Sugar and Brain Health: How Diet Shapes Kids’ Focus, Mood & Microbiome | Dr. Elisa Song

26:20So I don't, it's my conjecture, but, you know, we have so many hormone disrupting chemicals, right? And so many of these hormone disrupting chemicals are really mimic estrogen more than testosterone. Yeah. Right? And so if - Well, and some of them were designed like BPA to actually be estrogen replacement therapy. Yeah. And I don't think many people recognize that. But, you know, to your point, endocrine disruptors playing a role. Tell us more about that. Yeah. Well, so these endocrine disruptors or hormone disrupting chemicals, we know that they can impact girls' early puberty. That is one of the things that we're linking.

26:59But for boys now, we have to think, okay, is this flood of estrogen-like chemicals impacting their puberty? So then they're actually becoming more delayed in their puberty. And, you know, so many other impacts, right? And so one article that I read, it was one of the best articles I've read on endocrine disruptors. Please send us the links. I will. In the show notes. I will. And the researchers call for changing the description of these chemicals instead of calling them endocrine-disrupting chemicals or hormone-disrupting chemicals to really shift to call them microbiome-disrupting chemicals. Because every single one of these endocrine-disrupting chemicals, whether the phthalates or PFASs or parabens or BPAs, they have all been shown to profoundly disrupt the gut microbiome.

27:47cause leaky gut, cause gut dysbiosis or an abnormal balance, you know, too many bad bacteria, not enough of the good bacteria. And that is why we see in our kids, not just impacts on their hormones, but impacts on their brain development, impacts on their immune system. I mean, these hormone disruptors have way more impact on children and teens than on hormones. And so - Do you mean on, than on adults? Well, I don't know the research on adults. I'm sure it still does too, but in terms of like for, For kids, babies who are exposed to these endocrine receptors, which of course we all are, right?

28:22No matter how clean we live. But it can impact cognitive development, cause problems with cognitive delays. It can impact the risk of certain immune disorders, atopy, allergy, all of which are on the rise in our kids. And so, you know, is it that it's just the impact of these toxins or is it because they're shifting the microbiome, which then has that double whammy of compounding and worsening the impact of these hormone disruptors. So there's the things we can't avoid, but what can parents avoid and what can they be doing to safeguard their children's health against these hormone disrupting chemicals or potentially microbiome disrupting chemicals?

29:02So one of the things that parents don't necessarily think about, and we can do all the things to try to remove these hormone disruptors in our lives. So BPA free cans, knowing that there might be some BPFs and other things that don't have to be reported, you know, paraben-free cosmetics and skincare and, you know, hair care products. Forever Chemical is a little harder because they are everywhere, right? And these microplastics are everywhere and they're not, you know, as they're not labeled, right? You're not going to see a product with the amount of PFAS or the amount of microplastics in the product.

29:39But there are ways from an environmental standpoint, household cleaner standpoint, that we can reduce our exposures to endocrine disrupting chemicals. But we also have to make sure that we are able to process and clear out these endocrine disruptors when we're exposed to them. Your first pass is actually through your microbiome. And what people, I was fascinated to learn, so I'm hoping that people are fascinated to learn that our livers have this thing called the cytochrome P450 enzyme system that helps us detoxify whatever it is. I mean, even estrogens, right? And so our microbiota have very similar cytochrome P450 enzymes.

30:22And as we inhale or ingest these toxins, they go through our gut. That's one of our first exposures beside our skin. and our microbiota start to conjugate or detoxify some of these chemicals. So we have to have a healthy gut microbiome if we want that first pass to clear out as many toxins as possible. And one study in teenagers found that a higher healthy eating index, what does that mean? Higher fruit and vegetable intake basically, significantly lowered their PFAS levels and increased their RBC folate levels, which is really important, right? Another study found that eating fermented foods could significantly decrease your PFAS chemicals.

31:11Now, why do I point to PFAS in particular? Because parabens, phthalates, BPAs, once we stop our exposures or lower our exposures, we can clear them pretty quickly from our system. And they come out pretty easily in our urine. They can even come out in our sweat. pee fasses don't come out in our sweat very well. Sauna is not going to help. We don't pee them out. We have very few ways to get rid of them. So why not load up or tell your kids, we're going to be exposed to forever chemicals for the rest of our lives. So higher fruit, vegetable intake, higher fermented foods, that's going to help your body, your brain, your hormones really become as resilient against these endocrine disruptors as possible.

31:56Except that children think they're invincible. and their prefrontal cortex has not developed for their executive function or their reasoning skills all the way. So what are other ways that parents can get their children to start shifting their diet? So, you know, one thing, um, we talked last episode about my toddler. Like I have this like older child who's like the perfect eater. And then I have the, you know, very challenging eater. And he went on this like peanut butter and jelly kick. It's like all he wanted to eat. So I was like, fine, I'm mixing yogurt in there and I'm also mixing chia seeds in there or I'm mixing flax in the meal in there.

32:30And so I would grind up these fiber sources and put it in there and then making sure that the bread also is a fiber source. So that's one way that I was like, let's get more fiber in and a variety of fiber for your microbiome. What are other ways that parents can start taking action? Yes, well, I love that way, right? Because in my book, I have a recipe for - It's right here, everyone. Right here. I call it a gut hero booster. But you can just look in your pantry. What are the fiber sources that you already have? Or maybe you need to buy some. You just grind them up into a powder and you can store them in an airtight container and you add them to things.

33:07I mean, if you pulverize them to a fine powder, right, you can mix them into nut butters. You can put them in your soups. If you're baking goods, you can throw them in pumpkin seeds. Well, so why, you know, why the fiber, right? We know that less than 5 % of American kids and adults actually meet their minimum daily fiber requirements. Isn't that wild? That's including people who are eating healthy, right? I would bet on many days, especially, you know, I'm here in Mexico City with you. I am sure that I've not met my daily fiber requirements, except maybe with the vegan dinner last night. Yeah.

33:43Well, I don't know about you, but I got a leak that was like the terminal end of the leak that nobody ever wants to eat. And it was so fibrous and so chewy. And it was, yeah, I was having a hard time with my teeth, but I was like, Dr. Stacey, who we had on the podcast, great dentist. She would be very proud of me. But after I swallowed it and Bryce, my husband was like, I can't believe you ate that. I'm like, my microbiome is so healthy right now. Like you have no idea. Like my microbiome was like, this is new. This is different. This is interesting. We love you for it. Yeah. So getting those boosters in are really, really helpful, especially until your kid's prefrontal cortex can kick in a little bit more.

34:25Now, even when they're younger, though, what I love is you just have to make it fun. And I know if you have a really selective picky eater, you may have tried all the things, right? And if you just keep reinforcing and making it fun, not a battle, it will change, right? It will get into their brains. But I always talk to kids about their microbiomes. And when they're little, I might call them their tiny little friends in their tummies, right? As they get older, I call them your microbiota, right? There's friendly bacteria, there's friendly yeast and not friendly yeast. And we talk about it, but also talk about what it means for them, you know, to really take care of the microbiome.

35:04How is it impacting their ability to make and keep friends, you know, stay in a good mood, fall asleep easily, not have hard poops, not have itchy skin, right? For teenagers, the acne, right? The skin and the hair, right? So always tying it back. And then I just have kids think about how we are taught to take care of our world around us, right? Our ecosystem around us. And, you know, even preschoolers learn to reduce, reuse, recycle, you know, all the things. Because we know our world is suffering. And if we don't take care of our world, we are not going to have a world left that takes care of us.

35:43And so I let them know that same ecosystem is inside of us, the same care. Like most of us, if we, I mean, I don't know about most of us, but when I see someone throwing a can, you know, let's say, I don't know, whatever can of a drink into the regular garbage, I'm like, and I've been known to actually go and take it and put it. This is like the power of Captain Planet. If you know, you know. But like we talk about this. My husband and I had like this Captain Planet cartoon show that was on and all the messaging we got. And like you have a visceral reaction. That's right. Because it's how you were raised.

36:19It's how you were trained on repeat to live. That's right. Or like trash out the car window and you're like, no. Right. So, I mean, our kids can learn that stewardship. Right. And in the same way, they can learn that stewardship and the responsibility of how we live and eat every day impacts the ecosystem inside of us. And of course, they're going to not make the choices that we would want them to make all the time. But we also don't make all the choices that we know we should make all the time. No, perfection is not the goal, right? It's what we do on the whole because, one, this is where I see a lot of parents.

36:57I think we get a little too stuck on being perfect with the diet or too stuck on, you know, getting rid of every toxin. The goal is not to be perfect, as you said. The goal is to create that resilience in our immune system and our microbiome so that whatever happens, we know it's going to bounce right back. And in fact, in microbiome testing now, we can actually see and measure something called a resilience score. Like how likely is your microbiome to bounce back to a healthier state after a round of antibiotics or exposure to like finals week and sleep deprivation? I mean, whatever is going to be stressing your microbiome.

37:33You brought up focus. Are there foods that parents can add to their children's diet to help improve focus? Well, we want to make sure, I mean, I would say there's two sides of the coin to that, right? Right. Because kids need, when we think about amino acids and dopamine for focus and attention, all of these neurotransmitters or brain chemicals, they're built on amino acids. So kids have to be getting enough protein, but high quality protein. It can't just be protein shakes and protein bars. Right. So that's one thing. But there also have been studies looking at, again, higher fruit and vegetable, higher antioxidant load to improve focus and attention.

38:16Because we know that, for instance, all of these conditions that we might think of, quote, brain issues, whether they're anxiety or ADHD, we know that there's an inflammatory component to it, right? It's not just, oh, it's something happening in your brain. There's overall systemic inflammation and brain inflammation going on. And what do those colors, those phytonutrients do in plants and vegetables? They reduce inflammation, right? They reduce that oxidative stress that we need to keep our whole body working well. So that's one thing. But then oftentimes I think, well, what do we need to get out that's really inflaming the brain more, right?

38:58We've already talked about the sugars, all of those artificial dyes, which hopefully are on the way out now, right? But those artificial diets, they wreak havoc on your gut microbiome and your brain. And I'm going to talk about this category of food called emulsifiers that some parents may not be as familiar with. Emulsifiers are the kind of food additive that are added to keep whatever packaged food from becoming a goopy mess. So you can find them in protein bars. You can find them in all sorts of barbecue and salad dressings, barbecue sauces. You can find them in ice creams. It's not going to say emulsifiers on the package, but what it will say is something like CMC or carboxymethylcellulose or mono and diglycerides or carrageenan or even xanthan gum.

39:49So you have to know what to look for. You don't necessarily have to memorize. I actually have a whole list of a lot of different emulsifiers in the book that you want to avoid. But once you just scan the package, like now my kids know if they see something that says mono something, they just put it right back, right? But even during pregnancy, women who had a diet high in emulsifiers were found to have offspring that were more likely to have attention and focus problems. And emulsifiers in, there's a study out of Japan that looked at emulsifier consumption and found that the rapid rise of emulsifiers in packaged foods correlated with a very similar trajectory of rise in autoimmunity.

40:31Oh, interesting. Because emulsifiers can directly disrupt your gut lining and trigger leaky gut and also promote the growth of the wrong kind of bacteria, these gram-negative bacteria, that also are highly linked with autoimmune disease risk. So I just want to kind of put it together for everybody. So you brought up neurodivergent children. So anxiety, autism, ADHD, OCD, tics, we can see there's a lot of conditions that fall into that umbrella. We understand now that the same gene clusters tend to be among those children who have a higher rate of inflammation. Autoimmune disease can also be linked in that.

41:13And what we know about children who are neurodivergent, they have gut microbiome profiles that are different than their neurotypical counterparts. So the inflammation is a very key piece. I also, you know, you brought up what you consume in pregnancy and your child having this diagnosis or being noticed that, you know, the attention focus issues are earlier on. My question for you is that, did the diet actually cause these conditions or did the diet exacerbate what was already there to which a doctor could pick it up sooner that they actually got recognized and diagnosed sooner? So that's an interesting question.

41:50And also when I talk about prenatal diets or early life diets and lifestyles that can impact future health, one of the issues there is, okay, that's information. And it's information you want because you want to know how your child got to where they are today. But it's information that just tells you the story because we can't go back and change that, right? So I don't want any mom thinking, oh my gosh. No, we don't blame moms here. We do not. We never blame and shame on it. You and I are moms and we know there's plenty of things that we're like, dang, if I knew that 10 years ago, it would be so different.

42:25And what is fascinating is that the studies show now that even if your kids had a certain life that maybe included antibiotic exposure and exposure to ultra processed foods, your child and your own current diet can be shaped by what you're eating now. And your diet right now can really influence about 30 to 40 % of your microbiome. It's powerful. So if we can really start changing our diet to a more microbiome nourishing one, it will make a huge difference. I mean, in one rat study, they found that the change in your microbiome could be accounted 47 % by diet. And so what we eat really matters.

43:09Now, when we're talking about neurodiversity and we're talking about how do we support neurodiverse kids to really feel and function as optimally as they can without trying to change who they are, right? That's not what this is about. But we know when there's inflammation, you know, a lot of kids just, they don't even know how poorly they feel until that inflammation is gone, right? They don't realize how much their tummy's hurt or the fact that there's sleep problems. We know ADHD and sleep disorders go hand in hand, that their sleep problems were actually driven by inflammation. You get rid of the inflammation, you sleep better.

43:46And then all of a sudden, yes, you may still have underlying ADHD, but your symptoms are so much better, right? What I wish would be routine in every single pediatric office was not just blood testing that I mentioned before, but gut microbiome testing. Because we can see changes in your gut microbiome, even before we start to see impacts on your immune system or even on your brain and mental health. And I'll just point to this one little girl. She was 10. And she came to me after she'd been on three or four different psychiatric medications. None of them helped. They all had horrible side effects.

44:26She stopped growing. And so she was diagnosed with, I mean, you name the acronyms, right? ADHD, OCD, ODD. You know, she had dyslexia on top of that. I mean, the works, right? And so, you know, she came and she told me, honestly, as this little girl, you know, 10 year olds can feel, you know, very grown up. And she said that she was not interested in taking supplements and, you know, she was very selective in her eating. So I just spoke with her about the microbiome and how it could be impacting her brain. And, you know, that I know she wants to feel better because she was miserable and the whole family was miserable.

45:07And then we did some microbiome testing and I went through it. So she had, I mean, astonishingly high levels of this particular bacteria called Enterobactericia or gram-negative bacteria, really high levels of Klebsiella and Citrobacter, which in an adult, that is an alarm bell for, oh, is there an autoimmune risk? Exactly. Yeah. And she had really high levels of this compound that is found on the cell membranes of these particular bad bacteria called LPS or lipopolysaccharides. Really high levels. And so I said, look, we know that this LPS that these bacteria are producing, they can affect your brain function.

45:51They can affect how you feel. They can affect your immune system. What do you think about trying to get rid of those? And so she was game. and we put her on some antimicrobials to get rid of those bad bacteria. I put her on something called serum-derived bovine immunoglobulin to lower the LPS. She actually agreed to take some prebiotics and maybe try to get in one more fruit or one more vegetable in her diet. After a month, her mom called back and said her daughter was a different kid. Her daughter felt it too, that she was finally getting her daughter back. She hadn't smiled in months and was starting to smile.

46:33She just felt so much more at ease. And the only thing we really did was heal her gut. So she still has ADHD. She still needs support in school. The dyslexia is still there. But she's now able to access the parts of her brain that she wasn't able to because of the inflammation. and be able to then succeed and feel the way that she wanted to. So there's so many things that we're not told, you know, when as a parent, you're given a diagnosis and you're like, okay, I guess there's the meds and the therapy and the school supports. But what about beyond that? Yeah. Yeah. And I think, you know, we're seeing currently, you know, politically and socially, people are very focused on how do you cure ADHD?

47:16How do you cure autism? How do you cure these things? we're not going to cure neurodiversity. Like these are the wiring of our nervous system. And what we can do though is help someone thrive optimally and we can address the differences, the things that are going on for them that are impacting their life. And that is my fear in the research is that if we continue to look at only cure, then we are missing all of the ways that we can support people. And we are, you know, confusing sometimes conditions before you and I started recording of like, when people are talking about profound autism, I brought up that that is autism with intellectual disability.

47:55These are two separate diagnoses. And when you start just putting everything, I see this a lot. People are like, oh, everything is autism. And I'm like, hold up because if somebody is autistic and they have anxiety, like we need to treat that anxiety differently. Just as I think it's very easy for people to understand, like some neurodivergent conditions are associated with seizures. We're not going to just call that neurodiversity and not treat the seizure. We're going to treat that separately. And so we have to separate these things out, but also be looking at how do we support someone's lifestyle?

48:31How do we support their quality of life? How do we help them thrive without this idea of we have to absolutely change everything? I also always laugh when I look at autistic research or I hear clinicians that are like, we reversed their autism. And as they're talking through everything, I'm like, it sounds a lot like you taught that person to mask and you trained them and you healed them enough that they had the energy and the wherewithal to actually mask more. And so you didn't actually cure anything, but what you should celebrate is this person actually has enough of the energy, the mental, I mean, masking takes tremendous amount of mental energy, like to be able to do that.

49:09Like Like that is also a win. I mean, it's not that we want people masking all the time, but it has a time and a place. It's also a win that you can do that at that level of mental energy. You brought up gut microbiome testing. Everybody's probably wondering right now, like, what are you talking about? We're doing saliva? We're doing stool? Like, what are we doing here? We're doing poop. We are. We're doing poop. Okay, perfect. When you're looking at your microbiome, that's, well, we have several microbiomes, right? You had Dr. Stacy come on and, you know, we have an oral microbiome, which is part of our digestive tract, right?

49:40But our oral microbiome looks very different than the microbiome that's lower down in our large intestine. Our skin has its own microbiome. Our uterus has its own microbiome. Our eyes have their own microbiome. So our brain does too. And we're gonna be finding all of these different microbiomes and the different organisms that really are meant to be there. Now, when we're looking at the gut microbiome, we're really looking at your large intestinal microbiome. And the only way to measure that is through poop. It's super fun, guys. You get to scoop your kid's poop three times. That's right. When they're old enough, they can learn how to do it themselves, right?

50:14Now, the microbiome testing. So earlier this year, I believe in February or March of 2025, there was an international consensus of microbiome testing in clinical practice. And it's a very important international consensus because it helps guide us on the huge array of microbiome tests that are available. Well, how do we choose as a clinician and as a parent or as a patient, right, if we're an adult patient? And the consensus notes that really the gold standard now should be something called shotgun metagenomics or metagenomic testing. because we have the ability now to identify, you know, all, not all, but many, many, many of the, you know, of the trillions of microbes that are in our gut down to the strain level, right?

51:05And also looking at their genomics, we can identify their function. Just because you have a good amount of, let's say, acromantia, right? Is it doing what you want it to do? Does it have the genomic profile? Just because you have enough bifidobacteria, is it actually making the short-chain fatty acid acetate for you? Does it have the genes to produce GABA or neurotransmitters for you? So it's opening up this fascinating world of not just identifying what's there, but are they actually doing what we want them to do for us, right? And also these abnormal bacteria or parasites or fungi, whatever's in there, are they actually causing harm, right?

51:49And then we mentioned this LPS. We can now measure LPS in the stool and see if our microbiota are releasing that. And so PCR testing really doesn't have a big role, except if you're trying to identify one bad player. Then again, I mean, through COVID, we saw PCR testing amplifies the sequence of the SARS-CoV-2 virus. And sometimes we amplify it too much and we see something that really isn't a problem, right? Same thing with PCR testing in the gut. We might be amplifying H. pylori too much, or maybe candida isn't as much of a problem, right? So I do, I use a test called tiny health and just full disclosure, I'm the chief medical officer.

52:34And the only reason I would have ever agreed to that is because I think this is the best test out there. And using shotgun metagenomics profiling, also some enzymes that practitioners are used to like calprotectin and lactoferrin to make sure that there's not inflammatory bowel disease. Now, one thing with testing as well, we are going to get to a point, and I think it's not too far from now, where we can see a more precision, personalized microbiome analysis based on your age, your sex, your menopausal status, right? Because we know your microbiome shifts depending on hormones. I mean, there's, you know, baby microbiomes, you know, children microbiomes will go along the steady progression until puberty.

53:26And then when progesterone and estrogen or testosterone come into the picture, boys and girls, by sex, their microbiomes differentiate. That is very important to know. So we can't just have a one-size-fits-all approach for, you know, an adolescent female who's having, you know, horrible PCOS symptoms. Well, are we going to look at a standard from like a general viewpoint? or we're going to look at it as at a standard of what this developing adolescent females microbiome should look like. So we'll get there at some point. And then the ability for us as practitioners to really hone in on the microbiome science and create a truly precision plan for you will be phenomenal.

54:07Who should we be running microbiome testing on? every woman who's trying to conceive, every male partner who is helping that woman try to conceive. Because we also know that the paternal microbiome before conception, I mean, it is wild. This is a rat study, but we're finding this now. I mean, there are human studies going on, but these rats who had dysbiosis, so they had antibiotic-induced dysbiosis, right? And there's epigenetic signaling that changes when your microbiome changes. So then the sperm microRNAs changed and those babies in utero had worse pregnancy outcomes, right? And even those pregnant rats had worse outcomes like, let's say, preeclampsia or gestational diabetes equivalent, right?

55:03Right. When those male rats were given probiotics to correct their microbiomes, those pregnancy outcomes normalized. So we think, oh, it's the mom's microbiome that shapes, mom's vaginal gut microbiome that shapes the baby's microbiome after birth. It's also the paternal microbiome. We cannot leave the paternal microbiome out of this, right? So I would love all men and women before conceiving to optimize their gut microbiomes. Women, especially if they have antibiotics or in pregnancy, I would love a prenatal microbiome test and a vaginal microbiome test. We can see signatures now in the microbiome that indicate an increased risk for gestational diabetes or preeclampsia.

55:46So why not correct your microbiome to reduce that risk, right? And then babies, do they all need microbiome testing? I mean, I would love to start babies off with the best microbiomes, but especially for babies who are born by C-section. babies who have had antibiotic exposure around the time of delivery, and babies who are formula-fed, we know that that changes the trajectory of your child's microbiome to one that might increase the risk of things like allergic diseases and even mental health concerns later on. So I would love for those babies to have a microbiome test somewhere within that first month of life so we can course correct if needed.

56:25Yeah. And then in terms of neurodivergent children, do you recommend across the board they have microbiome testing? 100%. Absolutely. So in fact, any kiddo or teenager who comes to me with any chronic concern, whether it's attention and focus issues, anxiety, pants pandas, autoimmune issues, eczema, asthma, of course, gut symptoms, right? All of those kids, I start with a gut microbiome test. Because I can, you know, there are some things where by the pattern of what parents are describing, I can guess that there's blood sugar dysregulation and there's a blood sugar roller coaster. If I look at a kid with eczema, I'm just going to assume that they have a zinc and an omega-3 deficiency or insufficiency.

57:13I still would love to test because I don't know how much supplementation and how much to focus on which foods for you. But your microbiome, I cannot tell what's there if I don't look. You just have to look and then that can guide your diet and supplement plan. Because I don't want to throw a ton of supplements at your child if I don't know that they're going to be helpful. But when we know that they are, it can make a huge difference. Yeah. Right now, social media, everybody's out there saying everything is due to parasites. And we're seeing influencers putting children on parasite cleanses, recommending that everybody's child has a parasite cleanse.

57:51How problematic are parasites in reality? And what do you think about all these parasite cleanses in children? Yeah, it's interesting because, of course, I'm getting lots of questions from parents. Should we do a parasite cleanse? Is my child of a parasite? Now, parasites, I will say, they are hard to detect on the stool in stool testing. We got to get three collections and even then we're like, mm-hmm. Right. Now, metagenomics profiling is more accurate than just looking under the microscope and And seeing is in that one particular stool sample, does there happen to be a parasite egg or the actual parasite in there, right?

58:27But parasite testing is really challenging. And so do I think that there are more kids with parasites than actually are detected on stool testing? Absolutely, right? I do think so. Do I think that every kid who has a problem has a parasite? No, right? Now, I go through some, you know, I mean, there are some clinical patterns. And this sounds really weird. But, you know, we as living creatures, all of us, including parasites and humans, are sensitive to the moon cycle. Yes, we are. Right? I mean, all of us. My mom, you know, was an OBGYN, you know, back in the 80s and 90s. And, you know, she knew.

59:13She just never booked vacations during the full moon. Because she knew she would be flooded. It's baby time, right? So we see this. So we also see this with parasites. So if you're kids, I just have parents kind of track and see, is there a cyclical pattern to your child's behaviors or their eczema or their sleep problems or whatever it is, right? And if there's a cyclical pattern that seems to correspond with either the new moon or the full moon, then I have a much higher index of suspicion, even if the stool test doesn't show a parasite that, you know what, maybe we'll try it. Maybe we'll try a parasite cleanse, right?

59:54And it sounds very strange, but it is what it is, right? I mean, we just, we have to know that we are not in full control of our bodies and brains. I mean, we have other forces, right? And so, you know, or itchy butts, right? I mean, pinworms. I mean, pinworms tend to, I will tell parents, if we're really trying to find pinworms, sometimes we'll treat. I mean, in other countries, you just deworm, right? Every whatever. No, in Mexico, if your children are living on farmland in a rural area, they're getting ivermectin treatments. I mean, my mother-in-law, she grew up in Puerto Rico and she's like, we got regular parasite treatments because of what we were getting exposed to.

1:00:34So there's certainly areas where this can be problematic. But I always think about like the people who are living in middle America, they're cooking all their meat. Well, they don't even have a passport. So they've never traveled anywhere. Like they have a water filter. Like, you know, we start to look at like, what is your exposure really like coming into contact with parasites? Like if you were a regular gas station sushi eater, yeah, I'm going to guess you probably have a parasite. So, and with, with parasite cleanses, I should say, I mean, what does that mean? Right. Right. And I do see some of the parasite cleanse protocols out there.

1:01:09They're pretty harsh. They're super harsh. Some of them I'm like, not all herbs are safe. That's right. Some herbs are going to raise, so as you talked about liver enzymes earlier, they're going to raise liver enzymes. What does it tell us? It's a stress on the liver. And so I see them and I see the dosages and I'm like, that's high for an adult. And you would give that to a child? I would not give that to a child. Yeah, no, absolutely. So I do not recommend myself any of the parasite cleanses that are out there, especially for young kids and older kids. And I want to make sure that they have a good gut restoration program in place.

1:01:45Because one of the things that, you know, for us as humans, when we find out there's a bad bug in us, whatever it is, we want to kill, kill, kill, right? I mean, I think it's also something like, I mean, I don't know how you feel about parasites, but I'm just like, oh, like the freeloader, like sucking off my energy, like it grosses me out so much. And so I know whenever I have patients and we do find a parasite and they're freaking out, I'm like, I feel this so hard, but I'm with you. Like the seek and destroy and kill and wipe everything out approach, which we use in so many things, right? Like we look at weed killers.

1:02:21We We look at like how we treat pests in our homes, like those kinds of things. And as you say all of this, I'm like, this is back to your stewardship of the earth of like, treat your body like you would treat the earth. Like it's not about just destroy everything, but it's also about like, how do we prevent this? How do we rebuild? How do we nourish? So how do we do that? I know people are like, shut up, Dr. Brighton, let her say it. I mean, because it is true, right? We have this kind of scorched earth policy and we're like, you know what? You have to rebuild the rainforest, right? And that's where, especially for children, the younger you are, the more malleable, the more changeable your gut microbiome is, for better or for worse.

1:03:01As an adult, I mean, if you've been living with chronic yeast, you know how hard it is to change, right? But kids can change really rapidly, their microbiomes especially. And so one of the really most important foundations of any gut regimen where we're trying to get rid of abnormal bugs, the first thing is you have to regrow and really create that ecosystem that is friendly to these beneficial flora, right? Because that is going to start crowding out already. Parasites, they don't want to live in a healthy gut. You know, these enterobactericiae, these gram-negative bad characters, these bad bacteria, they don't want to live in an environment that's full of phytonutrients and, you know, fiber and fermented foods.

1:03:45They would prefer to live in an environment that's full of emulsifiers, right? Or, you know, high saturated fats and high sugar environments, right? We know that that changes the microbiome for the worse. Or, you know, in a diet that's loaded with glyphosate, right? So first thing, you don't feed those bad bacteria. You start feeding the good bacteria. Then you have that foundation there. You're building up the terrain. The soil is healthy now. There's fewer bugs to kill. And so once you get to the killing, it's not as hard. The reason I'm not really for many of these gut cleansing and parasite cleansing protocols is, as you said, some of these herbs can be very harsh.

1:04:30And we know also that some of these herbs can cause just as much dysbiosis as antibiotics if we're not careful, right? People think, oh, it's natural, it's herbs, it's not going to cause the same problems. That's not true. If we're doing higher dosages or for very prolonged periods, it could cause problems. So what do I typically do for a parasite? I actually do do prescription antiparasitic. I just find that layering in either nidazoxanide, which is alinea, unfortunately very expensive, or metronidazole or flagell, which tastes gross. I mean, you know, so, but I'll usually layer that in. Honestly, though, like anything that is killing off like parasites or killing off in the microbiome tastes gross, whether it's an herb or antibiotic.

1:05:18Well, think about the herbs, right? Like artemisia and berberine, they're bitter, bitter, right? Um, but, um, but I just like to get those in. I had this one kiddo who the parasites in him, he had, you know, high levels of blastocystis, which, um, which did show up on stool testing. And, um, I wasn't sure what was going to happen. He had lots of behavioral issues and, and, you know, really his tics were getting worse and worse, you know, sitting in front of the TV, blinking, shoulders showing you whole body jerking. I mean, it just looked painful, right? Um, started him on Flagyl two days, tics gone.

1:05:52Yeah. I mean, it was fascinating, right? But then after we stopped, did a 10-day course or so, the ticks started to come back. So what we did was then every full moon for the next three full moon cycles, I layered in the flagell for that week around the full moon and also added in some antiparasitic herbal combinations. I mean, there's some ones that are more gentle and did that while we're in between those cycles, really doubling down on, you know, getting in a more microbiome friendly diet, fixing, not fixing, but modifying the lifestyle as much as possible, right? Knowing that, I mean, he's a kid, right?

1:06:35I mean, he's going to go out and hang out with his friends. He was old enough that he was buying some of his own food, but he knew. He didn't like the ticks, right? Because his friends were starting to notice and it was uncomfortable for him, right? So he had more motivation to try to stick with a diet that, you know, really got rid of the dyes. And, you know, he started reading labels. He started trying to choose healthier chip options. And when he bought candy, he was trying to buy ones that weren't as bad as some of the other candies that he used to have. Yeah. Well, and I appreciate that you talk about how you leverage pharmaceuticals in this way.

1:07:07You know, it's often something that, you know, it's like, I think about a yeast infection. If a woman has a yeast infection, why wouldn't I give her Diflucan so we can get rid of that right away and then we can start to work on everything else? Because the reality is that when you have something that is overgrowing, these are commensal flora, but it is causing inflammation. It is distracting you and it's taking extra energy from your body and it becomes so much harder for you to actually focus on the nutrition and lifestyle components. And so I just appreciate you offering that because I think so often people are like, well, if you're integrative or you're natural, then it's just all about only doing herbs.

1:07:46And our perspective, and this is why I'm having you on, is that it's about the right tool in the right situation and making sure that we're meeting the patient where they're at with what they need. And certainly when you're dealing with a parasite, it's like, we want that gone as soon as possible, especially if you're presenting with symptoms. We're rolling into back to school time soon. what can parents do to support their children's immune system so that they're not getting sick all the time? You know, the foundation is still going to be the microbiome, but when we focus on diet, I would say just keeping the sugars down, you know, less than 25 grams of added sugar per day.

1:08:23What does that mean? That's about six teaspoons of added sugar in a day. You're not going to know how much sugar is in a food until you read the label, right? But that's as we start heading back from the summer, back into school, just, you know, I know summer vacations diets can go all over the place, but just getting a better handle on, let's get back to eating more vegetables. Let's get back to cutting out the daily ice cream and popsicles, you know, can happen over the summer. So that's one thing. You know, when we think about, a lot of parents want to know, are there some supplements that can help support?

1:08:55I'll talk about probiotics, right? Because I don't, now I actually don't necessarily think that kids and adults for that matter should take a probiotic supplement every single day. We want to know, well, why are you taking this probiotic? For what goal? And does that probiotic supplement have the right strains in it for you? If you're supporting vaginal health, very different probiotic supplements than if you're supporting immune health. But this one study, this huge, you know, a Cochrane review of studies, looked at probiotic supplements and cold and flu wintertime and found that if I get the numbers wrong, forgive me, but I want to say something that was jaw-dropping to me, that if every person took a probiotic supplement over the wintertime, that there would be something like 54 million fewer missed days of work and school, right?

1:09:46Just the power of the microbiome. And there are particular probiotic strains that we know in children can reduce the risks and rates of colds and flus and fevers and missed days of school. So why not? Especially if you have kids who are really picky and you're like, I don't know if I can get any fermented foods into them. I don't know if I'm going to get more fruits and vegetables into them. Then probiotic supplements can be really helpful. I would say for immune functioning and winter support, I would want an immune probiotic, a vitamin D supplement because across the board, most kids need more vitamin D.

1:10:25Most adults. And most adults. We're giving it all of us. More vitamin D, right? And then depending on the situation, I usually do suggest extra zinc and extra fish oils because most kids aren't getting enough, right? And then when it comes to fermented foods, I mean, this is fascinating. There's actually a kimchi research institute in Korea. I love this. I am like, sign me up for this. So because kimchi, and not just because I'm Korean, but kimchi has amazing, amazing immune and brain and restorative powers. And there actually was this one study looking at kimchi. This was during the, I'm sure you remember that long before the pandemic, there was an H1N1 flu scare.

1:11:10And it was, I mean, panic, not on the level of pandemic, but I mean, a lot of panic. And this research institute came out and showed that H1, that kimchi could kill the H1N1 influenza virus in vitro, right? And then I love, you know, there's another study looking at fermented foods and young women with social anxieties. How many have that, right? And found that fermented foods significantly reduced their social anxieties. And the researchers even comment, which I had to laugh about, that that could be a low-cost intervention for these women. Why not? Low-cost, low-risk, right? Right not, right?

1:11:52But women don't know. But we're also, for many, many people, they're thinking about fermented foods as sauerkraut or kimchi or pickles. And they're like, I don't know, my kids don't really like that, right? But you can ferment foods in lots of different ways. In the book, I have a fermented blackberry lemonade recipe that I've made with my kids' classmates. And super easy, super fun. It's a way to get fermented fruits and still has fermented power, but it's a little bit sweet. Kombucha, if your kids like kombucha, kefir. I mean, there's more and more. You don't have to make your own. It's super fun too.

1:12:27But I was at Trader Joe's and they had a whole row of water kefirs, like this agua fresca water kefir that actually tasted really good. And so you have to watch the added sugars. That's the only thing. But there are different ways to get fermented foods. And besides just thinking, how am I going to get sauerkraut into them? What specific strains of probiotics can help support a child's immune system as they move back into school or winter cold and flu season? Okay. So there are a few of them. I'm not going to remember all of them, but there's lactobacillus, I think it's lactobacillus acidophilus NCFF.

1:13:06Okay, NCFM. There's a Bifidobacteria lactis BIO7, lactobacillus remnosus GG. Those are probably three of the most common ones that are really well studied. Now, you'll notice the strain is important. Okay. So lactobacillus acidophilus NCFM is going to be different than lactobacillus acidophilus LPC-37, right? And I may be saying the LPC-37 wrong, but the strain matters because we have probably hundreds of thousands of different strains of bacteria in our gut. And for instance, bifidobacteria, you know, this bifidobacteria lactis BIO7, that BIO7 is the strain of the bifidobacteria lactis. When we talk about lactobacillus rhamnosus, the GG is the strain.

1:14:10And so these are the strains that are most widely studied for immune support in kids, right? But lactobacillus rhamnosus has many other strains. Some of them are good for vaginal health. Some of them are good for gut health. Some of them are better for brain health. So the strain can really make a difference. Now, if you're supporting your overall gut microbiome, then you want to choose just a broad array of different microbiome strains. Again, do I use probiotics every day? Not necessarily. You want to get the fiber, fermented foods, the phytonutrients in, and then you can kind of sprinkle in probiotics here and there, especially after time travel, going across time zones is a big stress to your microbiome, going to altitude, antibiotics after a meal where you're like, oh, I didn't have, you know, that was not the best choice.

1:15:02Maybe some ultra processed foods got in there. Anytime you have that, then throwing in some extra probiotics can be a better kind of a safeguard against that. But bottom line, you just have the foundations in there. For teachers who are listening or maybe room moms, what are ways to cut down on germs with in the classroom. So that can be a double-edged sword too, because we don't want too clean. Yeah, right. But we don't want Lysol and hand sanitizer everywhere, right? I mean, it's interesting because there are studies looking at hand sanitizers and excessive hand sanitizer use as disrupting your gut microbiome.

1:15:40Now, why is that? Well, we can think also, okay, anything you put on, your skin is going to get absorbed. So some of that antimicrobial property is going to get absorbed systemically. So maybe that's part of it. But also if we're sanitizing everything, we know we're going to get an inoculation of hopefully beneficial bacteria when we have some hands-to-mouth behavior, right, for eating. So we don't want too clean. And washing with soap and water is fine, right? Washing with soap and water is a regular soap, right? I mean, dove soap, you know, we can actually keep your hands free and clear of abnormal microbes and not disrupt your skin microbiome.

1:16:22That's really important, right? I do, you know, I would say, you know, what can we do? I mean, I look at this also from the lens of, you know, my PANS-PANDAS patients where I really don't want them to get sick, you know, and exposed to different illnesses. I think that we just need better policies overall to support kids to stay home and allow parents to stay home until they are well. Now, what does that mean? I mean, okay, you might have some guidelines. 24 hours after no fever without any fever reducing medicines, I want them to be well. Like I want them to be back to almost their baseline energy.

1:17:00They may still have some lingering runny nose or a little cough that can linger. I mean, a cough can linger for three weeks after a cold. You're not contagious at that point. But in those early stages where your kids are feeling crappy and they're still wanting to lay around, they're probably still somewhat contagious. And they're also not ready to go back to school, be exposed to new germs, and be able to ward those off, right? But we don't have a system in place where parents can take off that time from work when their kids are sick. And kids, if they have a whole stack of homework, feel comfortable and safe staying home from school and being able to catch up.

1:17:38So I think that has to happen. I think school snacks, school lunches, that has to change. I mean, so many of our school snacks and lunches are filled with too much. I mean, we had my school. I love my school. And most of the parents in my school are more health-minded. But one of the school breakfast choices was whole grain, multi-grain frosted flakes. Oh man, I thought you were going to say Pop-Tarts. Just as bad. That is not really a great choice if we're going to support our kids' immune system. We should not be giving out candy and sugary snacks as rewards. You know, the candy bucket for like the A on the quiz.

1:18:28I mean, that needs to stop. So I don't know if that's what you're looking for and what room moms and teachers can do. But I feel like, you know, kind of systematically changing the school environment where food is not used as a reward, where, you know, we encourage movement every day, where, you know, we're really allowing kids to fully recover is going to go a long way and having fewer kids be sick. I mean, I feel like it is the obvious one. If you want to reduce germs in the classroom, you have to eliminate the vector from bringing the germs into the classroom, which is the child who is sick.

1:19:06And I think you're right. It's going to take a big policy change because really at the root of all of this is that parents can't take time off work. Schools have ridiculous, you know, requirements in terms of attendance. Like I know parents get like where they hate on school because they're like, oh, they have these strict attendance, but it's also funding issues. It's absolutely, yeah. This upstream, really something our politicians all control right now. And I would say like, if our politicians were truly invested in this make America healthy again paradigm, we would see, we would see maternity leaves.

1:19:42We would see a sick time leave. We would see teachers getting better funding, getting better support. Like we would see a lot of these changes that we're unfortunately not seeing that absolutely have the biggest impact on the future of our children's health. Well, that is one of my biggest concerns is we can look at downstream. Great, let's change the crappy food industry. Awesome, right? But that's downstream. We have to look at how do we get these kids born in as healthy a state as possible. I mean, prenatal care, healthy foods and microbiome testing for all pregnant women. pre-conception care, supporting the mom, extended maternity and paternity leave so that that baby can have the richest environment to support their microbiome instead of having to go for financial reasons to daycare at six weeks and mom's right back to full-time work.

1:20:38I mean, we're not thinking about these first, these critical first 1000 days, which starts from the moment that baby is conceived until about three years of age, where we actually, from a public health standpoint and an individual health standpoint, have the biggest opportunity to change that child's health trajectory and optimize their immune health and their brain health and their metabolic health. If we don't tackle that, we're still going to be fighting fires and putting out these fires everywhere after kids are sick. So I'm hoping the conversation starts to shift. It's not there right now, but it really needs to be.

1:21:24Yeah. It is something that I talked with some of the people that were involved with Maha and they were talking about wanting to promote breastfeeding and getting rid of formula and making these shifts so you get more women breastfeeding. And when I said to them, do you realize that the reason why we don't have maternity leave is because Nestle, one of nestle you're one of the most corrupt companies out there and i'll say it every day i said what i said um they have lobbied formula companies are the ones who've lobbied against maternity leave because that forces that mom back to work that baby into daycare and what happens milk supply dries up and you're super stressed and so then what happens baby's microbiome starts to shift immune health they start getting exposed to things that they wouldn't necessarily get exposed to if they were at home and even just having play dates.

1:22:13Like they're in a completely different artificial environment that is incredibly stressful for the entire family. And so I think, you know, you're absolutely right. It's the things that I look at with these policies where I'm like, we do have to go upstream. I have always said that mothers are the people who create and caretake for the future of our species. So any society that's not taking care of their mothers is not a society that cares about health outcomes of their population. Absolutely. Absolutely. I mean, I just even think about, you know, in my Korean heritage and the culture, there are certain foods that are supposed to be prepared for the mom.

1:22:54The mom is not supposed to do anything but sit at home with their baby and be, you know, laying with their babies. I mean, I was even yelled out by my aunt for going outside for a walk. She's like, you can't do that. But there are these traditions to nurture the mom and support the mom-baby dyad, which is really one of the only ways we're going to successfully implement a breastfeeding initiative that is going to have women successfully nurse. There's too many factors against that. I mean, we know stress, like you said, immediately tanks your supply. And not all women have the ability to take a break every two to three hours to go into a crappy bathroom stall and pump, you know, and try to express milk for their babies.

1:23:41So we just, we have to have more of a global outlook on children's health. But it has to start, as you said, upstream. We need upstream and downstream. What's missing is the upstream right now. Mm-hmm. So well said. Well, thank you so much for coming back on the podcast. Like I said, we're going to link to your previous episode because I think I would definitely, you know, you can listen to them in any order, but I would definitely catch both of them because I feel like we built on so much of the knowledge that you shared before. So thank you so much. Well, thanks for having me.