Is Picky Eating a Nutrient Deficiency? Dr. Elisa Song Explains

0:00How do we cultivate the two-year-old's gut, the five-year-old's gut, the ten-year-old's gut? How do we cultivate gut health? Dr. Elisa Song is a Stanford, NYU, and UCSF-trained holistic pediatrician on a mission to revolutionize how parents care for their children. The founder of Whole Family Wellness, one of the nation's leading integrative pediatric practices, and the creator of Healthy Kids, Happy Kids. If your child is really selective, has a very narrow palate, chances are there are some nutrient deficiencies or insufficiencies. that are actually exacerbating the pickiness. So looking at that, and the number one is really...

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1:15Like earning up to 5 % cash back with Venmo Stash on a bundle of brands. So, order more pizza. The math demands it. Get the Venmo debit card. Venmo Stash bundle terms and exclusions apply. See terms at Venmo.me slash stash terms. Venmo Checkout not available at all merchants. Venmo MasterCard is issued by the Bancorp Bank N.A. How can you build a nutrient-dense diet working with what the kids will eat? If your child is really selective, has a very narrow palate, chances are there are some nutrient deficiencies or insufficiencies that are actually exacerbating the pickiness. Okay. So looking at that, and the number one is really zinc.

1:52So a lot of kids are insufficient or outright deficient in zinc, And zinc changes your taste preferences. It changes your sensory issues. So if you have kids who are really sensory about the smell, the texture, the feel of the food in their mouth, or other sensory issues like the tag on their shirt or they can't do the blender or the vacuum in the house, that to me is like, okay, they need zinc. Just by optimizing their zinc levels with a little supplement, maybe for a month or two, can make a huge difference. I actually was just down in LA speaking with a mom who said that she heard me listing off all the signs of zinc deficiency.

2:34And she's like, oh my gosh, I'm checking out the boxes. That's my daughter. And her daughter was eating like three foods at the time. So she started zinc, like a liquid zinc that she bought off Amazon. And as she said, within like not even two months, like a month and a half, her kid was wanting chicken. able to have a little bit of broccoli on her plate, like expanding. It was actually having five more foods than when she had before the zinc. That's something to really help support kids' actual sensory experience of food. And then, you know, from the behavioral component, it's just all the things that we as parents try to do, getting your kids involved in the grocery shopping list, the food meal list.

3:17And even if they're not going to take a bite, at least they've had a hand in it. And then eventually they may want to take, they're much more willing to have a little, even touch it on their tongue. If they've had a say and like, oh, you know, I kind of want to, you know, look at this vegetable today or maybe go to the farmer's market and pick out something brand new. You mentioned zinc supplementation for children because, you know, ideally it would be diet first, but if we've got it food adversions, we're starting with supplements. What are you looking at for zinc? There's different forms of zinc.

3:48Zinc picolinate, zinc glycinate. Those are probably a little bit more easily absorbed. I think I've had kids do well on zinc sulfate, but usually I'll use the picolinate or the glycinate form. One of the most common side effects is that it can upset your tummy. And I think adults experience this too. I remember taking a whole bunch of vitamins in the morning and just feeling so nauseous. Oh, I've done it. I'm sure a lot of other people relate to that. And it's probably the zinc that is one of the biggest culprits. So taking it with food or taking it at night before bed so that you're not feeling, you know, kind of gross during the day.

4:20And, you know, the dosage, you can start with a liquid one or a chewable one. The zinc capsules, there's one zinc capsule. It's called Zinc 30. I mean, it's super tiny. So if your kids are at the age where you're thinking, you know, maybe they can learn how to swallow pills, which, by the way, I've had a three and a half year old patient learn how to swallow pills. So they can do it when they're young. But that's a really good kind of starter size. It's smaller than a Tic Tac. I mean, it's super tiny. But looking at zinc and probably, you know, ideally I would check a red blood cell zinc level.

4:51Because sometimes I am floored at how low kids are and how much zinc they actually need to get to optimal levels. So if you don't have that option, then starting off, I mean a toddler maybe start off with 5 to maybe 10 milligrams. If you have a middle school age kid or an elementary school age kid, you could start maybe 10 to 15. or even 25 to 30 milligrams, depending on what's going on. I mean, if they're getting sick frequently, if they have eczema or if they have diaper rashes that aren't healing. For boys, you know, are boys, if they have delayed puberty, that's another sign that they probably need a little zinc because zinc is really important for testosterone.

5:30So if there's any other signs of zinc deficiency, then I might start with a little bit of a, you know, on the higher end of the dose and then see if you can check levels once you've started. Mm-hmm. For people who want to start optimizing the diet, what are the best food sources of zinc? Animal proteins, really. So, I mean, it may be that weather is okay on the zinc, but you know, even then, I see some kids who are total metosaurs and you're like, wow, they still need a lot of zinc, right? But so zinc levels are highly correlated with animal protein intake. Shellfish, you know, shrimp scallops are really high in zinc.

6:09They're also really high in cholesterol and choline, which is so great for brain development. But apart from that, your legumes, nuts, and seeds are really good sources of zinc. And I had one mom who, she was so smart, and they were vegetarians. So I thought, well, chances are they're going to need a supplement. But what she did was she took some pumpkin seeds and ground them in a coffee grinder to powder and put the powder into everything, into soups, into salads, mix it with her kid's oatmeal, put it into smoothies. And this kid's zinc levels went up really amazingly well. And if you're having trouble getting zinc levels up, a lot of people have heard at this point now that quercetin is a zinc ionophore, right?

6:50That it helps zinc get into the cells. But that really helps too. So that's where I think on a vegetarian diet or incorporating more fruits and vegetables with your zinc source, so many plant-based foods like red apples or red grapes or purple onions and capers and watercress, they're high in quercetin. that then when you have it with your zinc source, it helps the zinc be utilized better. That is such a great pearl for people. I always love like food combinations. Like, you know, the fact if your child's low in iron and you are vegetarian, making sure you couple it with vitamin C rich foods. Because your body really is designed to, you know, absorb these things, but sometimes it needs assistance.

7:30But as you were saying, you said in certain circumstances, you know, kids are meditarians, but they're not actually absorbing. their nutrients. What's going on there? Well, I mean, I always focus and in functional medicine, we focus on the gut microbiome. It is so essential for children. And we know this. I mean, even before conception, the health in the state of mother's vaginal and gut microbiomes really impacts that baby's developing microbiome from birth. And the microbiome really for babies and toddlers and really all kids, they're going to shape how their immune systems develop, how their brains develop, how their hormones and metabolic systems develop.

8:12And also really importantly, it's going to really determine how well they're absorbing the nutrients from their food. And also, oh, by the way, your microbiome makes all of these amazing B vitamins like folate and vitamin B12 and vitamin K and also really helps to support and sustain our immune system in our brains with all of these amazing postbiotics like GABA and serotonin, which help your kids stay calm and relax and can help with some of the anxiety around, you know, foods or new sensations if that is something that's really more stressful for them. So, I mean, it's amazing. And so when we take a closer look at their microbiome, whether it's through a stool test, a specialized stool test, or simply by trying to support their microbiome with food if we can, and also with targeted supplements, that can make a huge difference.

9:05What are you looking for in a stool culture? So the stool test is really fascinating. And I love talking about stool analyses because a lot of people listening, I'm sure, have maybe done a functional stool analysis for themselves. And when we look at children's microbiomes, their microbiomes are completely different than adult microbiomes up until about the age of three, three and a half years of age. After that, their microbiomes take a little bit more of an adult-like pattern. But even then, their microbiomes are constantly developing just like they are through childhood, through their tween years, and even their teen years.

9:41And what's really fascinating is we're also finding distinct microbiome differences between boys and girls. As soon as puberty hits, those hormones cause a divergence, obviously, in a lot of different areas, but also the microbiome. So when we look at babies' microbiomes, for instance, one of the things that a lot of people don't realize is for adults, we think, oh, we want a lot of microbial diversity. All those trillions of tiny microscopic organisms, you know, probiotics, we want a lot of different kinds. So for babies, it's the exact opposite. We want very little diversity. In fact, for an infant, their microbiome should be nearly 80 % to even 100 % bifidobacteria and not a lot of other stuff.

10:24And then on the flip side, we have for training their immune system in an appropriate way. There are actually bacteria like these bad E. coli or Klebsiella or Citibacter that we don't want to see at all in adults. But for babies, we need a little bit, maybe up to 5%. It's sort of like this training because babies are brand new to the world. And so just like they need to encounter different pathogens, different stressors to train their bodies, their microbiomes need that same stress too to develop into a healthy pattern. It's the same reason why we see kids who live on farms with lots of parasites and animals.

10:59They tend to have less eczema and asthma because their immune systems were trained early on to tolerate those things. Yeah, that is fascinating. When you are talking about microbial diversity happening at puberty and how that really differentiates, this is something I'm actually speaking on this weekend. My talk is about how the loss of estrogen in menopause decreases microbial diversity. And one of the key things that I really want everyone to understand is that mom's microbiome becomes baby's microbiome, which is why women have to have that microbial diversity. It's so important. So how do we cultivate, you know, the two-year-old's gut, the five-year-old's gut, the 10-year-old's gut, the pubescent teen?

11:45I've got the preteen in my house right now. So how do we cultivate gut health? Yeah. So, I mean, in my book, I talk about the five things for microbiome magic. And the reason I looked at this in five things is because these are five things that we're doing every day anyway. And they're things that I don't want a teenager or a mom or a kid to feel like, oh, my gosh, I have one more thing to do. Because we all have a lot of things to do. And to add one more thing can feel like I'm not going to do that right now. But these five things we're doing every single day anyway, we have to eat. We have to sleep.

12:19We have to breathe and move and drink. But if we do them in a way that is really gut-centric, in a way that allows our microbiome to flourish, so many things will fall into place. I mean, Dr. Alessio Fasano, he is a pediatric gastroenterologist at Boston Harvard Children's and really the leading expert who brought the idea that celiac and non-gluten sensitivities are the foundations for so many pediatric and adult chronic illnesses. And so he is credited with saying that your gut microbiome is not like Las Vegas. Hello, we're in Las Vegas. Your gut microbiome is not in Las Vegas. what happens in your gut does not stay in your gut.

13:04And we know that because your gut microbiome influences pretty much every single organ system. I mean, talking about hormones and in our tween teen years, as kids are going through puberty, the rise in certain sex hormones clearly impacts what microbes want to grow. And then vice versa, the composition of your microbes determines how you're processing and metabolizing all of your sex hormones. And so it's not isolated. And whenever we have anything going on with your kids, whether it's eczema or whether it's ADHD or anxiety or an autoimmune illness, we have to look and see, well, what's going on in their microbiome?

13:42How do we set the foundations of microbiome resilience? This is even before we start thinking about supplements. I mean, we have to have those foundations because a patient coming to me with eczema or asthma or anxiety, I could get them on a ton of supplements and do all the testing and get them into, quote, remission. But unless you have the foundations, the basics of how we're eating, breathing, sleeping, hydrating, and moving to nourish your microbiome, you're going to fall right back. You're going to get right back into maybe three months down the road, six months down the road, the eczema starts to come back or the anxiety starts to creep back in.

14:17And so the foundations really, really matter. Okay. So people can certainly read your book to get all five, but can you give us one of the five that people could implement right now? Well, I'll give you two of the five. Okay. Okay. I'll take it. Not that there are, um, it's not that one is more important than the other. Because when we think about, you know, sleeping or hydrating or moving, what's fascinating is an optimal amount of sleep or an optimal amount of movement every day has been shown to optimize your gut microbiome. independent of diet, which is fascinating. So if you have a kid who's eating three foods, then don't start with diet.

14:54That's going to stress everyone out, right? Start with movement or start with optimizing sleep. And then all of that will kind of move the needle forward because what's fascinating is you start optimizing the microbiome, let's say by optimizing sleep, that actually changed your taste preferences. I mean, we think that we're in control of our food cravings, but it's really not us. I mean, a lot of microorganisms, like if you have, you know candida or yeast overgrowth your cravings for sugar well guess what that's your candida telling your brain like feed me feed me feed yeah yeah and same thing with other preferences for these ultra processed foods so everything's going to move the needle but when we think about what we want to get in and nourish our gut microbiome it's also really important to think about what we want to keep out so things that we want to get in i have a whole gut rainbow chart with our three f's so our fiber yeah our phytonutrients which i know is a ph but it sounds like an afro and fermented foods so just simply every day thinking with every meal or snack i tell kids and and you try to you make it fun right i mean you can kind of gamify it in a little way there's handouts that you can use but if you think about making every meal pop with plants on purpose just one more thing what's one thing that they can do now phytonutrients is an interesting one because that's the color in our fruits and vegetables.

16:14And so, you know, let's say for you guys, if broccoli is always going to be a hit, great. Well, go to the farmer's market or the grocery store, see if they have purple broccoli because that's a different phytonutrient and that still counts as making your meal pop. It's still something a little different, right? But I would say as our kids get older and you in between, I have teens, they're going out with their friends, you know, they're making their own food decisions. So teaching them how to be really, really savvy food label leaders being food label detectives to know okay this food i don't want to buy this food i do it's okay for my gut my brain my immune system and that's really important because as much as i would love to say you know that our kids aren't going to eat out of packages and you know eat all kind of unprocessed foods once they're out in the world with their friends they're going to be making some choices on their own and so we do this exercise with my kids you know my son his kids want to drink the prime, right?

17:11With like the sucralose and the acetylbutacium and, you know, the colors and the whatever. So I said, yeah, you know, let's think about you, you want to play, I mean, you have a soccer tournament coming up. Yeah. Probably not helping you, you know, be at your best. So I tasked him with running up and down, you know, the, the refrigerated aisle while I was shopping to say, why don't you read the labels and choose a drink that you can have with your friends that you'll feel good about. Yeah. And I'll feel good about. And so he ran up and down and he picked one and I was like oh this actually looks okay right um it's called liquid death oh yeah yeah the best water branding ever that's right the best water branding and you know sure it has a little bit more sugar than maybe but it's not exorbitantly high yeah it's better than a frappuccino and no no artificial sweetener so I'm like okay and then he feels cool drinking it's got a really cool bottle yeah I mean everybody wants to drink something with a skull right like at least you're 12 and you're like liquid death I'm so badass that's right so so that was I mean you just want to make it a win-win right so teaching your kids how to do that and then I would say the second thing is really learning how to regulate your nervous system I mean we all as a society um you know what we're thinking about we're just talking about our aura rings before right yeah sometimes you can't stand what it tells you but um what what it's really good at is tracking heart rate variability, which is a measure of, I mean, it's one of the best measures of current and optimal, current and future optimal health.

18:40The other fascinating thing is, it is a measure of how your vagus nerve is functioning, how well your autonomic nervous system is able to get into that rest, digest, and restore state. Well, we know historically, kids' heart rate variabilities have been decreasing over the past decades. Oh, wow. Yeah. There's a cardiologist - That's scary. Yes, there's a cardiologist in Germany who's been measuring them in kids with ADHD and kids without ADHD. And he noted, yes, there's been a decline, I mean, since the 80s. What do they see between ADHD and non-ADHD children? So ADHD kids do have lower heart rate variability in general, too.

19:18So that makes sense. But globally, and I would bet that adult, I mean, I'm sure there's got to be some studies looking at adult heart rate variability and how it's decreased over the decades. We know our gut microbiome diversity has decreased over the past century. I mean, there's a reason why, you know, we're all even at our healthiest, quote, healthiest state, even for babies who are born, you know, by vaginal delivery, breastfed exclusively, doing all the right things. We're still seeing, you know, kids who are having concerns because our modern life is just not supporting our microbiomes and our brains and our hormones and all of that.

19:55So when we learn how to regulate our nervous system by diaphragmatic breathing, you know, belly breathing or using apps like the there's a breathe app or an oak app or actually the breathe app, I don't think is around anymore. but the calm inside timer, all of those things make a huge difference in turning on that parasympathetic switch every day so that whenever we have this sympathetic fight or flight switch response turned on, which is pretty much all the time, right? Our autonomic nervous system, our parasympathetic nervous system knows how to kick in so that, you know, if you're, if you make it to school on time, you, you did your test or you got through the soccer tournament, okay, there's no more saber-toothed tiger anymore.

20:41There's no reason to be in that fight or flight. So we have to kick in on purpose our vagus nerve. And we're not doing that enough. I mean, adults are not doing that enough. And so I feel like this is something that moms, dads, parents, and kids can do together. And I mean, I have a whole chapter on it. It's that important. I hope you enjoyed this episode. If this is the kind of content you're into, then I highly recommend checking out this.

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