I'm Maya Shetreat-Klein. I'm a pediatric neurologist
and an herbalist and a naturalist
and the author of The Dirt Cure: Healthy Food, Healthy Gut, Happy Child.
I came to this journey of integrative health probably pretty early.
I was actually first interested in
becoming a psychoneuroimmunologist.
When I watched a Bill Moyers special called Healing and the Mind
when I was in college and I thought, "Wow, I want to work with mind, body and
think of the body as physical, emotional and spiritual,"
and there was this field apparently called psychoneuroimmunology
so I went to med school. I wrote about it in my med school essay.
They somehow let me in.
Once I got to med school, I kind of got lost in
all the things you have to do to become a doctor
and I got very caught up in– I got married,
I had 3 kids over the course of my pediatrics training and neurology training.
But once I finished or I was close to finishing,
my youngest child developed very severe breathing issues that appeared to be like asthma
and no one was really able to help me figure out
what it was or why it was happening.
I felt pretty desperate
because not only did he have the breathing issues,
but he also had a huge developmental plateau at the same time
where he started to fall all the time and got like very clumsy
and wouldn't catch himself, so he lost his protective reflexes
and he stopped gaining new words at that time as well.
I obviously became really worried and yet
all the great doctors and colleagues that I took him to
basically had nothing to say. They just said, "Well, you know, he's going to be fine,"
or "He's a reactive kid," or,
you know, "Well, there's nothing that much to do right now. Just watch."
What I ultimately found was that he was severely allergic to soy
and when we took him off of soy,
his breathing problems totally reversed
and after 10 months of constant issues and constant medications.
At that point, I realized how powerful food could be
and in addition to that, realized how important it was
that the gut and the immune system and the brain were also
deeply connected to each other and I wanted to be able to bring that to not just my family,
but to my patients and the larger community as well.
Any time that you practice medicine differently than how everyone else does it,
you're going to get the shaming.
You're going to get angry colleagues. You're going to have a lot of general disapproval.
I mean, I think there was a lot of, "Well, show me the science for that,"
and then you show them the science.
My book has over 700 references and they say, "You call that science?"
It's definitely a journey. You have to have pretty thick skin to do things
differently than other people do but it would be impossible for me to do it in any other way.
My book is really about the concept of dirt which is three things.
It's being exposed to germs and microbes,
it's eating fresh food from healthy soil and it's getting out into nature.
That is definitely the foundation of what I do with my patients
and my patients can come in with all kinds of issues.
They come in with autism or ADHD or
learning disabilities, explosive behavior,
tics or PANDAS,
which is sort of a combo of tics, anxiety and OCD, seizure disorder.
We really have the gamut walking through the door,
and then there are the kids who have things no one can figure out
and they've been to lots and lots and lots of different places.
The job that I do is really a lot of detective work.
It's first of all– sometimes to figure out what the real problem is,
but especially to work backwards and figure out what the root cause is
and so often, the root cause is related to what the kids are eating
and really their exposure, not getting enough exposure to very diverse organisms
and foods and experiences outdoors because that's what our bodies and brains crave.
We have thought for a long time now that being sanitary
and being hygienic and being sterile was what we needed in order to be healthy,
but it turns out that we have this entity called the microbiome
which is 3-5 pounds of bacteria and other organisms that live in and on our body.
It turns out also that these organisms are orchestrating,
in relationship with our body,
many, many, many healthy cycles and they basically keep us healthy.
From our gut, they're regulating how we digest
and our immune system in our gut.
From our immune system which is in constant conversation
with all these different diverse organisms, hopefully diverse organisms,
and our brain, so there's a whole field of study now called psychobiotics
where pharmaceutical companies are basically investigating the impact of microbes
on our mood and our cognition and the way that we think and feel.
Basically, being exposed to all of these organisms is critically important.
Meanwhile, kids are washing their hands with antibacterial soap.
They're on antibiotics at the drop of a hat.
Houses are being cleaned with bleach.
We use dishwashers instead of using sponges which actually have bacteria that are
potentially really beneficial because we need a lot of diverse organisms,
and kids are indoors so much,
whether it's because they're on screens or because of stranger danger
or because they have a lot of homework. Whatever it is,
they're not getting that diverse exposure to microorganisms
that are really very critical for gut, immune and brain health.
There's actually studies that have looked at
children who live in urban apartments and compared them to children who live on farms,
and looked at the diversity of organisms and how many bacteria live in each environment
and it turns out that there's an equal number of bacteria
that live in the urban apartment as compared to the farm,
but the difference is that children who live on farms have far more diverse exposure to bacteria
and that's why children who live on farms are a lot less likely
to have allergies, asthma, autoimmune conditions
and other things, and they're actually much better prepared to fight infection as well
because when they have such a broad array of organisms,
it means that no one organism is going to grow out of control.
A lot of people might wonder,
is there danger to touching the pole in the subway
which probably has a lot of bacteria on it and how is that different from being exposed to,
let's say, farm bacteria
and is there danger to farm bacteria?
Of course, you know, the answer is, I mean,
we want to have different exposures, but what might be on a subway pole
is not necessarily a very, very diverse number of organisms as compared to, let's say,
what we're going to find in soil,
because in 1 teaspoon of soil,
there are as many organisms as there as people in the entire planet,
whereas in the subway, we're talking about what we find in an urban environment,
which is much, much more restricted.
We don't necessarily want to go licking the subways,
but at the same time, it probably isn't as bad as we think it is either.
But I do recommend washing hands with just regular soap
after being on subways or being on farms,
just because I think that it's okay to have some exposure
but we don't need to, pour it into our bodies in that way.
In terms of having clean fruits and vegetables,
I mean, the goal on the one hand is to actually,
when you eat your fruits and vegetables, to maybe have a little trace of soil
or some exposure on the fruits and vegetables.
It's not that you want them to be completely free of any exposure.
You just want to make sure that that's not going to be a dangerous exposure
and that it's not some kind of toxic chemical pesticide
that actually can cause real damage in our bodies.
For me, I try to grow food if I can grow food.
I buy from farmers' markets
where hopefully they're not massively power washing all the vegetables and fruit.
I do want it to be rinsed. I don't think it needs to be caked in soil.
But if you think about– if you go to a pick-your-own place
or if you are picking like a string bean off of your own plant,
you're not necessarily going to go and scrub it down with something.
I mean, you're going to enjoy that right there and then.
That's really how it was intended to be.
For me, having some of that exposure is good.
I might like pull something out of my garden and rub it on my pants or something,
but I usually will rinse it, wash it.
I might use soap depending on how dirty it is from my own garden
or if I'm buying it from the grocery store.
I don't really go above and beyond that, but I do try to buy
organic or especially biodynamic whenever I can.
I mean, I love being in the dirt. I love gardening.
I love being barefoot on the ground,
and so gardening and growing things is incredibly important to me.
I also love to be in relationship with plants.
That's something that just brings me joy and I think that's important for every person.
As a physician,
I really wanted to not just have these things available to my own family,
like keeping chickens or keeping bees or growing medicinal herbs or growing food
which I thought was really important for my own kids
for many reasons, but also I think when people come to see their doctor
and you can take them outside or they see the chickens
and they can run out and they can see the chickens are laying eggs
or take an egg home with them
or see that maybe one of the herbs that they take every day,
they can see that beautiful plant growing and maybe the flower and see how pretty it is
and connect with it in that way,
I think that's really important and it really takes us back to the way that
medicine and healing should be practiced,
which is that all healing really comes from the earth,
so it's important to have a relationship with it.
When someone normally goes to a pediatric neurologist,
the neurologist will take a very detailed history
and do a very detailed exam
specifically to test different parts of the nervous system
and then depending on the problem that they present with,
more often than not,
they're going to get a pharmaceutical as their treatment
and they may also be sent to physical therapy or occupational therapy
or speech therapy, something of that nature
if they're having some kinds of difficulties with
learning or development.
But ultimately, what's really most commonly offered is a pharmaceutical,
and that could be a stimulant for ADHD or it could be something for behavior,
mood stabilizer for behavior.
It could be a medication to help with migraines.
It could be something for seizures, right, to help stop seizures.
In my practice,
when I began practicing,
I did not want to write a prescription for every single kid that walked in my door,
particularly for kids who had behavior issues or emotional issues or focus issues.
I felt like there had to be another way so I dived into the literature.
Essentially, I tried to find what was out there that was
in food and in nutrition and in nutrients
and in herbs
and that's really still what I use in my practice as the mainstay
to treat children with all those kinds of chronic issues.
The first thing that I tell parents, and I think this is across the board, whether
a child has an issue
or if they're perfectly fine and you don't want them to develop any issues,
is to really cut processed food as much as possible,
which means really looking to eliminate food chemicals like
MSG and aspartame or any artificial sweeteners,
things like high fructose corn syrup, food dyes, preservatives,
all of those are things which can be very disruptive to neurological health
and I've seen very miraculous reversals at times
simply by just cutting out food chemicals.
The next thing I recommend is looking at possible food reactivity.
A child who has any kinds of,
let's say, eczema or asthma or
hives or rashes or
stomachaches, chronic stomachaches or constipation,
oftentimes, they're reacting to food and when you remove that food,
then you see a huge leap in neurologic health or in terms of mood behavior,
all of those things.
The third thing I would say is I'm a big fan of fat for children.
The brain is made up 60 to 70 percent of fat
and so healthy fats which can include things like butter or ghee,
coconut oil, olive oil.
I'll even recommend using like marrow
from marrow bones in soups or things like that,
any pastured eggs.
All of those kinds of foods are filled with healthy fats
and actually healthy cholesterol
which is critically important for brain health and for mood health.
Terrain medicine is really this idea that
we are connected to the natural world around us.
Inside of us, we have our bio-terrain which is
all of our organ systems, right, our body and everything that goes around inside of our body.
Outside of us, we have our eco-terrain which is
food, soil, plants, water, wind, air, sun,
all of the things that are around us.
Up until now, it seems like we've really separated those two things,
so we thing that we can be healthy just in and of ourselves
without thinking about our eco-terrain, thinking about the world around us.
But ultimately, the only way that we can actually be healthy
is if the world is healthy with us and we have to be in alignment with that.
Some of what I learned from terrain medicine comes from science.
Some of it comes from I think common sense ways that,
you know, probably many of us grew up or maybe our grandparents grew up
where we were really connected with the outside world.
Some of it actually comes from indigenous people that I've studied with for many years
and the way that they connect with the natural world which is
profoundly different than we do in kind of the developed world.
It's about learning how to not just eat well,
not just how to be exposed and not just how to get out in to nature and take a hike
or garden which are all incredible things and I think a little bit more obvious,
but also using different kinds of plant medicines,
both ingesting potentially but also making mandalas with plants
or working with kind of sacred space and plants.
In my practice, I try
always to avoid writing a prescription
unless I really have to.
But sometimes I have to. I mean, if you have a child who's having seizures,
you can't be rigid about this idea that like medication is always bad.
It's not always bad.
For me, whenever I write a prescription,
and I would say it's pretty rare,
I always am thinking, how are we going to get this kid off of this medication?
I have this family that had twins
actually with– and they were both having staring spells,
which is kind of absence seizures
and they had been on numerous medications and were really not able to tolerate those medications.
They had gastrointestinal stuff or they had drowsiness
or they had other kinds of reactions and basically both of these kids
were having like 100 staring spells a day over the course of the day.
The parents were kind of desperate.
What we realized was these were kids who were also highly allergic
but they were eating a lot of the foods that they were allergic to.
Once we cut those foods
and really started to help calm down their gut and their immune system,
their seizures just completely stopped.
They were seizure-free and actually were able to come off their medications
and stopped really having seizures completely.
Two twins who were having 100 seizures a day
and ultimately really got better not on medication but by changing their diet.
Neurologists are a very smart group of people
and actually are great problem solvers and great detectives.
I think the challenge is really how to bring in the idea of lifestyle,
both because it's really not taught in medical school.
I mean, most medical students get not more than a few hours of any kind of nutrition
education at all,
so the concept of food as medicine is
really distant still from most medical students' experience.
But even more so the idea of not wanting to use medications as much,
right, like why not use medications if you have them
because medications are a band-aid.
First of all, they're not getting to the root cause of the problem
and in addition to that, they have a lot of side effects.
If you go out into the woods
and immerse yourself in the woods for an hour,
and this actually– this is something that's well-studied mostly in Japan
but also in other parts of the world,
and it's been looked at in children too
–focus is better, executive function is better,
mood is better, sleep is better,
natural killer cells increase which means your immune system is stronger.
Anti-cancer proteins are produced in greater amounts which means you're fighting cancer.
That's simply by going for a walk in the woods.
You're more creative. I mean, literally,
there's no pill, there's no medication, there's no even combination of medications
that can achieve that.
In Japan, actually because it's a part of the culture there,
this concept of Shinrin-yoku or forest bathing,
this is something that's done all the time and it's studied and it's prescribed,
but generally speaking,
we're not doing that in neurology
and it's probably one of the most powerful things we could really offer to people.