The Dr. Hyman Show - Anxiety, Autism, Allergies: The Hidden Triggers in Children No One Talks About

Episode Date: June 23, 2025

Rates of chronic illness, behavioral disorders, and neurodevelopmental challenges are rising rapidly among children, often tied to underlying gut dysfunction, nutrient deficiencies, and environmental triggers such as toxins and ultra-processed foods. Conventional treatments frequently overlook these root causes, relying instead on symptom management or medication. Functional approaches emphasize foundational lifestyle changes—clean nutrition, microbiome support, movement, sleep, and stress reduction—as powerful tools to restore health. Children are especially responsive to these changes, often experiencing rapid and dramatic improvements in behavior, mood, and physical symptoms. With education, testing, and family-centered strategies, parents can take simple, effective steps to help their children thrive. In this episode, I discuss, along with Dr. Elisa Song, Dr. Suzanne Goh, and Dr. Elizabeth Boham why a root-cause approach is just as important for children, as it is for adults. Dr. Elisa Song, MD is a Stanford-, NYU-, UCSF-trained integrative pediatrician, pediatric functional medicine expert, and mom to 2 thriving children - and she is on a mission to revolutionize the future of children’s health. Dr. Song is the bestselling author of the Healthy Kids Happy Kids: An Integrative 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 bridge the gap between conventional and integrative pediatrics with an evidence-based, pediatrician-backed, mom-approved approach. In her integrative pediatric practice, she’s helped 1000s of kids get to the root causes of their health concerns and empowered parents to help their children thrive by integrating conventional pediatrics with functional medicine, homeopathy, acupuncture, herbal medicine, and essential oils. Dr. Song is chair of A4M’s pediatric education and has lectured around the world at leading integrative and functional medicine conferences and premier parenting events. She has also been featured in hundreds of top podcasts, print and online media outlets, including the Wellness Mama podcast, BloomTV, Forbes, Healthline, MindBodyGreen, National Geographic, PopSugar, Parents, Motherly, Parade, Verywell Health, and New York Post. Dr. Suzanne Goh, co-founder and chief medical officer at Cortica, is a Rhodes Scholar and graduate of Harvard University, University of Oxford, and Harvard Medical School who has spent decades working with autistic children. Her work as a board-certified pediatric behavioral neurologist, behavioral analyst, neuroscience researcher, and author led her to create the Cortica Care Model, an innovative, whole-child approach that combines optimal medical treatment with the most effective strategies for advancing cognition, communication, and behavior. Dr. Elizabeth Boham is Board Certified in Family Medicine from Albany Medical School, and she is an Institute for Functional Medicine Certified Practitioner and the Medical Director of The UltraWellness Center. Dr. Boham lectures on a variety of topics, including Women’s Health and Breast Cancer Prevention, insulin resistance, heart health, weight control and allergies. She is on the faculty for the Institute for Functional Medicine. This episode is brought to you by BIOptimizers. Head to bioptimizers.com/hyman and use code HYMAN10 to save 10%. Full-length episodes can be found here: How to Raise Healthy Kids: A Functional Medicine Approach The Surprising Causes of Autism & Why It's On The Rise Addressing The Root Causes Of Childhood Obesity

Coming up on this episode of the Dr. Hyman show. 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. I'm all about food first, but some nutrients like magnesium are nearly impossible to get enough of through diet alone. Our soils are depleted and things like sugar, caffeine, and stress drain our levels.

Magnesium supports over 300 functions in the body. Think metabolism, sleep, energy, pain, and more. That's why I recommend magnesium breakthrough by bioptimizers. It's the only supplement with all seven forms of magnesium for full body support. Get 10% off at bioptimizers.com slash Hymen with code HYMAN10. Before we jump into today's episode, I want to share a few ways you can go deeper on your health journey. While I wish I could work with everyone one-on-one, there just isn't enough time in the day, so I've built several tools to help you take control of your health.

If you're looking for guidance, education, and community, check out my private membership, the Hymen Hive, for live Q&As, exclusive content, and direct connection. For real-time lab testing and personalized insights into your biology, visit Function Health. You can also explore my curated doctor trusted supplements and health products at drheimann.com. And if you prefer to listen without any breaks, don't forget you can enjoy every episode of this podcast

ad free with Hymen Plus. Just open Apple podcasts and tap try free to start your seven day free trial. As a pediatrician, I always try to approach things with some fun, 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 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, the inevitable pushback, right? that for our children, when we do that as a family, even if they push back as teenagers, the inevitable pushback, right? My kids are pre-teen, teenagers, and there's gonna be pushback. That's part of life, right?

But if you lay those foundations, they're gonna go back to it. I mean, the teenagers who knew how to cook, right? I mean, they were much more likely to choose vegetables when they were off to college, right? I mean, it were much more likely to choose vegetables when they were off to college, right? I mean, it pays it forward. And so, you know, the gut reset is really akin to the five Rs 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, 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, right?

Maybe not, but an abnormal balance of bacteria, yeast, parasites, whatever else. I mean, viruses that we're not really yet able to measure yet, right? But the foundation of that reset, so the R, first RE, return, is returning to those five things for 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. Well, you can't heal your microbiome, you can't out supplement a poor diet and lifestyle 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. You know, they start sliding back, right? I mean, what we want is, I don't even wanna call it remission. I wanna call it, okay, this is your new state of health. This is your new normal now. And so I have parents who are kind of

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 in their pants pan-nest or when's the next time 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. It was so fun. I mean we taught all about their microbiome. But made it fun. I mean poop with kids, all about poop, right? And connected the dots to why 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 able to sleep in here. Or being better in school. Better in school, running faster down the soccer field. So connect to 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 25 grams of added sugar in a day. And look at this, they have like this package of whatever it is, let's say, or let's say boba tea, right? It's 35 grams 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, right? 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. So why not just do it for themselves, but for all their trillions of microscopic friends? You're not alone. You're not alone, 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 human cells. I mean, who are we really nurturing, right? 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? So how can we do each of those five things in a way that supports your buddies, supports you? And they were all into it. And 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.

So we've already talked about that, right? Fiber color fermented foods. Prebiotic foods. Prebiotic foods, right? Creating symbiotic meals, right? That means pairing a fiber-filled food with a fermented food. So, I mean, just think like yogurt and, you know, nuts 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. 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. Oh, that's crazy. And the list, it's called Everything Added to Food in the United States. I mean, what a silly list, right? But over 3,000 to make our food taste better,

sweeter, saltier, have a better mouth feel. I mean, it's creepy, right? It's bad, and these things aren't really food. and they're mostly not regulated. They mostly haven't been tested Yeah, they're often not allowed in other countries like in Europe. That's right. And and we use them here right now Get Kellogg is getting a bit of a backlash because it produces Foods in America that have certain colors and additives that they don't allow 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. 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 10 years ago.

You know, I 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? Right. Second of all, the American people, they actually prefer the brighter colors and they prefer X, Y, and Z.

I mean, come on. They might also prefer cocaine in every corner in a special machine. So it is true. I mean, Europe 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 tell you a quick story on just how we had had, before when we bumped into each other in the hallway and we were chatting about just how quickly kids can get better compared to adults. And kids aren't filled with all the toxins, whether they're physiologic toxins or environmental toxins and psychological toxins.

100% more resilient. And so small changes can have profound results. And 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 to me and said, I don't think this is just sensory issues, right? There's something else going on. Sat with a mom who was just exhausted, at her wits end. One of the things that was heartbreaking for her was her son. I mean, he just couldn't stay in touch.

So when she would kiss him, he would wipe it off, right? He just moved away from her hugs. I mean, that's heartbreaking as a mom. Yeah, of course. 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, what did you find?

Well, I mean, this kiddo did end up having PANS, okay? So that's sort of the backstory there. There was something different going on for his sensory issues. But as you were going- What is that you just said, PANS? So PANS, Pediatric Acute Onset Neuropsychiatric Syndrome. It's a mouthful, but it just means kids have these weird

neuropsychiatric problems, we don't know what it is. And it's called the syndrome, because we have no clue how to deal with it. That's right. But we actually do, from a functional medicine perspective. We do, we do, absolutely. And for some kids, an abrupt, pretty dramatic onset of OCD, food 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 mold, you know, mycotoxins. It could be infections. Like strep. Like strep. And when it's caused by strep, it's caused PANDAS.

So pediatric acute neuropsychiatric syndrome disorders associated with streptococcal infection. That's another mouthful. 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, as we were 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 diet.

It was like the Feingold diet, right? Feingold was this pediatrician back in the 70s who said food additives were causing ADHD. Yeah, and it's, I mean. There was something to it. For many. It's not in every case, but yeah. As a pediatrician, I think it's really important to not just say to do something, but make it concrete.

So we went through and figured 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. I mean, how about coconut water, right? But there are other hydration drinks that are much cleaner than the Gatorade, right? The Skittles, what could be replaced that with?

So we really concretely discussed what swaps to make. And then she went home, she was a little overwhelmed by everything, right, as can happen in that first visit. It's like drinking from a fire hose sometimes, but she was committed and mom took out the artificial dyes, sent me a message two weeks later. Two weeks, right, two weeks. I have the message from her in my portal

and it makes me tear up every time I think about it. And she said she just wanted 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. And he even asked for a hug. That's amazing. 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. Or maybe it's like your partner or your grandmother. I mean, we're not depriving your kids, right? We're helping them thrive. I mean, I wanna pause there for a sec because 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 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 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 kind of putting band-aids and everything and it can be 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 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. I mean, who gets kicked out of kindergarten? It was on ADD medications. And he had all these other issues that were not, quote, psychiatric. He had stomach aches. He had anal itching. He had asthma, he had allergies, he had headaches,

he had anxiety, he had insomnia, like he had a whole 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. And we did a bunch of testing and I want to talk about testing. Cause 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 efficient in almost everything in vitamin D, B6, magnesium, zinc, you know, just like omega-3 fats. He had high levels of all these trans fats in his blood.

He had from all the processed food, he had high levels of inflammatory fats. He had high levels of really toxic trans fats in his blood. He had, from all the processed food, he 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 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 the nutrients he needed, some multi vitamin D, fish oil, zinc, magnesium, B6. Two months later the mom brought him back and said he's a completely different kid. He's got no ADD, he's off all his medications, he has no more headaches, no more stomach aches, no more asthma, no more any of the other things

he was suffering with. He stopped drinking all the sodas and everything and was drinking all the junk food. And his handwriting, which was the thing that blew my mind, went from completely illegible to completely perfect penmanship. And I was like, wow, 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. And so whether a kid's got sensory or behavioral issues or the kid's got allergic or autoimmune issues,

it's so important to get a proper evaluation. When I was just starting my medical journey as an emergency room physician, magnesium It's so important to get a proper evaluation. When I was just starting my medical journey as an emergency room physician, magnesium was a critical element of our care. We used it to treat all kinds of conditions, from arrhythmia to constipation to preeclampsia. It turns out that magnesium is critically important outside of the emergency room too. In fact, it's one of the most important minerals for all aspects of health. It participates in over 300 different biochemical reactions in your body.

Yet over 60% of the population doesn't get the amount of magnesium they need from their diet alone. That's why I'm such a big advocate of bioptimizers. Their magnesium breakthrough supplement is the only supplement on the market that offers the full spectrum of all seven types of magnesium specially formulated to reach every tissue in your body to provide maximum health benefits. That's how you. magnesium specially formulated to reach every tissue in your body to provide maximum health benefits. This height. Bio-Optimizers is offering my community 10% off.

Just head over to bio-optimizers.com slash Hymen with code Hymen10. That's bio-optimizers.com slash Hymen with code Hymen10 at checkout. 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're talking about. And 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 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 going to have consequences their whole life long from these conditions. And then maybe allergies, tolerance to 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? With the

child present too. I mean 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 with the whole plan is really important, that they understand. Because if mom comes home and just says, okay, we're gonna overhaul your diet and all, I mean, it's not necessary for some kids in my, but for many kids, it's not gonna work, right?

I've got to show the kids their test results, like here, look at this, you're allergic to gluten, or look at this, you've got, yeah. Across 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 that's so many kids are suffering from anxiety nowadays and when I tell them that 80 to 90 percent of the serotonin in their bodies is made by their gut microbiome, right? And then usually there's a pause and parents and kids are like, what?

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, right? It's not just about like what you're eating. you're eating, it's about, okay, what factors are harming your gut microbiome, and guaranteed no matter what kids have, we can kind of link it to that. That's an easier way, I think, to have a conversation around food. Interesting.

And you have to work with their goals, right? For parents, it might be to... What do they want? They want to feel better, don't have stomachaches, they want to do better in school, they want to... Yeah, yeah. The foundations, as you said, I mean we always talk about the foundations

of food as medicine, that sometimes is the hardest thing to change, honestly, right, for a lot of kids, and talking about, I mean, even for this one teenager who came in and he's been gluten free on and off, and I mean, he knows it makes a huge difference for him, but he was having a flare of his... Sometimes the kids just wanna eat that pizza. him, but he was having a flare of his... Sometimes the kids just wanna eat that pizza.

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, right? 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, you know, 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

and make them with information. Right. Um, but the foundations really, you know, in healing the gut are, I mean, the foundations, right? Do you test kids? I mean, do you do testing and. So I do.

I mean, when I, the first thing I'll test is blood work for nutrient deficiencies. So what do you have to optimize? So the foundations are the CBC, I do a ferritin. Yes, complete blood count, a ferritin. Which looks at iron. 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. Yeah, pre-diabetes in kids, right? Yep, even for kids that don't fit the overweight profile. Can you measure the insulin levels in these kids? 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. I mean, because it's just the average blood sugar. So if they're, most kids are kind of rollercoastering up and down, right? So if they have low lows and high highs,

their A1C might look perfect, right? I do a red blood cell zinc, a red blood cell magnesium, 25 hydroxy vitamin D. So those are kind of my foundations. I do an omega-3 profile. It's not always available, but I do add that omega-3 and And those are kind of my foundations. Omega-3s? I do an Omega-3 profile. It's not always available, but I do add that Omega-3 and my Omega-6 profile. And also for the young kids,

you can only take so much blood at a time. But those are my foundations. Lately I've been really trying. And are you seeing a lot of nutritional deficiencies in these kids? 100%. 100% of kids have a nutrition. I'm not gonna say 100%, maybe 99.9%.

Okay, that way, just stop right there. So what you're saying is, in the world's most affluent country, where you're probably seeing a fairly high-end population of people, not people who are highly underserved. Many who are already healthier. Already quote healthier, parents are very proactive, they're coming to see you.

In this population, you're seeing almost 100% of kids have one or more nutrient deficiencies. And I'm gonna say, I'll back that up a little bit and say nutrient deficiencies and insufficiencies. Yeah, so not optimal levels. Yes, so suboptimal, bottom of the barrel, right? And 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, um, 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 glyph depleted from the glyphosate from you know, we're not talking about processed food We're talking about like fruits and vegetables. Yes Yes, it should be nutrient dense, right? So that's why even kids who have the quote healthiest diet It's it's not uncommon to see these Nutrient deficiencies and by the way what you're talking about, is not something that most doctors or pediatricians will check. They don't check nutrient levels on a kid. This is not done. Maybe you'll do an iron level on a little kid,

but that's really unusual. 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, prilocaine numbing cream that is magic. You put it on your elbows and I mean kids just have- Is that Emla? Emla, it's Emla cream. E-M-L-A.

Yep, I would highly recommend that 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, right? This is, screen time has a pass for this where they can watch Dora, they can do whatever, right? So our food is depleted, ultra processed foods deplete our nutrients even further.

Explain why. Well, so some of these kind of anti-nutrients, right? I mean, they compete with absorption for our proper nutrients, even if we're kind of pairing it with healthier foods. And ultra processed foods, they're devoid of most nutrients anyway. 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 and methyl cobalant. Well, they add them to enrich the food. But they have to add back vitamins and minerals. I always say they're enriched because they're so impoverished in the first place.

Yeah. That's right. Why would you need to add back nutrients to a food, to a real food? Right. And so, and I also think our kids have a higher That's right. Why would you need to add back nutrients to a food to a real food, right? And so and I also think our kids have a higher need For nutrients, yes, we have more stresses, more toxins. Yep, 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. Also, when you eat ultra processed food, you're not getting all the cofactors that you need to metabolize that food. So 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. I mean, yeah, it's like a double, triple whammy. And zinc especially, just as a little pearl for parents listening and for practitioners,

if you have kids who are super picky, sensory, cover their ears when they're in a public toilet or the kids have to leave if they run the blender or the vacuum or maybe they 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, 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 to 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 20, because I had to tie their shoes over and over again, because they weren't tight enough, right? Or palate is actually expanding a little bit. It could be as simple as 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 that. You ever use a zinc taste test? The tally. Use a zinc sulfate. Yeah, I mean, sometimes it's harder for kids, but yes. You basically take this zinc liquid, and if you don't taste anything, then you're deficient.

That's right, yeah. So instead of doing a blood test, you can actually do a, just like a test in the office or at home. Totally, yeah. With zinc sulfate, yeah. So this is amazing. so that sort of speaks to the need 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 non-negotiable? And what should kids be taking? Especially if I don't. And not Flintstone vitamins. 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 going to 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 tests because they're so much easier to get. So much easier to get a poop test and a blood test sometimes.

A pee test. Than a blood test sometimes. If we wanna look at methylation stress, you can look at methylmalonic acid or FIGLU for mimino glutamic acid, right? These are just markers of folate or B12 deficiency that you can see in the urine. Yeah. And then even on stool testing, if I see inflammation or digestive insufficiency,

right, they're not digesting, they're not absorbing their fats or their proteins or their carbohydrates, I might do digestive enzymes. But across the board, I 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've measured kids, they are not optimal. Yeah, that's true. 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. And unless you're running around half naked in a bathing suit for at least half an hour a day, from 10 to two in the afternoon. Not lathered in sunscreen. Not lathered in sunscreen, you're not around half naked in a bathing suit for at least half an hour a day, from 10 to two in the afternoon. Not lathered in sunscreen. Not lathered in sunscreen. You're not gonna get exposures

that are gonna make a difference. Maybe for a life card you'll be all right. But I'm not. That might be fun. But so almost all kids, and I would bet their parents who need vitamin D, so vitamin D3, do they need K2? I'll add K2 when they get older for sure for teenagers almost all kids need an omega-3

Yeah, a fish oil right important for ADD depression skin health hair all of it Yeah, kids hormones if if kids have atopy eczema asthma. I'll make it a 369 fish oil Omega-6 supplement with GLA. So that's an omega-6, guys, found in borage, black currants, evening primrose. It's really good for autoimmune and atopic conditions. Yeah, people think all omega-6s are bad.

They're not, they're not good or bad. It's the quantity we have, and certain types are actually really beneficial, like you're talking about GLA, which is from evening primrose or borage oil. Yeah, yes, it's 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.

You haven't found one? I mean, I found a few that I'm okay with, right? And none is perfect, but there's some that are better than others. What I would move away from are some of the over-the-counter. Gummy vitamins. Gummy vitamins. Now some, like we carried a gummy line that was awesome

because each gummy only had.5 grams of sugar. But some of them, if kids are getting the gummy vitamin D and some extra gummy magnesium and gummy vitamins. I mean, in that handful of gummies that they're gladly chomping away on 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 a mouthful of sugar How parents go about finding good products like you know omega-3 vitamin D and multi Maybe zinc if they needed magnesium Obiotics, I mean, it's kind of a zoo out there to find the right it is it is kind of a zoo I mean I use the practitioner brands brands right because I available to consumers. That's right brands, right, because I. But they're available to consumers. That's right.

Like pure encapsulations or. Designs for health now is available to consumers. 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, you know, storing, handling things well. If you're going to buy from Amazon,

make sure you buy it from the manufacturer's store, not from like Judy's health food store. Yeah, because a lot of these, like they might buy a lot that someone's expired, they might have it on sitting on the tarmac, you know, in a warehouse that's at 120 degrees and it's a problem out there. So you have to be careful for products you buy on Amazon. In just the past 20 years alone, the prevalence of autism has risen 400%. 400%. 400%.

400%. 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. 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 hundred different genetic variants that we know can influence brain development in a way that can lead to autism. It's usually not just one. So genetic susceptibilities. Genetic susceptibilities. It's usually a complex interaction of many. Many genes, right.

Yes. 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,

its 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 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 blood, on stool, on urine. Always, 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. 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. Yeah. Looking at toxic load, at urinary organic acids, at nutritional levels, or methylation, and all these genes that are in combination.

I've often said that environment is a big factor, but genes load the gun, the environment pulls the trigger. Yeah. So it's a sort of interplay, an environment across these kids' genetics. And I've seen this, you know, I've seen all these different genetic patterns of low glutathione genes and methylation genes

and detoxification genes that are really common in these kids and they tend to be sort of at risk you know and I think you know one of the things that really struck me when I started learning about this was the work of Martha Herbert and I'm sure you know is another Harvard neurologist who studied autism and brain imaging yeah and she you know she talked's another Harvard neurologist who studied autism and brain imaging. Yeah, and she, you know, she talked about these biopsy studies on kids who accidentally died with autism. And all these kids have massive amounts of neuroinflammation. Their brains are on fire. And when your brain is on fire, it's hard for it to function. And Alzheimer's is a brain on fire. Depression, now know is a brain on fire, right? Schizophrenia we now know is a

brain on fire. So what's causing the fire? Yeah. Well, we actually, so, you know, prior to establishing Cortica, I was on faculty at Columbia university and we did, we had an NIH funded research program using multimodal brain MRI to study autism in children and adults. 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. And when, 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, chronic, smoldering types of inflammation.

And the research is really pointing to autism falling within that second category. Yeah, it's not encephalitis you get from right a virus Yeah, and angitis. It's it's really a much more slow. Yeah, insidious Yeah, and harder to detect some of our test, you know, it 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 this, the mitochondrial dysfunction, which is linked to this chronic low-grade inflammation is influencing the function of the brain and autism, and it's also quite dynamic.

So it's not, there's a term used for a very long time in pediatric neurology called static encephalopathy and that couldn't have been, now we know it couldn't be farther from the truth. The brain is not at all static. It's extremely dynamic and influenced by so many factors and so we, you know, 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 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, the socialization, communication, executive function, anxiety, not to mention endurance, stamina, physical health. So just tremendous benefits to some of those lifestyle changes.

And it's an anti-inflammatory for the brain. Yes. And it increases new brain connections. That's right. With BDN changes. And it's an anti-inflammatory for the brain. Yes. And it increases new brain connections. That's right. With BDNF, right? Brain-derived neurotrophic factors, like miracle growth for the brain. Yes.

So yeah, that's amazing exercise. So huge, huge benefits. The second category, changes to the diet. Third, related to that, dietary supplementation. Wait, wait, before you go off the diet, go, don't just like bump right over that. There's so much to say about that. What role does nutrition play?

Because I want to go slow with these six things. You've got a lot in there that's really powerful and very unique. So what is the role of nutrition and diet in autism? 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 beings. For all of us, yeah. Yeah. And for, in autism, there's a lot of interest in diet.

There always has been. But I think some of that interest is- That's supposed to be healthy, but as a therapeutic tool. Yes. The emphasis in the past has been on various types of elimination diets. So diets where you remove something from the diet. Like gluten or dairy, which is the most common, right?

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. Right, very particular, right. Or what this reduced flexibility.

Pick eaters basically. Yes. And so the diet often is very, very limited already to begin with. And also often limited to highly processed foods. So if you remove. Mac and cheese diet. That's right, or 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 foods. Let you add, right?

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 child. 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, then there are a lot of elimination diets worth exploring. So we do know that, for example, celiac disease, gluten allergy is more common. It's actually considered a co-occurring condition. Yeah. Isn't it like six or 17% of kids with autism have elevated gluten antibodies? I don't know the exact percent, but it definitely 20% of schizophrenics. And yeah, it's more common in autism and, and the

signs may be a little bit harder to detect also in a child who has behavioral differences already, who may, may have a harder time communicating. We call these co-occurring or comorbidities, but that's really a false term. These are things that are all interrelated. They are very interrelated. They are very interrelated, yeah.

But it's been a huge step just to get to the stage of thinking of co-occurring conditions. But you're right. Why do they co-occur? Because they all have common underpinnings. Yeah, and the gluten triggers leaky gut, which creates inflammation in the body then inflammation in the brain.

So we know that gluten can be really a problem for a lot of brain issues. So sometimes that's a big factor. And 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? Yeah, so what's very interesting about dairy is that there's some research suggesting that it can interfere with folate metabolism. Yeah, um, that's right. So, um, so there are some tests available to look at folate receptor antibodies, for example. Yes, and then those for years reduce on a dairy free diet. So All of that's very important information to get for a child. Yeah. So what you just said in english for everybody Basically what happens when you eat dairy All of that's very important information to get for a child. Yeah. So, so what she just said in English for everybody,

basically what happens when you eat dairy, there, there are antibodies that form your immune system, produce 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, you know as you're saying it's not one thing

There's like no one thing to do but there's many things to do that is personalized based on what you find in each kit Exactly. Yeah, exactly. And so so it means looking at a lot of things. You know, we do pretty intensive, for example, genetic testing because those genetic markers are very helpful information. 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, right? Yeah, genes that relate 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. 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? That's also a huge misconception. I 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. And there are, as you know, lots of technologies now that actually do change genes in various ways. And so it's that the future of gene modification, gene therapy is on the horizon.

Yeah, it's pretty exciting. Yeah. So you combine this sort of genetic testing with other things that look at nutritional factors and dietary testing. So you mentioned, we could spend the whole time on diet because I think that plays a role. I actually had a kid, I remember,

who many kids respond to gluten dairy-free diets and you're right, you have to add in real food. You have to kinda get them. That's a really important point. But one kid was really violent. He was like an eight-year-old autistic kid and it 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, completely changed him. He became more normal, no violence, got more speech. All the autistic features kind of regressed. I wouldn't say he was perfectly normal, but he went from like a non-functioning, non-verbal kid

to a more kind of normal kid. And so that taught me a lot. It's like, wow, these kids, something in these kids' diets can be playing a role. 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. Change is very hard, change. Especially for children. It's very hard, yeah. Particularly for these kids because they're so picky. You mentioned the next step, which was supplements. Yeah, so dietary supplementation can be very impactful as well. So there's so much to potentially say

about this area too. But I think as it 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. Like carnitine or? Like carnitine levels, coenzyme Q10, liver function,

lactic acid, mesocarnitine profiles, urine organic acids, amino acids. So there are a lot of markers. Not what you're gonna get at your typical checkup with your regular doctor. So if you go to your regular a lot of markers. A lot of what you're getting at your typical checkout with your regular doctor. So if you 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 in your centers do all this, which is really revolutionary. And fortunately more and more. I think the base, because the research has really. Caught up. Yes, so there's more awareness now, but it's still a work in progress. So you're actually testing their mitochondrial function through tests that are

available. Yes. And then you're customizing the treatment based on what you find. That's exactly right. So for example, if there are levels that are low, so, so, you 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 a sort of an energy currency or powerhouse. But there are things like low carnitine levels

or even supplementation with carnitine, supplementation with creatine. It's like what bodybuilders use. Yes. But it's a mitochondrial cofactor. 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.

That could help a lot with their learning and their development. I know, and when I first learned about your work, I read some of your papers that looked at brain imaging and the metabolic function of the brain, meaning the mitochondrial function of the brain. And you're some of your papers that looked at brain imaging 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. And that led you to kind of go, well, maybe if we tried to correct some of these mitochondrial pathways, which we learned about with these inherited metabolic mitochondrial diseases that are really rare, we 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 mitochondrial therapy. What did you find? Well there 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 and 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- You mean supplements just don't cause expensive urine, as most doctors say? No, they can, when they're matched,

when you have the right supplement for the right person. Exactly, right. They can just- Personalized nutrition. Yeah, yeah. So you use these compounds in- Yes, so as an example, 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 months to three years of age. And it also is often associated with what we think of in medicine as a physiological stressor. So, you know, 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. So. I'm gonna jump into a really controversial topic, which I'm sure you know this guy's 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? And the reason I say that is I had a kid who was 22 months old, perfectly normal kid. His mother worked for a major pharmaceutical company and he had a vaccine at 15 months and started to progress and lost all his developmental milestones, became nonverbal and fully autistic.

And so I don't know if that was a 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 gotta be something there. And I'm not saying vaccines cause autism, but they may affect a kid who's vulnerable, who 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 born by C-section. They don't breastfeed. They've had lots of ear infections. They've had lots of antibiotics and microbiome's messed up. And so they're kind of sitting ducks and maybe they have all these polygenic risks for getting into trouble when they have an insult. So could this play a role? What's your take on this?

Well, I will say, and you're right, vaccines is a topic that unfortunately is so polarizing in autism. Pro life or pro choice. Like it's so, it's pro choice. It's not religion. Let's talk about the science. So 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, 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. Yeah.

So, and I think as physicians, we all have very, when a patient comes to us and the, 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. 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. I think now doctors are partners. Doctors shouldn't be viewed as authorities or those who have the answers. Amen.

So, yeah. Um, so, um, yeah. So when, when children, especially when children go through a period of developmental plateau or regression for, 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.

Time is brain. Time is brain. And it first developed around stroke to get people to act more urgently around stroke. But I think time is brain really applies also to autism. Yeah. And why is it that a child might be diagnosed with, sometimes a child will have the first signs of autism

at a year or 18 months, 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 to improve brain function. There are certainly medications but not

just you know... Hyperbaric oxygen I've seen used. Yeah there are there are 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, 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. The average child is consuming 270 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 2 diabetes, and metabolic issues throughout their whole life. As we've talked in the past, all about how that shifts your fertility. And I mean, there's so many aspects to it.

So, I mean, that's a great place to start. And no, really most of our kids, all our kids, very few of our kids need any sort of sports drinks at all. Energy drinks, sports drinks, juice boxes. Yeah. I mean, it's terrible. One soda increases a kid's risk of being obese by 60%. Energy drinks, sports drinks, juice boxes. Yeah. I mean, it's terrible. One soda increases a kid's risk of being obese by 60%.

One soda a day. It's crazy. It's pretty crazy. And it's a huge part of their caloric intake. It's up to 15% of the average kid's intake. And it's something that's just so unnecessary. I was at a conference on childhood obesity and it was in Atlanta and Bernice King was there.

It was really fascinating. It was with 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 has a pediatric liver. I'm like, he said, here he's a uh pediatric liver i'm like he's a well you know we're seeing enormous rates of fatty liver in kids and we're seeing teenagers on the

transplant list for livers yep all because of insulin resistance and mostly from sugar sweetened beverages yeah right from high fructose corn syrup which 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 starred in well not really starred 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. I mean there's a kid who's 16 years old who needs a gastric bypass Right, right

Huge that makes sense. It doesn't make any sense. So we want to talk about what can we do? What can you do when you know, how can you feed your child right from the start? Right, and so the first thing we always talk about is the importance of breastfeeding You know, we know that whenever possible you want to breastfeed your child because it decreases their risk of obesity lifelong So, you know that is an important thing. How does that work? So that's a great question. I have some ideas, but I want to hear your idea.

You're shifting, it's the composition of the breast milk. 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. There's 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, right? So if the bottle is a hard plastic, we know, for example, BPA is impacting

our metabolism and our weight. Pre-diabetes. Yes, so there's probably so many issues with breastfeeding breast and our weight. Yeah, cause it's pre-diabetes and some resistance. Yes. So there's probably so many issues with breastfeeding versus bottle feeding. Yeah, I mean 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 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. I think that's really key. What else can parents do? Yeah. And avoiding those sugar sweetened beverages, as we've mentioned, that's- No liquid sugar calories, period. Period. No juice. No juice, no sports drinks, no soda, you know, no, I don't know, it was, you know, Kool-Aid or any of those.

There's just no need for any of it. It's it's empty calories and there's there's no need every once in a while. You know, 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. And and some part of their fruit and vegetable consumption. No, it's not part of their fruit and vegetable consumption. So that's key.

Getting your kids moving, getting them outside every day, that's really important. It gets them, 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 they either they're playing a sport or they're just having fun and they, you know, they spend some time. They're doing a lot of finger exercises on their phone. Oh my goodness, the phone. It's you know, it's-

Scrolling, tapping, liking. It's making it so much harder for parents. 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 a TV, a phone or a 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 10 hours a night. Those six to 12 year olds need nine to 12 hours of sleep a night. And of course, you know, the one to two year olds are needing 11 to 14 hours. So, you know, as you get younger, you're needing more sleep.

But even though teenagers need eight to 10 hours of sleep, and that's, you know, 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, you know, it's really important. We know that children in the children years, if they get to sleep before 8 p.m., they have a lower rate of obesity and they have a lower rate PM, they have a lower rate of obesity and 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. Yeah. If you don't sleep enough, you're hungrier and you crave more sugar and carbs. Absolutely. And then you create this- That's true for adults as well.

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. I bet. Well, the other thing I often talk about 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 7-eleven to get a big gulp. 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. you're making make cookies yourself like make it from real ingredients Don't you know eat a ton of them you can have stuff But if you want french fries make them yourself, you know like I I think there's a level of of responsibility that the parents have which was also important for themselves to actually create a Safe home environment for their children. They 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 then the fruit loops you're serving them for breakfast or the French toast or the

You know that 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 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 you you there are there are grocery

stores where you can buy healthier forms of snacks. There are a place like Thrive Market, you can 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 really aren't taking this seriously as a society. 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, I mean, I think we have to be getting our kids into the kitchen at a young age,

as even 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, you know, really is helpful. You know, we don't wanna be just like, oh, you can't have this and you wanna have this. You want them involved in the process. It makes it a lot better.

You know, you want them having suggestions like, well, you know, let's come up together with some healthy food that you wanna 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 and they become part of the recipe and the preparation and then they love it more and then they want to eat it more. Yeah, and you can make cool stuff that's delicious. Instead of making waffles from white flour,

you can make waffles from cashews, for example. So I mean cashew waffles or you make almond flour pancakes So you get their substitutes and swaps that kids can still have fun And you know, you don't have to put on ton of maple syrup. You can use fruit. You can use fruit spreads So there's a ways there's a lot of hacks when I 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 that are made From real ingredients and so so I 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 uh, you know You came a little bit late, but like but George was there and Todd was there early. Literally nothing was ready and it was 5.15 and everybody was coming over at 5.30. Literally dinner was ready on the table at 5.45 and we made this incredible meal. I just stuck some lion's mane mushrooms in the oven. We sauteed some Chinese cabbage and garlic, which took three minutes. We put a roasted salmon in the oven for 20 minutes

and roasted squash, butternut and kabocha squash and tossed some cinnamon on there. And we just threw it all in the oven. It was almost like delicious. It was delicious, Mark, thank you. It was a gourmet meal, but it doesn't have to be so hard and it can be incredibly yummy and delicious. 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 really makes a huge difference for them later on. Don't forget, there's a way to listen completely ad free. With Hymen Plus on Apple Podcasts, you can enjoy every episode without any breaks.

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