I mean, it's, it's a while ago, but not that long ago and things have changed dramatically.

So why do you think that is? I mean, I, I know, you know that I'm all about toxins and environmental, environmental screws. So why do you think this is happening?

Well, I think, I think environmental toxicants play a huge role. I think, you know, when we look at how much our health has changed and our genes haven't changed alongside, we know that there are things that there are in lifestyle, environmental factors that are really pulling that trigger, that are really tipping us over into poor health and our kids into poor health. For me, it really comes down to for most kids, how their microbiomes start off in life and what tips their microbiomes over into a less than optimal pattern that then can set the stage for a higher risk later on of metabolic disorders, hormone disorders, neurologic, neuropsychiatric disorders, immune dysfunction and autoimmunity. So looking at that, and what's fascinating is as you look at how children's microbiomes have changed in the last century or so, adult microbiomes are following. I mean, they follow a very similar pattern. And here's the thing with environmental toxicants. We know that many of them are classified as endocrine disruptors, but almost all of them have also been found to be really profound microbiome disruptors. So there's not, you have to think what else is disrupting their microbiomes. It's so many of the factors that are present in our modern world, but that we also have control over. Which is the great news?

Well, I think you, you just said something that totally triggered my thought process because we talk a lot about glyphosate in our practice and glyphosate is the most common herbicide in the world and its use doubles about every seven years, but it's everywhere. And it's implicated in a number of issues, but predominantly outside of the cancer and the liver issues, it doesn't directly harm you, but it harms the bacteria in your gut that are protective. And so if you have a Developing gut and it's harming those good bacteria. It makes sense that you now have a whole generation of children exposed to glyphosate who are their gut microbiomes. It's more just in my brain that it's killed the good guys and the bad guys don't have the pathway that respond to what glyphosate disrupts. And so the bad guys grow and the good guys are dying.

Yeah, I mean, 100%. I mean, you know, some of the listeners may know that glyphosate was patented by Monsanto as an antimicrobial. So it's not just even an antibiotic, a broad antimicrobial. So that has so many implications for, you know, disrupting our microbiome. And our microbiome is not just bacteria. We have yeast that, that should be there at a certain level. You know, we have certain other, you know, we're finding maybe some parasites are commensal. But when you broadly wipe out your gut microbiota and glyphosate, it has a sneaky way. There was one say that was. I'm like, oh, my gosh, it's so insidious because it can, it can preferentially kill your beneficial bacteria, your flora, and preserve the not such good flora like Clostridia. And so we get this, this process. We often think of gut dysbiosis or an imbalance in your gut microbes as, oh my gosh, there's a lot of bad stuff. Well, I would say for, for infants and for probably most adults too, it's really the loss of the beneficial flora that has the most significant impact. Because when we can get that beneficial flora in, that can crowd out anything that doesn't wanna stay. And the pathways that you're talking about, I mean, the glyphosate will knock out some of the pathways that are really responsible for our microbiota, creating neurotransmitters for us, like our serotonin and our dopamine and acetylcholine. So when glyphosate knocks out that pathway and it kills the bacteria, kills the remaining bacteria's capacity to make our neurotransmitters. I mean, it's no wonder we have a crisis of mental health and neurodevelopmental concerns.

Yeah, so, so glyphosate's one. What are some other things that are disrupting our kids microbiomes? If. Do you have like a pick list? Okay, here's the top five things.

Yeah, so there's glyphosate There. And in the book, I call them microbiome mischief makers. Okay, so glyphosate is absolutely the one of the top three that I mentioned. The other two. So these FDA approved food additives, these are things that we have to understand how to keep out of our diets even at a very young age. And I. And you know, if we can keep these out, preconception. And when you're pregnant, any of these, I mean, for instance, when we know, we know for babies, I mean, there is some controversy over whether or not moms pass their microbes, their gut microbes, through the placenta, but certainly they pass them through vaginal delivery. And so a healthy infant microbiome from the beginning relies upon a healthy mama gut microbiome and a healthy mama vaginal microbiome. So if moms are exposed to environmental toxicants and glyphosate and ultra processed food additives that are really disrupting her microbiome, we're not helping to support our babies to have the healthiest microbiome to start with. But with these food additives, there's a class of food additives that I really pay particular attention to in terms of the microbiome and the resulting immune disruption that can occur and neurodevelopmental concerns. They're a category called emulsifiers. So emulsifiers. In some countries, the rapid rise of emulsifiers in food products has been also correlated with a really rapid rise in autoimmunity. And so, you know, we wanna be aware that these emuls can disrupt the gut microbiome, can trigger leaky gut from happening as to happen as well. But you're not gonna see emulsifiers on the label. Right.

I was just gonna ask you, like, what am I looking for in the label?

Yeah, you're not gonna see emulsifiers. And this is where one of the most important things that I think can move the needle for kids and teens health, to really propel them to be, you know, the, the most well and empowered young adults as possible, is to teach them how to read food labels like a gut hero. That's like the number one thing because it is not realistic for most kids, teenagers, young adults, to never ever buy any packaged foods. Right. But if we can be savvy. And the emulsifiers, they are the chemical ingredients that are designed to keep your food together, prevent it from becoming a goopy mess. So you'll find them in protein bars, even the ones seem, quote, healthy. You'll find them in ice creams, you'll find them in in, you know, sauces, right. Very commonly, like salad dressings or, let's say, barbecue sauces. So what you want to look for? Carrageenan, xanthan gum, carboxymethylcellulose or cmc. Mono and diglycerides are also very common. Now, I don't expect people to have this list memorized in, but once you start reading food labels and you just have that visual memory of, oh, if it says mono something, I'm gonna put it back, right? That's just. That's an emulsifier that I don't want. So. And I've tasked my kids. I mean, this is something we want to teach our kids. So when my kids, when we go grocery shopping and they're like, hey, mom, can we, you know, have some ice cream? Right? I'm like, all right. So I tasked them with. You go to the aisle, find an organic ice cream that doesn't have emulsifiers in it. Find a label that. That I would be happy with and that you would be happy with. You know, for me, from a perspective of, you know, that it. That it's not going to destroy their gut microbiome for them from the perspective that, oh, it's going to taste good, right? And so it's. It's. I mean, so many of them have mono and diglycerides.

So I don't really like ice cream, which must make me not American. But I don't really. I've never liked it when I was a kid. It's so funny. Like, 15 years ago, one of my kids came home. It was made maybe a little bit less. She came home with this bright blue bottle of water. And she goes, we got this in school, Mama. And like, great, great. She goes, can I drink it? I'm like, I don't know what's in it. And she goes, I don't know. I said, well, turn it over. Let's look at. Let's read the label. And she starts rattling off these things. She goes, why don't you read it? I can't read these words. And I said, well, that's kind of your first indicator. If it's got stuff you can't pronounce and you can't read that, it's probably not food. Like, don't eat that. So she reads it off. And I've always had a particular issue with artificial colors and artificial flavors. So immediately when it starts to say saccharin, aspartame, I'm like, no, we're not doing any of that. But it also has Artificial colors. And then it literally has stuff I can't pronounce. So I said to her, I don't know. Do you want to put that in your body? And she goes, I don't think so. I was like, no, it's not food. Don't put that in your body. Like, that's not food. If you want, we can look for some organic food coloring that doesn't have dye in it, that's powered by beets. And we can make your food blue if you really want it to be blue or algae, but we're not going to drink that, so I totally get it. I always make my kids, like, you do the work, you tell me what's in it.

Yeah, well. And we want them to do that work because then it empowers them for when they're out with their friends and all their friends are buying a bag of Takis with monosodium glutamate and red dye 40 and all that to find a bag of chips that they can all hang out, eat their bag of chips. They're not left out, but they're buying chips that they know aren't gonna harm their brain or their gut or their immune system. And, you know, the truth is, sometimes our kids will choose that other thing, right? And so if they do, and, you know, I cringe a little bit, but then it's really important to make sure that they then check in with their body and their brain and just notice. How do you feel after that? Right? And I mean, I've had kids in my practice choose not to have the Gatorade after practice because they've noticed that after they have that, they come home and they're just. They're angry and agitated and irritable and then. And can't, you know, have fruitful play dates with their friends. And so they're like, it's not worth it to me, right? So we want kids to make that informed decision.

All right, so we have glyphosate. We have emulsifiers. What else is on that list of things that disrupt the microbiome?

Added sugars. You know, added sugars are.

Sugar's the devil, man.

Sugar really is. You know, you can link virtually every chronic disease in kids and adults with sugar dysregulation, insulin dysregulation. And, you know, and I have. I have. I mean, when I check. And so as a. As a functional medicine pediatrician, I check more blood work than most other pediatricians, right? And when I have the opportunity, I love to check fasting blood work and I love to check fasting insulin and fasting glucose in children. I also do check a hemoglobin A1C, but that is rarely, rarely, rarely in kids. You know, at a, at a range that I'm worried about. The reason being is, you know, I'm guessing for most kids they're on a sugar roller coasters. So they have a lot of highs, a lot of lows, and so the average looks perfect. Right? So I, so I explained that to kids. I'm like, look, the average doesn't mean that you're always in a good state. It could mean that you're having a lot of highs, a lot of lows, but your average looks great. But when we look at a fasting glucose matched with the fasting insulin, and I see slim, active, athletic, physically appearing fit teenagers and middle schoolers with an insulin of 17, 18, 22, which is more and more the norm. So just for listeners, right, the average. So the normal insulin range will vary a bit by age, but you know, for quest, it's usually, you know, under 18 they'll say is normal, but normal we know in functional medicine is not optimal. Right. So I want kids and anyone for that matter to be under five if they can. Well, when you see an insulin of higher and sometimes outright high, I tell kids, look, you are heading into a pre diabetic state and your body is not responding to blood sugar. Your body's insulin production is not matching. This is the road, the path to chronic inflammation. Right. And all the things that we don't want you to have when you're in your 20s, 30s, 40s or later. And so what is one of the most causative factors? It's the added sugars. And sometimes, you know, even so we'll start with the family who, and the teenager who is really trying to eat, you know, their, their healthiest and watching the sugars, but they don't realize how much the added sugars add in. And that's where reading the labels really, really matter. Because if they don't, they could be like me before I started reading every label and buying the, you know, the Greek yogurt, yay protein and probiotics. That's vanilla flavored.

Thinking, 21 grams of sugar.

Yeah. Thinking it's so healthy and it's 21 grams of added sugar. Or your teenagers who are thinking, oh, I'll have an acai bowl for breakfast. And it's like, wow, that you, you don't realize what a sugar bomb it is until you read the label. Or even something like you know, there's one of, you know, Dave's killer breads, you know, multigrain, 21 seeds. You're like, w, this is so good. High fiber. And yet you turn it over and One slice has 4 grams of added sugar, which is 1 teaspoon. Right? So literally, you're sending your kids off with two teaspoons of sugar in, you know, in their sandwich, not to mention the added sugar in, you know, the jam that, that, that you're spreading on. So we just have to read, read, read. And I give an example in the book, because kids should have no more than about 25 grams of added sugar in a day. And that's no more. You can certainly have less. There's no lower limit. But 25 grams, I mean, that doesn't, that's not really. It doesn't hit home for kids. So if you. I tell them 25 grams, that's about six teaspoons of white sugar. So then you can visualize six teaspoons of white sugar. And so then when they look at a label and they see, oh, okay, this, this particular, you know, drink that I would like has 35 grams of added sugar. Okay, let's calculate 35 divided by about four. That's about. Whoa, that's almost nine teaspoons of sugar right there. Right. So it just helps them think and understand how insidious it is. And so I have kids and parents just take a sugar inventory. A normal day. No judgment, but just know where you're starting from. Because when you know where you're starting from, then you know, wow, I didn't realize my sandwich bread had this much added sugar. I'm going to look for another one that has less added sugar in it.

I mean, think about a can of Coke has 39 grams of sugar in it. Yeah, 39. And the RDA is 40 grams. But that's for an adult. So I used to say to my kids, take your weight, let's turn it into kilograms. And you shouldn't be eating or drinking more than your kilograms in grams. Not to say that you multiply it out, but if you weigh 30 kilograms, then you really shouldn't be drinking more than 30 grams of sugar or eating 30 grams of sugar in any given day. And yeah, the goal would be less. So I used to do it by their weight in kilograms just because I'd be like, this is too much sugar for you. You're too little.

For sure, for sure. And then so for. Let's take these teenagers and these middle schoolers, the most common Culprit is really, it's those sugary drinks, but not even a Coke. It's like the Boba tea that they're going out with for their friends or the Starbucks frappuccinos that they're getting and thinking, oh, well, I just, you know, I had a hard workout, and I'm just gonna hang out with my friends and, you know, go get, you know, a mocha Frappuccino, whatever, with, you know, two pumps of caramel that has 54 grams of added sugar. So it's just to be mindful and knowledgeable about that, because the average teenager today has about 34 teaspoons of sugar in a day.

So what is that? 200. 200 grams of sugar?

34 times 4.2 is like 156, I think, if I do the math right.

Okay.

I mean, crazy. So. But that's, you know, and this is. Even people who are not. I mean, it's just it. They're not realizing. And I think if you realize and you have your eyes open, then you can at least make that informed decision. That's what we want. So a teenager might say, I still am going to have this Frappuccino with, you know, 40 grams of added sugar. All right, well, then how about we build a health bubble around that? Let's cushion it so that, you know, you after, when you come home, we have a really balanced dinner. We balance it out with really great fiber and, you know, getting a lot of color and phytonutrients. Not artificial, but phytonutrients in our diet so that we can cushion the impact of whatever you just had.

Have you ever done a continuous glucose monitor on yourself?

Um, I have not. I actually have four that I'm setting up for a whole family. I'm going to have to convince Kenzie and Bode, but it's. I think it's one of the most insightful things you can do. And, you know, just to really get that personalized view.

I happened to do it last year, and I remember that vividly because it was my birthday and I didn't feel well, and I had the CGM on and I ate the weirdest dinner. I ate Manchego cheese Crispy pucks, and I slathered them with chopped liver. I didn't eat anything else at dinner.

I know, it's sounds kind of good to me.

Oh, I think it's delicious. But it's like a weird meal when you see people, let's have chopped liver on crispy cheese. People say, what? So I Eat this for dinner. And then I felt a little bit better and I had a piece of cake and my blood sugar after eating all of this, you know, the cheese and the chopped liver is 100% protein. And then I had a piece of cake and my blood sugar didn't go anywhere. And the take home message is really like protein first, protein first, protein first. Because it levels out the impact of if you're going to eat sugar, you want to have that buffer beforehand. So I always say to my kids, like eat your protein first, don't eat your rice first, don't eat, don't. No, eat your protein first because that's going to level out your blood sugar and allow your body to have more resilience around whatever you're exposing it to. Instead of spike your blood sugar, play catch up, spike your blood sugar some more. It's just a lot, it's so much more workable that way.

Yeah, absolutely. Yeah. That is, you know, when we think about pairing foods too, I mean it is really important for, you know, the teenagers going out or your middle schoolers going out and making these choices is to know first of all, pay attention to how you feel. You know, about an hour after, you know, you have that thing, you know, watch for that crash. But then also notice if you compare it, you know, with some protein and healthy fats first, then notice how you feel. But yeah, the CGM is, I think that that really would be one of the best steps for, especially for curious middle schoolers and teenagers to really know like what is the impact on me? Like if, how if I, you know, if you're an athlet athlete and you want to be the top of, you know, in your, whatever you're, you're want to be the fastest soccer runner, more accurate goal or you know, fast, faster on the mile, whatever your goal is. If they realize how much sugar is impacting and their microbiome is impacting their, their athletic performance and can see this immediate feedback, you know, what they're eating. I, that's just such a, an amazing way for them to then make those decisions and understand what's going to optimize their chances of reaching their goals. Right.

So, okay, so we have sugar glyphosate emulsifiers. Is there anything else in that nasty sort of do not fly category?

Not so much in the food. Well, yes, I mean the artificial dyes, you know, anything that's artificial we just want to, we want to keep out. But I think one of the most insidious microbiome disruptors that people don't really think about is psychological stress. And so, you know, that is an area that I think, you know, kids, parents, kids, teenagers, so important to understand how to optimally manage stress and restore nervous system regulation in order to also optimize their microbiomes and their brains. And so, you know, we just. I think we just have this crisis of loss of resilience in our kids and our teens, but we're seeing that with adults, too.

And let's take a step back, Elisa, just for the listeners. So when you talk about psychological stress, what I'm hearing is when you're stressed, you're shutting down digestion. You are no longer restoring or resting. You are losing resilience. And when you shut down digestion, your food sits in your gut and rots. And then the bacteria that are designed to digest you when you die, the anaerobic bacteria, they come out to play because the food is rotting. And then you have an increase in gut gas and bloating and dysbiosis and discomfort. But the other thing you want to look at is when you're stressed, your adrenals say to your liver, hey, don't detox because we're stressed. And then the adrenals and the liver say to the gut, stop. Stop the presses. This is not a priority right now. So it's important to understand that it's actually on a biochemical level. You will alter your gut microbiome from having sustained unremitting stress, whether it's physical, emotional, chemical, social, whatever it is.

Absolutely.

It'll shut it down.

Yeah. And the really fascinating thing is that psychological stress. We know that psychological stress can create just as much inflammation in our body, maybe even more than any physiologic stress, any infection. But psychological stress can also trigger the release of zonulin, which. Zonulin is a marker for leaky gut. It's released by our small intestinal cells when the junctions become leaky between them. So it's gonna have a direct impact also on the function of your entire microbiome system. And so when we think about that, and one thing that you said that I think is really, really key, that when we have sustained unremitting stress. So the reason why that's key is because we, I think, as a society, and certainly for our kids and teens, have lost a lot of our stress tolerance. Being stressed for an exam, that's entirely appropriate, right? Being stressed, you know, because you had an argument, you know, with. With your friend, that's an appropriate response. So many of our Teenagers and our kids now don't want any stress. Many parents don't want their kids to have any stress. You know, all stress is bad. And we have to recognize that there's two sides to the coin. Stress is not bad in and of itself. Stress is an adaptive response, and it's simply your body's response to getting ready for something. And so we need that stress, and then we need to recover from that stress to develop that memory of how to do it even better the next time. It's the same thing with inflammation. Inflammation in and of itself is not bad. It's if it's sustained, chronic, persistent. And so we just. We need to have the tools to learn how to manage stress in an appropriate way.

I want to go back to the zonulins too, because you're 100% right. We've said two magic words in this conversation that always set me off. One is glyphosate and the other zonulin. So zonulins are particular. Zonulins are the substance that will dissolve the tight junctions in your gut. And they're particularly nasty because if you eat gluten, you increase the zonulins that get put out because there's a receptor called CXCR3 in your gut lining. And if you eat gluten, you have this. Anyone in the world has it. But if you have one or both of the gluten genes for celiac, you have more of these receptors, you make more zonulins, you have more leaky gut that's sustained for periods of up to four hours when you eat gluten. And the reason this matters for our kids is that 40% of the population has one or both of these genes. So anytime, if anyone eats gluten, you create a state of leaky gut. But if you eat gluten and you have this gene, it doesn't last for 15 minutes, it lasts for four hours. And then layer on the standard American diet, which is bagel or cereal for breakfast and a wrap for lunch or sandwich, and then pasta with chicken for dinner. And you've created a scenario where now not only is the gut open for 12 hours, but the decrease in the gut microbiome that's occurred from the emulsifiers and the glyphosate now creates a scenario. Oh, and by the way, your stomach acid's probably low because you're stressed. So now we're not killing the bacteria. They're getting through the lining of the gut, they're getting into the body and the food. Particles and the toxicants. And now our body is on fire.

Yeah. Yeah.

Here we are.

Yep. And I really, I want to highlight something you said. I love how we're like, you know.

Two peas in a pod.

Yeah. Just back and forth so that gluten can trigger this reaction in anybody. Even if you don't have celiac disease, even if you don't carry celiac markers, it can happen to anybody, which is why having gluten on a daily basis can eventually wreak havoc with your child's gut, their gut immune system connection, their gut brain connection. So it's really important to recognize and also why, when we're thinking about restoring your disruptive gut, microbiome healing, leaky gut, removal of gluten is so important. Also, dairy can. Casein can have very similar reactions as well. And so it is, you know, because a lot of parents ask me, and some of the kids, of course, you know, you let them know, okay, let's, we're gonna heal up. Let's kind of remove anything that's offending and we talk about gluten. And some kids. Right. Mindset. Right. Some kids are like, okay, that's fine, I'll do it. And you know, because I want, I want to feel better, I want my gut to heal. And, and you know, other kids, I'll do anything but that. Right. So, you know, that takes a little bit more work. Right. And more coaching. But. But it is really important for people to understand.

So I know you're all about the microbiome, Elisa, so talk to me about, in the course of life, infections happen. And as a parent, it's always this, like, fine line between, am I going to give my kid antibiotics anytime they're sick? Or how do we determine that? So when kids get sick, can we talk about what are the things that as parents, we should be asking the pediatrician looking for, contemplating, like, how do we evaluate this as a parent?

Yeah, it's so important on a number of different levels. So just from a global public health standpoint, we know that antibiotics, many, many antibiotics are inappropriately prescribed either for viral infections that aren't necessary or just a broader spectrum. Meaning they kill more bugs than they need to. Right. So we are now at a place where antibiotic resistance could become a leading cause of death worldwide by 2050. I mean, that's right around the corner.

That's our life.

That is our life. And that's our kids lives. That's our grandchildren's lives. Right. And we're also in a place where we know from Many studies that up to 70% of antibiotics prescribed for children are inappropriately prescribed. So this is really important for parents to understand now. Parents, grandparents, anyone listening to this podcast. I know you're not the parent who goes to the ER with the. The sole goal of walking out with an antibiotic prescription right there. I mean, there are parents like that. I used to work in urgent care in the er. And yeah, that is. You can tell that is something that some parents would like. Most parents, like you guys listening, want to use antibiotics if they're absolutely necessary, but also want to be judicious about using them and know that they really are necessary. So. So there are a couple of things in the book. I give six questions to ask the prescribing doctor before you start antibiotics. The number one question, the most important question, and this is even for you as an adult, when you're prescribing an antibiotic, the number one question to ask is, hey, doc, is this really necessary? Cause you might think, well, of course they're only gonna prescribe it if it's necessary. But here's the thing. Some studies have found that doctors can be twice as likely to prescribe an antibiot, even if they don't think it's necessary, if they think that the patient wants it. Right? And so simply by asking that question, you're opening the door to letting this doctor know, you know what? I'm not one of the parents that came in here just for the prescription. I just really want to know, is it necessary? And if it's necessary, I'll do it, but I want to know, you know, for sure. And so. And then, you know, ideally, which is unfortunately not going to often be the case, but ideally, they would also be able to tell you if it's not immediately necessary. Are there some other options from maybe an integrative or a natural standpoint? What would happen if I waited on this antibiotic to start? Are there any tests to confirm that it is bacterial and that it needs to be, you know, an antibiotic is needed. Right, that last question. Any tests especially important when it comes to strep, because I. Strep throat, because I have had kids go to the air over the weekend, really sore throat, pus on the tonsils, looks terrible. And the doctor says, I can tell just by looking at strep. So here's the antibiotic prescription. I can guarantee that there's not a single practitioner out there who can diagnose strep strep simply by looking or saying that it smells like strep. I've heard that too. Right. You need to have a culture at the, at the, I would say a rapid strep and a culture because I've. The worst sore throats I've seen are actually viral. I mean, Epstein Barr mono can, can cause if the same or even worse.

And Covid laryngitis.

And Covid is nasty.

Sore throats.

Yeah.

Okay. Okay, so. Okay, so let's fast forward. It's necessary. There's no other treatment. It's gonna get worse if we don't treat. We give their kid or ourselves the antibiotic. How do we restore the disrupted. Because antibiotic is not selective. So we're now essentially scorching the earth and killing all that hard work and getting rid of the good bacteria. So how do we rebuild that disrupted microbiome?

Yeah, so that's really important because antibiotics really are the single biggest, most significant acute disruptor of the gut microbiome. We can consider psychological stress as the most important chronic disruptor. But when we think about antibiotics, like you said, they immediately, I mean, they don't care what they kill, they don't kill selectively. Although what's also insidious, similar to glyphosate. Some of these antibiotics will preserve the pathogenic flora, which is why we see C. Diff infections after antibiotics. Right. Sometimes Clostridia klebsiella, they're protected and those are the kind of bacteria that we don't want to stick around. So ideally, in the ideal world, what would happen is when you're taking the antibiotic, your child's taking the antibiotic, we would use and give a clinically backed probiotic that is known to restore your gut microbiome after disruption by antibiotics. Right. And there are, you know, in the book, I list specific strains, but you know, there are some broad spectrum probiotics that do have these, these strains in them. I also add a beneficial yeast probiotic called Saccharomyces boulardii, because that in children has been found to reduce the, the incidence of antibiotic induced diarrhea. But it's not enough to just sprinkle back in the probiotics because they need a place to call home, they need a place to stay, they need to want to stay. And so we need to create that environment and make sure we're nurturing your child's microbiome with the food that these beneficial flora need to grow and thrive. And that might mean during the antibiotic course, you're giving them a prebiotic supplement. But we also wanna make sure. That there's a good foundation there. And that's all about really getting in your fiber, your phytonutrients, your fermented foods. In fact, one study out of Stanford found that fermented foods was better at improving microbiome diversity than fiber. It didn't mean fiber wasn't important, but in terms of that one particular marker. And then antibiotics can also some of them trigger leaky gut. So we're giving gut supporting nutrients like your omega 3s, zinc is, can be really important. Quercetin, glutamine. So whatever regimen you have, I have a gut reset plan that I work through patients with. But then you also. We need to remember for parents, it's not just one in death. Right. When we think about giving the probiotics. Sure. I mean, you can give them while you're taking the antibiotic course away from the antibiotics. I would continue on for maybe a month or two. But your gut wants to return to the state it was in before antibiotics were given. It likes to bounce back. And so we wanna make sure that even as we're moving forward or back or starting before antibiotics, that we lay the foundations for an optimal microbiome for your kids and teaching them how to do that for themselves. And that's why I have in the book the five things that create microbiome magic that you can do every single day. You know, five things every day. I'm not adding on another thing, but five things that we can think about that are going to enable and establish an optimal microbiome to begin with so that whatever disruption occurs, it can bounce back to that state. Because things like environmental toxicants, I mean, we're never going to get rid of them completely. Doesn't matter how clean you're living. I mean, we are going to have forever chemicals in us. I mean, microplastics are going to be in us. We can't completely avoid them. So the key is laying down those foundations every single day.

And I want to remind, I think this is a good point to remind the listeners that don't forget your gut runs your body. So if your gut is dysfunctional, that essentially serves as the domino effect for all of these chronic autoimmune cancer, degenerative diseases, all the things that make us suffer. So this is really important. And what I'm hearing, you focus on kids, but it sounds like people can do this for themselves. Healthy kids, happy kids. Get the book, read it, but apply it to yourself too. Right. Like, don't just map it for your children, map it for yourself. Because why do it just for them and not you?

I mean, it should be for the whole family. And I've had, you know, grandparents read the book. I've had parents read the book and say, oh my gosh, I did my own own sugar inventory. Now I know how to, you know, where I can swap things to really move the needle on that front or, you know, wow, I didn't realize these were some of the things to look out for on a food label. Or I didn't realize how important, you know, vagus nerve work was for optimizing the gut microbiome. It is especially important for children, but. Well, I don't want to say especially it's important for all of us, you know, all of these things, right? Because just as, you know, for infants in particular, if we have this opportunity to lay that foundation before babies are born and in that first really key zero to three months of life, that's ideal. I would love that. Because some of the research now shows that any disruption to your baby's microbiome in the 0 to 6 months of age. So for instance, babies who received antibiotics or antacid medications in the first six months of age are, are, have an increased risk of virtually every single allergic disease like hay fever, eczema, asthma, even anaphylactic food allergies by the time they're four. And another really large study looked at mother infant pairs and looked at antibiotic exposure in the first two years of life. They even included antibiotics that were given in utero to mom for, let's say, a sinus infection or uti, and found that those, those infants who were exposed to antibiotics in the early days of life were significantly increased risk for developing mental health concerns by the time they were older or teenagers. So things like adhd, anxiety, depression, sleep disorders, and the more rounds of antibiotics, the higher the risk. And again, the risk was highest for the 0 to 6 month of age. So if your kids are older right now and they've had antibiotics from their babies, I know it can be stressful to think about, but this is why we just have this information, right? We sit with it. I let people know. My own two kids had antibiotics, both of them, when they were under five weeks of age, we can only move forward. And now you have the knowledge because no matter how old you are or how disrupted your gut microbiome is, we can still restore your microbiome. It's just that it might take a little longer, right? But the first step is in the knowing, right?

And more than that, you Want to also be pragmatic. Right. So when I was six months old, I had pneumonia, and so they gave me antibiotics for that. Yeah, but what's the op. What are the options? Right. You know, the alternatives are really worse. So always. And I actually ended up taking antibiotics for a really nasty infection about four months ago. And I'm still rebuilding my gut, like, focused on rebuilding my gut, and I'm like, just sort of taking on these things that you're seeing and going, okay, I can rebuild. It's slow and steady, and hopefully I won't have antibiotics for a while. So, again, so I think. I mean, this has been amazing information. I think the question people are left with other than where do they buy the book?

Right.

I have the book. I'm going to. I don't lend it out, though, because then I never get it back. So where can people buy the book and where can people find you?

You? Yeah, so my book is. Is available pretty much anywhere books are sold. So of course, Amazon, something like 80, I think 75, 80% of all books are bought on Amazon. And if you would like to support someone other than Amazon, you can find at Barnes and Noble, your local indie bookstores. In fact, there's the indie bookstore.com where you should be able to find if there's someone close to you. But, you know, Walmart, Target, Barnes and Noble, of course. And then to stay in touch, keep learning from me, you can sign up on my newsletter, that's healthykidshappykids.com if you check out the website. I have articles and lots of information there. And I'm most active on Instagram, which is where I share more frequent updates. So that's HealthyKidsHappyKids.

Awesome. We'll put it all in the show notes so people can reach you. So for the listeners, thank you for joining us for another episode of the Feel Freaking Amazing Podcast. And. And I hope you enjoyed this episode. Dr. Alisa Song, thank you for being here. This was awesome, and it's such a pleasure to have you on the podcast.

Well, thanks for having me. And I get to see you in not too long, so.

Exactly. All right, y' all have a good day. Stay well.