Anxiety, Autism, Allergies: The Hidden Triggers No One Talks About - Transcript
Dr. Mark Hyman
All these kids have massive amounts of neuroinflammation. Their brains are on fire. When your brain is on fire, it's hard for it to function. Before we jump into today's episode, I want to share a few ways you can go deeper on your health journey.
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Dr. Elisa Song
As a pediatrician, I always try to approach things with some fun, you know, some joy, some hope. Because as you said, it can be like, oh my gosh, the world is against me. How can anyone be healthy in this world? And we can. So just, you know, empowering kids and parents to know there are simple steps that we can take to be healthy and that for our children, when we do that as a family, even if they push back as teenagers, right?
I mean, the inevitable pushback. My kids are preteens, teenagers, and there's gonna be pushback. That's part of life. But if you lay those foundations, they're gonna go back to it. Mean, the teenagers who knew how to cook, they were much more likely to choose vegetables when they were off to college.
It's True. Pays it forward. And so, you know, the gut reset is really akin to the five R's of functional medicine on how to heal the gut microbiome, but the foundation. So the reset would be really if your child has any sort of persistent health concern. And we have to presume if your child has a persistent health concern, chances are they have a leaky gut.
Chances are they could have gut dysbiosis, maybe not but in an abnormal balance of bacteria, yeast, parasites, else. I mean viruses that we're not really yet able to measure yet. But the foundation of that reset, so the R, first R E return is returning to those five things from microbiome magic. Those are the fundamentals, the essentials. I mean many people listening have heard the saying that you can't out supplement a bad diet and lifestyle.
Dr. Mark Hyman
Well
Dr. Elisa Song
you can't heal your microbiome. You can't out supplement a poor diet and lifestyle for your microbiome. I mean, I could tell you 10 different supplements to take. And you might get a little better. And in fact, I've had kids going through the gut reset when they're like, okay, not changing the diet.
I'm not gonna go to bed, get eight hours of sleep. They can get better on the supplement plan and they can even quote go into remission. But here's the thing, and as practitioners listening, we've all had this experience where your patient gets better. I mean, that's awesome, right? They're in remission.
But then what happens? Six months later
Dr. Mark Hyman
Yeah, they slide back.
Dr. Elisa Song
They start sliding back, right? Mean, what we want is don't want you to want to call it remission, right? Wanna call it, okay, this is your new state of health. Right? This is this is your new normal now.
Right? And so I have parents who are kind of, you know, just holding their breath, waiting for the next shoe to drop because they're like, okay, when's the next time they're gonna flare, you know, in their PANS PANDAS? Or when's the next time, you know, that their rheumatoid arthritis is gonna flare? So those five things. I had this opportunity, it was so fun for my kids.
They go to a public charter school and rely on parent volunteers to teach some of their quote electives. And so for their third and fourth grade combined class, so eight to 10 year olds, I created a six week curriculum. We call it Healthy Belly, Happy You.
Dr. Mark Hyman
Uh-huh.
Dr. Elisa Song
It was
Dr. Mark Hyman
It's great.
Dr. Elisa Song
So fun. I mean, we taught all about their microbiome.
Dr. Mark Hyman
I mean, poop with kids. I bet they love it.
Dr. Elisa Song
Poop with kids, all about poop. Right? And connected the dots to why they're they're these tiny little microscopic friends are so important for not missing school so much because you're sick or getting along better with your friends or being sleepy
Dr. Mark Hyman
in year.
Dr. Elisa Song
Better school. Running faster down the soccer field. Right? Mhmm. So connecting the dots.
And these kids, they learned how to look at packages, read food labels, check the sugar, make sure there's nothing artificial. They were going home telling their parents, mom, I shouldn't have more than 20 five grams of added sugar in a day. And look at the look at this. They have like this package of, you know, whatever it is. Let's let's say, or let's say boba tea.
Right? This is 35 of sugar. Now some kids, of course, my kids too included, they may choose to have that. Right? But at least they know they're making that informed decision.
Dr. Mark Hyman
Right?
Dr. Elisa Song
And then they know, okay, how can I get my microbiome to bounce back from that? Right? We made kombucha That's so fun. And sauerkraut. I mean, that's the way to do it.
Right? So we just spoke about the five things that they have to do every day anyway. Yeah. So why not just do it for themselves but for all their trillions of microscopic friends?
Dr. Mark Hyman
You're not alone. You're not alone.
Dr. Elisa Song
You're not alone. And really and truly, you know, with I mean, the numbers keep changing. Right? But whatever. 10 times more bacterial cells, you know, on and in us than than human cells.
I mean, who are we really nurturing? And so, you know, we have to eat every day. So why not eat to support your microbiome? We have to breathe and drink and sleep and move our bodies. Even if you're a couch potato, you're still moving.
Right? Yeah. So how can we do each of those five things in a way that that supports your buddies, supports you? And they were all into it. Yeah.
Dr. Mark Hyman
We love that.
Dr. Elisa Song
And, you know, we go through each of these in the book, but I would say the two most important things are number one, nourishing your gut microbiome. And that includes what kind of things you get in. We've already talked about that, right, fiber, color, fermented foods.
Dr. Mark Hyman
Prebiotic foods.
Dr. Elisa Song
Prebiotic foods. Right? Creating symbiotic meals. Right? That means pairing, you know, a fiber filled food with a fermented food.
So, I mean, just think like yogurt and, you know, nuts and and granola. Right? I mean, right there. Right? Or blueberries on top.
But equally important, especially for our kids who are, you know, quote picky and for parents who are like, okay, they don't let a vegetable touch their plate. Like, I gotta figure something else out. Sometimes even more impactful is to teach them how to read food labels to know what to keep out. Yeah. Right?
The things that are really especially harmful to their gut microbiomes. And I don't make it too complicated, but, you know, I really talk about these food additives. You know what was hilarious in doing research for the book? There are over 3,000 FDA approved food additives.
Dr. Suzanne Goh
Oh, crazy.
Dr. Elisa Song
Right? And the list, it's called everything added to food in The United States. I mean, what a silly list. Right? But but three over 3,000 to make our food taste better, sweeter, saltier, have a better mouthfeel.
I mean,
Dr. Mark Hyman
it's it's creepy. Yeah. These things aren't really food. And they're and they're mostly not regulated. They mostly haven't been tested.
Yep. They're often not allowed in other countries like in Europe.
Dr. Elisa Song
That's right.
Dr. Mark Hyman
And and we use them here right now. Kellogg is is getting a bit of a backlash because it it produces foods in America that have certain colors and additives that they don't allow in Yeah. Canada and other countries. And they remove those from other countries' products that they sell where they sell Kellogg's, but they don't remove it in America. So our kids are getting exposed to very harmful things that they're protected from in other countries.
Dr. Elisa Song
It's true. You know, they were big to do about getting rid of the artificial colors. You know, this was I mean, this was probably about ten years ago. You know, was really excited. And then they pulled back.
Right? They said, well, you know, first of all, we're not removing those because they're actually harmful. Right?
Dr. Mark Hyman
Right.
Dr. Elisa Song
Second of all
Dr. Mark Hyman
First neighbor in The UK.
Dr. Elisa Song
The American people, they actually prefer the brighter colors and they prefer x y and z. I mean, come on.
Dr. Mark Hyman
Might also prefer cocaine in every corner in a Yeah.
Dr. Elisa Song
Dispensing machine. So it is true. I mean, already for years has had a warning label that foods with artificial dyes and preservatives can affect children's behavior and attention and focus. And so teaching kids how to keep those things out, really impactful. And I'll just I'll tell you a quick story on just how we had had, you know, before when we bumped into each other in the hallway and we were chatting about just how quickly kids can get better, you know, compared to adults.
Dr. Mark Hyman
It's true.
Dr. Elisa Song
Yeah. Kids aren't filled with all the, you know, the the toxins, whether they're physiologic toxins or environmental toxins and psychological 100% more resilient. And so small changes can have profound results. There's this one kiddo, he was probably about six years old, tons of behavioral concerns, tons of sensory issues. He didn't feel right in his skin.
He was getting into fights with every kid on his soccer team. Not a good thing. His occupational therapist was really astute and referred him to me and said, I don't think this is just sensory issues, There's something else going on. Yep. Sat with a mom who was just, I mean, exhausted at her wits end.
One of the things that was heartbreaking for her was this was her son. Yeah. I mean, he just couldn't stand touch. So when she would kiss him, he would wipe it off. Mhmm.
Right? He just moved away from her hugs. I mean, that's heartbreaking as a mom.
Dr. Mark Hyman
Yeah. Of course.
Dr. Elisa Song
And so as we sat and talked about different tests that we might do just to figure out, dive a little deeper, could there be some Yeah.
Dr. Mark Hyman
What did you find?
Dr. Elisa Song
Well, I mean, this kiddo did end up having pants. Okay? So that's sort of, you know, the backstory there. There was something different going on for his sensory issues.
Dr. Mark Hyman
As you're going that you just said, PANS?
Dr. Elisa Song
So PANS, pediatric acute onset neuropsychiatric syndromes.
Dr. Mark Hyman
Which is a mouthful, but it just means kids have these weird neuropsychiatric problems. We don't know what it is. Yeah. And it's called the syndrome because we have no clue how to deal with it. That's right.
That's But we actually do for
Dr. Elisa Song
a functional medicine. Absolutely. For some kids, an abrupt, pretty dramatic onset of OCD, restrictions, aggression, separation anxiety, cognitive decline, handwriting decline. PANS can have many different causes, so that's where as a functional medicine practitioner you need to do the digging because it could be molds, you know, mycotoxins. It could be infections like strep.
And when it's caused by strep, it's caused PANDAS.
Dr. Mark Hyman
Right.
Dr. Elisa Song
So pediatric acute neuropsychiatric syndrome disorders associated with streptococcal infection. Yeah. That's another mouthful. But So he ended up having that, but here's the thing. After his soccer practices and games, often there would be treats of, like, the bright neon blue Gatorade, And the Skittles and the family otherwise was pretty healthy in terms of their diet, but it was just this thing that, well, it's a treat after soccer, right?
All his friends are doing it. So, you know, as we're thinking about the testing, I said, look, let's just do one thing right now. One thing. Let's just remove all of the artificial colors and preservatives from his
Dr. Mark Hyman
like the Feingold diet. Right? Feingold was this
Dr. Elisa Song
The Feingold. Yeah.
Dr. Mark Hyman
Pediatrician back in the seventies who said food additives were causing ADHD.
Dr. Elisa Song
Yeah. And it's mean
Dr. Mark Hyman
There was something to it. It's not the case, but yeah.
Dr. Elisa Song
As a pediatrician, I think it's really important to not just say to do something, but make it concrete. Yeah. So we we went through and figure out, okay, the Gatorade. Okay. What's an equally acceptable non artificial, no artificial sweeteners either, no sucralose, no aspartame, hydration drink he can drink.
Yeah. I mean, how about coconut water? Right? But there are other hydration drinks that are much cleaner than than the Gatorade. Right?
The Skittles, what could be replaced that with? You know? So we really concretely discussed what swaps to make. Yeah. And then she went home, she was little overwhelmed by everything.
Right? As can happen in that first visit. It's like drinking from fire hose sometimes. But but she was committed and mom took out the artificial dyes, sent me a message two weeks later. Two weeks.
Two weeks. Right? Two weeks. I have the message from her in in my portal and I just it makes me tear up every time I think about And she said she just wanted to to thank me because for the first time she could remember in so long, he didn't wipe away her kiss. Right?
For the first time.
Dr. Mark Hyman
That's amazing.
Dr. Elisa Song
And he even asked for a hug.
Dr. Mark Hyman
That's amazing.
Dr. Elisa Song
Right? So I mean, two weeks is not that long and so that's where the mindset shift has to happen because a lot of people think, oh, I'm depriving my kid. Maybe it's like your partner.
Dr. Mark Hyman
They're helping your kid.
Dr. Elisa Song
Mean, we're not depriving your kids. Right? We're helping them thrive.
Dr. Mark Hyman
I mean, I wanna pause there for a sec because you you what you said was just so important. That there are these kids walking around with all these health issues that are treated by traditional medicine, usually with medications or with nothing. Like Yeah. There's no treatment for sensory issues with kids. It's just like, you know, behavioral therapy or other kinds of therapies that really don't work that well.
And what you're saying is that there are underlying biological causes of many of the things that are correctable and that kids respond really quickly and really well to these things in ways that sometimes adults don't. So being a pediatrician has to be extremely satisfying when you're using this approach. When you're not, you're just kinda putting Band Aids and everything, and it can be a very frustrating. I think pediatricians have one of the lowest job satisfactions and the highest burnout rates. And it's because they're really kind of just on this treadmill of traditional care, which isn't actually helping their patients.
Your, case reminded me of a boy I took care of who was 12 years old who was so disruptive, severe ADHD, kicked out of kindergarten. You know? I mean, who gets kicked out of kindergarten?
Dr. Elisa Song
Right? Yeah.
Dr. Mark Hyman
He was on ADD medications. And he had all these other issues that were not, quote, psychiatric. Right? He had stomachaches. He had anal itching.
He had asthma. He had allergies. He had headaches. He had anxiety. He had insomnia.
Like, he had a whole
Dr. Elisa Song
All the things.
Dr. Mark Hyman
Muscle cramps. I mean, he had all these things that were really problematic but were treated by all these different specialists who was on seven different medications. Yeah. And what we found was that he lived on a diet of processed food. Mhmm.
And we did a bunch of testing, and I wanna talk about testing because I think it's an important thing for for how do we sort of figure out what's going on with our kids. And we did a number of tests, and we found he was severely nutritional deficient in almost everything, vitamin d, b six, magnesium, zinc. You know, just like omega three fats. He had high levels of all these trans fats in his blood. He had from all the processed food, had high levels of inflammatory fats.
He had high levels of really toxic stuff in his system like lead, and his gut was a mess. He had overgrowth of yeast and leaky gut and food sensitivities, and he had gluten antibodies from eating gluten that he was sensitive to. And, you know, all I did was really do what you're talking about was reset his gut, put him on a Whole Foods diet, get rid of the bad bugs, put in some probiotics, get him get him the nutrients he needed, some multivitamin d, fish oil, zinc, magnesium, b six. Two months later, the mom brought him back and and said he's a completely different kid. Yeah.
He's got no ADD. He's off all his medications. He has no more headaches, no more stomachaches, no more asthma, no more any of the other things he was suffering with. He stopped drinking all the sodas and everything. Was drinking all the junk food.
And his handwriting, which was the thing that that blew my mind Yeah. Went from completely illegible to completely perfect penmanship.
Dr. Elisa Song
Yeah. Yeah.
Dr. Mark Hyman
And I was like, wow. Like, this is crazy. When you see something like this, you go as a doctor, you go either you dismiss it because it doesn't fit your paradigm, or you go, wait a minute. There's something I've been missing. Yeah.
And that the body and the brain are connected in ways that are so important. So whether kids got sensory or behavioral issues or whether the kids got allergic autoimmune issues, it's so important to get, the proper evaluation. So how do you start to think about looking at these kids who are who are stuck? One is prevention. Right?
We talked about that. Getting the mother's health and the father's health, great preconception. They both need to be on the right supplements, correct the things that are off, fix their guts, get rid of the metals, all the things we talked about. Now you can listen to the podcast on preparing to conceive as it talks about what to do for both men and women. But then we have all these kids who are suffering and and these kids with chronic illnesses.
These I mean, these kids who are on multiple medications and who are stuck in this treadmill that they're on for life and that they're gonna have consequences their whole life long from these conditions. Yep. And then maybe allergies, tone, and autoimmunity when they get older, and it's just kind of a mess. So when you have these kids who come in to see you and they have, you know, ADHD or autism or autoimmunity or they're allergic to everything or they have eczema, how do you start to think about assessing these patients and helping these parents think about taking care of their kids in a different way?
Dr. Elisa Song
With the child present too. I mean, we I always want to educate and inform kids in an age appropriate way. So I think that's where making sure kids are on board for with the whole plan is really important, that they understand. Yeah. Course.
Because if mom comes home and just says, okay, we're gonna overhaul your diet and all. I mean, it's it's not necessary. For some kids, it might. But for many kids, it's not gonna work. Right?
Dr. Mark Hyman
I'm kinda showing the kids their test results. Like, here, look at this. You're allergic
Dr. Elisa Song
to gluten.
Dr. Mark Hyman
Or look at this. You've got yeah.
Dr. Elisa Song
Across the board, when I tell parents and kids, when they're sitting in front of me, if they have any sort of attention concerns, behavioral concerns, focus concerns, anxiety. I mean, so many kids are suffering from anxiety nowadays. And when I tell them that 80 to 90% of the serotonin in their bodies is made by their gut Right? And then usually there's a pause in parents and kids are like, what? Right?
So that's a perfect segue into listen, let's think about all the things that are happening that are disrupting your gut microbiome. And so that's an easier in to say, let's look at the foods. It's not just about like what you're eating, it's about okay, what factors are harming your gut microbiome? And guaranteed no matter what kids have, we can kinda link it to that. That's an easier way I think to have a conversation around food.
Interesting. And you have to you have to work with their goals. Right? For for parents it might be, you know, to
Dr. Mark Hyman
to And what do they want? They wanna
Dr. Elisa Song
feel better do they want?
Dr. Mark Hyman
Make eggs. Exactly. Do better in school. They wanna
Dr. Elisa Song
Yeah. Yeah. The foundations, as you said, mean, we always talk about the foundations of food as medicine. That sometimes is the hardest thing to to change, honestly, right, for for a lot of kids. Talking about I mean, even for this one teenager who came in and and he's been gluten free on and off.
And it I mean, he knows it makes a huge difference for him. But he's he was having a flare of his
Dr. Mark Hyman
Sometimes the kids just wanna eat that pizza.
Dr. Elisa Song
Well, so he was having a flare and he came to me and we did some testing. He's like, just please, please don't tell me I have to go off the gluten. And I'm like, look, I'm not gonna tell you you have to, but I'm gonna tell you what decisions are going to help serve your body and your brain and make you feel better. Right? And he took some time to think about it.
And of course, I expect that in a teenager. But especially for teenagers, I let them know that we're working as a team and the decisions you make, I mean teenagers, they're all about trying to make it, be an adult. I'm independent. But if you're going to be given the opportunity to make adult decisions, then you have to make them like an adult. Yeah.
And make them with information.
Dr. Mark Hyman
Right?
Dr. Elisa Song
But the foundations really, you know, in healing the gut are, I mean, the foundations. Right?
Dr. Mark Hyman
But do test kids? I mean, do you do testing and diagnosing?
Dr. Elisa Song
I do. I mean, I the first thing I'll test is blood work for nutrient deficiencies.
Dr. Mark Hyman
So what
Dr. Elisa Song
are looking So foundations are the CBC, I do ferritin, yes, complete blood count, a ferritin.
Dr. Mark Hyman
Which looks at iron.
Dr. Elisa Song
That looks at iron stores. I'd like to do a comprehensive metabolic panel that's fasting because I wanna see what their blood sugar is doing even for fit, active, slim kids. So many more kids are showing signs of insulin resistance.
Dr. Mark Hyman
Yeah, pre diabetes in kids, right?
Dr. Elisa Song
Even for kids that don't fit the overweight
Dr. Mark Hyman
And you measure the insulin levels
Dr. Elisa Song
in the So I measure fasting insulin, fasting blood sugar in the comprehensive metabolic panel. I look at their liver enzymes specifically too because AST and ALT can start to creep up. I do hemoglobin A1c but that's rarely high. Mean because it's the average blood sugar. So most kids are kind of roller coastering up and down.
So if they have low lows and high highs, their A1c might look perfect. I do a red blood cell zinc, a red blood cell magnesium, twenty five hydroxy vitamin d. So those are kind of my foundations. Threes? I do an omega three profile.
It's not always not always available, but I do add that omega three and my omega six profile. So and also for the young kids, can only take so much blood at a time. Yeah. But those are my foundations. Lately, I've been, you know, really trying
Dr. Mark Hyman
And are seeing a lot of nutritional deficiencies in these kids?
Dr. Elisa Song
One hundred percent.
Dr. Mark Hyman
A hundred percent of kids have a nutrition?
Dr. Elisa Song
I'm not gonna say a hundred percent, maybe ninety nine point nine percent.
Dr. Mark Hyman
Okay. That way, just stop right there. Stop right there. So what you're saying is in the world's most affluent country Mhmm. Where you're probably seeing a fairly high end population Yes.
Yeah. Of people, not people who are highly underserved.
Dr. Elisa Song
Many who are already Who are healthier.
Dr. Mark Hyman
Already quote healthier. Parents are very proactive. They're coming to see you. In this population, you're seeing almost a hundred percent of kids have one or more nutrient deficiency.
Dr. Elisa Song
Mhmm. And I'm gonna say I'll back that up a little bit and say nutrient deficiencies and insufficiencies.
Dr. Mark Hyman
Yeah. Right? Because optimal levels.
Dr. Elisa Song
Yes. So suboptimal, bottom of the barrel. Right? And the most the most common is zinc. Yeah.
Okay. Zinc is is the most common nutrient insufficiency and deficiency. Sometimes it's shocking how low a red blood cell zinc is. If you were to eat you'd have to eat the equivalent of eight oranges today to get the nutrients that your grandma had with one orange. I mean, it's probably not quite as simple as that, but our food is less nutrient dense.
It's depleted from the glyphosate from, you
Dr. Mark Hyman
know, non opiates. Processed food. We're talking about, like, fruits and vegetables Yes. Yes. And Yes.
That should be nutrient dense.
Dr. Suzanne Goh
Right?
Dr. Elisa Song
So that's why even kids who have the quote healthiest diet, it's it's not uncommon to see these nutrient deficiencies.
Dr. Mark Hyman
And by the way, what you're talking about, Lisa, is is not something that most doctors or pediatricians will check. They don't check nutrient levels on kid. This is not done. Maybe they'll took an iron level on a little kid, but but that's really unusual.
Dr. Elisa Song
It's unusual. For parents listening who are thinking there's no way I'm gonna get my kid to do a blood draw, there's a numbing a lidocaine Prylicaine numbing cream that is magic. You put it on your elbows and I mean kids just
Dr. Mark Hyman
have Is that EMLA?
Dr. Elisa Song
EMLA. It's EMLA cream.
Dr. Mark Hyman
E M L A.
Dr. Elisa Song
Yep. I would highly recommend at least that first blood draw that you use EMLA so that your kid doesn't feel the poke and you know just have a distraction. This is screen time has a pass for this where they can they can watch Dora, they can do whatever. Right? So our food is depleted.
Ultra processed foods deplete our nutrients even further.
Dr. Mark Hyman
Explain why.
Dr. Elisa Song
Well, so some of the these kind of anti nutrients, right, I mean, they compete with absorption for our proper nutrients even if we're kinda pairing it with healthier foods. And ultra processed foods, they're devoid of most nutrients anyway. Yeah. So the thing with the ultra processed foods is when you read labels, I used to say if you can't pronounce something, put it back, but some of those things are things like riboflavin
Dr. Mark Hyman
Sure. Methyl
Dr. Elisa Song
and cobalamin.
Dr. Mark Hyman
Well, they add them
Dr. Elisa Song
to enrich the to add back vitamins and minerals.
Dr. Mark Hyman
I would say they're enriched because they're so impoverished in the first place they have to eat.
Dr. Elisa Song
That's right. Why would you need to add back Right. Would need nutrients to a food to to a real food. Right? So and I also think our kids have a higher need for nutrients.
Dr. Mark Hyman
Yeah. We have more stresses, more toxins.
Dr. Elisa Song
Less nutrients getting in, more use of them because psychological stress. You need zinc, you need magnesium as as cofactors for many of your neurotransmitters. You need your b vitamins. All of these are getting depleted.
Dr. Mark Hyman
Also, when you eat ultra processed food, you're not getting all the cofactors that you need to metabolize that food. Basically, in order to process your food in your body, you need a lot of vitamins and minerals to run the chemical reactions to turn the food into energy and do everything else. So you're kind of in a double whammy. You're not getting the nutrients and you need more of them.
Dr. Elisa Song
I mean, it's yeah. It's like a double, triple whammy. You know, it's and zinc especially, just as a little pearl for parents listening and for practitioners. If you have kids who are super picky, sensory, you know, cover their ears when they're in a public toilet or parents have to the kids have to leave if they run the blender or the vacuum or maybe know to buy seamless socks or cut off all the tags on the shirts. So if you have a kid like this, you know exactly what I'm talking about, right?
And that can be one of the most challenging things. Well, zinc deficiency alters your taste profile, so it can trigger pickiness
Dr. Mark Hyman
High eating rate.
Dr. Elisa Song
Low appetite. Also there's amplification, it's called auditory gain where sounds sound louder. The sensory issues, the tactile, tags, socks, shoes, all of that. If you have a pediatrician or a physician who is not ordering tests for you or you're not able to find a practitioner order tests, sometimes just supplementing with a little extra zinc and parents will say, oh my gosh, they got out the door in five minutes, not twenty because I had to tie their shoes over and over again because they weren't tight enough. Or palate is actually expanding a little bit.
It could be as simple that, but knowing that zinc is one of the most common nutrient deficiencies in kids, it can be so profound just to see I mean, there are clinical clues that kids may be deficient, but I always look at
Dr. Mark Hyman
use the zinc taste test?
Dr. Elisa Song
The tally?
Dr. Mark Hyman
Use a
Dr. Elisa Song
Yeah. Mean, sometimes it's harder for kids, but yes.
Dr. Mark Hyman
Basically take this zinc liquid, and if you don't taste anything, then you're deficient.
Dr. Elisa Song
That's right.
Dr. Mark Hyman
So instead of doing a blood test, you can actually do a, just like a test in the office or at
Dr. Elisa Song
home Totally.
Dr. Mark Hyman
Yeah. With zinc sulfate. Yeah. So this is amazing. So that sort of speaks to, you know, the need for for supplements.
Because you think, oh, kids are healthy, they're young, well, they don't need supplements. But do kids need supplements? And if so, what supplements are nonnegotiable? And and, you know, what what kid what should kids be taking?
Dr. Elisa Song
You know, especially if I don't
Dr. Mark Hyman
And not Flintstone vitamins.
Dr. Elisa Song
Not Flintstone vitamins, please. If I have the opportunity to check lab work, then I will supplement individual nutrients based on the lab work. You know, many, many kids are gonna have, especially if they have chronic issues, they will have issues with methylation and need more methyl factors. But I have yet to see a young kid with an elevated homocysteine. Maybe on their urine.
So I will do urine organic acid test because they're so much easier to get. So much easier to get a poop test than a blood test sometimes. Pee. A pee test than a blood test sometimes. If we wanna look at methylation stress, you can look at methylmalonic acid or figlu for meminoglutamic acid.
Right?
Dr. Mark Hyman
And these are just markers of folate or b twelve deficiency that you can see in the urine.
Dr. Elisa Song
Yeah. And then, you know, even on on stool testing, if I see inflammation or digestive insufficiency, right? They're not digesting, they're not absorbing their fats or, you know, their proteins or their carbohydrates. I might do digestive enzymes. But across the board, would say virtually all kids need extra vitamin D Even in the middle of summer when kids are out at summer camp and they have that golden tan, even then when I measure kids, they are not optimal.
Dr. Mark Hyman
Yeah.
Dr. Elisa Song
Right?
Dr. Mark Hyman
That's true.
Dr. Elisa Song
So and in the Northern Hemisphere where we live, apart from summer, you're really not gonna get enough conversion through your skin in any other season.
Dr. Mark Hyman
Unless you're running around half naked in a bathing suit for, you know, at least half an hour a day from ten to two in the afternoon.
Dr. Elisa Song
Not lathered in sunscreen.
Dr. Mark Hyman
Not lathered in sunscreen, you're not gonna get exposures that are gonna make a difference. Yeah. Maybe for a lifeguard, you'll be alright.
Dr. Elisa Song
That might be fun. Yeah. But so almost all kids, and I would bet their parents to need vitamin d, so vitamin d three. Do they need k two? I'll add k two when they when they get older for sure for teenagers.
Almost all kids need an omega three
Dr. Mark Hyman
Yeah.
Dr. Elisa Song
Of fish oil. Right?
Dr. Mark Hyman
So important for ADD, depression, skin health, hair, all of it.
Dr. Elisa Song
Yeah. And their kids hormones. If kids have atopy, eczema, asthma, I'll make it a three six nine fish oil omega six supplement with GLA. So that's an omega six, guys, found in borage, black currants, even churros. It's really good for autoimmune and atopic conditions.
Dr. Mark Hyman
Yeah. People think all omega sixes are bad. They're not. They're not good or bad. They just it's the quantity we have, and it's Mhmm.
Certain types are actually really beneficial, like you're talking about GLA, which is from evening primrose or borage oil. Yeah.
Dr. Elisa Song
Yeah. Yes. So important. So I would say those are my staples. And I will say I am forever on the hunt for a high quality children's multivitamin that I love.
Dr. Mark Hyman
You haven't found one?
Dr. Elisa Song
I mean, found a few that I'm okay with. Right? And none is perfect, but there are some that are better than others. Yeah. What I would move away from are some of the over the counter
Dr. Mark Hyman
Gummy vitamins.
Dr. Elisa Song
Gummy vitamins. Now some, like, we carried a gummy line that was awesome because each gummy only had point five grams of sugar. But some of them, if kids are getting the gummy vitamin d and some extra gummy magnesium and, you know, gummy vitamins, I mean, in that, like, handful of gummies that they're gladly chomping away on, you know, before they head off to school, they might have had like four teaspoons of sugar in that one sitting. Right? And so we don't wanna send our kids off with with a mouthful of sugar.
Dr. Mark Hyman
And how do parents go about finding good products Like, you know, omega three, vitamin d, and multi, maybe zinc if they need it, magnesium, probiotics. Mean, it's kind of a zoo out there to find the right
Dr. Elisa Song
It is. It is kind of a zoo. I mean, use the practitioner
Dr. Mark Hyman
Brands.
Dr. Elisa Song
Brands, right, because I But
Dr. Mark Hyman
they're not available to consumers often.
Dr. Elisa Song
That's right.
Dr. Mark Hyman
Pure encapsulations or
Dr. Elisa Song
Designs for Health, you know, is available I think Zymogen now is available to consumers. So it's much easier to find. And what I tell folks is either purchase from your practitioner who you know is storing, handling things well. If you're going to buy from Amazon, make sure you buy it from the manufacturer's store, not from Judy's health food store.
Dr. Mark Hyman
Yeah, because a lot these, they might buy a lot that's almost expired. They might have it on sitting on the turmeric, you know, in a warehouse that's at a 120 degrees, and it's a problem out there. So you have to be careful for for products you buy on on Amazon.
Dr. Suzanne Goh
In just the past, you know, twenty years alone, the prevalence of autism has risen four hundred percent.
Dr. Mark Hyman
Four hundred percent.
Dr. Suzanne Goh
Four hundred percent. And sure, we know part of it is related to changing diagnostic criteria, greater awareness, but there's a big part of that increase that isn't. You know, it can't be attributed just to greater awareness or changing diagnostic criteria. And we know actually a lot about the different causative, contributing factors. So, the way I like to explain it, to professionals and to caregivers is that there are a set of factors, related to genetics.
So we know genes matter, but they also aren't the entire story. So there are over a 100 different genetic variants that we know can influence brain development in a way that can lead to autism. It's usually not
Dr. Mark Hyman
just So genetic susceptibilities.
Dr. Suzanne Goh
Genetic susceptibilities is usually a complex interaction of many.
Dr. Mark Hyman
Many genes, Yes. Right.
Dr. Suzanne Goh
And then on the other side, there are also non genetic factors or environmental type factors. And usually it's not just one, it's many. And those interact with genetic factors in complex ways. So it's a complex picture. But those non genetic factors are really interesting because many of them give us insight into autism, biology, and some in a sense are modifiable too.
So we know that there are a set of parental health factors that are increasingly common over time and are very likely contributing to the rise in autism. Things like parental age, things like maternal health factors, maternal metabolic conditions, maternal autoimmune conditions. We even know there are certain, they fall in the category of toxins. You know, things in our environment like industrial chemicals, pesticides, a whole range of things that are now really widespread in the environment. And a lot of research has been done showing that they affect brain development and brain health.
So how that influences our approach at Cortica is that we really seek to understand a child's medical history. So we get a lot of information about the pregnancy, the birth, family history, family health conditions. And then we also do a deep dive into the child's own biology by looking at a range of different test results. So, these might be done on saliva, on blood, on stool, on urine. All ways, in addition to a very thorough physical and neurological exam, of course.
But these are all ways to try to gain insight into what is happening for that child.
Dr. Mark Hyman
And many of these tests are not things you get when you go to your regular doctor or neurologist. They're things that are kind of outside of mainstream. You're looking at toxic load, urinary organic acids, nutritional levels, methylation, all these genes that are in combination. I often said that environment is a big factor, but genes load the gun, the environment pulls the trigger. Yeah.
So it's this sort of interplay environment across these kids' genetics. And I've seen this. I've seen all these different genetic patterns of low glutathione genes and methylation genes and detoxification genes that really common in these kids. And they tend to be sort of at risk. You know, and I think one of the things that really struck me when I started learning this was the work of Martha Herbert.
Dr. Suzanne Goh
Mhmm.
Dr. Mark Hyman
And I'm sure you know is another Harvard Yes. Neurologist who studied autism and
Dr. Suzanne Goh
And brain imaging.
Dr. Mark Hyman
Mhmm. Yeah. And she, you know, she talked about these biopsy studies on kids who accidentally died with autism. And and all these kids have massive amounts of neuroinflammation. Their brains are on fire.
And and when your brain is on fire, it's hard for it to function. And Alzheimer's is a brain on fire. Depression, we now know, is a brain on fire. Schizophrenia, we now know, is a brain on fire. So what's causing the fire?
Dr. Suzanne Goh
Yeah. Well, actually So prior to establishing Cortica, I was on faculty at Columbia University. And we had an NIH funded research program using multimodal brain MRI to study autism in children and adults. And, one of the research studies that we published showed that there was a pattern of neurochemistry essentially that really pointed to both mitochondrial dysfunction and inflammation in the brain. As a neurologist, when I think about inflammation in the brain, there are kind of, you know, two, there's sort of a set of maybe more acute or sudden onset fulminant types of brain inflammation.
And then there's this other category of more low grade Smoldering. Smoldering types of And the research is really pointing to autism falling within that second category.
Dr. Mark Hyman
Sure, yeah, it's not encephalitis that you get from like a virus like It's really a much more slow and insidious type of inflammation.
Dr. Suzanne Goh
And harder to detect. Some of our tests, you know, may not show up on a routine MRI, for example. Sometimes it does though. And, I certainly have seen that in my practice. So, yeah, it's the mitochondrial dysfunction, which is linked to this chronic low grade inflammation, is influencing the function of the brain in autism.
And it's also quite dynamic. So it's not, there was a term used for a very long time in pediatric neurology called static encephal encephalopathy. That couldn't have been, now we know it couldn't be farther from the truth. The brain is not at all static. No.
It's extremely dynamic and influenced by so many factors. And so we do as much as we can in our practice to try to understand what those factors are for a particular child. And then we can take steps that can really be very impactful, like making changes to, so I think of these interventions as falling in six categories. The first, lifestyle changes. So things like making changes to sleep routine, movement, what part exercise plays.
Really fascinating is that there's now a lot of research in autism showing that exercise improves the core features of autism. So socialization, function, anxiety, not to mention endurance, stamina, physical health. Just tremendous benefits to some of those lifestyle changes.
Dr. Mark Hyman
And it's an anti inflammatory for the brain. Yes. And it increases new brain connections, we call
Dr. Suzanne Goh
That's right.
Dr. Mark Hyman
With BDNF. With BDNF, right? Brain derived neurotrophic factors like miracle growth for the brain.
Dr. Suzanne Goh
Yes.
Dr. Mark Hyman
So yeah, that's amazing So
Dr. Suzanne Goh
huge, huge benefits. The second category, changes to the diet. Third related to that, dietary supplementation.
Dr. Mark Hyman
Anyways, before you go off the diet, don't just bump right over that. There's so much What role does nutrition play? Because I wanna go slow with these six things. Because I think you've a lot in there that's that's really powerful and very unique. So what is the role of nutrition and diet in autism?
Dr. Suzanne Goh
Yeah. Well there's a really very big role. I mean there's a very big role for nutrition and diet in health for all human
Dr. Mark Hyman
beings. For all of us, yeah.
Dr. Suzanne Goh
And for, in autism, there's a lot of interest in diet. There always has been. But I think some of that interest
Dr. Mark Hyman
Not just to be healthy but as a therapeutic tool.
Dr. Suzanne Goh
Yes. Yeah. The emphasis in the past has been on various types of elimination diets. So diets where you remove something from the diet.
Dr. Mark Hyman
Like gluten or dairy,
Dr. Suzanne Goh
which are the most common, Yes, and then see how that might affect a child's behavior and their learning. What I found in clinical practice is that because many autistic children tend towards a more restricted diet anyway, because of sensory sensitivities.
Dr. Mark Hyman
Particular, right.
Dr. Suzanne Goh
Or this reduced flexibility. Yep,
Dr. Mark Hyman
picky eaters basically. Yes.
Dr. Suzanne Goh
And so the diet often is very, very limited already to begin with. And also often limited to highly processed foods. If you remove
Dr. Mark Hyman
Mac and cheese diet.
Dr. Suzanne Goh
That's right. Or a goldfish or potato chips, french fries, a standard American diet, unfortunately. But if you remove something from a diet that's already very restricted, you risk some serious nutrient deficiencies. So we find it's almost always a better approach to work on first expanding the diet. So expanding whole foods, nutrient dense Yeah,
Dr. Mark Hyman
which you add, right?
Dr. Suzanne Goh
Yes. And so we have a nutrition and feeding program that's a collaboration between our medical providers and our feeding therapists, our speech therapists, our occupational therapists who help a So it's both what you eat, the nutrition side, and how to eat, the feeding side. And then once you've increased a child's diet to a degree where you then feel comfortable eliminating things, and there are lot of elimination diets worth exploring. So we do know that for example, celiac disease, a gluten allergy is more common. It's actually considered a co occurring condition.
Dr. Mark Hyman
Isn't it like six or seventeen percent of kids with autism have elevated gluten antibodies?
Dr. Suzanne Goh
I don't know the exact percent, but it definitely is It's twenty percent of schizophrenics. Yeah. It's more common in autism. The signs may be a little bit harder to detect also in a child who has behavioral differences already, who may have a harder time communicating.
Dr. Mark Hyman
We call these co occurring or comorbidities, but that's really a false term. These are things that are all interrelated.
Dr. Suzanne Goh
They are very interrelated, It's been a huge step just to get to the stage of thinking of co occurring conditions. But you're right. Why why do they co occur? Yeah. Because they all have common underpinnings.
Dr. Mark Hyman
Yeah. And the and the and the gluten triggers leaky gut, which creates, you know, inflammation in the body, then inflammation in the brain. So we know that that gluten can be really a problem for a lot of brain So sometimes that's a big factor. You can measure antibodies in these kids and often they're high. And you're just like, wow, I didn't know that.
And you see a big change when you get rid of it. I've seen this in my patients. What about dairy?
Dr. Suzanne Goh
Yeah, so what's very interesting about dairy is that there's some research suggesting that it can interfere with folate metabolism. Yeah, that's right. So there are some tests available to look at folate receptor antibodies, for example.
Dr. Mark Hyman
That does
Dr. Suzanne Goh
I've
Dr. Mark Hyman
doing those for years.
Dr. Suzanne Goh
Produced on a dairy free diet. So all of that's very important information to get for a
Dr. Mark Hyman
child. So what you just said in English for everybody was basically what happens when you eat dairy, there are antibodies that form. Your immune system produces antibodies that attack the receptors for a vitamin called folate or folic acid. And this is a critical nutrient in regulating mitochondrial function, detoxification, neurotransmitter function, inflammation, glutathione production. It's so critical.
It's called methylation. And when that doesn't work, and these kids almost all have these methylation issues, they get pretty significant dysfunction. So what you're saying is it's not one thing. There's no one thing to do, but there's many things to do that is personalized based on what you find in each kit.
Dr. Suzanne Goh
Exactly. Yeah. And so it means looking at a lot of things. We do pretty intensive, for example, testing because those genetic markers aren't very helpful information.
Dr. Mark Hyman
And just to be clear, the genetic markers aren't like, I have the gene for autism. Maybe you have these methylation genes that are off or glutathione genes or other genes that relate to oxidative stress or other things that you're looking at, relate
Dr. Suzanne Goh
to mitochondrial dysfunction, genes that relate to ion channels in the brain and different So yes, there are a whole host of different genes that can be really informative.
Dr. Mark Hyman
And you can modify treatment based on those genes, right? That's right. They're not fixed. You can actually improve their function by giving them nutrients or changing different things in their diet or lifestyle or environment or maybe medications, right?
Dr. Suzanne Goh
That's also a huge misconception. Sometimes parents will say to me, well why should we test genes? We can't change them. Well, we can change the effects the genes have. We can influence gene expression.
There are, as you know, lots of technologies now that actually do change genes in various And so the future of gene modification, gene therapy is on the horizon.
Dr. Mark Hyman
Yeah, that's pretty exciting.
Dr. Suzanne Goh
Yeah. Yeah.
Dr. Mark Hyman
So you combine these sort of genetic testing with other things that look at nutritional factors and dietary testing. So you mentioned that we could spend the whole time on diet because I I think that plays a I actually had a kid, I remember, who, you know, many kids respond to gluten, dairy free diets. And you're right. Have to add in real food. Have to kinda get them.
That's really important point. But but one kid was really violent. He was like an eight year old autistic kid and was just really aggressive, really violent. The parents didn't know what to do. I said, well, why don't we try a ketogenic diet?
And they did. He ate it and completely changed him. Wow. Completely changed him. He became more normal, no violence, got more speech.
You know, all the autistic features kind of regressed. I wouldn't say he was perfectly normal. He he went from like a non functioning, non verbal kid to a more kind of normal kid. And and so Yeah. You know, that that taught me a lot.
It's like, wow. You know, these these kids something in these kids' diets can be playing a role.
Dr. Suzanne Goh
Yes. Well, diet, I mean, it just has such a profound influence on the body's metabolisms, biochemistry, and therefore behavior and learning. So it's hugely important. But it's also an area that can be hard to change.
Dr. Mark Hyman
Change especially for children. Particularly these kids because they're so picky. Yeah. You mentioned the next step, which was supplements. Yeah.
Dr. Suzanne Goh
So dietary supplementation, can be very impactful as well. So, there's so much to potentially say about this area But I think relates to my area of specialization around mitochondrial function, there are a lot of blood tests that we can do to look at, to give us insight into a person's mitochondrial function.
Dr. Mark Hyman
Like carnitine
Dr. Suzanne Goh
levels, coenzyme Q10, liver function, lactic acid, mesylcarnitine profiles, urine organic acids, amino acids. Yeah. So there are a lot of markers
Dr. Mark Hyman
A lot of what you're gonna get at your typical checkup with your regular doctor. So if go to your regular neurologist, they're not gonna know what you're talking about. But there are neurologists and doctors like you around the country and your centers do all this, which is
Dr. Suzanne Goh
really And fortunately more and more. I think because the research has really
Dr. Mark Hyman
Caught up.
Dr. Suzanne Goh
Yes. So there's more awareness now. But it's still you're right, it's still a work in progress.
Dr. Mark Hyman
So you're actually testing their mitochondrial function through tests that are available.
Dr. Suzanne Goh
Yes.
Dr. Mark Hyman
And then you're customizing the treatment based on what
Dr. Suzanne Goh
you find. That's exactly right. So for example, if there are levels that are low, so, know, there's so much, you know, mitochondria are complex. You gave a really nice description earlier. So one of their major functions is to fuel the body.
They're sort of an energy currency or a powerhouse, but there are things like low carnitine levels or even supplementation with carnitine, supplementation with creatine.
Dr. Mark Hyman
It's like what bodybuilders use. Yes. But it's a mitochondrial co factor.
Dr. Suzanne Goh
B vitamins can be really helpful. Antioxidant vitamins. So there are dozens of different dietary supplements that we might think about for a particular child could help a lot with their learning and their development.
Dr. Mark Hyman
I know and when I first learned about your work, read some of your papers that looked at brain imaging Mhmm. And the metabolic function of the brain, meaning the mitochondrial function of the brain. And you're some of the first to show in addition to neuroinflammation there was mitochondrial dysfunction. Yes. And that led you to kind of go, well maybe if we tried to correct some these mitochondrial pathways which we learned about with these inherited metabolic mitochondrial diseases that are really rare, they actually could help these kids.
It was a hypothesis and you actually studied it and it worked. So tell us a story about what you've done in a patient that used this approach for diet and mitochondrial therapy.
Dr. Suzanne Goh
Yes.
Dr. Mark Hyman
And what did you find?
Dr. Suzanne Goh
Well, are some, so mitochondrial dysfunction is actually very common in many different neurological conditions, very common in autism. There are now research studies showing that in blood, in muscle, in brain. So some of the research that we did using brain imaging, showed patterns of which parts of the brain even are affected by mitochondrial dysfunction in autism. And then there's also a lot of research showing the value of certain supplements, like the ones I mentioned and many others. And so as part of
Dr. Mark Hyman
You mean supplements just don't cause expensive urine, in most accuracy?
Dr. Suzanne Goh
No, they can, when they're matched, when you have the right supplement for the right person.
Dr. Mark Hyman
Exactly, right. Personalized nutrition, right.
Dr. Suzanne Goh
Yeah, yeah.
Dr. Mark Hyman
So you use these compounds in
Dr. Suzanne Goh
Yes, so as an example, you know, children, there's a pattern of regression, developmental regression that's quite common in autism where a child loses developmental skills. As you can imagine, it's really frightening for parents to see. Very often that regression in autism happens between 18 to three years of age. And it also is often associated with what we think of in medicine as a physiological stressor. So, an illness of some kind or a surgical procedure, or even something like starting a new school or new daycare or the birth of a sibling or moving to a new city.
Dr. Mark Hyman
I'm gonna jump into a really controversial topic, which I'm sure you know is coming, that I've seen in my practice and is almost heresy to say in medicine. But is there a role of vaccines in maybe being one of these triggers? The reason I say that is I had a kid who was 22 old, perfectly normal kid. His mother worked for a major pharmaceutical company, and he had a vaccine at 15 and started to progress and lost all his developmental milestones, became nonverbal and fully autistic. And, you know, and and so I I don't know if that was the cause, but it was it was a moment where things changed.
And I've heard the story so many times from so many patients that there's got to be something there. And I'm not saying vaccines cause autism, but they may affect a kid who's vulnerable. Because this kid, you know, typically you see they're born by C section, they don't breastfeed, they've had lots of ear infections, they've had lots of antibiotics, their microbiome's messed up. And so they're kind of sitting ducks. Maybe they have all these polygenic risks for getting into trouble when they have an insult.
Dr. Suzanne Goh
Right. Right.
Dr. Mark Hyman
So it could this play a role? What's what's your take on this?
Dr. Suzanne Goh
Well, will say and you're right. Vaccines is a topic that, unfortunately, is so polarizing
Dr. Mark Hyman
Yeah.
Dr. Suzanne Goh
In autism.
Dr. Mark Hyman
Pro life or pro choice. Like, It seems like it's religion. Let's talk about the science.
Dr. Suzanne Goh
Yeah. It is an area where I certainly wish there could be much more open discussion and less controversy, less heated debates. But I will say, you know, when it comes from the point of view of mitochondria, it actually, a stressor is a stressor, you know? And like all this that I just mentioned, whether it's a psychosocial stressor, you know, or whether it's an illness, in many ways, the mitochondria respond in the same way. So, and I think as physicians, we all have very, when a patient comes to us and the parents have observed something, we really, I think it's important to believe, it's important to believe the parents and what they've seen and understand their experience.
And then to really think
Dr. Mark Hyman
That's a radical idea as a doctor. We know how it's supposed to go, so that doesn't fit my theory, so it's not relevant. But actually, it may be very relevant.
Dr. Suzanne Goh
I think now doctors are partners. Doctors shouldn't be viewed as authorities or those who have the answers.
Dr. Mark Hyman
Amen. So, yeah.
Dr. Suzanne Goh
Yeah, so when children, especially when children go through a period of developmental plateau or regression, it is a red flag. It is an emergency. And so I think of, you know, there's a term in neurology, time is brain.
Dr. Mark Hyman
Time is brain.
Dr. Suzanne Goh
Time is brain. And it first developed around stroke to get people to act more urgently around But I think time is brain really applies also to autism. Yeah. And why is it that a child might be diagnosed with autism? Sometimes a child will have the first signs of autism at a year or 18, not get a diagnosis until they're three or four, Not get any medical testing until they're six, seven or eight or 15 or 21.
I've certainly seen, I know you've seen that too. And so we have to be much more quick to identify when the brain is struggling, when it's not getting the energy it needs, when it's under excessive stress, and then be much more quick to act. And action means doing the appropriate tests and then taking steps in lifestyle changes, dietary changes, dietary supplementation, or some kind of very interesting newer approaches like neuromodulation. So there are different ways of using electrical and magnetic stimulation to improve brain function. There are certainly medications, but not just
Dr. Mark Hyman
you know Herbaric oxygen I've seen used.
Dr. Suzanne Goh
Yeah, there a variety of some of these novel interventions that are really exciting. So in the area of neuromodulation, one that we use is a form of tiny microcurrent electrical stimulation that, stimulates the vagus nerve, which is the major nerve of the body of the parasympathetic nervous system. And we know that it helps to then counter the body's chronic stress response and sympathetic overstimulation, which is so common in many conditions and including autism. So that's yet another really exciting category. And then the final one of the six is what I call developmental behavioral approaches.
This is a huge, huge category, including things like occupational therapy, speech therapy, dance movement therapy, art therapy. You know, it's all these ways that we can teach children and create those learning opportunities.
Dr. Elizabeth Boham
The average child is consuming two seventy calories a day, which is 10 to 15% of their total caloric intake on sugar sweetened beverages. So that's 10% to 15% of calories that are nutrient devoid, no nutritional value, and are only leading to this whole problem of weight gain, insulin resistance, type two diabetes, and metabolic issues throughout their whole life. As we've talked in the past all about how that shifts your fertility. I mean, there's so many aspects to it. So, I mean, that's a great place to start.
And really, most of our kids, very few of our kids need any sort of sports drinks at all.
Dr. Mark Hyman
Energy drinks,
Dr. Elizabeth Boham
energy drinks,
Dr. Mark Hyman
juice boxes.
Dr. Elisa Song
Yeah.
Dr. Mark Hyman
I mean, it's terrible. One one soda increases a kid's risk of being obese by sixty percent. One soda a day.
Dr. Elizabeth Boham
It's crazy.
Dr. Mark Hyman
It's pretty crazy. And and it's it's it's it's a huge part of their caloric intake. It's up to 15% of the average kid's intake. And it's it's something that's just so unnecessary. Was at a conference on childhood obesity and it was in Atlanta and Bernice King was there.
Was really fascinating. With, you know, one of the major universities there, Emory, I think. And there was a guy, a doctor there who was a liver specialist. And I'm like, What are you doing here? He's a pediatric liver.
I'm like, he said, Well, you know, we're seeing enormous rates of fatty liver in kids, and we're seeing teenagers on the transplant list for livers.
Dr. Elizabeth Boham
Yep. All because of insulin resistance and mostly from sugar sweetened beverages. Yeah. Right.
Dr. Mark Hyman
From high fructose corn syrup, which is specifically targets the liver in terms of creating a fatty liver. And for those of you who really want to understand a lot about these issues, there was a movie a few years ago, came out in 2014 that I started. Well, not really started, but I was in it. And it's called Fed Up. It's on Netflix.
And I encourage you to watch it because it really highlights the ways in which our children are so affected by this. Mean, there's a kid who's 16 years old who needs a gastric bypass.
Dr. Elizabeth Boham
Right. How
Dr. Mark Hyman
does that make sense?
Dr. Elizabeth Boham
It doesn't make any sense. So we want to talk about what can we do? What can you do? How can you feed your child right from the start? And so the first thing we always talk about is the importance of breastfeeding.
We know that whenever possible, you want to breastfeed your child because it decreases their risk of obesity lifelong. So that is an important thing.
Dr. Mark Hyman
How does that work?
Dr. Elizabeth Boham
So, you know, that's a great question.
Dr. Mark Hyman
I have some ideas.
Dr. Elizabeth Boham
You know, you're shifting, it's the composition of the breast milk, you're shifting. There's better limitations on what the baby will consume. So when they're breastfeeding, they don't consume as much as when they're bottle fed. You know, the bottle feeding, you get more milk faster through a bottle than you do through a breast. And so that actually impacts the amount of calories that the baby consumes.
Probably issues, sure, there's issues with the microbiome that gets shifted through breastfeeding that is not happening when babies are bottle fed. There could be even what's in the bottle itself, So if the bottle is a hard plastic, we know, for example, BPA is impacting our metabolism and our Yeah,
Dr. Mark Hyman
because prediabetes has some Yes.
Dr. Elizabeth Boham
So there's probably so many issues
Dr. Mark Hyman
Yeah, what's fascinating is when you drink formula, it actually changes the microbiome and feeds bugs that are pretty toxic and create inflammation in the body. And what's really fascinating about breast milk is that there's all these undigestible fibers and starches in there called these oligosaccharides that have no nutritional value for the baby, but they're designed completely to feed the microbiome, which is just this beautiful sort of virtuous cycle that is allowing these kids to thrive and get healthy and reduce inflammation and really get them healthy. So not everybody can breastfeed, but it is really important. Think that's really key. What else can parents do?
Dr. Elizabeth Boham
You know, in avoiding those sugar sweetened beverages, as we've mentioned, that's, you know-
Dr. Mark Hyman
No liquid sugar calories, period.
Dr. Elizabeth Boham
Period. No juice. No juice, no sports drinks, no soda, I don't know, Kool Aid or any of those. There's just no need for any of it. It's empty calories, and there's no need.
Every once in a while, you can give a child some diluted 100% juice if you want to, but it's not necessary. It's not something they should have every day.
Dr. Mark Hyman
It's not part of their fruit and vegetable consumption?
Dr. Elisa Song
No, it's not part
Dr. Elizabeth Boham
of their fruit and vegetable consumption. So that's key. Getting your kids moving, getting them outside every day, that's really important. Unfortunately, it's harder to move these days unless you put it into your schedule, and we need to put it into our kids' schedule. We need to make it part of their day that they get out and they move and either they're playing a sport or they're just having fun.
They
Dr. Mark Hyman
spend some They're doing a of finger exercises on their phone.
Dr. Elizabeth Boham
Oh my goodness, the phone. Scrolling. It's making it so much harder for parents to help their kids grow and develop. So screen time, really, the recommendations are none for kids under the age of two. And then, you know, less than two hours after that, you know, you want to limit screens in the bedroom.
You know, there's no need for TV, phone, or computer in the bedroom. So you just have the kids not have it in there. It helps with their sleep, which is another thing that's critical. Most kids are not sleeping enough in this country, and that has a huge impact on their metabolism. We know that when we're sleep deprived, we're more likely to gain weight.
We have higher levels of insulin. We have higher levels of insulin resistance and metabolic syndrome. So, it's really important that you put restrictions on your children's sleep and wake cycle. That really is helpful. You know, our teenagers still need eight to ten hours a night.
Those six to twelve year olds need nine to twelve hours of sleep a night. And of course, the one to two year olds are needing eleven to fourteen hours. So, as you get younger, you're needing more sleep. But even though teenagers need eight to ten hours of night of sleep, and it gets harder when they get older. They want to stay up late.
They want to be on their phone. They want to talk to somebody. And it's really important. We know that children, in the children years, if they get to sleep before 8PM, they have a lower rate of obesity. They have a lower rate of weight gain.
They have less, of course, sleep deprivation. They get better sleep. We know that sleep deprivation, as I mentioned, increases insulin, it increases ghrelin, which makes them hungry.
Dr. Mark Hyman
Yeah, if you don't sleep enough, you're hungrier and you crave more sugar and carbs.
Dr. Elizabeth Boham
Absolutely. Then you create
Dr. Mark Hyman
It's true for adults as well, right?
Dr. Elizabeth Boham
It is. It creates this inflammatory process in the body that even if you're eating the right foods, you're more likely to gain weight, which I think is important to remember. That even if you're eating the right foods, if you're not sleeping enough, your metabolism can be messed up. I talk to my daughter about this one all the time.
Dr. Mark Hyman
I bet. You know, well, you know, the thing I often talk about is is how do you make your home a safe zone? Yes. I mean, you know, the kid who's three years old who's gaining weight or five years old isn't saying, hey, dad, can I have the keys? Go to car.
I'm going to go to McDonald's or I'm going to seven Eleven to get a big gulp. But they're not doing that. How do you make your home a safe zone? I think this is so important. Yes, it's Okay to have treats if you're making make cookies yourself, like make it from real ingredients.
Don't eat a ton of them. You can have stuff, but if you want french fries, make them yourself. You know, I think there's a level of responsibility the parents have, which was also important for themselves to actually create a safe home environment for their children. People put little things in the plugs. I mean, the kid is less likely to die from electrocution than they are from the bad food that you have in your cupboard than the Froot Loops you're serving them for breakfast or the French toast or the, you know, the sweetened yogurt, which has more sugar per ounce than a can of soda.
Yeah. So we really have to take that seriously. And in my house, you know, my my son once said, you know, dad, I wanted to buy my friends over, but there's nothing to eat in the house. Right? And of course, there was a lot to eat.
It just was stuff you had to cook and make. And it was, you know, real food. I said, Okay, let's go to the grocery store. I said, you can get it whenever you want, buy whatever you want. There's one condition and you have to read the label and it can't have any trans fats or high fructose corn syrup.
He's like, Dad, there's nothing to buy. Nothing. And I'm like, exactly like there are there are grocery stores where you can buy healthier forms of snacks. There are a place like Thrive Market. You go to thrivemarket.com and find delicious snacks that are lower in sugar, that are higher in protein, that have good fats that don't have all the refined starches and sugars.
So you can do it, but it takes a little work and it takes a little education. And I think that's the problem is we are we really aren't taking this seriously as a society.
Dr. Elizabeth Boham
And now your son is an amazing cook, and he loves to cook and make delicious food that I've gotten the great opportunity to consume. So, think we have to be getting our kids into the kitchen at a young age, when they're two, having that high chair or their bouncy seat right in the kitchen, getting them used to and around your cooking, getting them involved, having them have input, really is helpful. We don't want to be just like, Oh, you can't have this and you want to have this. You want them involved in the process. It makes it a lot better.
You want them having suggestions like, Let's come up together with some healthy food that you want to have tonight. What would you like to help me cook? Can you help with preparation, peeling or cutting or mixing? That really gets them involved, Yeah. And they become part of the the recipe and the preparation and then they love it more.
And then they they want to eat it more.
Dr. Mark Hyman
Yeah, like, and you can make cool stuff. It's delicious. Like, instead of making waffles from, you know, white flour, you can make wash waffles from cashews, for example. So I make cashew waffles or you make almond flour pancakes. So there's substitutes and swaps that kids can still have fun.
And, you know, you don't have to put a ton of maple syrup. Can use fruit, you can use fruit spreads. So there's a way there's a lot of hacks. When when my kids were young, we had a book called Pretend Soup, which was like 50 recipes that are fun to make with your kids, that have fun names that are delicious to eat, are made from real ingredients. And so so I think, you know, we all have to get back in the kitchen.
I think the average, you know, person in America spends more time watching cooking on television than actually cooking themselves. So I think we have to get back into the cooking situation. It doesn't have to be that hard. You know, we had a doctor dinner at our house the other night And, you know, you came a little bit late, but like George was there and I was there early and literally nothing was ready. And it was 05:15 and everybody's come over 05:30 and literally dinner was ready on the table at 05:45.
And we made this incredible meal. I just stuck some, you know, lion's mane's mushrooms in the oven. We we sauteed some Chinese cabbage and garlic, which took three minutes. We put a roasted salmon in the oven for twenty minutes and roasted squash, butternut and kabocha squash and tossed some cinnamon on there. And we just threw it all the oven.
Was almost like delicious.
Dr. Elizabeth Boham
It was delicious. It is
Dr. Mark Hyman
a gourmet meal, but it doesn't have to be so hard and it can be incredibly yummy and delicious.
Dr. Elizabeth Boham
And I think, you know, that was delicious. Thank you. And I think what's really critical is just recognizing how important it is to to be working right from the beginning, right when your kids are when they're born and early in life and not just sort of putting it off because it it really makes a huge difference for them later on.
Dr. Mark Hyman
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