Best Of: Fact or Fiction

Summary

Podcast Summary: "That Can't Be True with Chelsea Clinton"

Episode: Best Of: Fact or Fiction
Date: July 9, 2026
Production: Lemonada Media & The Clinton Foundation
Host: Chelsea Clinton

---

Episode Overview

In this special "Best Of: Fact or Fiction" episode, Dr. Chelsea Clinton brings together leading experts to tackle popular health myths and misconceptions making the rounds in public discourse and online culture. With advice from gastroenterologists, pediatricians, public health economists, and more, the episode offers listeners actionable insights to navigate health misinformation, debunks widely circulated myths, and infuses expertise with humor and relatability.

The episode is structured around the show's trademark Fact or Fiction segment, featuring condensed and punchy mythbusting discussions on topics from toilet habits to microplastics, hydration, vaccines, allergies, weight, and wellness trends.

---

Key Discussion Points & Insights

1. Healthy Toilet Habits

Guest: Dr. Tricia Pasricha, Gastroenterologist
[01:04 – 10:32]

• Reading on the Toilet:
  • Fiction, with Caveats: Reading in the bathroom is only problematic insofar as using a smartphone keeps people on the toilet longer, increasing risk of hemorrhoids. Reading a book/newspaper is less of an issue ([01:46]).

  "The smartphone, which, like, keeps you scrolling all the time. You lose track of time. That's what I think you should keep outside the bathroom. Primarily for hemorrhoids." – Dr. Tricia Pasricha [01:46]

• Bowel Movement Frequency:
  • Fiction: Once-daily bowel movements are not a requirement. "Normal" varies by individual, diet, and culture ([02:27]).

  "Don't be so hung up on the number as much as how that number makes you feel." – Dr. Tricia Pasricha [02:27]

• Toilet Type & Toilet Paper:
  • Fact: Bidets are better, especially for hemorrhoids or sensitive conditions; heated seats are a luxury, bidets a necessity. Two-ply toilet paper is recommended over one-ply ([04:00 – 05:43]).

  "The dream toilet is one that has a heated seat and is a bidet. No, the heated seat is the luxury. The bidet is the necessity." – Dr. Tricia Pasricha [04:00] "One ply is for people who don't love themselves." – Dr. Tricia Pasricha [05:09]

• Leaky Gut Syndrome:
  • Misunderstood: Increased intestinal permeability is real, but "leaky gut" is often used to oversimplify broader health issues; stress, NSAIDs, alcohol, and ultra-processed foods can increase permeability, but there's no validated clinical test or cure ([06:00]).
• Coffee & Gut Health:
  • Filtered vs. Unfiltered: Filtered coffee is preferable due to diterpenes in unfiltered coffee (French press, espresso) that may raise cholesterol. Moderate coffee consumption (3–4 cups) is fine ([07:55 – 10:32]).

  "Drinking filtered coffee is associated with a mortality benefit. You're going to live longer if you drink coffee..." – Dr. Tricia Pasricha [09:13]

---

2. Sleep, Water, and Nutritional Myths

Guest: Dr. Mike Varshavsky ("Dr. Mike"), Family Medicine
[11:17 – 23:28]

• Melatonin:
  • Nuanced: Some evidence links high-dose, long-term melatonin use to increased heart failure risk, but causation is not proven. Melatonin is best for short-term circadian rhythm resets (i.e., jet lag); high doses are not recommended ([11:17]).

  "People are taking 20 milligrams... This is supraphysiologic doses where we don't even know what the harms of that is because we're not studying them at such high toxic doses." – Dr. Mike [12:00]

• 8 Glasses of Water a Day:
  • Fiction: Hydration needs vary; check urine color as a better indicator ([12:37]).

  "Your urine...should be pale colored. If that's generally the case, you're in a good spot." – Dr. Mike [12:39]

• Electrolytes in Water:
  • Fiction: Most people do not need electrolyte supplements unless engaged in extreme physical activity ([13:59]).

  "This is the biggest scam to sell something." – Dr. Mike [13:59]

• Protein Crisis:
  • Fiction: Americans are not in a protein shortage; overconsumption of refined carbs is a bigger issue ([15:16]).
• Fever & Contagion:
  • Nuanced: You might still be contagious after a fever breaks; depends on the illness ([15:43]). Over-treating mild fevers is discouraged unless medically necessary ([16:31]).
• Blue Light & Sleep:
  • Fact: Phones and screens before bed disrupt sleep quality via melatonin suppression and increased anxiety ([19:10 – 21:37]).

  "You shouldn't be on your phone before bed, you shouldn't be doom scrolling... that's antithetical to good quality sleep." – Dr. Mike [19:47]

• Sleep Hygiene Tip:

  "If you are trying to fall asleep and you lay there for 15, 20 minutes and you can't, get out of the bed...so that when you return to the bed, you know, that's my place of comfort." – Dr. Mike [21:13]

---

3. Vaccine, Parenting, and Wellness Myths

Guest: Emily Oster, Economist, Author, & Parenting Expert
[23:39 – 32:41]

• Hep B Vaccine for Kids:
  • Fact: Needed because Hepatitis B can be contracted early via household exposures, not just sexual transmission ([24:09]).
• Mercury & Toxins in Vaccines:
  • Fiction: Modern vaccines do not contain mercury; aluminum adjuvants are not toxic and are different from tinfoil ([24:53 – 25:02]).
• Vaccine Schedule:
  • Fact: No benefit to spacing out vaccines beyond official recommendations ([25:21]).
• Microplastics in Food:
  • Exaggerated: While present, the "credit card per week" claim is false; health risk at current exposures is unproven ([25:36]).
• Heavy Metals in Formula:
  • Rare: Not generally a concern due to regulation ([26:25]).
• Creatine Supplementation:

  "I do. I think there's a lot of evidence that creatine is...beneficial for performance...and for adults over like 65, adding creatine...can improve your muscle maintenance." – Emily Oster [27:03]

• Multivitamins:
  • Fiction: Most people eating a typical diet do not need a daily multivitamin ([28:20]).

  "That's stupid...the kind of general multivitamin is really just basically a waste." – Emily Oster [28:22]

• Continuous Glucose Monitors:
  • Fiction: Important for diabetics; little benefit for the general population ([29:06])
• Botox While Breastfeeding:
  • Fact: Safe while breastfeeding ([29:10])
• General Parenting Advice:

  "If it's going to improve your mental health to, like, put down your phone for a couple days...that's okay." – Emily Oster [31:13]

---

4. Body Weight, GLP1s, and Weight Loss Myths

Guest: Dr. Fatima Cody Stanford, Obesity Medicine & Public Health, Harvard
[32:47 – 36:43]

• BMI as a Health Metric:
  • Outdated: Waist-to-height ratio is more accurate; BMI should not be used for most people ([33:13]).
• Health at Every Size:
  • Nuanced: “You have to look beneath the hood” for true health markers; body size is not an automatic indicator ([33:50]).
• GLP1 Medications and Cancer Risks:
  • Promising Data: GLP1s may reduce risk of certain cancers; more research ongoing ([34:31]).
• GLP1s & Fertility:
  • Fact: Can increase fertility but should be discontinued two months before conception ([35:08]).
• Apple Cider Vinegar & Weight Loss:
  • Fiction: No evidence it helps with weight loss ([36:00]).
• Healthy Changes at Any Age or Weight:
  • Fact: It's always possible to make positive changes, regardless of age, illness, or weight status ([36:35]).

---

5. Allergies, Immunity, and the Environment

Guest: Dr. Zachary Rubin, Pediatrician/Allergist
[36:43 – 44:12]

• Vitamin C and Zinc for Immunity:
  • Fiction: Won't boost immunity unless you are deficient ([37:25]).

  "Vitamin C is just gonna make expensive pee." – Dr. Zachary Rubin [37:49]

• Kids Playing in Dirt:
  • Partial Fact: Exposure to diverse (healthy) microbes is important. Don’t eat dirt, but minor exposures help develop the immune system ([38:33]).
• At-Home Allergy Tests:
  • Fiction: Often produce false positives, cause unnecessary anxiety, and lack clinical utility ([39:27]).
• Curing Allergies:
  • Fiction: There is no cure; allergies may wane with time or treatment, but can return ([40:08]).
• Hypoallergenic Cats and Dogs:
  • Fiction: No breed is truly hypoallergenic—technological solutions can help, but not erase risk ([41:09]).
• Innovative Allergy Treatments:
  • Purina's Live Clear formula reduces cat allergen; Omalizumab/Xolair helps tolerate more of a food allergen; EpiPen nasal spray (Nephi) as new emergency therapy ([42:20 – 44:12]).

---

Notable Quotes & Memorable Moments

• "One ply is for people who don't love themselves."
  – Dr. Tricia Pasricha [05:09]

• "Drinking filtered coffee is associated with a mortality benefit."
  – Dr. Tricia Pasricha [09:13]

• "People are taking 20 milligrams...This is supraphysiologic doses..."
  – Dr. Mike Varshavsky on melatonin [12:00]

• "Your urine should be pale colored."
  – Dr. Mike Varshavsky [12:39]

• "The general multivitamin is really just basically a waste."
  – Emily Oster [28:22]

• "If it's going to improve your mental health to, like, put down your phone for a couple days...that's okay."
  – Emily Oster [31:13]

• "One of the more recent ones is...an epinephrine nasal spray...instead of having to use a needle...for a severe allergic reaction."
  – Dr. Zachary Rubin [43:33]

---

Segment Timestamps (Highlights)

• Toilet Health & Habits: [01:04 – 10:32]
• Hydration, Electrolytes, Sleep: [11:17 – 23:28]
• Vaccines, Parenting & Wellness Trends: [23:39 – 32:41]
• Weight Science & GLP1s: [32:47 – 36:43]
• Allergy Myths & Innovations: [36:43 – 44:12]

---

Final Takeaways

This episode weaves expert mythbusting with actionable guidance, debunking popular wellness claims while empowering listeners to question health advice lacking evidence. With wit and clarity, Chelsea Clinton and her rotating panel model how to separate science from fad—and encourage self-care through moderation, curiosity, and critical thinking.

"If it's actually important, it will still be there next week. And if it's not important, it will be gone. And then you will not be sorry that you missed it."
– Emily Oster [32:07]

---

Transcript

[Dr. Tricia Pasricha]

Lemonada.

[Chelsea Clinton]

Welcome to that Can't Be True, a show that sorts fact from fiction, especially on issues impacting our health. I'm Chelsea Clinton, and today we're doing something a little different. If you've listened to the show before, you know that each episode ends with a segment we call fact or fiction. Basically, I throw out some claims that we've seen online or heard offline, and our guest tells us if they're fact, fiction, or maybe need a little nuance. And it's one of my favorite parts of the show. So today we're going to start with gastroenterologist Dr. Tricia Pasricha, whom you might know from the Washington Post's Ask a Doctor column, where she answers readers most googled and sometimes awkward health questions. Here's our Fact or fiction segment. Reading on the toilet is bad for you. Ooh.

[Dr. Tricia Pasricha]

We have been reading on the toilet since the dawn of time. Like, we have. So I. This is gonna, like, you know, like, my lab, we study a lot of things. One of them is what we do on the toilet. So, like, this is, like, near and dear to my heart.

[Chelsea Clinton]

So, like, like, I'm now so curious. Like, what else do people do on the toilet? They, like, do you decide the difference between, like, reading on a phone versus reading a book versus, like, doing a crossword puzzle versus sudoku? Like, what does that mean?

[Dr. Tricia Pasricha]

Trisha, we should recruit you to the lab. Like, those are the. Exactly. Corre. So we know in the past, there was this, like, very nice study in the 70s that showed that people who read the newspaper. This was a British study, read the newspaper. Tended to spend longer on the toilet than people who didn't bring the newspaper in.

[Chelsea Clinton]

That's not terribly surprising.

[Dr. Tricia Pasricha]

Not terribly surprising. We updated that study last year in my lab and looked at does taking your smartphone to the bathroom not only increase the amount of time you're spending, but is it associated with an increased risk of hemorrhoids? The answer is a resounding yes. Yes. So my advice to people is I think reading on the toilet is not inherently a bad thing. I think it can help you relax. You kind of need to relax to have a bowel movement. If you want to just, like, bring back the old fashioned bathroom library, be my guest. The smartphone, which, like, keeps you scrolling all the time. You lose track of time. That's what I think you should keep outside the bathroom. Primarily for hemorrhoids.

[Chelsea Clinton]

You should have a bowel movement sl. Poop every day. Fact or fiction?

[Dr. Tricia Pasricha]

Fiction. This one. Shocker, right? Because, like, we've been saying since like civil war era medical manuals that you should have one a day. You should have a bowel movement as often as feels comfortable for you and at a socially appropriate time, whatever that means for you. Now there's some like, guardrails, which is to say, like, if you're going more than three or four days without a bowel movement, I want to talk to you. If you're having it like so often a day that it's interfering with your social life or your work, then we can talk again. But you know, like, for example, it depends on your diet. It depends on other habits. In India, where people have. In eastern India, there's been studies where people have like a very, very high fiber, mostly plant based diet. Two or three bowel movements a day is considered normal, you know, and like in America, it's like just like one, maybe even slightly less than one is considered normal. It's just entirely dependent on you and your diet. So don't be so hung up on the number as much as how that number makes you feel and making sure that you able to do it in a way that's not interfering with your daily life.

[Chelsea Clinton]

Not all toilets are created equal. Some are better for you than others. Fact or fiction?

[Dr. Tricia Pasricha]

This is one of my favorite topics.

[Chelsea Clinton]

I love that this is one of your favorite topics. I'm now, but now Trisher, I want to know, like, what are your other favorite topics? What have we not talked about yet? I mean, do you have views on like, toilet paper? Like, I'm like, I'm now so curious.

[Dr. Tricia Pasricha]

Oh, 100% like, okay, all right, well,

[Chelsea Clinton]

so I'll ask about toilet paper next. But first tell me about whether or not all toilets are as good for you as could be or. No, some are better for you than others, you know.

[Dr. Tricia Pasricha]

Okay, so I will say the dream toilet is one that has a heated seat and is a bidet. No, the heated seat is the luxury. The bidet is the necessity. Okay. And I know, like, people are not ready for this conversation in this country. Okay?

[Chelsea Clinton]

I mean, I'm like, this is the only thing that we've talked about in like over an hour. I'm like, really?

[Dr. Tricia Pasricha]

Stick with me, Chelsea.

[Emily Oster]

All right?

[Dr. Tricia Pasricha]

A bidet.

[Chelsea Clinton]

I'm here. I'm not going anywhere. All right, tell me more.

[Dr. Tricia Pasricha]

Better for you if we're talking about hemorrhoids. Better for you if you have a lot of diarrhea. I recommend bidets all the time to like, my postpartum women who are like, you know, like that whole area Is very sensitive. Anybody who doesn't want to be constantly wiping people who are struggling with movement. Like, so my Parkinson's patients, I tell them to get a bidet because it's actually the toileting experience can be really hard if you have bal. Of course, you know, it's like difficult, but the bidet can help you with that. It can not only clean things up, but it can air dry. And so you don't have to actually reach back there and struggle and fumble as much as you would if we're just using toilet paper. Now if you want to have the toilet paper conversation.

[Chelsea Clinton]

I do, I do. Now tell me more.

[Dr. Tricia Pasricha]

All right, so we've got one ply. We've got two ply. Right? And first of all, like, the. For me, like, let's not do toilet paper at all. Let's go bidet. But I think one ply is for people who don't love themselves. You know, like, everybody deserves two ply. And there's absolutely no reason other than like saving your corporation some money by going one ply. I haven't proven this in a study yet, but I'm desperately trying to get my.

[Dr. Fatima Cody Stanford]

Hopefully you.

[Chelsea Clinton]

You will next time we talk have real data to back up the superiority of two ply.

[Emily Oster]

Okay. Okay.

[Dr. Tricia Pasricha]

This is just my expert opinion that two ply is what people who practice self care use.

[Chelsea Clinton]

It's amazing. Okay, a couple more. We can cure leaky gut syndrome. And I guess I'd first ask what is leaky gut syndrome? And then fact or fiction? We can cure it.

[Dr. Tricia Pasricha]

Leaky gut is so deeply misunderstood. We all have this physiological phenomena in which we have increased intestinal permeability. That means that the cells that line our gut, at times they open up a little bit more and things can pass through into our bodies a little more easily. And at times they close a little bit more tightly.

[Chelsea Clinton]

And is that related to anything that we do? Any choice that we make?

[Dr. Tricia Pasricha]

It is related to things that we do. We know that stress increases leaky gut. Like psychological stress has been shown. They studied this actually in college students about to orally defend their thesis that will increase intestinal permeability. The stress of that. Nsaids. So like ibuprofen, Aleve, Excedrin, Motrin, all these things that causes those tight junctions to open up a little bit. Alcohol. You've heard that before. Ultra processed foods. You've heard that one before. These things are not considered good for us and they can cause increased intestinal permeability. But our intestines are kind of infections can do it like they're kind of fluctuating at all times. I think the problem is that a lot of people have attributed these big broadcasts, symptoms that are hard to understand, hard to treat, like bloating, like brain fog, too. Leaky gut. And to me, one, we don't have a great test for it. We have tests for it in a research setting. We don't have a good clinical test that's been validated. To me, leaky gut is like a lot of things we've talked about today, which is that it is a sign of something. It's not actually the, like, underlying problem. Like, you have to go a little deeper with all these things to figure out what is it that I might be. That's happening to me or that I might be doing, contributing to it.

[Chelsea Clinton]

Okay, last question, which I ask with a cup of coffee in my hand. Not all coffee is created equal. Filtered coffee is better for us, or at least better for our gut than unfiltered coffee. Like French press. Fact, fiction,

[Dr. Tricia Pasricha]

half fact.

[Chelsea Clinton]

So you're like, I choose not what you said. I'm making up my own category.

[Dr. Tricia Pasricha]

So coffee, like, your gut loves coffee, right?

[Chelsea Clinton]

Like, love hearing that. I'm so happy that you have not mentioned coffee as, like, one of the dangers to avoid. Cause I'm, like, thinking. I'm like, oh, yeah, I have a good diet. I exercise. I don't drink a lot of alcohol. I have, like, a pretty good sleep. I gene. I drink a lot of coffee. Definitely.

[Emily Oster]

Probably too much coffee.

[Chelsea Clinton]

But she hasn't mentioned it yet, so maybe in this context, I'm.

[Dr. Tricia Pasricha]

Okay, well, let's talk about that.

[Chelsea Clinton]

We can talk about it.

[Dr. Tricia Pasricha]

So moderate amounts of coffee, like, on the 3 cup range, even 4 cup, depending on how you do it per day. I do that.

[Chelsea Clinton]

Yeah. Okay, great.

[Dr. Tricia Pasricha]

Okay. Amazing.

[Chelsea Clinton]

I aspire to drink less than four a day. And, you know, more often than not, I reach that. And then some days, I really fall off the wagon.

[Dr. Tricia Pasricha]

We all have those days.

[Chelsea Clinton]

Thank you. Thank you for that empathy. Thank you, Tricia.

[Dr. Tricia Pasricha]

I try. So one, your gut loves coffee because it stimulates the gastrocolic reflex. It's why about a third of us who drink coffee have to go to the bathroom afterwards. That is normal. Your gut loves it. The problem with French press comes in, unfortunately, Chelsea, when you are drinking, like, multiple cups a day, like the six to eight cups a day.

[Chelsea Clinton]

But what if I'm just drinking filtered coffee?

[Dr. Tricia Pasricha]

If you're just drinking filtered coffee, you're in the clear. So what a. And we're talking about paper filtered. Okay. Not like a metal sieve like we see in French press. Not espresso like a traditional espresso, which is not filtered filtered coffee with a paper filter that is, is eliminating this compound in the coffee called diterpenes. And these basically elevate the cholesterol in our blood. If studies have shown that people who drink several cups of espresso a day and or people who drink several cups of French press, which is unfiltered, both of these are unfiltered coffees. They have higher levels of cholesterol. They seem to have less of a mortality benefit than the people who drink filtered coffee. By the way, this is the good news part of this story. Drinking filtered coffee is associated with a mortality benefit. You're going to live longer if you drink coffee or at least you have an association of living longer.

[Chelsea Clinton]

Tricia, I am going to clip this and send this to my mother because my mother is often like, you drink too much coffee. And I think importantly too, even if you're only having a couple of espressos or a French press a day, that sounds like you're not dripping into the danger area. It's if you drink a lot of

[Dr. Tricia Pasricha]

that, I think the studies have really shown that it's in that higher amount. But I will say if you're somebody who has high baseline cholesterol, like I probably myself would move away from French press and I would like, even if I'm only drinking, only drinking like three or four cups a day, I probably would. But it's a conversation you should have.

[Chelsea Clinton]

Look at us. We're so moderate, Tricia. We're so responsible. Next up is Dr. Mike Varshavsky, better known as Dr. Mike, a board certified family medicine physician and one of the most recognizable doctors online. He's known for making complex medical information easy and practical to understand and for pushing back on viral health myths and misinformation. All right, so fact or fiction? We talked about melatonin earlier a bit. Taking melatonin long term will help your sleep improve and also can increase your risk of heart disease. Does it help your sleep improve and increase your health?

[Dr. Mike Varshavsky]

There was an interesting presentation that was done where it linked those who were taking high doses of melatonin or taking melatonin long term with higher rates of heart failure. That is not a causative proof that one causes the other. They just found this association to exist.

[Chelsea Clinton]

Maybe Sounds like exactly where we need more research.

[Dr. Mike Varshavsky]

Exactly. And even when we use melatonin as an example, people I think misuse it Often because they don't quite understand how it works. It's really good for resetting a circadian rhythm. So if someone is jet lagged and they're not used to the time zone that they're in, perhaps that could be a good way to restart your body's natural circadian rhythm in the correct way. But people taking it long term, taking all ultra high doses, I mean, the normal dose that we would use in a medical setting is 1 milligram, 2 milligrams, maybe three people are taking 20 milligrams. I was on a TV station and the person behind the camera said, I take 20 every night. This is not what is. This is supraphysiologic doses where we don't even know what the harms of that is because we're not studying them at such high toxic doses.

[Chelsea Clinton]

And it maybe wouldn't be ethical actually to study it at that.

[Dr. Mike Varshavsky]

Yeah, exactly. So we would need to be trusting the researchers that their examples of what could go wrong there would be. Right. So very scary stuff when people overuse these supplements.

[Chelsea Clinton]

Everyone needs to drink eight glasses of water a day.

[Dr. Mike Varshavsky]

This is something I think from my generation of education and it's a place to start. I don't like attacking that one. Too bad, because eight glasses of water is pretty good. That's not a hard and fast number for everyone. If you sweat more, you might need more. If you're a larger person or smaller person, you might need different amounts. So on average, look at the color of your urine. It should be pale colored, pale straw colored. And if that's generally the case, with some fluctuations here and there, because with life, your body adapts quite well, you're in a good spot. But if you're consistently, your skin is dry, your lips are dry, your urine is really dark, that could be a sign that perhaps you need to be hydrating a little bit more often.

[Chelsea Clinton]

Is it true we need to drink more water in the winter?

[Dr. Mike Varshavsky]

Yeah. You do experience more loss, fluid loss, especially from your mucous membranes. When we pump the heat up, it dries out the air. Air, less humidity. We get cracks in our lips, our noses. In fact, some of the theories as to why we get sick in the winter more often is because there's more areas in our mucosal membranes for bacteria and viruses to get in. Also, when the air is drier, germs have longer hang time. So you can walk into an empty room not thinking about it and someone sneezed there 30 minutes ago and the germs can still be hanging Out.

[Chelsea Clinton]

Just hanging out. Yeah, just hanging out. All right, one last question about water. We all should be adding electrolytes to our water.

[Dr. Mike Varshavsky]

Oh, this is the biggest scam to sell something. Unless you're training for a long period of time and you're sweating excessively, the need for electrolytes is almost absent because especially in the United States, we over consume salt as like a general rule as part of the American standard diet. So you need to be really careful about adding more electrolytes than you need. Some of these companies actually twist the research encouraging the average person to have a huge amount of sodium and that's really risky for those especially who have underlying conditions like congestive heart failure. They can become fluid overloaded, put tremendous strain on their kidneys. So no, not everyone needs electrolytes. I see this so often of someone going in for a 20 minute lightweight workout and they're pounding electrolytes. You did not lose enough electrolytes to need repletion.

[Chelsea Clinton]

But if you ran a marathon.

[Dr. Mike Varshavsky]

Yeah, that's what I'm saying. So for athletes, I mean, I trained for a professional boxing match. I was drinking electrolytes because you could. I could squeeze the so box. Yeah. Which is not healthy competitively. So I wouldn't recommend it. But if you want to take a class, you want to hit the heavy bag, that could be really good for the cardiovascular system.

[Chelsea Clinton]

We have a protein crisis in America. We're not eating enough protein. That's what you know. Also RFK Jr has recently said, are we not eating enough protein?

[Dr. Mike Varshavsky]

Well, what we are seeing a pattern of is people over consuming refined carbohydrates, added sugars, and that's absolutely a good target to get people perhaps to swap over to healthy sources of protein. Sure. Protein is satiating. It helps you feel fuller along with fiber. So it's not necessarily bad to encourage people to consume protein, but acting like we have a crisis where people are under consuming, that's not exactly an evidence based statement.

[Chelsea Clinton]

One thing I certainly have heard is that if your fever breaks, you're no longer contagious.

[Dr. Mike Varshavsky]

Yeah. So it's gonna be dependent on the infection that caused the fever. It's gonna be different person to person. Generally, I think this is a safe rule to understand that if your fever breaks for the risk of contagiousness goes down. But again, there are certain instantaneously but not instantaneously. And there are certain conditions like with diarrheal illnesses where it could be even longer than that that you're contagious. So it really is Gonna depend condition to condition.

[Chelsea Clinton]

So ask your doctor.

[Dr. Mike Varshavsky]

Yeah, exactly. That's where a great communication with your doctor goes far. And my patients call me all the time with questions like this. And we welcome it, we're passionate about it. So don't be afraid to ask those questions. Oh wait, can we talk about fevers for a little bit longer?

[Chelsea Clinton]

Yes, absolutely.

[Dr. Mike Varshavsky]

I don't know why as peoples we've gotten anti fever. When I was in the hospital, patients who were otherwise healthy, who had a mild elevated temperature were reflexively given medications to lower their fever.

[Chelsea Clinton]

Like Tylenol?

[Dr. Mike Varshavsky]

Like Tylenol, ibuprofen, whatever. And I just don't understand why. And in fact, some great researchers that are head of infectious disease programs, Dr. Paul Offit, who does great work, love Dr. Offit too. He talks about how, why are we medicating fevers and those who can tolerate a fever, who can rest with the fever, when the fever is part of our body's immune system, that helps our immune system work better and hurts the infection's ability to replicate within our bodies.

[Chelsea Clinton]

So I would ask, does not interfere with our body's immune system?

[Dr. Mike Varshavsky]

Yeah.

[Chelsea Clinton]

And also high fever should be treated.

[Dr. Mike Varshavsky]

Yeah. So that's why there is a balance there. But for me, I'll give an example as myself, not advice to anyone specifically on an individual level, but me as someone who's an otherwise healthy 36 year old person, if I have 101 fever and I know I'm sick and I know the cause and I have the flu, I don't reflexively go to lower my temperature if I need to rest. If, let's say we zoom this out to one of my patients, their heart is frail because every time your temperature is elevated, your heart rate also goes up. So if we're concerned about something we can treat, but it has to be with a treatment in mind, like why are we treating this fever? So just blindly treating fevers, I think is the issue. Not treating fevers as a whole, but just blindly reflexively treating fevers can be problematic.

[Chelsea Clinton]

This though is why it's so important that hopefully you have a good primary care doctor, you have a good primary care doctor, which you know, sadly is not true for many Americans.

[Dr. Mike Varshavsky]

Yes, rfk, let's go. Let's solve a problem.

[Chelsea Clinton]

Let's solve a problem.

[Dr. Mike Varshavsky]

Why don't we have enough primary care doctors to treat America?

[Chelsea Clinton]

Yes, well, I agree, clearly. And why also don't we have enough nurses and kind of enough just people to be able to do the work to actually help us be healthy?

[Dr. Fatima Cody Stanford]

Sure.

[Chelsea Clinton]

Maybe make America healthy, period.

[Dr. Mike Varshavsky]

Yeah, yeah.

[Chelsea Clinton]

And then keep us healthy.

[Dr. Mike Varshavsky]

And it's like he'll take out some obscure chemical out of Skittles. Titanium dioxide and like. Is that why Skittles was a problem? No. Kids are over consuming added sugars, candies. And we need to change this from a nutritional standpoint, not remove a single chemical in order to get a PR win over it. But that's what it seems like this administration is more interested in, in getting these PR wins. Staying in office, staying in power, as opposed to actually making meaningful change and

[Chelsea Clinton]

helping protect communities, whether we're here in New York City or back in Minneapolis.

[Dr. Mike Varshavsky]

Exactly.

[Chelsea Clinton]

All right, last one. There has been a lot of reporting recently about, like blue light and, you know, are we reading on Kindles at night? Is that good for us? Is checking our phones before we go to bed part of why maybe America isn't sleeping enough? Which there seems to be, you know, good agreement on that. We all need kind of more sleep and higher quality sleep. What are your own habits before bed? What do you tell your patients? Is this really where we should be spending as much kind of time, energy and focus as we are right now?

[Dr. Mike Varshavsky]

Yeah. This strikes at the heart of what's known as sleep hygiene is an interesting way to put it and probably the area where I've been the biggest hypocrite in the sense of I tell people,

[Chelsea Clinton]

thank you for being so honest.

[Emily Oster]

Yeah.

[Dr. Mike Varshavsky]

To say, hey, you shouldn't be on your phone before bed, you shouldn't be doom scrolling. And I have done that way too much in the last few years, whether it's reading bad news on social media, seeing what's going on with my friends lives, and feeling bad for them. And that's antithetical to good quality sleep. If you're gonna spike your anxiety immediately, before the time you're supposed to rest, repair and digest, you're not gonna be rest, repair and digest. You're gonna be fight or flight mode. And it makes it hard to fall asleep. And even if you are able to fall asleep, you'll have worse quality of sleep. And that's where blue light comes in. So with blue light, you get a drop in that melatonin hormone that we've talked about earlier with supplements. So that actually has been proven. We see a drop in the melatonin, the amount of sleepiness that you experience. But even when you do go to sleep, you don't go through all the phases of sleep as you would had you not been exposed to blue light, to caffeine, to all these disruptors of sleep, alcohol, marijuana that people routinely use to aid in them falling asleep. Oh, I'll just play on my phone till I get sleepy. No, it's actually not a good way to create a healthy relationship with sleep. And the biggest tip that I give, that I've been starting to institute more and works quite well is if you are trying to fall asleep and you lay there for 15, 20 minutes and you can't get out of the bed, you have. It's annoying because you're like, well, I'm so cozy. Maybe I'll get it. If you create an association with anxiety of difficulty of falling asleep in the bed environment, the next time you get into the bed, you won't associate it with restful sleep and it makes the problem worse. So get out of the bed, try and get sleepy elsewhere so that you could have that frustration elsewhere. And that when you return to the bed, you know, that's my place of comfort. Almost like Pavlov's dog. Remember that here is where you sleep. So that's a good strategy.

[Chelsea Clinton]

Is it working for you?

[Dr. Mike Varshavsky]

Yeah, actually it has. And I'll go on my couch, I'll read something, I'll try and spend time in low light environments. And then when I go to bed, I fall asleep right away. And I feel like that works quite well long term. But it's, it's not almost intuitive. It feels weird, like, why am I leaving the bed when I should be falling asleep? But I think laying there and just getting more and more mad that you're not sleeping is not a good strategy.

[Chelsea Clinton]

Getting angry before bed.

[Dr. Mike Varshavsky]

Yeah, it seems.

[Chelsea Clinton]

At yourself.

[Dr. Mike Varshavsky]

Yeah.

[Chelsea Clinton]

Or the world for sure. Seems not so healthy.

[Dr. Mike Varshavsky]

Have you ever had an issue with doom scrolling?

[Dr. Zachary Rubin]

No.

[Chelsea Clinton]

This is probably not healthy either. But when I wake up in the morning, I used to listen to the radio. I grew up listening to npr. My mom always listened to NPR when she was getting ready in the morning, I would listen to NPR or the BBC World Service. I stopped doing that because I have kids and I didn't want them to hear candidly, like all of the terrible things happening. And so like we still get newspapers, but on the weekends, so often, like on the weekends I'll be reading the newspaper early in the morning or not. On the weekends I'm reading the news early in the morning and so I wake up to the doom.

[Dr. Mike Varshavsky]

Yeah.

[Chelsea Clinton]

So it's not. I'm good about not doing that at night, but it's probably also not the healthiest. I should probably like get up and take some Deep breaths and have a cup of coffee first.

[Dr. Mike Varshavsky]

Maybe that's my next thing that I want to strive towards.

[Chelsea Clinton]

Maybe this can be a February resolution. I can't really be a February resolution. Try to have some space between when I wake up and when I kind of super saturate my neurons.

[Dr. Mike Varshavsky]

There's definitely something valuable to going for a walk, spending time away from technology for the first few minutes upon waking. There's definitely something there. And that's a struggle.

[Dr. Fatima Cody Stanford]

Right?

[Chelsea Clinton]

Okay, I've put it into the world. I'm gonna try to hold myself accountable. Whenever we're next in common conversation, you're gonna ask me how I'm doing and

[Dr. Mike Varshavsky]

I'll be honest and I'll do the same.

[Chelsea Clinton]

Now we'll hear from one of my favorite guests who will be returning with us this season, economist Emily Oster. She's a best selling author and professor at Brown University and runs a popular newsletter and website called Parent Data. She brings clarity and evidence based analysis to some of our most confusing and complex decisions that we have to make as parents. Kids don't need to get vaccinated for hep B because the president says it's a sexually transmitted disease only. Is that true?

[Emily Oster]

That's not true. Hepatitis B is actually most dangerous if it is contracted early in life because and it can be contracted from mom or from other household members. And if you contract hepatitis B early in life, it's very, very likely to lead to being a carrier, which then raises the risk of liver cancer quite a lot. So that is why we vaccinate babies at birth and the universal vaccination at birth comes about. So we make sure that we vaccinate anybody whose mom might be a hepatitis B carrier. For some people, if they know that mom is not a hepatitis B carrier, they'll sometimes wait until eight weeks to do the first vaccine, which can work in that setting.

[Chelsea Clinton]

Also, vaccines have mercury in them. Fact or fiction?

[Emily Oster]

No, that's fiction. They do not.

[Chelsea Clinton]

Vaccines have other unsafe toxins in them.

[Emily Oster]

They do not. The other one that comes up a lot is aluminum adjuvant, which is a thing that makes the vaccine work better. It is not tinfoil. People have this idea you're injecting your kid with tin foil. Like that's not true. It is a thing which makes the vaccine makes the immune system work better, but it's not tinfoil and it's not toxic.

[Chelsea Clinton]

The vaccine schedule for kids is too aggressive and should be spaced out.

[Emily Oster]

There's no evidence that kids do better if the vaccines are spaced out. The Vaccine schedule is designed to provide protection over the time period that kids are exposed.

[Chelsea Clinton]

All right, switching topics. Microplastics. I've heard that we have a credit card worth of plastic in our diets every week. Is that true?

[Emily Oster]

That number is wrong. That is far, far, far too high. It is true, though, that you have substantial amounts of microplastics in your body, or at least some microplastics in most of your organs of your body. And I think we are still trying to understand the degree to which that is problematic at very, very high doses in rats. It is problematic at the doses we see in humans. We haven't seen much evidence of that. Clearly, having a lot of microplastics in your liver is not good. There's a pretty open space, but it's not as bad as the credit card story.

[Chelsea Clinton]

How about heavy metals in baby formula? Fact or fiction?

[Emily Oster]

There have been examples of contamination of baby formula, and that is why we have regulatory environments around this. However, this general fear that formula is full of heavy metals is not true.

[Chelsea Clinton]

Also, parenthetically, why it's still really important that we have a regulatory body that checks the integrity of baby formula.

[Emily Oster]

Agreed? Yes.

[Chelsea Clinton]

So I've heard a lot about creatine. I am not taking creatine.

[Emily Oster]

What?

[Chelsea Clinton]

I'm curious, are you taking creatine? Should we all be taking creatine?

[Emily Oster]

I do.

[Chelsea Clinton]

You do take creatine?

[Emily Oster]

Okay, I do. I think there's a lot of evidence that creatine is a. So creatine helps build muscle. Build and maintain muscle mass when combined with resistance exercise. There is a lot of evidence that it is beneficial for performance in people who do, like, weightlifting. There's some good evidence that it's beneficial for performance even in endurance athletes. That's why I take it. And there is also some evidence that for adults, you know, over like 65, adding creatine to your resistance exercise can improve your muscle maintenance. So like your parents.

[Chelsea Clinton]

I should call my parents and be

[Emily Oster]

like, mom, call your parents. When I. The last time I did research on this, I emailed both my parents and my husband's parents and was like, hey, you need to start taking creatine, but also make sure you're doing some weightlifting.

[Chelsea Clinton]

And did they listen to you?

[Emily Oster]

My father always listens to me when I tell him stuff like this. And my in laws, I don't think so. I'm not optimistic.

[Chelsea Clinton]

You can ask them at Thanksgiving or whatever. You see them.

[Emily Oster]

I can be like, oh, did you bring your creatine with you?

[Chelsea Clinton]

You're like, if not I have. Should we put it on the turkey?

[Emily Oster]

If not. If not, I brought mine. I brought my giant container of creatine.

[Chelsea Clinton]

We can share seasoning. All right, so I have to do some research and see whether or not I should be taking creatine. I do take a multivitamin. How do you feel about multivitamins?

[Emily Oster]

That's stupid.

[Chelsea Clinton]

Stupid.

[Dr. Fatima Cody Stanford]

Why?

[Emily Oster]

Sorry. No, sorry. I don't mean you're stupid. Most people don't need multivitamins. Most people are not vitamin deficient. You might need iron. So many women are anemic.

[Chelsea Clinton]

And so, yes, I have been anemic at different points in my life. I am not currently. At least I don't think so.

[Emily Oster]

But yes, many, many, many women are anemic. And if you are anemic, you should be taking iron. Iron generally wants to be combined with vitamin C for absorption. But the kind of general multivitamin is really just basically a waste because people who eat a sort of typical diet get plenty of appropriate amounts of vitamins. And if you have more vitamins than you need, then you just pee them out.

[Chelsea Clinton]

We should all be wearing a continuous glucose monitor.

[Emily Oster]

No. Continuous glucose monitor is an amazing invention for diabetics because it allows them to monitor their glucose much more closely, which is really helpful for information. It can be helpful for other people in certain circumstances to try to wear for a short period of time and figure out things about how your glucose varies. But for the vast majority of people, this is not gonna be a relevant technology.

[Chelsea Clinton]

What have I not asked you about that I should have? What's, like, the one thing you think

[Emily Oster]

the number one question that parents ask me is, can I get Botox while I'm breastfeeding? Number one, every single week on my Instagram stories, every single week, people ask if you can get Botox when you're breastfeeding. The answer is yes. So if you are a listener here and you are hoping to get Botox while you're breastfeeding, it's fine.

[Chelsea Clinton]

You know what, Emily? If you had asked me for, like, the list of, like, the top 100

[Emily Oster]

questions, you never would've come up with that.

[Chelsea Clinton]

No, I would have been like, is there arsenic in rice cereal? Should I still keep taking prenatal vitamins while breastfeeding?

[Emily Oster]

I get all those questions, but nothing as much as Botox while they're breastfeeding. I think it's because you and I are, like, a few years too old for the Botox situation.

[Chelsea Clinton]

I'm speechless. That doesn't happen to me very often. What's Number two, like, can I get fillers?

[Emily Oster]

That does come up, but not that often.

[Chelsea Clinton]

Okay.

[Emily Oster]

Something about GLP1s. Can I date GLP1s at this time? That time, like, GLP1s are a big. A big topic space now also, while

[Chelsea Clinton]

breastfeeding or just generally.

[Emily Oster]

Yeah, people want to know while they're breastfeeding.

[Chelsea Clinton]

Well, again, like, I'm grateful that people are asking you that. They trust you to tell it to them straight in a way that is not ideological to you, but rooted in kind of your expert read of the evidence.

[Emily Oster]

Exactly. That's my job.

[Chelsea Clinton]

Just final question. What advice do you have for all everyone who's navigating this moment? Do you have a kind of piece of parenting advice that's particularly salient for navigating this or kind of personal mantra in addition to your daily dose of creatine?

[Emily Oster]

Take creatine. I think people could stand to hear that it's okay to not engage for some period of time. Like, like, it's, you know, if. If it's going to improve your mental health to, like, put down your phone for a couple days and not check on the news that often, like, that's okay. I think we need to give people more permission to hold that part of their mental health a little bit. There's so much information. There's so much stuff to worry about. It's not that I think people should disengage, but I also think we. We need to balance the desire to engage and to try to help in whatever way we can with a need for sometimes taking a break.

[Chelsea Clinton]

And if a parent is worried they're going to miss, like, some great new piece of data around something we should be doing kind of with our kids or for our kids or protecting our kids kind of from something, if they get to it next week, that's probably okay.

[Emily Oster]

Yeah. If it's actually important, it will still be there next week. And if it's not important, it will be gone. And then you will not be sorry that you missed it.

[Chelsea Clinton]

Like, I'm so thankful I missed it that her.

[Emily Oster]

You missed her.

[Chelsea Clinton]

A child missed her child.

[Emily Oster]

You missed the whole thing.

[Chelsea Clinton]

You didn't even miss the whole thing.

[Emily Oster]

You didn't have to worry about it. Exactly. That was so great for you.

[Chelsea Clinton]

And I'm sure that it was also good for my kids, because I think if I had been anxious about that, like, that anxiety permeated onto my kids as I was like, we got to tie our shoes and get to the bus on time.

[Emily Oster]

I told my daughter this, and she was like, of course I'm going to be an anxious person because I'm your kid. I don't think it's about rushing me. I was like, that's what it is. It's the genetics.

[Dr. Tricia Pasricha]

Thanks.

[Chelsea Clinton]

Next is Dr. Fatima Cody Stanford, an obesity medicine, physician and scientist at Massachusetts General Hospital and Harvard Medical School and one of the leading voices on how we, or at least we should, think about weight, health and chronic disease. I'm going to start with something that we didn't talk about and maybe we should have in the main interview. Okay, BMI is outdated and we should get rid of it. Fact or fiction?

[Dr. Fatima Cody Stanford]

Fact.

[Chelsea Clinton]

What should we use instead?

[Dr. Fatima Cody Stanford]

So I was one of the Lancet commissioners that published a full thought process at the beginning of January of 2025 that basically eliminates BMI for everyone that's under a BMI of 40. And it looks at waist to height ratio and it gets rid of this idea of just height and weight being a simplification of our weight status. So that's outdated. It should have never been used.

[Chelsea Clinton]

People can live in bigger bodies and be perfectly healthy. Fact or fiction?

[Dr. Fatima Cody Stanford]

I think that there's more nuance to that. I think we have to look beneath the hood, and when I say beneath the hood, like, look at what's going on in the insides. So you can't just say, you know, you're healthy. Just, you know, if you're either living in a leaner body or one that has, you know, carries more excess weight, you have to do an internal investigation, like, what's going on inside of that leaner body. Maybe that leaner body isn't healthy, and maybe the larger body is healthier, but what's really going on inside of that body, which is why I do a full workup of that individual before I can make that assessment. So I think there's more nuance to that.

[Chelsea Clinton]

GLP1s can affect your risk for cancer.

[Dr. Fatima Cody Stanford]

There are definitive studies that are showing that GLP1s can likely reduce the risk of multiple types of cancers. I've published some of the research. I'm working with individuals and helping to advise their research on this area. I think there's more to come in this area, so I think that we'll see some very promising data that is going to continue to come forward as the years move on. In this, this domain, in multiple areas

[Chelsea Clinton]

of cancer, there's this phrase, quote, unquote, ozempic babies, babies who are born to parents who are on GLP1s. Can GLP1s help you get pregnant fact or fiction?

[Dr. Fatima Cody Stanford]

Fact. GLP1s do seem to increase fertility. They seem to reduce inflammation within the body, which can impede individuals that are having issues conceiving, particularly individuals that have a history of things like pcos or what we call polycystic ovarian syndrome, or even individuals that may not have that carry that diagnoses but may have excess adiposity or other issues. We are seeing this actually happen. We do prefer for patients to be off of GLP1s for two months prior to conception. That is the label for all GLP1s. But we have seen this happen frequently.

[Chelsea Clinton]

Consistent use of apple cider vinegar or any supplement can help you lose weight.

[Dr. Fatima Cody Stanford]

There's no data to support that, so I would say fiction. Apple cider vinegar is a bactericidal, so meaning something that kills bacteria. I think that it can make you feel good because it's just killing some type of bacteria in the system. But there's no consistent data to support that.

[Chelsea Clinton]

So. Last question. You're never too old or sick or at a certain weight to make changes to help you be healthier.

[Dr. Fatima Cody Stanford]

Fact.

[Chelsea Clinton]

Fact.

[Dr. Fatima Cody Stanford]

Absolutely fact.

[Chelsea Clinton]

And to close things out, here's Dr. Zachary Rubin, a double board certified pediatrician and allergist who shares practical advice on allergies, asthma vaccines and more. Really helpful to us as parents and also for ourselves, we like to end the show on a segment called Fact or Fiction. So the one I want to start with is something that I certainly have heard my entire life, that vitamin C and zinc, particularly in the winter, help boost your immune system and help you avoid getting sick and hopefully help you recover more quickly if you do get sick. So vitamin C and zinc boost immunity. Fact or fiction?

[Dr. Zachary Rubin]

That's fiction. My question back to you is how do these things boost your immune system? When people say that, I would love to know how they actually boost it. I have no idea. Nobody knows. What do you mean? Increase the antibody production, your T cell responses, complement proteins. I mean, what are you actually boosting?

[Chelsea Clinton]

They give little capes. They give little capes maybe to the little orange, like vitamin C, capes.

[Dr. Zachary Rubin]

I mean, vitamin C is just gonna make expensive pee.

[Chelsea Clinton]

Expensive pee?

[Dr. Zachary Rubin]

Yeah, yeah. I mean, if you. Obviously if you're deficient in a vitamin, you gotta supplement, you should take it. Yes, but people who are out and about healthy, they don't have underlying chronic issues. If you take different supplements or vitamins, oftentimes it just gets excreted. And so I like to joke a little bit that you're just emptying your pockets and Making expensive pee.

[Chelsea Clinton]

I'm not going to forget that either. Kids should be playing in the dirt and trying to get as as much stuff on them as possible because it helps build their immune system. Fact or fiction?

[Dr. Zachary Rubin]

That's a bit of a fact in the sense that we should encourage kids to play outside, not just for exercise and social benefit. But exposures to healthier microbes does have an impact on the immune system that as it's developing, you need certain exposures, not infections. I want to make that very clear. It's not infections. It's the healthier, what we call old friends hypothesis that there are certain microbes that you do need some exposure to. So if you're getting your hands into dirt, little things like that are not that big of a deal. It's partly why we see lower rates of allergic diseases in the Amish community, because with their traditional farming practices, they're exposed to healthier microbes. But if you're in an urban environment, you're not necessarily getting that same type of exposure. So it's not always hyper cleanliness, it's just what is the right exposure.

[Chelsea Clinton]

But don't eat the dirt.

[Dr. Zachary Rubin]

Oh, don't eat the dirt.

[Chelsea Clinton]

No, don't eat the dirt. At home. Allergy tests with food swabs or mail in kits are accurate. Fact or fiction?

[Dr. Zachary Rubin]

Fiction. So the problem with at home testing for allergies is sometimes they're not even testing for a clinically relevant thing like food sensitivity tests. They're testing for something called igg, which is an antibody you make naturally in response to just eating food to protect you from having an allergic reaction. So the problem with doing it at home is you don't have expert interpretation because these tests are not easy to interpret and it may end up causing false positives, meaning it says you're allergic to something when you're not and create a lot of unnecessary anxiety and potentially nutritional problems.

[Chelsea Clinton]

You can cure allergies. Fact or fiction?

[Dr. Zachary Rubin]

Unfortunately, it's fiction. There's really no cure for allergies at this point. The immune system decides when it wants to stop being allergic to things and tolerate them. You know, if you have a baby who's allergic to eggs, they're more likely than not to outgrow that and be able to tolerate eggs later in life. But peanut and tree nuts, a lot less likely. So cat allergies tend to be persistent throughout life, but some people now and again will lose that allergy. But when we do allergy shots, it's not technically a cure because the treatment can reverse on Itself. If you stop it, it may go back to being allergic in the future.

[Chelsea Clinton]

Since you mentioned cats, I do have to ask as someone who had a cat as a child whom I loved very much, even though my mother was allergic to cats, so it was a great act of love for her to permit me to have a cat. I'm curious, if you are allergic to cats, can you now get a hypoallergenic cat? Is that real fact or fiction?

[Dr. Zachary Rubin]

That's fiction. There's no such thing as a hypoallergenic cat, despite what people may tell you. Or dogs for that matter. If your cat has saliva, urine and skin cell, they can produce allergens. And especially for cats, even a small amount can provoke severe allergic reactions for people. For me as an example, I used to be severely allergic to cats until I put myself on constant immunotherapy, on constant shots. I would wheeze at my brother's place.

[Chelsea Clinton]

I was about to say, why did you do this to yourself? Because someone in your life also had a cat?

[Dr. Zachary Rubin]

Yes, yes. My brother and sister in law have two cats. I think they actually just recently fostered some too. So now when I go over there, I'm just mildly itchy. But. But it used to be pretty severe for me as an example. So there are newer technologies being developed and there's a type of cat allergy food that you can give cats to neutralize some of the allergy antibodies in their saliva.

[Chelsea Clinton]

There's a food that you can give the cat so the cat provokes less of an allergic reaction in someone who has a cat allergy.

[Dr. Zachary Rubin]

Yes.

[Chelsea Clinton]

Oh, wow.

[Dr. Zachary Rubin]

So just to give conflict of interest disclosure, where I trained at Washu and St. Louis, it's right by the Purina's headquarters. So some of the allergists that I trained under, they helped develop this.

[Chelsea Clinton]

Wow.

[Dr. Zachary Rubin]

So it's Purina's Pro Plan Live Clear formula where it's a really fascinating way that they developed it. They immunized chickens with the cat allergen protein called Feld1 that's normally found in their saliva. Those chickens made a neutralizing protein called an IGY antibody that gets into the egg yolk. They take the egg yolk, sprinkle it on the food, the cats eat it, and after a month, they measured out almost a 50% reduction in cat allergen proteins.

[Emily Oster]

I'm fascinated by that.

[Chelsea Clinton]

What other very cool interventions could you share with us? Are there others?

[Dr. Zachary Rubin]

This is why I love what I do, because we're constantly getting new breakthroughs. So one of the more recent ones is there's the first ever FDA approved medical treatment for a drug treatment for food allergies. It's an older medication that was originally designed to treat food allergies that got shifted towards asthma, chronic hives, nasal polyps. It's called Omalizumab or Xolair. It's an injection that's given every two to four weeks that blocks the allergy antibodies from activating mast cells. So if you have a peanut allergy, as an example, the clinical trial showed amongst almost 200 kids and adults that if they were to get this for four months, they would be able to tolerate about four peanuts without having a reaction. So it gives you that buffer zone in case something happens. Not a cure, but that's a huge step in the right direction. Or we now have EpiPens that have been converted into a nasal spray called Nephi, where instead of having to use a needle to inject yourself for a severe allergic reaction, it's the same device as Narcan, but for anaphylaxis as an epinephrine nasal spray. So we are consistently finding new and novel ways to help treat people with allergic diseases and I'm excited for the future.

[Chelsea Clinton]

I hope you enjoyed this special episode of that Can't Be True. You can find the full episodes with all of these guests in our feed and we'll be back with a new episode next Thursday. Thanks for listening. Talk to you next week. That Can't Be True is a production of Limonada Media and the Clinton Foundation. The show is produced by Katherine Barnes, mix and sound design by Johnny Vince Evans. Kristen Lepore is senior Director of new content and Jackie Danziger is VP of Narrative and production. Maggie Kralshore is our Managing Director of Partnerships. Executive producers are Jessica Cordova Kramer, Stephanie Whittles, Wax, and me, Chelsea Clinton. Special thanks to Erika Goodmanson, Sarah Horowitz, Francesca Ernst Kahn, Caroline Lewis Sage, Paige Falter, Barry, Lurie Westerberg, Emily Young and the entire team at the Clinton Foundation. You can help others find our show by leaving us a rating and writing a review. And if you can think of someone who might benefit from today's episode, please go ahead and share it with them. There's more of that Can't Be True with Lemonada. Premium subscribers get exclusive access to bonus content when you subscribe on Apple Podcasts. You can also listen ad free on Amazon Music with your prime membership. Sam.