Dr. M's Women and Children First Podcast

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