Baby Gut Health Expert: What every parent should know about gut health, immunity & nutrition (with Dr. Stephanie Culler)

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0:44The next thing you know, you're in a cycling crew. Well, a community cycling group. The thing about Facebook, you might find more than what you're looking for. From a browse to a bike ride, this summer, find more on Facebook. This is so fascinating. It's so fascinating that kids need this. Yes, and that was a surprise to me. I had been working in cancer research for most of my career, most of my adult life. And along the way, I learned about this problem. I have a daughter. She's four, very energetic. She's at grandma and grandpa's house right now. I dropped her off on the way here. Oh, shoot.

1:22We like to hear that. Yes. So busy mom. But when I found out that most babies today, because of modern life, modern practices, are missing the microbes in their gut to train their immune system, I was really upset. Because what that means is when babies have this deficiency, they're missing these key bacteria, their immune system doesn't develop properly. So the role of that initial bacteria is to tell the immune system, develop properly. when they're not when they're absent the immune system gets errors in its development and that's what's leading to food allergies eczema asthma we think it's linked to obesity and other conditions that is fascinating yes do you want us to start a lot to pack in here so yes so we can get started yeah that was exactly the spiel we needed okay yeah that was so it's so good um welcome back to another episode of Two Parents in a Podcast.

2:22Today is going to be so fascinating and so informative. We are joined by Dr. Stephanie Kohler. Doctor, right? I get to call somebody a doctor. I get really excited. And you are the co-founder of Persephone. Yes. Do you know I had to spell that wrong? So I knew how to say it. I had to spell it completely different on here. Most people, it's all over the map, but it's okay. I was like, oh my gosh. Persephone Biosciences, which just published the largest study on infant microbiomes in the U.S., that is incredible. And she brought us a kit today. We're going to learn all about what our infants and what our toddlers need.

3:00To be their healthiest selves. Yes. But before we get into it, we'd love to hear about your background, Dr. Culler. Thank you. I am a scientist by training. I did my Ph.D. at Caltech, focused in developing new cancer therapies. Started as a scientist because I lost both my grandmothers to cancer when I was a young teenager. Thank you. And inspired a personal passion, actually, for cancer research, but also how I could prevent disease. It's been kind of a lifelong mission of mine. And after Caltech, I really wanted to start a company. And after a number of years in biotech working with microbes, bacteria like what we have in our microbiome, I co-founded Persephone Biosciences almost eight years ago, which is a microbiome company developing both therapeutics to prevent and treat disease, but also consumer products that can impact health starting with infants and toddlers.

4:01Wow. Okay, let's get into it. Today, we're going to talk about gut health. Yes. And before we talk about gut health, in its simplest form, what is it and why should people care about it, both for themselves as well as for their children? Great question. So maybe we can start with a really easy definition of the gut microbiome, and that makes sense in the context of gut health. So the gut microbiome are essentially the bacteria, fungus, essentially the microbes that line our GI tract and serves to promote normal immune function to prevent and fight disease. Most people don't know that most of our immune system is in our gut.

4:50Eighty percent of our entire immune system is in our gut. And so the kinds of microbes that we have and what they produce from our diet is exceptionally important on our immune health and our overall health. And I would say that's kind of the definition of gut health. And the way I think about the microbiome, it's essentially the gatekeeper of our immune system. If we have really bad microbes, the unhealthy microbes, we're going to have a lot of inflammation in our gut. And that's going to help lead to chronic illnesses. And so we really want to preserve a healthy gut microbiome, take care of it, nurture it throughout our life, especially from the very beginning and then throughout adulthood.

5:29and why is it important through different stages of life? When we are born, we normally inherit our microbes from our mother, our mother's gut microbiome through the vaginal birth process and as they're coming out, they get exposed to the mom's gut microbiome and that's essentially what seeds us and the role of that initial microbiome is to train the immune system. So the child's immune system develops to be really robust for life. If it doesn't develop properly, if it doesn't have the right microbiome, these children are at much higher risk for developing chronic conditions because their immune system hasn't developed properly.

6:08And so in early life, you know, up to elementary school, the microbiome is developing. It develops maybe a dozen microbes. You and I have hundreds of kinds of microbes in our gut that help us really process nutrients from our diet and really keep our immune system in check. I think like what I know and I think what Alex knows is like we want a really healthy immune system. Yes. In its simplest form. And what I think long we have never paid attention to is like, all right, well, how do you actually have a healthy immune system. And I think like, I almost feel like growing up, I would have thought that like, you know, you're born with the immune system you have, and there's not really much you're going to be able to do around that.

6:58But it feels like what we're learning is how much what we're putting into our body actually affects then how effective our immune system is. And the underlying thing that determines how healthy our immune system is, is our microbiome. Is that it in its most layman terms? I think that's a really good summary. Okay.

7:25So is it fair to say kids are more sick today than they have been in the past 100 years in the United States? Absolutely. Okay. Okay. And is it also fair to say that what we are putting in our bodies and what we are putting in children's bodies from a very young age is driving all-time lows in their health? I think that's a huge part of it. And then there's other aspects. Okay. So like antibiotics. Okay. Antibiotics vary early on, even during pregnancy. Because, again, the babies inherit these microbes from mother. Right. And we can get into C-section. I can talk about the key differences. C-sections also cause some differences in the microbiome.

8:17But babies, again, are inheriting these microbes. So if the antibiotics during pregnancy kill off those good microbes, again, the babies aren't inheriting the right set. And then if they get antibiotics in early life, within the first few years of life, it's been shown globally that these kids are a much higher risk for developing all of these chronic conditions. So it's the food. It's diet. It's modern life. It's the diet. It's the antibiotics. It's how the babies are born because C-section, babies don't get these microbes from mom. They are or mom's gut microbiome. They're getting it from the hospital environment.

8:59They're getting it from skin because they're not surgically coming out. And that already doesn't have the right bacteria. And so we see that all of these practices, including like formula feeding, really does alter the gut microbiome. So it's all these different things, especially ultra processed food as well. OK. Love it. We really got our work cut out for us. Yeah. And it's complex. We're going to do the best we can. We're going to get tangible. You guys are doing really good. So this is helping me a lot. First, what I'd love to I'd love to start off with is some statistics as to. that describe the step backs in health that children have taken over recent decades?

9:53So one of the big ones is that 40 % of children in the United States have one or more chronic conditions. This includes obesity. This includes diabetes, for example. It includes asthma, food allergies. So that's a big thing. And as of this year, about 20 % of kids in the United States are obese. In the 1970s, around 5 % of kids were obese, right? And so that's four times what it used to be in the 70s. Kids now, one out of 13 kids have food allergies. So all of these have started to increase. And we also know that the current generation is also much higher at risk for developing cancers that impact the GI tract.

10:50This also includes early onset of colorectal cancer, meaning people under the age of 50 getting colorectal cancer, which is now in the rise. And so the goal of today's conversation is going to be around what can we do as parents to have our kids live the healthiest life possible and have those statistics look much more like they did 20 years ago than they did today. And my assumption would be that what you're going to say is that by doing A, B, and C, it actually solves what may seem like uncorrelated health issues. And there's a lot more correlation between things like cancer and obesity than one would otherwise have thought.

11:45Yeah. Okay. Perfect. So then I think that that's the great foray into as parents, what is the number one thing we should be focused on in helping our kids live their healthiest life possible? I would say it's a combination of nutrition, the right nutrition. So lots of fiber, lots of fermented foods in combination with getting them the right probiotics very early on. Okay.

12:20So, let's talk about this. When does it start? It really starts before the child is born and really thinking about as you're preparing the nursery and getting everything ready. You should be prepared on day one of the child's life, even in the hospital, to be setting their microbiome and nutrition up for life. We have found that having the right microbiome very early on is really critical in having their immune system develop properly. And so it's this mindset of thinking about gut health before you even have your child. And even as they transition to solid foods, it's a journey for the first three years of life.

13:01But really coming prepared, you know, we are prepared for all these other aspects, the car seat, the changing station. this is the other aspect we really need to be considering. And so what does that mean? Like in practice? So in practice, what it really means is thinking about, we now know based on a lot of research around the world that most babies today are missing the right bacteria that's important in the first thousand days of their life for training their immune system. And so we as parents to help that journey need to essentially put them back. And they're really simple solutions. essentially probiotics that you can add to breast milk, formula, and as the child gets older, to food as they transition.

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14:26That's why I love using it on my face and on my scalp, you guys. It is truly unbelievable. OneSkin is the world's first skin longevity company. By focusing on the cellular aspects of aging, OneSkin keeps your skin looking and acting younger for longer. For a limited time, you can try OneSkin with 15 % off using code 2Parents at oneskin.co. That's 15 % off at oneskin.co with code 2Parents. After you purchase, they'll ask you where you heard about them. Please support our show and tell them that we sent you. So we, because I do think we need to actually address the study because we're referring to the study.

15:05Okay. And so you ran the largest microbiome study ever. Yep, in the U.S. In the U.S. And so we'd love to hear about that study. So it was the My Baby Biome study, largest, most diverse study in the U.S. to map the infant gut microbiome. So these are newborns in the United States from 48 out of 50 states. And, you know, what we found is really shocking that 9 out of 10 babies, so 90 % of U.S. babies, are missing the key bacteria that are needed to train the immune system. And these are specific kinds of bifidobacterium. So you might see these in the grocery store. There are many types of these probiotics.

15:49But what the babies need is something very specific. These bifidobacterium, these probiotics, thrive in the presence of breast milk. So they consume the special sugars only found in breast milk. So how many infants were tested? Over 400 babies. And it's a seven-year study. Seven-year study. And what was the average age of those infants? Yes, about one to three months of age. One to three months. And so is the underlying core assumption that we're drawing out of the gates is they are born deficient? Essentially, they are born deficient. Okay. Yes. And then the next question being, and they're born deficient of 74 % are born deficient of the bifidobacterium.

16:4890%. Sorry, 90 % are born deficient of the bifidobacterium. Of key bifidobacterium. Okay. And now are we saying that breast milk, if breastfed, they can make up and they can solve that deficiency? no that's what's puzzling here okay so the breast milk is essentially the right water right yeah but if you don't have the seeds you're gonna only water weeds and that's what happens yeah and so the baby ends up getting weeds like the bad bacteria yeah instead of the good and so the good bacteria is just not there and the weeds grow way faster than the good bacteria if you don't have enough and so basically the modern diet modern everything the modern life society modern birth modern yes modern birth hospitals hospitals modern life which is you know the biggest uphill battle to fight is creating this and we're not going to focus on that we're going to focus on we are living in a world today where babies are being born deficient to very critical elements that uh for their health yeah okay it's it's a building it's like legos it's like the first three legos that you're supposed to get when you're like you know okay can i keep hijacking this totally hijack away because what i'm hoping goes on right now is that the listener's brain is kind of following my brain and this is all new to them as it is to as it is to me it's it's and And it's new to me, too.

18:24And it's fascinating that we've made it this far and haven't heard of it yet. OK, so why I decided to do this, because I was on a track to do cancer therapeutics. It was like, I'm a mom and I am a leading researcher in gut health. And I didn't know that this was such a big problem. It's a global problem and it's not just a U.S. problem. But, yeah. So, I mean, that's why I kind of took it on a mission. Absolutely. And so.

18:52So how big of a difference? So we're looking to solve this deficiency. What do we want to call the deficiency? We call it a deficiency. It's a bifidobacterium deficiency. Okay. So we have a key microbiome deficiency. Yes. We want to solve it. We know of external solutions on how to solve it. But before we get to the external solutions, How big of a difference in your study did you see in the deficiency between breast milk-fed babies and formula-fed babies? We saw some pretty key differences. But what we noted is that when you don't have the right microbes, breast milk will still feed the wrong bacteria.

19:38And so regardless of how they're fed, they are not getting the right bacteria from any sources, essentially. And that's really the issue. As you did say before. A lot of people, like when you're breastfeeding, you think it like cures everything. I mean, listen, I didn't think that vaginally born breastfed babies had any issues, right? But now we're finding almost every baby that is vaginally born breastfed is missing these bacteria. They're just not getting it from anywhere. They're not getting it from breast milk. They're not getting it from family members. It's just gone. Okay. Fascinating. Fascinating.

20:16And so no matter, you know, if you do things in the most, in the way that's perceived as the most optimized, as you said, vaginally birthed and breastfed, still see significant deficiencies. And so what is the solution? The solution is really to restore what Mother Nature intended, was these key bifidobacterium that thrive in breast milk, kind of restore what we all used to have. You know, in the United States, the Amish have these bacteria, the hunters and gatherers. So the world that we used to live in over 100 years ago. And so that's what's really key here. It's these specific bifidobacterium probiotics, but they need to be fed properly.

21:02So they need those breast milk sugars, which we call prebiotics. So if you're, but let's say you're giving them this, okay, sorry. And to dumb it down really quickly, are you saying, for example, if I had given my daughter your packet, which gave her the microbes, the probiotics. The probiotics that she needed. Yep. And then I watered it. So that was the seed that was planted. And then I watered that plant with breast milk. It would grow beautifully. It would not grow the weeds. Yes. Okay. But let's say that I couldn't produce milk, and I gave her the probiotic, and then I used formula. Then what happens?

21:42So that's why you need what we've essentially developed is a symbiotic. You have the prebiotic and the probiotic, right? These prebiotics are the ones found in breast milk so that every baby, regardless of how they're fed, they get the right water for the seeds, which are the probiotics. That's like literally huge for baby number two. So I'm sitting here and I'm sure a lot of moms are too. And I'm like, wow, I'm going to have spent a year of my life breastfeeding or pumping or something. And it's like I truly wish I would have known this earlier about the gut health, the microbiome for the baby.

22:22But over the first several years of life, it's still developing. So really at any time, you can really start to like nourish it and help it. You said a thousand days? Thousand days. But we know the microbiome starts to look more like an adult's microbiome around the ages of four to five. So by the time they're in elementary school, it's much more mature. But during those preschool, you know, from, you know, infancy to preschool, that's when it's developing. And so that's where these right probiotics or symbiotics can help with the right diet as well. so if we're gonna stop breastfeeding her at the one year mark we would give her the probiotic plus the symbiotic it's already it's yeah it's in there yes so that's what a definition of a symbiotic is like a fancy word for pre and probiotic together so they're this kind of unit the food for the bacteria the probiotic and then the probiotic so i'm gonna i'm gonna um zig for a moment here and you know listening to you i don't get the you know and and i'm i'm doing this because we're talking about a product yeah and that was not the intention of of the podcast today but it feels very relevant and so but the vibe i'm also getting from you is that you did not start this to make money you started this to solve a very big problem yeah and i normally don't talk about the product but you know but it's frustrating to hear yeah it's frustrating to hear you should give something and then it's like what is the something can you give me an example and we happen to have an example but that's where i i think what my my hunch here is that we'll get a really interesting story about how you discovered this problem and the why behind the why behind the product.

24:18I also, frankly, I can't believe that like we haven't heard of this. And I know you just said that. But to me, there feels like a very big why here. And I know there's the help. But I'd love to hear about the discovery process of like, this is the problem. I was focused on another massive problem in cancer research. and this is where we're going. Yep, yep. So about almost four years ago, we at the company had just announced a partnership with Johnson & Johnson in cancer research. How through the microbiome we could prevent colorectal cancer. How can we make cancer patients respond better to treatment?

25:02And right after we did that partnership, a number of scientists from their baby side came to me. This is during COVID. My daughter is six months old. And they came to me and said, you know, we're partnered with you in cancer research. We think the technology you've developed that essentially goes from poop to a product could be really impactful for infants and the global infant gut problem. And I took a step back and I got extremely emotional and really upset. My daughter, who's six months old, Elizabeth, was off camera and, you know, a little boppy. And I was really upset for a number of reasons.

25:44One, I am a leading researcher in the microbiome space. I've spent nearly a decade of my life focused on this and is trying to solve cancer. But I didn't know that this was a massive global problem. And second, well, what was this infant problem? How come nobody had told me about it? How come my pediatrician didn't say something? How come my OBGYN didn't? How come other friends didn't, you know, knowing that I am a microbiome researcher? And it turns out this problem is really because of modern life. It's the antibiotics. It's C-section births. It's formula use. It's poor diet. It's impacting what the babies are born with.

26:22They're simply born without the right bacteria that trains their immune system. But this research is really just stuck in academic labs. The academic scientists, there's over almost 10 ,000 scientific papers on this problem, but it's not getting mainstream. And it was really when I got off the phone that day, I made a promise. I said, I'm going to do something about this. One, I need to research this. I need to understand how big of a problem this is, especially in the United States. But then how can I fix it? And the reason these scientists were coming to me was that there has been no solution.

26:59There are partial solutions, but there wasn't one that actually fixed the baby's gut. And obviously I had been focused on cancer, which is so complex. And so we decided we could really leverage these tools we developed for cancer to solve what we think is one of the biggest problems of our century. That's incredible. Incredibly powerful. And so what supporting studies do you have as it pertains to the efficacy of this product? Yes. So we are conducting, we're wrapping up a clinical trial called Artemis, evaluating our infants and toddlers symbiotic in infants and toddlers. It's the largest ever to be done in the United States.

27:48These products really don't get evaluated in American babies. It's normally in Europe or other countries. And so this is the biggest of its kind. And so we've already demonstrated, obviously, safety. But what's really important is that it fixes the gut microbiome. It gets into the gut of the babies. The microbes grow. And they produce those right signals that helps the baby's immune system know to develop properly. And so that's what we've done. And we look to do more clinical studies. we'd like to be able to maybe develop a therapeutic that could help prevent eczema, prevent food allergies. That's the future of what we think with this product.

28:32Wow. It's just, I know some parents that their kids have eczema and to the tune of like scratching their bodies on the concrete and it, and like them, them, and then them saying like, I can't even go to dinner. Like I can't leave her at home with the babysitter because we'll come back and like her skin will be raw. And it's something that I never understood if there was a way to prevent it or if it was just genetic. We think that the microbiome, you know, our data from our large My Baby Biome study was really linking that microbiome of newborns. If they don't have these microbes, they are at much higher risk for eczema.

29:07And so, yes, we are exploring if we can put those bacteria back, can we have that impact on eczema? Wow. And food allergies. And food allergies. Which is just a huge one. It's rapid these days. And then if your kids alert, we had this thing called Grow Happy. I went to like a luncheon and they gave me a little packet where you could give your kid egg, sesame, peanuts at such an early age and introduce it. And I did do that. But at the luncheon, they were talking about how many kids these days have these debilitating allergies and how it's just getting so much worse rapidly. And it would be cool to go to the root cause of that and prevent it that way.

29:44And that's what this is really trying to get to. Absolutely. I know it's a huge, like, I never even understood allergies until then you become a mom and you're like, I don't want a peanut allergy. You know, like you don't want that for this like precious thing. So totally. So our children today are being born with deficiencies around their immune system. Yeah. Okay? We've talked through a great product that you've created here that helps that. What else can parents be doing to put their child in their best health position? Thank you. You're welcome. I think there's a number of things. When we think about diet, I really think through the lens of the gut microbiome, what makes our microbes happy in our gut?

30:39Fiber, fiber, fiber. The American diet, Western diet, is just very low in fiber. And fiber has the right prebiotics to essentially feed the gut microbes. Well, what is that? That's like having really good fruits and vegetables, making sure we have a diversity of them. The more kinds that we can introduce into our child's diet, the better because they get exposed to all kinds of fiber. And that really helps keep that ecosystem in check and allows it to thrive. And I think the other missing thing, again, because of the Western diet, our children don't get exposed enough to fermented foods. These are your kefir, your kimchi, tempeh.