How to Address Fatigue in Teenagers with Joel Warsh, MD - #121

How to Address Fatigue in Teenagers with Joel Warsh, MD

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Hey everybody, welcome back to the EnergyMD podcast where we help you resolve your chronic fatigue, chronic fatigue syndrome, otherwise known as ME-CFS and long COVID so you can live the life that you deserve. So really excited about today's guest. We're going to be speaking with my friend Joel Warsh, Dr. Joel Warsh, a pediatrician. And so let's learn a little bit about him.

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So we can talk about fatigue in kids and teenagers. So you're gonna wanna tune in and listen to the things that you can do, some really practical ideas on what you can do in order to help out your kids and your teens. So Joel Warsh, AKA Dr. Joel Gator of the popular parenting Instagram account is a board certified pediatrician in Los Angeles, California, who specializes in parenting, wellness, and integrative medicine.

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He is the author of Parenting at Your Child's Pace, the Integrative Pediatrician's Guide to the First Three Years, which you can pre-order now and releases in August. He grew up in Toronto, Canada and completed a master's degree in epidemiology before earning his medical degree from Thomas Jefferson Medical College. He completed his pediatric medicine training at Children's Hospital of Los Angeles and then worked in private practice in Beverly Hills before founding his current practice, Integrative Pediatrics.

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Dr. Gator has published research in peer-reviewed journals on topics including childhood injuries, obesity, and physical activity. He has been featured in numerous documentaries, films, summits, podcasts, and articles. He is also the founder of the parenting masterclass series, Raising Amazing Plus, and the supplement line, Tiny Roots Apothecary. Joel, thanks so much for joining me today. Thank you so much for being here. And I'm excited to...

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I guess I'm excited to chat about fatigue. I think it's an important topic and it's something that we're seeing more and more of and there are more concerns from parents than ever I think. Yeah, so let's dive into that. You know, the people that I focus on are adults, but we know that there's potential issues in kids. Are you seeing a lot of fatiguing kids these days? We're definitely seeing more of it. It is a more common concern that parents present with and certainly a bigger concern in the teen population.

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I think it just because it's gotten a lot more media impressed, I certainly there's a lot more knowledge about chronic fatigue syndrome and different symptoms, different syndromes and different items that might cause fatigue. I think that that's more in our awareness these days. And so parents are a little bit quicker to come in and say, my child is fatigued. Is this normal? Is it not normal? And that can often be a difficult thing to tease out, especially when it's fatigue, there's so many things that could be causing it. And so it is a really important.

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discussion because it could have some underlying issues or, you know, is it just a regular teenager or a regular kid who's just a little bit more tired and didn't get enough sleep last night? So that's what we're doing in the office to figure that out. Yeah. So how do you discern that? One of the big ways, you know, of course, is taking a good history. It's really speaking to the patient and trying to figure out, you know, how long has it been going on for? Are there other things that could be related? You know, oftentimes at the beginning, it's not very easy to figure that out. You know, if a patient comes in and they said, oh, you know, I'm...

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I've been a little bit more tired for the last week or two than is at the beginning of something or is that just part of being sick? Did they not get enough sleep? So a lot of times it's just a discussion and then over time, if it's something that's not improving or we're noticing some other symptoms or other things that we're worried about, then we can certainly move towards diving in a little bit deeper and really thinking through what could be some of the root causes. I think that is what's really important when it comes to integrative medicine, of course, as you know, is not just assuming that the fatigue is normal.

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and diving into it a little bit deeper. But at the same time, I would say with kids and teenagers, but especially with the younger kids, you have to be very mindful if you're gonna do more testing that it's really a reasonable thing to do because getting a lot of blood work on kids is not that fun. A lot of the testing is not really very well validated. In kids, you can certainly do it, but it's not always, it's not meant for kids as much as it is for adults, especially in the functional medicine world. And so you really have to be intelligent and kind of...

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slowly working our way through if we're going to do a fatigue workup for anything outside of the regular child tiredness, which is pretty common. Well, and I'm glad you talked about taking a good history and physical because a lot of people don't realize that most of the diagnosis can actually come from history and symptoms, right? Definitely, especially with something like fatigue, it's quite a vague symptom. So really could be...

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related to anything, right? Related to a lot. It could be all the way from cancer to you didn't sleep that well last night, you're on your phone too much to you had some sort of infection and it's a chronic fatigue syndrome. I mean, there's such a wide range of what it could be and it really can be a very difficult symptom to narrow down the root cause, certainly in the short term. So that is where having a good relationship with a patient I think is really important. And then just thinking about the why. You know, you don't...

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you're not necessarily going to figure it out that first time you go into the practitioner's office. In fact, a lot of times the patients are the ones that figure it out over time. They realize that their symptoms are due to these kind of things or they're recognizing that, oh, actually my teenager really is on their phone at night and they're really not sleeping. They're actually getting only three hours of sleep and I didn't even realize they were on their phone all night. These are common things that we see in the kids and teen years, whereas it might be a little different in adults because they obviously know what they're doing themselves.

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little better history, but we're not always getting the best history from a teenager or a child. Yeah. And that's challenging, especially with mom or dad in the room. The teenager also doesn't want to lose privileges. I have a 16 year old right now. So we have ongoing conversations about that and I actually still have control over a significant part of her phone and I can see kind of like what she's doing for my phone. So let's digress in that direction. So in terms of...

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phone use in kids and teenagers. What do you recommend? Yeah, that's a very big issue right now. It's really interesting how, and I'm happy that it really has become a major topic of discussion. Jonathan Haidt's book really has brought it to the forefront and there is a lot of discussion even here in Los Angeles. I was just on the news the other day talking about phone bans, right? They're talking about banning phones from schools and really there is a lot of discussion around

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minimizing use, increasing the age at which teenagers can be on social media, on the phones. And so the awareness is starting to be there. But I think it is very important that we push back smartphone use as much as we can. It's hard to do that if you're the only parent doing it. If everybody else is on it, then it's hard for you to do it for your children. But if everybody starts to push back, I think that's going to be very helpful for kids and teens. Certainly,

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we cannot have our phones in our room at night. I think that is very stressful and very difficult for sleep for our teenagers. And if they're scrolling through social media, they're getting that hit of the newsfeed, which can be very anxious at times. You can be seeing what your friends are doing. That can be very anxiety provoking, but of course just even being on your phone and the light can affect your sleep. And we know that almost conclusively at this point. So I don't think there's any debate there really.

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the debate is what to do about it. And I think it is totally reasonable as a parent to set boundaries that we don't have screens in our room and we're not on screens during bed. It doesn't mean we can never be on screens. Of course, there are things that we're gonna do for school and homework and that kind of thing. But if we can minimize it, then I think that's reasonable because average teenagers on the screen seven to nine hours a day now, seven to nine hours. So much. And that means that you're not getting outside. You're not getting exercise.

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You're not getting sunlight. You're not socializing in person. I mean, you're spending so much time on our screens and it's not what's on the screen. It's what we're not doing. I think is the biggest issue. And, and we are at a point where it's, it's gone to the extreme and we need to find some sort of balance there. Screens are not going away, but I think we need to find a happier balance and a happy medium because our mental health is certainly affected and our fatigue and our rest.

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and our normal daily cycles, I think, have been severely affected. And it's a big problem in teens. It's one of the things you can talk about and most make a difference with a pretty simple changes. Yeah, that's really interesting the way that you said it's what we're not doing. Because oftentimes people are talking about how social media puts us in comparison. And so these kids who don't have any tools, they feel like crap because they're in comparison with these people who always put all the positive things that are happening in their...

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their lives on social media, which obviously isn't the reality of the situation. Yeah, and so, oftentimes when I'm having a conversation with my 16-year-old and talking about, okay, well, what are you using your phone for? Is it education? Is it entertainment? Like, are you reading? She does a lot of reading on her phone. She listens to audiobooks, podcasts, stuff like that. And so it's

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Are you scrolling? She calls it doom scrolling, like kind of like when you're looking at those shorts. I mean, I've definitely gotten stuck in a short loop for a half an hour, an hour, where I'm like, WTF, like what am I doing? And then it's also like, what are you not creating in the world? You know, when I think about all the things that I wanna do, and I mentioned that to her today, actually, I said, you know, like, there's a lot of things I know that you wanna do in your life, and I wanna make sure that you're able to achieve those, and you're not spending, and that you're not

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wasting your time on your phone and you're not able to achieve those things. So it's such a big conversation and it's so important. And most adults, or I would say 99% of all, I mean, I don't know any adults actually who've actually taken a course on how to manage cell phone use. I know that you're a pediatrician, but what do you think is healthy for adults to be using their cell phones? I mean, it's probably the same, right? I mean, it's probably not that healthy to

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We can see where the numbers are for our mental health. I mean, the numbers, the statistics are as bad as they've ever been. Anxiety disorders are skyrocketing. It's like 10% of adults now and teenagers have an anxiety disorder where it was like 5%, 10, 20 years ago. Depression has increased in teens. 50% of teens by the age of 18 had some sort of mental health diagnoses. One third of teen girls have thought about suicide. Like these numbers are...

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extremely staggering. And it's obviously not all phones, but I think that's a big part of it. And I do think that this is something where we can manage it, we can make some changes, and we can set some good boundaries to kind of bring things back into balance a little bit more. And I don't think it's all or none. I don't think we have to get rid of screens. But I do think that we have to recognize how big an impact these are having and what they can do. And the data is quite clear. There are other countries and other places

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phone use in teenagers and schools over the last year or two. I mean, Norway's a great example. They banned school, they banned in most of their districts, cell phones from school and bullying went down. The visits for mental health to the guidance counselors went down by 60% in just a couple of months. Depression rates went down, anxiety rates went down. They were doing better in school. The academic performance went up. And this is just in a couple of months. So, and any study I've ever seen shows

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an improvement there. So I think we know that it will help. And that's also just common sense. I mean, if you focus in class and you don't have a screen to distract you, then most likely you're going to do a little better. I mean, it's hard to pay attention. I imagine in school, if you can kind of scroll on your screen, if something comes up in the news that you're worried about, it's kind of hard to refocus back to your math problem. Yeah, that's to me common sense. And so I think that there's a balance between

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the reality of the world and emergency contact versus needing to be on social media. And I think there is a way to be in between. And I think that leads very well into what we should be doing as parents, right? Because then we have to have that conversation with our kids at home and you don't want to be the the fuddy-duddy parents where you're like, no, you can't be on the phones when everybody else is. But I think if we all kind of come together as parents and start to make some reasonable boundaries, then there isn't going to be as much pushback.

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the more data that we collect and the more that we can talk about this, I think it gives a lot more power to parents to say, look, like we know you're not gonna sleep well, that's gonna affect your school, it's gonna affect your sports, it's gonna affect your whatever it is that you're doing that's important to them. And so we are not gonna have phone in your room. Like that's just how it's gonna be. We're not gonna take it away, but you're not gonna have it in your room. We're gonna make sure that you're sleeping well, because I don't want you waking up tired and you need your eight hours of sleep. If you're getting three hours of sleep.

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and you're stressed and you're waking up, the first thing you're doing is looking at the news and some horrible thing. It just sets your day off in the wrong path. And it doesn't have to be that way. Let's do something different. Let's find a middle ground somewhere that we can both be happy with. I have some teenager clients who have anxiety there. They've got like pans. So they've got psychiatric manifestations from infections and toxins. And they find that, you know, they'll have their phone in airplane mode and they'll be listening to

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affirmations or something soothing or some sort of audio book or whatever. What do you think about that situation where they feel like their anxiety is being helped? Like they're having a hard time falling asleep and so consequently or if they wake up in the middle of the night with anxiety, it's helpful to use something like that. They're not looking at the screen. They're not looking at social media.

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Do you think that that is a middle ground or do you feel like that that's also a no? Well, I think that's a middle ground if that's what they're doing, right? I think that you have to be fair and reasonable and realistic to yourself. And you are able to keep your phone on airplane mode and you're gonna listen to some calming music or something like that, and that's fine. But if you're gonna start turning off the airplane mode and start scrolling every now and again, then maybe that's not the right thing to do. And...

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If you want that calming music or the calming podcasting, that's totally fine. But there are, again, there's other ways to do that. You can get a little device that you can have those things on. So that way it's not your phone, but it's something that you can still do that with. Yeah, so I think each child is gonna be individually different, but I do think it is very hard and it's very tempting.

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to assume that you're gonna be able to control yourself and you're not gonna Google something, you're not gonna look at something, there's not gonna be something going on in your life that you're super stressed about. And then you're like, oh no, I'm just gonna look at it for one second. And then your whole night is thrown off. That's tough for adults and teens, I don't think that's any different. So I think that we just need to be reasonable. Some people it's probably fine. I mean, that would be reasonable to me, but I would be cautious about that. And I do think that it is a good rule to just keep it out of the room in general. Also,

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from a Wi-Fi Bluetooth kind of perspective, we still don't really fully grasp yet. I think that over the years, we're gonna learn more and more about how these signals affect us in a negative way. And the farther it is away from you for all those hours, the better. Cause you know, if that's eight hours or whatever it is, if that's right by your head, then I wonder if in 10, 15 years, we're gonna really be like, I can't believe we were receiving by our phones. How bad was that? And I think that is gonna be the case.

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Yeah, and I think that you can turn off everything on the phone, it can be in airplane mode and it still has a battery. It's still going to be admitting some sort of wavelength, some sort of frequency. So let's go back to fatigue. Do you... When was the last time you diagnosed chronic fatigue syndrome in a kid? I don't know that I've ever diagnosed it.

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Personally, I think I've worked with kids that I thought it was the case and send them to specialists who also diagnosed it or we talked about it. Oftentimes I'll work with different specialists on it. But I would say, you know, if you do see it, I would say not frequently, but frequently enough. Like it's not something that I was really taught when I was training. And now I would say you see it every couple of months, every month, something like that, where there's a child or a teenager that has

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severe symptoms from fatigue or from some sort of infection, and then they get diagnosed with it later. And it's a hard diagnosis sometimes because you're kind of excluding everything else at first. I think for me, a lot of times what I would be doing is trying to be excluding some of the other things, working to make sure it's not allergies or anemia or a thyroid issue. And then once you've ruled out a lot of those other things, then by process of elimination, then that could be something that we would diagnose, I would say.

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Yeah, so and in my work, you know, I find that the root cause of a lot of chronic fatigue or chronic fatigue syndrome or even long COVID is a combination of what I call the toxic five. So it's like heavy metals and chemicals and molds and infections and trauma or nervous system dysfunction. Is it the same in kids? What are you seeing? And you've kind of alluded to some of these just now. But what are you seeing in kids as the causes of these?

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And I would imagine, you know, with the increased incidence of fatigue in kids, and then also with the increased incidence of the mental health issues, I would imagine on many of those causes are the same. Yes or no? I would say the causes are probably the same. I think it is very hard to say what is more common versus less common because it's so infrequently thought of in pediatrics, I think. And so it's not necessarily something that's going to get diagnosed very easily. And

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I would say it probably gets diagnosed more based on what makes sense for doctors to test for, which would be infections. So I feel like we would find it more often as part of like PANs. PAN does some sort of infection where they also have some fatigue and then you either lump it in under the diagnosis or you give it a separate diagnosis of chronic fatigue, whatever it is that the child has. That's where I feel like you find it most often. Certainly mold is getting...

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into the thoughts of doctors a little bit more and practitioner a little bit more. So I definitely have seen it and I definitely seen people look into it and have mold found in their home, whether that was the reason or not, who knows, but usually cleaning it up helps. So certainly could be one of the big contributors, metals, definitely one of the big contributors that is something that is not always tested in kids, but certainly could use some functional medicine testing, some hair testing, blood testing, urine, you could see high levels and thinking about some detoxification can help.

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So, yeah, I think those are certainly big reasons for it, but a lot of the time for kids there actually is a good reason too, and that's where it's important to have a – or not a good reason, but a reason that you can find in regular pediatrics like anemia, like thyroid issues, like allergies, symptoms of seasonal allergies, things like that, where you actually can get a diagnosis. And if you manage that, then the fatigue does.

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does improve. So I think it's a little bit of both and probably in kids, there is a diagnosis that's not chronic fatigue more often than chronic fatigue. And I feel like that kind of changes as you get older, like the older they are, the more likely I would say it's chronic fatigue versus one of the other things or something that you can't find another reason for. Yeah. And I'm glad you brought that up because, you know, chronic fatigue syndrome is a diagnosis, it's not a cause, right? And so

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Oftentimes, it's so when people get stuck with the diagnosis, sometimes they feel relieved because they're like, oh, I have this diagnosis, but it doesn't tell them what to do. Then you turn to your doctor and say, okay, thanks for the diagnosis. What do I do now? And they say, well, we don't have any treatment for you. You should just pace, right? Just take it slow, right? So yeah, so it's important always to look at those underlying causes. And it seems like part of the difference is that the kids may have like one or two causes.

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well, when the time they get to see me as adults, oftentimes there's a combination of like 20 different causes, and so it's like this buildup over time where eventually the body kind of like calls it quits and says, hey, I'm done. Well, with the kids, it might be a more simple fix like thyroid or anemia or something like that. Yeah, and I would say logically based on just kind of thinking about it from the outside perspective, for kids, it would be very abnormal to be so fatigued, right? At least that's the way we think.

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Right? So I think that for a kid who has a very severe fatigue, nobody's going to stop looking for a solution until they find something versus an adult. I think it is much easier to kind of put up, oh, is this chronic fatigue? Oh, you know, you just, you just, you know, who knows why you're just tired. And they kind of, they either put it off themselves or the practitioner puts it off as just being normal, which I think is, is more accepted maybe in the adult world versus a

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let's say an eight year old who's really tired and not active and not playing at the playground, you're like, that's very weird, there's something wrong and you just keep looking, you figure something out. So I do think there's a little bit of bias there in terms of, we would expect it to be less normal, maybe for kids, whether that's true or not, probably not actually true, but I think the way that we would think about it would be, we would not let a kid be so tired that they can't play, we're gonna keep looking until we figure it out. Yeah, how often would you say that

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their fatigue is from obesity and inactivity. I think that's a big, big part of it. My practice is not a huge part of it just because I have a very self-selected population. There's not a lot of obesity. Most of my patients eat fairly healthy just because that's what they're selecting, my office because of integrative medicine. And so in general, they're a little bit more mindful of these things. But certainly when I used to work in the hospital, when I used to work in the other practices,

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That is a huge issue and I imagine that's maybe one of the biggest issues in Western society right now, given the obesity rates of like 20, 30% in kids, 40% overall, something like that at this point. And that is a huge issue. I mean, if we're not eating healthy food, we're not getting the nutrients that we need, then how do we expect our body to function? Of course, we're going to be fatigued. And to me, for most adults, for most kids, for most teenagers, that's a good place to start. I mean, if you...

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If you've done any sort of workup and you've ruled out anemia, thyroid down, those kinds of things, then I would first think about food and diet. That to be, is the easiest place to manage and the simplest thing that you can make a change and just see if that's gonna be a big difference. And a lot of times it is. I mean, we, I've in many instances in the past, now change up the diet, whether it's for fatigue or for other things now, you know, even more commonly, change up the diet and you see those symptoms improve significantly. If you don't have all the nutrients, how do you expect your body to function?

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Yeah, that to me is number one, almost for, not talking about chronic fatigue, just really everything. Anything that I'm seeing these days, that's a good place to start. And so what do you recommend for kids to be eating? Well, the first thing I always recommend for parents is reading labels. So I think that's the first key is really starting to become a savvy consumer for reading everything that you're purchasing. And so that way, you know what's going into your children and trying to buy things that you actually know what they are. So I'm not...

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a big fan of one specific diet versus another. I think you need to eat real food. You need to buy the freshest produce that you can. That's local if you can get it. So farmer's markets, try to get real food, vegetables, fruits, wherever you can. Meat, you know, proteins, things like that. And try to make it as much as you can. That is gonna get you the most bang for your buck. A lot of people just buy pre-prepared food. There's a lot of preservatives. There's so much sugar. They're eating the ultra processed foods. And so you don't...

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oftentimes even need to dive so deep at first, you just need to kind of shift the needle from, we're buying prepared food to we're making our food. We're not gonna eat so much pasta and bread. We're gonna move to getting some more veggies and fruits. And if we're gonna buy a snack, then we're gonna turn it over and we're gonna look at the label and we're gonna buy the thing that has real words on it, that we actually know what they are, as opposed to the long chemical things. And usually if it's some word you don't even know what it is, it's probably not good for you. And I tell parents, you don't need a PhD.

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Don't need to know chemistry, just look at the label. And if you are buying a bag of chips, like look at the two of them and pick the one that has the better ingredients. And that's gonna get you a long way. And it adds up, I think a lot of what we're seeing with chronic disease, whether we're talking about chronic fatigue or many other autoimmune conditions or a lot of what I'm seeing in pediatrics as it goes up to adulthood, it's that we're so inflamed by everything that we're doing. Our food is so crappy, we're not getting the nutrients that we need and we're getting too many toxins.

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And if we start to give the body what it needs and we start to remove some exposure to those toxins and our bodies are magical and they can handle most things. But what do we expect to happen if we don't give it the nutrients that it needs? So that's what I think is going on. And just those simple shifts can make a big difference. And that's even why I wrote the book, right? That's why I wrote my book, Parenting Air Trials Based, one of the big reasons because I wanted to focus on those first couple of years. I wanted to talk to parents about these things, about the foundations of health, about...

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thinking about this from day one, whether you're pregnant or whether you have a young child, because we as practitioners wanna prevent people from ever getting to that point where they have a condition. And I don't think that we're thinking about this very often. We're not thinking about the food that we're eating. We're not thinking about the toxins. We're not thinking about the stress or the sleep. We're just kind of going about our day. And the numbers are so scary in terms of chronic illness at this point that we have to take notice of this and we have to set up our lives.

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around health. And I think it's important from day one to think about those things. And so that was one of the big reasons why I wrote the book. Yeah, health is no longer a guarantee for our young ones, unfortunately, like it was, you know, for our generation, where it seemed like the majority were not taking medications. And we're, you know, we're coming out all right, at least until we, you know, gotten to adulthood.

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So what sort of advice do you have for parents who have a picky eater? I think that with picky eating, it depends, right? Because there's two kinds of categories of picky eating. There's the child with a condition in which they're very picky, you know, they have autism, something like that. That's more difficult. And I think you work with a practitioner for that, for the just average, you know, picky eater. I think you stick with it. You keep offering different things.

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Obviously, it depends on the age, but you keep offering things over and over again. You don't force them to eat anything, but try to get them to take a bite, try to include them as they get older in purchasing. So take them with you to the store, take them with you to the farmer's market. Picky eater might not like apples, but if you go to a farmer's market and there's 20 different kinds of apples, maybe you can try a few, maybe they like one, and then you get some apples in there. Maybe you can do smoothies, maybe you can make popsicles, maybe you can include them in the cooking.

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You can use the rainbow, like eating a different color every day is a good way to get, to get kids included. So it's really about continuing to try because picky eaters, you know, they do get there, you do get the food in them, but sometimes we give up too easily. And we certainly can get those picky eaters to eat a little bit better. And the other big thing that I also talk about with picky eating is sometimes it takes a little bit of humility as a parent to realize that maybe we're not the best chefs.

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Maybe we're not the best at cooking. And so if you do have a picky eater, then sometimes it can be really helpful to take some cooking classes or watch some videos. And there's a lot of great resources out there for cooking. And your child might not eat broccoli, but it might be the way you're preparing the broccoli that they don't like. If you prepare it a different way, maybe they would. And again, some humility comes in really handy here because a lot of us didn't really learn to cook or didn't really spend a lot of time like our great parents.

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great grandparents did, it was like, you know, this was what everybody used to do, right? You're cooking every day and they have family meals and that really shifted over the last 50 years to prepared foods and quick foods and TV dinners and all of these things that we've moved to over the last few years. And so for many of us, we never really learned to cook. We didn't really get involved with our parents. And so maybe we're just not the best at it. And if you want your child to eat some of this food, then maybe learning to prepare it a little bit differently can be very helpful.

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to get that child to eat. So yeah, there's a different ways to do it. It'll get better either way, but I think there are ways that we can improve things today if we're willing to spend a little bit more time on it. My favorite new tool is ChatGPT. So I'll ask it, I'll tell it, I've actually created a GPT, which is kind of like a customized version that I call my cooking assistant. And I tell it, whatever I tell you, I want you to make a...

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give me a recipe that's gluten-free, dairy-free, sugar-free. And so I walk around my kitchen and I tell it what I have and then it tells me what I can make from it. And so I could see it also being a good utility for, hey, I've got broccoli, give me five ways in which I can make broccoli taste better for my kid or that sort of thing. So the other thing too that I found was helpful with our daughter when she was growing up was saying...

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not yet when she would say, I don't like broccoli, we would say, add not yet to that. It's kind of like a neuro-linguistic reprogramming sort of thing. So it's this idea that at some point you will, and at some point that did happen, but our taste buds are constantly changing. And so we have to remember that even though if our kid says no right now, it doesn't mean it's going to be necessarily no forever. We're not going to label them with

30:22

they don't like this particular food forever. And I would imagine that's kind of like a concern that sometimes some parents can kind of get into for ease of use, be like, okay, this is our shopping list. And it's just easier to be like, you know, our kid doesn't eat these particular foods. Right. Exactly. And I think that's very key is that you don't really just narrow it down to the only things that they'll eat. You keep trying to expand it. You keep trying, you know, that eventually it's going to get there. And I think that is

30:51

that is key. I mean, we just have to work with them. And I know that kids can be picky, but that doesn't mean that you have to go from chips to broccoli, right? There's a big in between there, you know, even if it's chips, like, well, you can buy the better bag of chips, right? And we can kind of work towards a little bit more healthy, a little bit better. And that adds up, it makes a difference. And so don't don't discount that you make little changes, whatever you can do within whatever budget that you have.

31:18

And some of that is just education and reading and picking between two things that are similar, similar price, but just one with better ingredients. And as you become a more mindful consumer, then you're buying better products. You start learning about things and you're like, wow, why was I buying this thing? I would never want to put that in myself or my kids. That's a crazy ingredient. I don't even know why that's allowed in America or wherever you live. So that is where you get to over time. It doesn't take very long once you start learning about these things, but you don't...

31:43

really have to, you just need to become mindful. And most people just go to the aisles and pick whatever, or pick the thing with the box that has the cartoon character that their kids know to get them to eat. And that is not a good way to purchase things. You need to purchase based on the ingredients. And it's not very hard to do that. It doesn't cost anything more. It just takes a little bit more time to turn that over. And not very long, a couple of seconds. Just look at the label and then you're gonna be like, oh my gosh, how much sugar's in there? I don't want that. Like that doesn't take very much to know, like 25 is more than five.

32:12

Right? We know that, right? So I think we can all do that. And that's going to be a big difference for our kids. It really is. I mean, I watch my four-year-old now. It's really interesting. You watch your own kids as they grow up and we eat very healthy and you go to a party or something and they eat a little different for one meal and how different they act later in the day based on that one meal. And it really gets you to think as a parent or as a practitioner, like what?

32:38

is the food doing to our kids? How much of the behavior, how much of the issues that we're seeing, how much of the fatigue or how much of the hyperactivity is actually just related to the food only? I mean, it's not all, but how much of it is just related to that that we're seeing? And I think it's more than we think because it really impacts my child and other kids that I know that eat very healthy. And you watch them and you're like, that is a different child eating. So it's really just an interesting thing. And it makes that much of a difference. It really does.

33:08

Yeah, and for those parents who are listening to this, who are trying to do that sort of thing and give your kids the best possible, and then they go out and they eat someplace else and they're noticing that, realize you're not alone. Like, we're all kind of dealing with this or have dealt with it. And so one of the things that we've done before is like we've brought dessert with us to these parties, right? My kid gets a cupcake or whatever. Or my daughter's actually from an early age was actually quite good at taking pills.

33:37

And so we would bring activated charcoal. And so she'd be like, hey, can I have a piece of this gluten, sugar, dairy cake? And I would say, okay, here's a couple capsules of charcoal, and it's not perfect, it's not 100%, but allows her to feel included. And then afterwards having a conversation about it. And when their behavior is different, noting that for them, how do you feel after having that, right?

34:06

Right. Because that to me is the goal overall. And that's the angle that we should be taking is we're trying to teach them, right? We're not trying to stop them from eating a piece of cake. We're trying to teach them why that piece of cake makes them feel bad and why that's bad for their health. And so the only way I think to do that is to expose them to these things and not make them feel excluded to do within reason, right? Not to have to eat a whole cake, but you know, you have a couple of bites, you have a piece when you're at a party. Okay. But as they get older, they start to understand

34:33

healthy food versus not so healthy food, food that makes me feel good versus food that makes me feel bad. And I would hope and what I want for my child is to just understand that, understand that in their own body that I eat this thing, I don't feel so good. So it's not that I can't eat it, it's just like, these are the consequences if I do. And so maybe I won't do that so much when I'm out on my own, you know, and I think that's fine. And also just giving yourself some grace too, that like, okay, if they eat a bag of chips once in a while or a piece of cake, it's not the end of the world. If you are...

35:01

managing their food most of the time, then your body's pretty good at handling these things. Yes, it might affect your mood or your behavior for a couple of minutes, but it's not gonna be something that's gonna be long lasting versus where we're getting to these days, which we're eating the crappy food over and over and over and over again. And that leads to the chronic condition, the autoimmune condition, the diabetes, whatever it is, that's what we're seeing these days. And so let's be mindful to kind of push things back and to control most of it. And I think that's gonna be good enough for most kids.

35:31

Yeah, and I like the flexibility that you're talking about too, because I think if you're too strict also with your food choices, the kid is going to have anxiety around having different kinds of food. I do know that I've had clients and teenagers who, let's say they've got food allergies and then we're healing things and removing the toxins and they can tolerate things more.

35:57

they still have so much anxiety around like being exposed to a certain food, you know, or participate in or eating that food, right? So we have to make sure that we're not stressing out the kid even more by being really strict with our food choices. Yeah, I couldn't agree more. I think that there's extremes on both ends and you definitely hear about the kids that are totally extreme when they're young about not eating anything. And then as they get into teen years, they gorge themselves on all the things they never

36:23

have before. So I don't think that's a good solution either. I think there's a middle ground. And I absolutely think that boundaries are just fine. You know, I think that is something that we have to be okay with. And we have to take back our power as parents. That is totally fine to have boundaries. And it is totally fine to bring snacks, like you mentioned, or make sure that we're eating healthy things. But it's about teaching them. It's not about keeping them away from it forever. So they never have a sugary snack. It's about teaching them, managing it.

36:51

when they try it, you talk to them about it, just like you said, like you eat that snack, like how do you feel? This is why we don't wanna eat this, how you're acting, like these are the things that, over time, I think they really do internalize it and it helps and it's gonna stop them from having a lot of anxiety around food, but just understanding that there's a lot of good food out there, there's a lot of food that's not so healthy, and so we try to eat the healthier food most of the time so we can be healthy and so we feel good, there's nothing.

37:18

There's nothing majorly anxiety provoking about that. It's not about not eating food. It's just about choosing the best option for yourself and your health. And that's an educational process that takes years, but it's something that we can foster in our kids. And that's what I hope that we impart on next generations so that they're eating healthier, because we've gone in the direction, we really got in the wrong direction. And I, at least I'm happy to see it starting to push back. Like there is a lot of discussion around healthier eating these days. A lot of parents are being more mindful of these things.

37:48

people are buying better products. And that's really what's gonna push the needle is just not buying the crappy products anymore because companies aren't gonna make what doesn't sell. Mm-hmm. Yeah, and I think that a lot of it also comes down to modeling. Obviously, if it's not in the house and if mom and dad are eating this way, then it becomes the norm. Like, this is how we eat, right? This is healthy eating, right? Mm-hmm, yeah, you can't expect your kids not to eat Oreos if you have Oreos in your house. You know, you just can't purchase it anymore. And if your kids are younger,

38:17

it's easier because they don't know any different. So that's just what it is. And I think that's fine. If your kids are older, then I think you need to have a discussion with them and say, you know, we're gonna work on our eating. I wanna be healthier. And so we're just not gonna buy some of these things anymore. We're gonna have lots of good food and lots of good snacks. You can come with me and we can pick snacks, but we're gonna be more thoughtful about what we have in our home. So that way we can be a little bit healthier and then you can still eat your treats and snacks other times, but we're gonna, as a family.

38:42

We're just not going to buy these things anymore. And they might be upset for like five minutes and then they'll get over it. You know, they'll move on. As long as you provide them with things that they will still eat and they're still happy with it, then it shouldn't be an issue. They might be a little upset, but they'll get over it very quickly. And they will, they'll not starve themselves. They'll eat. There's good food there. Yeah, we ended up leaning quite heavily, you know, on fruit, you know, for my daughter. What do you think about in terms of

39:11

What percentage of meals should be fruit or, you know, throughout the day, how many pieces of fruit? I don't know if I have an exact answer for that. I think it's hard to eat too much fruit. I mean, I'm sure you could, but nobody eats enough. So I feel like, you know, the bigger issue there is just making sure we're getting some fruit and some vegetables. I think if you can get in fruit like twice a day, that's good. At least once a day would be nice, but two times is fine. When it comes to sugar, you know, I'm not...

39:40

super concerned about natural sugars that come from fruit or vegetables or honey, things like that. I mean, yes, you can have too much for sure, but that's not where I'm going to put my foot in the door in terms of worrying about what's going on these days. I think we want to get rid of the artificial sugars and we want to eat as much fresh fruit and veggies as we can. So if your kids like something, then get it in there. A couple of servings a day is totally great and reasonable.

40:07

If you're mixing it up, that's really where I think the key is just variety, different things, different fruits, different vegetables, different colors. And if you're doing that and you're getting like one veggie a day, one fruit a day, ideally more, but at least if you're getting that to start, then that's going to get you a long way. Yeah. The stats or supposedly the recommendations are like nine vegetables per day or what are those recommendations? Yeah. There's something like five to 10 servings.

40:33

But I think the reality is you try to have some veggies with each meal, some sort of veggie with each meal. I mean, maybe not breakfast, but you can have some fruit with breakfast or something like that. But I think if you're having a fruit or a veggie with each meal, that's good. If your snacks can be somewhat veggies, I think that's good too. Maybe one of them a day could be a veggie as opposed to some other thing. But the recommendations are different than reality. And right now for me, as a practitioner, seeing what's going on out there, it's really just get them in there.

41:02

diet at all. Let's say that I mean, some kids, it's like 79%, they're eating ultra processed foods, that's their entire diet. In totality, they're really never getting veggies, they're really never getting fruit almost at all. So let's just start with once a day. And if you are if you are a parent who and most people are listening to you probably are a little bit health conscious. So maybe you can get one more meal in a day one more fruit or veggie one one more meal of cooking a day. I think that's a reasonable goal for almost everybody. Let's just notch it up one, one degree and that's going to do a lot for our kids.

41:31

And in terms of cooking, do you think it has to be done every day or can some of it can be going to be done on the weekend, you know, in terms of preparation and then you cook on the specific day or can you cook it on the weekend and then kind of eat it throughout the week? What do you think? Yeah, well, I think that there's levels of good, right? I think the freshest products that you can get the more you can cook it that day.

41:55

and pick it that day and cook it that day, that's gonna be the best. That's not very realistic for most people, but that's gonna be your best version. Now, is it better to prepare something on the weekend and then freeze it or keep it in the fridge and eat it later during the week? Yeah, absolutely. That's better than buying some pre-prepared packaged food. So that's totally fine. And I think that's a reasonable thing for most families to do. Cook something that's a bigger meal, have extras that way you can have it during the week, and then you have two or three home cooked meals from just one.

42:22

I think that's a really great solution for the busy parent. And when I talk to parents, it's really just cook as much as you can. Because the more that you cook, the more that you know exactly what the ingredients are. And even by the best possible food that there is, there's still probably a bunch of ingredients you don't even know what they are. And things are sprayed that you didn't even know or they're not on the label. So that's the best case scenario. So if you're buying things that are pre-packaged, then there's all of that plus everything else that's listed that's not so great for you and all the preservatives that keep them. So the more that you can cook, the better. That's going to be healthier.

42:52

and you know exactly what's in there. But absolutely, if you cook a bigger meal and you have some, let's say you're more free on the weekends and you cook a big meal so you can have that two or three days during the week, that's great. I mean, that's two or three meals that you've cooked and you didn't have to spend the time two or three times. So yeah, I think that's a great suggestion and certainly reasonable for a busy parent. And so it sounds like really a focus on produce and I would imagine as organic as possible. As organic as possible, produce, yeah, so veggies, fruits.

43:22

Um, you know, if you're not vegan or vegetarian, getting good meats that are either local or, you know, fish that's wild, whatever you can do the best possible version, but even still, I would still rather you get something that's that you prepared yourself than something that's already been prepared. So if you're going to buy, let's say a farm raised fish, I'd rather it be something that's in a package that you now prepare than something that's already pre-prepared that has a bunch of stuff on it, cause they sprayed in all sorts of chemicals and preservatives to do that. And so we have to move.

43:50

one step forward and whatever that is for you, that's going to get you some benefit and it's going to decrease the chemicals you're exposed to. So for parents who are vegan or vegetarian and the kid is being raised vegan or vegetarian, how do you handle that if the kid comes in and they have symptoms that might be related to the diet?

44:19

That is something that would have to be discussed with the parents. There's a lot of controversy around vegan, vegetarian lifestyle in terms of especially with kids, but I've very rarely seen it be a major issue as long as you're eating the variety of foods to get all your nutrients. There are certainly some people that I have seen or adults that I have known that did try to do a vegan or vegetarian lifestyle for a time and then were not so healthy and were missing some vitamins.

44:48

maybe we're a little bit anemic or whatever it was and reintroducing some meat or other things did help them. That's not always the case. I think you can be healthier vegan or vegetarian or healthier or not depending on what you're eating and the quality of food. If you're eating crappy vegan food, then that's not any healthier than eating as a regular meat eater. I think if you eat really healthy food as a vegetarian and a vegan, then potentially you could certainly be healthier than someone that's eating really crappy meat and really crappy...

45:14

know, veggies and lots of processed foods. I think there's a middle ground there. But I don't think that the diet is the issue so much as just thinking it through and then having a discussion. Because sometimes, yes, it could be based on the diet, it could be low on something that the child needs, but that's probably less so than all of the other things that we talked about already. Yeah, definitely lower on the priority list. So

45:39

why do bad foods taste so good? I think sometimes it's helpful for people to kind of like understand they're like how can it be bad for me when it tastes so good? I think it's been engineered to do so. You know these companies they're smart, they know what they're doing, they have all the money that they need and they have studied and researched what's going to taste the best, what's going to light up your pleasure centers in your brain. It's basically a drug and they know how to give you food that makes you really happy but doesn't make you full.

46:08

and makes you want more. And they've perfected that. I mean, a lot of the food companies were bought out by smoking companies when smoking was kind of on the downswing, you know, 50 years ago or so, then a lot of those companies bought up food companies and they've used many of the same tactics to kind of get us addicted to these foods. And I don't think we really realize how much is marketing and how much of the foods are really...

46:34

It's even hard to call them food sometimes. It's chemicals that light up those centers and they're food-like substances, but they're not real food. There's a lot of chemicals and preservatives. So yeah, they know what they're doing and they have done that and they give you calories, but not good calories. Sounds like we're talking a lot about addiction here. So food addiction, talked about phone addiction a little bit, social media. There's a lot of companies out there that

47:03

by having humans more addictive to their product? Yeah, I mean, realistically, what is a company's job is to make money. So we can't fault them for that. That's their job. That's the CEO's role is to make more money this quarter than last quarter. And so anyway they can get there is how they get there. It's not necessarily nefarious. I mean, sometimes it probably is, but for the most part, it's not nefarious. It's just like, well, how do we get as many people as possible to eat our product or to use our product or to be on our product? And they'll do whatever they can.

47:33

to get there and they're not gonna be thinking about your health, they're gonna be thinking about how can we get you to buy our product again? And that's their job. Their job is not to think about health. We have to make them think about health. Yeah, it's an interesting conversation because oftentimes people say, I can't believe that this company is doing this, that they have these practices. But the thing is that when they're a company that is trying to make money, that is what they do.

48:02

Like we can't be aghast at their behavior when this is what they do, right? All we can do is take care of ourselves and make different choices and vote with our dollars. Right. Exactly. It, there, there's no rocket science there. There's nothing that isn't very basic common sense. A big company wants to make more money. That's it. That's there's nothing else there. They're not trying to harm you. They don't want to.

48:24

They want them to use their product more. That's it. I mean, I'm sure there's some nefarious people in the world that do some crazy things, but that for the most part is really what they're doing. And so we just need to know that. I mean, if you're a big company, if you're a big food company, you're not trying to make sure that your people that are eating your food are the healthiest. You're trying to make sure they buy it. That's it. That's what you're worried about. And they're not going to make something organic unless you make them make it organic because then it costs them more to do it. So they're not going to take out an ingredient unless you make them take out that ingredient.

48:54

and they're going to take it out because we force them to by law or because we don't buy their product anymore with that thing on it. And then they are like, okay, well, I guess we should take this out since no one's buying it anymore. That's how it works. There is no other way that it's going to work unless the whole system changes, which is not going to happen in the next two weeks. So I think that it's something that we have to be mindful that we have to take care of ourselves and our family, be mindful consumers. And that is going to get us most of the way there.

49:21

Okay, so let's go into vaccinations, childhood vaccinations, because I know this was a struggle that we had when we were bringing up our daughter and making that decision. What is your opinion? Yeah, so first I'll say this about vaccines. It is really unfortunate to me that even the mention of the word begins a crazy cycle. No matter what you do, it's like you get into an argument, you can't post about it anywhere, you can't talk about it. It's really...

49:50

I think at this point, really ridiculous that it's so censored and so crazy of a discussion. I think it is very important that we have open, honest conversations about vaccines so that way we can have the healthiest kids possible. And right now it seems like you can't even have a discussion about it, which is super frustrating as a dad, as a pediatrician, and as somebody who cares about health. As a practitioner, I can't give people advice on what to do or not to do. You can't give medical advice, certainly.

50:20

anything outside of the office and the recommendations are what they are, right? The recommendations are, you know, if you look at the CDC, you look at the American Academy of Pediatrics, they have their schedule, and that's what's recommended to follow. Anything else outside of that is really up to the parent and up to the family and up to discussion between them and their doctors. And so I think it is reasonable to ask questions. I think you should ask questions. I think you should do your research. I think there are a lot of things that are really unknown at this point about shots. There's really

50:49

not the best research on anything long term or anything in combination with each other. And so I do think that there's a lot of questions that need to be answered over the long run, but the recommendations are what they are and that's the best that we have. And so, you know, you have to decide whether you want to follow the CDC guidelines or do something else.

51:09

So Long COVID is a new player on the block, obviously the last couple of years. Are you seeing kids with Long COVID or MISC? What is it? MSIC? Yeah, a little bit, not a ton. I've certainly seen one or two. I think it's not as common in kids. And I think, yeah, I haven't seen a ton of it. I've definitely heard of it, but it's not, I wouldn't say it's super common. Maybe one or two kids in the practice potentially have it.

51:35

Um, and, and well, one of them, one of them did, but they're getting much better now. Um, there was another one that, that, you know, maybe, maybe had it, maybe not. It wasn't very severe symptoms, but they had like more fatigue and things like that as well for, for a long period of time and some issues with smell and taste and things like that for a while. Um, but that has improved. So I think by and large, it's, it's not as common in kids, but it's certainly around.

52:00

So we've got just a couple minutes left. So where can people learn more about you and the wonderful work you're doing? Yeah, thanks. So they can find me on Instagram or X at drjolgator, or you can grab the book, Parenting at Your Child's Pace, and it's available everywhere. You can get books, or you can go to pare and you can grab it from there. And I know a lot of your audiences.

52:24

you know, maybe a little bit older or not necessarily having kids, but maybe some of them do. So if you're having kids, then this could be a great book for you. If you know someone who's having kids, if you're a grandparent and one of your kids are pregnant, then this could be a great book for them. And again, it's a really nice foundation. I go through all the regular parenting questions, but from an integrative parenting spin and also talk about helping parents to de-stress as well as to set that foundation for health. And there really isn't any other parenting books that do that.

52:52

as far as I know. So that's really why I wanted to do the book is to really balance that health perspective with all the regular parenting questions that new parents have. Awesome. And you have a free gift for our audience. What is it? So there's a couple of things. So if so you can download from see if you go to pare you can or from you guys you can get a vaccine guide. There's a health a healthy guide top 15 tips and you can also get a free month.

53:21

to my parenting community. So it's a great place to chat and ask questions. There's a lot of resources in there and courses. And so if anybody wants to offer a free month, access to that as well. And if you grab the book from my website, you can get a bonus chapter and a free chapter. So all that's on the parenting at yourchildspace.com or you can reach out through your link. Excellent. And then there's also, is that the rais

53:47

Oh yeah, that too. A lot of things that are out there. Yeah, so raiseamazingplus too, so you can get a discount with that too. So that's the courses. Excellent. And so it sounds like that's a free sneak peek, download vaccine information, simple shifts for a healthy family guide for free. Awesome. Yeah, that's where you can get the guides, yeah. Yeah, I know that parenting is challenging, you know, and all we really know is how to parent.

54:16

based off of what we learned from our parents and what we potentially don't wanna do, right? And so it really requires a lot of mindfulness and any advice that we can get, I think is welcome. So I definitely encourage people to go check out your book. Thank you very much. And thanks for everything that you do and all the patients that you're helping. Thanks Joel, thanks for coming on. All the best. So if you have chronic fatigue, long COVID or mass cell activation syndrome and you're looking for help,

54:45

Check us out at energy MD method.com. We have a program for almost every single budget and we're here to help.

54:54

I hope you learned something on today's podcast. If you did, please share it with your friends and family and leave us a 5-star review on iTunes. It's really helpful for getting this information out to more people who desperately need it.

55:09

Sharing all the experts I know and love and the powerful tips I have is one of my absolute favorite things to do. Thanks for being part of my community. Just a reminder, this podcast is for educational purposes only and is not a substitute for professional care by a doctor or other qualified medical professional. It is provided with the understanding that it does not constitute medical or other professional advice or services. Thanks for listening and have an amazing day.