Family Medicine with Dr. David Tusek

Social Media and Mental Health 0:00

to feel depressed." And I'm like, what? Seven to eight days. She's like yeah. And i'm, like well what do you do on the eighth day when you're starting to fell depressed? She was like I have to delete it. I need to get it off my phone. That's incredible. How much of your feeds on Instagram would you say are uplifting, inspiring, positive in any way and how many of them would you say are toxic? What percentage? And she said it's about 80-20. 20% are whatever fuzzy cute kitty cats and things that warm my heart and uplift my soul and about eighty percent of it is absolutely poisonous toxicity.

And so then I asked her well How many of your friends do the same thing that you do? You know, delete your Instagram when you intuitively notice yourself dropping in to a dark and gloomy mood and mental state. Let me guess. Is it zero? She really was like, I honestly don't know if any of my friends, do that. And I really, really worry about them. You know, I think this is such a huge problem that fits in with all of these things. It's like, how are we spending our free time? Whether we're eating, whether we are exercising, or whether were hanging out with friends.

And increasingly, not only are not getting the physical activity, we also feeding our poor brains with these poisonous messages through our Instagram feeds and Snapchat and TikTok. Yeah, it takes a lot of awareness for someone to realize that, um, especially because I feel like all kinds of social media are designed to suck you in and keep you there. Um, you know, whether it's YouTube or Facebook or Instagram or Tik Tok, all of them are just designed. To make you feel, like you're socializing. And so you were actually missing on that quadrant, of actually interacting with other humans.

It keeps you inside. So you are not interacting, with nature. And it keeps you sitting so you're not moving around and disconnects you in all kinds of ways. And most of the time, most people don't even realize that it's happening. I think that's amazing that your daughter was able to realize. Yeah, no, it. It's really wild and. almost hard to imagine how in such a short period of time, you know, these are, our kids are digital natives. They grew up with the internet and like we never did, but in a such short time.

You know this has taken up like you would know better than me, the number of hours that the average kid spends on social media. I don't know. It's probably six or eight, right? That's what I saw recently. Yeah. Six to eight. Crazy. other than say delaying introduction to social media in children and ideally limiting the amount of time that they're on it.

Five Pillars of Child Health 3:04

What are some other ways that you can support these pillars of health in children? I think it's really helpful to know that there are five. It's not one or two, and it is not 500, right? It is a very manageable number of immensely critical priorities that our bodies need to thrive. And I always say, our bodies actually ask so little of us. They don't really need that much from us, but they need adequate hydration. So what does that mean? It means my urine is relatively clear. If it looks like Mountain Dew, you're not drinking enough, not hydrating enough.

Probably the most universal problem that we see in our pediatric population is underhydration and dehydration. And it presents in all kinds of ways. It presents with headaches. inattentiveness, ADD-type symptoms, malaise, fatigue, all kinds of things. I just don't feel good. And when you do a urine test on them, there's specific gravities off the charts. For whatever reason, And I'm not sure exactly how this works actually, but kids, young kids seem to have like a decreased thirst response or thirst drive.

I've honestly not quite sure why, But I think parents need to like remind kids to keep drinking, especially if they are active. The food thing, you know, that's the second one. And then if we eat outside, the perimeter of the store rather than in the interior and That's harder to do, but you know what, with a decent cookbook that teaches you how to make really good, healthy, nourishing foods from those primary ingredients, meat, vegetables, nuts and fruits, It's doable. We recently completed a cookbook with Maria Cooper.

I collaborated on that called the Heartful Kitchen. And what was great about that is we actually included that fifth component of nutrition there, which is the personalized one. So if people are lectin-sensitive or histamine- sensitive or have autoimmunity or problems with the gut-associated psychology gaps syndrome, we have a little key at the bottom of every recipe that says, hey, if you're trying to decrease FODMAPs or lectins or histograms, substitute this ingredient for that ingredient. So that's a handy tool called the Heartful Kitchen.

That's awesome. We'll put a link so that people can find it easily on this. I think you covered the exercise pillar really, really well. You know, just like you, we focus on some cardio, some strength, and some flexibility. And kids are sort of natural acrobats and natural athletes. So they love to do that. Those types of activities include all of those. Then I also think another massive priority is sleep. You know, if I was president, the first thing I would do is I'd say, no teenager must ever go to school before 10 a.m.

I think this idea of making these kids get up at 5.30 or 6 or at 6.15 in the morning, it's just their brains need way more sleep. And probably eight is the bare minimum. Many kids may need more like eight and a half or nine hours of sleep to really function optimally. And I think we're just driving them too hard as a society, as culture, and certainly as an educational system. That needs to be reformed, in my opinion. Um, so parents are stuck with this. Well, we get home late, you know, We go to practice, then we have to do homework and get dinner in there.

And then they have. To do a few chores and suddenly it's 10 AM or sorry, 10 PM or 11 PM and. They just don't have enough time to get those eight or nine hours in. So I don' know, there's no perfect answer, perfect solution, other than to say, this is really a priority that we need to at least be thinking about and trying to prioritize. And then the fifth one, maybe the most important of all, because it's the one that's most tied to our quality of life, of All. We call it stress. But another way to say that is, am I able to self-regulate my autonomic nervous system?

Yes or no? And to what degree? Literally, people who can do that well have a very, very high quality of life and wellbeing in general. People who cannot do well really, really suffer. Stress is not only the mental anguish of stress and anxiety and worry and fear-based emotions, but as we all know, stress also fuels all of our diseases. So it starts with dis-ease and that turns into disease. And so really teaching our kids at an early age what it means to have the tools. You know, first of all, what?

It means we have this thing called the autonomic nervous system that you and I were taught in med school is called The involuntary nervous System. That's the term we use literally. And now it's like, well, actually, I can regulate it myself with some very, very simple techniques. And there are many techniques, there's beautiful work on vagal stimulation and polyvagal theory, Dr.

Building Healthy Habits in Early Childhood 9:00

Stephen Porges, and heart rate variability and all of these different neuromodulation techniques that we can use. But a very very simply one is just learning how to take deep breaths. We are a culture of shallow breathers, and shallow breathing is consistent with being in a sympathetic, hypervigilant, fight-flight-freeze nervous system state. And we want to learn how to move out of that into rest, digest, calm focus, rather than the jittery, nervous, worried, frenetic, adrenaline, sympathetic tone.

And so moving on to sympathetic and parasympathetic tone is a skill that can be learned, taught, and I think it's something we really need to cultivate for our kids, but really for everyone, including our adults. With kids, we tell them, imagine that you're smelling some flowers and then you are blowing out some candles. And those are the sort of breath movements that make it easy for them to visualize. I just want to go back real quick over these five pillars and how parents can really start implementing them even in the first year of life, but especially starting at age one.

Then maybe we can talk about how if they have older children, how to get back to that. When children are a year of age in the US, we used to always recommend switching to cow's milk instead of breast milk or formula. And that recommendation is starting to go away. So it's actually better just to start giving them water when they turn one. If you have a baby that's on formula and they really need that bottle to fall asleep, they need it for comfort, you can start watering it down. You can with like three quarter strength formula, in one quarter water and then half and half for a week.

one quarter formula with three quarters water for another week and then just water after that. And it's a really gentle way to ease them into just drinking water. We don't recommend juice really at all in children. The maximum is four ounces per day because juice is really just sugar water and the amount of nutrients in it are so negligible compared to how much sugar is in juice. So really, if you can just start your kids off on water at a year and you start with water as early as six months when they start eating solid foods, you offer water.

At the same time, that's a really good way to get them on that path with the foods when a child is less than five years old. They have. essentially no means of getting their own food. The parents are providing all of the food for them. And so you can start off by offering a wide variety of foods that are all healthy options. When children naturally go through their picky eating phase at two to three, you want to still keep offering of variety things. I know it's very easy to fall into the trap of beige foods, especially in the U.S.

with things like chicken nuggets, french fries, pancakes, toast. A lot of kids will only eat about five foods. Mac and cheese. They only eat about five foods in that age range, but make sure you continue to offer all of these different options because they will, given the choice, start to eat some of those again as well. And with the exercise, you know, just having the culture of we play outside, every day, at some point in the day and children will get used to that and it becomes the norm. The breathing we had talked about, the sleep, helping children, allowing children to sleep and not trying to force them to, sleep I feel like is more helpful.

There's a lot of mixed feelings about sleep training and training kids to I'm really not a fan because a lot of it involves some emotional trauma to the child. So rather than going with their signals, you're sort of forcing them to go to sleep. And part of that here is, because parents have this idea of like, I need to put my kid to bed and they need sleep so that I can then finish up my tasks for the day and have some time to myself to do things. If you are doing things together as a family, if you go into bed together All at the same time, I think that can really help to get those habits built in early on.

But yeah, with older children I see some families that parents tell me my kid won't drink water, they don't like it. And so with those I say like whatever they are drinking, you can kind of start gradually watering that down. If they are drinking juice, make sure it's at least half water or more in that juice. But when you first start off, it, It's not as sweet. It is going to taste different to them. So it can be a little bit of a shock. Yeah. Do you have any other suggestions for like older kids or even adults that have fallen into these?

We fall into this patterns, right? Of what's easy and processed foods are easy. And sitting on the couch after dinner is easy? How do you, how do that motivation and momentum going? I mean, Beautiful overview there. I think this idea of like, you're really calling out this, idea, of listening to one's own body, learning how to intuit what you need, whether it's my child actually needs to. sleep in my bedroom for a while and we need to co-sleep for awhile as we gradually get more comfortable again regulating the nervous system around the idea of sleeping by myself to the Idea of being connected to my body so that I understand that hang or Kool-Aid or the kind of juices that come from concentrate or Capri-San drinks and things high C and all these things are full of chemicals and dyes and flavorings and colorings that do not exist in nature.

They are, you know, at best enhanced with natural flavors and colors, but the bulk of them are synthetic chemicals that don't exist to nature and so that first step, Carol, so important to create a sense of understanding that our goal is to feed our body or provide our bodies with what it needs and most of those things simply come from nature. We moved from a time when The big concern with infants was failure to thrive. And we would see these little babies or one year olds or 1 and a half year old, and they were just super thin, super skinny.

They were falling off their growth charts. Honestly, I don't see those kids anymore. The incidence of that problem is very, very low, at least in my view, from what I can see in patients. Yeah, I've noticed the same. But what we do see is kids that are overweight yet malnourished, if that makes sense. Well, that totally makes. And this is where, again, educating the parents. There's so many times where I see grandma and mom come in. and they're just fussing with glee and delight over how cute their baby is when they are really, really chunky.

And sure, again, you don't want your baby to be thin, that's for sure. But there is a point that you're making, which is this child actually is moving down a path that is actually pretty dangerous and it's going to set them up for a metabolic dysregulated life, metabolically dysreglated life. So what are your methods of discerning like a healthy chubby baby from someone that's maybe overdone it a little bit?

Nutrition, Weight, and Self-Soothing 16:48

Really, I have to just dive into their dietary history and also the parents sizes when they were that age, if they Um, yeah, if they were like chubby kids that then became a normal average weight when they became, you know, went through puberty, became adults, I'm a little less concerned than if we were really tiny and our kids really big, or we're really and are kids are really, like those when the genetics are different like that I worry a bit more. But I've also noticed that our culture has really become one of there's always a snack for the kid on hand.

You always have at least, you know, one to five snacks in your purse, in the diaper bag, just in case your kid gets a little bit hungry and they're giving them breakfast at school, they have lunch at schoo,l and then they get home and usually have another afternoon snack and dinner and dessert. And we've really gotten into this habit, kids that do any sport event ever, One of the parents needs to bring snacks for them after their one hour of activity, playing a game of, you know, soccer or basketball or anything, any kind of sport activity.

We have this culture of like, we have to feed the kids to replenish that lost energy. And I mean, when I was little, I remember there were times when i felt hungry and that was normal. three meals and we had after school snacks. So we sort of three and a half meals in the day. But that just isn't the case anymore. And even if you're giving your children healthy things, like I had a patient in residency who was a young child, three or four years old, who is obese and the mom said, well, I only give her fruits and vegetables and pulled out a gallon size bag of watermelon chunks, another gallon sized bag And I think like three or four other, you know, snacks like that, where we're just saying this is a massive amount.

Is that for the whole day? And she said, no, this was just for like the morning or, it's just part of the day. So it is possible to overdo it. And, I, think some of, the best advice I had heard summed up was eat food, not too much and mostly plants. That's sort of a good healthy guideline of You want to go towards those more naturally occurring things and in a moderate amount, not to the point that you're stuffed and not continuously throughout the day. Yeah. And I think that's why, to your point, I completely agree.

When we look at the pillar of nutrition, it's not one thing, It's five things. So what is it? Where does it come from? How much? When? And the personalized stuff. How much means even the healthiest diet, it's composed of the right things from the rights sources. Healthiest possible diet for that individual person. But you can still either eat too little and undernourish yourself or eat to much and overdo it. And so listening to those body cues is really important. I think that just like with social media, food is falling into this category of this is actually how I self soothe, I've taught myself, not consciously, it's just what's happened.

But I have taught and trained myself that when I'm nervous or worried or tense or anxious in any way, I need to self-soothe. And so what do you do that? What do use to do, that self soothing with? Well, it's either social media or it is very, very high glycemic index foods typically. Or it, whatever, online shopping and later in life, alcohol and nicotine and all these things, but they're really used by all of us and to some degree, oftentimes in ways that we're just trying to tune down the overstimulation of our nervous system.

And as a culture, we just have to call that out and say, Hey, this is what's happening. To to then begin to think about all right, if that's so, are there more healthy ways for me to calm down that nervous system when I'm feeling anxious? I had 1 last question for you about vitamins and supplements and. I've heard it said that you can't out supplement a poor lifestyle, which I love, but also I usually don't recommend vitamins and supplements for everyone. I think when children are going through their picky eating phase and they're not getting enough of the micronutrients, that's a good time to add in a multivitamin.

But really outside of say ages two to three, I don t routinely recommend like on a daily basis, how do you feel about vitamins and supplements? And I know some of the supplements are more that sort of individualized, like if you can't eat certain foods, or you get enough of this nutrient, then you need to supplement what's missing. But if can supplement it with what you're eating and with food, I think that's a better option, right? Unfortunately, the standard American diet, called the sad diet not only comes from a lot of non-real food sources and substrates, synthetic things, the artificial things that we talked about, but whatever is natural within them is limited in its nutrient density by the depleted soil.

that those plants are grown in and oftentimes even organic food, but certainly conventionally grown crops are absolutely hosed down by all kinds of pesticides and herbicides. And so the overall food quality of our country has declined significantly in the last few decades. And therefore, I think we're oftentimes past the point of saying, you know, fish oil is good for you or vitamin B is for your vitamin D is it for. I. Think we are moving fairly rapidly and certainly in my practice, we were doing a lot of this testing, which is personalized nutrient evaluation.

And so there are labs now that can do very, very detailed analytics on your precise, any individual's precise nutrient needs at that time, not just vitamins, but also minerals and antioxidants. And then it also assesses for those toxicities that I mentioned, and many of the toxins that we ingest come from our food in the form of everything from PFAS chemicals to phthalates to the BPA, endocrine disruptor, plastic compounds, microplastics to pesticides, et cetera. And heavy metals, right? So from fish, we get a lot of potential mercury exposure.

Supplements, Local Food, and Closing Remarks 24:12

So there are tests that don't cost terribly much And for people that are interested, for me or for my child, what are the particular supplement needs or the vitamin needs at this moment in time? And that can change over time. That's probably the best way, in my opinion, to do it, really customize it on the basis of what your lab data actually shows. Yeah, use the science right find what's missing and then fix that like it. I think also, because this podcast is international there's people listening all over the world.

Eating foods that are local to your area are. probably more in line with your genetics, right, than things that have been grown across the world and shipped across. And I know also, like, a lot of the produce that we have in the U.S. that is shipped from far away, it needs to be picked early so that it doesn't over-ripen by the time it gets to the stores. if it wasn't good soil, which a lot of the times, like you said, it's not. Like we don't have as many nutrients in the soil as there used to be.

And so even our produce is sometimes not enough for our bodies. I mean, if you can grow your own food, that's amazing. If not, next best would be finding something that is local. Then outside of that, finding that something is grown in nature from a different place. Last on the list is those processed center of grocery store type of foods. Yeah, Carol, I think if there's one thing we could do as a nation to improve the health of our country, it's to support local regenerative agriculture. support farm-to-table restaurants, support farmers markets, supports CSAs, because they're connecting all of these dots.

They're growing real food, they are sourcing it in the right way. Whether it's plants or animals, They are doing it an unconscious way, without chemicals and pesticides and herbicides. And they're doing it exactly as you say, both locally and they are very mindful of the quality of soil, much more so than big agriculture. And it includes that very important principle that you mentioned, which is. not just local, but also seasonal. So is something in season, is it ripe? There's a big, big difference between a cultivation that's based on things that are in-season at this moment in time.

American medicine doesn't spend a lot of time on this, but certainly the practice of Ayurveda and some of the Asian traditional medical practices spend huge amount of emphasis on the importance of cycling, not just between when I eat and when don't eat, so they include a lot of fasting practices, which I think are super important and healthy for all of us to learn about and know about, but also this idea of food seasonality, ripeness, and that probably has a phenomenal impact on our microbiome in a positive way if we're eating in coherence with those seasonal cycles in our particular environment.

Yeah, that is excellent advice. Well, thank you. I think we have to wrap up, but it was so great to talk to you and get your perspective on all of these ways that we can keep ourselves and our children really healthy. Really inspired by this talk. Any other closing comments you wanted to make? Well. It's a pleasure to see you again, Carol. Um, I wish you well. Uh, send many blessings of health, healing and happiness to all the listeners. and yeah, stay in touch. We're at cloudmedical.io in Boulder County.

Thank you for tuning in. Make sure that you like and subscribe so that can be the first to know when new episodes come out. Also, you can check out the four first seasons of the Baby Manual podcast on your favorite podcasting platform or check my YouTube channel for lots of videos and shorts that will help you feel empowered as a new parent as I answer all of common questions that tend to come up in the couple of years of life. Have a wonderful day.