hey guys and welcome back to the root cos medicine podcast I'm your host for today Dr Kate kresy and we have a brilliant episode for you if you're someone who loves kids whether you're a parent grandparent teacher Aunt Uncle you name it if you care about keeping your kids healthy this episodes for you so all of us know the kid who is constantly sick or we wish our kids got sick less often but how do you safely help a child reach their optimal immunity how do you actually prepare them to go in a room full of other sick kiddos and maybe reduce their chance of coming out sick or at least reduce the severity of the illness they get we're going to cover that and so much more with Dr Chris mcgr Dr mcgr is an integrative pediatrician at Southbury Pediatric Associates he's the medical director there and he's also the chairman of Children First of North Carolina I met Dr Chris by watching him present at a conference and I was blown away by the information he shared he's one of the smartest people I know and he has a really amazing talent for finding the latest research and immediately applying it to clinical practice what I love about his practice is that it's really conventional in the sense that they see people in a conventional model with insurance and yet they still are able to weave in natural evidencebased interventions into each appointment I really love the Practical tactical advice that we get from Dr Chris and we're going to start with immunity and also go through things like how to optimize your child's whole person Health including their brain health in the first few years of life we're going to talk about sleep asthma you name it if you wish that you could have just sat down in front of an integrated pediatrician with Decades of experience and pick their brain this episode is going to feel just like that and you're going to come away with so much more confidence and so many helpful takeaways Dr Chris welcome to the root cause medicine podcast oh it's a pleasure to be here Kate thank you for the invitation and as always it's lovely to see you likewise I actually love the story of how we met we met at the ifm conference and I knew you were a pediatrician because you asked for my sparkly jacket for reference people who don't know this when Rupa goes to conferences we show up either in astronaut suits because we're the future of medicine if we're super goofy super fun and I had on this very oversized what looked like I think a magician jacket it was like blue and green Sparkles and I was thinking to myself what am I gonna do with this thing like when I go home like I can't put it in my suitcase it's gonna like get on my clo sparkling and Dr Chris showed up and said I'll take it because my kids will love it yeah and I didn't think you'd send it to me but there it comes in the mail a couple days later I started laughing and then I wore it and the kids laughed and loved it so yeah it was pretty awesome I love that it it has a life of its own now it's continuing to bring people Joy but that's where I learned that you run a huge pediatric clinic and you have for a long time and I've since listened to you give lectures and have really appreciated how well you understand the root cause of so many conditions that can feel really big and scary and baffling to parents and so I'm so thrilled to have you here today we could have you talk about anything but what we're going to focus on today is immune resilience asthma infections and I kind of wanted to start by just picking your brain like I feel like this winter I saw so many adults getting sick but then if they had kids in school they were just kind of throwing their hands up and being like we're just going to be sick for the next four months and I feel like there's got to be things we can do and so can we start there yeah absolutely and I love the intro and love the story of us and I think that's sort of the beauty of life in medicine spending time out there and just approaching with a wide open lens and I think for me that's the essence of root cause medicine is looking at everything wide open without a slanted view without an alpath view without a Eastern View without any side of any kind of view it has to be it's just let's see what is the best and let's see what works and so if we take that mindset and shift to what's going on right so I've been in practice now for 24 years in the same building and we are dealing with more viral induced and bacterial induced illness than my entire career has seen now if we go back to why I think the major reason is covid I think what ended up happening was during covid we basically shut the kids out they didn't go to school for a long time they were locked away from each other they didn't spread disease like they normally do and so antibodies sort of disappeared and we know this when you look at just Co antibodies being tested after you get your viral infection or you get your vaccine within 8 weeks to 6 months your antibodies sort of disappear unless you get reinfected or reexposed so for roughly a year and a half to two years kids lost their antibodies now the reason being if people are curious is it's an evolutionary smart thing to do because antibodies are proteins and so if you keep all of these circulating antibodies against all the thousands and thousands and thousands of microbes you can get exposed to your blood would be thick and you die so it can't do that so it builds the proteins and lets them go away needed and we'll talk about B cells and T cells later and how they make these things so the body just goes into what's called a memory phase it just sits there quient but your blood doesn't really have circulating antibodies that are ready to attack whatever pathogen jumps in the system so fast forward to now all of a sudden kids are back in school kids are back with each other playing Co is sort of gone The Masks are gone all of these things and when I mean CO's gone I mean it's the virus is here but we're not worried about it we're not avoiding it and so all of a sudden the kids are now living with each other and there swapping spit like they always do and snot and everything else and if you ever want to see how kids do this go to Walmart sit in the toy section and be there for about a half hour and in that half hour you will see a child with a big snotty nose touch a bunch of toys walk out the next kid will come by touch those same toys pick his nose touch her eyes and you have the nidus with spread and we'll talk about measles later and measles will sit on an inanimate object for two hours and viruses have different levels of amount of time they can survive there so we know the spread is simple and easy that's why kids spread so much much disease so then we sat there and said okay well this is interesting now all of a sudden kids are getting sick constantly well flu came back with a vengeance RSV came back with a massive Vengeance and then you had your typical Corona viruses which is your common cold Aran viruses and so essentially you're basically a naive immune system with memory but no active antibodies and so kids get sick back to back to back to back to back part of it was unavoidable because of what we did with this experiment of Co but to Point are there things you can do to reduce this problem the answer is yes right so when we think about this we have to look at it from a perspective of what does the immune system need to function well right and when I think of this I think of sort of the pillars right and the first thing is most important for a child to sleep if your child does not sleep well their immune system will be wrecked and we know this from study after study after study but kids in general should be sleeping anywhere from 8 to 14 hours a night depending on their age and so screens have gotten in the way of this I've seen a little bit of lack of parenting around this getting in the way of this they've seen different things disrupting a child's natural sleep iron deficiency so anyone who's had a child knows that if they've not had a great night's sleep what do they do they're whiny they're cranky they're irritable well your immune system is part of that game as well and so one of the first things I tell folks is make sure your kid gets to sleep on time right make sure you set a balance bound is apparent that you're not going to accept delayed sleep so their immune system is constantly functioning at its best and the super interesting anthropologic thing around this is when does your immune system turn on right and this is sort of interesting your immune system turns on when the sun comes up it follows C cadium biology and why would that be well when do we all experience interaction with each other when do we first eat when you wake up so immune system cranks up in the morning and then as the day goes on it starts to wne again so your IM your immune system is the least active after the sun goes down because what's supposed to happen after the sun goes down according to our genetics well the sun goes down and you go down you're supposed to go to sleep what do we not do now so we're sort of a mismatch there so sleep's my number one number two is nutrition by far and the reason nutrition is so important is because nutrition is a co-actor reality and when I use the word co-actor I'm speaking of minerals and vitamins and things that help enzymes work in your body and in this case specifically we're talking about how those co-actors are helping your immune cells do their job and we need lots of them zinc is a big player and we know this because you think about just zinc deficiency it's a disease called acrodermatitis and terop while zinc insufficiency is sort of a similar problem where your immune system just doesn't function well so I talk to parents about where they're getting their kids intake of zinc we talk about vitamin D everybody knows all about vitamin D and everyone who follows your podcast knows you probably speak to this probably every podcast and so vitamin D is a big player and where are we supposed to get vitamin D I'm a natural guy so I'm sitting there going okay we can get this from food but also you want to get it through the sun exposure right we want magnesium right this is another big player in this function of how the cells do the job and then iron those are the sort of the big four so in kids I will test them do blood and look and see we'll test RBC zinc which is red blood cell label zinc so we get a 120-day cycle of what your zinc is doing red blood cell magnesium ironite test in general with fertin to see how their stores are and then vitamin D and then we supplement if needed but before you even get to that level of blood I'm always telling folks let's maximize where you're getting your sources of these and if you're ever curious as parents I encourage you to go to the Linus Pauling website for Oregon State University they have a phenomenal micronutrient section where you can go through any micronutrient you can read about what is involved in cycle structure-wise co-actor wise what enzymes is helping and then it gives you a list of what foods have that and that's where you start to say okay how do we get these Foods in our kids right and then what else is involved in immune Health exercise movement hugely involved in that so get the kids out now that's generally not a huge problem for young kids but as they get older it becomes a problem because they're on their bloody phones and all these other things that are sort of structurally dysfunctional so that's sort of one I do encourage parents to get their kids outside get their kids playing games get their kids moving and then stress reduction is always a big one now that's a much harder lever to pull on because usually the the stress is familial or something at school and you have to really get involved in that but I'm always telling folks to help their kids do box breathing 478 breathing get him involved in listening to music relaxation all that stuff so that's sort of a a a rapid primer through a very long story so we might have some parents at home who are thinking well I wish I could get my kid to sleep but my kid has a hard time falling asleep or my kid wakes up in the middle of the night do you have some favorite tricks for sleep yeah so biggest thing by far is kids are creatures of habit so if they know the brain is pavvan you know the pavl study the brain knows that when it's starting to go through a pattern repeatedly we'll start to accept that pattern and start to keep that pattern going so if you have your child that's young and you have 6:00 p.m. dinner 700 p.m. bath time 7:30 reading they'll start falling asleep regularly at that time especially if you keep the lights in the house dim you don't have lots of lighting you don't fight your natural circadian biology because again the sun goes down as the sun is leaving the sky and it's getting dark the light changes entering your eye the photons actually send the signal to your brain to turn on melatonin cortisol is supposed to drop adenosine supposed to drop and then you fall into the sleep pattern if you fight that by light spectrum that actually suppresses melatonin's effect and raises cortisol because you're hyp excitable you're playing video games well then you're going to make it harder for you to fall asleep so I'm always a fan of what was intended so go back to what nature asked so that's number one if they wake up in the middle of the night then I'm worried about iron deficiency because iron is very important in sleep biology and it's not a sleep onset problem it's often a sleep maintenance problem we learned this from the neurologist who figured out that restless leg syndrome was highly associated with iron deficiency and this is not a issue of an anemic problem you can have totally normal CBC with normal blood count but you just don't have enough iron for storage in the fertin cages and so that's somewhere where I'd say okay get an iron level through uh fertin and if it's low then you want to supplement that back and the absence of those two then avoiding caffeine all the basic sodas things like that that might keep your kid up and then trying to make their sleep environment as dark as possible dimmers in the rooms even red lights now are getting super interesting what do you mean by that so red light therapy right so there's all this data and again I'm not an expert in this so I'm gonna probably butcher it but the wavelengths of the Sun have a certain Spectrum from like 460 to 600 ANM I think is what it is or angstroms but below that there's the infrared and above that there's another wavelength and those wavelengths also are functional it turns out and there's some healing biologic effects that this is the way we see as the sun goes down these other wavelengths are there as well and so there's some data now coming out that having red lights at night actually induces healing inside the body via these path ways that have been with us forever through the Sun and the Moon that we just avoid because we're indoors too much and so there's a lot of folks now who talk about having red lights in their rooms when the Sun goes down because you can still see and do but you're not actually getting incandescent lights like you would from the Sun so it actually turns on all the biologic effects we want that's awesome so maybe putting some red lights in your kids's room yeah I'm actually really interested in doing full spectrum lights at home and then red lights at night everything so that's a deep dive I've done in circadian biology recently so about to head down this road big time so let's wrap sleep up I want to ask you about the kids who do use their phones a lot because I'm sure you run into this all the time like have you learned some successful hacks for helping kids and teenagers stop using the phone at night so they can get restful sleep depends on the age right so if they're of the age where you have a little bit more control over what they're doing where you just have to parent up and say no take the phone away you had give him limits on it and be very authoritative not authoritarian but like I love you too much to let you do this to yourself so let's have a conversation on how much time you're going to be allowed and if I catch you going longer than that we'll take it away for a bit until you can start to recognize what is healthy for you because given the absence of parenting children will do what children do which is to have fun and not worry about the consequences of their behavior and there's so many Downstream bad things that happen from a screen right the most common thing that that I'm seeing now other than in attention is kids are going worse in their ability to see distance so they're becoming more myop because they're spending so much time staring close to these screens that their eye shape is changing and they're having to get glasses now more frequently and this is something that's been well seen in in Far East Asia and Korea and Japan for a long time so I let parents know all of those details like here are the things that are going to happen to your child if you don't change this and that sort of gives parents a lot more fear which I hate using that as a metric to why but if fear makes change in the right direction fear is useful right so I think we leverage the things that are going to be detrimental to the child and have the parents paing up on that when they become teenagers like car driving teenagers a lot harder because they can be out of your purview a lot so then I go to the let's look at your screen usage right so I ask them to give me your phone how you see your screen usage oh boy if you can't get below this your phone's going to have to come back to me and I'll hold it for a while or we can get your flip phone and the statement of flipping to a flip phone will make every teenager run for the hills and so that's a good motivator and again this is not in my mind Draconian parenting this is effective parenting because if and when they realize that you're serious Behavior change occurs and again you're not being mean you're not saying you can't have your phone in the future you're just saying let's limit the time so when you adjust your time course back then we'll give you the phone back sort of like if they were driving a car drunk would you say oh it's okay no you say your car's gone right but somehow we think that phones are a right they're not a right they're privilege just like many things children have they're a privilege and we shouldn't be giving them as our right and somehow we've normalized way too many things for kids and I'm a little bit old school I think we should just say I love you too much here's what we're going to do it's helpful to hear I mean especially you've been doing Pediatrics now for 24 years I think a lot of parents feel this impulse but then they're alone in the battle with the kids and everybody else is doing it and everybody else's parent is letting them do it and it can be really hard to stand strong around that and I think knowing the science and having an appropriate level of concern is really useful and I I love the science you shared today about that yeah let me add one other piece to this for the parents listening when you parent up your kid will thank you they won't thank you in the moment they won't thank you the year later but when they're older mine just turned 201 and 18 like 20-year-old has said to me over and over again how grateful he is for what we did around these issues because he's now watching friends that are in school who have no control no self- wisdom around these decision-making pieces and now they have this control group that they can look at that says wow my parents love me enough to do this and it comes back full circle after all the pain and struggle and arguing and fighting eventually you're like wow it was the right thing and my kids are not even saying like when they when they have kids they're not even going to have phones like it's that funny it's like Dad I don't know how you did it cuz when my kids are born they're not getting phones ever and I'm like I'm waiting to see because I'll be the grandparent laughing you mentioned magnesium zinc iron vitamin D do you have any favorite foods that you suggest to parents or like maybe their kids can't take pills how do people get more of these nutrients in their diet the simple answer is vary up your Foods constantly and always choose Whole Foods that's a big one right so one of the easiest ways to get a lot of these things in your kid is liver right so it's something nobody eats right and unfortunately if you watch an animal eat another animal the liver is one of the first things it eats so I was actually I saw this live it was the coolest thing ever I was in Wyoming on a ranch and a little dog was there was like a terrier kind and I saw him take off out of the distance and then all of a sudden he catch a little they called them chislers it looked like a little prairie dog and it flipped the prairie dog on its back gutted it and then ran away didn't eat any of the muscle it ate only internal organs and so that was a real big wakeup call from me mother nature always had a plan and why do we eat the chicken breast the least healthy part of the chicken over the other parts where we have storage of all the good quality micronutrients so Nicole my wife who's a nutritionist and an amazing Chef has made liver Burgers different ways to get in the kids that we taste tested and the children had no idea there was liver in it so you figured out how much liver you can put in to make the burger not taste like liver which is a very specific taste but also have a lot of those Health nutrients in it so a lot of that involves cooking so liver is one big one I recommend I do love a lot of beans and nuts they have a lot of magnesium in them so I'm encouraging folks to eat beans and nuts zinc is in shellfish so I encourage folks to give their kids shrimp salmon is a great source of vitamin D so you really just got to pick through foods that are not typically on the kids's plate and you say this is again I love you too much here's the food right if you don't want to eat it call me when you're hungry and you bring out the same plate right you get away from this McDonald's Happy Meal world that is Wrecking our children even if you look at school food it's abominable that United States government as rich as we are we allow children to eat high calorie nutrient poor food 66% of the meals they eat per day it's terrible you gave me your wife's book and it is one of my favorites actually have to find it so I can show everybody it's called nourish your tribe but I want everyone to see it who's watching on YouTube and it's brilliant and you have some of these recipes in here yeah well when you have a Rd as a mom and a doctor as a dad I love under the nourish your tribe it says boost your child's immune system conquer chronic illness restore family gut health sharpen the teenage brain function optimized gene expression like with delicious recipes everyone needs to go buy this book I mean we need to have Nicole on with you next time to like talk about this in more in depth but I love that advice I me we talk about the attention trail mix whenever I do ADH detox because you can throw like pumpkin seeds and almonds in there which are going to be really good sources of magnesium you can throw some cashews in there some walnuts really good source of Omega-3s and that's portable like you keep a bag of that in your purse and like the kids can munch on that all throughout the day it's full of fiber but it's got those really critical minerals and fats that your body needs for so many things including brain development yeah what brain development's massive I mean as one of the big talks that I did last year at AIC was all about the growing brain and and micronutrients the co-actors are so important in every aspect of neurogenesis and that's one of the biggest worries I have is that pregnant mothers aren't getting the sources of nutrients that they need and it's a long conversation but I think that's one of the major reasons behind the epidemic that we're seeing in neurodiversity and autism is this whole world of macro micronutrient insufficiency deficiency coupled to toxins it's just a mess so you didn't say a multivitamin so I'm curious your thoughts like do you recommend multivitamins for your pediatric population like how do you feel about them I have no problem with them I don't like them as a substitute for healthy eating so when I hear parents say to me oh well he's got a multivitamin he okay no sorry the human body is far too smart to take a m multivitamin is the main source of how it heals itself I think the way Synergy of food works together is very very critical to outcomes and I think car Fitzgerald's work I think is heading down this path of learning how epigenetics Works through food as a synergistic model I don't think supplements are the answer to True healing I think supplements are a very good help in certain situations where you know the biochemical dysfunction but I don't like it as an answer to not doing the parent if you say to me I want to hedge my bets against holes in their diet randomly sure fine all day long I think that's great but I don't like it other than that that's fair do you have a brand or a form that you do like when parents are thinking okay doc I'll do my best it's going to take us a while to get here as a family I want some nutrition Insurance in the meantime because I'm going to start with carrots once a day and I'll get to deliver in a year or two yeah so absolutely vitamins are terrible tasting so let's just get that out of the way they're amines that's where it gets the name vital amines vitamin and so amines are bitter and if you have a bitter substance your kids are not going to take it end of story right that's why vegetables are harder for kids to eat than fruits because they love sweet they don't like bitter so broccoli is a much harder cell to a child than let's say an orange but when they add sugar to it in small volumes it's palatable and then they'll get it in so I like Nordic Naturals Nordic berries and again parents will say well they have sugar in them yeah I get it but show me a under eight-year-old who's going to take one that doesn't have sugar and then the other one that I think is reasonable smarty pants I think that's a good one when they get older I like Garden of life's multivitamin for men for the teenage boys and I go prenatal for the teenage girls who are menstruating because as soon as they start menstruating as far as I'm concerned they're prenatal I don't care whether they're pregnant I want them to be sufficiently available to have a child if they by accident have a child so that child has the best chance of an outcome So to that point so that's fascinating right so here I am recommending a multivitamin every day for teenage girls right but I wouldn't say that first line for a little infant right because the reality there is that you control the infant's Behavior around food right you can control what they're exposed to you cannot control your teenage daughter or teenage son easily around food I have lived this it's very difficult so I am okay in that point hedging my bets knowing that I have less control over the child's outcome yeah now you mentioned like wanting to make sure that the teenager is taking a prenatal and I find that people are confused about the difference between a multivitamin and a prenatal because they're very very similar but there's like one or two key differences what are the key differences in your mind so it's methylation making sure they have the right forms of co-actors that drive epigenetics and now that's what we sort of know now back in the old days there was a way to prevent neural tube defects we had a disease that we were talk talking about we found out oh if you give folate they don't get neural tube defects in the same amount now we know with Steven zel's work here in North Carolina colen is a huge player multivitamins for women do not have enough choline in them that's one thing if for those listening eggs are a great source of choline so if you are a soon to be pregnant woman a pregnant woman I would encourage you to eat eggs Rhonda Patrick does a great talk on this kind of stuff and she was eating four eggs a day while pregnant to make sure she got her choline again these are all massively important foods that drive the epigenetic cycle that reduces the risk of the child's development going arai this is awesome cool okay I want to talk to you about measles because there was a recent measles outbreak and I think a lot of parents were feeling nervous a lot of parents were asking us about vitamin A and if they should be giving their kids high do vitamin A what have you been telling your folks in your clinic about measles and what they should do yeah so first let's describe what measles is I've never seen meas let's just be honest right so measles disappeared once MMR was effectively given to most of the population I have a partner who is 85 he's brilliant smartest man in our Clinic still working three days a week love him Dr K he and I talked at nauseum when he was in Texas he saw measles all the time and measles is nasty one in a thousand kids who gets measles will get incilius one in 10,000 of those kids will get sspe or Subacute sclerosing pen and sephtis years later so it's a bad disease right highly infectious let me just give you the data I wrote it down here Omron is about a reproductive rate of about a 12 right and that's almost the same as measles so reproductive rate means for every one person infected 12 other people will get infected those 12 then go out into the community infect 12 more so now you're at 144 those 144 now go out and infect 12 more you're at 1728 those 12 go out now you have 20736 people in four exposures that's faster than anything on the planet right so measles andron are roughly around the same infectivity they're nasty they're fast they go your sickness essentially comes on usually eight days nine days after you're exposed to somebody and you have a 4-day period of feeling nothing before the symptoms turn on and then things are sort of a mess right so that's sort of what it is what is the actual virus present as I've never seen it again so I always reread the data to make sure I can catch up to what I'm going to see it's a high fever right so it's not a low-grade fever it's really high fever it's a rash that starts on your head and heads down to your toes you start coughing you get body AES everywhere sort of the very similar myalgic fever stuff you get with other viruses like the flu you get a sore throat you get really red eyes and then there's this really pathom monic thing called a Copic spot which is a little white it almost looks like yeast inside your mouth on the Buckle mucos of the sides of your mouth but it sits on a red base which yeast won't look like so people can look this up online Copic k o l i k spots right if you ever see that in the kid's mouth with all these other symptoms your child has measles now here's the important part do not take your child straight to the doctor's office please do not do that if you do that you are going to put everybody else in that clinic at risk so you need to call us or your provider and say hey I think my kids got measles and let's prepare for you to come in and be seen in a room where we can isolate them from everybody else and not allow that child to infect the whole environment because again one in a thousand kids will develop en sephtis and that can kill you so it's a really big deal right so then let's fast forward to what you're speaking to in the sense of the vitamin A Story vitamin A like vitamin D and actually bacteria in your gut are heavily involved in immune regulation right one of the big things they do is they turn on this Gene called Fox P3 fored box 3 that turns on t- reggulator cells and for those who don't know what those are those are the military police for the immune system when you have an infection your body will ramp up an entire Army Navy Marines and Air Force to kill whatever pathogen it's fighting against when the infection is over or getting better your immune system should then say okay we need to quiet you down and those are the t- regulator cells they send out certain cyto kindes or chemical signals that say okay let's shut back down vitamin A vitamin D and your natural gut bugs actually induce this military police that says all right everybody body go back into relaxation mode but vitamin A also when it attaches to a retinoic acid receptor it also turns on the pathogen apcs or antigen presenting cells so they accept the tissue or the protein of the virus or the bacterium and present it to the te- cells to then train the B cells to make the antibodies or have those te cells switch into the cd8 type which is The effector Killing Type these are the ones that actually go out and directly kill the cells that have virus in them vitamin A helps turn on those effective killer cells so it's at the center of all of it and so when I say to somebody okay do you should you take vitamin A in general I would say no because a d and K are the four fat soluble vitamins right they live within fat the danger with that is you can get toxic with them so too much a too much D too much e and too much K is poisonous to the body so you have to be very careful in saying okay just take a bunch of these things now if you are actively sick you know you are sick then you can ramp up for five days with no risk like you can take 10,000 IUS international units of vitamin A you're not going to be in big trouble but to say Baseline take vitamin A every day for a long period of time I do not recommend that now you can take beta keratin not pre-formed retinol you can take beta keratin through carrots and all that and you'll never end up in trouble it's only if you give the pre-formed retinol or the vitamin A as an analog that you can get into trouble with so I don't recommend that but I do recommend again where where are you getting your vitamin A natur from food right and so what do we want to eat the rainbow red peppers carrots salmon liver again great source of vitamin A and so that's my sort of story around that piece but the biggest thing is we just don't want to get sick with measles to begin with so how do we do that we just avoid measles by getting vaccinated and again there are those who may find that to be a controversial discussion in 24 years of practice I've never seen a child in our group and we have thousands upon thousands upon thousands of kids that we see every week I've never seen a case of measles induced autism and it's just my view of the world and so I am not against the vaccine for those folks that come to our Clinic that want to delay it till 3: I'm generally okay with that as long as they're watching carefully for outbreaks and they vaccinate their kid and if there's an outbreak nearby but that's a risk they're taking I would rather them get the vaccine at least by two years of age but again these are controversial for some folks the really super in one and I pulled this one just to read about in the journal science in 2019 Dr Mina did this article where she wrote about what measles actually does to our immune system is super fascinating the measles virus directly wipes out our antibodies and memory to other infections and itself so let me say that again when you get sick with the measles the actual virus your immune system will lose antibody circulation against other infections it eliminates them so you actually become like a clean slate against other pathogens and so your what we call humoral immunity or antibody response disappears in anywhere between depending on the person up to three quarters of the people lose their immune response to other PA so sort of goes like that when we started this conversation around the covid debt right crazy right that's sort of the reality of this stuff and I don't think we pay enough attention to how powerful infections can be if we don't see them right and we don't see measles so people think measles is no big deal it's one of the nastiest pathogens out there other than the human-made new version of Co I'm glad you're talking us through this this is really helpful I'm curious a lot of moms who are pregnant are in a position where they're being talked to a lot about things they can do to amplify the immune system health of their baby when their baby's born including like getting vaccinated for certain things but are there nutrients are there lifestyle things like how do you counsel pregnant Ms about the best way to set their kiddo up for succcess when they're born yeah I go a thousand days before they're even getting pregnant right so if you really want to have this conversation it's a book I wrote a while ago that I never published it's just sitting on my computer yeah it's sort of comical but it's just sitting there and it's Gathering dust but really truly what it is is you want to set the table for the ability of the child to have the best outcome and how that starts is really going through the four pillars of Health right out of the gate so movement stress reduction nutrition and toxin avoidance those are the Big Four four and you could put in a five ad sleep right those five things will set the body up for the most likely chance or most likely outcome benefit for the child now there's huge levers to pull on in there right so if we think about mom being pregnant not even until the child's born one of the biggest risk factors I think today for bad outcomes is the ingestion of fructose and specifically as fruit sugar and how would that come in it comes in mostly through beverages like Frappuccinos like soda like juice all these sugared beverages hit the liver and turn on a cassette of genes in the body that actually are metabolic syndrome genes and they all made a lot of sense a thousand 2,000 years ago when we had Boomer bus cycles and food exposure so when you had calories especially sugar calories you wanted to store them so you could survive a famine well those genes that are turned on in induce fat dep in the liver fat deposition in the periphery metabolic derangement of blood pressure so elevated blood pressure and foraging Behavior and the forging behavior is the critical one because what's happening is the body knows that when there's sugar around it wants you eat a ton of it why because that means you'll store more fat for the period of time when you run out of food what doesn't happen anymore we don't run out of food so that foraging Behavior drives more people to eat more and and specifically sugar so pregnant women who are eating more more of the sugar is driving dysfunction in the baby Rick Johnson's work was fantastic here we showed that they had delayed placentation in mothers who consume fructose where actually the placenta where the spiral arteries invade the placenta to bring oxygen in to start the metabolic cycle of the placenta delayed weeks that induced preclampsia and preeclampsia is one of the major reasons for pre-term delivery oh by the way big risk factor for autism right so that's to me is the cycle of where we need to say okay sugar should be really limited or removed from the diet when pregnant and do you need fruit or high fructose corn syrup or what do you mean when you say that I mean fruit in an Americanized Ultra processed form if you are eating let's say strawberries the fiber will delay digestion you won't get that smack to the liver in the same way now if you eat five buckets of strawberries with nothing else are you're going to turn that on and the and the orangutans have proven that when they sit in the jungle and eat fruit after fruit after fruit they get fat why to survive the winter where there's no fruit right so we know this happens but in a normal human who eats normal volumes of fruit fruit is excellent for you it carries all kinds of these micronutrients that we talked about great macronutrient structure but it's just volumetric now it's more of the sugars the cakes the juices the koolaids the sodas would go deep into another pathway I think humans have lived with real food for thousands of years why do we need processed food and a podcast I did with Peter anger who's a dental Anthropologist from the University of Arkansas we talked about why humans are having so many problems with wisdom teeth having so many problems with crowding of teeth braces the bottom line is we don't chew enough fibrous foods and so by giving kids Ultra purade Foods for the first year of life we're actually Des stimulating the maxillary bone and the mandible to be constantly working which is changing the shape which is changing the growth and so they're too small now they can't hold all the teeth so if you go to the jungles of Africa you won't see these teeth problems why because they chew fibrous food so I encourage parents now to chew real food let's let's give your kid real food let them chew right be there know how to deal with choking you don't want to ever give him something that's big enough to choke on but let's give him food to chew on like let's do the real stuff what did God intend what did nature intend whatever you believe let's go back to way it always was meant to be and stop this modern American Way everything's got to be simple and peaceful no you thermia is terrible you everything's terrible we have to have cycles of swings of everything when you say know how to prevent choking like know how to deal with choking because I did you say four months start having the kid chew yeah start having kid to have food like so again what would they have done in the old days Mom would have chewed something up and given it to the child to eat right so again but it's tiny little pieces of stuff what would the kid do if they can't eat it they they'll push it out their tongue will push it out when they're not ready so you know a child's ready when they're taking something on their tongue and they're taking it down now if it's in a nice small chewed up form and the child can sit and gum with it and play and work on it they'll do it and again so people find this to be very sort of to your point like shocking what did humans do for three million years right and so we sort of think about these things in the context of modern society well modern society isn't doing everything right and when I meet with the anthropologists and I understand what humans did forever it makes a whole lot more sense so understanding how to vent choking is to not give a size that could get lodged in the airway be there the whole time not let your child when they're older eating and running all of the stuff the basic simple things know what to do gravity's your best friend head down feed up right if something like that happened but historically I would not imagine that children choked a lot back three million years ago I just don't think so I think mothers made sure that they protected their children right and that's what we do I mean I don't I'm the guy but I know all moms are hyper focused on their children's outcome so I think it comes down to finding the best source of food for the child that's natural like peas take them smash them up and then give it to the kid right so they're not going to get hurt by that wow this is cool so let me ask you have you seen these new like suction things for choking what do you think of those I have not used one so I can't speak to actually seeing it work I always worry when people try and get something out of the airway that they'll push it farther down grab gravity tends to be in my mind the best thing heick maneuver gravity it works 99% of the time so I would say that's probably the best answer it's just to go old school I always tell parents to tell their children never to try and get the thing if if their sibling is choking because they will push it farther down more likely and cause more problems I've been practiced 25 years I've never had a child die of choking so let's go with honest risk here like what are we talking about yet does it happen yes it's a big deal but does anyone die no in general no because we are all in general as parents we're there to make sure nothing goes sideways so take that all into context I think is probably the best answer okay so you're a fan of the flip him upside down hit him on the back type of gravity yeah and it depends on age right if they're babies you're going to push the belly and you're going to give the back blows but there's all those videos online I encourage everyone to go on to YouTube and pull up choking videos and just the CPR side of it's very useful I would lean that way unless somebody can show me Great data that these suction devices are better okay cool I love that I get to pick your brain about all this stuff I know I'm like firing so many questions at you I saw you present on asthma and I thought it was brilliant and you just mentioned asthma and so I'm curious what do you think causes asthma what's the easiest way to say this without spending another hour break in tolerance is probably what I'm going to say the most and when I say tolerance I mean the immune system's natural ability to see the outside world what we call the expose not overreact to it think it's dangerous so I think in context of the greatest risk factor I think is probably related to an abnormal microbiome of the parent coupled to host genetics and then the fact that we're growing up in an overclean environment I think covid is going to drastically increase the volume of atopic disease because we were too clean for too long for these little kids tolerance is the function of the immune system when you're born you have a naive immune system which means it's never been programmed to see anything other than what you may have been exposed to in the placenta which is minimal things the immune system then once you're born the first thing you do slide through the vagina and you get exposed to vaginal Flora bacteria and viruses and Arc that in your vagina and also most of the time stool it's not a weird event that women defecate during pregnancy it's actually more common than not why because that's your route of getting the mom's microbiome we understand all this now and so as you slide through the canal you get exposed to these wonderful bacteria those bacteria that enter the baby's mouth and nose the immune system starts to see the pathogens and think about how many pathogens you're getting all at once right the immune system then says okay I see you I see you I see you it starts tasting all these little pieces of protein in these dendritic cells and apcs and then chews up that protein and sends signals to all of what we call the thymus or the local lymph nodes and says okay buddy we're going to train we're going to educate you on who's good who's bad who's good who's bad and this process is very very powerful if that process is disrupted for some reason C-section not getting exposed to the right bacteria mom's microbiome is actually dysfunctional right because of Americanized behaviors or modern behaviors then that tolerance mechanism doesn't develop correctly and then the immune system may see things that we see normally as bad for example a peanut right child gets exposed to a peanut and oh by the way the immune system says oh you must be a bacteria I'm going to kill you and then the child aniflex there's a problem so the basics of that to me is where this is all coming from right so somewhere we have a break in tolerance somewhere have a break in how the immune system recognizes right from wrong and then when that immune system then sees something else it then sends out the signals that we see of as disease so for example if you have milk protein in tance is a huge problem at our Clinic where the child is given a cow milk formula or they're getting exposed to cow milk through mom's breast milk the immune system sees that as an Invader and starts to attack it these child present all the time by three to four weeks of age with collic green stools eczema which is a skin Ras that's called atopic dermatitis they have wheezing when they get a little bit older and they're chronically congested well that's a marker of immune response to that consistently ingested milk protein that then leaves the k kid looking sick right when I started medicine em to UVA got great education thought I knew the world of this stuff the answer was creams and Medicine nobody's asking the question why is this happening well the reason it's happening is because the tolerance broke and the immune system is overreacting to things that should be normal so the why is not genetic right so yes genes are involved in everything genes are involved in why you're predisposed to Alzheimer's and I'm not or vice versa or whatever but those genes aren't your destiny unless you turn them on and so the epigenetics reality when I interviewed Randy jle and mosha Schiff that was the story that said okay now we get this there is something happening in the environment that's driving the immune system to be angry and it's not pathologically angry like it doesn't want to hurt us it is angry that it thinks it's taking care of these things that keep in bombarding our body and know by the way that happens to be cow's milk or it happens to be peanut or it happens to be pollen it happens to be dust so the story is the exposome or the external environment that's driving this tolerance to not be functional and so in the end of the game what do we really need to do we need to go back to what nature intended be exposed to bacteria naturally deliver vaginally breastfeed do all the things like avoid toxins that trigger immune responses all these things that are negative towards the body endocrine disrupting chemicals I mean again we can go on and on and on thousands of different things but if you go back like my wife and I talk about ourselves as Tree Huggers with iPhones like I want to be as clean as I can living like 1850 but I want to have my iPhone to be able to connect and do and read and get on the internet whatever right so yeah I love that so let's say a parent comes in their kid just got diagnosed with asthma they have a whole list of medications and inhalers and all the things what's some of the first things you tell them to do or are there tests that you run like how do you get them started on a path to actually healing the root cause first question did you have kic as a baby absolute first question again this is assuming we've diagnosed him with asthma already right and just so we dial back one second here for the parents listening if your child coughs when they run they cough at night and they cough in the morning but otherwise are pretty well that's asthma and especially if you have a family history of asthma you or your husband if it's Mom I'm talking to or you or your wife if it's Dad I'm talking to this is the story of asthma and it's often missed because people aren't paying attention my kids just coughs a lot when they run he just doesn't look already slowing down fasting kids that's and especially if they're over the age of three if they're under the age of three it can be just small lung tubes that Fernando Martinez figured out that they usually outgrow but that being said if we think it's asthma or we know it's asthma first question was your child kak is a baby and often times they'll say no and they say well what were they what do they drink and in my clinic we have a lot of Medicaid patients so unfortunately we have a higher volume of formula usage and it's always on formula what kind well I don't remember what color was the can oh it's purple okay elementum elementum is a hydrolyzed formula that means child had milk protein to and soy protein in toolerance so I'm like okay let's just take your kid off Dairy for one month and I want you to increase the volume of fiber and whole Natural Foods daily and of course we'll put them on medicine if we need to because they're acutely that sick so for example if a child is wheezing to beat the band they will get a steroid pulse dose and we might even put them on an inhal cortical steroid a drug that they put in inhaler to their lungs to cool down the inflammation if I think I need to but I'm still doing all that other stuff because what invariably happens if I'm right and it's a milk-based issue as soon as we remove that increase the dietary co-actors through healthy food all of a sudden all the symptoms are gone I say okay let's get rid of the steroid and then if they don't occur B done end of story and that's happened more times than you can imagine and again I'm always looking for eczema colic constipation in the older kids is a big sign of milk protein talents chronically congested but their allergist tested them and all their IG testing for allergies or skin testing was negative my kid has allergies but every test that the allergist ever ran was negative that's milk to proven otherwise so that's the first big thing I'm going to go after then if there's no history of that then I'm going to say okay well do you have true allergies is it seasonal do you have dogs cats dust is there something else that's in the environment that I can get rid of back in the early 2000s late 90s I ran an asthma clinic and one of the things I used to tell parents to teach them to understand this topic was think of asthma as a glass of water if the water is spilling out that means you're sick that's the wheezing so what's filling up that glass to help you spill right so we go through the things that'll do that viruses will trigger the heartbeat but that's something it's hard to control control but oh by the way if milk's a part of that we definitely want to pull that out if there's smoking in the house vaping in the house Glade plugins if you live near a farmer fractory where they're spraying stuff if you live near Woods where they're burning stuff all that stuff we try and pull out and then watch the water level drops so when they get the virus they don't weed right so it's all about reducing the antien exposome triggers that drive the inflammation that we see of as the disease asthma that requires steroids it's the same thing with ADHD same thing with every other disease if you go and get Upstream to the reason why they're there the drug usage is minimal or not at all and that's the beauty of functional integrative medicine as opposed to alpath straightforward drug first medicine it's awesome do you recommend that if there are environmental triggers in the air that parents consider things like HEPA filters in the home 100% so two things I recommend all parents buy if they can afford it is a under sync filter for their water they're drinking water I want all of their drinking water filtered with either R reverse osmosis and if that's expensive if that's too much try for charcoal at least like a good charcoal filter and change it out every six months like it's recommended and then definitely a air filter in the child's bedroom help a filter in the child's bedroom for sure and then in their main play Space if they're always in the den absolutely suck that out and then I'll probably jumping ahead a little bit here but while it's on my mind sublingual immune therapy I absolutely 100% recommend sublingual immune therapy there's a phenomenal company in Wisconsin called allergy choices and so what we do is we draw blood we get IG specific mediated disease issu so we find out the child's got IG antibodies against let's say dog cat dust and grass so I send the results off to this lab in Wisconsin in Lacrosse and they develop a sublingual glycerin with these proteins in it in fragments put it under the tongue it absorbs through the tongue space and starts to retrain the immune system not to be irritated by those things it works phenomenally my own son had to use it for dust and within six months of being on sublingual he was he stopped sneezing completely Nom meds no nothing and so allergy choices highly recommend them they don't pay me any money I don't have any financial interest so you're not getting a biased opinion here this is after thousands of kids on their sublingual fantastic stuff downside not covered by insurance I'm not going to say why I believe that's true because I'll make some people mad but it is part of the way medicine runs things all right you said something about ADHD a minute ago this wasn't our plan but we have to talk about this because we're running right now the six week ADHD boot camp with Dr greenblat and Kelly Heim and like I'm having so much fun talking with all these clinicians about ADHD but you mentioned like if you treat the root cause you can often reduce the need for medications like what in your mind is the root cause of ADHD and how do you help parents treat their kids so James and I actually talked and I love the way he sees the world and I agree with him James blad is a brilliant psychiatrist up in the Boston area and to your point let's first get this out of the way ADHD is not a disease it's a mismatch of our current environment and the history of how kids should be living if you think about it the attention deficit that we call a disorder was actually highly beneficial thousands of years ago because these were the Explorers these were the folks who are willing to do really interesting things impulsive but that's an huge evolutionary benefit the folks that are less likely to be HD are the ones who are more likely to want to sit on their Farm not challenge anything not do anything so let's just get that out of the way I don't like calling kids with ADHD disordered right I'm the poster child if you open Webster's Dictionary and you look up ADHD my picture is there like a completely dysfunctional child that was you in that book yes I tell the story one of the greatest days of my life and probably the worst of my parents life was the day when I was in third grade and I walked into Hagen Elementary School and they had all the instruments lined up right and I'm walking around and at the end was the drums and at the front end were the the the strings and then it go to the piccolo and the flutes and my sister chose the flute my brother chose the violin yeah not yours truly yours truly is walking down walking down walking down parents are passing this oh this looks great how about that how about this nah n n n n get to the snare drum bang done give me that thing and my dad died two years ago and my mom's still alive but they took it on the chin they allowed this little whipper snapper kid to have a drum in the house to bang around make all this noise for years and then eventually I went over to a full set I can't even imagine what it was like to listen to me try and play like ACDC was the first stuff I tried when I was 13 like H but to the point that's what ADHD kids do so long aside but so James's way of looking at the world I think is ideal right so these neurochemical changes that allow us to be impulsive and be inattentive but hyperfocused on that which we love is not a problem unless it gets in the way of your ability to succeed in life so I tend to layer this into again the four pillars is your child sleeping if they're not sleeping they're inattentive it's just sorry you just won't do well if you don't sleep so piece number one make sure your kid sleeps adequately number two are they eating healthy you need the co-actors for your brain to work 30% of every calorie consumed by your body is burned in your brain or more depending on how much you're thinking so are you putting in B vitamins for fatty acid oxidation are you putting in magnesium and iron are you putting in kreb cycle pieces right so that I'm going to focus on heavily then I'm going to work on exercise it's very clear that exercise drives cellular activity in your brain if you don't move a lot the blood doesn't flow a lot you don't clear out the toxins and other things and again that's another piece how do you clear out the toxins at night when you sleep lymphatics turn on during deep sleep so you want to make sure they're sleeping again but food's big exercise is big and then the other one toxin avoidance right we got to get these kids away from chemicals that are bad for the brain I mean one of the ones I always talk about is the old Lewis Caroll story Matt is a Hatter right so if you think about Allison Wonderland the hatter h a TT R they use mercury in the felting process to make hats well the Mercury absorbed through the skin is highly volatile and you end up going to your brain where it's fatty tissue gets in there and dysfunctionally disrupts the pathways of the brain so you end up with neural damage and we call them mad crazy well it's actually no it's called Mercury toxicity so we want to make sure kids aren't getting any toxins in their brain and the two biggest ones I think of is Mercury and copper right so we don't want a lot of copper in the brain well that's what Dr greenblat thinks and I agree with him one of the reasons zinc is a problem is because they're yolked to copper and if you have too much copper coming in through copper pipes or some some other source then you're going to need zinc to to fix that let's look at where you're getting that so that's also again why I want filters on water thanks I love that so I want to give you the floor like get up on your soap box for a second like what have we not covered here that is on your heart or on your mind that you feel like parents who are listening or other docs need to know right now I mean parent up parent up parent up parent up parent up parent up let me say that 9,000 more times parents have to become parents again you are not a friend to your child you love your child so much that you're are going to parent them and parenting is conflict conflict needs resolution and it's only resolved through love and touch so when you criticize your child which I hope you don't criticize them but when you tell your child something they don't want to hear they'll hear it as criticism always begin with I love you but I love you and this is not okay I love you and your decision to do that is not okay it's not going to ever change that I love you but that's not okay and I'm not going to allow it when you're 18 and you're not living here you can do whatever you want I have 18 years to help you become the best version of yourself and again you're doing the work I'm just guiding you and so my parents did it for me and I'm going to do it for you I'm not going to abdicate that job one iota that would be the thing I would say to every single parent out there I am deeply distressed at the lack of parenting in the world especially around screens I go to restaurants and and four kids are on screens the two parents are just maybe talking to each other maybe they're on screens that's unacceptable my children were not allowed to have screens at the dinner table ever and when we went to restaurants they had salads and people like how'd you get your kids eat a salad they do it's not an option you don't have an option you don't eat the salad you don't eat lunch right then you go home hungry and then you'll call me when you're hungry and you'll let me know and that's not a lack of Love Actually that's so much love that you're willing to do the hard thing because what's the easiest thing a parent can do do nothing just let your kid be freeer range wild Indian right Wild Child just going crazy right that is not parenting that is letting your kid live without boundaries and those children really suffer and you can see that that's an anxiety provoked disease waiting to happen boundaries are useful effective boundaries we all know what if you give too many boundaries you have the child like I remember a young man when I was in church growing up that his father was a deacon and he was a kid standing up front with a long hair and the Mega Death t-shirt and looked like he was rebelling a th% he was he didn't like the control so don't overcontrol your kids but parent up on sleep parent up on food parent up on screens parent up on exercise parent up on time you spend with them so clearly don't sit on your phone when you should be spending time with your child so I think that in and of itself would solve so many problems like all the conversations we're having in general still revert back to how do you parent your child that's my soap boox I really want more tips around this like are there books are there podcasts because part of what we're seeing now is maybe people grew up with parents who parented just like you said and now those kids are having their own kids and they may not have a model for how to parent like this so what resources do you recommend parents to who want to learn how to parent up best book is written by Allison gnik gopnik she's a professor at Stanford if I remember correctly and the book book is called the Carpenter and the gardener and it is an anthropologic and you'll get this unfortunately from me you're going to always hear the word anthropology with me because I am a huge fan of history and anthropology is the way we learn from our own ancestral genetic understanding and so she is an anthropologic behavioralist and she went back and looked at where and how humans and primates existed as a family unit as a parenting structure and all of those things and and her book basically drills it down into two types there's the carpenter parent and there's the garden The Gardener is the parent that provides soil light water micronutrients and safety and doesn't care which direction the plant grows so if that plant happens to grow sideways and up and around and torturous it's totally fine at the end they get to the light and they get to what they need the carpenter parent I sort of likened to that recent book The ch Chinese dragon mom or Chinese something mom I can't remember I'm probably butchering that but that book was sort of the essence of the carpenter I am going to Chisel I'm going to measure I'm going to nail I'm going to do everything perfectly so my child ends up perfect hi your mom yes that is not in the child's best interest that's your best interest and as a parent we need to check our need to achieve a goal as opposed to what is a child's goal and the child goal is simple they want to be loved they want to be safe they want to be fed and they want to be let loose to explore the world right they want to be in the backyard digging the dirt throwing things doing this learning through relationships you know they get to fight with their sibling my job is not to fix the fight my job is to be there if something gets really sideways to protect them my job is to counsel them if they need counseling but I'm not there to break up the fight if I'm not in the room and the children are fighting and they come out screaming at me I don't know I wasn't there so how am I going to adjudicate that process so I look at them both like my kids knew this if they came to me and they're both arguing I never saw I said I didn't see it so if you can't resolve it I'll resolve it and you're both going to suffer right the consequence with both of you because I wasn't there and guess what they stopped bringing stuff to me and they sort of self-resolved and they learned how to be in relationship with each other to make it work because if Dad got involved it generally wasn't good for either of them now if I witnessed it that's easy then it was singular to the person that was the perpetrator of that which wasn't good so I think to me that's the biggest piece of this entire world structure we live in as a pediatrition I would love to see more focus on parenting I think that it's a crime that the United States Society government whatever we want to call it doesn't have parenting classes or requirement for having a child you need to license to fish you need a license to drive a car you need a license to pick your nose but anybody can have a child with no education around how it is to Be an Effective parent and then the last thing I'll lean on be careful to look in the mirror of that which you had struggles with in your own childhood and you're trying to fix in your kid it's not your job you're not your job to fix your own wrongs through your child and so be very cognizant of your own weaknesses your mirror of choices and I've been very careful to watch those things even in myself because it's so easy to go well I did this wrong I don't want you to make the same mistake well maybe they need to make the same mistake yeah I think it was Carl Young Who said there's no greater influence on the psyche of a child than the unlived life of their parent W it's beautiful I forgot that one that's great look at that digging that one deep in the memory banks that's awesome Kate I want to thank you for your time today you're always our expert on peeve your time today but also the work you're doing in the world and I want you to tell everybody where can they find you if they want to come to your practice but also you do so much free education where can they find you and where do you put that out sure it's a labor of love anybody can get it any time Salsbury pediatrics.com www.s l i SB y Pediatrics with an s on theend.com that website has the links to everything there's a newsletter that's every Monday morning comes out at 5 a.m. that I write every Monday and it's on all kinds of topics it's at time science heavy but I will let you know that so you can skip past that to the take on points so that the parents can get all the Deep knowledge they want but like I just did a big part on circadian biology like we talked about I actually talked about that article on vaccination like I'm encouraging parents to try and get morning appointments now for their vaccines to get a better response so that's what all this stuff is about the podcast is Dr M's Women and Children First that is on Spotify and apple and so that's an interesting one because that's half guests of which you are one soon to be released which I'm super excited about releasing because that was so much fun to do but in between those is me audio casting the newsletter so if you don't want to read the newsletter you can listen to it unfortunately you have to hear my voice again but that's the way it is done because I do everything myself I don't have a team and so part of that is to keep it cheap and free I do it all myself so you have to struggle through my voice and then coming to the practice anybody who's in North Carolina I'm in the north of Charlotte area and a place called Salsbury and then the last shout out which I'm super excited about is this new company form called Children First of North Carolina where we have 55,000 Medicaid kids now getting State money to help their social determinance of Health improveed dramatically and that has been my labor of love the past two years and hopefully the next 30 so that kids get everything they need and the last thing I'm going to say and then I'm going to really shut up I don't understand why politics does what it does how are we not all screaming for clean air clean water and clean food before we scream about anything else we should be firing every single person who is not speaking to those three things because that is where all of our dysfunction comes from and so if I ran for office which I won't because I'd be assassinated I would 100% run on that ticket and I wouldn't stop until the companies that are dysfunctionally hurting our children and us were dealt with yeah I think we need a whole we probably in a year or two I would love to see are you guys going to publish the results of like what you're doing with this new initiative yeah when you do let's have you back to talk about it because I think that is going to change the lives of millions really yeah it's the way medicine should have been forever and it wasn't and at least in North Carolina which I'm grateful to the Senate and the assembly for choosing this path to give us the money to hire the people to do it where the boots are on the ground like I give you a quick story there was a young female teenager who rolled in who I had never met before who was clearly losing weight and her family loved her very much and we were talking about it and it was clear that she was going to need impatient admission this was not one that I was thinking could do outpatient but it was going to be a struggle so I enlisted our care management team which is made up of folks who were in the social work environment also RNs and they came in and met with a family while I was able to move on to other patients and spent two hours figuring out exactly what this family needed in order to get in the perfect environment and so she could then Thrive I could never have done that one I'm not tapped into those systems the way they are two I didn't have the time everything about this was a win-win win nobody lost I won the team won the patient won and at the end of the day who should win the patient and far too often in medicine right now the patient isn't winning because the patient's not at the center money is at the center money should never be at the center as soon as money enters the center people make bad choices around health so yeah it's cool it's awesome I'm just so grateful for North Carolina state folks to allow us to do this and it's been an absolute pleasure we'll have you back to talk about the results from that in a bit thank you for doing that work too so everyone go follow Dr Chris go see him if you're nearby with your families and we will talk to you soon thanks for all the work you're doing in the world same to you Kate I so great ever since that day we met it's been a pleasure to have like minds and spend the time together and for what you're doing I just want to applaud you you're doing amazing work and I'm grateful to be here with you thanks so much we'll keep doing it together amen take care welcome to rot the health the best place to order advantage and track results from over 30 different lab companies in one single place for free it's going to take you under 2 minutes to sign up and you can order any functional medicine lab for your client in under 30 seconds let me show you how it's done so here's our beautiful interface I'm typing in the name of my client 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