Holistic Pediatrician Reveals Top Reasons Why Kids Are Sicker Than Ever Before And How To Raise Resilient and Healthy Kids With Dr. Elisa Song

This episode delves into the alarming trend of increased health issues among children, discussing how modern lifestyle choices and medical practices contribute to this phenomenon.

1. Childhood Chronic Illness: Nearly half of all children are now diagnosed with a chronic health condition, with autoimmunity rising rapidly among teenagers.
2. Mental Health Crisis: A significant portion of teenage girls contemplate suicide, highlighting a severe mental health crisis exacerbated by lifestyle and environmental factors.
3. Gut Health Importance: The episode underscores the importance of gut health and its impact on overall well-being, linking gut dysbiosis to various childhood illnesses.
4. Diet and Lifestyle: The role of ultra-processed foods and poor dietary choices are discussed as major contributors to poor health outcomes in children.
5. Actionable Health Strategies: Dr. Song offers strategies to improve children's health, focusing on diet modifications, reducing environmental exposures, and leveraging functional medicine principles.

1: Introduction to the Health Crisis

Dr. Song and Dhru discuss the severe increase in health issues among children, linking it to modern environmental and lifestyle factors. Elisa Song: "We are seeing unprecedented levels of chronic diseases and mental health issues among our youth today."

2: Gut Health as a Keystone

The discussion focuses on the gut microbiome's role in children's health, explaining how early life disruptions can lead to long-term health issues. Elisa Song: "The gut microbiome established in the first 1000 days of life plays a crucial role in shaping a child's immune and brain development."

3: Dietary Impacts on Health

They explore the detrimental effects of processed foods on children's health, emphasizing the need for dietary vigilance. Elisa Song: "Ultra-processed foods are not only poor in nutrients but actively contribute to health degradation."

4: Medical Interventions and Their Consequences

This chapter examines the overuse of antibiotics and antacids in children, discussing the long-term consequences of such practices. Elisa Song: "Frequent antibiotic use in early childhood can lead to a weakened immune system and increased vulnerability to diseases."

1. Focus on Whole Foods: Encourage consumption of unprocessed, whole foods to support gut health.
2. Reduce Antibiotic Use: Limit antibiotics to when absolutely necessary and explore alternative treatments.
3. Enhance Outdoor Activities: Increase time spent outdoors to decrease exposure to environmental toxins typically found indoors.
4. Educate on Gut Health: Teach children about the importance of gut health and its impact on overall wellness.
5. Mindfulness and Stress Reduction: Introduce practices such as mindfulness to help manage stress and enhance mental health.

This episode is brought to you by LMNT, Momentous, and Lifeforce.

Despite advances in technology, children today are facing significant physical and mental health challenges. We are in the midst of a mental health emergency, and chronic disease among children is on the rise. The stressors of the modern world, ultra-processed foods, and excessive screen time are all contributing factors. Today’s guest is here to offer hope to parents, grandparents, and caregivers, navigate these challenges, and show us how to keep our children healthy and happy.

Today, on The Dhru Purohit Podcast, Dhru and Dr. Elisa Song discuss raising healthy and happy kids. Dr. Song shares the latest research on the rise in chronic disease and mental health disorders in children. She also discusses factors that can harm and protect the gut microbiome and lifestyle factors that have protective effects on overall wellness and help build resilience. If you are looking for a guide to raising healthy and happy kids, Dr. Song is here to lead the way.

Dr. Elisa Song is an integrative pediatrician and pediatric functional medicine expert. In her integrative pediatric practice, Whole Family Wellness, she’s helped thousands of kids get to the root causes of their health concerns and helped their parents understand how to help their children thrive. Dr. Song is also the creator of Healthy Kids Happy Kids, an online holistic pediatric resource to help practitioners and parents bridge the gap between conventional and integrative pediatrics with an evidence-based, pediatrician-backed approach.

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Elisa Song, Dhru Purohit

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Dr. Elisa Song

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Dhru Purohit
The kids are not okay. Kids are sicker than ever, and the trend is getting worse and worse. Can you give us some stats? Big picture? Yeah.

Elisa Song
Well, you know, let's go way back to 2005. And this is where I remember starting out as an integrated pediatrician. I opened up my practice in 2004 as a functional medicine doc. And I remember reading this article in the New England Journal of Medicine that said that for the very first time in history, our kids are expected to have shorter lifespans than us, their parents. And I thought, oh, my God, we need to.

What's going on here, right? With all of these medical advances now, fast forward almost 20 years. And I would say that we're certainly not in any better shape, and we're probably in worse because we have almost one in two kids diagnosed with a chronic health concern, and then forget about an actual diagnosis. I mean, so many kids have health concerns that are not quite yet diagnosed. But we do know that one in five kids has eczema, one in ten has asthma, one in ten has adhd.

The number of kids with autoimmunity is on the rise. And the age group with the fastest rise in autoimmunity are teenagers out of any other age group, the twelve to 19 year olds. And then when we look at anxiety, mental health concerns, which, as we know in the functional medicine world, we cannot separate out than the rest of what's going on with our gut, our brains, our immune systems. So by the time kids are 18, one in two is going to be diagnosed with a mental health disorder. And when we look at our teen girls, I mean, we know that through the pandemic, this mental health emergency has really been.

You know, the alarm has been raised for our kids and teenagers. We had that long before the pandemic. But now we know that one in three teenage girls will seriously think about suicide in their adolescent years. And one in four has actually thought of a plan, and one in ten has tried. And so that's someone that you know, right?

If you're a parent or a grandparent or a teacher or whatever it is, you are going to know someone in your life that is suffering a child who has a chronic disease or a chronic mental health concern. And so we need to. If we don't want this trend to continue, the time is now. We can't wait. You know, one of the ones that you didn't mention inside of there, but that you mentioned inside of your book, is also autism.

Yeah. The autism rates that I was looking at, they're nuts in a sense, that they should be mind blowing. I think that they, I mean, you may know the rates better than me. I don't have them offhand here, but I think that they've increased almost like, doubled since, like, the beginning of, like, just even the early two thousands. Yep.

Well, you know, so I finished my residency at UCSF in 2000, and I remember as we're kind of being left off to the great wide world and opening up our practices, I remember being told that if I saw a handful of kids in my career with autism, it would be a lot. That was 2000. In a matter of years. I opened up the practice in 2004. Within the first year, I was flooded with kids, parents who were saying, my kids have been just diagnosed.

I'm worried they have autism. What can we do? And now the latest numbers are one in 36 kids is on the autism spectrum. Now, is some of that better diagnosis? Are we capturing more kids?

I think that's some of it. But there are certainly more kids who are on the autism spectrum who really need our support, need our help in feeling comfortable in their bodies, in their brains, understanding some of the underlying pathophysiology with the neuroinflammation, the immune dysregulation, the gut dysbiosis that we know underlies a lot of the concerning behaviors and symptoms that kids with autism have and that their parents really want to support them with. You mentioned gut. That's a big through line inside of your book. Talk about that a little bit more.

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Livemomentous.com with the code dashru. That's me, drew for 20% off today. So what I really want to do in my book is lay this story for practitioners who may not know as much, and it's not that practitioners, many people listening. I mean, everyone, I would say, listening to this podcast has heard of the gut microbiome, the gut brain connection, the gut immune system connection. What I really want with my book is for parents, practitioners, grandparents, educators, to understand the profound importance for this, for our children.

Elisa Song
So we know that the developing gut microbiome takes shape from maybe a little in utero, but really, from the moment kids are born, there's this critical window, this first two and a half to three years of life, this first thousand days. And the way that that microbiome forms and develops informs the way that their immune system develops, the way that their brain develops. In fact, some of the studies, and I couch these studies in the sense that a lot of parents listening will think, oh, my God, that's my kid. That happened to my kid. They have eczema now.

They have anxiety now. I wish I had known, and there are a lot of things that a lot of us wish we had known. We only were doing our best at the time that we had. And some of the studies, there's this large study, nearly 800,000 children, and they looked at antibiotic use, or antacid use in the first six months of life and found that for those children who received those antibiotics or antacid medications in the first six months of life, they had a significantly increased risk of virtually every single disease, allergic disease. By the time there were four.

Dhru Purohit
Wow. Every single one, including asthma, allergies, eczema, anaphylactic food allergies, and hives. They're giving antacids to babies. Well, you know, there's this trend, which I think is, I don't know if it's going down, because my practice is integrative, and I rarely use antacid medications in children. But I remember traveling around the world with my husband back in 19.

Elisa Song
Let's see, back in 2002, with the idea that I would open up my own practice when I came back. Now, in 2000, when I graduated from residency, babies were not getting antacid medications. Zantac urbanidine was not authorized for children and infants. When I came back and I started working as a pediatrician, all of a sudden, all these babies were getting put on Zantac because suddenly it was authorized for babies with reflux. Now, what we have to understand is that all babies have some amount of reflux, right?

Right. Their lower esophageal sphincter is not very strong, and the food from their stomach sloshes back up and down their esophagus really easily. That doesn't mean they have reflux disease. And so when we have this, this fussy baby who happens to be spitting up, I think a lot of babies were mistakenly diagnosed with reflux disease and put on Zantac, and it's become this persistent problem now. Why antacid medications in this study, why were they looked at with antibiotics?

Well, they both can disrupt the gut microbiome and the way the gut microbiome develops in babies pretty immediately. We also know the same thing is true for mental health concerns later. So there's another study. Denmark actually can study their populations really well. They have these amazing databases.

And so they followed this enormous number of mother infant pairs and looked at antibiotic use from in utero through childhood and found that even just one round of antibiotics could increase the risk of that child developing mental health concerns by the time they were older kids or teenagers. And the risk was highest when those antibiotics were received before they were six months of age. And so that when we understand the importance of foundation of the gut microbiome and how it informs that brain development or how it informs the immune system development, we want to do everything we can to preserve and optimize gut microbiome development in babies and also through their lifetime, because it doesn't change. I should back up and say, it's not that it doesn't change, but our children's brains and immune systems continue to develop. And that same fascinating explosion of synapses in our children's brain, infants brains, is happening in their preteen and teenage years, and it's mirroring this change in their composition and diversity of their gut microbiome.

And so we have these points of intervention, and that's where, as a parent, if you're looking and thinking, oh, my gosh, my child has eczema, they got antibiotics when they were four months of age. That's okay, it's fluid. And we have times that we can intervene, and it's never too late. It might get a little harder. I mean, that's why, as an adult, if you have got dysbiosis or yeast overgrowth or whatever it is, it may take a lot longer than for a three year old to restore their microbiome.

But it's not impossible. I mean, that's why we do the work that we do as functional medicine docs. And so it's just now being aware of all the different factors in our modern world that, that are, are changing our children's microbiomes, and they have changed. I mean, when we look back a hundred years ago, there was a pathologist, a microbiologist in Scotland who happened to be measuring the microbiomes of formula fed babies versus breast fed babies at the time. 100 years ago.

100 years ago. And how were they. How were they doing that? Just like through culturing. Yeah, culturing.

And so with this pathologists found in Scotland was that the breastfed babies had almost exclusively Bifidobacteria species in their microbiomes. Right. Formula for babies had different microbiomes. We know that from our studies today, formula for babies and breastfed babies do have different microbiomes in our modern world. What's fascinating is, though, that the breastfed baby of today looks much more like the microbiome of the formula for babies from 100 years ago.

Our infants are losing their very important bifidobacteria, which is so important for supporting butyrate producing species, which is so important for supporting their brain development and immune tolerance to things like food allergens. And this loss of bifidobacteria is fascinating. There were some studies during COVID that found that a reduction in Bifidobacteria species also correlated with increased risk for more severe COVID. So bifidobacteria is really protective, and our infants and our children are losing it at pretty rapid rates. Wow, that's mind blowing.

Dhru Purohit
As you're painting today's story that we are continuing to tease out, connecting the dots for our listeners right now, and also doing it for myself, too, as, knock on wood, a future parent one day, you know, kids are not okay. They're getting sicker every year. Chronic disease is exploding, and it's leading to all sorts of challenges. Ultra processed food consumption amongst young people continues to go up, and we are in this sort of emergency state. And this diet now that we have here in the west, is being exported all around the world.

It's not a good look for the future of our species and the health of our species. And a big part of that comes back to our gut health, not just for adults, but, of course, kids. And it starts with how our gut health is as kids. And there's a lot of things that are going on in this modern world that are making our guts as kids. Or if you're a parent, you have a kid, they're making their guts say, ouch.

By damaging it, you identified one of the main ones, which is overuse or early use or improper use of antibiotics for children. What are some other things that you have also found from both your research and being a pediatrician, that are also damaging the guts of kids? Today. Yeah. So the single biggest acute disruptor are antibiotics, right?

Elisa Song
And as you said, it's really, you know, it's the inappropriate use, but also the overuse. And so that's where, as parents and practitioners, we just have to be really good stewards of antibiotics. There are some estimates that by 2050, which is really right around the corner, antibiotic resistance is going to become a leading cause of death worldwide. That is frightening. That's crazy, right?

And so, and in some studies, they found that up to 70% of antibiotics for children are inappropriately prescribed. So. Prescribed for things like viral infections for which antibiotics sick. It has nothing to do with bacterial. You just give him an antibiotic, which that happened to you and I when.

We were growing up, we were just talking offline. And my mom was an ob gyn. I grew up in a very conventional medical household. I mean, I remember taking antibiotics like they were candy for every little thing. Totally.

Oh, you have a stuffy nose. Here's some antibiotics right now. At the same time, I mean, I think you and I, coming from immigrant families, I had the barley tea that my grandma would make and she would make different kinds of soups with who knows what was in it when we were sick. And so it was this interesting, interesting blend. But now, I mean, you touched upon the ultra processed foods.

Children today are exposed to so much more than we were exposed to in terms of, quote, foods, right? These fake foods that are directly disrupting their microbiomes. And it's not just a matter of, oh, let them be kids. Well, yeah, we had some of that when we were kids, but now at least two thirds of our children's and teenagers diets on average are from ultra processed foods. And when you take a look at Americans, american kids on any given day, one in three kids doesn't have a single item of fruit and one in two kids doesn't have a single vegetable.

And so our diets, our palates are shifting. And what I tell kids and teenagers, because, of course, what do teenagers want? They want control, right? They want to be independent. They want to make their own decisions, right?

Well, those mad scientists in the food industry, they are making sure that you are not in control of your decisions, right? They're hijacking your kids, they're hijacking our brains, right? I mean, they are direct. They know exactly how to make the food more addictive. You know, really get that mouth feel that makes you just need more.

It's not just want more. And so we've lost control too. And when it causes gut dysbiosis, the microbes in our gut can also inform what we want to eat. I mean, think about yeast dysbiosis and sugar cravings. I mean, that's one classic example where the yeast will feed on sugar and tell our brain that it wants more and more sugar.

But they've even found different microbial patterns can actually impact our taste buds and what we want to eat. And so when we're thinking about, hmm, what do we want to eat? I don't think the food scientists were necessarily thinking, oh, we're going to change their microbiomes, but that's what's happening. And the microbial composition that we have today is really leading us also to want more and more of these foods that are serving our addictions. And so the studies around ultra processed foods and kids is really frightening when you look at it.

I mean, when I look at the brain studies, right, a steady diet of ultra processed foods for children has been found to shrink parts of their brains that are responsible for emotions, decision making, rational thought processes, and smooth out their brains. So, I mean, kids, all kids have seen models of brains, right? They see all these folds in the brains, these gyri. And so ultra processed foods make kids brains lose some of the gyrification. That's frightening.

And a steady diet of ultra processed foods when kids are four is much, is significantly correlated with behavioral problems and neurodevelopmental concerns by the time they're seven. So, and this is the thing, you know, for folks who are listening to your podcast, they're not running out saying, I'm going to buy ultra processed foods for my kids. I mean, that's not who is listening right now. But here's the thing. Until I really dug into the science and started really teaching not just my own kids, but the kids in my practice and parents in my practice, how to be really savvy about the packages they were buying and really read labels to understand what these modern day microbiome mischief makers are.

I was buying packages of food that I thought were just fine, right? And so that I thought were, quote, healthy, right? Because the front of the box says, oh, healthy, gluten free, you know, all the things like whole grain, I mean, all the things that we might be looking for. But I would say one of the most ubiquitous food additives that I want people to know about and to put right back on the shelf if they see it. There are these category food additives.

And, you know, the kind of, it's kind of funny, but not really funny. The FDA actually has a database, it's called everything put into food in the United States. It's this database of over 3000 food additives. I mean, who would think we need 3000 food additives to make our food actually taste good, right? I mean, it's all that kind of mad science behind the scenes.

But there's a particular category of food additives called emulsifiers. They're the things that keep our food together, keep them from making this goopy mess. They're found in some protein bars that our kids are gravitating towards. They're found in ice creams, they're found in ready to feed infant formulas, even at levels that are known higher than what are known to be harmful. So we need to be savvy about this, because these emulsifiers, many of them have been found to directly cause gut dysbiosis and preferentially preserve the pathogenic bacteria while killing the beneficial probiotic bacteria.

And some of these have been found to directly increase intestinal permeability, so directly cause leaky gut. In fact, the rise, this huge rise of food emulsifiers in our packaged foods in some countries can be seen to kind of directly correlate with the rapid rise in autoimmunity that we're seeing in our populations. The package isn't going to say food emulsifiers. It's going to say things like mono and diglycerides, carrageenan carboxymethylcellulose or cmc polysorbate 80 xanthan gum. So there are some things that we just want to be on the lookout for.

Now, the gums, like xanthan gum or guar gum, acacia gum, some of them actually can be beneficial for our microbiome. So we just have to be savvy. But that's where if all kids could learn how to choose their packaged foods or chips or their drinks or their whatever it is, so that they can sit with their friends, and yeah, their friends can have the prime and the takis. They can choose maybe the siete chips and the liquid death, you know, hydration the drinks, then they can sit with their friends, have fun, you know, be kids, but not have the disruption to their gut microbiomes. And they're simple swaps like that.

So that's what I want every parent, grandparent child to understand.

Dhru Purohit
If you had to rank on the topic of food. And we'll go to a few other categories that are these sort of mischief makers, right? Things that can disrupt the gut microbiome, antibiotics being a big classification, but sticking to foods for a second, if you had to rank what is harming kids gut health the most just based on what you've come across, there's no definitive research that's out there that maybe it's one thing or another outside of maybe you pointing to antibiotics, outside of food, how would you rank that? Because you hear a lot of arguments on different sides. Some people say it's the presence of too much sugar in the diet.

Some people will say that it's things like emulsifiers, like carygien, which is in a lot of products that are even in, like Whole foods and Trader Joe's, that people are shopping in. Some people will say that it's too much of something. People will say it's not enough of something. What are your thoughts? So I think there's this sort of what do we want to try to get in versus what do we want to try to keep out?

Elisa Song
And, I mean, they're both important. What I have parents and kids think about is what's going to be the easiest for them, because, yes, you need that foundation. We need to feed and nourish our microbiome. Our microbiome is not just the bugs in our gut. It's a whole ecosystem, and it's our genes.

And so if we want to nourish that ecosystem inside our gut, which is really our largest ecosystem, right? I mean, all kids learn, oh, we want to, you know, save the world. You know, save the world. It's Earth day. We want to, you know, reduce, reuse, recycle, reuse all of that.

Right. We want to think about our gut microbiomes ecosystem in the same way. It needs to be protected, because if we don't protect our gut microbiome, we are not going to have the resilience to withstand whatever comes our way, whether it's.

I mean, we'll talk about psychological stress, because in terms of food, I think there are some key hitters. I think, though, that one of the most disruptive factors to our kids microbiomes today is chronic, unmanageable psychological stress. I think that is something that is very different than how we grew up, our parents grew up. There are so many forces that are really playing into making psychological stress an unnecessary harm to our kids brains into the microbiomes. But as far as the foods go, when we think about nourishing our gut microbiome, I'd say that the biggest things to keep out are, I mean, how do I rank them?

I mean, the added sugars are way up there, right? I mean, at least 50% of added sugars in adult diets now is coming from sugar sweetened beverages. I mean, think the boba and the Starbucks for our kids, some of them, it's almost every day that they're having these bobas or these frappuccinos that have upwards of 35 to 50 grams of added sugar, when kids should really have no more than 25 grams of added sugar in a day. And I'm seeing it in kids blood work. I mean, what's startling is as an integrated pediatrician, I do more blood work on kids than I would say the general pediatrician because I really want to understand what's going on underneath.

How do we take the data to really fine tune our kids health? And even these slim fit, athletic, young middle schoolers and high schoolers who are not anywhere near the picture of what most people think of as having type two diabetes. When I check their fasting blood sugar and their fasting insulins and their hemoglobin a one cs, they are reaching pre diabetic ranges, and they're certainly not optimal ranges. So I think that's the sugar. And we know that poor glycemic control and the resulting inflammation is one of the biggest factors in chronic disease.

I mean, when we saw COVID, right, I mean, one of the biggest risk factors really, was that underlying poor glycemic control. And so that's one thing that kids just need to be aware of, right? Sure, they can have the boba, but maybe not an everyday thing. Or if they're going to have the boba, maybe they decide not to have the ice cream for dessert after dinner, right? This episode is brought to you by Lifeforce, the diagnostic company I personally use every quarter.

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Just a little quick tangent, and I always share this with, you know, folks, anytime your name comes up, I so I've always respected you and your work as early as I found out about your work. And I send you as a resource to everybody that I know who's dealing with any kind of thing about fevers or should I give my kid Motrin or this, that you have so many incredible resources and I send so many of your articles to people. And then when the COVID-19 pandemic happened and we started having a lot of early conversations about vaccines, and that started these early conversations even before the vaccines were out, about sort of mandates and we need to protect, you know, vulnerable and kids were getting lumped into that conversation that we need to get the kids protected. And even before the vaccines were out for kids, the COVID-19 vaccine, there was this real drumbeat and sort of march to, I would say from the outside, it really felt like we, it felt like a campaign to kind of bulldoze parents. And this just needs to be a massive tidal wave so that we don't have anybody questioning whether or not kids should or shouldn't, we're just going to give you the science and this is it.

And you were one of the first mainstream pediatricians who has your foot both in the integrative world and the functional world, who is, you know, well educated, well respected on both sides that came out and said, hey, hang on 1 second, let's have an honest conversation about this. Right? And I really respect you for that. You came on my podcast quite early still, and we were even debating about do we do this topic? You were talking a little bit about it on social media.

And I believe at the time, even some of your own posts got flagged, right for potential misinformation, which everything was getting flagged at that time. Anybody who was discussing anything that was different than the typical narrative and I really want to acknowledge you because after, you know, you came out and talked about so many of the nuances that are there and how kids are not a vulnerable population for COVID-19 how we're misunderstanding a lot of the breakdown of the science, how there's actually very little research on the vaccines that were done for kids, how it's okay to have questions as parents. I saw so many of my friends that would be typically not very open to the conversation, all of a sudden have a much more open mind because you weren't trying to convince them. You were just saying, I'm gonna walk. You through the science.

Let me show you how many kids. Have actually died from COVID-19 that didn't have a comorbidity that I believe one of the studies you referenced was in Germany. Not one child had died from, like, COVID-19 yeah, out of, like, out of, like, the last year or something like that. Anyways, you went into all the detail, and I just want to say that probably at the time, took a lot of courage to be able to do that and present this voice to parents who were just looking to get answers. So I want to acknowledge you for doing that, because you open it up.

Dhru Purohit
And now, if we look at it, not to make this about the COVID-19 vaccine or pandemic or anything else, but it's really the larger topic that's there is there were a lot of individuals that didn't really want to have the full conversation. And you look at it today, I think even when the vaccines were fully out there, less than, like, 5% of, you know, parents, like, got the vaccine for their kids because people were ultimately making the risk benefit analysis and saying that, hey, listen, maybe this isn't the intervention that's needed. Sure, there could be other interventions that are needed, but this particular intervention is not. Is not needed. And how I feel that's tied to today's conversation is that a couple things.

Number one, we're not talking about how bad the state of health is for kids today, and it's getting worse every year. And if we don't see it as a national emergency, that is multifaceted. Sure. I'm. I'm sure devices play a role into this.

Food plays a role. The health of parents, especially the health of the, you know, the mother plays a role. Environmental factors, you know, play a role. Sure. I'm sure the vaccine schedule plays a role.

There's so many different things that play a role. But if we're not willing to talk about how bad it is. We're never going to end up getting to the right solution. So that's part of the reason why I wanted to make this acknowledgement on the podcast in this moment for this conversation. Yeah.

Elisa Song
Well, thank you. I mean, you know, this is where, I mean, clearly what we're doing in conventional medicine and pediatric for our children, I'm not going to say it's not working. It's working in a sense, but it's not working to end chronic disease in children. And if anything, we're just seeing a higher and higher trajectory. So we need to understand the value of the conventional approach because there is, and yet we also need to understand for, let's say, something like antibiotics, all of the downstream unintended consequences that may be putting our kids for longer term harm than the initial infection itself.

Dhru Purohit
Risk, reward. Right. And so, you know, when we think about all of these factors, you know, it is interesting you mentioned. Yes, yes. Devices have a role.

Elisa Song
In fact, what's fascinating is screen time use and, you know, gamers, when they look at the microbiomes of children and kids, and I think, I think this must say was even for adults, too, they have different microbiomes than people who spend less time on their phones. Well, there could be a number of reasons. I don't know if it's EMF, but what are you doing when you're on your phone? You're not exercising. Right.

And we know that exercisers have different microbiomes than people who don't exercise. And then you think about the environmental toxicity. I mean, we have to worry about these forever chemicals that, I mean, some of them have a half life of 25 years. They're not leaving your kid system very quickly. And so these forever chemicals and many of these endocrine disruptors directly harm our kids microbiomes, too.

And so when we understand that foundation, I mean, here's the thing. We can think about all the things that we shouldn't do. That's a hard way to live. Right. It's overwhelming.

Right. And so, yes, there are some things that we want to focus on and choose what's going to be easiest. If your kid is addicted to screens, I'm not going to tell you tomorrow, get rid of it. I mean, we need to work on that. But if, if your kid loves exercise or loves other things, let's think about what is going to be doable in the moment, because all of those will make a difference each little step.

And so, I mean, yes, there's so many different factors. I would say for kids and their microbiomes. When we think about the biggest mischief makers, it's going to be, you know, these, the ultra processed foods, which include the added sugars, I mean, that's part of it. Psychological stress way up there. And then all the things that, because of the different lifestyle factors, they're not doing to support their microbiomes.

And so it's kind of a combination of, okay, what are the things that we can take out that are easy to make swaps with? And what are the things that we can add in to their diet and their lifestyles that are going to create that foundation of resilience in their microbial ecosystem? So that the next time they have the boba or the next time they have the takis with the artificial ingredients and the MSG and all that, their microbiomes can bounce back. I mean, the whole conversation around COVID, this word resilience kept coming up over and over again. It's not about avoiding everything.

You can't do that. And for our kids, we don't want to do that. We don't want to put them into lonely little bubbles where they don't do anything except eat at home and don't interact with friends in any way. That is really, you know, the way kids interact. I mean, I look at my son and my daughter and going downtown with their friends now independently, and, you know, they need to learn how to make these choices without living in a bubble.

And so when we build that foundation of resilience, microbiome resilience, immune resilience, brain resilience, then they can withstand a lot of these stressors. It's understanding what these stressors are and then giving them the tools to build that resilience that really will help them for lifelong health. One of the things that I often hear just in listening to conversations, and sometimes it'll come from individuals that I would call that might be in the grandparents stage of their life right now. And they have kids, and their kids are having kids right now, and they're grandparents. They'll often be the sentiment of, like, you guys are doing so many different things, and you're trying to have your kids live in this bubble by protecting them.

Dhru Purohit
When we were young, we just ate whatever, and we didn't have eczema, peanut allergies. We didn't have all this stuff. We were fine. And, you know, you go through a phase as kids. You eat your lucky charms or your whatever processed cereal that they ate at the time, maybe wheaties, and you kind of, you know, grow out of that, and you start to learn how to like your vegetables later on.

And, you know, we didn't have any of those issues that you see that kids are having today. What do you say to the people who say things like that as, as the explanation for what's uniquely going on today, that kids seem to have a lot more things comparatively? Is it simply primarily because of the introduction and the overuse of antibiotics? Is that the biggest culprit? Is there something else that's there?

Elisa Song
I think that probably, you know, the introduction of antibiotics is, is one of the biggest culprits. I mean, that's the change in the number of prescriptions that's been written. But, you know, what's interesting, too, you know, we, we think about antibiotics as being the biggest acute microbiome disruptor that we have. But when we look at the studies, what's really alarming to me is the number of other medications that can disrupt the gut microbiome pretty much as significantly as antibiotics. They include things like, well, we already talked about reflux medicines, but nsaid medications like ibuprofen.

Right, Motrin or Advil, antihistamines like Zyrtec or Claritin, SSRI, antidepressant and anti anxiety medicines, the birth control pill, steroids. I mean, think about, when I think about what's going on with our teenagers today. Think about how many teenage girls are on birth control pills for their horrible period cramps. They're on low dose doxycycline for their acne. They may be on a steroid inhaler for their asthma.

They're on an SSRI because they have anxiety. Right? And when they get their period cramps, they pop the ibuprofen. Right? I mean, all of those things that if we're not supporting their microbiomes, they're going to continue to get more and more disrupted.

So it's sort of this, you know, this synergistic effect, and we need to step back and help understand. I'm not telling kids, you know, when kids come to me and they, and teenage girls and they come to me and, you know, they want to consider being an SSRI, or they want to, you know, be on the birth control pill before they go off to college, that's a common one, right? I mean, I've been in practice now 20 years. I had a whole bunch of kids going off to college during the pandemic. And last year was a big graduation for a lot of my kids.

And it is common. A lot of girls want to be on the pill when they go off to college. I don't say never know. What I say is, look, let's understand. Just like when you buy your first car, you are most likely going to do your due diligence and do all the research, look at multiple different car options, decide which one is best for you.

We wanna do the same thing with any medication that's recommended. And so when it comes to the pill, okay, let's look at it. Well, birth control, yes. We also wanna make sure we're protected against STD. So that's not gonna be the pill.

Birth control. We know the pill will disrupt the gut microbiome. Let's make sure if you wanna take this medication and make responsible decisions as a young adult, understand how to nourish your gut microbiome so that the pill doesn't cause so much disruption. We know that the pill also depletes certain nutrients like methyl b twelve and folate, which when those are impacted, methylation is going to be disrupted. Your neurotransmitters are going to be disrupted.

Which is why I think in the first two years of starting the pill, we know that many women and young girls will suffer from depression, mental health concerns directly related to beginning the pill. Well, our young woman teenagers to the early twenties in their first two years of starting the pill have a significantly increased rate of suicidality and er, and suicide attempts. And if we can support their methylation, support the nutrients that are depleted, we could probably mitigate a lot of those. So it's just knowing the information and not just blindly saying, I'm here, I'm going to take this prescription. All right, I like this prescription.

And what are the side effects? How do I support myself from the side effects? Are there any other options? I mean, it's the same thing when, you know, a doc prescribes antibiotics. I have a list of questions that I suggest that parents ask the prescribing doctor.

Not to be controversial or not to be challenging, but to really have that open discussion of, hey, I'd like to make this informed decision. Can you help me make this for myself if you're an adolescent, or for my child, if you're a parent with a younger kid, there was this big. Article that just came out. We'll link to it in the show notes in the Washington Post. I don't know if you saw it at all.

Dhru Purohit
It was all over TikTok and Instagram, but it was basically talking about this explosion of women online who have been talking about some of the challenges that they experienced with the pill, with the pill. And it was talking about a few different influencers who that's been a big part of their brand, or they maybe written a book or they have online courses, and then they were interviewing a lot of, quote unquote, experts in this space who are scientifically have a background in it. But we're largely saying any of these conversations about the downsides, it was, in a way, blanketly sort of saying these are unscientific. They're trying to come at women's rights. And largely, there was an undertone there because it was the Washington Post, that this is all part of this sort of right movement, this conservative movement of women's health being under attack.

They were connecting it to sort of going after abortion rights for women, Roe versus Wade, and a bunch of other stuff that was completely unrelated to the story. It brought up a lot of feelings for people that are in this space. You know, I'm sure you saw a little bit about that. I don't do too much social media, even though, I mean, I love Instagram, but I did see, and I thought, that is really so interesting. Right?

Elisa Song
I mean, because we have to have this conversation and women should be allowed to have this conversation, right? They were almost attacking women, and they were saying, if you ask any questions about the pill, they're basically saying, you are against Roe versus Wade and you are a deep MAGA supporter. It's like what, we can't have an honest conversation about something that happened to our bodies? Obviously, that's the women talking about it who went through that. And a lot of the women did speak up.

Dhru Purohit
And ultimately all things I think people understand. Legacy media is one perspective, and individuals are going to come in with their own slant, just like our podcast is going to have its own bias. It's going to come, and it led to a lot of just healthy conversation online. But what was really interesting to hear from a physician's standpoint is that, hey, you have seen that again, it's not a blanket thing, that the pill is going to be an immediate solution. First of all, a lot of people get placed on it like my wife did when she was very young because they have very painful periods.

Well, there is a lot of factors that go into a reason why a woman might have a very painful period. And the worse off your metabolic health is, the less fiber you have in your diet, the less active you are. All those things that would be making you healthier overall if you were doing them would also be things that would help mitigate how painful a period would traditionally end up. Being. So if you're just giving somebody a pill, you're not having a conversation about root cause medicine that's there.

And everybody else also acknowledges that, you know, the pill has done so much for women's rights and their choice of when they, you know, their reproductive cycle, when to have a baby, when not to have a baby. That's been a huge part of that. And just because something has been a huge part of things doesn't mean that we can't question it along the way to make better and more informed choices for the individuals that end up taking it. Yeah, I mean, that's exactly right. I mean, that's.

Elisa Song
I mean, we need to be able to question the existing status quo in order to be able to make things better and better. And so, you know, this is. It's the same thing as you've said, you know, with the vaccine issue with kids, we weren't necessarily allowed to say anything. It's like, well, why not? We just want the best for our kids.

You know, even, you know, when parents are being prescribed antibiotics, the first question I recommend asking the doctor is, well, hey, doc, is this really necessary? Right. Simple question. Simple question. But what that does is it opens up the doctor's mind and to the idea that, oh, you're not the parent who necessarily came in here just to get a prescription.

Right, right. Because some studies have found that doctors are twice as likely to prescribe an antibiotic even if they think it's not going to be beneficial if they think the person wants a prescription. Right. I mean, it's just the way it is. Right.

And I get it, you know, you're in this er, you're seeing like, you know, one patient every five minutes, and you're just go, go, go. But if someone stops and says, hey, you know, do I really, is this really necessary? Is there anything else I could do? It does make the doc pause and say, hmm, all right, well, you know, I don't know whether you have a sinus or a bacterial, you know, a viral or bacterial sinus infection. You know, you could hold onto this for a little bit and just wait and see what happens.

Dhru Purohit
Right. Right. Now, what would be amazing would be if that doc also had maybe some other tools, like, hey, why don't you try neti pod? And how about some thyme essential oil to break up that mucus? And all the other things.

Elisa Song
But sometimes just the doc saying, hey, look, it's okay. You can wait it out. We know a lot of things are gonna resolve on their own. I mean, that could make a huge difference in saving that child's or your microbiome in that one moment from an unnecessary antibiotic. Also, just from a public health standpoint, reducing the risk of antibiotic resistance even.

Dhru Purohit
Further, which is a huge problem. I'm not sure if you saw this. I'll link to it in the show notes, a lot of articles to link to Tyson Foods, one of the largest manufacturers of meats, especially chicken, packaged chicken. They recently, along with one other large processor, came out and I got to dig into this a little bit more, but they said that we, for a long time, because a lot of people have been very worried, mainstream, you know, medicine scientists about antibiotic resistance. It's a very real issue.

They was enough pressure to tell these large, uh, poultry and chicken and hog manufacturers and harvesters and slaughterhouses, hey, you're overusing antibiotics in the way that you're treating things. So they all pulled back, and now two of the largest ones just said that, hey, we're going to start using them again in the feed. And primarily because I think that animals are continuing to get sicker. And some of the solutions have been more expensive. But they did say, we are going to work together with public health officials to sort of narrow the sort of antibiotics.

We're going to try to keep it away from things that are similar to stuff that's being used on humans. But I think ultimately it was, from what I understood from the outside, I got to dig into it a little more. It was a cost thing, right? It was a cost thing, which a lot of things are. Yeah, right.

Elisa Song
I mean, yeah. I mean, we even know, I mean, that unless these animals are raised in a, you know, ethical, regenerative, sustainable way, you know, a lot of farmers will feed their chickens arsenic, same thing, because it's antimicrobial. And so, I mean, if we're, if we are eating poultry that isn't organically, you know, raised and free range and pastured and all the things we could be getting, our kids could be getting a dose of arsenic simply by eating the chicken tenders, you know, that are, that is not organic. And so, I mean, it's all these things that really the food producers don't have to disclose. And so it's really the food industry and the regulations have to change.

I mean, you know, the fact that, you know, lead is found in infant formula and infant foods, I mean, that's, that's astonishing. Even, even organic, I think it was. I don't want to throw anyone under the bus, but there were some organic brands too, that were found to have levels of lead in their baby food products that were unacceptably high. And these are foods that consumers, as a parent, you're choosing. Oh, I'm buying the organic, slightly more expensive baby food for my child because I want something better.

And sure, I would love to home cook and home puree all of their foods, but, you know, this is on the go. It's easy, right. And it's a necessary thing. I mean, I give my kids a squeezy things and, you know, a lot of the jarred foods. And we're trusting, right.

We're trusting that these food manufacturers and the FDA is going to make sure that our baby food is safe for our babies. And it's not. Unfortunately not. I mean, you know, there are some brands that are, are better, but when it's a profit driven company, we have to really be aware consumers, and not just aware consumers. We need to, once we have that awareness, be able to vote with our dollars so that we can demand better.

It's going to come down to our dollars whether the manufacturers are going to change or not. You know, to add to that, one of the big takeaways that I got, really, from your book and following your work is that. But there are a million things that are wrong with this world. There's going to be all sorts of stuff, things that we can't control, air pollutants, other things. But if you can make your gut resilient, if you can go from not dealing with leaky gut, which we're going to talk about in a second, to actually having a healthy gut.

Dhru Purohit
And there's multi, it's not just about food and it's not just about avoiding antibiotics. It's about working out and getting the right things and fiber and other stuff. If you can do that, you are so much more resilient, and then you can't control everything else. And there's gonna be plenty of times where you're gonna want to partake in things that may not be the healthiest choice, but you're a human being and that's natural and we all do that. But you're not gonna be that, you know, kid who's sick all the time as a kid and now sick all the time as an adult.

You're gonna be somebody who's resilient in this world. So we're going to talk about what it looks like to be resilient in a second. But I want to touch on this idea because gut health is really the central theme in the idea that you're talking about today is that as much as this idea of leaky gut sounds new, we've actually known about the connection between leaky gut and chronic disease for quite some time. Can you chat about that for a second? Well, you know, as I was doing the research and trying to think about, oh, gosh, how long.

Elisa Song
I mean, how long have we known about leaking gut and children, when in the literature was this first cited? Because it's not this new concept, and it's just still not something that's taught in medical school. It's not something I learned about in residency. It's something that I had to learn years after finishing residency as I was embarking on this functional medicine journey to figure out, oh, my gosh, this thing called the microbiome, which we didn't learn about in med school, this thing called leaky gut could actually be one of the underlying causes for virtually everything that's going on in our kids. Now.

There's a different journey to gut dysbiosis and leaky gut for every person, but that as an underlying factor, that if we can support a child's gut microbiome, either to first prevent a chronic health concern from happening in the first place, or if they do have a chronic health concern, to be able to reverse that. And I do mean reverse that. I mean, I have a kiddo that I talk about in the book who, you know, as a teenager, older sister had rheumatoid juvenile arthritis and Crohn's disease. And we were able to finally, after doing all the things like elimination diets and anti inflammatory supplements and, you know, all the things, the one thing that flipped the switch and put her into remission for good was treating her Klebsiella gut dysbiosis. Wow.

Same thing happened to her brother. Her younger brother got rheumatoid arthritis. His was a little harder to manage because he was more. It was a little harder for him to keep away from those mischief makers in his diet. And so sugar, additives, sugar.

And he loved his corn chips and loved the Gatorade at that time. There wasn't prime didn't exist back then, but, yeah, a little bit more of an uphill battle. But eventually, once he learned how to really kind of get in the foods that are going to keep his microbiome healthy and make some of those swaps, when we treated his klebsiella gut dysbiosis, that also flipped the switch. It can be. I mean, that seems like such a simple thing.

Oh, treat the dysbiosis but we know that there are many dysbiotic organisms in the gut that can predispose and even trigger autoimmunity. Some of those, I mean, for instance, let's say glyphosate will preferentially. I mean, many people know glyphosate as roundup, you know, an herbicide. Some people will know that glyphosate was originally patented as an antibiotic. Well, glyphosate can trigger leaky gut, you know, just on its own.

Glyphosate kills your lactobacillus and bifidobacteria. So it kills the beneficial probiotics in your gut and can preferentially keep these dysbiotic organisms, especially things like Proteus or Klebsiella. These organisms that we know are more closely linked with autoimmunity.

That's where we just want to unravel that story and help parents understand. Okay. One of the foundations, if your kid comes to me or develops a persistent health concern, we always want to look at their gut, even if they're not having any, quote, classic gut symptoms. Right. They could have the perfect looking poops and still have gut dysbiosis and leaky gut going on.

Dhru Purohit
The gut is really that through line. It's the. It's the really the first place that the immune system gets built for the entire rest of the body. Yep. Yeah.

For the parents that are listening at home and the grandparents, too. Right. Because everybody cares about the future of kids on the planet. What is the first step in now that we understand a little bit more about the problem and we understand how bad it is and that there's a problem even in the, you know, half. Half the problem is just understanding there is a problem.

Elisa Song
Yes. Right. Now, you know, all these different inputs that are there that can lead to the situation. Some of these mischief makers. How do we begin to unwind and actually create kids that are happy and healthy?

So, you know, one of the things that I want to make sure when I wrote the book was that parents didn't feel the overwhelm. That grandparents didn't feel the overwhelm. And I've had grandparents read the book and, in fact, I mean, gotta love the grandparents. God bless them, right? But oftentimes I'll have parents saying, you know, they cringe when they go to grandma and grandpa's house because, you know, grandma and grandpa think that, you know, going to McDonald's and, you know, stocking the freezer with all sorts of, I mean, treats.

Yeah, treats, quote, unquote, treats is the way to love their kids, right? And I remember. I mean, this was. This was me, too, right? When.

When Kenzie was first born. And I remember my sisters pulling me aside and saying, look, you gotta, like, tone it down. Cause, like, mom, she gets nervous when you come around. Cause she doesn't know what to feed the kids, right? And I was like, oh, my gosh.

That's the last thing I wanna do, is have my mom feel nervous about what's in the fridge. Cause I used to. Anyhow, yes, we have to kind of step back and understand us about building that resilience. But I've had one grandparent in particular. She reached out to me and she's like, you know what?

I totally get it now. And I had a conversation with my husband. We cleaned out the pantry. We're getting totally different snacks for our kids. And I was like, that's what we want to happen, right?

And she was so upbeat about it. She's like, this is. This makes total sense. It's. I.

Now that's the answer. I don't feel like I'm depriving my grandkids because they're not getting that, you know, artificial. Whatever. I'm going to. I'm going to call out my.

My stepdad, the. The bunny tracks ice cream that he loves to get the kids. Right? He. They now know, okay, we're going to buy this particular ice cream that doesn't have the artificial colors.

And, you know, I tell my kids, you know what? Like, mint ice cream shouldn't be fluorescent green, right? It should be, like, this natural color. So. But.

But where do we start? It's really, like you said, with the foundations of knowledge. Like, what are the things that can contribute to disruption to your child's gut? Microbiome. And then we step back and we let go of the overwhelm, right?

Because I had one mom, I remember she was pregnant, and she came to me, and she just. Her health was not good, and she was pregnant with the second sibling. I'm like, what is going on? You could see that she was just so wired and anxious, and she just read all the horrible things about water. All the horrible things about, oh, my gosh, I can't have water that's in plastic.

And if I had this water, what if it's contaminated with x, y, and z? And I don't know what purified it used. She was so paralyzed, she stopped drinking water. I mean, literally, we cannot have that. That is not the way to build resilience.

You should be able to have water in a plastic bottle. Right. And be able to bounce back. Right? Sure.

I'd love it if you had water in a glass bottle all the time, whatever it is, but that I'm like, wow, I never, ever want to instill that kind of fear in a parent or a child or a grandparent or whomever, so that they feel like, I can't live in this world. We can live in this world and thrive if we know the biggest needle movers for us. Right? And so, you know, one of the biggest needle movers that I said, mentioned before was really if we can learn how to manage our psychological stress a little bit more reasonably. Right.

Dhru Purohit
For the parents, for the kids, for both. Everyone, right? Everyone, right. Who doesn't say, oh, my gosh, I'm so stressed, me. But I'm the only person that I know that doesn't say that.

Elisa Song
I've stopped saying it. You know, the other thing I've taken out of my vocabulary, I've stopped saying, I'm so busy. Yeah, that's a good one. Who's not busy now, right? And so it's really, we have to shift this mindset.

But if we don't teach our kids how to do that, and we often have to start with the parents because parents have not learned that. Right. Yeah. But when we can improve our mindsets, what does that do? I don't call it mindset.

Mindfulness meditation. I do in the book. But really, when I talk to kids face to face, I teach them about our vagus nerve, I teach them about their gut brain connection, and I teach them that when we do our vagus nerve work, just like, you know, we should exercise our bodies every day. We need to exercise our vagus nerves every day. And guess what?

You're going to be able to manage stress better, and your gut microbiome is going to improve even if you don't change your diet. I mean, that's what one of the studies showed, that kids who engage in activities that improve their heart rate variability as a proxy for vagus nerve function, their microbiome diversity and function improved independent of diet. So for a lot of parents, changing the diet is one of the most daunting things. And so if their kids are addicted to the artificial, this and that and the too much sugar in the MSG, okay, we're going to work on that because being addicted is hard and it's hard to get rid of those. We're going to work on that.

Right. But if we can work on your child's vagus nerve and they can work on it and be engaged with it. Not only are they going to have tools to build emotional, psychological resilience for the rest of their lives, they are going to improve their microbiome, which then. With. Which then with the gut brain connection will improve their mental health resilience.

So it's this kind of, it's this two way street and it becomes a positive cycle, right? Instead of a negative cycle, where psychological stress that we can't manage releases zonulin within an hour directly triggers leaky gut, causes gut imbalance and gut dysbiosis, which then we don't have the microbes to manufacture our serotonin and dopamine. Then we can manage stress less well and the cycle goes on. We want to build this positive cycle forward. So if we start with the vagus nerve work, which there are some simple, easy ways that kids can do that, I think that foundation of microbiome resilience will be so much easier to attain.

Dhru Purohit
Some of those simple and easy ways. Do you want to just name a couple that offhand? Yeah. And how much of it is also kind of removing the stimulus that's constantly around, that's putting us in this sort of fight or flight? Like, you know, I actually think one of the most stressful things for kids is how much advertising they're exposed to.

Like, I would much rather have, and I'm not a parent right now. Sure, I get it. Kids are going to be on their iPad, they're going to do stuff. But when I look around, it's interesting. I see a lot of kids, like, the amount of ads they get on YouTube, the amount of ads that they get on these free games on apps.

And these ads are like, they're jarring. They're designed to grab your attention this, and they're different voices. They're this. There's so much stimulus. I'd rather pay for my kid to have a PlayStation where there's no ads or unfortunately, I try to buy YouTube.

Premium for my nephew and niece for their Gmail account because it's under YouTube. And YouTube was like, oh, you cannot have. Google was like, you cannot have kids. It was something about like, they're not old enough, right. You have to be above the age of 14 or whatever, because they're like, tracking or whatever.

I was like, I'm trying to have these kids, like, not watch ads by getting them YouTube Premium and, like, YouTube is not allowing me to do it. Yeah, yeah. Anyway, so the question was how much of this is sort of reducing stimulus and how much of this is sort of adding in activities which we know are important, like working out or being active. Not even working out for kids, but just being active. Yeah, I mean, I think to the extent possible in the moment, removing that stimulus is really important.

Elisa Song
I mean, we know that, of course, video games too. I mean, those video game scientists, I mean, you bet they're trying to make that as addictive as the food scientists are, right? All of these things. And so again, I mean, video addiction is real and, you know, screen time addiction for kids. And so it may take some time to undo that, but that is critical.

If your kids are really and truly addicted to their screens and constantly looking, there's some work that has to be done. And so which it seems like kind. Of every parent is kind of going through that right now is what I've just been noticing, especially for my friends. Their kids are sort of at the age of like seven, eight now they're becoming like 910, eleven. It's a, it's a tough thing I feel for, and I'm sure I'm gonna go through the same situation.

Dhru Purohit
Everybody's trying to deal with it and trying to figure out what is their unique form of sort of carrot and stick or boundaries that make sense. But I do feel like the kids need boundaries. And the ones my friends who's, my friends who are parents who have those boundaries with the kids that make sense for their own family, which may not make sense for another family, those kids are genuinely less anxious is what I feel. Yeah. Yeah.

Elisa Song
Well, and, you know, during the pandemic for boys, especially video games and communicating on discord was really the way they could stay connected with their friends. And for girls, it was texting. Right. One thing that, you know, I am all for educating kids and teenagers and in an age appropriate way, but they can be pretty savvy and they can understand a lot of the science when you explain it to them. And so when kids are even before, hopefully they get their phones or they get that first video game console to have a discussion about how addictive they can be, how they can drain their neurotransmitters.

And I talk to kids about neurotransmitters, your brain chemicals that affect your mood and your cravings and how you interact with other people, how you sleep and all of that. And so having that conversation about how addictive they are or if they've already had it, if they already have their devices, talking to them about how addictive they are in the moment and letting them know, look, if there is a time because of course when you ask someone if they're addicted, they'll say no. Even adults, a lot of adults are addicted themselves. Yeah. And say, of course I can get off anytime.

I let kids know and teenagers know. Look, if you feel like when moms called you ten times to come down to dinner and you just have to do that one more thing on your device, that's addiction and you're not in control of your brain, those video game manufacturers are. Think about that and let's figure out how to get you to have control over your playing time. Really talking to kids about, about that and all the other forces that can make that addiction harder. But it is true.

I mean it's so hard for parents, it's so hard for kids. I talked to kids about social media before they get social media and let them know that some of the studies have found, I mean there can be some benefits. I'm not saying that screen time is all bad. And in fact, in one large study they did find that there was an increased rate of depression and suicidal thinking. And the higher the number of, of hours on social media and screen time, the higher the risk.

I mean any, you know, 5 hours and up was significantly higher. And so I will have parents and kids pull out their phones in the office and look at their screen time usage because, you know, a lot of kids are like, there's no way I'm using that much screen time. I mean, and parents too. And then they look and they're like, oh my gosh, I have like 8 hours today, right? I mean it adds up because that little scroll while you're in line at the cafeteria or the, you know, in the car ride ten minutes away to your soccer game and you're kind of looking, I mean it all adds up, right?

So 5 hours or more was significantly increased risk. Now when they looked at protective factors too, because it can't just be about, oh my gosh, this is doom and gloom and it's all fear. Protective factors, they included playing on a sports team, right? Whether that's the community or whether that's physical exercise. It included reading print media.

I mean who reads a newspaper now? But you know, it was print media. Shout out to my older sister Hershel who helps me with the podcast. She not makes, but she reads the newspaper with her kids. The paper.

That is so good. You can tell Hershel that was a protective factor. The number one protective factor was face to face in person communication with your friends. Yeah, number one. And not just sitting on the sidewalk all on your phones.

Together. Right. It's like interacting. And so that was the most protective. So even if your kids are on screens.

Right. You can mitigate a lot of that by getting them playing sports, having them be in person with their friends. Counterbalances. Yes. Yeah.

Dhru Purohit
So how much of this is the problem with screen time, which obviously screen time is not going anywhere and not just having other options because I've generally seen from kids of all ages, if there is something to do that's fun, like playing a sport, going and doing something. You know, obviously every kid, and I had this, too. I'm sure you had that. You know, when you're younger, you don't, you naturally, especially in your teens, you don't want to, like, spend a lot of time with your parents. You want to be independent.

You want to do your own thing. I say that my kids are almost. Teenagers, but, you know, you'll hang out with, like, an uncle or, you know, this or like, whatever. Like somebody who's making something fun or cool. Like, kids want to do stuff.

Elisa Song
Yeah. They want to go do something. Right. And if there just has to be options that are available, which I know is, you know, obviously every family has to figure that out and see what that is or find out what activities to be enrolled into, but there just has to be counterbalances that are there. Well, and you know what?

They're taking cues from, from their parents, too. Right. I mean, I, you know, I have some families who are amazing and really doing the best they can, and yet I, you know, and my practice as a functionality, pediatric, integrated, pediatric practice, parents select, I mean, they choose to come to me because they want a more integrative approach and that, by virtue, tends to be a little bit more of a natural, healthier approach. Right. And yet I still have parents come in and saying, gosh, is screen time really that bad for my kids?

Spending hours on the weekend playing video games together? Great if that's a family bonding thing. But then show model that you can put time limits around, that. We do this and we balance it with going for a hike in the canyon or going for a family bike ride after dinner. We want a model that we can also temper our own use and that it's a balance.

I have kids coming to me, kids they do have. When they have Internet access, they're going to look up all sorts of things. One thing that kids come to me, which I'm so grateful they do, I mean, for my patients, I talk to them, you know, if they're looking at a different supplement or a thing that they're interested in. Just shoot me a message, pick up the phone. Right.

I'm happy to go over, you know, what it is, right? Because I've had some coaches recommend certain protein shakes or, you know, whatever, muscle building things. And I look at the ingredients and I go through each of them, you know, with the kids and say, okay, what are your goals? Why do you want to take this? Is this the right thing for you?

Could we reach your goals in other ways? If you take this, what are some additive things that we can help to reach your goals? But one of the things that a patient found was this. One of the markets in the supplement industry that is one of the fastest growing is the gamers market. These no tropics for gamers.

You stay on longer and be sharper when you're playing your games. There's this one that's really popular. And so a patient brought it to me and he wasn't really interested in gaming, but, you know, he's super smart, he's into robotics, and he just wanted his brain to be more focused so he could do all the things that he wants to do. And I'm looking at this, I'm like, oh, my gosh. It says artificial everything on it, right?

I mean, it's like dyed this, like lemon lime fluorescent green. I'm like, let's find a different one. But of course he wanted that one, right? So I, you know, we went through and we tried, we found some other, other supplements that had similar ingredients, not necessarily marketed to the gamer, but would help him achieve the goals that he wanted to. But you talk to your kids.

I mean, even kids younger, when they're younger. When I taught, I created this, one of my favorite things I've ever done, ever. It was these group of eight to ten year olds in my daughter's third and fourth grade combined class. And I created a six week curriculum teaching them all about their microbiome. We didn't call them their microbiome.

We call them their tiny little friends in their tummies, right? And they learned about how their microbiome is so important for their brains. And if you can't sit still in class or you have trouble falling asleep or it's hard to get along with your friends or you're tired of getting sick all the time and missing parties, right? And so they, in those six weeks, learned how to read labels and count sugar. We made kombucha.

We made sauerkraut. And they were going home telling their parents about this. I mean, that's how we get the change. And they were eight to ten year olds, and these parents were calling me like, I can't believe they just picked up a box of, like, this unicorn thing they normally would have wanted. And they looked at the ingredients, like, now let's choose something different, right?

I mean, that's how we empower the next generation. It's education, it's personalizing it to the kids goals. I mean, I ate like shit when I was a kid. Yeah, I grew up primarily vegetarian, and I ate. That meant that I basically ate anything that just wasn't meat.

Dhru Purohit
So that was a lot of Gatorade and chips and honey buns. I wasn't eating, like, health. They didn't really have, like, healthy vegetarian food at my school, so I'm just eating, like, whatever the processed food snacks are that are there. And then at home, my parents would make a good dinner and everything like that. Healthy dinner, you know, for what they knew at the time.

And it wasn't until I had really bad acne when I was in high school, going into my senior year, and then when I got into university, I was very motivated. I was asking questions, what is driving my acne? Because I tried all these different gels and creams, and nothing was working. And then that's when I started doing a little bit of digging around. And I went to this lecture at this conference that I was at.

Actually, it was a religious convention that I went to from my background in the jain community, and I heard a speaker over there talking about how for some people, for some, especially teens, dairy can make their acne worse. Worse off. And I was like, I had never heard that. And as a vegetarian, so much of my diet was dairy. And I was like, you want me to give up dairy too?

That's like the only thing that I could eat. Like, that's why I go to Taco Bell. So then I tried it, and I was drinking a lot of milk and having a lot of cheese, and I saw a huge difference. In about a month and a half, my acne cleared up. You know, that was my situation.

I'm not saying that's for everybody. And that got me sort of motivated. So it's like, what are your kids goals? Whether it's being more focused, having more energy, how do you tie it into them and just realizing that every kid is pushing back in the beginning. Right?

Like everybody does. I'm sure you did in your own version and own way. Oh, yeah. But bringing back to something that you shared earlier, I was asking you, like, how do we begin the process of unwinding this. And you were saying, you know, starting off with the vagus nerve and starting off with having these resilience activities that lower and have us have a counterbalance to psychological stressors.

So. Great. And that can be done through a multitude of things that you talked about and more that's outlined inside of the book. Then where do we want to go from there? Well, so we start with setting the foundations, and then sometimes, despite that, there's still some imbalance.

Elisa Song
Right. And so then we have to do a little bit more of the work of healing a disrupted gut microbiome, which, unfortunately, many of us have. Right? Most probably. And so there might be some cleanup that you have to do.

And this is, you know, even for kids who don't have a particular diagnosis, you know, if they're just. If they're more sensory, you know, when I was in med school and residency, there was no such diagnosis as sensory processing disorder. And, I mean, that term didn't even exist. And then when I started my practice, I'm like, sensory issues? What are sensory issues?

Of course, sensory issues are when kids don't feel comfortable in their own skin. Right. But now so many kids are sitting there and they don't like the tags on their shirts and, you know, the seams on their socks or certain food textures or they cover their ears, you know, when the vacuum is going, or the blender, which. Which, I mean, as a one off, that's okay. You can live like that.

But if it's everything every single day, it's really hard to live in this world. Absolutely. And so, you know, so many kids now have multiple sensory issues that are just making it impossible to sit still in class or, you know, be calm. And so, I mean, part of that. Part of this is just trying to figure out how do we support our kids even if they don't have a diagnosis, if they're showing signs that something is happening, that they're not thriving.

Right. And we've come to accept that it's normal for kids to wiggle in their chairs or, you know, have huge worries and huge meltdowns or have sensory issues. Well, they don't have to. And if that's happening, that's a gut brain issue. A gut brain or gut immune.

I mean, kids should have babies. Some babies have that buttery soft skin that you just want to touch, and it's so silky smooth. And babies should have smooth skin. It shouldn't be accepted that babies have eczema on their cheeks and, oh, that's every baby has eczema, right? Or, oh, every baby's colicky.

It doesn't have to be. But we've just. We've sort of created this world now where we've normalized a lot of these things and we've forgotten what it really means for a kid to thrive in their whole body and in their whole mind. And so then when we look back and see, okay, we know the foundations. We have to.

We have to get back to the foundations of, you know, nourishing your gut microbiome. And I talk about your microbiome champions, too. I mean, these are the fiber, the phytonutrients and fermented foods, which may be, in some, in one Stanford study, even more important than fiber, at improving gut microbial diversity. Right. But apart from that, if your child already has a dysbiotic gut or they have a leaky gut, we need to do some of that cleanup, too.

Dhru Purohit
Yeah, they might have too much of the wrong type of bacteria. That has to be addressed. That could be done through, you know, supplemental intervention, food intervention, in some cases, maybe some targeted antibiotics. Yeah, yeah, yeah. Well, so, you know, the.

Elisa Song
The kiddos I was mentioning earlier with the Klebsiella, I did use antibiotics, right? I used a prescription because I wanted to make sure I was getting this Klebsiella out. And in the particular stool study I used, I could see what antibiotic was going to work, you know, what the sensitivities were. So I chose that one so that I knew, I'm going to kill the Klebsiella. And then we did all of that gut restoration to make sure that we could replenish the microbiome.

And that's not just, you know, a lot of people now think, well, I'll just throw tons and tons and tons of probiotics at your gut microbiome. And that's all I need to do, right? I mean, that's kind of. It's this very western american phenomenon. More is better, but it's not necessarily more.

It's really about the right strains and about feeding and nourishing those strains. You know what I tell kids? It's not like Jack's magic bean sucks. You can't just throw some probiotics into your gut and expect this whole ecosystem of microbes to want to grow and stay. You have to nurture.

And that's where, I mean, that is going back to the foundations of making sure that we're not inadvertently preventing those microbes from wanting to stay because we're eating ultra processed foods or too much sugar, making sure that we're feeding them what they need to grow, like the fiber, the phytonutrients, and the fermented foods. For anybody who is a parent and is in this sort of world of integrative and functional medicine, or anybody who, it's just even looking for somebody who's like a more open minded clinician, one of the things that they've seen for their kids, right, or for a family member that is a child, nephew, niece, grandkids, whatever it might be. There's just not that many integrative and functional pediatricians that are out there, right? And sure, there's probably a few more open minded individuals, even if they don't use that classification that seems to be growing every year, but it's still a tiny little bit. How much of this gut reset for kids who are regularly sick have eczema, all these food allergies, sensory issues, all the stuff that we see today, that 20 years ago would be very abnormal, but today is, like, super normal.

Dhru Purohit
Pretty much one out of every three kids, maybe one out of every two kids, is dealing with some version of that. How much of this is things that parents can kind of do at home themselves with using, like, a book like yours as a little bit of a guidebook? And how much of it would you say, percentage wise, for, you know, the population that's out there is parents having to really find a clinician to help guide them through some of the more personalized recommendations? That's a great question. I mean, because in the ideal world, all practitioners would practice this way.

Elisa Song
And the second your child develops, like, a little patch of eczema, we'd say, oh, let's work on their gut. Let's look at x, y, and z factors. And you're right, there are more and more. And I'm really, really putting a lot of focus in these next years to work on training more pediatric practitioners. But our kids can't necessarily wait until that time, which is part of the reason I wrote this book for parents who don't have a guide just yet, so that they can understand the steps of the gut reset program and do a lot of it on their own.

And then also for practitioners, I've had practitioners read the book and say, oh, my gosh, this is so great. I mean, so many different things that I hadn't thought of, even if they're already practicing functional medicine or if they're pediatricians, and I still have a lot of very conventional pediatrics friends and colleagues who are like, this is so great. I can't wait to incorporate this or at least be able to refer to some of my functional medicine colleagues. But at least now I know, right, right. Because, I mean, pediatricians, they go, I mean, we go into this because we love kids, right.

It's not because we want to do harm, but the knowledge isn't always there. And so really the start is knowledge, even for practitioners, right, who have that open mind, who and when, it's driven by the data, it's so much easier to say, oh, okay, I want to do this for my kids now. Right. There are some things that are going to be more challenging to do without a practitioner. Now, there are some general herbs that you can use that can target a lot of the organisms that might be dysbiotic that can be safe to use for kids.

And that's why I give suggestions and even suggested dosages based on, on age in the back of the book, because, I mean, that's actually one of the most common questions I get from practitioners, too, are starting out, well, how do I dose for kids? Right. We know this is healthy, but they're younger. How much should we actually give? Yeah.

And so you could. You can do that. Now what we won't know without a gut microbiome test is what are some specific bacteria, parasites, yeast that were not necessarily, necessarily getting with those herbs. Is there maybe a time for pharmaceuticals? Does your child have any underlying, maybe inflammation in the gut that we're not aware of that also needs to be addressed?

So there are some things on a stool test that can be really helpful to know, but starting out, we don't necessarily have to know them. The other thing that's a little bit more of an uphill climb if we don't know, is many kids, especially if they have underlying chronic health concerns, they can develop certain nutrient deficiencies or insufficiencies. But frankly, I see so many healthy kids who are low in vitamin D, low in zinc, who need more iron or need more magnesium. But if we don't address these nutrient deficiencies or insufficiencies, even if they're in the normal range but they're not at optimal levels, it can be harder to heal a leaky gut lining. If you don't have enough zinc, it can be hard to reverse autoimmunity.

If you don't have enough vitamin D, it can be really hard to manage your child's anxiety or constipation if they don't have enough magnesium. So some of these things, if we know blood levels, we can optimize those levels, and then it makes it so much easier for the other things to fall into place. Now, for parents who don't have practitioners to order the lab work, I do give some suggested lab work to say, hey, doc, do you think we can order these for my kids? Or they can go to their regular pediatrician and say, hey, here's the reason why I want to order this. That's right.

And they're very blood tests that you can easily get at a conventional lab. Or I also have graphs of each nutrient that's a common nutrient deficiency in kids. And some of the clinical signs, like what you might see, how do you suspect that my child has iron deficiency or zinc deficiency? Some of the clinical clues so that if you read the list and you're like, oh, my gosh, my kid has, like, ten of these, oh, maybe they need more zinc, right? So you can kind of, you know, have an approximation that they.

That they need a little bit more. No, that's great. The book is a fantastic resource with all those different things in the back. It's kind of like you're getting some signs at least, to know what questions to ask next, because even sometimes when you have a practitioner that you like, a lot of this is parents having to do a little bit of the digging to even know kind of what to bring up, what questions to ask. And I think you have a lot of material inside the book that can kind of point people in the right direction.

Dhru Purohit
There's an important quote that you have from the book, and I think it's one to mention, especially for kids who are getting a little bit older, who have been sick for years. And the quote, I'll paraphrase, is like, it's never too late to start to heal the gut, right? For a gut that's been challenged, that's been a child that's been dealing with leaky gut, it's never too late to turn things around. Can you talk about that for a second? Yeah.

Elisa Song
Well, and that's where I always want to lead with hope, because there are so many. I mean, you just go on social media, and it can be overwhelming. All of the x, y, and z toxins that are making you sick, glyphosate. Microplastics, this antibiotics, all this stuff, all this stuff. You're done.

Dhru Purohit
Don't even try. It's true. And you're just like, oh, my gosh, what do I do? Crawl under a rock? And so you have to leave with hope and with solutions.

Elisa Song
So I never want to say, okay, these things are things that are harmful without giving solutions. And it is true that, but, I mean, it really is never too late to restore a disrupted gut microbiome. And we can do that. We have the tools. We have the knowledge.

Now, here's the thing, though, for many people, and this is for functional medicine practitioners, if you have the experience that you've gotten your patient into remission or their gut is restored, you do another stool test, and, oh, my gosh, look, the dysbiosis is gone.

Three months later, some symptoms start trickling back. Six months later, they're almost back to where they started from. Not quite, but they're turning the corner for the worse. Again, it's not lasting. And when it's not lasting, it's because we haven't necessarily, and I say we, like, even me, this has been my experience, that we haven't laid the foundations of how to build that resilience to begin with.

It's just, okay, kill the gut dysbiosis, seal and heal the leaky gut, and now you're good. It's like, well, yeah, but if they go back to, you know, not getting optimal sleep, sleep deprivation can disrupt your gut microbiome within 48 hours. It takes seven days to repair the damage that was done. Right. So if we don't make sure as we're working on the leaky gut, patients know, okay, this is really important.

It's not just so you're well rested and feel better in the morning. It's so that your microbiome can stay healed. So just kind of imparting all the things that build that foundation, and it really and truly is never too late. It may take, like I said earlier, it can take a little bit longer if it's been longstanding, but we can get there. And for the babies, like, for the little kids, you know, the reason, one of the things that is so rewarding as an integrated pediatrician is how quickly kids can respond.

And when you start, you know, the foundation's young. It sticks with them. Sure, the pushback, you know, when they're tweens and teens, but they have those foundations to take with them. And I'm just, you know, like I said, I have a bunch of kids who have gone off to college, and it's just, it, like, is so good for my heart to have them call me when they're at school saying, hey, doc, I'm having x, y, and z symptoms. What do you think it could be?

And, like, trying to do some digging and, you know, saying, oh, you know, I know I had, like, I had too many drinks this night, but I'm working on it and I'm going to, you know, and they know about their gut health. They know about the gut brain connection. So they're learning how to adult in a way that's really, you know, optimal for their microbiomes and for their brains and for their health. And that's what we want as parents. I mean, they're going to push back at times, but if we have those foundations, they can go off and we can trust.

Okay. They know how to make those good decisions. They're going to get back to it, then they're going to make those good decisions for our grandkids. Right. And it goes on and on.

So we really want to. That's what we want. We just want to pay it forward to our next generations. Well, one of the positive things about social media that I definitely feel like I'm seeing, and sure, there's a little bit of a coastal bias because I live in California. You're also on the west coast as well.

Dhru Purohit
But I see that it's actually cool for kids to take care of themselves. Yes. Right. Even though, sure, there's a lot of extremes that still exist in this world, people combining alcohol and caffeine and these crazy drinks that, you know, are having, kids end up in the hospital. But in general, there's this trend towards, you know, even like, a lot of my friends who have teenage boys, like, boys are really into, like, taking care of their skin.

Elisa Song
Yes. It's like now really cool to, like, for all kids to, like, want to work out. Right? Like, there's a lot of themes that are kind of creeping in, and it's like, it's cool to want to take care of yourself where I don't think that that was always the case back in the day. And sure, that can have some positives, it can have some negatives, but I think that there's a big cultural shift and people are realizing the importance of wanting to take care of your temple in a way.

Dhru Purohit
And I think that's a lot of the credit goes to, you know, this previous generation that was there before that's been advocating and putting out information that's kind of trickled down. The kids call it crunchy moms and dads on social media, right? They make fun of the parents for all their healthy choices, their granola parents, their crunchy parents. But hey, one way or another, the message is getting out there. That's true.

Elisa Song
And Birkenstocks are cool again. Birkenstocks are cool. That's true. Tell us a little bit more about the book. The title, when people can get it, where people can get it.

So the book is called Healthy Kids happy, an integrated pediatrician's guide to whole child resilience. And the book is really about the everyday things that we can do to foster microbiome resilience, to foster whole child resilience. And I really wanted to make sure it was simple things that people can do every single day, not an add on. Right. These are the ways that we can live as kids, as teenagers, as families, to set the habits for life.

Right. Because we can be weekend warriors as adults and be sedentary all week and then, like, go out and bike, like, 50 miles on the weekends. But it's the things that we do every day that make the biggest difference. And so we want to teach our kids those everyday things in a way that really have some excited about nourishing themselves and nourishing their microbiomes. So the book comes out May 14, and it's available pretty much anywhere where you can buy books.

Support your indie bookstores, please, if you can. But, yeah, it's available anywhere. That's fantastic. I know one thing that you're always great at is you do a ton of online education. You have e courses.

Dhru Purohit
You do just even a ton of free content on Instagram. I'm always sending your reels. I think there was a reel that you made a few days ago or a week ago. It was about Tamiflu and how it really doesn't work the way that people think. And I had a friend just asking about this, like, this past winter when all the kids were getting sick and stuff, and I sent to them the reel.

I said, save this for this upcoming winter season. Any other places that you want to send our audience to. So Instagram is the social media that I'm most active on. And then my website, healthykidshappykids.com. Have you made the jump into TikTok knowing that a lot of your own patients are probably there right now?

Elisa Song
Oh, yeah, they are there. I actually. It's so funny. I started and then I stopped. But I do have some videos on TikTok, and my friends, my kids friends are like, your mom's on TikTok.

And, I mean, it's hilarious. So I have not, I have not jumped yet, but that is probably the next thing. Well, we'll have the link to the book, as well as your Instagram and all the other great courses that you've developed over a period of a few years in the show notes below. And also, if there's any practitioners that are listening, how do they raise their hand for maybe one day when you are doing more training or shadowing or something like that? If they want to reach out to you, how do they reach out to you?

I love that question. So right now I am chair of pediatric education for a four mm. And so we are, this is our third year of hosting a pediatric symposium to provide pediatric functional medicine training. So that would be the best place to. That happens online, or is that in.

Their Vegas conference, actually. So it's not their, it's their fall conference. And this year it's going to be in LA at the LA live. Yeah, in September. So we're trying to hop back and forth, but they're committed to bringing pediatric functional medicine out to practitioners.

And you can just reach out to me. I love chatting with practitioners, and when I started in integrative pediatrics, this was back in 2004, I opened the practice. There weren't really a lot of colleagues for me to chat with, not at all, and kind of go through this journey together. So I'm always happy to give some of my tips that I've learned through. The years to practitioners, audience, grandparents, existing parents, future parents like myself.

Dhru Purohit
Pick up a copy of this book. Give it to somebody you love. Doctor Elisa song. Thank you for coming on the podcast. Oh, thanks for having me, Drew.

Hi, everyone. Drew here. Two quick things. Number one, thank you so much for. Listening to this podcast.

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