What's the deal with gluten?

21:17Celiac disease broadly is a disease that in which people cannot tolerate gluten. Tell me how we know about it.

21:25Emily Oster:Fascinating. We've known about it for centuries. The oldest reference I found was 300 AD. And what celiac disease presents as is a chronic disease of the bowels. Celiac literally means belly in like ancient Greek or something. So celiac disease is just like belly disease. Not very descriptive. But it's not just that. In kids, it typically presents as GI symptoms, malnutrition, failure to thrive, so growth limitation and stuff. And for a long time, it was really thought to be a disease of children. We now recognize that celiac disease can present in later life. And it's actually quite easy to diagnose, but you have to think of it first.

22:07Emily Oster:And celiac is one of those great imitator diseases. So, yes, it gives you GI upset, diarrhea, excessive gas, and things like that. But so do a lot of things, right? It can also cause joint pain. It has a very characteristic rash called dermatitis herpetiformis, sort of a vesicular, intensely itchy rash on the extensor surfaces of the arms and legs and stuff. A lot of fatigue, anemia, osteoporosis. And so these are like, so, I mean, this isn't, there's an issue with a disease like this where these are such generic symptoms. People come in, they say, I'm not feeling good. I've got floating and diarrhea.

22:48I have a weird rash. I've got some anemia. A lot of people are anemic. A lot of people are tired. Yeah.

22:55Emily Oster:Yeah. So your doctor actually has to think about it. But the good news, if you think about celiac disease, it's a blood test. There's a screening blood test, anti-tissue transglutaminase antibody. It's 95 % sensitive and specific. That's not perfect. You do need a confirmatory biopsy test, which is done by endoscopy. But broadly speaking, if you think about it, you test for it, and you're well on your way. Historically, it's really interesting that although the disease has been known about for two millennia, it was only in World War II that they figured out what the cause was. So celiac disease is a classic autoimmune disease that is due to a genetic susceptibility.

23:34Emily Oster:So it's largely genetically mediated, but it has an environmental trigger. And for all this, until World War II, it wasn't clear what the environmental trigger actually was. And it was a Dutch pediatrician, William Carroll Dickey, who found that his patients, his kids with this disease, got better during the Dutch hunger winter of 1944 to 1945 when they ran out of bread. And then the allies air dropped bread into Holland, I guess. And the kids developed the symptoms again once they were eating bread again. So it was actually that long before we knew at least that it was a wheat product. I think it took a little longer to figure out exactly that it was the gluten in the wheat, what the cause was.

24:18So the incidence of this has gone up over time. I mean, this is quite interesting. So if you think of this as a genetic disease within an environmental interaction, over the past, I mean, it's gone up a lot in the past few decades. Some of that's going to be diagnosis and awareness, but some of that is aligned with the general rise in autoimmune diseases. Almost certainly this is not genetic drift. It's just not enough time for there to be genetic drift. So there is something going on in the environment or the food that we are eating that means that more people are having this, the gluten that we're providing, the foods that we're providing are more likely to trigger this in people.

24:59Emily Oster:Yeah. And we actually know that it's a true increase, again, because that blood test is pretty good to detect celiac disease. There was a study in the Journal of Gastroenterology in 2009, which looked at banked blood samples from Warren Air Force Base, where the privates had gotten their blood sampled in 1948 and 1954. And they went back to those old samples and tested them for this anti-tissue TENS glutamina antibody, this diagnostic test for celiac disease. And some of them had it. They probably weren't even diagnosed at that point in time, but based on their blood, they had it. And that rate has increased over time.

25:35Emily Oster:So we do know something's going on. And here's where we should talk about sourdough. It's never a bad time to talk about sourdough. Is it the lack of sourdough? Tell me why we should discuss sourdough. Okay. So some people are hypothesizing that our modern industrial bread making process is a problem here. And the reason is that in the old times when we made bread and sort of with a slow fermentation, so think sourdough where it's like it takes 24 hours. And I've made sourdough. I actually don't love it because it's so labor intensive. And I just like getting yeast from the store and it's easy.

26:11Emily Oster:But you've got 24, 36 hours. Over that slow fermentation process, the gliadin and gluten and proteins are broken down somewhat more by the yeast. And so they're potentially in a less immunogenic form. Modern industrial bread is made with a process called the Chorleywood process, which is crazy and incredibly fast. You can make one of those whole like loaves of bread basically start to finish takes about two hours now. How do they do that? So I did read about it. They use a lot more yeast. they like mix the dough really fast and it actually gets hot as they're mixing and they have to inject like cold water to keep it from getting too hot i think they inject some maybe some gas or co2 in it themselves but the bottom line is the yeast don't have much time to like do their breaking down of proteins thing so some people are saying that like it's the old-fashioned bread um that that might be people say things though yeah like it's speculative sourdough bread It could be something you would enjoy, but that feels speculative to me.

27:18Also, there's a lot of evidence that autoimmune disease, other autoimmune diseases have gone up over time.

27:22Emily Oster:This is also true, but we can't blame Brad for everything. All right. Worth noting is that people often take quite a long time to be diagnosed because this is not clear, an average of 11 years between first symptoms and diagnosis. And so, you know, if some of what we've described here seems like it's you, there is a test and a gluten-free diet is truly curative, although you have to keep up with it over time. Right. And for real celiac disease, I mean, a tiny amount of gluten will set it off. So this is like the real deal gluten-free diet. And one thing we're going to say here is that for all of the conditions we talk about, jumping straight to the gluten-free diet is generally not the recommendation because it's hard and not easy.

28:04Emily Oster:And with celiac disease, at least we can test and make sure you have celiac disease and then put you on a gluten-free diet. But you don't want to do that. You don't want to pull that trigger if you don't have to. Yeah. Okay. You can also be allergic to wheat. To have a regular, just a regular person, wheat allergy, just like you can be allergic to other foods. This is separate from a gluten allergy and would present with normal allergy symptoms, difficulty breathing, a principal anaphylaxis. So separate gluten, celiac disease and wheat allergy are not the same thing. Have you heard of weed-dependent allergy, exercise-induced anaphylaxis?

28:43Emily Oster:Have you heard? Because you're an exercise person, Emily. I have not. So it's this weird phenomenon, which I like to say we don't fully understand, but it might be one of those weird phenomenon that I don't fully understand and other people do. So allergists, let me know. But basically, it's people who have a weed allergy, but it only presents during exercise. And so it's like this weird combination where if they just eat wheat or they just exercise, it's fine. But if they do both in proximity and time, they develop anaphylaxis. It's not just like while you're running. It's not like if you run and eat a bagel, you're like if you eat a bagel too close to the bagel.

29:19Emily Oster:No, I think it can be in your system, but that's sort of a weird one. And then there was a bizarre Japanese facial soap wheat allergy incident that occurred with the Chano Shizuku soap, which was documented in epidemiology circles. The short version is this was a soap that contained wheat. I don't know why. I guess, whatever. People put a lot of things in wheat. But for whatever reason, it was wheat in some kind of digested form that was pretty allergenic. And when people were putting it on their faces, they were getting it like they were inhaling it and doing stuff like that. There's a lot of evidence in the allergy literature that when you eat something, it's protective in terms of allergies, right?

30:03Emily Oster:Like giving kids peanut butter when they're extremely young is protective. But when you get it in a different way, like if you inhale it or if it gets like under your skin or something like that, then you can generate allergies. So this happened in like several thousand women in Japan developed wheat based anaphylaxis based on a soap. Very strange. That's extremely odd. Don't buy weird soaps. don't wash your face with flour I don't know I'm sure people do you probably do I'm sure there's like a tic-tac influencer whose whole thing is like flower face and she like puts flowers on her face and then covers it with one of these masks and then like stays on the airplane for like nine hours and at the end she's like look at this and then her face is just like a crumbled mass of of dough oh I'm gonna try to find this person and if not I'll have AI make it yes AI I needs to make that.

30:55Okay. Do we really need to talk about gluten ataxia? We're just going to get people freaked out that they're going to have neuron loss. Yeah.

31:03Emily Oster:No, that's okay. There's another rare condition that is gluten ataxia, which is another autoimmune condition kind of related to celiac disease, but it attacks your brain instead of your small intestine. And that's not great. But this is pretty rare. All of this is just to say that, yes, of course, like any Any protein that's out there, including peptides that you might be getting from China or other places, anything like that can be a potential allergen. Your body's a complicated place and can induce strange symptoms and strange disease states. But the vast majority of people don't have celiac disease, don't have weed allergy, and certainly don't have gluten ataxia, thankfully.

31:47Emily Oster:What most people have or are concerned they have is non-celiac gluten sensitivity. And I guess that's what we need to get to after the break.

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32:42Hey, I'm worried about mom. She keeps forgetting her famous sweet potato pie recipe. Some things come with age, sis. And some don't. Knowing the early signs of Alzheimer's in a loved one will help you make the best decisions for your family. Visit 10signs.org to learn the signs. Brought to you by the Alzheimer's Association and the Ad Council.

33:01Emily Oster:I'm Mungus Shatigular and I'm back with a new season of the podcast Skyline Drive. This time I'm diving into a rabbit hole of peptides, organoids, blood boys, blue zones, and brain replacement to try to understand what this longevity obsession is all about and what it really means to live forever for all of us. I learned about some rad science. I can make a brain for you and then we can test what draw is the best for your brain as opposed to his brain. Here's some hard truths. I would expect Indians to age faster, but I did not expect it to be almost a four to five year acceleration. And get myself into a world of trouble.

33:46I'd say probably start bone smashing. That doesn't work. Make it look more defined. They say it works. I don't know.

33:52Emily Oster:Listen to Skyline Drive, How to Live Forever on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.

34:03Okay, we're back. And we're going to talk about non-celiac gluten sensitivity, which is what many people seem to think that they have. And I will say this conversation a little tricky because there is no defined characteristic of sensitivity. So people often say that they're sensitive to foods, by which they mean some combination of I don't like that food and I don't feel great after I eat that food. And it can be hard to think about outcomes in this case if what you are saying as the sensitivity of the outcome of the sensitivity is just like, I don't feel I don't feel great. Like I don't eat spicy food.

34:40I don't eat spicy food because the next day I feel really bad and I have a lot of problems in the bathroom. We don't need to go into it. But I would say I have a sensitivity, but it's not like a like a documented sensitivity. So I don't know. I think this is what people mean here is something different, something fundamentally different than I don't like to eat that food or that food doesn't agree with me. They mean something like I am having a version of a celiac reaction to this food and therefore need to avoid it for medical reasons as opposed to almost preferences. Does that make sense? It's such a hard distinction.

35:20Emily Oster:Yeah, it's tough. We do not have a diagnostic test or a clear biomarker for non-celiac gluten sensitivity. So in contrast to celiac disease where it's like, yep, blood test, biopsy shows it, these characteristic symptoms, people who are like, look, I feel bad. And by the way, we should say feeling bad generally is in the GI system. People complain of bloating, diarrhea, sometimes constipation, but also brain fog, fatigue, depression, other symptoms that can be hard to pin down. There's no case definition for non-celiac gluten sensitivity. And more importantly, there's no blood test. There's no signal of immune activation like we can see in celiac disease.

36:01Emily Oster:In celiac disease, you can find the immunoglobulins that are directed against the proteins and things like that. We don't have that in this. This is not to say that this is not a real thing. And we can go, I think there are always people who are going to be skeptical of this because like, wait, okay, you don't have a blood test. This is just someone kind of complaining that they get gassy sometimes and we all get gassy sometimes and who cares whether it's the gluten or not. So the thing I think to take home or an important set of studies that looks at non-celiac gluten sensitivity are blinded challenges.

36:37Emily Oster:So the way this works is you take people who believe they have gluten sensitivity for whatever reason. And instead of just saying, okay, go on a gluten-free diet and see how you feel, in which case there's going to be a lot of placebo effect there, right? Like you're doing something, you're being proactive, you're eating different foods in general. You give them a blinded challenge where at random, you give them either food containing gluten or food containing non-gluten. And basically, when you do this, you find that, let's see, 16 to 30 % of those who believe they have gluten sensitivity get the symptoms reliably reproduced in blinded challenges.

37:22Emily Oster:Now, there's two ways to look at this. One is to be like, oh, that's like glucose. No one has non-celiac gluten sensitivity, but that's clearly not true. I mean, some people obviously do. Up to 30 % of people who believe they have some non-celiac gluten sensitivity can reproduce it in a blinded challenge, which means something is happening even if we can't see it in the blood. But it's also really important to realize that there's 70 % of people out there that don't have a non-celiac gluten sensitivity. And I think it's important to realize that there's a heck of a lot more in bread products than just gluten.

37:59Emily Oster:And it's so critical to determine if you're sensitive to something, what you might be sensitive for, because as we pointed out at the beginning, cutting out gluten means cutting out a lot of really great, a lot of really great things. Yeah, let me just double down on this point about how we do these blinded challenges, because there's also some, I think, very nice, what people would call nocebo evidence. So in these kind of trials, they give people, in this case, who are potentially gluten sensitive, they either tell them that they're getting gluten or tell them that they are not. So there's a difference in your expectations.

38:39And then they either give them gluten or not.

38:43Emily Oster:Oh, diabolical. Okay. The people who, so what they find here is that, you know, there's significantly more gastrointestinal symptoms. If you tell someone that they're getting gluten and they get it, then if you tell them they're not getting gluten, but they do get it. So there's a sort of like the expectation is driving it. And moreover, the people who think that they're getting the gluten and are not getting it, look like the people who think that they're getting it and get it. So the, in this particular study, the expectations about whether you were going to get gluten were much more important than whether you actually got it in driving the symptoms.

39:20Now, again, that doesn't mean that there aren't, I mean, this is like one study and there's variation across people. It doesn't mean that there aren't people for whom the symptoms deliver based on getting, getting the gluten and not on the expectations, but there is clearly in some of this either something about another product that people are consuming or something that is effectively a placebo expectation. Great.

39:47Emily Oster:Remember that your brain talks to your gut. This is not just it's all in your head. In fact, your brain can make your small intestine and colon do things. You've actually all experienced this, like when you finally get close to a bathroom that you like and then you have to poop, that is your brain telling you like, okay, it's like something is going on here. So the fact that expectation can induce GI symptoms is totally reasonable and it's not like a psychology problem. It's how the brain works. But it's really critical to remind people that gluten travels in the company of several other molecules that can give you some gut distress.

40:29Emily Oster:And I think the big one, and there are a lot, but under the sort of it might not be the gluten that you're sensitive to are the fructooligosaccharides or so-called fructans. These are essentially chains of sugar molecules that you can't digest. Humans lack the enzymes to digest these things, but the bacteria in your colon are more than happy to digest them. And when they do, those bacteria produce gas and a feeling of bloating, which certainly mimics a lot of the symptoms that people with non-celi gluten sensitivity say they have. And the main source of fruit tans in the Western diet is wheat.

41:09Emily Oster:So if you cut out gluten, you're by proxy cutting out wheat, and therefore you're by proxy cutting out fruit tans, so you might feel better, but it actually wasn't the gluten all along. And if you knew that it was the fruit tans, you might do something different than cut out gluten. That is true. Does that make sense? In fact, what you might try is what's called a FODMAP diet, which is a specific kind of diet that eliminates these oligosaccharides, but does not require an elimination of all gluten. Yeah. And just to hit on the theme again, like jumping to the conclusion, I should stop eating gluten like Seth Rogen in the beginning is often incorrect.

41:51Emily Oster:Like the way you should do this is potentially discussing with your doctor, but more importantly in a situation like this, talking with a dietician, because there's actually a really defined pathway of trying different foods and recording your symptoms to sort of isolate what the sensitivity is. And that's such an important piece of knowledge if you can actually dial it in. Maybe it's gluten, but if it's something else, it's so important to know that. I think there's a sort of step back on this, which is to say some of what's going on here, almost a lot of what's going on is people are saying, I'm not feeling great.

42:25I'm eating food and I'm not feeling great. I feel bloated. I feel nauseous. I feel fatigued. I have brain fog. And one of the possibilities is that it is related to what I'm eating, which in the case of gastrointestinal symptoms seems like a totally reasonable assumption. And then the question should be, what is it? And yes, gluten is one of the things that you would put on the list of possibilities. But actually, for most people, there's a lot of other things that you would want to have on that list. Maybe you'd want to have these saccharides. But also, you might want to say, like, maybe you're not having enough fiber, maybe you're not having enough hydration, maybe you're drinking too much, maybe you're not drinking enough, like what there's various other possibilities.

43:06And so one of the sort of insidious things about this gluten business for me is that I think some people are having these symptoms and just saying, oh, it's probably gluten sensitivity. Let me just cut out all this gluten, which is both making their life worse because bread's delicious, but is also actually probably not fixing the problem as much as if they took a more holistic view around the symptom pattern and ask the question, what could I do to improve my symptoms. And this is a little bit what happens in this influencer space, which is people see, you know, oh, I don't feel good. And then this influencer says, you probably have a gluten allergy, you know, everybody, or you probably have a gluten sensitivity and, you know, make your tortilla out of cottage cheese instead of bread and everything will get better.

43:50And that could be delicious, but it might not fix your problem.

43:54Emily Oster:Absolutely. And, and I think, you know, there's obviously an entire industry, a gluten-free industry out there, you can buy gluten-free tortillas and gluten-free bread and gluten-free pasta and all that stuff. It's worth noting that in general, these gluten-free foods are more processed. They're more in the ultra-processed food spectrum. They tend to be lower in fiber, lower in folate, generally higher in fat and sugar, and two to three times the price. So there is a cost to be paid for switching into a non-gluten framework. There have been some studies of rice flour. I'm pulling something from the journal Epidemiology from 2017, looking at the unintended consequences of a gluten-free diet.

44:38Emily Oster:And one of the things they found was higher arsenic and mercury levels in the urine because rice flour tends to be slightly more contaminated with arsenic and mercury. So yeah, don't jump to conclusions here. You might regret it. Yeah. And I think also we sort of see one of these people are constantly reporting is that their gluten sensitivities are better when they are in Europe. Oh my gosh. I've had friends say that. Yes, yes, yes. Like in the flour is different. The croissants are different. Like, well, French croissants definitely have gluten in them. Now they may be cooked differently. The wheat is different, but there's no question that they, they have, like, if you are a person with celiac disease and you eat a French croissant, you will feel like crap the same way that you will, if you are an American, American cuisine, like no difference.

45:23And so this suggests either for some fraction of these people, there's something else in the food environment that is different. Maybe there's something about the interactions with stress. Maybe there's like, maybe there is something else going on. And maybe there's something about the difference in the way the flour is processed. But my strong instinct is it's actually some other things. Yeah.

45:46Emily Oster:The epidemiology of both celiac disease and non-celiac gluten sensitivity is the same in Europe and the US. So there's just as many. It's not like, oh, no one has celiac disease over there. They do in the same rate as we do. So yes, everything tastes better in France, 100%. And we all feel better when we're in France. I can speak from personal experience there. But it's probably not anything magic that they're doing with their wheat. I just feel like if people are not, I have a hard time expressing this, but I feel like this has gotten in the way of people improving how they feel because it has given people an easy answer that companies are obviously delighted to take advantage of by saying, oh, you know, you can buy our gluten free crackers.

46:32and you can buy our gluten-free bread and gluten-free this and that and the other thing. And that it has gotten people into a space where they're not actually trying to figure out what's wrong. They're just defaulting to something which may or may not really be the solution. And that feels bad to me.

46:48Emily Oster:Yeah. And these symptoms, because they're amenable to both the placebo and nocebo effect, you might feel better by switching, even if it has nothing to do with weed at all. Even if your symptoms are due to like, you aren't getting enough fiber, the very act of taking initiative and switching all your bread to gluten-free bread, that has an expectation to it that can have placebo effects as well. They tend to not last forever. And I've had plenty of friends and patients and stuff who have been gluten-free for a period of time. And then things start creeping back, like symptoms start creeping back and people start to realize, you know what, like maybe it wasn't the gluten.

47:24Emily Oster:And at that point in time, they actually do what's real work is to figure out what you're sensitive to. It's not something that you're going to do overnight. It takes documentation of symptoms and very specific dietary changes over time. But once people do that work, they're generally happy that they did. Yeah, but it is work. I, as per tradition, tried to find a study that would show that avoiding gluten would improve your athletic performance so that I could get Emily to be gluten-free for the next 10 years. And I failed. All I found was a study appearing in the journal Medicine and Science in Sports and Exercise in 2015, which took 13 endurance cyclists and randomized them in a crossover fashion.

48:08Emily Oster:So they went like a couple of weeks having gluten and a couple of weeks not having gluten and then did time trials. And nope, they were just as fast and just as endurance as they, regardless of what their gluten intake was. I'm actually shocked that this did not go in the other direction. Oh. Even that I would think it would be hard to maintain the kind of carbohydrates that you need without, you know, gluten containing products. So I guess these guys probably just ate a lot of rice. I think they had a dietician. I think they were calorically equivalent. Yeah. Yeah. Yeah. I know very few endurance athletes who avoid gluten because it's just hard to get enough carbohydrates and sugars.

48:55Emily Oster:Yeah. I also checked because people ask, is there a difference between organic wheat and non-organic wheat? And the answer is not in terms of gluten. They both have gluten. But it could be something else. There could be something else between these things that are bothering you. Yeah. I don't know. Yeah, talk to a dietician and work it through. Yeah. If you are having these, here's my takeaway here, and then we can smash or pass, is if you are having symptoms like this, you should be tested for celiac. And if you don't have celiac, you should do something broader to try to figure out what's bothering you rather than just eating some Mary's crackers, even though it's a very good kind of crackers.

49:41Emily Oster:Not an ad, but send us some Mary's crackers. All right, Perry, are you a smash or pass on gluten? I'm a smash. I'm a lover of pasta, a lover of bread. I feel for all of you who have any form of gluten intolerance, whether it's celiac disease or otherwise. And I implore those of you who might just be assuming that they have gluten intolerance to try to figure it out for 100 % certain because a life without gluten is just a smidge less happy than a life with gluten. Emily, smash or pass? I'm a smash. All my favorite foods contain gluten and I will ditto you that I think I love people to just make sure that this is what's going on with you and maybe you'll be able to have gluten.

50:29All right, that's it for gluten. Mailback question of the week after the break.

50:36Remember, always be generous with the nutmeg. Just eyeball it. Okay. Mom's wisdom has served you well, but now it may be your turn to guide her. Hey, I'm worried about mom. She keeps forgetting her famous sweet potato pie recipe. Some things come with age, sis. And some don't. Knowing the early signs of Alzheimer's in a loved one will help you make the best decisions for your family. Visit 10signs.org to learn the signs. Brought to you by the Alzheimer's Association and the Ad Council.

51:06Emily Oster:I'm Munga Shatikular and I'm back with a new season of the podcast Skyline Drive. This time I'm diving into a rabbit hole of peptides, organoids, blood boys, blue zones, and brain replacement to try to understand what this longevity obsession is all about. And what it really means to live forever for all of us. I learned about some rad science. I can make a brain for you, and then we can test what draw is the best for your brain, as opposed to his brain. Here are some hard truths. I would expect Indians to age faster, but I did not expect it to be almost a four to five year acceleration. And get myself into a world of trouble.

51:51I'd say probably start bone smashing. That doesn't work. Make it look more defined. They say it works. I don't know.

51:58Emily Oster:Listen to Skyline Drive, How to Live Forever on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. We've all been there. We've had seasons that have shaken everything. The question is, what remains when the shaking stops? Hi, I'm Gary Valenciano. And on my podcast, Unshaken with Gary Vee, I sit down with amazing personalities and we talk about the seasons that nearly broke them. The lows that carried them to their highs. Listen to Unshaken with Gary Vee on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. Hi, Emily and Perry. This is Ellie. And I'm Josh.

52:47And we're calling from Toronto. Our question is, is coffee really bad for kids? Does it really stunt kids growth? Like, would it hurt if I love it to drink a bit? That's our question.

53:02Emily Oster:Emily, do your kids drink coffee? My kids don't drink coffee because they tell me that they see how dependent I am on coffee and they don't want that for themselves, which I think shows a level of maturity I have not achieved. What about you? My 16-year-old will occasionally, but not too often. Coffee does not stunt kids' growth. This is a myth. I've 100 % told my kids this, by the way, 100%. Totally. It's a myth you can be using. Knowing it's not true. So turn this off in front of your children. It's a myth. I think there are reasons to not give your child coffee, which are that you can develop a tolerance for caffeine and then you will need it.

53:52And that's not a terrible thing. But it may not be something you want to develop in a child. And particularly since many of us use caffeine to address our lack of sleep, I would urge you to make sure your children are sleeping enough so they don't need coffee. And definitely they should not have coffee at the end of the day because it does interfere with sleep, even if it doesn't interfere with growth. Well said.

54:19Emily Oster:One note that teenagers and kids are getting most of their caffeine not from coffee these days. They're getting them from energy drinks and sodas, and those are also not good for kids. And actually, the Celsius energy drink, that has a lot of caffeine in it, arguably more than coffee. So people do want to be pretty careful about those. do you did you i know you're probably this is not going to be for you did you watch if you're watched saved by the bell i mean i remember sure i remember saved by the bell yeah and do you remember the episode do you remember the jesse episode where jesse spano gets addicted to the caffeine pills yeah yeah they were like we can't do real drugs but that is burned this image of jesse spano like dancing around her room because she's had too many caffeine pills it's like burned into my mind forever.

55:10And I have, in high school, even though I was tempted because I was not sleeping anywhere near enough, I would never have ever taken caffeine pills because of that Saved by the Bell episode. Stay off drugs, kids.

55:21Emily Oster:Oh my God, it worked. It worked on a very special episode of Saved by the Bell. Yes, oh my God, that was so great. All right, well, Josh, it's probably not a good idea for you to have too much coffee, but it's not gonna make you short. All right, that's it for us today. Stick with us next week when we'll ask, what's the deal with fluoride? Oh, we're gonna get some emails about that one. People get upset about fluoride. Wellness Actually is produced in association with iHeart Media. Our senior producer is Tamar Abishai. Our executive producer at iHeart is Jennifer Bassett. Our theme music is by Eric Deutsch.

56:04and our content is for educational purposes only.

56:07Emily Oster:If you like the show, help other people find us. Leave a rating and review on Apple Podcasts or your podcatcher of choice and help us spread the word about the show. You can follow us on Instagram at wellnessactuallypod. And don't forget, we want to hear from you. Head over to wellnessactually.fm and leave us a question for our mailbag or suggest a topic for a future show. We'll let the influencers have the last word. No time. There's never any time I don't have time to study. I'll never get into Stanford. I'll let everyone down. I'm so confused. Jesse, hey. Hey, just calm down. It's okay. You're right.

56:45Everything will be okay.

56:46Emily Oster:Yeah. I just need one of these. Pills? You mean you really are taking drugs? I need them. Jesse, give me those. I need them back. I have to sing. Jesse, you can't sing tonight. Yes, I can. I'm so excited. I'm so excited. I'm excited! I'm so scared! Jesse, Jesse.

57:19Emily Oster:I'm Mange Shatigular and I'm back with a new season of my podcast, Skyline Drive. This time I talk to scientists, biopunks, curmudgeons, blues owners, super seniors, and Goa's top cryotherapy lab to try to understand this obsession with living forever and what it means for all of us. And I get into a bit of trouble along the way. I'd say probably start bone smashing. That doesn't work. Make it look more defined. They say it works. I don't know. Listen to Skyline Drive, How to Live Forever on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. This is Michael Rappaport and my podcast, the I Am Rappaport Stereo Podcast, is unlike anyone you've ever heard.

57:58Emily Oster:If you're looking for strong opinions about sports, entertainment, politics, pop culture, and whatever else catches my attention, then subscribe now. This kid Jafar Jackson should absolutely, positively get nominated for his portrayal as Michael Jackson. Listen to I Am Rap Report on the iHeartRadio app, Apple Podcasts, or wherever you get your podcast.

58:44Emily Oster:that's just for you. Listen to Waking Up With Ryan on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. This is an iHeart Podcast. Guaranteed human.