The Dr. Hyman Show - How To Prevent Childhood Obesity And Create Health For Our Kids

Episode Date: April 15, 2022

This episode is brought to you by Athletic Greens and Rupa Health.   The foundation we set for our children’s health in childhood—starting even before conception—will carry them throughout their lives. Yet a third of all American children are overweight or obese, and we are seeing an increase in type 2 diabetes in children.    In today’s episode, I talk with Dr. Elizabeth Boham, Sam Kass, and Dr. Tracy Shafizadeh about the urgency of prioritizing and establishing good nutrition habits in infancy, in the home as the child grows, and in school.    Dr. Elizabeth Boham is a physician and nutritionist who practices Functional Medicine at The UltraWellness Center in Lenox, MA. Through her practice and lecturing she has helped thousands of people achieve their goals of optimum health and wellness. She witnesses the power of nutrition every day in her practice and is committed to training other physicians to utilize nutrition in healing.   After cooking for the Obamas in Chicago for two years, Sam Kass joined the White House kitchen staff in 2009. During his White House tenure, he took on several additional roles, including Executive Director of First Lady Michelle Obama’s “Let’s Move!” campaign and Senior White House Policy Advisor for Nutrition. As one of the First Lady’s longest-serving advisors, he helped Mrs. Obama create the first major vegetable garden at the White House since Eleanor Roosevelt’s victory garden. Currently, Sam is a partner at Acre Venture Partners. Acre is a venture-capital fund investing in the future of food with a mission to improve human and environmental health in the food system. The fund focuses on early-stage, highly disruptive impactful companies in the food system focused on agriculture, the supply chain, and the consumer. Sam is also the author of Eat a Little Better: Great Flavor, Good Health, Better World.   Dr. Tracy Shafizadeh is leading the work in understanding the infant microbiome. She is a nutritional scientist who helps new and expectant moms learn about creating healthy gut bugs in their babies. She translates her extensive scientific knowledge of breastmilk and the gut microbiome into practical terms to help parents understand how a balanced gut from infancy can lead to a healthy immune system and metabolism for life. Dr. Shafizadeh received her PhD in nutritional biology from the University of California, Davis, and spends her free time "loving the guts" out of her two boys.   This episode is brought to you by Athletic Greens and Rupa Health. Right now, when you purchase AG1 from Athletic Greens, you will receive 10 FREE travel packs with your first purchase by visiting athleticgreens.com/hyman. Rupa Health is a place where Functional Medicine practitioners can access more than 2,000 specialty lab tests from over 20 labs like DUTCH, Vibrant America, Genova, and Great Plains. You can check out a free, live demo with a Q&A or create an account at RupaHealth.com. Full-length episodes of these interviews can be found here: Dr. Elizabeth Boham Sam Kass Dr. Tracy Shafizadeh

Coming up on this episode of The Doctor's Pharmacy. The average two-year-old can recognize junk food and call for it by name when they go to the grocery store and they can't even walk. Hey everyone, it's Dr. Mark. One of the most important tools I have for helping my patients optimize their health is testing. And that is why I love what Rupa Health is doing. Functional medicine testing can require placing orders with lots of different labs, and it can kind of get really complicated for doctors and their patients to easily access results and keep track of everything. But Rupa Health has totally streamlined that process. Looking at hormones, organic acids, nutrient levels, inflammatory factors, gut bacteria, and so many other internal variables can help us find the most effective path to health and healing. I'm really

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All you have to do is visit athleticgreens.com forward slash hymen. Again, that's athleticgreens.com forward slash hymen to take ownership over your health and pick up the ultimate daily nutritional insurance. Now let's get back to this week's episode of The Doctor's Pharmacy. Hi, this is Lauren Fee and one of the producers of The Doctor's Pharmacy podcast. A third of American kids are overweight or obese. And in addition to raising rates of

childhood obesity, we're also seeing a significant increase in type 2 diabetes in children. This may sound alarming, but the good news is that there are many things we can do to change the trajectory of our children's health. In today's episode, we feature three conversations from the doctor's pharmacy about the importance of childhood nutrition. Dr. Hyman speaks with Dr. Elizabeth Boehm about how we can address the skyrocketing obesity epidemic in our children. He also speaks with Sam Kass about the importance of nutrition in school programs, as well as with Dr. Tracy Shafizadeh about the role of a healthy microbiome starting at birth. Let's jump in. When a child gets obese or overweight as a child, it makes it so much

harder for them when they're an adult. Kind of programs them. It programs them, it gives them extra fat cells, it makes it very hard for them to maintain a normal weight as an adult. Prevention is really key here. It's very important that we deal with prevention because it makes it easier for that child for their whole life if we prevent that weight gain in the first place.

And it's not just the health consequences, which are staggering, right? Increased heart disease, gallstones, fatty liver, sleep apnea, high blood pressure, asthma, sleep apnea, all kinds of orthopedic problems. Those are bad enough. But it is the worst stigma for a kid to be overweight. I mean, they've studied kids and they'd rather hang out with a kid in a wheelchair who's a quadriplegic than a kid who's overweight.

Yeah. That's how bad the stigma is. Yeah. And we often stigmatize each other and the kids because we have this view that it's personal choice. that are designed to hijack your brain chemistry, hijack your hormones, hijack your metabolism deliberately, designed by food companies in taste institutes who hire craving experts to create the bliss point of food. I'm not making this up. Literally, the terms they use in their internal corporate documents to create heavy users, I mean, this is just criminal in my view. Yes. It's criminal. And the food marketing to kids, I mean, the average two-year-old, you know, barely talk, but they can recognize junk food

and call for it by name when they go to the grocery store and they came and walk. Yep. You know, that is terrifying to me. And kids can't distinguish on television or an ad between reality and fiction until they're eight years old. Yep. And there's now stealth marketing, which is terrifying because, you know, kids see, you know, thousands and thousands, maybe 10,000 commercials a year

on television. But Facebook, for example, had 5 billion with a B, billion ads for junk food targeted at kids in one year. How do you fight that? It's so hard. It's so hard to fight it. But it's important. I mean, when you go, when you bring your child to the doctors, what you're looking at, they look at the growth chart and they look at the BMI. And if, you know, the BMI or body mass index is not a perfect marker. I mean, there's problems with it, but it is something we use as a guide, and it can give you some indication of where your child's at. So if you're greater than the 85th percentile for your child's age and sex, they're considered

overweight. And greater than 95th percentile on that growth chart, you're considered obese. And now we have a category for the severe obesity, which is super obese, which is 20% over that 95th percentile. And, or BMI- It's not going to be more than 100%. I know. It's like you're 120%. Right. And so if your BMI is greater than 35 for a child- Just to put that in perspective, you know, these percentile graphs are made on population data where they look at the entire population and

the whole population has to fit into 100%, right? Zero to 100. Now they had to create a new category of 120% or more. Yep. Well, how does that happen? It happens because the entire population shifts into a category that never existed before. There were no kids who were that overweight unless they had some weird genetic disorder, like, you know, Pickwick syndrome or something. I think we are really in this crisis now because we're

threatening the next generation of our entire human race. And this is happening globally. It's not just here. Absolutely. We see it's 5% of children or adolescents in the US. And for those teenage years, 7% of girls and 9% of boys are in that severe obesity category. And as you mentioned earlier, a third of children are either overweight or obese. And as we have just talked about, prevention is key here. That's just making it so much harder for them throughout their whole lives. And whatever we can do at this stage of the game with your young children, whatever you can do at this stage of the game with your young children, whatever you can do at this stage of the game is really critical for setting them up for success. And it's often a lack of education, awareness, understanding.

It's generational. It's food apartheid, which is this term that's been used over the last few years by people in these communities to talk about what's really going on. Because a food desert sounds like a natural phenomenon. Oh, it's a desert. It's a forest. It's a river. No, this is much more serious. This is segregation and division of our culture in ways that lead and perpetuate to racial injustice, to structural racism and structural violence that drives these communities to continue to suffer from chronic disease and health disparities and obesity.

I mean, the average African-American kid drinks twice as much soda as a white kid. Not because they like it more. It's because there's just a lack of education, awareness. And there's also increased pressure of marketing in these communities. I mean, every time there's a food stamp coming out every month and you get your food stamps for the month, the local bodegas will actually put giant ads up for, you know, get your two liter bottle of soda, we take EFT, electronic funds, whatever they call it, EFTs. It's just unconscionable to me.

And it's terrifying to me because we're really threatening the next generation of our population. And if we don't stop and take care of this now, it's terrifying. Harvey Karp, who's a friend, a physician, who's a pediatrician, said, you know, if a foreign nation were doing to our children what we are doing, we would go to war to protect them. We would go to war. We are not doing anything to protect our kids. Nothing. We're not limiting food marketing. We're not getting rid of all these junk crap foods that they're targeting kids. We're not fixing the school lunch program.

School lunches are better because of Obama's Healthy Hunger Free Kids Act, but it's still not where it needs to be. A pizza is still a vegetable. Yeah. And I mean, that's a great place to start is just with the added sugar. I mean, they say that 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 two diabetes, and metabolic issues throughout their whole life. You know, as we've talked in the past all about how that shifts your fertility and your 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, 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, well, 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, right? Yeah. 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 starred in. Well, not really starred in, 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. How does that make 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 there's you really How does that work? So, you know, that's a great question. I have some ideas, but I want to hear what you're like. 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.

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. Yeah, causes prediabetes and insulin resistance. Yes. So there's probably so many issues with breastfeeding versus bottle feeding. Yeah. with the with yeah it was fascinating is when you drink formula it actually changes the microbiome

and and feeds bugs that are pretty toxic and create inflammation in the body yeah and what's really fascinating about breast milk is that there's all these undigestible fibers and starches in there called these oligosaccharides that, you know, 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. I think that's really key. What else can parents do? You know, and avoiding those sugar-sweetened beverages,

as we've mentioned, that's, you know- No liquid sugar calories, period. Period. No juice. No juice, no sports drinks, no soda, you know, no, I don't know, you 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 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 it's not part of their fruit and vegetable consumption. No, it's not part of their fruit and vegetable consumption. So that's it. That's key. You know, 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 either they're playing a sport or they're just having fun. And they spend some time – They're doing a lot of finger exercises on their phone. Oh, my goodness. The phone. 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 wanna limit screens in the bedroom. 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, we, 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 night of sleep, and that's, you know, 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, 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 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, 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. You know? Well, the other thing I often talk about is how do you make your home a safe zone? Yes. I mean, a 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 a 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. If 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, I think there's a level of responsibility that 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. Then the Froot Loops, you're serving them for breakfast or the

French toast or the sweetened yogurt, which has more sugar per ounce than a can of soda. So we really have to take that seriously. And in my house, my son once said, you know, dad, I want to invite 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. And I said, you can get whatever you want.

Buy whatever you want. There's one condition. 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 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, you know, even when they're, when they're two, you know, having that

high chair or, you know, 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 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 know, you want them having suggestions like, well, you know, let's, let's come up together with some healthy food that you want to have tonight. What would you like to help me cook? Let's, can you help with preparation, peeling or cutting or mixing that really gets them involved and they become part of the, the recipe and the preparation. And then they love it more and then they want to eat it more.

Two out of 10 kids now are obese, not just overweight. Four out of 10 are overweight. We're seeing this affect their cognitive behavior and academic performance. What's most striking in the studies that really shocked me was that the kids who are the most obese are also the most nutrient deficient. When you look at their vitamin and mineral levels, they are among the lowest because they're eating crap. And it's affecting their cognitive function, their metabolism, and setting them up for really bad, bad outcomes in lives, lower life expectancy, lower ability to earn higher incomes. And in schools, it's a cesspool there. Sugar, salt, processed carbs,

industrial refined fats. And they like, I mean, I went to the school, they had, you know, McDonald's Monday, Taco Bell Tuesday, Wendy's Wednesday. They had advertising all over the gymnasiums and bathroom stalls. And you guys really went to work on this with the Hunger-Free Kids Act, the Healthy Hunger Free Kids Act, which was signed into law in 2010. Can you tell us about that? And what were the challenges you found that you faced in addressing changes to the school lunch program from the food industry and from the Congress? And, you know, what was that like? There are lots of them. You know, so when we got there, there was no rules at all about what you could sell in schools. So in vending machines and in the a la carte lines and the lunchrooms, there was literally zero

standards. You could sell anything you wanted. And the guidelines hadn't, hadn't been updated in terms of the new standards for the school lunch meal itself in 20 years. And there had been new resource for the program in 30. Wow. And, you know, part of the challenge, there's lots of different challenges. One we were trying to do it in the middle of economic collapse, not too different from what's happening right now. That was 2008, right?

Yeah. And so we were working on this through 2009. So pretty intense time to try to get a bill like that done. But for us in the administration, and it, by the way, it took President Obama intervening and push, helping to push with, with the first lady to get that done. You know, as we think it was the bedrock of the future of the nation. And so that's why it was such a priority for us. You know, I think there's a lot of challenges. One, like on the vending machines, you know, they are huge sources of revenue for things that we care about in schools like art class and music class. The school's budget. Yeah, for sports.

So these budgets have been cut so much that schools are depending on basically selling these kids junk food to key programs that we all care about alive. So there's a real tense conflict there. But obviously killing them prematurely over the long term is not a solution for art. They can write great poems as they're dying and great songs as they're dying. We're like, we just have to work this out. There is huge raging.

And sometimes, you know, the debates in Washington just, you know, leave you scratching your head. But huge debates on whether you had to just offer the vegetable to the kid or actually had to serve them the vegetable. Well, they talk about competitive foods in schools, which makes me crazy. I mean, a competitive food is a donut versus an apple. So if you put them side by side, guess which one the kid's going to pick? Yeah. It makes me crazy. I mean, a competitive food is a donut versus an apple. So if you put them side by side, guess which one the kid's going to pick?

Yeah. It's not exactly competitive. Big, big, big fights there. And, you know, then there was a pretty infamous effort by the Frozen Food Institute, which is basically the pizza and French fries. Yeah. That got, that made the, the tomato sauce on the pizza to be counted as a vegetable.

Yeah. And French fries, we were working very hard to put limit. We were, we proposed limitations on the amount of fries that could be served in a given week. Which is also a vegetable. Right, exactly. You didn't know?

Ketchup also is a vegetable. Yeah. And so they got Congress to intervene, and they attached that onto another bill and got that through. So we were able to then increase the serving of vegetables. So you could serve fries, but you still also had to serve like broccoli or something like that. So it really kind of defeated the purpose of serving the fries.

So we were able to constrain that significantly at the time anyway. I remember a story that, you know, Swanson's Pizza, which is a big pizza company in Minnesota, is the largest supplier of pizza to schools. And Amy Klobuchar, who's the senator from Minnesota, a Democrat, was instrumental in getting pizza being included as a vegetable. Which just goes to show you the ways in which the food industry is so influential in driving our policies, which have nothing to do with science. Yeah, that is true. We had big fights on potatoes in many arenas, similar to school lunch as well as with WIC.

You know, so, but I got to say, like, so there was real fights. I do think there's this, like, I have gotten over the outrage that industry is going to pursue their interests. I'm sort of just like, we've got to get over it and just win and just beat them at this game and need to be smarter and more strategic and get in power, run for office, get in power, and win. So you think that congressmen and senators would be your allies? Did you find that?

I mean, clearly the food industry pushed back. quite very, very strong. There wasn't enough money for the program. Could it be improved? Of course. Could it be significantly improved? Absolutely. But was it just a transformational bill compared to what was there before? Absolutely. So, you know, and it took a Herculean effort to get it done at be given everything else that was going on in Washington. So, um, so, you know, look, I mean, I, that was just a huge win. And, um, Was there,

was there any followup data on how kids did in terms of their weight, their academic performance, the impact of the new school lunch guidelines? The, uh, the, I haven't seen a robust analysis for the whole program in its entirety the other part of the bill that we buried and didn't really talk much about because we didn't look at the yeah but maybe the most impactful thing in this bill i don't know one you could debate it was uh was provision that basically said it's called the Community Eligibility Program, and it allowed schools that had 40% free or reduced, basically where the majority, almost the majority of their kids were low-income kids, you could serve breakfast to every kid

in the school for free, and every kid got lunch for free. And so what's very powerful about that is not as much at lunch, but at breakfast, because at lunch, everybody's eating together, and you don't know who's who. But breakfast was only in the cafeteria for the poor kids. And so what would happen is those kids would have lunch at school. They'd go home. Most of them don't get food at home when they get there,

maybe a bag of chips or something. And then they'd come back to school, they'd go home. Most of them don't get food at home when they get there. Maybe a little bag of chips or something. And then they come back to school, but they were so ashamed of being identified as poor that they would skip breakfast, even though they hadn't eaten since lunch the day before. Wow. And so by serving breakfast in the classroom and serving it to everybody,

all, like millions of poor kids are getting food now that otherwise wouldn't. And so you saw there increased participation, better improved, significantly improved attendance and significantly improved reading and math scores because, you know, those kids, you know, can you remember when you were like 12 or 13, how hungry you were all the time? Yeah.

And imagine you hadn't eaten since, you know, lunch and it's now nine o'clock. You didn't lunch the day before and it's now nine o'clock. And you're asked to like focus on a math test. Yeah, forget it. Forget that. I could barely do that if I was full, let alone if I was tired. Right. And so, you know, so it was a transformational piece of legislation in that regard.

And for the district, they've seen just incredible results. There's been challenges to implement it, but those resources remain, and more and more districts each year are signing up for it. And so, you know, I think we have to be careful. Like, things are are messy and politics is messy and you're going to have people lobbying for their for their own interests of their businesses sometimes in ways that you know i can understand sometimes that i find disgusting and just abhorrent and you share some stories of what you experience that you know kind of reveal the

underbelly about what you're fighting against i I mean, look, it cut both ways. I mean, I think when we banned trans fats, which there was an attempt to try to figure out from the industry side if they could still, because of a few people who wanted it and various icing and other couple products where it was harder to replace, they wanted to like go fight uh to try to allow a certain level right in under the ban am i allowed to swear on this podcast you can i mean and i told

a lot of the head lobbyists for these guys like if you want to have that fucking fight like let's go because i cannot wait to take it to you on this if you want to make sure that you're pumping trans fats that is a known killer like let's go at it so you know there's people like that's like clearly something that was killing everybody a very specific thing that had ample evidence um and sometimes just like ready for a nasty fight but i will also say and it's important for everybody to understand there's a lot of nuance and a lot of gray. So there's some issues like pizza as a vegetable or trans fat, which is a black and white issue. But there's a lot of other companies that have done tremendous work to try to make it easier and more affordable for families to get decent food that are working with real constraints from Wall Street. You know, like if CEOs try to change too much too fast and lose some revenue in a three

or six month period, they're going to get fired. Right. So those efforts are, you know, would be undone in a minute. So if you're trying to get something to change, there's a pragmatism that has to be taken from them as well. And by the way, like a lot of people talk about wanting to eat better and how we need better food. But consumers, you know, tend to eat what they eat and tend to like pretty unhealthy food. That's because that food likes them.

It's addictive. And it sort of sets up the biology of hunger and craving and addiction, which is very hard to fight with willpower. And that's part of the problem. That's absolutely right. But it's also a real problem for the industry. So they box themselves into a problem of creating highly craveable food. And now people want it and they like it. And they identify themselves with eating it. So it becomes the whole, you know,

what we eat is really how we understand who we are. And so when you start to change, you're saying you want to change me as a human. And so it gets super complicated and people aren't changing as fast as we think they are. And so for a CEO who's like, I get it. Like my portfolio is not good. I've got to make some real change. It's not like they're in the position to say, I get these products are terrible. I'm just going to get rid of them.

Yeah. Well, they're innovating. These companies are innovating. They're getting the crap out. They're reformulating their products. They're getting there. They're getting there. I just think we have to be careful to see the monolith evil food industry.

I agree. Versus everybody. Because it just actually doesn't capture the reality, nor is it going to go away. And so I think we have to work to figure out who's a good actor trying to do the right thing, who's not and just needs to get called out and pressured and fought and won.

And then work strategically to make progress, you know, to work collaboratively when you can and fight when you have to. Yeah, it's hard to have the sniffed test test her on for the greenwashing. You know, what's true, what's not. And a lot of people are saying the right things. Are they doing the right things? You know, one of the things that's challenging, all the hard work you did with the Obamas to get the Healthy Hunger Free Kids Act passed in 2010, the current administration is trying to roll that back. And their arguments are that, oh, kids are throwing out the food. It

doesn't taste good. People won't eat it. You know, so we have to fix those guidelines, fix the guidelines, which means roll them back so that more junk can be in the schools. And I think, you know, there's a real challenge in the culinary world in school lunches. And as a chef, I'd love your opinion about this because like we're talking about before, you've learned how to make delicious, yummy meals in a short order from ingredients that aren't going to break the bank and that can be done. And I think there are models of this. You know, my friend Jill Shaw, I think I might've talked to you about her, who's also gonna be on the podcast talking about My Way Cafe, where she got top chefs to create

delicious meals within the school and nutrition guidelines within the school budget for school lunches, which is not very much. And kids love it and they're not throwing it out and they're eating it. And I've seen this happen over and over throughout the country. So can you speak to the rollbacks that are happening, why they're happening and what we can do to fight those? Yeah, well, the main reason they're happening is because of the School Nutrition association uh and that is an organization whose name they it does not deserve uh school malnutrition association yeah basically um so basically what's happened with them is you know they represent the school chefs as i call them uh and and you know they've been under a lot of pressure for for years. And, you know, I will say that school chefs around this

country have, for the most part, they go into these cafeterias with very little resource, with almost no support. They love those kids, and they're really trying to do right by them. Unfortunately, the organization that represents them is one that is just dominated by some of the worst players in the food system. Those same pizza and french fries guys, ConAgra and a few others are the most influential companies on their board. And they were very supportive of the Healthy Hunger-Free Kids Act and the work that we were doing and we were real allies of theirs and then they realized that this was standards were going too far and kind of in the middle of the whole thing they fired the the ceo uh brought in a bunch of hacks for uh big food and have then since started fighting us and now have been lobbying the Trump administration

to roll back these standards. And so if they're listening, I haven't talked to you guys in a while, but shame, shame on you. It's just an abomination of your role in our society to be safeguarding the well-being of the kids that are eating in our society to be safeguarding the wellbeing of the kids that are eating in, uh, in our schools and representing and supporting the, the people, mostly women who are working so hard with so little support day in and day out to, to do the best they can with these resources. And I just am so disappointed, um, in how that has played out. Um,

you know, the argument that it's just good enough to have some green beans on the line, that that's like a serious argument for a 10-year-old to say they want it. It's just a joke. The reality is all the evidence shows that, the evidence shows two things.

One, people, kids have been throwing out school lunch since the day it was invented. And that is nothing new, and there's zero evidence that our new standards led to any increased food waste. Secondly, the evidence shows that there's a substantial increase in consumption if you actually serve the food to the child. If you put it on their plate. If it's on their plate, they're more likely to eat it.

What do you know? In fact, we had to research that, but it's true. It turns out that's how it goes. So that's where these things really get backward, and they're going to push on to do that, which is really troubling, especially given the fact that while we made a tremendous amount of progress, this is a generational effort. And we have a long way to go.

And so we should be tripling down on our efforts, not rolling them back. And as a chef, you believe that if we somehow figured out how to get food service providers to recalibrate what they're doing that and get you know cooks i mean getting the ladies and the guys who are in the kitchens and schools actually cooking yeah it's doable so i think um so i think it's doable to uh if there was a tremendous increase in funding right now most of these schools't, a lot of them don't have real kitchens. Infrastructure is lagging. Schools haven't been upgraded in years. Schools have way bigger, a big part of the problem for school lunch is that, you know,

these school kitchens were designed, cafeterias were designed for like, you know, 300 students. Now there's 700 in the school. And a big part of the problem that nobody really talks about is like a lot of kids are getting lunch starting like 10 o'clock and then they have like 20 minutes to eat. Yeah. And they're just not, they just don't have enough time to eat. So there's a lot of really just structural problems. And so I think there's a middle ground where if we could bring some capacity of cooking back into kitchens or have better sort of hub and spoke models where food is being prepared more fresh and integrating that with high quality sort of pre-made foods i think that's a

likely scenario but you're talking about billions and billions and billions of dollars of infrastructure needs hundreds of billions you mean you mean kitchens is that what you mean yeah kitchens and staff like now all of a sudden you need a lot more people to cook uh well this is what you know jill shaw showed that you you you actually don't increase costs at all that you can do it if you put the kitchens in and then teach the staff how to do it and create the right recipes with food that's low cost but delicious and nutritious that it's doable it i'm not saying it's not doable i I'm just saying that it's definitely doable. It's hard.

And there's some school to do it. I'm just saying it takes increased resources. The food cost doesn't necessarily need to go up. I agree with her. But there's no way she's – and I love her, so I don't want to disagree with her about anything. There's just – each school is different, so it's hard to speak just you know general you know

just complete generalities but if you have a staff that all they're doing is taking frozen things and heating them up you have a pretty lean team if you're going to prepare everything and chop every vegetable uh then you're just going to need more hands most likely depend now there could be some things that have a big staff and you could do that but for the most part I think there's some increased cost there most likely. It's more decentralized, right? It's not a federal program. It's all based on local school districts and

everybody decides themselves so it's a harder thing to sort of nationalize. Much harder. Yeah, that part is hard. And look, what we found in the restaurant sorry, what we found in these schools is that for the school chefs who really were excited about you know serving better food passionate about it really wanted to do right by their kids they figured out how to make really delicious food uh within the budget and meeting the standards and sometimes dramatically exceeding

the standards and we found that in districts where they didn't believe in it, they didn't care about health, they thought that these Democrats in the White House were trying to tell them what to eat. Nanny state. Nanny state. They just serve food that tastes terrible. And so a lot of it is just about your will and your commitment to doing.

Well, we need to do it because we are destroying our children and the future generation. And it's a, you know, a friend of mine said it was a doctor that was a pediatrician said if we're, if, if, um, a foreign nation was doing to our children, what we're doing to them, we'd go to war to fight it. We can no longer ignore, um, the microbiome as a key organ in our, in our body. If we think about babies, when babies are born, they're essentially born with a sterile gut. They have very few microorganisms in their intestine. They are, they're brought into this world as, as we like to think as a blank slate, that's good news and bad

news. The good news is we have the opportunity to set them on a path of having a healthy gut microbiome from the moment they're born. The bad news is most babies don't get put on that healthy trajectory. Most babies have a disruption in their microbiome from the day they're born. So maybe I'll just take a step back and think a day in the life of a baby as it's being born. Um, so a baby is essentially thought, um, of traveling through the vaginal canal during vaginal birth. We all can appreciate that vaginal delivery is a crazy, messy process. There's a lot of stuff happening. Um, one thing that we want to happen is we want moms to be able to pass their gut microbes onto their babies. Well, what's in mom's gut has to get to baby somehow, but baby's traveling through the vaginal canal. And as they

exit the birth canal, their little faces emerge first. They hopefully will get exposed to mom's gut microbes through what we call a fecal oral transfer. We can leave it at that, or we can go into that. You can totally ask. Sounds like eating poop. Yeah. Yeah. So, um, that if mom has a healthy gut microbiome, then she essentially gives the gift of, uh, seeding the baby's microbiome from the day they're born with their, their first little inoculation of microorganisms in baby's gut. And then breast milk, human breast milk is miraculous in that it contains everything that baby needs to grow and develop and go through the milestones of those first six months of life. It also has all of the food for the healthy bacteria that mom has passed on to baby. So it has food for baby baby has food for microbiome. When all goes

according to plan, it's a beautiful synergistic symbiosis, as you mentioned. But if we think about it, how, how many different ways can we disrupt that beautiful process. So there is a need for babies to sometimes be born by C-section. And in fact, up to 30% of babies can be born by C-section in this country. They bypass the opportunity to be exposed to mom's good gut microbes. If you think about just physically, they don't pass through the birth canal. They don't get exposed to mom's microbes. Well, where are their first microbes coming from? So they get their first microbes that sets them up for a lifetime of either health or disease

from the microorganisms that do well on the surfaces of the hospital, countertops and surfaces or from skin or from clothes. So their first microbes look very, very different. From the nurse who was in a bunch of other rooms, other patients who knows what was going on, right? Kind of, it's a little bit of a circus for those babies who get, who are born by C-section. And then if you also layer on top of that, the number of moms who are given antibiotics during labor and delivery for say group B strep, which can also be close to 30% of moms, any good microbes that they have in their gut, even if baby's born vaginally may or may not be there to pass on to baby. So we now, after generations of moms being born by C-section themselves, being exposed

to antibiotics and babies being exposed to antibiotics, there are now generationally, we have now really, really limited that natural transfer of good gut bacteria, specifically a type of bacteria that infants need called Bifidobacterium infantis. We've almost eliminated it in our population here in the U.S. I can imagine there's probably maybe not a single person who's never had an antibiotic. Maybe there is, but I can't imagine that there would be too many on this webinar that have not had an antibiotic, which means then that all the women who are listening who've had antibiotics have destroyed this particular bacteria, which turns out to be exquisitely sensitive to antibiotics. Right?

So if you just had a cold and the doctor said doctor said oh take this amoxicillin like you're screwed because then you decimate the population and it's gone so what we're seeing is this is this phenomena of missing microbes now there's a wonderful book written by i think michael gershon about missing microbes talking about this terrible phenomena of modern society that has literally decimated whole populations of really critical gut microbes that are necessary for our health, like Bifidobacterium infantis. So basically women have taken antibiotics either before or during pregnancy or birth. They, babies are born by C-section. So the likelihood of your baby not having any of this

particular bacteria is pretty high. And so now I want to come back to something you said about the breast milk, because this is striking to me when you think about how beautiful nature is. You know, 15% of mother's milk is not digestible by the baby. It's not like the baby's not getting any benefit from it, except it feeds this, this indigestible carbohydrate feeds this particular bacteria that you mentioned, Bifidobacterium infantis or B. infantis. And it, and it, and it loves this stuff. It's like, it's like actually made for it, you know, like, like, you know, like I don't know what, what's the analogy. I don't know. Can's like, it's like actually made for it. You know, like, like, you know, like I don't know what, what's the analogy. I don't know. Can't think of it, but you know,

like it's, it's really, it's made for this particular bacteria. So talk about, talk about a little bit about how this works and what happens and why formula is a problem because this, these, these sugars, these, these carbohydrates called oligosaccharides are not in formula. Yeah. So as a nutritional scientist, I think that this part of the research and part of the story is probably what was most impactful to me when I was learning about this topic and the research that was coming out of UC Davis and a team of researchers that were using human milk as an example of food that, in its perfect form, because if you think about it, human breast milk has not been impacted by mass industrialization and we haven't really

toyed with it too much. It's actually the pressure on human milk is actually from human evolution. And it really, the body is constantly dialing in human breast milk to be exactly what the baby needs to thrive and grow in the first six months of life. So this team of researchers at UC Davis at the foods for health Institute said, well, let's dissect and analyze every aspect of human milk and let's see what's there. And we'll use that as a template for what babies are supposed to be consuming. And everything was there that you would expect the lipids, the protein, the lactose, the water, the micronutrients, the macronutrients were there. What was really fascinating and you touched upon it is 15% of the nutrients in breast milk were these complex carbohydrates called human milk oligosaccharides or HMOs for short, that were completely indigestible by the baby, which makes absolutely no sense that human milk,

which is very metabolically taxing for the mom to make would have 15% of nutrients that completely were not used, utilizable or indigestible by the baby until they figured out that it's food for the infantis in the baby's intestine. So then you go back to kind of our day in the life of a baby. it's a, it's a rough 24 hours, but they, you know, they, they get through it and the baby is born. They're exposed to mom's gut microbes. B. Infantis hopefully sets up camp in baby's intestine and it needs food too. So human milk starts coming in to the intestine and it feeds the baby and it feeds B. Infantis. And then all of a sudden those 15% of nutrients in human milk are no longer locked up in these complex carbohydrates. B. Infantis

is utilizing them for fuel and turning them into something that the baby can actually use. And that's the short chain fatty acids called lactate and acetate and others. And those are actually signaling molecules. They're actually a fuel for the growing colonocytes, the intestinal cells, as the baby is rapidly developing, they are, they are changing the pH of the baby's intestine so that pathogenic or bad bacteria can't thrive. They're creating this protective environment in the, in the infant's gut. It's such a beautiful story that nature has designed. And so when baby has B. Infantis in their gut and they're consuming HMOs, preferably from breast milk, then it sets up a protective

environment where pathogens can't grow. B. Infantis is getting everything it needs. Baby's getting 100% of the nutrients in breast milk. And it's a, it's a, a, a very, um, calm, low inflammation, protective environment in baby's gut. Now, if you can imagine the opposite scenario, which B. Infantis is not in baby's gut, HMOs are coming in through the diet, completely locked up and, and not utilizable by the baby. Instead, pathogens are growing because the pH of the colon is in their perfect zone, which is not, um, hasn't been curated by B. Infantis. And those HMOs are actually being excreted in large amounts in baby stool. So what we see is we see babies that are missing B. Infantis with eight, five to five to eight to 10 watery stools per day. Those are, they're just HMOs.

And if you think about it, that's what pediatricians have been telling us moms for a long time. If you have a breastfed baby, expect five to 10 watery stools per day. But I'm not sure that that is actually what we're striving for clinical studies that we've been at, that we've conducted. We see that when babies do have B infantis and they are utilizing HMOs, they stop kind of pooping them out, dumping them out into the stool. They're no longer in the diaper and babies are accessing 100% of the nutrients and benefits of breast milk. Now you asked me about formula. All babies need to be fed all babies. And if you, and if a baby is not getting breast milk formula is the next best option. And we are big advocates of fed is

best. However, we know from a nutritional composition perspective, there are big differences between breast milk and formula and formula companies are working very hard to try to get formula as close to breast milk as possible. Yeah. There are, there's a long way to go. Long way. There's a long way to go. And the HMOs in formula, although they do have them on some of the labels contains HMOs,

they are not nearly at the, at the concentration of breast milk, nor are they at the composition of what's in breast milk. So it is a hat tip to the idea that there are HMOs in formula. It's like window dressing. It's good marketing. It is indeed. So I would say that babies exposed to antibiotics, babies born by C-section and babies that are receiving formula, they're not going to create this high B infantis protective environment in their gut. And they will, that is where we start to see the high levels of inflammation in the gut. And then the longer term effects, negative health effects as baby grows. Absolutely.

Because, you know, the baby's immune system when it's born is not developed. And the first year is critical for its development. And it develops the immune system by sampling the environment through the food it's eating and through the microbes that are in there. And when those microbes are off or out of balance, it's going to drive lifelong changes that are often challenging. And as a functional medicine doctor, I see this very often. You know, what's the story? Baby born by C-section, given antibiotics in the first years of life, lots of ear infections, sore throats.

Maybe then they get some eczema and diaper rash and they get asthma and then they get allergies and they get autoimmunity. And it just you see this pattern over and over when you start to pay attention to it. So when I take a patient's history, I start with the mother's health before birth, and I go all the way through to the timeline of what's going on. The study I read that was so striking to me that just put this in bold relief was a study where they compared the microbiome and the short-chain fatty acids that are produced with babies who are breastfed versus formula fed. Now, you mentioned a few of them, but one of the most critical short chain fats is something called butyrate.

And it regulates immunity, cancer. It feeds the colon. It's so critical. It's anti-inflammatory. It's used to treat colitis. I mean, it's quite an amazing molecule and it's produced by the bacteria, the right bacteria digesting the starch, the fiber, right? And in this study, they looked at the kinds of short chain fatty acids that are produced depending on what you're eating, if it's formula or breast milk. The breast milk babies all had high levels of butyrate, which

is what you want. The formula fed babies had high levels of butyrate, which is what you want. The formula fed babies had high levels of another short chain fat called propionic acid. Now it's a big medical word. What does it mean? It's one of the short chain fats, but it turns out that this is very neuroactive in a bad way. So they are able to induce autism in animal models by giving them propionic acid. And guess what it's also used for? It's a preservative used in flour. So anybody eating wheat in this country, unless you know for sure that the company is organic and this and that, and doesn't put anything in it, they put propionic acid in, which leads to behavioral issues and mood issues, attention issues. And like I said, in animal studies, it can induce autism. That's terrifying to me. And so I really

think that we should be looking at children's microbiomes. We should be looking at their poop. We can measure, I do this every day in my practice. I measure short chain fatty acids. I look at the types of them. I look at the kinds of bacteria there. And it's quite, it's quite amazing to see how many people have disordered gut microbiomes. And we don't even think about it. As physicians, we basically treat the downstream problems and not the gut. What you're talking about is going way upstream, way back to day one of a baby's life. And maybe even, I mean, I read a study years ago where they gave the mothers a probiotic and then the babies, and they gave the mothers a probiotic, helped the baby actually have less asthma and eczema and allergies. Essentially, if you don't have this as a mother in your system

and you don't pass it on to your baby, the baby doesn't have it, the baby doesn't get the ability even to use the oligosaccharides, ends up with all these problems, it creates a pretty bad situation long-term for the baby. So instead what's growing there are, we call them potentially pathogenic bacteria. It's not like getting E. coli or salmonella or shigella. It's not these horrible, but it's this imbalance in things like Klebsiella and Pseudomonas and Enterococcus and all these weird bugs that can be potentially infectious that are

irritating. And they're critical to get rid of or to change the environment in there because it will program the body for life. So talk about how important it is to have this early in life and what the consequences of not having it are when these other bugs tend to overgrow and lead to all these secondary problems down the road, not just colic and diaper rash and fussiness and a little diarrhea as a baby, who cares? Okay. The baby's miserable. You're miserable for the first year. It'll get better. That's not the real problem. The real problem is what I started out this webinar with, which is talking about this pandemic of inflammatory adult diseases that start in childhood, in infancy. So can you talk a little

bit about that and what happens with all these bad bugs and what do they do? Yes. So one thing that is paramount to us here at the Avivo team is that we insist that science leads the way for what we do here and where we go and what we publish and what we bring forth for people to be able to use and the products that we make. I would say that the vast majority of the probiotic industry kind of glosses over the rigorous clinical science that needs to take place in order to really be able to say, we understand what's happening in the gut microbiome. Here's a probiotic product that's going to actually address that problem. And here are the clinical outcomes that you can expect.

That is the rigor that is required, I think, is lost in the majority of probiotic products that are out on the market today. Our group, our team, which is, as I mentioned, a spin out from UC Davis and the Boots for Health Institute, we set out to say, let's let science drive the direction that we're going to go. And let's look systematically at what do babies look like if we don't do anything? And we just look at a population of babies born today in the Davis, California area, breastfed babies. What does it look like if we actually give B. infantis back to them, feed them a vivo every day? And what does that do not only to the amount of B. infantis in the baby's intestine, but to the abundance of the other pathogenic bacteria that were there in the absence of B. Infantis. So that is what over the last five years, close to 20 different clinical publications that we've been able to publish in

peer-reviewed journals have shown that when a baby is missing B. Infantis in their intestine, whether that's because of antibiotics or C-section, whatever reason, there is instead an almost full composition of what you mentioned as potentially pathogenic bacteria. And to your point, I want to make sure that we're clear that doesn't mean overt infection. That means kind of a quiet, but abundant composition of the infant gut microbiome that you can't really see from the outside of pathogenic bacteria setting up shop in the baby's gut microbiome, including staph, strep, klebsiella, clostridia, as you were mentioning. And they are causing inflammation in the infant gut. What we don't want to do is jump on the bandwagon, the microbiome probiotic bandwagon and over-interpret or hype, over-hype any data that we have so far and say, just spend a lot of money on probiotics and you'll be fine. We will not do that as a team and as a, as a company. So what we've done is we've gone through and said,

not only can you restore B. Infantis back to the infant gut through feeding Avivo to babies, we were able to answer that definitively in one of our early publications where we showed a complete restoration of B. infantis to babies who are fetal vivo. But then we looked at the composition of the infant gut and can we reduce those pathogenic bacteria? Yes, we can to up to, up to 80% reduction of those pathogenic bacteria. Then if you do that, can we see a reduction in the inflammation markers of inflammation? Can we see a reduction in antibiotic resistant genes? Can we see a reduction in many other of the, of the markers that show that a baby is either on a path toward autoimmune

and auto-inflammatory diseases or not. And that's really what we are. We are still on this journey. I would say collectively, not just the Avivo team, but the field of microbiome science, you have to be able to follow those kids out and do the clinical studies to be able to definitively show that you get prevention or treatment of any of those diseases that you mentioned. We're not there yet, but we have many very large clinical studies ongoing right now because there is enough early data. There's enough early basic science that shows we believe that this is exactly what's happening. We're reducing the inflammation.

We're reducing those pathogenic bacteria by feeding Avivo. And now we're going to systematically go through and say, what conditions can we prevent in those babies going forward? I hope you enjoyed today's episode. One of the best ways you can support this podcast is by leaving us a rating and review below. Until next time, thanks for tuning in. Hey everybody, it's Dr. Hyman. Thanks for tuning into The Doctor's Pharmacy. I hope you're loving this podcast. It's one of my favorite things to do and introducing you all the experts

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