Dr. M's Women and Children First Podcast

Today, we are honored to have Dr. E. John Wherry, a leading expert in the field of immunology, joining us. Dr. Wherry is the Chair of the Department of Systems Pharmacology and Translational Therapeutics at the University of Pennsylvania, where he also directs the Institute for Immunology. His undergraduate degree was obtained at Penn State University before completing his PhD in Immunology at the Thomas Jefferson University. A thought leader in T cell biology and immune memory, Dr. Wherry’s work has been instrumental in improving therapies for viral infections, vaccines, and immunotherapy treatments. His discoveries in the field of immune exhaustion have had a profound impact on the way we approach treatments for cancer and autoimmune diseases. Widely published in top academic journals including Nature, Cell, and Science, Dr. Wherry is a heavy contributor to Covid research and especially the understandings of long Covid. Today, we discuss Covid and the current state of the science regarding vaccines, long covid and what we can do better next time there is a pandemic. Enjoy, Dr. M

Review of Dr. Casey Means’ Good Energy In her book, Good Energy, Dr. Casey Means explores the complex relationship between our metabolic health and the quality of energy we experience in daily life. Dr. Means is an ENT surgeon that graduated from Stanford University Medical School before eschewing it all to dive into the world of disease prevention. Drawing from her background in integrative medicine and her deep understanding of metabolic science, Dr. Means presents a compelling case for why energy levels are not merely a factor of rest and diet, but a direct reflection of how well our cells are functioning on a biochemical level. And this is the key, the understanding of the biochemistry of the why! In today’s modern world, so many of us feel sluggish, fatigued, or burned out, and the causes are often elusive. We live in a time where external stressors, processed foods, environmental toxins, and sedentary lifestyles disrupt our body’s ability to produce and regulate energy efficiently. Dr. Means calls for a paradigm shift in how we view energy: it’s not just about getting more sleep or drinking another cup of coffee. It’s about restoring the metabolic health of our cells to optimize the energy they generate.....plus a literature review and a recipe. Enjoy, Dr. M

Literature Review Week Why do some people react to mosquitoes so vigorously? There is fascinating data for me in the Nature article, as I see lots of kids that react strongly to mosquitoes while others do not at all. A hyper primed immune reaction makes a lot of sense as the immune system is extra sensitive to the insult in individuals that have chronic allergic phenotypes. They are in effect polarized to see the outside world through an irritant lens and thus react in a more robust way. The cell called GD3 releases Interleukin 3 or IL-3 which is a cytokine signaling molecule that tells skin based sensory neurons to become more sensitive to allergens like house dust mites, environmental molds, and in this case mosquito saliva. Thus, the mosquito saliva induces more of the itch scratch cycle. The effect is to increase the gain sensitivity on the skin to 10. This is likely a main reason why having an allergic child take immunotherapy against allergens that they react to lowers the rheostat for all irritants. It is like a global check on the sensory system. This is another reason to consider SLIT and or SCIT immunotherapy in allergic children... Plus a discussion on the Joe Rogan podcast with Callie and Casey Means. Enjoy, Dr. M

Obesity and Change - The Tech Intersection Welcome to the podcast! Today, I am thrilled to host Dr. Deborah Tate, a distinguished professor in the Department of Nutrition at the University of North Carolina in Chapel Hill, with joint appointments in Health Behavior and Nutrition. She also holds a faculty appointment at the Nutrition Research Institute in Kannapolis, North Carolina where she explores innovative approaches to improve lifestyle behaviors that impact obesity, diabetes, and chronic disease risk. Dr. Tate is a behavioral scientist, receiving her Ph.D. in Clinical Psychology at Virginia Tech. Her research focuses on two main areas: (a) strategies for improving both short and long-term body weight regulation to reduce disease risks and (b) the development and translation of programs as alternatives to clinic-based care using digital and wearable technologies. She is known internationally for her work has published many papers in major nutrition and medical journals. Her work spans the intersection of behavioral health and obesity whereby she is a pioneer in digital health interventions. Her work has been pivotal in developing digital tools and online programs that support sustainable health changes, making access to wellness resources more inclusive and effective. Dr. Tate has been at the forefront of harnessing technology to create lasting change, blending behavioral science with digital advancements to empower individuals and families to make improved choices. Her contributions have transformed how we think about health interventions in today's digital age, offering scalable solutions that reach beyond traditional boundaries. Get ready for an insightful conversation with Dr. Tate as we dive into the science and the potential of digital health to foster resilience and well-being. Enjoy, Dr. M

Section I Understanding the Action and Use of GLP-1 Agonists in Children – A Pediatrician’s Viewpoint The United States, like much of the developed world, is facing increasing rates of childhood obesity and related health concerns. Despite years of research and various efforts, addressing this public health issue remains a complex challenge. This article reviews the potential mechanisms, benefits, and considerations for using GLP-1 agonists in children based on the current scientific understanding. While early research is promising, the application of these treatments in children requires careful consideration and should always be done in consultation with a healthcare provider. As a pediatrician, I recognize that while the science behind these treatments is evolving, it's important to remember that individual responses to treatments can vary. For children, every approach needs to be carefully weighed, considering their unique developmental needs..... Enjoy, Dr. M

Section I Are Smart Phones a benefit or a curse for the teenager in school? This is becoming a huge topic this past year or so. Logic would seem to dictate that this is a curse more than a benefit, but what does the data and expert opinion show? The Scientific American article "Do Phone Bans Help Students Perform Better in School?" examines the growing trend of banning smartphones in schools to enhance student performance and well-being. Numerous U.S. cities, including New York and Los Angeles, have recently implemented or are considering bans on phones in classrooms. Schools use tools like the Yondr pouch, which locks phones away during school hours, to enforce these bans. These measures are popular with educators and parents, with 60% of likely voters in New York State supporting such restrictions. Charlotte Schools has this policy: "In accordance with Charlotte-Mecklenburg Schools Student Code of Conduct, personal technology devices, including cell phones must remain off and put away during school hours. Violations will result in confiscation of the personal technology device. The district is not responsible (monetary value or replacement) for theft, loss or damage to personal technology or other electronic devices brought onto CMS property." (CMS) My informal poll has a higher number of parents interested in phone ban restrictions in North Carolina....plus a section on teen anxiety. Enjoy, Dr. M

Welcome to the podcast! Today, I am thrilled to have a true pioneer in the field of metabolic health, Dr. Robert Lustig, MD, joining us. Dr. Lustig is a neuroendocrinologist and Professor Emeritus of Pediatrics in the Division of Endocrinology at the University of California, San Francisco. He is best known for his groundbreaking work on the intersection of diet, obesity, and metabolic disease, particularly his deep dive into the role of sugar as a driving force behind many of today’s chronic health issues. As the author of several influential books, including Fat Chance, The Hacking of the American Mind and Metabolical, Dr. Lustig has been a vocal advocate for public health, helping to raise awareness about the harmful effects of processed foods, particularly refined sugars. His research has been instrumental in shifting the conversation around nutrition, focusing on the biological impacts of sugar and the ways it contributes to insulin resistance, obesity, and metabolic syndrome. His most recent paper entitled Obesogens, A Unifying Theory for the Global Rise in Obesity in the International Journal of Obesity - Nature is a ground stirring take on the current research. We are excited to explore his latest insights into metabolic health and the science of obesity, and how we can apply this knowledge to improve our own well-being. Let’s welcome Dr. Lustig to the show! Dr. M

Upcoming Podcast and Current Book Review. For all parents who love the content of this newsletter, I have a book for you to enjoy. It is a comprehensive look at parenting a child in modern times through the struggles of food, technology, stress and life in general. My good friend Elisa Song is a Stanford, NYU and UCSF trained pediatrician and lover of children. In her recently published book, Healthy Kids, Happy Kids, she offers a comprehensive and integrative approach to pediatric health that will resonate deeply with today’s parents who seek to navigate the complexities of modern healthcare and modern life. Dr. Song’s dual expertise as a pediatrician and a mother is evident in her compassionate and practical guidance. Much like the work of our mentor Sandy Newmark, her book is relatable but more importantly scientifically grounded. At the heart of Dr. Song’s philosophy is the idea that optimal health for children is not just the absence of disease but a state of overall well-being or optimal health, including: physical, emotional, and mental states. She emphasizes the importance of nutrition, advocating for whole, unprocessed foods while addressing the impacts of common allergens/intolerances, sugar, and artificial additives on children’s health. Her dietary recommendations are backed by a solid understanding of how nutrition influences immunity, inflammation, behavior, long-term development and ultimately chronic disease. Plus, a discussion on cancer, autoimmunity in children post Covid... Enjoy, Dr. M

Section I Literature Review 1) Long Covid in children - the symptoms are getting more clarity in who has what . From JAMA: 898 school-age children (751 with previous SARS-CoV-2 infection and 147 without) and 4469 adolescents (3109 infected and 1360 uninfected) were included in the analysis. The time between infection and symptom analysis was 1.5 years. In models adjusted for sex and race and ethnicity, 14 symptoms in both school-age children and adolescents were more common in those with SARS-CoV-2 infection history compared with those without infection history, with 4 additional symptoms in school-age children only and 3 in adolescents only. These symptoms affected almost every organ system. The cumulative data shows us that neurocognitive (Headache, attention concerns, sleep dysregulation), pain, and gastrointestinal symptoms in school-age children were common, but changed to loss of smell and/or taste, body aches and pain, focus struggles and fatigue related symptoms in adolescents. (Gross et. al. 2024) Age has a huge effect on these outcomes as the older population has more frequent and problematical disease findings. Mood disorder is highly associated with worsened findings. I suspect from the historical data set over the last four years that children with chronic mental stress, poor quality diets, sleep issues, and poor activity levels at baseline have worsened acute and long term prognosis. Plus a section on a book review for Change Your Genes, Change Your Life. Enjoy, Dr. M

Children are and always will be a marker of a society’s quality and focus on their health. When we look at the landscape of childhood health trajectories, we see a declination in quality and an inclination toward diseases of immune dysregulation and underlying chronic unchecked inflammation. What is the genesis point, or where is ground zero? For me, that answer is the newly understood ecosystem called the intestinal infantile microbiome. What is the Intestinal Microbiome? The intestinal microbiome is a complex and dynamic community of microorganisms that plays a crucial role in all mammalian health, particularly in the early stages of life. The development of the human infant intestinal microbiome has profound implications for the child's immune system, tolerance to the outside world, metabolism, and health trajectory. Understanding the factors that influence the establishment and evolution of this microbiome can help in devising strategies to promote optimal health from infancy through adulthood. This article dives deep into the key aspects of the development of the infant intestinal microbiome, highlighting the critical stages, influencing factors, and long-term health implications. How Do Infants Establish Their Gut Microbiome?.....

David L. Katz, MD, MPH is a specialist in Preventive Medicine and Lifestyle Medicine, with particular expertise in nutrition. He earned his BA at Dartmouth College (1984); his MD at the Albert Einstein College of Medicine (1988); and his MPH from the Yale University School of Public Health (1993). He completed sequential residency training and board certification in Internal Medicine (1991) and Preventive Medicine/Public Health (1993). Katz is the founder and former director of Yale University’s Yale-Griffin Prevention Research Center (1998-2019); Past President of the American College of Lifestyle Medicine; President and Founder of the non-profit True Health Initiative; and Founder and CEO of Diet ID, Inc. The recipient of numerous awards for teaching, writing, and contributions to public health, Katz was a 2019 James Beard Foundation Award nominee in health journalism, has been a widely supported nominee for the position of U.S. Surgeon General, and has received three honorary doctorates. Katz has served as a nutrition columnist for O, the Oprah Magazine; an on-air contributor for ABC News/Good Morning America, and with appearances on most major news programs and contributions to most major magazines and leading newspapers, including OpEds in the New York Times and Wall Street Journal. His most recent book, How to Eat, co-authored with Mark Bittman, is a 2021 IACP Awards finalist and is worth your time. I have had the pleasure of hearing him speak many times over the years and he is an amazing orator and I am blessed to have this hour with him. Today, we dive into the science of childhood obesity and what are the public health pain points that can be pressed on to change the negative trajectory. Enjoy, Dr. M

Literature Review 1) Does oral health affect your life if you are sick and in intensive care? According to a new study in JAMA, the answer is yes. From the study: 10,742 patients - "toothbrushing was associated with significantly lower risk for Hospital Acquired Pneumonia and ICU mortality. Reduction in pneumonia incidence was significant for patients receiving invasive mechanical ventilation but not for patients who were not receiving invasive mechanical ventilation. Toothbrushing for patients in the ICU was associated with fewer days of mechanical ventilation and a shorter ICU length of stay. Brushing twice a day vs more frequent intervals was associated with similar effect estimates....Non-ICU hospital length of stay and use of antibiotics were not associated with toothbrushing." (Ehrenzeller et. al. 2024) Why does this matter? In effect, what this study shows is that patients with oral hygiene needs that are not met will have increased bacterial burdens leading to infectious disease risk via systemic inflammation and possibly bacterial translocation. At the end of the day, oral hygiene is very important to lower the total burden of inflammation in everyone, but especially in the most ill patient. It is super important for everyone to brush 2-3 x daily and floss daily at night..... Plus a discussion on Back to School. Enjoy, Dr. M

This week I sit down with Dr. Elisa Song to discuss her new book, Healthy Kids, Happy Kids. Dr. Song is a graduate of Stanford University with a degree in political Science. She then attended New York University for her medical degree and finally a stop at the University of California San Francisco for pediatric residency training. In her own words, Dr. Song is a holistic pediatrician. She founded Whole Family Wellness, an integrative pediatric practice in Belmont, CA – one of the first and most highly regarded holistic pediatric practices in the country. She created Healthy Kids Happy Kids – dedicated to empowering parents to take charge of their kids’ health … naturally! She lectures around the world for the Center for Education and Development in Clinical Homeopathy (CEDH), Academy for Pain Research, Institute for Functional Medicine, and Holistic Pediatric Association, A4M among others. In this interview we look at health through a prevention first lens with a deep look at the intestinal microbiome and nutrition. Dr. Song's immense fund of knowledge is on full display in her book and this interview. Please enjoy my conversation with Dr. Elisa Song, Dr. M

Sleep Part IV Continuing the sleep education from a few weeks ago. Sleep is a most special event that we all need to continue to focus heavily on in order to live a healthy and long life. It may be the single most important event that we do daily. Here are a few more quick hits on sleep from the Matthew Walker's Book and other publications. 1) Aim for a minimum of 7 hours nightly to maintain adequate memory consolidation, immune health and emotional regulation. Young children and teens need 8-14 hours depending on age. 2) Do not eat close to bedtime. Stop eating three hours before you plan to go to sleep. Avoid rapidly digesting refined carbohydrates as they turn into energy quickly raising core temperature which makes it harder to fall asleep as we need our body temperature to drop 3 to 4 degrees F at night to fall asleep. Heavy protein meals at night are not a great idea. Eat the heavier proteins early (before 6 pm) if at all in the evening....plus a section on summer Covid surge. Enjoy, Dr. M

Sleep Part III Finally, the other elephant in the room related to sleep is STRESS. Stress alters the function of the hormone cortisol and can significantly alter night sleep function. There are three major chemicals that affect sleep: cortisol, adenosine and melatonin. In normal conditions, adenosine rises during the day making you sleepy, cortisol hits its low point at night and melatonin rises as the sun goes down. This combination puts pressure on you to feel sleepy and want to go to bed. Unfortunately, modern life has made many of us feel stressed and sympathetically fired up which affects cortisol function. Instead of being at its nadir at night, the stress response causes cortisol to rise at inappropriate times disrupting sleep onset and maintenance. Couple this stress with facebook addiction and screen induced melatonin suppression and you have a recipe for insomnia and disrupted sleep. (Hanson et. al. 2010)....Plus, a section on cellphones and driver knowledge. Enjoy, Dr. M

This weeks guest is Dr. Colleen Cutcliffe. Dr. Colleen Cutcliffe is a researcher and a thinker with persistence. Throughout history, these are the human qualities that lead people to develop amazing products and lead projects for the world to benefit from. Her story is one of discovery, passion and caring. Dr. Cutcliffe holds a Ph.D. in Biochemistry and Molecular Biology from Johns Hopkins University and a B.A. in Biochemistry from Wellesley College. Her scientific background is complemented by her experience in managing both research and operations teams in the biotech sector. Before founding Pendulum Therapeutics, she held senior positions at Pacific Biosciences and Elan Pharmaceuticals, where she was instrumental in developing various technological platforms. She is the co-founder and CEO of Pendulum Therapeutics, a biotechnology company focused on developing innovative solutions to improve gut health through microbiome-based interventions. With over 20 years of experience in the biotechnology industry, Dr. Cutcliffe has become a recognized leader in microbiome science, applying her expertise to bridge the gap between cutting-edge research and practical, consumer-facing health solutions. At Pendulum Therapeutics, Dr. Cutcliffe has led the development of novel probiotic formulations specifically designed to address metabolic diseases like type 2 diabetes. Her work has been pivotal in the growing recognition of the microbiome's role in human health, pushing forward the concept of targeted probiotics as a potential therapeutic option. Under her leadership, Pendulum Therapeutics has gained recognition for its scientific rigor and innovative approaches to personalized nutrition. Today, we discuss the story of her discovery and the fact that her work is the beginning of a hopeful wave of change for humans through gut microbiome manipulation. Dr. Cutcliffe helps us understand the basics of the microbiome, what helps it stay balanced and conversely, what upsets it. How does it support our metabolism and health in general. The main thrust of her work comes into the spotlight with Akkermansia mucinophilia, a keystone species for positive health. Please Enjoy my conversation with Dr. Cutcliffe, Dr. M

Epigenetics and Pregnancy Epigenetics is the study of environmental signals and their effects on our genes. Our genes are not altered so much as they are read and used differently based on the environmental inputs. Epigenetic effects are critical during the pregnancy period as the environmental signals can alter an offspring’s outcome both in good and bad ways. Making sure that we control for better environmental signal exposure while pregnant can go a long way to protecting our children’s DNA from dysfunction and thus their outcome with health. It is well known that chemicals are generally negative insults to our epigenome while anti-inflammatory whole foods are positive. These epigenetic marks can be conserved over multiple generations making them extraordinarily beneficial or dangerous. Here we will discuss the lifestyle mitigating factors for a positive pregnancy and newborn outcome....plus an ode to Brenda Wassum. Dr. M

Sleep Part II Let us pause here! So far we now know that humans at all ages will suffer from memory dysfunction and brain sewage cleanup problems leading to inflammation and damage long term. What ages are most at risk? They are likely mirrored by other physiologic events that are at risk based on age. Teenagers, infants and toddlers are rapidly growing creatures requiring more macro/micronutrients, water, and toxin avoidance for success. It is likely that sleep follows these same principles. Going to a simple google scholar search for "sleep deprivation age risk" brings up countless articles on the effects of sleep deprivation in mothers and children on risk of obesity, diabetes, premature birth and much more. ....Plus more on gender and emotion as well as a recipe of the week. Enjoy, Dr. M

Kenneth R. Pelletier, MD, PhD is a Clinical Professor of Medicine, Department of Medicine; Department of Family and Community Medicine, and Department of Psychiatry at the University of California School of Medicine (UCSF) in San Francisco. He is Director of the Corporate Health Improvement Program (CHIP) which is a collaborative research program between CHIP and 15 of the Fortune 500 corporations including Ford, Oracle, Prudential, Apple, Dow, Lockheed Martin, Pepsico, IBM, American Airlines and NASA. Dr. Pelletier served as Clinical Professor of Medicine at the University of Arizona School of Medicine and Stanford University School of Medicine. He was a Woodrow Wilson Fellow, studied at the CG Jung Institute in Zurich, Switzerland and has published over 300 professional journal articles in behavioral medicine, disease management, worksite interventions, alternative/integrative medicine, and epigenetics. At the present time, Dr. Pelletier is a medical and business consultant to the US Department of Health and Human Services, the World Health Organization (WHO), the National Business Group on Health, the Federation of State Medical Boards, and major corporations including Cisco, IBM, American Airlines, Prudential, Dow, Disney, Ford, Mercer, Merck, Pepsico, Ford, Pfizer, Walgreens, NASA, Microsoft ENCARTA, Blue Cross/Blue Shield, United Healthcare, Health Net, the Pasteur Institute of Lille, the Alpha Group of Mexico, and the Singapore Ministry of Health. Dr. Pelletier is the author of fifteen (15) major books, including the international bestseller Mind as Healer, Mind as Slayer and Change Your Genes – Change Your Life: Creating Optimal Health with the New Science of Epigenetics. Today we enjoy the amazing viewpoint that Dr. Pelletier has for humanity. We have control over our destinies individually and collectively. This conversation is the culmination of years of incredible study. Enjoy, Dr. M

Sleep Update for 2024 Sleep has always been a necessary function of everyday life for all mammals. From an evolutionary perspective this cannot be a mistake as during the period of sleep you are vulnerable to predation. Therefore, there has to be a really good reason for mammals to sleep for extended hours. What is that reason? Why are toddlers and frankly all of us more cranky when we do not sleep enough? Why are our genes tied so tightly to circadian rhythms? Why are people so metabolically unwell when they are sleep deprived? ...plus updates on heat exhaustion and covid. Enjoy, Dr. M

Klotho Part II Last week we discussed Klotho as a protein that has pleotrophic effects in the body as it relates to cellular aging. This week let us focus specifically on the brain. What are the effects of klotho as it relates to cognition and function over time? Klotho has neuroprotective effects based on studies that show that better cognitive performance in translational models over time occur with the injections of klotho. Klotho is also shown to have neuroprotective effects if naturally elevated, i.e. individuals with host genetics that promote more klotho production over time without being taken or given. The pivitol research occurred in 2015 in a mouse model of Alzheimers Disease (AD) where Dr. Dena Dubal and colleagues looked at two groups of intervention mice with and without higher levels of Klotho. and a literature review on micro plastics and screentime. Enjoy, Dr. M

Jeff Kessler, FACHE Allergy Choices This week I sit down with Jeff Kessler to discuss allergies and sublingual immune therapy. Jeff Kessler is a business leader and a thought leader in the allergy therapy space. His relevant backstory goes back to 1999 when he had the fortunate opportunity to work on a project to select and implement an Electronic Medical Record system for the Allergy Associates of La Crosse (AAOL) clinic in La Crosse WI. Fortuitously for his daughter who at the time suffered profoundly with allergies, asthma and eczema, this opportunity presented a new course of therapy that would eventually be taken for the entire family leading to allergic disease modification. Enthralled with the therapy and company, Jeff dedicated his career in the healthcare industry from that point on to the allergy treatment approach that he witnessed change thousands of lives including his families. The growing AAOL organization became linked to Allergychoices, an education company dedicated to teaching healthcare providers around the U.S. on the protocol (La Crosse Method - LCM) that had been perfected since 1970. Jeff has served as President of Allergychoices since its formation and its services have grown to help providers deliver immunotherapy using the LCM to their patients directly at the primary care level. Bringing together AAOL, the most advanced allergy immunotherapy clinic in the U.S. and Allergychoices, capable of delivering the benefits of disease modifying allergy immunotherapy to anyone, anywhere, the distinctive competencies of these companies continue to help hundreds of thousands of allergy sufferers of all types, including foods. Jeff earned a bachelors in science from the University of Wisconsin LaCrosse before he received his MBA in Strategic Planning from University of Minnesota’s Carlson School of Management in 1987. Please enjoy my conversation with Jeff Kessler, Dr. M

Klotho Part I Ok, it is time for a potential log step shift in the human understanding of neurological decline with age starting from birth. Enter the peptide, (C)Klotho, named after the greek goddess of fate who spins the thread of life for all. The Klotho protein was discovered by researchers looking at mice that aged faster than the general mouse population. These mice were noted to have a shortened lifespan, stunted growth, renal disease, blood vessel calcification, cardiac hypertrophy, hypertension, pulmonary disease, cognitive impairment, multi-organ atrophy and fibrosis. (Prud'homme et. al. 2022) When they looked closer, these mice were found to have hypoactive klotho proteins leading to an explosion of research over the past two decades to understand why. The next question was, could the hyperactive state provide an anti aging effect? The answer was a resounding yes! and a discussion on fast food. Enjoy, Dr. M

Sleep Restriction and Immune Health It has long been known that sleep is a truth teller of mood. The poorer the sleep quality, the poorer the emotional response. Every parent knows this with a child short on sleep. What are the cellular effects? From an abstract looking at catch up sleep and human inflammation we find the following: "Despite its prevalence in modern society, little is known about the long-term impact of restricting sleep during the week and ‘catching up’ on weekends. This common sleep pattern was experimentally modeled with three weeks of 5 nights of sleep restricted to 4 h followed by two nights of 8-h recovery sleep. In an intra-individual design, 14 healthy adults completed both the sleep restriction and an 8-h control condition, and the subjective impact and the effects on physiological markers of stress (cortisol, the inflammatory marker IL-6, glucocorticoid receptor sensitivity) were assessed. Sleep restriction was not perceived to be subjectively stressful and some degree of resilience or resistance to the effects of sleep restriction was observed in subjective domains. In contrast, physiological stress response systems remain activated with repeated exposures to sleep restriction and limited recovery opportunity...... and a section on literature review. Enjoy, Dr. M

Reading Part II Let us follow up on last weeks newsletter on reading as a cultural advantage and a human need in truth. What do we know about the neuroscience of reading dysfunction or weakened ability to achieve the goal of reading proficiency? What is the frequency of concern? Depending on the study, 5-10% of children have reading issues like dyslexia. This has profound lifelong consequences if these issues are not dealt with in the early years of education. Let us start again by looking at the neuroanatomy of the human reading interface. The first point of human involvement in reading is visual acceptance of the written word on page. In order to complete this task one must be able to see the word clearly in the order that it is displayed on the page and then send the neuroception to the brain via the optic nerve to the visual cortex. Then the angular gyrus interprets the words leaving the frontal lobes to engage in decoding and comprehending the information. This intricate interplay of neural networks not only facilitates the understanding of written language but also strengthens cognitive functions such as memory in the hippocampus, attention in the prefrontal cortex, and critical thinking in the neocortex...plus a piece on exercise. Enjoy, Dr. M

Reading If you want to spend any amount of time with your child beyond hugs, feeding and basic life duties, I would recommend reading above all else. I find it hard to believe that this is the first article that I have written on reading. I pondered that for a minute and concluded that this, in effect, was me taking this information for granted. That ends today. When I reflect on my journey on the road to reading literacy, I note that I was not an avid reader. Nay, I hated reading for most of my childhood. My first self chosen pleasure book was The Firm when I was 23 years old. Why would this be? To sit for me was and is akin to mild torture. While other kids loved to dive into a book, that was not for me. Run, play, drum, hike, yes sir. All in....plus a Literature Review and section on Memorial Day. Enjoy, Dr. M

This week I sit down with Philip Bugaiski to discuss ocular tracking, reading difficulties and vision therapy. Dr. Bugaiski was born in New York and first developed an interest in optometry as a result of childhood vision challenges, requiring vision therapy. He studied science as an undergraduate at the Penn State University graduating with honors. He was awarded one of six national scholarships for optometry from the US Air Force. He served his country with distinction. He finished his doctoral work at the State University of New York College of Optometry. He completed fellowships in Synotic Optometry and Vision Therapy. He worked as Chief of Pediatrics and Vision Therapy for a multi-doctor practice until he founded The Developmental Vision Center in Charlotte, North Carolina. He specializes in Vision Development, Vision Therapy, Pediatric Optometry, and Vision Rehabilitation. Dr. Bugaiski is also North Carolina’s only Fellow of the College of Syntonic Optometry. He is a sought-after guest speaker for various groups on a local, national, and international level. All too often, children and adults are told that their eyes are healthy, they have 20/20 eyesight or their glasses are the correct power, and there is nothing else to be done. They are told that their reading issues are inborn dyslexia and other reductionistic diagnosis. At The Developmental Vision Center, Dr. Bugaiski looks beyond 20/20 eyesight. His team is there to treat the person, not just their eyes. Vision therapy is a program of progressive visual activities performed under doctor supervision, individualized by a vision therapist to fit the needs of each patient. In a statement, he is treating the child not a diagnostic name. Please enjoy my conversation with Philip Bugaiski, Dr. M Dr. Bugaiski Website LinkedIn Link

Stress and a Woman's Ability to Conceive - The Healthy Mind Is Key. How was it meant to be? Humans were designed to be excellent at handling acute stress while chronic stress on the other hand was never expected to be part of our day to day existence. We run from the tiger and survive the event or we die. That being said, chronic mental stress is the greatest disruptor of human balance and health. To truly know this fact and work towards alleviating it is the immediate route to a healthy life and a healthy pregnancy. Mental stress has profound negative effects on immune and hormonal function to the detriment of mom and her babe. Chronic mental stress is known to disrupt pregnancy conception and perinatal events. Perception of one’s stress is often more important than the event itself. Becoming aware of your perceptions and working toward a minimally stressed mind is a key to a healthy pregnancy. A woman should be honored and protected while pregnant to keep external stress levels low. In this chapter, you will learn why and how stress has the ability to hurt a pregnancy. The to do section gives tools to reverse the negative process......plus a graduation note. Enjoy, Dr. M

Demographic Deception This week I sit down with Dustin Whitney to discuss population growth and its relevance to everyday life. Dustin is an author, an entrepreneur and a man looking at the world through a different lens. He recently published book the Demographic Deception which outlines the reality that the global population is contracting as opposed to the rapidly expansion that has been espoused by many over the past 40 years. He gives us a politically agnostic but incredibly optimistic view of the demographic problem. Dustin graduated from Boston College with a BA in marketing from Carrol School of Management in 1995. He subsequently entered the business world achieving business acumen while growing various companies. He is described as a modern-day business executive with balance in his life. Innovative thinking and good use of common sense have helped his businesses succeed. As a people person as well as a business person, Dustin has always been interested in what people do, and how they do it. Dustin is focused on building teams and fostering collaboration. The goal is to bring people and ideas together to facilitate progress and success. Dustin brings his 25+ years of business executive experience paired with a passion and mission to uncover and analyze global trends to help us understand how those trends impact long-term business growth and human life. We dive into all things population based covering healthcare, history and an optimistic future. In a word, this conversation is expanding. Please enjoy my conversation with Dustin Whitney, Dr. M Dustin Whitney Website LinkedIn Link

What are the main preventable etiologies for childhood death under the age of five years? According to the data compile by UNICEF, we see the following for the world: 1) Prematurity 18% 2) Pneumonia 14% 3) Birth Asphyxia 12% 4) Malaria 9% 5) Diarrhea 9% 6) Congenital anomolies 8% 7) Injuries 5% 8) Blood infections/sepsis 3% 9) Tuberculosis 3% 10) all others From a global perspective, we are on the right track as deaths have decreased significantly from 12 million in 1990 to less than 5 million annually in 2022. This is a massive improvement in global childhood health. More work to be done as pneumonia and diarrhea based death should be less than 1%. Access to clean water, clean medicines and adequate medical care could crush these issues....plus a literature review as well as an ode to mothers. Enjoy, Dr. M

Excess Weight Gain, Obesity and Immune Related Diseases in 2 cases I want to share a few recent case experiences that shed light on the patient provider experience in the context of a collaborative clinic model based on prevention and the patient first mentality. In the struggle against the US based disease onslaught that is excess weight gain, longevity with the patient remains the greatest winner for a quality outcome. What do I mean when I say this? Let me tell you a story. I care for a wonderful young man who is about to turn 17 years old. I have known him since birth and his struggle with weight has been profound for most of these 17 years...... Plus an article review about weight loss and a recipe of the week. Enjoy, Dr. M

This week I sit down with Dr. Blaine Leeds to discuss oral health, sleep apnea, bedwetting and more. Dr. Leeds is a leader in the dental field. He speaks nationally on tele-dentistry, oral health and dental treatments for sleep disordered breathing and sleep apnea. He is a graduate of Arkansas Tech with a Bachelors degree in Chemistry before attending the University of Tennessee School of Dentistry where he graduated with honors. His skills in dentistry have also spurned many technological companies to help dentistry reach far locations. He is the author of, What happens when your child doesn't sleep? a book exploring the connection between oral motor function, anatomy and sleep. This is a very important topic as poor sleep will dominate a child's behavior in a negative way. He has been a guest on many major news networks sharing this wisdom. Today we sit down to dissect the issues of oral health, sleep and a whole child approach. The exploration is exactly what we need, root cause analysis and treatments based on the reasons not the symptoms. Please enjoy my conversation with Blaine Leeds, Dr. M

“It is your reaction to an adversity not the adversity itself that determines how your life’s story develops.” Dieter Uchtdorf WHY? What are the Underpinnings of Disease? What have we really learned over the last one to two hundred years of medicine? We left an era where infections killed the majority of children and adults, especially during childbirth and the first 5 years of life. Science gave us antimicrobial medicines and vaccines that altered this landscape and humans began to live decades longer. Medicine had conquered disease. However, it was not so. Insidiously, these victories were met with new problems called diseases of aging - heart disease, asthma, autoimmunity, diabetes, cancer, obesity, dementia and others...... and a literature review. Enjoy, Dr. M

The Book that I never published. It is time for me to take another look at the mother child story in book form. In 2019, I embarked on a project of writing a book about maternal health and WHY it matters tremendously that we address the issues driving offspring dysregulation. The time since has ushered in an era of podcast guests that in some instances have solidified my beliefs on knowns while also shattering some beliefs leading to new ideas. Over the coming weeks, I am going to relook at this topic. Part of this project is going to be taking a page out of the Derek Sivers' book writing style, brevity and meaning are paramount. I am naturally hyper verbose and my writing style follows this reality. Thus, I am going to fight my natural style and desires in an effort to make this book shorter, much shorter and still powerful in delivery. Here goes! WHY? The story of normal maternal health and how we are disrupting it in modern America.......Also a Literature review and recipe of the week! Enjoy, Dr. M

Enuresis, Encopresis and Constipation This week I sit down with Dr. Steve Hodges to discuss bedwetting, constipation and more. Dr. Steve Hodges is a Urological surgeon and expert in the field of enuresis, encopresis and child urological health. He received his BA in classical and ancient studies from Duke University before completing medical school and residency at Wake Forest University in North Carolina. He completed further Pediatric fellowships in Urology at the University of San Diego and again at Wake Forest. From there his career is one of exploration, questioning and seeking new answers to old questions. He has authored multiple books including It’s No Accident, Emma and the E Club: An Epic Episode About Eliminating Enuresis and Encopresis, and the MOP book anthology. He is widely published in top Urological Journals. Today we sit down to dissect the issues of enuresis(Bedwetting), encopresis (self stooling) and chronic constipation. The exploration is exactly what we need, root cause analysis and treatments based on the reasons not the symptoms. Please enjoy my conversation with Steve Hodges, Dr. M

Unraveling the Mysteries of the Amygdala: A review of a section of the book Behave by Robert Sapolsky In the world of neuroscience, Robert Sapolsky stands as a luminary, a maestro of unraveling the intricate dance of our brain's circuitry. Among the many deep dives that he delves into, his perspective on the amygdala resonates profoundly for me. The amygdala emerges not as a mere anatomical curiosity as he decides that rather than reducing the amygdala to a simplistic seat of fear and aggression, he highlights its diverse functions, emphasizing its involvement in the vast array of behaviors and experiences. It is a narrative view of the why the brain developed as it did to aid us in the fight against pathogens, predators and stress. Sapolsky's take on the amygdala is nothing short of revelatory, akin to a seasoned detective peeling away layers of a perplexing case. There are diverse neuronal pathways in this almond-shaped structure nestled deep within our temporal lobes and they have profound purpose. The amygdala emerges not merely as a primal seat of fear and aggression, but as a nuanced orchestrator of our emotional lives. All mammals have emotional responses that are split second to threat, joy and relationship. This is mediated......Plus a section on DNA and memory. Finally, a recipe. Enjoy, Dr. M

Literature Review 1) In a first of its kind study in mice, we see concrete evidence for how the mitochondria in obese individuals are a root cause of disease based on nutritional input. This fascinating animal translational study gives us insight into how a high fat diet is also a major component of mitochondrial damage through fission and fragmentation leading to worsened cell bioenergetics. The cells have reduced fatty acid oxidation or fat burning capacity due to a single gene's actions. The end result is a tilt toward fat cell production, fat storage and fat cell inflammation which are associated with diabetes and insulin resistance and ultimately metabolic syndrome. This starts to explain the paradox that is obesity where the person has a ton of stored energy, but has limited capacity to utilize it. It is like having a gas tank of fuel with a gas line that only allows for 1/10th of the flow required for optimal function. Science Daily has an excellent review of this paper. Link below. 2) Women's brains change during pregnancy as per a new study. The authors looked at brain changes before and after birth as well as with or without a vaginal delivery route. Their study findings noted transient changes in some brain regions as well as permanent changes in other brain regions that turn on self-reflection and empathy for others...... and a recipe of the week. Enjoy, Dr. M

This week I sit down with Dr. Stan Gabryszewski to discuss allergies from multiple angles. Dr. Gabryszewski graduated from Princeton University with a degree in Molecular Biology before attending Columbia University for his MD as well as a PhD degree in Cellular, Molecular and Biomedical Studies. He then completed his pediatric residency and is a senior allergy immunology fellow at the Children's Hospital of Philadelphia where he now teaches and performs research in the lab of Dr. David Hall. His research is focused on better understanding the epidemiologic and immunologic features among pediatric allergic disorders, in particular the food allergies IgE-mediated food allergy and eosinophilic esophagitis. In this conversation, Stan and I sit down to discuss his recent paper in Pediatrics entitled, Patterns in the Development of Pediatric Allergy. This article is a much needed look at the true prevalence of allergy and allergic diseases in children. We discuss the statistics as well as the thoughts behind the why this is occurring. The upstream reasons are very important, hard to tease out but worthy of discussion. Please enjoy my conversation with Stan Gabryszewski, Dr. M His recent paper in pediatrics.

Teenagers and tweens are a challenge to any parent as they embark on their identity development. These are years filled with angst, joy, love and pain, as our kids develop physically, mentally, and emotionally. As we attempt to guide but not control, we struggle watching them make and maybe repeat obvious mistakes. We, so dearly, want them to make the right choices (in our mind) and respect their bodies. What can we do to help? Dictating to teens will never work. They are more likely to sabotage their own lives in order to prove that they are in control. The tighter parents squeeze, the more the adolescent rebels. I think of this stage of parenting as motivational interviewing.... and a literature review. Enjoy, Dr. M

Micro/nano-plastics (MNP) - the new ultra threat to our health In a first of its kind study, a group out of Italy has found quite disturbing results in the hearts of a few hundred tested individuals. From the study: 257 patients completed a 35 month study where they detected polyethylene in the 59% of the patient's heart's carotid artery plaque. In addition, 12% of the patients had detectable amounts of polyvinyl chloride. "Electron microscopy revealed visible, jagged-edged foreign particles among plaque macrophages and scattered in the external debris. Radiographic examination showed that some of these particles included chlorine." (Marfella et. al. 2024) Individuals with micro/nanoplastics in the carotid atheroma were at significantly higher risk for myocardial infarction, stroke, or death than those without detectable MNP. The hazard ratio is 4.5 which is to say that the risk is 4.5 X higher for the plastic exposed people.....plus a literature review. Enjoy, Dr. M

This week I sit down with Dr. Stephen Porges, He is a Distinguished University Scientist at Indiana University where he is the founding director of the Traumatic Stress Research Consortium. He is Professor of Psychiatry at the University of North Carolina, and Professor Emeritus at both the University of Illinois at Chicago and the University of Maryland. He served as president of the Society for Psychophysiological Research and the Federation of Associations in Behavioral & Brain Sciences and is a former recipient of a National Institute of Mental Health Research Scientist Development Award. He has published more than 400 peer-reviewed papers across several disciplines including anesthesiology, biomedical engineering, critical care medicine, ergonomics, exercise physiology, gerontology, neurology, neuroscience, obstetrics, pediatrics, psychiatry, psychology, psychometrics, space medicine, and substance abuse. In 1994 he proposed the Polyvagal Theory, a theory that links the evolution of the mammalian autonomic nervous system to social behavior and emphasizes the importance of physiological state in the expression of behavioral problems and psychiatric disorders. The theory is leading to innovative treatments based on insights into the mechanisms mediating symptoms observed in several behavioral, psychiatric, and physical disorders. ​ He is the author of multiple books on his Polyvagal Theory: including the Neurophysiological foundations of Emotions, Attachment, Communication, and Self-regulation, as well as Polyvagal Safety: Attachment, Communication, Self-Regulation. His newest book cowritten with his son is called Our Polyvagal World, How Safety and Trauma Change Us. Dr. Porges is the creator of a music-based intervention, the Safe and Sound Protocol ™ (SSP), which is used by therapists to improve social engagement, language processing, and state regulation, as well as to reduce hearing sensitivities. This is such a fascinating conversation. He brings the worlds of psychiatry and anthropological physiology into union for us to understand the why of trauma reactions and the future unwinding that is now possible. This is a must listen to conversation if you know anyone with trauma history. Please enjoy my conversation with Professor Porges, Dr. M His recent paper in Frontiers in Integrative Neuroscience Website for Dr. Porges Newest Book - Our Polyvagal World

Allergy Season and School - What is your plan? Spring is coming and maybe even here already in Carolina. School is in full swing for kids and they are filled with joy and excitement. They are back outside enjoying sports and play. For the parents of allergy suffering kids, this is a time for check ups, medicines and the countless forms required by school. I know! What a pain! The goal for parents and educators is to limit missed or unproductive school days due to asthma and allergies and to get the most out of the learning environment for all children. My goal is to help children be symptom free or as close as possible while also focusing on reducing mucous development which is a direct precursor to bacterial sinus and ear infections....and more Enjoy, Dr. M

To Forgive The act as defined as I see it - to release consciously another person from your negative feelings based on an event that was hurtful toward you from them whether it is perceived on your part or known by both parties. What I find fascinating is that often the act of forgiveness may have to push past an unconscious threat injury in order to take root. This is to say that we can be harmed at a conscious and an unconscious level. The unconscious harm is understood at the vagal nerve level which is a primitive emotional safety response state that all mammals have that developed a long time ago. This is the essence of polyvagal theory which states that when humans feel safe, their nervous system supports the homeostatic functions of health, growth and restoration, while simultaneously become accessible to others without feeling or expressing threat and vulnerability. (Porges S. 2022) Thus, the opposite exists, when humans are threatened, their nervous system supports a break in homeostasis that can be short lived or long persistent based on the severity and chronicity of the harm. This break can lead to persistent mental and physical health challenges..... and a section on sleep followed by the recipe of the week. Enjoy, Dr. M

This week we sit down with Dr. John Warner, an Emeritus professor of Pediatrics at the Imperial College of London in the United Kingdom and also at the University of Cape Town in South Africa. We discuss his recent paper entitled: Strategies and Future Opportunities for the Prevention, Diagnosis, and Management of Cow Milk Allergy. Dr. Warner completed his undergraduate medical training in the School of Medicine, University of Sheffield and his initial pediatric experience was at the Children''s Hospital, Sheffield in the United Kingdom. He moved to London as Professor of Pediatrics and Head of Department at Imperial College St Mary's hospital campus. He is also Hon Professor of Pediatrics in the University of Cape Town. In 2008 he became Director of Research for the Women and Children's Clinical Programme Group, Imperial College Healthcare NHS Trust (ICHT). He was the lead for pediatrics in both the Biomedical Research Centre in ICHT and the NW London CLAHRC (Collaboration for Applied Health Research and Care) and was President of the Academic Pediatrics Association. Professor Warner's research has focused on the early life origins of asthma and related allergic and respiratory disorders. He has published over 500 papers in scientific journals on these topics. He was Editor in Chief of the journal Paediatric Allergy and Immunology from 1997-2010 and chairman of the paediatric section of the British Society for Allergy and Clinical Immunology for 5 years until 2010. He was also a member of the Speciality and Training committee of the World Allergy Organisation and a past Trustee of the charity known as The Anaphylaxis Campaign. He was a member of the Advisory Committee for Novel Foods and Processes of the Food Standards Agency for 12 years until 2012 and was recognised for his work in food allergy research by the award of an OBE in 2013. Please enjoy my conversation with Professor Warner, Dr. M

Pregnancy is a super important time. Do not take by inhalation, ingestion or other exposure anything that is a potential toxin for the body. Things to avoid: 1) Caffeine - in low to minimal doses, it is clear that caffeine is safe for pregnant women and their offspring. Caffeine easily crosses into the placenta and thus the baby's circulation. In utero babies cannot metabolize caffeine well putting them at risk with increasing exposure. The data does not support the same reality for more moderate to high doses. Caffeine is known to raise blood pressure and heart rate in all users in variable numbers based on metabolism capabilities...... plus a literature review and a recipe. Enjoy, Dr. M

Measles Overview Again From the CDC: As of this week, there have been 35 cases of measles, the Centers for Disease Control and Prevention (CDC) reported including seven direct importations of measles by international travelers and two outbreaks with more than five cases each. Most of these cases were among children and adolescents who had not received a measles-containing vaccine (MMR or MMRV), even if age eligible. (Site) In 2023, there were 58 total cases. A far cry from the 1274 cases in 2019, but still a sign that risk persists for some unvaccinated and immune compromised people. What is measles - a refresher? Measles is a serious, highly contagious and potentially deadly viral infection. It is caused by an RNA paramyxovirus. It is spread by contact with droplets from an infected person's nose, mouth or throat. Sneezing and coughing can aerosolize the droplets and increase the range of infectious spread. Enjoy, Dr. M

Dr. Kate Kresge is the Head of Medical Education at RUPA Health and host of the Root Cause Medicine Podcast. Dr. Kate collaborates with clinicians to bring leading-edge root-cause medicine information to the world through bootcamps, courses, podcasts, articles and more. Before joining RUPA, Dr. Kate was the founding Director of Functional Medicine at Sanare Today, a multi-location practice on the east coast of the U.S. that combines therapy, coaching, natural medicine and more to help people thrive. Dr. Kate’s training in naturopathic medicine began at Bastyr University where she learned how to approach a patient through a prevention focused lens. She focuses on therapies like biofeedback, micronutrient cofactor support and nutrition, allowing her to emphasize root-cause treatments that are both low-cost and effective in order to help keep functional medicine accessible to all. Today, we look at ADHD and the upstream levers that can be pulled on to help reduce the symptom burden. What are the nutritional, lifestyle and other mitigating factors for symptom amelioration? How does Dr. Kate approach a child and the family? What is a meal plan and so much more. Please enjoy my conversation with Kate Kresge. Dr. M

APOE4 and the history of human disease Apolipoprotein E, discovered in 1973, is derived from a polymorphic gene called ApoE that encodes for a signaling protein on a class of fatty proteins that primarily carry cholesterol and other molecules around the body. We find ApoE primarily on VLDL, very low-density lipoproteins and HDL, High density lipoproteins. It primarily helps to shuttle cholesterol from the periphery of the body back to the liver. ApoE proteins are also involved in neuronal signaling, neuroinflammation and glucose metabolism making them especially critical for brain activity. This is becoming a critical part of the story for understanding dementia and neurodegeneration. (Williams T. 2020) ApoE is most famous for an isoform, APOE4/4, being highly associated with Alzheimer’s dementia in modernity. Unfortunately, as we do with many things in medicine, we have been focused on this genetic protein variant as a net negative in humans because we look at things as black and white. Either good or bad. A binary choice. Rubish! ..... Enjoy, Dr. M

Light and It's Impacts on Health - Circadian Rhythms Circadian comes from the latin Circa Diem or about the day I have long believed that indoor sedentary behavior is profoundly bad for us beyond just the lack of movement and outdoor natural education. Today, we will look at another major concern: light. We will also get into a circadian rhythm post looking at Dr. Panda's work. A final addition of a recipe of the week. Enjoy, Dr. M

ADHD without Drugs - This is a reboot of this podcast from 2022 as it aligns with the podcasts of Dr. James Greenblatt and Dr. Kate Henry Sandy Newmark, MD is the Director of Clinical Programs at the University of California at San Francisco's Osher Center for Integrative Health. He is an Integrative Pediatrician and a Professor in the Department of Pediatrics at UCSF with the title of Osher Foundation Endowed Chair in Clinical Programs in Integrative Medicine. To me, he is an amazing teacher and onion peeler in the world of attention deficit. I met Sandy back in 2006 as he was the lead Pediatric teacher in the University of Arizona's Integrative Medicine Fellowship. He immediately made an impact in my career as a leader in this new way of seeing the world of medicine. His bio lists: Dr. Sanford Newmark specializes in integrative neurodevelopmental pediatrics including autism, ADHD, and related conditions. Dr. Newmark lectures widely on both autism and ADHD and has authored three chapters in integrative medicine textbooks. He is the author of the book “ADHD Without Drugs, a Guide to the Natural Care of Children with ADHD.” His online video, “Do 2.5 Million Children Really Need Ritalin? An Integrative Approach to ADHD,” has been viewed over 4.5 million times. Know this, this is an hour of your life that you will want to dedicate to Dr. Newmark's thoughts. Especially, if you or your child has ADHD. Enjoy my conversation with Dr. Newmark, Dr. M