Mind Body Connection in Food and Healthcare with Pediatric Gastroenterologist Dr. Mazen Abbas

The Western model of care, lacked a real crucial ingredient, to improving health, especially with chronic conditions. I would say it's probably that combination of environmental changes, food changes, and then also added stress, and and lack of being outside and being in nature and and exploring and farming and doing things that we used to do as humans. The father of Western or current medicine, as we think about it, was Hippocrates. Right? All medical students have to give the Hippocratic oath. And Hippocrates, one of his famous quotes is, let food be thine be medicine and medicine be thy food. Aloha, and welcome to Tuesdays with Morrisey where we share insights from great thinkers. Today, I'm excited to be joined by doctor Maaz and Abbas. Doctor Maaz is a pediatric gastroenterologist based in Hawaii focused on bringing together the knowledge of western medicine with traditional medicine traditions. Doctor Mas, thanks for coming on the show. Hey. Thanks, Adam, for for bringing me on the show, and and aloha, from Oahu and Hawaii, where I've been living for twelve years now. In addition to being a practicing gastroenterologist, you're also the cofounder of the HEAL Foundations and a new supplement company called Funbiotic aimed at, kids. You're clearly on the forefront of this wave of integrative medicine and health. I'm curious. Why is it so important that we think more about bringing together western medicine with traditional medicine traditions? Well, that's that's really, a crux of kind of what my career has been. So, you know, as I finished my training, in osteopathic medicine, so I'm a DO instead of an MD, we were taught a lot about holistic health and and but as a medical student, it wasn't something like that was at the top of my mind. You know? I just wanted to get through medical school. I wasn't really thinking all this integrative medicine, holistic health, and traditional medicine. But it was an important part of my training and coming from a public health background, working for the Centers for Disease Control. And as I trained to be a pediatrician and then later to to be a pediatric gastroenterologist, I started realizing that the Western model of care, lacked a real crucial ingredient, to improving health, especially with chronic conditions. And I what I as a pediatric gastroenterologist, one of the biggest indicators for me for what's going on in the environment and in our food supply is the the gut gut of a child. Like, what's going on with the gut of a child. Like, it's an indicator for me that there is something wrong going on in that child's environment. And and western medicine is great. It's it's the technology and the advances in the research we've had with western medicine, it's been enormous in the last fifty years, the amount of advancement we've had in terms of, treatments and diagnostic procedures and medications. It's probably the most amount of knowledge in medicine that we've gained in in our history. But it's really good for acute care. You know? The the all these advances are great to stabilize, you know, patients and and and get them to to somewhat back to function, but it's not actually great at addressing the root causes of most people's illnesses. And it's not great at helping people see that that healing comes from within. You know, the the the quote from the father of Western or current medicine as we think about it was Hippocrates. Right? All medical students have to give the Hippocratic oath. And Hippocrates, one of his famous quotes is, let food be thy the medicine and medicine be thy food. So what what does that mean when we think about, you know, our food supply and what's happening in the change of food and what's put into food and how people view food in today's world. That's a really important part of why we're seeing a lot more gut disorders in children. The goal of an integrative health and medicine is what I've read and what we talked about in in the prep is to create a holistic health care system not that not only addresses individual health, but also considers family community environmental health, aiming for comprehensive whole person care. Couple months ago, we did an episode with doctor Rashika Fernandapule. Doctor Rashika was the founder of a company called Iora Health, which sold to One Medical and then ultimately Amazon. And what we talked about is, like, really simple. He's like, yeah. Health care can really come you don't even have to be a doctor. It can really come down to a couple things, moving your body, watching the food you eat, and having community and and social interaction. Yeah. It's, such a simple easy recipe. Right? But when people are sick, that that is really hard. Right? Like, it's hard for them, to get past the fact that they're not feeling well. And getting people to see these things after they're sick is much harder than to try to help influence, the population from from the beginning. Like, I spend a lot of time educating parents on, you know, how to keep their kids healthy, you know, instead of waiting till their kids are really sick. And and that's like a preventive model. Right? So integrative medicine is using these ancient knowledges that we've had as humans for, you know, probably hundreds of thousands of years. Humans have known what good health comes from and how to prevent disease. But we, over time, have lost those instincts because we're not out in nature. We're not really connected to the plants like we were before. We're not, you know, getting into the soil and feeling the soil and what's in the soil. I, you know, I was volunteering on a farm here in Oahu, called YoGarden. And, Zach, Zach Bush, who, I don't know if you've if you've had a chance to see any work by Zach Bush, but he was talking about the health of soil. He's a physician, and he happened to be volunteering on the farm the same day. He was living in Kaneohe here on Oahu. And, we talked a little bit about soil health and and pesticides in the soil and Roundup and and how that's really affected the gut of children, especially. And and and seeing diseases like pancreatitis in young children, especially when I was working in California was pretty astonishing to just see diseases that, like, you know, thirty, forty, fifty years ago, children weren't getting that they're getting now. So, yeah, so for me, like, part of why I'm I'm I'm moving towards more integrative medicine and incorporating that into my practice is that these traditional ways of healing that have existed for thousand years, things like Ayurveda, yoga, traditional Chinese medicine, acupuncture, many other modalities that have always been there and humans have used to help prevent disease, but also help bring, restore wellness and healing to the body. These are important methods that we shouldn't discount. We should be incorporating into our day to day practices. I wanna spend a little bit of time talking about how we got here. You know, the big things are, like, you know, food, supplements, health care. You know, you hear all the stories all the time. People go to Europe for a couple weeks and be like, you know, you'd never believe it. I was in Europe. I was eating whatever I wanted, and I lost weight, and I feel great. You hear that all the time. The other thing you're hearing or at least I'm seeing is, like, most people are buying their supplements from some influencer, which I think is pretty crazy. And then on health care, obviously, we were talking about some of the things of, you know, more reactive, more acute treatment than, anything preventative or collaborative. So I'm just curious on what you've seen that has led us to this point. Yeah. I mean, it's a complicated thing. Right? Industrialization. You know, and even before that, just humans going from nomadic, you know, tribal living living, off of the land and then eventually concentrating in cities and developing agriculture. So, you know, these are, like, the beginnings of when when when things started to change in terms of our health, but especially in the microbiome, which is the the this universe of bacteria, viruses, other organisms living inside of us and on us. And it turns out there's more of them than us. You know, studies show that there's, you know, up to ten times more, you know, bacterial and microorganism cells in the human body than there are human cells. Although we do shed most of it every day, you know, when we go to the bathroom or when we clean our skin, but that microbiome gets developed at a really young age. And the disruption of this microbiome is, I think, the root cause of a lot of what's going on. More and more research is coming out that's supporting that. And, you know, things like autoimmune diseases, allergies, inflammatory bowel diseases like Crohn's disease, obesity, even diabetes, a slew of other conditions, asthma, eczema, and even autism. And ADHD now research is showing that's linking it to a microbiome that's been altered, a dysbiotic microbiome. So that's important for us as physicians to know when we're dealing with our patients that, like, what is going on in the microbiome, especially in that first few years of life when the microbiome is developing. Like, what was that child eating? How were they delivered through c section or through, vaginal birth? So these are important, changes that we know are happening that are the root cause of some of the disease. But what in the environment has changed? Well, soil health, obviously. That's important. The food we're putting into our body, that's changed significantly. There's not a diverse set of food we're eating like we used to eat. And I know as a physician that we are always, you know, talking about the Mediterranean diet, what's important about the Mediterranean diet. Well, it's obviously this diverse, you know, amount of food that people eat in the Mediterranean regions, but also it's not just the diet, it's the lifestyle. Right? Like, when you say you go to Europe and you feel better and you lose weight, what is it about, like, traveling and being in an environment where you're exploring and having fun and not stressing and and not feeling depressed and sad? You're you're feeling happy because you're on vacation. Right? And people who live in Europe tend to be happier. You know? Like, if you look at studies coming out of Denmark and Norway and Sweden and a lot of the Northern European countries, you see that that happiness is something that a lot of people there, you know, report. You know, like, up to eighty percent of their populations report being happy. So so then we think about, well, what is that that brings happiness? Well, it's, you know, it's obviously feeling safe and secure and and having, you know, an income that, you know, that you can get by and you're not feeling stressed about. And then it's also about, you know, the choices your government makes about what products are allowed to be in in food, in the soil. And I think there's a much different approach in Europe towards that in terms of protecting health by looking at what are the underlying causes of disease instead of just focusing on treating disease. So that's, you know, the you know, we could go on for a long time trying to decipher all the different things that have gone, you know, wrong and why, you know, human health is is is resulting in more chronic conditions than than ever before. But I would say it's probably that combination of environmental changes, food changes, and then also added stress and and lack of being outside and being in nature and and exploring and farming and doing things that we used to do as humans. Yeah. I like what you're saying about when you're on vacation, you're happier. I was I was looking up Zach Bush, and his tagline is curiosity is the most powerful force on earth. Like, some of my some of my guests in the past have been, leadership development authors and such, and they're always talking about approaching problems with curiosity. You know, when you're not approaching them with curiosity, you can be stressed and more fear based and all this stuff, and and that obviously can has a link on health. Something you said really struck with me. I I'm a Crohn's and colitis patient for about fifteen years now, and I I was thinking I always thought about, like, you know, how could anybody live like this in the past? Because, especially, I mean, even for me, it took me two years probably to figure out even what I had and then probably a little bit more time, maybe a year about to figure out what I had and then maybe, like, six more months to find the right treatment. But I couldn't imagine going through some of that in the past. It reminds me of, I asked one of my dentists once. I was like, guy can be captain obvious sometimes, but I was like, hey. Like, what did people do before the dentist? And he's like, you ever see one of those old skulls and they have perfect teeth? And I was like, yeah. What's the deal with that? And he was like, well, before agricultural revolution and, like, mass production of sugars, like, people's teeth just didn't shift that much. So it's very similar to what we're seeing here in the microbiome, it sounds like. Yeah. I mean, the micro oral microbiome health is so important. Right? And and sugar is a big contributor to all this unhealthy teeth that we have, but also, you know, that unhealthy teeth leads to additional chronic Mhmm. Diseases, inflammation in the body that's that you might not notice on a day to day basis, but builds up and can result in in disease later in life. So it's important. Like, we take care of the microbiome both in our oral region as well as in our gut and our skin by what products we put into those areas. Right? And, and we know that. I mean, it's not like this is not nothing I'm telling you has not been human knowledge for for thousands of years. It's just we kinda lose track of it when we get caught up with stress and needing to temper our stress with things that make us feel good. Right? And and sugar is one of those. Right? It's, but there's plenty of other things that we engage in that are detrimental to our microbiome and our our general health, and we know it, and we ignore it, and we just keep doing it. I mean, I remember when I started medical school and and this is funny. I was training in Dayton, Ohio in one of the hospitals there, inner city hospitals, and, I walked out of the hospital, and in the smoking section right there outside when hospitals had smoking areas, people could smoke, there was the pulmonologist and the respiratory therapist smoking. Like, the pulmonologist who's taking care of sick patients with COPD, asthma, and so on, lung cancer, they're out there smoking with the respiratory therapist that's treating all these patients all day long. And I remember just when I walked out thinking to myself, like, how can a doctor and a respiratory therapist be so clueless, right, on what the effects of smoking are to the human body when every day they are dealing with patients that have the effect of smoking. But then it just surprised me that even more recently, I'm a pediatric gastroenterologist, got invited to another pediatric gastroenterologist, dinner, And the food they put out, was just, like for me, there were hardly any greens. There was a lot of cheese, a lot of meat, you know, you know, they had sodas for people to drink, and, and then they had, like, all the sugary snacks and and and sugary desserts there. And I was thinking to myself, wow. Like, the the doctors that are treating children who have gut issues and develop obesity and all these inflammatory diseases are even more clueless about what they're putting into their own body. And and and it's because, you know, it's stress. It's, it's not lack of knowledge, I don't think. It's it's typically people just wanna feel better, and and they do it through food, and they do it through engaging in unhealthy behaviors. And the best we can do is to try to address that root cause of why people feel so depressed, so stressed. Right? And one of my favorite authors is Deepak Chopra, where, you know, he he talks about the importance of, you know, the whole mind mind body connection, in his books and and his talks. And then, and then another favorite recent book that I just finished reading, is called The Myth of Normal by Gabor Mate, which talks about the effect of trauma, especially in early development in childhood. And he goes kinda through the different stages of what the effect of stress on the mother and stress on families and stress on the individual results in in in a lot of, like, this dysfunctional health that happens, including autoimmune diseases later in life. I wanna I wanna go into, what you're seeing in the youth you're treating, and, also, I I definitely wanna talk about our body's ability to heal. Before we do that, a a story and a reaction from one of your stories. I I worked, I used to work at one of the consulting firms, and one of our clients was a big health care company. And the CFO was really tough to get a hold of. But if you wanted to find them, you could find them outside a couple times a day smoking cigarettes, which I just thought was just the same irony as what you were sharing. And then when you were talking about the level of stress, a friend of me a friend of mine the other day sent me a picture of this coffee cup, and it said, don't talk to me until I've had my ice bath meditation gratitude, morning sunlight, red light therapy, all this stuff. So, like, I I'm curious to get your thoughts on, like, when we think about treating stress and, like, you go on the Internet these days, and I I just wonder if you think we've gone a little bit too far on some of this stuff when people's morning routines can take three to four hours. And granted, I live in Austin, Texas, so I might have a skewed view. Well, I mean, I I'm I'm kind of more of a common sense kinda guy, like, when it comes to how how to improve our health. Like, you know, I I I don't, I don't want to say that I'm perfect at what I do, but I know that there's a few things we could do in our life that can really make a huge difference in terms of, you know, stress and how, we react to stress. Because normally, stress from a physiologic standpoint is not a bad thing. Acute stress is something that our body actually needs. It's it's kind of a way to prepare the alarm systems in our body in case there's danger. So, you know, on a day to day, you know, having some acute stressful event like, you know, you know, pushing yourself at the gym to get your heart rate going up or, you know, or getting really engaged in, you know, in something you're doing, like, work wise, you know, for a short period of time is actually not bad for you. It's, this chronic from waking up till you get home where you're just on the go nonstop and you're constantly using your sympathetic nervous system. And, you know, there's the autonomic nervous system is divided into two parts. There's the sympathetic and the parasympathetic. Sympathetic being kinda your fight and flight kind of stress, you know, response of action. And then the parasympathetic is more the rest and digest and kinda heal. You know? And we spend most of our waking hours in a sympathetic state. Right? And that's through everything we're doing, like the constant work we're doing and, the driving in a car, which is pretty stressful even though we we've become so numb to it, we don't realize it's stressful. But we remember when we were sixteen learning to drive how stressful it was. Right? And all these things, this being in the sympathetic nervous system is draining on the body, and it's causing your body to live in a what I call a constant glue repair, glue repair kind of state where you're just your body is just trying to get by, and it thinks there's a lion chasing it all day long. So it's constantly adjusting for that by releasing a lot of cortisol, adrenaline, noradrenaline, these hormones that are there to help you evade danger and survive. But what happens is that when we're living in that state all day long, we never interrupt it. We never tell our body everything's safe, everything is okay. We we cause damage and just and it just builds over time, and then it it presents itself, you know, with autoimmune diseases, with cancers, with heart disease, and so on. So the best thing we can do, going back to what you're asking, is is to slow down. You know? Take deep breaths. You know? It's just really simple. Like, when you go to sit to eat, you know, turn off the phone, be present with the food. My favorite authors, of all time in terms of about food and is Michael Pollan. And, you know, my favorite book that he wrote is in the defense of food and eat eaters manifesto. I don't have you have you read that book? I haven't. I I've read your mind or your body on plants, your mind on plants, and then I listened to the audiobook on coffee, which he talks about how coffee domesticated humans. Yeah. Yeah. I mean, he he he has some real interesting insights. But in the defense of food, you know, he talks about, like, this whole, you know, slowing down and being present and cooking at home and, you know, just paying attention to the process of eating and listening to your body signals. You know? Like, he he promotes that. And, you know, one of the things he says, you know, like like, this whole, you know, change that's happened in the last fifty years, right, in the way food is processed and ingredients, all these things are put into food and made easier to make, like, you know, processed food where you don't have to spend hardly any time getting to know your food and taking your time with it, has really affected our nervous system's relationship to the food. And and so then we're not seeing food as an important part of our healing on our repair. We're just seeing food as energy for our stress state to survive the lion that's chasing us. Mhmm. Right? So your body shifts us all its its energy and metabolism to a state of survival instead of a state of thriving. You know? And and I think that's that's super important for us to recognize when we're so all these other ways of destressing are important for you know, I I'm not saying that every person has to find their way. What is it that works for them? There is no one method that works for every single person. But, you know, there's simple things. Like, one, pay attention and slow down. You know? So just doing, like, a bunch of things in the morning that are stressful, that are supposed to de stress you doesn't sound like a good idea. Right? Like, if you're having to wake up at four in the morning and you're doing all these things that you think are are are contributing to your longevity, but you're just feeling stressed the whole time, I wouldn't I wouldn't be doing that. But if it if it's not stressing you and you're feeling relaxed and you're feeling good and you don't feel at all, like, pressure, which is what basically stress is Mhmm. On you to do it, then, you know, it's probably healthy for you. That's, you know, the best I can say about that. When when you say that, I'm thinking about, you know, it's not necessarily what you're doing, but how you're doing it. I had, some guests from the conscious leadership group that have a framework that's called above the line and below the line. And, basically, like, the question is, like, hey. When you're doing this thing, are you reactive from a place of openness and trust and gratitude and appreciation or anxiety, fear, shame, you know, that sort of stuff? So, like, you can still be high performing, and we I've had a lot of conversations about, in the, what I call, emotional spiritual growth process, your motivation shift. You know, as our bodies and we heal, we can go from being driven by anxiety, fear, shame to more, authentic motivators. But in that time period in between, there's a gap, which is always interesting to navigate, and I I think it it changes over time. But I I really resonate with that, and it's crazy. It's, like, how little we think about the fact that this meal is keeping us alive. So some intentionality is really powerful, to recognize how special that is. Yeah. I I think, like, that's that's why I think a lot of cultures, people stop and they give a blessing or some kind of acknowledgment of where the food came from. And and that gratitude putting gratitude into it, automatically opens our body to receiving it in a in a healthy way. You know? So, you you know, and it helps, you know, with our digestive enzymes to start flowing and so on. You know? So it has multiple purposes, but it but it is you're allowing this energy source that keeps you alive to come into your body and be used in a way that allows your body to heal and grow and and and thrive. And we if we stop and acknowledge that even just three times a day, you know, for a few minutes, makes a huge difference in in our health. Yeah. It's interesting too. Like, I had a guest a couple weeks ago from a group called Paragon, and and they a lot of their work's from a group called the Heart Math Institute. So they just they go into companies and and really they build a coaching and leadership platform around getting people to do meditations while focusing on their heart. And they have, like, some supplementary tests on what that does to the nervous system and overall stress levels. It's just when a lot in a lot of our conversations, I've been thinking about how just our time horizons are just way different from our ancestors, you know, in terms of, like, how much we eat, like, like, our relationship with stress and safety. You know, we're still running on old software and hardware, I suppose, like evolutionarily. I'm not Noah Harari or anything, but it makes a lot of sense that, like, you know, a couple hundred thousand a couple hundred or a thousand years ago, you'd want to eat the food that was in front of you, especially if it was a more of a feast and famine type situation. Yeah. That's that's something I deal with in my practice every day. Talking to parents, one of the things parents will say when you tell them, like, you know, you had you you should give them more greens to eat and more vegetables and fruits and, you know, because I live in Hawaii, I'm always using the rainbow, like, have them eat foods from the rainbow. Right? And then, you know, plants. And and, you know, almost every time I get a parent saying, well, they won't eat it. You know? They no matter what, like, they only want the chicken nuggets or they only want the hot dogs or and I said, well, where where are the hot dogs and chicken nuggets coming into the home from? Right? Because they're you know, I said humans have ate food, you know, for you know, our existence millions of years without a problem. And and it's not that the child won't eat the food. It's the fact that they're constantly exposed to and offered the wrong foods, and it's hard for them to make the choice to eat the healthy foods when they keep given their keep given the options to eat the unhealthy processed salty sugary foods. So if you really wanna make a difference, you just don't allow it into your home. You know? You just don't bring the processed foods. You don't bring candy. You don't bring snack foods into the homes. You don't make processed meals for them. And you get them involved in the cooking process. Like, you know, you you just families usually you know, parents are cooking and the kid is just playing video games or watching TV or doing homework, and they're never involved in actually the process of cooking. And I used to bring stories back to, like, my grandmother. So I was born in Lebanon, grew up in Beirut, and used to spend a lot of time over at my grandmother's house helping her out. She always needed, like, help with dishes or cleaning or something. You know? And, you know, I'd be in the kitchen with her doing all these dishes. They have dishwashers. And, and, you know, she would constantly shove, like, different fruits and vegetables in my mouth. Like, literally, I wouldn't be able I wouldn't have a chance. Like, I was twelve years old, and next thing you know, carrot is going in my mouth. She's like, eat this. This is good for your eyes. And then she'll, you know, give me something else. Eat this. And then I'll watch her I mean, it's not like I ever got involved in the process cooking with her, but I was watching her cleaning, cutting things for her, doing things that that she's constantly like, she's not an educated woman. She didn't, like, go to high school. You know? And she learned everything through, like, just knowledge her grandmother and mother taught her and also reading magazines and books. You know? She she wasn't, like, educated at all in the sciences, but she seemed spot on with the benefits of everything she would give me. You know? And and although that, you know, of course, I you know, when I became a teenager in college, I you know, living in in the United States, I went to eating a western diet and not thinking much about those foods. But as I got older and had my own children and started thinking, like, how do I affect their health? I started thinking of the way my grandma, you know, did, and I would cook them, you know, on weekends. I would cook them meals and try to teach them about the health benefits of everything we're putting into the food. You know? And, you know, they're like typical American kids. You know? They went out and ate whatever they want. But I noticed, like, you know, my daughter's twenty one now, and, you know, she was just finished school in New York, and I was visiting with her. And I noticed, like, yeah, she's shopping at Trader Joe's, and I saw what she was buying. I'm like, hey. She's she learned some things. And it was good, you know, good to good to see that that she's she's making good choices, you know, and that's the best we can do as parents for our children. I wanna talk a little bit about what you're seeing in youth. Are we seeing, like, rise in certain GI diseases? Like, what's going on on the ground? Oh, yeah. I mean, I just like you know, I think GI as a profession for pediatric, specialty is just a growing profession because we're just seeing more and more, you know, gastrointestinal issues. We're seeing a lot of constipation. I mean, I spend probably forty percent of my day just dealing with constipated kids. We see a lot of tummy aches, stomachaches, and then, of course, you know, the other things like celiac disease, food allergies, food intolerances, babies that aren't growing, overweight, obese children that have fatty livers that look like an alcoholic's liver, and inflammatory bowel disease like Crohn's disease and ulcerative colitis. You know, I just diagnosed a patient just this week with ulcerative colitis, and and mother was asking, like, what could have caused this? You know? Right? Like, seventeen year old all of a sudden developing colitis. And and it's hard to answer that because it's such a complicated thing. You know? But all I can do is say, like, you know, now that we know, you know, your son has this, let's, you know, let's focus on what we can do to help help his body heal, and not become dependent on external, you know, medications if we can. If we can do it holistically, let's try to do that. You know? And it's hard because some patients, if they're really in severe pain and they're having a lot of symptoms, they want a quick solution. You know? They want something that will fix them right away. And and, you know, our instinct as physicians is to give them steroids or put them on these new biologics right away to help them heal, and there's some patients that's appropriate. But others, you know, I it breaks my heart when families just opt for the medicine straight up, and they don't even wanna try, you know, alternative or natural ways. And that's why, like, I started wanting to learn more, about integrative medicine and learning what are what else is out there. You know? What what other treatment modalities that don't have, you know, a pharmaceutical industry attached to them, can we offer to help in our in the healing of these kids? And it's amazing how much is out there. As I started a fellowship in integrative medicine now at George Washington University, I am just enormous amount of learning, and it's actually a little bit overwhelming because there's so much out there. And I can see how it's hard for a patient to go out there and try to navigate all this integrative stuff that's out there. And, again, you know, like you mentioned earlier in the show about, like, all these, you know, supplements that are out there that people have to choose from and then, influencers try to push these supplements. Well, you know, not everything out there that we're being told works actually works, so we have to actually look at some evidence too. So I still use that Western training that I have in terms of looking at analyzing the evidence and trying to decipher, like, how can we use that ingredient, whether it's an Ayurveda ingredient or whether it's mind body medicine. Like, how do we use these things, in a way that can help our patients without the clear evidence that comes from, you know, research? Because research, honestly, is kinda tough to decipher when it comes to these these alternative things because western medicine based model of research is based on this idea that you have to be able to control for any factors that can influence the patient's mind, which is called the placebo effect. Right? So, you know, so you have to blind them to the treatment, which is kinda hard to do if you're doing yoga or if you're doing, you know, acupuncture. You know? You have to do sham treatments. And sometimes, you know, the sham treatment has a placebo effect of itself. So how do you really navigate doing research on, things that are evident and it's hard to blind the patient to or the the practitioner? Because a lot of times, you know, for a study to be deemed like New England Journal of Medicine worthy, a lot of times it needs to have been double blinded or triple blinded where the investigators are blinded, the patients are blinded, the statisticians are blinded. It's like, how do you do that? Like, when you're doing, like, integrative things, like, where somebody's touching the body and doing mind body medicine or when you're using herbs that have a certain flavor, right, or you're putting into food and they know it's there. Yeah. That that's that's typically the the the hard thing to navigate, and it's good to get training in it as a physician to be able to learn how to incorporate that into my practice and how to know what things do work and what things are just kind of a sham people out there just trying to make money off of, you know, sick people. I don't think doctors, certain ones at least get enough credit for the practice of medicine incorporating both the the science, which which is, like, the knowledge and then the art of when to apply it. I'm curious to learn what is, what are some of the alternative, like, treatment options for, let's say, you had a thirteen year old with IBS or something, what are some things that they could do? Yeah. I mean, so the way I approach things is first is, I start with the mind, because if we don't understand what's going on in the mind of that thirteen year old and what stressors are in their life, and what trauma they might have already experienced in their childhood and what happened in their delivery or pregnancy and first year of life, then, you know, then we're gonna just play whack a mole, which is what typically people wanna start right at the food or the gut, and they forget the mind. And then they're like, oh, we tried gluten free. We tried dairy free. We tried this and that, and and the symptoms are still there. Right? And for for your audience, IBS is just a complicated syndrome of different symptoms of a mind gut disconnect that happens, where the nervous system of the gut is not either functioning like it should, or something going on in the mind is influencing that function. Right? And so I start with the mind trying to get really good to know what's going on in the mind of that child, what kind of stressors are in their life, and figuring out how I can help alleviate that or at least get them the help they can, from, like, a therapist or a counselor. And then I move down to the gut. And the first thing, like, I wanna do is I want to alleviate the concerns of the parents and the stress that the child might be experiencing from the pain. You know? And that's where Western medicine comes in. You know? This is where I order some tests, you know, just to make sure there's not something more serious or they haven't already developed something like celiac disease or they have Crohn's disease. And that really helps at least reduce some of the stress that the parent is feeling from the child having, you know, missed days from school and complaining of pain every day or having bad diarrhea or constipation. And then the next, I move down to the gut, itself and what's in the gut. Right? And that's the microbiome. So I just kind of assume that if there is dysfunction happening in their gut, then there, you know, then there's probably alterations in that microbiome. Right? And so the the next step is to how do I clear their microbiome and kinda get it to reset. And, usually, that's where I I give them a cleanse to do. You know? I'll I'll use some some natural products. If if I can't, then I'll use some medications to help get their gut cleansed to get all the poop out. And then that's when I will advise them to start some healthy pro pre pre and probiotics. So they get, they get both the healthy bacteria put into their gut as well as to provide them with, the nutrients they need to grow, these healthy bacterias. And then we talk about diet because that's the hardest one, right, with a thirteen year old. Like so, you know, and that's when we say, okay. Let's let's try to be as clever as we can with how to get them their their proteins. And I love suggesting, you know, products that have plant based nutrients, superfoods, smoothies that are flavored, that taste good, that are organic, non GMO that maybe they will be willing to drink every day because they won't eat their greens. Right? And then, you know, and then I advise the parents on how to slowly introduce the rainbow foods into their diet. Right? Start with ones that are they're more likely to want to eat, like, you know, sweet potatoes, for example. Right? That, you know, that's an easy one. You know? And, you know, because they you know, if we can switch them from eating just white french fry potatoes to sweet potatoes, maybe that's a small switch. Right? And then if I can get them to, you know, not have snack foods and sugary foods available in the house and if it is to have it locked. Like, I remember my grandma in Lebanon, man, you could never get to the sweets. You know why? She had them in a cupboard locked. There was a key. You know? You know? She knew that, you know, I would probably try to get in there and and eat the chocolates, and and she locked them. And parents don't do that anymore. Like, their pantries are just full of junk food, and the kids can just walk in there and eat it whenever they feel like. Mhmm. And and I think I teach parents these things. It's like, first thing is you gotta just you know, I know you don't wanna throw it out. That's fine. Lock it. If you can lock it up and and and dispense it only in a special occasion, like like parents used to do in the past, then it will be way more effective than just to to deprive them one hundred percent of it. Like right? Like, that's too stressful. Like, I don't I don't believe in a hundred percent don't ever enjoy yourself attitude. Like, I'm more of an eighty percent. Like, I'm a b student when it comes to, like, hey. You know, enjoy yourself twenty percent of the time or less. You know? Eighty percent eat, you know, healthy and, you know, like Michael Pollan says, you know, you know, the quote, I think, from his book was, eat food, not much, more plants. Yep. You mentioned Priam Probiotics. Can you talk a little bit about what you're building at Funbiotic? Yeah. So that's a new venture my wife and I, are starting, and we are in the process right now of building this idea of bringing a a healthy probiotic, with ingredients, the prebiotic ingredients that are needed for good digestion, but in a fun way that children will be willing to to engage with it and engage in this healthy eating. So it's not just about the actual probiotic, but it's actually the message we're gonna send out and the education material that comes with it. And it's to how to bring fun back into into good health, into eating healthy, into enjoying, food with your family, and then the ideas we have around it. How to how to build a program that parents can use when they use our supplements that helps restore health to their kid's gut. Awesome. You're clearly very passionate about this. I mean, in addition to practicing your in advance programs, you're on boards, you're building supplement companies. Why is this, pediatric, GI, problem so important to you? Well, I mean, it started with myself and my son, you know. My son had a significant struggle as a baby, and later as a toddler and as he grew older with his gut, And I didn't really know it. I just started medical school. I was, very stressed, and, my wife was taking him to the doctors, and they were just prescribing pills, pill after pill. And they and they kept telling her, yeah. It's just colic. You deal with it. You know? And we were young parents. You know? We weren't really aware of our diet. Like, we we grew up in the Midwest in Minnesota and Wisconsin. We were eating a lot of dairy, a lot of junk food, a lot of processed food and weren't really noticing, like, what that effect had both on our health and also the health of our, of our son. And and he struggled. And and when I went to do my training in pediatrics, and I started recognizing that I could make a huge difference in the health of of my patients by focusing on their nutrition and their gut. And that got me really interested in going and training in in pediatric gastroenterology. And I already had a background, a public health background, an environmental health background, and working for the Centers for Disease Control. So I already had this idea that there is something wrong in the environment, in the soil, in the food, and pesticides being put in food, but it probably forgot about all these things as I gotten stressed through medical school and just having a baby and not thinking about it. And when I finally, you know, came out of that training, in in pediatric gastroenterology and got involved here here in Hawaii with the triathlon community, training to do an Ironman, health number one thing became for me is what I put into body my body and what I advise my patients. And and also, you know, the other aspect that now as I've gotten older that I really actually even neglected when I was doing the triathlon training was the mindfulness and that come that is necessary to make these right good choices for my health. And and that's basically the journey that I've been on that's also kinda parallel with the journey of how I've approached, you know, you know, being a doctor for patients, you know, how how to be a better provider, how to how to help people realize they they have their healers within, that I'm just there to help them and guide them. I'm not I'm not actually anything more important than being able to be a guide. Wonderful story. I I think a lot about the mind body connection too. The mindfulness is definitely overlooked because, you know, with if you're not in an emotionally regulated state, it's harder to make good choices. Or when you're stressed, it's easier to cut corners. I I mean, I even know from my own Crohn's journey is, it made a lot of sense. Some people explained is, like, I had some anxiety as a kid, and, you know, basically, what anxiety is is your brain flaring up when there's no no actual attacker. And it's the exact same experience for Crohn's and colitis, which is inflammation of the GI tract, in flaming when there's no attacker. So I I really love what you're sharing about the mind body connection because I don't think it's something a lot of people think about. Yeah. It's, been a journey for me in twenty seventeen. I the first time I learned about mindfulness, was taking a course, that Jon Kabat Zinn had put together called mindfulness based stress reduction. And he created an eight week course that really helps teach people how to become more mindful, and and it was really implemented in hospitals. You know, when it it first started, it was for people that were experiencing a lot of pain and disease. And and when I did the course, that's like my first, you know, experience of recognizing, wow. There's a lot more to good health than just, you know, you know, dealing with the body. Like, that we have to deal with the mind, and the best way to deal with the mind is just to bring awareness to the moment. Like, it's not even about like, if you're in a stressful situation, it's not about getting rid of stress. It's not like going and living in a bubble where there's no zero stress, like, your whole life. You don't actually learn and grow from that. It's actually just the awareness that you're in a stressful state. And once you have awareness, it's just, you know, bringing awareness to your breath and slowing down for a second. You know? And that's, like, something that, you know, I try to do in my practice before I walk into every patient's room to just stop for a second and take a deep breath because when as health care providers, we're just rushing from patient to patient. We're just bringing stress from one room to the next. And now I've learned to just stop, take a couple of deep two or three deep breaths before I walk into the room so I can reset so that I'm not draining myself, but also bringing the stress of the other patient onto this new patient. And that these are just small techniques that as providers many providers, they're starting to learn to do for themselves, you know, as well as for their patients, make a huge difference in in in the outcomes. But, you know, we don't see the outcomes, you know, acutely like most western studies want, you know, wanna find, you know, outcomes based research that's looking, you know, eight weeks, twelve weeks, you know, six weeks, you know, maybe one year. But, you know, these things, they translate into good health ten, fifteen, twenty, thirty years down the road. Like, there's no studies, like, looking at mindfulness based stress reduction for twenty years. You know? It's you know, they're just all shortsighted. So when you look at the literature, it's all conflicting. You know, some literature wants to tell you these things don't work and, you know, same thing with probiotics. Like, you know, I'll I'll look at literature on probiotics and and and the microbiome, and and I'll see it. It's all over the place. Oh, this helps for IBS. This doesn't help for IBS. I'm like, yeah. Because it's all studies that are looking at short term outcomes. It's not looking at the long term health of that individual. It's not looking at like, if I give probiotics on a kid that's been eating a lot of sugar and has gotten a lot of antibiotics in their life, Like, it's a good idea just to keep them on a probiotic, especially if their diet is not diverse in plants. You know? That doesn't need a research study to prove that that's a good idea. You know? But research will say, oh, well, there's no benefits to that. It's like, yeah. There is in the long, long term. It's just we can't measure it very easily, but we do know that, unhealthy microbiome is a big setup for disease. We just know that. It brings me a smile to know that there are doctors in America taking a deep breath before entering patients' rooms because, you know, being a Crohn's and colitis guy and and having spent some time in doctor doctors' offices and hospitals, I know there's some really hurting people out there. I wanna close our time with a quote from, the Ayurvedics. They say, when diet is wrong, medicine is of no use. And when diet is correct, medicine is of no need. I I love that. That's a great thank you for sharing that. That's a beautiful quote. Absolutely. Before I let you go, doctor Mas, what's the best way for people to keep up with you, the work you're doing with, the pediatric gastroenterology and Fund Biotic? Well, it's pretty easy. You just go on our website, funbiotic dot com, and, just send a comment. Or, if you want to join our listserv for our products as they come out, you can join as well there, and, I'll be happy to interact with you there on through the email there. Awesome. We'll have links to the Fund Biotic website in the show notes. And thanks again for coming on the show, doctor Mas. Thank you for listening to Tuesdays in Warshie. That conversation was with doctor Mas and Abbas. Doctor Mas is a pediatric gastroenterologist based in Hawaii. What I enjoyed about the episode was his focus on bringing together knowledge of western medicine and traditional medicine traditions as well as very simple tips we can take to make ourselves and our families healthier. If you enjoyed the show, share it with a friend, and we'll see you here soon. Thanks.