← That Can't Be True with Chelsea Clinton
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- [00:02]
Emily Oster
Lemonade.
- [00:07]
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. Today I'm talking with Emily Oster. She's an economist, bestselling author and professor at Brown University. She runs a popular newsletter and website called Parent Data. And she's known appropriately for bringing clarity and evidence based analysis to some of our most complex decisions that we face as parents.
- [00:32]
Emily Oster
Parents.
- [00:33]
Chelsea Clinton
I first encountered Emily when I read her book as an expectant parent in 2014, I read expecting Better. That really was the product of her first pregnancy as she tried to navigate what was true and not true as a new parent. That meant a lot to me as I was expecting my first child, Charlotte. And clearly I wasn't the only one. She's here to talk about Tylenol, autism vaccines, supplements and all sorts of other things that are in headlines these days. Super excited to bring her on. Emily, welcome to the show.
- [01:10]
Emily Oster
Hi, how are you?
- [01:11]
Chelsea Clinton
You know, how am I? I'm many things. That's my answer these days.
- [01:16]
Emily Oster
Totally. Everything's going great. No complaints.
- [01:19]
Chelsea Clinton
I'm many things. Like my children are hilarious. Although my six year old woke me up three times last night, so I might just be awkwardly consuming unhealthy, I have no doubt amounts of caffeine throughout our conversation.
- [01:33]
Emily Oster
That sounds great. My older kid woke me up right before I went to sleep. So even if you have a teenager, sometimes they will wake you up and ask you for a thing.
- [01:43]
Chelsea Clinton
Was it a necessary wake up?
- [01:44]
Emily Oster
Yeah, I think as they get older the wake ups get more necessary or at least you know, less. Like give me a hug.
- [01:51]
Chelsea Clinton
I know that. I promise we could start the conversation, but I will say the last thing is like, even when his name's Jasper woke me up for the third time at 3:10 this morning, I was like, oh gosh. But you are so cute and cuddly and at some point you're probably not gonna just wake me up.
- [02:05]
Emily Oster
Cause you need a hug.
- [02:06]
Chelsea Clinton
Because you couldn't go back to sleep after the last nightmare that you had. And the nightmare like thankfully, knock on wood. Like the nightmares my children have are often like a hippo fell on me in the middle of the night and I'm like, oh sweetheart.
- [02:17]
Emily Oster
Like that's not gonna happen.
- [02:18]
Chelsea Clinton
That's not gonna happen. It's so great that I can't.
- [02:20]
Emily Oster
You hippos. It is a very dangerous animal though.
- [02:23]
Chelsea Clinton
Yes, but not falling from a ceiling in New York City.
- [02:26]
Emily Oster
Right?
- [02:26]
Chelsea Clinton
If we were like in a river in Botswana, maybe but in an inflatable.
- [02:32]
Emily Oster
Raft because they actually have the very sharp tusks anyway, hippos.
- [02:35]
Chelsea Clinton
But truly, Emily, this is like such a joy. For reasons that I will share in the conversation.
- [02:39]
Emily Oster
I'm really excited. Thank you for asking me.
- [02:42]
Chelsea Clinton
So let's start today's show, as we always do, with something that just can't be true. And certainly what has been top of mind for me, and I know many parents and non parents alike, is Tylenol. President Trump recently said that taking Tylenol during pregnancy can increase a child's likely likelihood of autism.
- [03:02]
Emily Oster
And I will say there are parts.
- [03:03]
Chelsea Clinton
Of the world that don't take Tylenol.
- [03:05]
Emily Oster
I mean, there's a rumor, and I.
- [03:07]
Chelsea Clinton
Don'T know if it's so or not, that Cuba, they don't have Tylenol because they don't have the money to fight.
- [03:11]
Emily Oster
Tylenol and they have virtually no autism. Okay, tell me about that one. And there are other parts of the world where they don't have Tylenol where they don't have autism. That tells you a lot.
- [03:25]
Chelsea Clinton
So, Emily, does this tell us a lot? I mean, President Trump himself says he doesn't know what's true or not. What do you think?
- [03:34]
Emily Oster
That fact alone does not tell us a lot. I think there's many pieces of that which are not true. I'm quite confident that you can access acetaminophen or paracetamol in Cuba and that also autistic traits exist among people in Cuba. But this general idea that you could ever learn anything from that type of evidence is not, is not true. And we can talk more about what we do know from the evidence on Tylenol and autism, which is that there is no link there. But that sort of set of amalgamation of facts would never tell us anything, either positive or negative about that link. It's just a bunch of sort of unrelated pieces of information.
- [04:20]
Chelsea Clinton
You know, Emily, you wrote a book that I read, Expecting Better when I was pregnant with my daughter in 2014. And you so appreciated kind of what you did in that book. And that I know has been kind of a central force of your work and your life and your mission, you know, in the decade plus since, which is effectively to be like a data interpreter in chief for expectant parents, for new parents, for maybe not so new parents. And I think you first, you know, addressed questions around Tylenol and acetaminophen, you know, in, in 2014. So this is also not a new set of questions. So as someone who spent dare I posit more time than President Trump kind of looking at this evidence, maybe, arguably looking at any evidence. What does the evidence say about Tylenol and any possible effects, positive or negative, on kids health?
- [05:21]
Emily Oster
Yeah. So I think it's, it's useful in this conversation to start with why we might have thought there was a link, because I often think when we're having these discussions, it can, you can immediately switch to, you know, well, there's no link like, trust me, I'm an expert, but I actually think people are much more likely to trust you if you explain why. So there is a large literature which shows a correlation between consumption of typically quite a lot of acetaminophen during pregnancy and neurodevelopmental issues in kids. So that is to say, people who are taking a Tylenol sort of more than 28 days during pregnancy are perhaps 1 percentage point more likely to have a child diagnosed with ADHD or autism. So there's a couple of things to say about, about that. One is that those effects are quite small actually, relative to, say, the rise in autism over time. But, but also, whenever we see evidence like that, we want to ask the question, well, is there something different about the people who are taking more Tylenol during pregnancy other than just the Tylenol? And the answer is yes, there are very big demographic differences across those groups, and there are also very big differences in the conditions that people have. And those differences, it seems very plausible, are in fact driving this small correlation we see in the data. So then, as a person who loves data, as a researcher, people want to ask, okay, well, how could I get better data on this? How could I better adjust for these other differences across people? And it turns out in this context, the, probably the best way we have to do that is to compare siblings. So take siblings where, you know, during one pregnancy, mom took more acetaminophen, and during another pregnancy she took less, and ask whether the autism rates are different across the siblings there. And the advantage of that kind of analysis is you can actually hold constant who the mom is and other characteristics of the family environment and so on. And when you do that, and there are some very good studies, there's like the sort of best one that people Citel, it's not the only one is in Sweden. It's like a whole population of Sweden, you know, millions of people. When you do that, you see that there's in fact no link when you compare within a sibling group between Tylenol and pregnancy and autism. So I think what I would say is it's not surprising that this would come up as a discussion point because of the correlation. But when you look for causal evidence, you do not find it. And causal evidence is the thing that we should care about, because what we really want to say is, as a person, you know, holding constant who you are, if you took Tylenol during pregnancy, would you be more likely to have a kid with autism? That's a causal statement. And the data says that there is no causal link there. And that is not true as a causal statement. And.
- [08:11]
Chelsea Clinton
And we know that the risk of high sustained fever in pregnancy actually can be a cause.
- [08:18]
Emily Oster
Yes.
- [08:18]
Chelsea Clinton
For quite serious adverse events for children.
- [08:23]
Emily Oster
Yeah. I mean, I think that's like such a great example of what happens when we try to rely on poor data and we don't take it all the way down the line when we look at one risk and we don't then look at all the accedent risks that are, are related here. And yes, indeed, it is true that fever, high fever during pregnancy is linked with neurodevelopmental outcomes. So it's reasonable to say if you told people, never take any Tylenol, you actually might get more of these issues rather than less.
- [08:51]
Chelsea Clinton
What do you think? As someone who spends a lot of time looking at a lot of data, what do you think explains the apparent rise in autism rates in the United States? Not Cuba.
- [09:01]
Emily Oster
Not Cuba. So I think the most important driver of the, of the rise in these diagnosis is a change in diagnostic criteria. So when we sort of think about explaining the rise in autism diagnoses, which has been very large from, you know, 2000 to 2022, this went from, you know, 1 in 150 to 1 in 31. Most of that increase, certainly the majority, possibly the vast majority, is a result of changes in how we define autism. So moving some diagnostic conditions that used to be Asperger's used to be defined in other ways, moving that into the autism diagnosis. So that's one feature, and then changes in sort of awareness and screening behaviors. So the AAP started doing more universal screening of kids, and that's good because that means that we are picking up diagnoses in kids that are probably more mild, but are in a wider variety of kids, maybe presenting in different ways, and then those kids can get, get, you know, services that they need, help that they need, etc. So this kind of package of diagnosis, screening incentives for a diagnosis behavior explains a very large share of the increase. It's not entirely clear whether that is 60%, 80%, 90%. You know, it's probably not 100%, but now we're looking for sort of much smaller other things that might describe it. And I think that is where there's really open questions about what is going on. So parental age is probably playing a role. Some people think environmental contaminants play a role. I think the evidence there is not yet super conclusive, but it's a useful thing to look at. And then there's some interesting theories about assortative mating, that people who have characteristics that are sort of in the direction of the autism spectrum are more likely to marry other people with those characteristics. And that has driven it. But again, these are all likely to be very relatively small. But actually we're looking to explain a relatively small increase because so much of the increase is in fact about diagnosis.
- [11:12]
Chelsea Clinton
Emily, I think one of the areas that I certainly appreciate your real clarity around is how you have written about and spoken about vaccines often. Also pointed to by our current Secretary of Health and Human Services as being a, not just a slight but a large cause of the rise of autism rates. I wonder if you can, you know, just reflect why you believe so strongly that isn't a cause.
- [11:44]
Emily Oster
Yeah. So the idea that vaccines cause autism is a. Is a, like a fairly old one. And I think I would often trace it, although maybe it would come up before this to Andrew Wakefield, who is a, who was a doctor, not anymore, but was a doctor. Disgraced, disbarred, Delicense. Word.
- [12:03]
Chelsea Clinton
Delicence. Is that a word? Should be a word, yeah.
- [12:06]
Emily Oster
Doctor in the UK who wrote a paper in the, in the 1980s in which he claimed that based on a case series of data that, you know, vaccines, the MMR vaccine in particular, was leading to sort of gut issues which then led to autism. You know, it turned out that paper was not only like wrong in the kind of senses that we talk about causality versus is correlation, but literally fraudulent fraud. So it was fraud. He had made up. He made things up.
- [12:33]
Chelsea Clinton
He made things up. And he also was working on his.
- [12:36]
Emily Oster
Own vaccine and also was working on a lawsuit. So there were like.
- [12:41]
Chelsea Clinton
And a lawsuit like he was trying to discredit.
- [12:44]
Emily Oster
There were a few reasons.
- [12:45]
Chelsea Clinton
Yeah. For just good old fashioned like charlatan for money.
- [12:48]
Emily Oster
Yeah, he's a charlatan grifter. And that was what that was. And so that is kind of one origin. And it's pretty clear that particular paper is kind of. That was not good. It was a lie. But this idea of the link between vaccines and autism then sort of took on its own contours. And there are many other. Also very bad in different ways papers which make sort of similar claims. We do have quite a lot of quite good data on vaccines and autism, which doesn't show any link. So we have large studies with millions of kids which show no link between routine vaccinations and autism. So this is a place I think many people find very frustrating. I certainly find it frustrating because it feels a bit like kind of whack a mole where, you know, even in RFK's confirmation hearing, yet another, you know, new study, quote, unquote, new study was raised. He raised. And like, you know, this is a study that shows a link, and if you go and you visit that study, you know, it's not in a journal, it's in an online blog. And it sort of has the many, many methodological problems, but it's a hard space to argue with because I feel like constantly people are gonna be like, what's this study? And it's like, again, I have to go into why that particular study is flawed in some way when we do have very good data that just shows no, no link. But this is a discussion that refuses to die.
- [14:20]
Chelsea Clinton
Refuses to die. And yet we know kids are dying, right? We've had children die of measles this year. We've had children die of whooping cough this year. So. So it's not as if kind of these efforts to discredit vaccines, for whatever reason, kind of almost ideological, I would say for some. I would say for many, you know, disgraced Andrew Wakefield, but also RFK Jr often with real kind of profit motivations.
- [14:48]
Emily Oster
I have to say, I think RFK Jr. Just believes this. Like, I genuinely, like, my view is, you know, I don't. I don't think he's right. Uh, but I think they really think it's sincere. I think he sincerely believes this. And I. I mean, I wish I understood it better because I think the evidence to me feels so clear, and I would love to be able to sort of sit down and try to understand, like, what are you. You know, what. Like, what is driving this belief. But I. I think that that is a genuine, sincere belief. I don't think that's true of everybody in this, in this space, but I think that. I think that is a genuine, sincere belief. I just. Not right.
- [15:19]
Chelsea Clinton
And if his son profits off of a lawsuit that he helped file, and if the Children's Health Defense Fund receives lots of dollars from people who feel the same way, that's just like a happy coincidence.
- [15:31]
Emily Oster
I, I mean, look, there's, there's a lot of money in everything. Let's put it, let's put it that way. I suspect he genuinely believes this, and.
- [15:39]
Chelsea Clinton
You might be right. I think it's unfortunate that someone who is impervious to evidence, you know, certainly is sitting atop what should be the most evidence based job, arguably in the federal government.
- [15:53]
Emily Oster
I think that is very, very true. Yes.
- [16:03]
Julia Louis-Dreyfus
Well, hi everybody. It's Julia Louis Dreyfus from the Wiser Than Me podcast. And I'm not gonna talk about food waste this time. I'm gonna talk about food resources. All that uneaten food rotting in the landfill, and it could be enriching our soil or feeding our chickens because it's still food. And the easiest and frankly, way coolest way to put all its nutrients to work is with the mill food recycler. It looks like an art house garbage can. You can just toss your scraps in it like a garbage can. But it is definitely not a garbage can. I mean, it's true. I'm pretty obsessed with this thing. I even invested in this thing. But I'm not alone. Any mill owner just might corner you at a party and rhapsodize about how it's completely odorless and it's fully automated and how you can keep filling it for weeks. But the clincher is that you can depend on it for years. Mill is a serious machine. Think about a dishwasher, not a toaster. It's built by hand in North America and it's engineered by the guy who did your iPhone. But you have to kind of live with mill to understand all the love. That's why they offer a risk free trial. Go to mil.com wiser for an exclusive offer.
- [17:46]
Chelsea Clinton
You know, I know you often say so much of your work is kind of breaking down what you call panic headlines. We started off this conversation talking about Tylenol. We've talked about vaccines, which, while maybe not classified as a panic headline, could be classified as panic headlines now over decades. What are some other panic headlines that you've addressed recently or maybe not so recently that you think have been really important for you as an academic, also as a parent, and as someone who really does think it's important that people understand kind of what's, what's trustworthy and not?
- [18:25]
Emily Oster
Yeah, so there's two categories of these kind of like panic headlines for, for parents, only two.
- [18:31]
Chelsea Clinton
Emily.
- [18:32]
Emily Oster
Oh, okay. They're very broad. So there are things we tell parents about the ways they're messing up their kids. And so one like category of this is, the example that always comes to mind is people got told, this may be six months ago, we started talking about a thing called hurried child syndrome.
- [18:51]
Chelsea Clinton
I totally missed this.
- [18:52]
Emily Oster
Okay, so this was like, this was like an all over people's Instagram feed was like, if you rush your kid out the door, they will develop anxiety as a result. Like you will. There is, you're gonna create a hurried child.
- [19:04]
Chelsea Clinton
I'm like, oh my gosh, we have to go to the bus. We have to go to the bus.
- [19:07]
Emily Oster
Yeah, get your shoes on. We gotta go to the bus. Like, that's it. Now your kid is like anxiety disorder for life. And for parents, this is the kind of thing where of course, when you reflect on it, like in a quiet, calm moment, you're like, well, that can't possibly, like, that can't possibly be right. But you know, in the moment when you're, when you're getting told that when it's getting sort of pushed on you out of your, your Instagram feed or, or your TikTok or whatever, whatever it is, I think it is very, it is very anxiety provoking. And so, you know, I think sort of with something like that, what I, what I can do that I think is valuable is try to figure out, like, what is this?
- [19:42]
Chelsea Clinton
Where did this come from?
- [19:43]
Emily Oster
Where did this come from? And it turns out there is a thing called hurried child syndrome and actually has nothing to do with this. It's like the idea that kids do too many extracurriculars and like, we kind of are pressuring them to be adults before they're ready, which is an interesting set of issues. Fundamentally very different than having to get to the bus with your shoes. And, you know, we can sort of then dial down the anxiety. But I think there are many things in parenting where we've given parents the impression that like, every moment with your kid is an opportunity to mess them up first forever. And that, that's like, that's just not true. Like, it is possible to mess your kid up, but it's not that easy. And it's, it's not. Every moment is not an opportunity to do it.
- [20:21]
Chelsea Clinton
Have you found any claims that have been particularly persistent over the last, like, decade plus that you've been doing this work where, you know, I know we already talked about vaccines where you feel like you play whack a mole, but are there others like that?
- [20:34]
Emily Oster
Toxins.
- [20:35]
Chelsea Clinton
Okay, talk to me about toxins.
- [20:37]
Emily Oster
I don't know, terrible toxins. So toxins are, I'll give You two. So, so one is toxins. And that's like a very difficult thing to. To discuss because people will be like, I heard that you need to do this to flush toxins. It's like, what do you like? It is true that like our bodies are equipped with like the liver and kidneys and they, you know, flush out things that would otherwise be toxic. Like that's their job. But the idea that you'd have to, you know, go on a juice cleanse or do something like, like that toxins are something that somehow are effect. Like that's not. That's not true. I don't even. I don't even. I don't even know what it means. So it's a very diff. That's a very difficult one. And then the other thing that comes up all the time is lead. And it's actually kind of interesting because lead is.
- [21:23]
Chelsea Clinton
Lead is a toxin.
- [21:24]
Emily Oster
Lead is toxic. And you know, having a lot of lead in your system is. Is bad. And over time, in the US There has been a sort of tremendous gains in our, like, limiting kids lead exposure. So now when you like get your kid tested for lead, your kid might test high for lead. That high level of lead has come down and down and down and down over time. Like when we were kids, like it was probably 5x, what it is now was the sort of limit. And as we have no unleaded gasoline and as we've like limited leaded paint, like everything has gotten. And that's really good. Like, just to be clear, those declines are broadly good. But we've gotten to a place where kind of people are afraid of even tiny amounts of lead. So California instituted a rule that. Where they have a thing called the maximum allowable daily limit of lead.
- [22:19]
Chelsea Clinton
Yep.
- [22:20]
Emily Oster
Which is set at I think 1/1,000th of the amount that has ever been shown to cause harm. So it's a very, very, very, very, very, very conservative limit. And as a result, nearly every food that you would ever consume, some version, some packaging of it, will have that amount of lead because things have lead in them. There's some lead around, and your body is able to process some lead. Not infinite amounts of lead, but definitely some lead that is possible. So one of the pieces of panic headlines people get a lot is like, you know, all of these foods have lead in them. They all have like, they're all poisonous. And because of this like, weird limit, we've created a cottage industry of people who are able to test foods, say, you know, this food has 1/20 of the maximum allowable daily limit in California. Like, it's really dangerous. And you have to be like, actually, that's 1/20 of 1.1000th of the dose that has ever been shown to show. Like. So I think. I don't know quite how to. How to describe this, but we've kind of, like, taken something which is good, which is like, we are trying to limit lead and actually have done an incredible job of that over the past several decades and turned it into something that's scaring people.
- [23:33]
Chelsea Clinton
Yeah. Well, Anne, then even in that vignette, I was reflecting how if we're spending so much time, whatever time we all have in our kind of brains and our hearts focused on that conversation around lead, we're probably not spending the time we should be spending as Americans focused on what we still owe the people of Flint, for example, to ensure that, like, we are supporting children who were exposed to toxic amounts of lead.
- [24:01]
Emily Oster
Yes. I think there's a more general point here, which is a lot of these conversations that are sort of like, what are all the things I could be doing to do better for my kid are happening in. In places where the. The marginal investment is, like, zero.
- [24:16]
Chelsea Clinton
Emily, do you. Do you want to be a little more blunt there?
- [24:19]
Emily Oster
It's like, yeah, rich people are talking about this, and we are not recognizing that there are a tremendous number of people with fewer resources who are not getting even basic services.
- [24:29]
Chelsea Clinton
Yep. Thank you.
- [24:30]
Emily Oster
And so we're like, we're having a conversation in one space that is in some ways not important and missing this opportunity to have a conversation about, like, how can we make sure that every kid in America has, like, enough to eat, a safe place to live, is not exposed to, like, toxic levels of stress before the age of three and arrives at kindergarten, like, ready to learn to read and be productive? Like, if we could do those things, we would have so much more impact on the, like, global sense of how good people's lives are than trying to worry about, you know, whether this pouch of applesauce has a minute amount of lead, which it does not, or who cares if it does.
- [25:11]
Chelsea Clinton
Yeah. I think that's part of why I struggle with this administration and their claim to be so committed to making America healthy. It's both, clearly, because I don't kind of share their views, which I think are not backed by anything you or I would consider evidence around things like vaccines. It's also, though, an administration that is simultaneously dismantling clean water and clean air protections, considering dismantling food safety standards, the ability to effectively Kind of monitor the safety of our food supply. And so it's hard to square all of that, as well as, of course, the cuts to supplemental nutritional assistance to supplemental nutrition for women and children through the WIC program. And so I think it seems deeply inconsistent to me.
- [26:01]
Emily Oster
Yes, it's deeply inconsistent. I think there's also, like, a sort of almost a lost opportunity here. And the place that I think about it the most is in, like, school lunches. So, you know, the school lunches for many kids are actually the best, like, the most nutritiously dense meal that they are offered during the day. And the idea that we should improve the quality of school lunches has long been the purview of the left. You know, Mrs. Obama was really into this.
- [26:29]
Chelsea Clinton
I mean, they're also the left fought back when President Reagan wanted or his administration wanted to classify ketchup as a vegetable.
- [26:34]
Emily Oster
Exactly.
- [26:35]
Chelsea Clinton
And tomatoes are fruit, Right? Tomatoes are fruit. I'm like, it's not even, like, based in a vegetable.
- [26:40]
Emily Oster
But, you know, this. The sort of. One of the pillars of the. Of the Maha movement is about improving diets. And there is a lot of focus on, let's improve diets for our kids. And that is good in the sense that there is a real opportunity to improve, and school lunches would be an opportunity to do that. And, you know, it's frustrating for me to think that we're kind of, like, focused on getting rid of vaccines when we. We could. There could have been an opportunity in a sort of like, Nixon goes to China kind of moment to be like, okay, yeah, like, the Democrats have always really been into school lunches, but, like, we're gonna be into school lunches now, and we're gonna do something different. We're thrilled by, you know, we're gonna make school lunches fun.
- [27:20]
Chelsea Clinton
I'd be thrilled by that.
- [27:22]
Emily Oster
And instead, we haven't done that yet.
- [27:25]
Chelsea Clinton
Since we've talked about toxins and cleansing, one of the things I, you know, also really appreciate about you is the effort to help parents, for ourselves and also for our kids, understand how important sleep is. I mean, I didn't get a lot of it last night because of children. One of my kids was up a lot, which just means I'm gonna be even hopefully more grateful for sleep tonight. Why do you think sleep hasn't kind of permeated more into the wellness and health conversation? Although I think it is starting to happen.
- [27:55]
Emily Oster
I think it's starting to happen. I think, you know, we have had. There's a sort of. Was a period in which kind of like, I sleep four hours a night. And, like, was. Was a sort of badge of honor, right?
- [28:08]
Chelsea Clinton
Yeah, Emily, that's. That's. That's my dad. Sadly, my dad is like, I only sleep, like, four hours a night. And for. For many years, my mom and I have been trying to tell him, but if you slept more, like, who even knows what your big brain could do? Like, your big brain has done so much, but maybe more would be possible.
- [28:23]
Emily Oster
Maybe there's more.
- [28:23]
Chelsea Clinton
Maybe there's more.
- [28:25]
Emily Oster
So, yeah, I think that there was a sort of, like, bravado period of lack of sleep, which I think we have kind of dialed down now. For me, the big. You know, I worry a lot about this with parents, and I spend a lot of time telling them, your kid needs to sleep more than you, than you think. And I think for little kids, there's this issue of just, it's hard to get your kid to sleep. And parents, like, there's one set of. It should be like, I'm dying to get my kid to sleep, but they won't. Da, da, da. As our kids get older, we get into a different space where I think parents. There's actually much more of a role for parents to make sometimes hard choices around sleep. So, you know, if you have a middle schooler or even a high schooler, you're gonna face some choices where there's extracurricular activities or, you know, other other things that are getting in the way of sleep. And sometimes I think we need to help parents understand that your kid sleeping is actually a priority. And it may be that that limits the amount of gymnastics that they can do. And, I mean, I am completely militant about sleep in my house. Like, they're like, we do not do activities that will prevent my kids, like, regularly. That will prevent my kids from getting a normal, like, what is in a healthy amount of sleep. Because sleep is incredibly important, and there's an opportunity to help our kids develop better habits but also develop an understanding. Like, sleep is incredibly cool. You know, every animal sleeps, including, like, dolphins, and they sleep half their brain at a time because you, like, they're swimming, I guess. And that suggests this must be so important because it's the stupidest thing, right? Like, every animal has evolved to have a lengthy period of the day in which they are totally unprotected. And, like, anybody could eat them at any time. So, wow, this must be so important if you are willing to get eaten to achieve it.
- [30:25]
Chelsea Clinton
Emily. I've never thought about anything that that's going to maybe Be my new standard. I'm like, what is so important that.
- [30:32]
Emily Oster
I'd be willing to get eaten? This is it. This is the one thing. This is the one thing. Maybe this and, like, gathering, like, ripe berries. Those are basically like sugar and sleep. Those are the things you're willing to get eaten to do. And so it must be very important. And even though we don't fully understand, I think we're having better understanding. We don't fully understand, but there's just tons and tons of evidence that sleep is. Is important. And I think this just. I'll say one last thing, which is I think this relates some to our relationships with screens. Not always in the way people think. People have this, like, blue light idea, and it turns out, like, blue light has kind of been a bit debunked. But when we are stuck on our phones and our kids are stuck on their phones, then they don't sleep. And so we gotta enforce good sleep hygiene.
- [31:35]
Chelsea Clinton
I want to move to something that we call kind of fact or fiction, where I'm going to throw out some statements and you're going to tell me whether they're fact or fiction.
- [31:43]
Emily Oster
Okay.
- [31:43]
Chelsea Clinton
All right. We're going to start with vaccines, but then we're going to go in other places, move on. Kids don't need to get vaccinated for hep B because the president says it's a sexually transmitted disease only. Is that true?
- [31:56]
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.
- [32:40]
Chelsea Clinton
Also, vaccines have mercury in them. Fact or fiction?
- [32:45]
Emily Oster
No, that's fiction. They do not.
- [32:47]
Chelsea Clinton
Vaccines have other unsafe toxins in them.
- [32:50]
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 tinfoil. 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.
- [33:09]
Chelsea Clinton
The vaccine schedule for kids is too aggressive and should be spaced out.
- [33:13]
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.
- [33:23]
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?
- [33:34]
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.
- [34:12]
Chelsea Clinton
How about heavy metals in baby formula? Fact or fiction?
- [34:17]
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.
- [34:28]
Chelsea Clinton
Also, parenthetically, why it's still really important that we have a regulatory body that checks the integrity of baby formula.
- [34:37]
Emily Oster
Agreed?
- [34:38]
Chelsea Clinton
Yes. So I've heard a lot about creatine. I am not taking creatine.
- [34:43]
Emily Oster
What?
- [34:44]
Chelsea Clinton
I'm curious, are you taking creatine? Should we all be taking creatine?
- [34:49]
Emily Oster
I do.
- [34:50]
Chelsea Clinton
You do take creatine?
- [34:52]
Emily Oster
I do. I think there's a lot of evidence that creatine is effect. 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 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, I should call.
- [35:26]
Chelsea Clinton
My parents and be like, mom, tell your parents.
- [35:28]
Emily Oster
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.
- [35:37]
Chelsea Clinton
And did they listen to you?
- [35:40]
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.
- [35:48]
Chelsea Clinton
You can ask them at Thanksgiving or whatever you see them.
- [35:50]
Emily Oster
I can be like, oh, did you bring your creatine with you?
- [35:53]
Chelsea Clinton
You're like, if not, I have. Should we put it on the turkey?
- [35:55]
Emily Oster
If not. If not, I brought mine. I brought my giant container of creatine.
- [35:58]
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?
- [36:08]
Emily Oster
That's stupid.
- [36:09]
Chelsea Clinton
Stupid.
- [36:09]
Emily Oster
Why? 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.
- [36:25]
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.
- [36:30]
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 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.
- [36:53]
Chelsea Clinton
We should all be wearing a continuous glucose monitor.
- [36:58]
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 going to be a relevant technology.
- [37:24]
Chelsea Clinton
What have I not asked you about that? I should have. What's like, the one thing you think.
- [37:28]
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. Yes. So if you are a listener here and you are hoping to get Botox while you're breastfeeding, it's fine.
- [37:43]
Chelsea Clinton
You know what, Emily? If you had asked me for the list of the top 100 questions, you.
- [37:48]
Emily Oster
Never would have come up with that.
- [37:49]
Chelsea Clinton
No, I would have been like, is there arsenic in rice cereal? Should I still keep taking prenatal vitamins while breastfeeding?
- [37:57]
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.
- [38:08]
Chelsea Clinton
I'm speechless. That doesn't happen to me very often. What's number two? Like, can I get fillers?
- [38:14]
Emily Oster
That does come up, but not that. Not that often.
- [38:17]
Chelsea Clinton
Okay.
- [38:18]
Emily Oster
Something about GLP1s. Can I take GLP1s at this time? That time, like, GLP1s are a big. A big topic space now also, while.
- [38:25]
Chelsea Clinton
Breastfeeding or just generally.
- [38:26]
Emily Oster
Yeah, people want to know while they're breastfeeding.
- [38:28]
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.
- [38:41]
Emily Oster
Exactly. That's my job.
- [38:43]
Chelsea Clinton
Just final question. What advice do you have for 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?
- [39:00]
Emily Oster
Take creatine. I think people could stand to hear that it's okay to not engage for, you know, some period of time. 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 disag engage, 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.
- [39:41]
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.
- [39:54]
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.
- [40:01]
Chelsea Clinton
Like, I'm so thankful I missed the.
- [40:03]
Emily Oster
You missed. Hurry child.
- [40:04]
Chelsea Clinton
Missed Hurry child.
- [40:05]
Emily Oster
You missed the whole thing. Missed the whole. You didn't have to worry about it. Exactly. That was so great for you.
- [40:09]
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. Cause I was like, we gotta tie our shoes and get to the bus on time.
- [40:21]
Emily Oster
I told my daughter this and she was like, of course I'm gonna 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.
- [40:29]
Chelsea Clinton
You're like, nature. We the more we learn, the more we actually understand how really dominating nature is. Totally. Emily, thank you so much. This has just been a joy. I was speechless at times and amused at others and informed throughout. So really, thank you so much for your time and thanks for coming on.
- [40:50]
Emily Oster
Thank you so much for having me.
- [40:54]
Chelsea Clinton
You can learn more about Emily OsterFemily Auster on Instagram or her website parentdata.org thanks so much 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 in sound design by Ivan Koraev. Kristin 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 Erica Goodmanson, Sara Horowitz, Francesca Ernst Kahn, Caroline Lewis, Sage Falter, Barry, Lurie Westerburg, 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. Thanks so much for listening and see you next week.