← The Pediatrician Next Door - Simple Advice on Parenting and Family Health
The Pediatrician Next Door - Simple Advice on Parenting and Family Health
Trust your Gut? Myths, Facts and a Happy Microbiome (Encore)
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My husband and I have started making an occasion out of folding laundry together. I mean, it has to be done, so we might as well use it as a time to catch up and talk. And you know what? My laundry is elevated because I use this product called Laundry Sauce. Laundry Sauce is a premium line of high performance detergent pods and laundry essentials infused with bold, sophisticated fragrances created by top perfumers. The pods are pre measured so there's no mess and no guesswork and no clunky bottle tipping over and dripping everywhere. It just makes the whole process feel elevated. But what really surprised me is how good everything smells. I actually look forward to getting dressed because my clothes smell incredible without needing perfume or cologne. My current favorite is Italian bergamot. It's bright and citrusy with notes of mandarin, sandalwood and patchouli, but they also have gorgeous scents like Australian sandalwood and Himalayan cashmere. You can subscribe to the signature package and have pods, scent boosters, dryer sheets and more delivered on your schedule. It saves you an errand and it makes sure you never run out halfway through laundry day. And they back it at all with a full money back guarantee for a limited time only. Our listeners get 20% off your entire order when you use code Dr. Wendy@laundrysauce.com that's 20% off@laundry sauce.com with promo code D R W E N D Y. After you check out, they'll ask where you heard about them, so don't forget to drop our name. Trust us, your laundry's never smelled this good. I feel like everything new in medicine that I hear about lately is related to gut health. There's legitimate new research that is constantly linking disease, our mental health, like everything, to the health of our guts. In pediatrics, I've heard things like giving reflux medications to babies can alter their gut microbiome and not in a good way. And parents often ask me if they should give their kids probiotics when they're on antibiotics. And it turns out we were completely wrong on our recommendations about both of these issues. And and the answers are not as straightforward as we thought because we're just starting to understand the role that the microbiome plays in our health. There is an entire community of fungi, viruses, bacteria and other microbes living all over our bodies. And we are just starting to understand how this community affects our health and what we can do to be the best host to keep them healthy. Why am I talking about this today? For two reasons. First, there are a lot of myths floating around about how to enhance gut health. And I want to bust some of those myths with my doctoring ness. And second, because if you're helping to raise a child, there is a lot you can do to help a kid be a good host to their gut microbiome. And I'm going to tell you how. I'm Dr. Wendy Hunter and I'm the pediatrician next door. I'm that doctor friend you call for practical advice about your kid's health. I mix the science of medicine with the reality of parenting. There are a lot of ridiculous claims on social media and information coming from healthcare practitioners who aren't actually doctors about gut health. Some of what these practitioners recommend may be legitimate and admittedly, some of the things that medical doctors say is frankly wrong, because many times we just don't know yet. One of my colleagues pointed this out and I really liked it that parents should never trust when a practitioner says something like here's a test you need that your doctor doesn't even know about. Let me be clear. We do know about these fake tests. We know exactly why they aren't legitimate tests. So please be careful about spending money on these scams. I will say, though, if you do see an alternative health practitioner, they are going to make you feel good and you will feel listened to. But they may not actually improve your health and they can miss important diagnoses. Anyway, here is one of the myths that I hear very often, and it always makes me shake my head. Here it is Refined carbohydrates like sugar or white flour cause yeast overgrowth in the body. Some functional medical providers do claim that eating too much sugar or refined carbohydrates can cause an overgrowth of fungus, particularly candida yeast, in your gut, leading to symptoms like intestinal discomfort, skin rashes, and fatigue. They suggest that treating this should be done with restrictive diets or cleanses or supplements or essential oils. And of course, they're happy to sell these to you. While it's true yeast overgrowth can cause issues like thrush in your mouth or vaginal yeast infections, consuming sugar or refined carbohydrates does not lead to excessive yeast overgrowth in the digestive tract. Fungal overgrowth in the gut is rare. It does happen, and it really only occurs in people with weak immune systems, or if you take a lot of antibiotics or steroids, or if you have a disease like diabetes or some severe conditions like really severe that slow down your digestion. If you actually have yeast overgrowth, though, it's treated with antifungal medications, not diets, supplements, or even cleanses. However, I do wholeheartedly agree that eating fewer refined carbs and more fiber is definitely good advice for overall gut health. Okay, here's the next myth. You can diagnose food sensitivities with a test. There are lots of companies that market food sensitivity tests that claim to identify problem foods by measuring your body's immune response. I've seen naturopaths claim that they can also use these tests to treat autism, but none of this is actually possible. So beware these tests. Check for IgG antibodies, which are different from the IgE antibodies that are involved in true food allergies. However, IGG antibodies don't indicate a harmful reaction. They simply show that you've been exposed to a food. I mean, duh. Even ones that your child eats regularly and tolerates well can show up on this antibody test. The most reliable way to identify food sensitivities is by eliminating them from your diet under medical supervision, where you just remove the suspected foods and then slowly reintroduce them while monitoring for symptoms. If you suspect your child has food sensitivities, talk to their doctor or see a registered dietitian before you rely on these kinds of expensive and unproven tests. All right, next myth. Eating lectins causes leaky gut. Have you seen this one? Influencers claim that foods containing lectins like beans, grains, and certain vegetables damage the gut lining, making it leaky and allowing harmful substances to enter the body. But this is a myth. Lectins are naturally present in most plants, and while raw or undercooked beans, they can cause digestive distress due to their high lectin content. Cooking destroys most lectins, making beans, grains, and vegetables safe and easy to digest. There's no evidence that eating cooked lectin containing foods could harm the gut. In fact, it's the opposite. When you avoid these foods, it can actually do more damage. Plant based foods provide great fiber that supports beneficial gut bacteria. And when gut microbes don't get enough fiber, they may start consuming the inside of the protective lining, that mucous lining of the gut, which can lead to real inflammation and gut issues. So rather than harming your digestive tract, properly prepared beans and other plant foods help keep your gut strong and healthy. People buy into these myths because our typical Western diet is generally terrible and a lot of kids are actually constipated. So a lot of my patients are on laxatives because that's easier than me going to their house and making them eat whole grains, veggies, and like sauerkraut. Okay, so that leads me to my last myth. The myth is you can become dependent on laxatives over the counter. Laxatives like Miralax, which is polyethylene glycol or magnesium oxide supplements, and stimulant laxatives like Senna or bisacodyl can help relieve constipation. We know that's true. And while it's true that stimulant laxatives are sometimes thought to cause dependence, there's really no evidence that they permanently weaken the colon in any way. However, most studies on the safety of these medications were only about four weeks long. So we don't know for sure except from our experience. And doctors have a lot of experience prescribing these medications. Experts recommend using them only occasionally or for short term relief. And I'm talking about the stimulant laxatives like Senna, not Miralax. That one's safe to use all the time. However, I do have patients who use stimulant laxatives like Ex Lax very, very often, and it does not seem to make their problem worse. So for long term constipation management, Miralax or polyethylene glycol, that's the generic name, is extremely safe. You may have had this recommended to you in the past. So the bottom line is you cannot become dependent on laxatives. If you need them, you need to use them. And if your child needs them, you need to give them to them on a regular basis. The most important thing is that your child poops. Nice poop that's soft and is every day. All right, so with all of these myths out there, what is true and what can we do to keep our kids guts and our own guts healthy and our microbiomes thriving as we get older? Let's take a step back. What exactly is the gut microbiome? Like I said, it's a community. Think of it like a big city full of trillions of tiny microorganisms all living inside your child's digestive tract. But don't worry, most of these microbes are really good. They help you with digestion, they support your immune system, and they even affect your mood and the functioning of your brain. In fact, scientists call the gut the second brain because it's directly connected to the nervous system, and it actually produces neurotransmitters like serotonin, which affects mood and sleep. That's exactly how dark chocolate works in the stomach to make your mind feel happy. So a healthy gut does not just help with digestion. It influences how kids feel and behave, too. It's true. And you may have heard this. I'm going to come back to this in a bit. It helps to understand a little bit more about the microbiome. And we can go way in depth here about the difference between microbiota and microbiome. So don't get picky. Okay, for now, let's get down the basics. I've got Dr. Lita Proctor, a microbial ecology researcher who was a program coordinator on the Human Microbiome Project, to explain. Here she is.
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So what are microbes? You know, we often use the word microbes to mean bacteria, but in fact, it's much, much broader. Of course, we admit that a lot of the initial focus has been on the bacterial component of the microbiome, but in fact, it's any kind of microscopic lipo that includes bacteria. Of course, any kind of virus would be considered a part of the microbiome bacteriophage, which are viruses of bacteria, fungi, and protozoa. So even though most of our attention here in the last decade or so has been on the bacteria, the microbiome in our bodies and anywhere, microbes live everywhere and in nature. I really want to point this out. There are a couple of very important key principles of how they live in nature, and it's also, in some regards, hindered our ability to study them. They live in communities and they interact in communities. So even though the classic way to isolate microbes from any environment is by trying to culture them in a flask or on a petri dish, in fact, we're kind of working against their nature. The reason I want to make this point, it's a really important point, and it probably forms the kind of conceptual foundation for the Human Microbiome Project, is the majority of these microbes that we encounter on a regular basis throughout our lifetimes, wherever we travel, don't cause disease. In fact, many of them are beneficial. We acquire our first inoculum at birth. We get our first dose. That's what inoculum means at birth, during the birth process. But in fact, our microbes are continually replenished throughout our lifetime through continuous exposure to all kinds of microbes in our environment.
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So we know a bit about how babies start building their microbiome from the moment they enter the world. We know that how they are born plays a role. Vaginal birth exposes babies to good bacteria from their mom, while a C section may have a slightly different microbial makeup for the baby. But don't worry if You've had a C section. There are lots of ways that you can support your baby in developing a healthy gut. So breastfeeding, it's not surprising that this is one of the most powerful ways to strengthen the microbiome. One of the reasons that breast milk is so special is because it contains human milk oligosaccharides, or HMOs, and probiotics, both of which play a big role in developing your baby's gut. HMOs are this type of carbohydrate that are only found in human breast milk and really nowhere else. And the interesting thing is that babies don't digest these HMOs, but that's because they aren't for the baby. They are meant to feed the bacteria in the baby's gut. Yeah, humans evolved to have their mothers make a substance that's only found in human milk, and it helps develop the baby's gut. One of the most important types of bacteria that HMOs help grow is bifidobacteria. You're going to see this word on some probiotics. This bacteria is beneficial for you because it protects the gut from bad germs by crowding them out. And it strengthens the gut lining so that bad bacteria don't get into the bloodstream. And then finally, this bacteria trains the immune system to recognize good and bad microbes. It's crazy. When you feed these good bacteria, HMOs, babies develop a balanced gut microbiome which lowers the baby's risk of infection. They have less diarrhea, and it even is known to protect against long term health issues like allergies and obesity. That's why breast milk is so important. HMOs are prebiotics. Prebiotics, which means they feed the bacteria. They're not probiotics. Probiotics are the bacteria. But breast milk also has probiotics, which are those actual live, healthy bacteria that go into the baby's gut and they start growing there. Probiotics work alongside HMOs to make this protective environment. And in breast milk, they help break down food so the baby can absorb vitamins and minerals better. Good bacteria, they help with germs, keeping in check, they lower your infection and that means the baby can fight off illnesses better. Research shows that breastfed babies have more beneficial bacteria in their gut compared to formula fed babies. It's sad and it's true. So this can help reduce the risk of conditions like diarrhea and stomach infections. It's not really true though, that you get other Immunoglobulins from breast milk. Those come from when the mom is pregnant and are transferred through the placenta. But allergies, asthma, obesity, and metabolic diseases later in life are all lessened when you breastfeed. Okay, what if a baby isn't breastfed? Some formulas do now contain prebiotics, which act like HMOs and probiotics. So look for those on the store shelves. It's been interesting for me to see over the course of my career that formula ingredients have really matured to become a lot more like breast milk. So the bottom line is breast milk is more than food. Then as babies grow, you can give them a lot of solid foods, and that helps to diversify their gut bacteria even more. Especially food fiber rich foods like bananas, avocados, and whole grains. Those are very important as kids grow, because when you eat fiber, your body doesn't fully break down the fiber. And that's a good thing, because instead the good bacteria in your colon eat it through a process called fermentation. As the bacteria digest the fiber, they make special substances called short chain fatty acids. You don't really need to know that. And those short chain fatty acids have very important jobs. They are fuel for the cells that line your gut. They make them strong and they prevent harmful substances from leaking into your bloodstream. There is no such thing as a leaky gut when you have a healthy diet. These fatty acids also control your appetite. Yes, that's really important. And they support your metabolism. They spread throughout your body to support your immune system and even brain function. They also do more than just help with digestion. They reduce inflammation and influence your mood and brain health through the gut brain connection. So to keep your gut bacteria healthy and making short chain fatty acids, you need to eat fiber rich foods, specifically soluble fiber. That's in things like oats, beans and fruits. They are especially good at feeding those microbes. Aside from the obvious role in keeping your belly happy, the gut microbiome also influences every system in the body. Our immune system resides in the gut, and the microbes living there help regulate immune responses. And here's something I found fascinating. The gut is directly connected to the brain through the gut brain axis. Scientists have found that gut bacteria influence mood and mental health. There was a 2016 study that showed when gut microbes from humans with depression were transferred into rats, the rats started to show depression and anxious behaviors. And while more research is needed, some studies suggest that certain probiotics can help improve anxiety and depression symptoms. Yes, I know, it's true. It Sounds like a myth. It is always better though to get those probiotics from food rather than a supplement. So what you choose to eat does affect your mood. And I talked about this before in episode 54 about ways to raise happy kids. So check that out. Episode 54. A Healthy Gut Leads to healthy digestion. But how do you know if your child's gut is working well? All right, here's my tip. One of the best indicators is their poop. And yes, you should look at your child's poop even when they get a little older, especially if they're having stomach aches. A healthy stool should look like a smooth snake or a sausage. I like to compare it to squeezing toothpaste from a tube. I have also compared healthy poop to soft serve ice cream. If stools are hard, lumpy or come out in separate pellets, that can indicate constipation. On the other hand, if stools are too soft or ragged or watery, that can be a sign of diarrhea. However, occasional diarrhea really isn't a concern. But frequent loose stools might indicate an infection or a food intolerance or something like irritable bowel. So keep an eye for that. How often should kids go? Well, frequency is not as important as consistency. Some kids poop several times a day while others go every other day. And that's okay. As long as they're not straining or having discomfort, their gut health is probably fine. So that's how you assess your kid's gut health and what we know about the microbiome and total body health. So what can you do as a parent to help your kids guts be the best they can be? All right, first, feed the good bugs. I've said this like a million times already, and I'm sorry to repeat it, but it is important. The best way to care for your child's gut is feeding both them and their microbes well. Fiber rich foods, vegetables, whole grains, nuts, seeds, beans, lentils. Those are key because fiber is essential for your beneficial bacteria. It doesn't just make your poop softer, it has a bigger role than that. It might help your kids to eat more of these foods. If you explain to them that you you're feeding the good bacteria that live in their intestines and helps them digest, they might be able to picture that and eat some of the foods you want them to eat. We know a diet rich in plant based foods makes a more diverse gut microbe colony which is linked to better health outcomes. One study found that people who ate more than 30 types of plant foods a week had a more diverse gut microbiome than people who ate fewer than 10 plant foods. So count what you're eating. Do it. Also adding fermented foods like yogurt, kefir, kombucha, sauerkraut, kimchi that can increase microbiome diversity and reduce inflammation. Research is ongoing in this area. So these foods are no doubt, though, a great way to support gut health. Next, I know this is not surprising. Limit antibiotics when it's possible. I mean, of course sometimes your kids need antibiotics, but they can wipe out the bad and good bacteria. One doctor I heard, he described antibiotic use as carpet bombing the gut microbiome. It can wipe out like 90% of beneficial microbes along with the harmful ones that you're trying to kill. While the microbiome typically recovers over a few weeks to months, that period of imbalance can make children more vulnerable to infection. Although research on how diet influences microbiome recovery is ongoing, experts do recommend that you want to stick to a high fiber plant based fermented food diet to support support gut healing. Interestingly, one study in 2018 that was in the journal Cell found that taking probiotic supplements after antibiotics delayed microbiome recovery rather than helping it. So that was the myth I mentioned at the beginning. While probiotics might seem like a good idea, it turns out that their benefits after antibiotic use may not be correct. And finally, I know you've heard this lots and lots of times. This is my last tip. Let kids get dirty. Yeah. Exposure to nature and pets and even a little dirt helps strengthen their immune system and diversifies their gut bacteria. So let them play outside and explore. The gut. Microbiome may be tiny, but it plays a huge role in our health. If you found this helpful, please share it with a fellow parent. Send it to them for more from the pediatrician next door. Find Find me on the web@ pediatriciannextdoorpodcast.com if you've got a question about the weird things kids do, send an email to hellopediatriciannextdoorpodcast.com for a chance to hear your voice on the show. I'm Dr. Wendy Hunter and I'm the pediatrician next door. This show is produced by Red Rock Music. Make sure to subscribe and leave a review wherever it is you're listening. I'll be back next time with more.
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So you have your own personal ecosystem of creatures on your body and it's called the microbiome. And the best understanding that I've seen is by Carl Zimmer, this terrific science writer. And Carl imagines that some twisted genius would vaporize all the cells in your body. Well, it wouldn't leave an empty space for a brief moment. There would be this body shaped cloud of bacteria and viruses and other organisms that live on and in your body. They live on your skin, in your lungs and in your digestive tract. So that's what your microbiome is.