Tommy Wood transcript I

Written by Christopher Kelly

Jan. 20, 2015

[0:00:00]

Christopher:    Hello and welcome to the Paleo Baby Podcast. My name is Christopher Kelly and I'm joined today by my wife and food scientist, Julie.

Julie:    Hi.

Christopher:    And then also on the call with me today, I've got Dr. Tommy Wood.

Tommy:    Hi.

Christopher:    He is a -- Oh, sorry, Tommy. Hi.

Tommy:    Hi. Sorry. Hello.

Christopher:    And Tommy is a qualified medical doctor. He graduated from Oxford University in 2011. He has a bachelor's degree in natural sciences and biochemistry from Cambridge University. And after working as a doctor in the UK for two years, he is now working on a Ph.D. in neonatal brain chemistry metabolism at the University of Oslo in Norway.

    That's quite a bio, actually, Tommy. For those of you who don't know, if you're in the US, Oxford and Cambridge are the two most prestigious academic institutions in the UK, and they've been around literally since the birth of universities. They are the two oldest universities surely.

Tommy:    I actually think the first university was in Lund or somewhere in Sweden. But they're up there.

Julie:    Nice try.

Christopher:    Isaac Newton went there. That's what we need to know.

Tommy:    They're both been around longer than United States, obviously.

Christopher:    Yeah. I mean, there's at pop plant at Kiev Garden that's been around longer than the United States also.

Julie:    He loves to tell people that.

Christopher:    That's my favorite thing. I'd tell everyone I meet on the street. So, yeah, we better get into it. Obviously, you're an expert on babies and brain development and--

Julie:    I want to know how you got into that because reading what you said, was it always something that's in the back of your -- What triggered the interest in the neonatal part?

Tommy:    Okay. So, that was actually a part of my shift from my bachelor's degree into medical school and beyond. And, I guess, I should start by saying that I'm not an obstetrician, and I also don't have kids. But because I'm a bit of a Paleo geek and I work oversea with stuff with babies, then I put the two together along the way. So what happened was during a summer, during my first degree, I got a scholarship basically that would give me some money so I could work in lab somewhere and get some research experience.

    And the lab that I ended up working in was the lab of my professor called Marianne Thoresen and she is one of the experts in terms of treating babies that were starved of oxygen during childbirth, so perinatal asphyxia. And she developed the current treatment which is the only treatment that is used for that which is hypothermia. They cool the babies down for three days after they're born if they have any kind of brain problems due to difficulties during childbirth particularly.

    And so, I was working in her lab. She convinced me to go to medical school. I went to medical school. She's from Norway. And after I'd worked as a doctor for a couple of years, she said, "I'm back in Norway. Come and do a Ph.D. with me." So, that's where I am. So, it was through her that I went into the neonatal side of things.

Julie:    That's really interesting. And where does it go? When I'm trying to think about where we are currently and I know I'm skipping large parts of your experience and your background and what you've studied but we have a lot to cover. What stands out to me and I think a lot of our listeners is the current state of health with pregnancy, gestation, childbirth.

    It seems like we're lacking and it seems like there's a lot of things that have presented themselves as problems that have been borne out of modern medicine and Western medicine approaches. Could you give us a synopsis of where we are and what's broken, what you think is broken?

Tommy:    I mean, it's really difficult to say exactly what's broken but, I think, what I'm finding and because I have some experience with the Paleo diet through some other parts of my work, when you look at what it takes to make a healthy baby and to have a healthy pregnancy, I think you automatically, if you look at things through an evolutionary perspective or a Paleo style perspective, you really see that some of the important stuff is that stuff that comes from an ancestral health perspective.

    

    And, I think, that's just what's broken is that we've lost that. We've lost the fact that the body is meant to make babies. And as long as we give it the right nutrients and put it in the right environment, it will do that for itself. And actually, I think the more that we fiddle and the more that we tinker with it, actually that's what messes it up.

Julie:    Yeah, I couldn't agree more. So, I guess, we should go through -- I'd love to go through the arc of gestation and where you think, what we need to do. And I'd love to include as much practical advices as possible for people because I love to give people actionable things that they can take away and do in their lives.

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    In terms of gestation, fertility gestation and pre-conception, how do you see Paleo specifically affecting those things nutritionally more generally affecting those things and what can we do? Where do we stand with that?

Tommy:    Obviously, there's a number of things you mentioned there that are incredibly important. And if you're looking at the pre-conception kind of area, then I think that three main things really stand out for me. One is just general nutrients status because we know that if you're deficient in nutrients and, I think, particularly iron and folate or any thyroid problems there, they're particularly important pre-pregnancy and, obviously, in the early stages of pregnancy.

    And then, obviously, activity. So, pre-pregnancy activity reduces the risks of things like pre-eclampsia which is a condition of high blood pressure and protein in the urine that can cause multi organ failure, growth restriction in the baby, pre-term birth or birth complications. It also reduces the risk of obesity and diabetes, which increase the risk of pregnancy later down the road.

    And then also reducing stress both before and during pregnancies has been shown to alter, say, the structure of your baby's brain, increases the risk of asthma, reduces the numbers of neurons in a number of parts of the brain and is linked with autism and ADHD. So, I think, what's very good about the Paleo view of things is that we're focusing on nutrient density so we're getting lots of things like folate and B12 from organ meat or livers.

    We're getting plenty of iron, if we're including some meats in the diet. People who come from Paleo perspective, they make sure that they keep their activity up. Obviously, people are either walking or maybe lifting or running or whatever suits them. And then they're obviously focusing on reducing stress as well, so meditation or yoga or making sure they get enough sleep or anything like that, however that comes best and, I think, those three things are really key. And, obviously, big pillars of Paleo type lifestyle.

Christopher:    What are your thoughts on the ability for you to make a difference after you become pregnant versus your nutrient status leading up to pregnancy? So, I sometimes wonder, women they become nauseous or get morning sickness once they're pregnant and then they're stuck in this awful situation where they know they need to be eating certain foods but they don't really feel like eating anything at all.

Tommy:    That's obviously something that a lot of people do struggle with. I think that for a number of things, the body is very good at building up stores of things and then depleting them over a longer period of times. So, like we just talked about things like B12, folate, iron. You have stores of those in your body. So, if you're not necessarily eating a huge amount every day, if you made sure that you have a nutrient replete before you get pregnant, then obviously, that gives you a bit of a buffer.

Christopher:    Going back to my question then,  does that mean I'm screwed then if I realize that I realize that I'd been eating like crap and maybe it was a one-night stand and now I'm pregnant but I really want to do well by this pregnancy? Do you think it's too late then by the time you become pregnant?

Tommy:    No, I don't think so. And the reason I don't think so is because they've done a number of studies where they've shown that just giving a simple multivitamin in women who have nutrient deficiencies, so this is particularly in the third world, but if women have nutrient deficiencies and they get just a simple multivitamin, then that can improve the outcomes of their babies. So it's definitely possible to get in the nutrients you need during pregnancy through whatever form that might be even if you haven't managed, even if you didn't do a good job before you got pregnant.

Christopher:    And then so lots of people are asking me about methylation and folic acids. One of the tests that we do is a urine organic acid test and it actually looks for these two organic acids that start to build up. They start to pool in the urine sample when there are deficiencies of vitamin B12 and also folate. And there's been some suggestions the root cause of this -- This person I just tested is eating the type of diet that you're suggesting. There should be plenty of folate in their diet. And still this is coming up as a problem.

    So there's the suggestion that there might be some sort of genetic abnormality that leads to problems with the metabolism of these especially folate. Do you think that's a real issue? Or is it most people don't need to worry about?

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Tommy:    I think this is something that's become very big recently as everybody is getting the, doing their 23andMe and then running their test through genetic [0:10:11] [Indiscernible] and CFHR mutation and they can't methylate anything. And what you see on a genetic level doesn't necessarily translate into the phenotype or what is actually happening in your body because there's a number of things going on.

    I think it's really easy to get bogged down in the tiny details. And that's something that us as a community are very good at because we have a lot of information and people are doing a lot of research. But I think for most people, I really wouldn't worry about that. I think purely because we've already put ourselves at a huge advantage by just looking after our bodies and eating properly. And, I think, for 99.99% of people, that's going to be enough.

Christopher:    What do you think then about those websites where you plug in your genetic data and then they try and sell you supplements based on that information?

Tommy:    If you try and look at the science behind what they're doing there, it's so far from where they pretend that it is. Supplements based just on a genetic test are so -- I mean, it's a science that's in its infancy really and we don't actually know nearly as much as we'd like to. So, I don't really think that there's that much real evidence to support people doing that. And I know the people get their frustration really because they tried all the other stuff and then they run out of ideas and that's something that seems very intuitive to them, if that would make sense that maybe their genetics are the problem and they can fix it with some supplements. But, I think, the science behind that isn't nearly as good as we think it is.

Julie:    Taking this a bit further with the supplementation and just the nutrition in general during pregnancy and brain development and the health of the mothers as well, what are some things that nutritionally are you think tantamount or paramount, like the most important things that we need to be focused on nutritionally and then also with supplementation during pregnancy?

Tommy:    Okay. I think we've talked about B12 and folate. Everybody talks about folate. So nowadays they're telling people to take folic acid. And, obviously, we know now that that requires methylation pathways in the liver so you can convert it into folate.

Christopher:    Can I interrupt you?

Tommy:    Yes.

Christopher:    Did you just say methylation again? You said methylation.

Tommy:    Yes.

Christopher:    Is this one of these things where I'd been saying the Americanized version of the words? I probably learned it after moving to the US. Is it really methylation?

Tommy:    It's methylation.

Christopher:    Okay.

Tommy:    And I say methylation.

Christopher:    Yeah, sorry. In that case --

Tommy:    It's definitely methylation. It's definitely methylation.

Christopher:    Okay. I'm sorry. I'm just checking. I'm really, really scared of doing that. As you were, sorry to interrupt you. I probably completely destroyed your train of thought but I'll let you resume.

Tommy:    Some people can't convert folic acid into folate because their methylation pathways don't work properly. So if you actually want folate in its natural state, you can either get that from green vegetables or more importantly from liver, particularly chicken liver. And then there are some things that I think are both important particularly -- So, I'm really using the baby's brains. So I tend to focus on the brain.

    There are some things that I think are important both the brain development and mitigate any downstream effects of problems during childbirth. So I study how we can treat babies who have a bad brain injury if they had problems during childbirth. And the first one of those is omega 3, so particularly DHA. And in order to grow neurons and maximize the ability for neurons to make connections in the brain, the body needs DHA ketones and a healthy thyroid.

    And the fetal fat, your baby's fat actually preferentially stores both DHA and MCTs, the medium-chain triglyceride, that we get from coconut. We talk about coconut or MCT oil. And MCTs, if people hadn't heard about them before, they're preferentially converted into ketones in the liver and then those ketones can be used for various things. The brain, in particular in babies, really loves ketones.

Christopher:    Sorry to interrupt you again, but this is something obviously that interests us both greatly. We're both eating a ketogenic diet. I suspect that Ivy's [Phonetic] diet is probably ketogenic given that -- She just doesn't really like eating carbohydrates. Like she'll have some fruit and that's really about it. She's much more of a meat and fatty vegetable type person like us.

[0:15:04]

    But I'm wondering, the ancestral health framework is obviously a very powerful device. But medium-change triglycerides don't really fit into that at all. Like you think about people living in Norway or the UK. Where on earth would they have got even coconut, the whole coconut, let alone the medium-chain triglyceride part?

Tommy:    No. I mean, you're absolutely right, and it's not something that we traditionally necessarily would have had a big intake of. But we actually synthesize them ourselves. Like breast milk is about 15% to 17% MCTs even if the mother isn't taking any of the MCT. So, it's something that we know we need and particularly as babies because when after you're born, your mother might not produce milk for a number of days.

    So you're not actually going to get that much food and you've got to survive on the fats that you've got. And you have about 60% of your daily energy intake as a newborn baby goes to the brain. So, a lot of that energy is going to come from the ketones from MCTs that are stored in the baby's fats. So, even though the mother isn't necessarily taking any MCT, she is creating MCTs both to feed the baby through breast milk and so that the baby can store it in its fats and produce its own ketones in that period when it's not actually getting any food.

Christopher:    So, am I right then in assuming -- So, even you could have a mother that's breastfeeding and eating a high carbohydrate diet and the baby then is still in ketosis because of the composition of the breast milk. Is that true?

Tommy:    So, babies will naturally keep ketones higher even if they have a higher blood sugar level. So, they naturally run ketones and glucose in parallel and use them as when they need. So ketones particularly important for things like making cholesterol and laying down new neurons, but then glucose might be used for some other metabolic pathways within the brain or elsewhere in the bodies. So they can actually run both at the same time.

Julie:    Do you have any insight into mothers who might be following a ketogenic diet or low carbohydrate diet and outcomes for birth and breastfeeding?

Tommy:    So this is something that I've tried to look into because I listen to the podcast about ketogenic diets and I did mention that I don't think a ketogenic diet is advisable for somebody who's pregnant. But the main reason behind that is because, I think, the amount of data that we have on that is so minimal. And in terms of an evolutionary perspective, obviously, depending on what time and year you were pregnant, you probably could have been in ketosis at times.

    But I don't think people ever really chronically for months on end in ketosis during any part of our evolution. So I'm not really sure that we're adapted to have a pure ketogenic diet the whole time during pregnancy. And also being in ketosis can increase peripheral insulin resistance and that might actually prevent you sending any glucose to the baby which might not necessarily be a good thing.

Christopher:    So for those listeners who are not familiar, what does peripheral insulin resistance mean?

Tommy:    Sure. So, basically, peripheral just means anywhere in the extremities of the body including the organs. And so anything that's peripheral from the brain. So outside of the brain essentially in terms of insulin resistance. And it's a completely normal thing if you're on a ketogenic diet, because you won't actually have that much intake of carbohydrates naturally and the brain does need a small amount of carbohydrate every day, probably less than 30 grams a day once you're probably keto, that's it. But it does need some.

    All of the glucose that you do have will be preserved for the brain. So the way the body does that is it basically stops the rest of the body picking up any glucose from the bloodstream. So that's peripheral insulin resistance. But that will also affect the baby. Insulin resistance is bad when it's part of Type II diabetes and your body isn't responding to the insulin you do have and you have really high levels of glucose in the blood and high insulin. And then it's a problem.

    So a lot of people think it's bad. But if you're on a ketogenic diet, it's not bad. It's completely normal. But I'm not sure that it's a good thing during pregnancy.

Christopher:    Okay. So, it's like another example of those things where you just hear the words and then you immediately jump to the association with the pathology.

Tommy:    Yeah.

Christopher:    Another really good example is the ketoacidosis, which is what most people think is ketosis but, of course, they're not the same thing. And that the physiological insulin resistance might not actually be a bad thing.

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    And I know you'll be able to probably tell me some others, but I know that red blood cells, for example, they don't have a mitochondria.

Tommy:    No.

Christopher:    So they have no ability to use ketones at all. So they must have glucose. So there are some tissues that have an absolute requirement for glucose. You can never go away from that.

Tommy:    No, absolutely. The minimal requirement is very small but you can never do completely without glucose.

Christopher:    And, of course, your liver will pick up a slack should you stop consuming. While we're on this topic actually, you might have the answer. We're kind of drifting away from the baby thing here. We will get back to that, I promise you. I have a quick question that you probably know the answer to: If I was to consume too much protein, would that be converted into glucose? Is that process substrate driven? Can I accelerate this process by consuming more protein?

    I know that some amino acids can be converted into glucose and fat.  The question is: Would any of that actually leave the cell and be taken up by the brain or some other tissue?

Tommy:    Oh, yeah, absolutely. And most of this is done in the liver. The liver is very good at taking in substrates and then spitting out other substrates to be sent around the body. When people talk about something like the Atkins diet as being a ketogenic diet, it was actually such a high protein diet, but I'm not convinced that many of those people actually have entered proper nutritional ketosis because their protein intake was so high.

    If you've got a protein intake of more than maybe one and a half grams per kilo of body weight, then it's possible that you'll never actually enter ketosis because your body is turning those extra amino acids from the protein into glucose.

Christopher:    It's interesting. I've been toying over this for a while now since I stumbled across a group on Facebook called The Optimal Ketogenic Living. They have this macronutrient tables everybody is supposed to follow and I know from personal experience that there's way too much protein. For me, I'm 150 pounds. They would want me having eating 130 grams of protein, which is not outrageous. It's still a normal amount of protein, I guess. But it's definitely higher.

Tommy:    That's not the upper end, I would have thought, for being able to maintain ketosis.

Christopher:    It's definitely higher than I know I can eat and stay in ketosis. But they argue vehemently. And there's some intelligent people in this group that gluconeogenesis or the process that we'd just been talking about is not driven by the amount of protein that you eat at all. And it's driven by the need for glucose.

Tommy:    But those two aren't mutually exclusive in somebody that's eating a low carbohydrate diet because if you're eating a lot of protein, you maintain your glucose requirement because you've never entered ketosis. But you're also eating a lot of protein, so you're putting more in and you're needing more to come out. I don't think the two are mutually exclusive.

Christopher:    Okay. Getting back to the prenatal and in the postpartum, how much protein do you think a pregnant woman should be eating? It makes logical sense, doesn't it? It seems sensible that you would need a lot more protein if you're trying to produce another human. But how much do you think you really need?

Tommy:    Actually, there's no evidence that you need to increase your protein intake once you're pregnant. They've done big analysis and studies which show that anything above about 25% of your calories coming from protein increases your risk of having a small for gestational age babies, small unexpected baby. And babies that are small for gestational age are also at risk of other complications such as problems during childbirth.

    Probably 20% to 25% of calories from protein is plenty. And they even, back in the '60s, they did the study where they told women to eat more protein and avoid carbohydrate or avoid carbohydrate heavy foods, so potatoes and rice and bread and things like that. And then when those kids reached 40 years old or something, very recently, they found that they all had higher cortisol levels, so higher stress levels, which obviously predisposes the things like high potential of cardiovascular disease.

    Increase in protein during pregnancy probably isn't a good thing and you probably don't need more than you're already taking in, except for the fact that people shouldn't restrict protein. And also, if you have a protein heavy meal, if you have morning sickness, so around 50 grams of protein, that's been shown to significantly improve your feelings of nausea. There's definitely a balance there. But you shouldn't have too much and then you can make sure you get enough and then actually eating protein may help you with your morning sickness symptoms.

[0:25:05]

Christopher:    Okay. Can you think of a course or mechanism there? Could it be that these women that were eating extra protein were also doing something else that was kind of wacky?

Tommy:    One thing that I notice in this study where they were told women to eat more protein, two important things stood out for me. One is they didn't record fat intakes. I have no idea what their fat intake were. It could have been -- Instead of what happens to a lot of people when they go to say a Paleo style diet or a low carbohydrate diet, what they do is they cut out the carbs but don't increase the fat accordingly to replace those calories.

    They could have been calorie restricted. They could have been eating a very, very high protein diet. And also, actually, in this particular study, 40% of the mother smoked because this is back in the '60s. Maybe actually the results don't mean anything at all. But it was an interesting thing to note. I think the real problem there probably was that they didn't increase their fat intake accordingly as they restricted carbohydrate.

Christopher:    It's a really tough one. These tests, I mean, I'm sure you've seen the same. Whenever you see some data -- So, you already suggested that the problem with the ketogenic diet is there's no data. Whenever you see a study, there's always some really glaring problem with it.

Tommy:    Absolutely.

Christopher:    Sometimes I see a ketogenic study on cyclists of my age. I'm like, "Yes." And then I'm like, "Oh, why did they do that? It's so annoying."

Tommy:    And the problem is that every study does something wrong that the thing that they do wrong is different, so then it's very different to compare studies and thought of that data together. Because nobody has managed to design the perfect study for anything. And that's probably because, I mean, study design is incredibly hard. So there's always going to be these things that you have to take into account.

Christopher:    Yeah. And I'm sure there's someone somewhere that's holding the money that's making these decisions too. That must be true. It's almost like, "Okay, I'll pay for this but you need to have them eat this." And I'm like, "Oh, I don't want to do that but I need the money, so I'm going to do it anyway."

Tommy:    Yeah, yeah. And these funding bodies have their own biases and goals. If you want to get money from them, you have to know where they're coming from and what they're aiming for. And then there's the work you do has to come within that framework. That's definitely part of it.

Christopher:    I wanted to talk to you about the temperature of babies. You already mentioned that previously, as a potential treatment for hypoxic injury, the cooling of the baby could be important. I know you've got lots of great information about the temperature that baby should be especially after birth. What are your thoughts on that?

Tommy:    This is something that we're definitely doing wrong in modern medicine, and that's the fact that when babies come out, and it happens down the road here, at one of the hospitals down the road, as soon as the baby is born, everybody assumes that its temperature has to be 100 degrees or 37 degrees Celsius or around there, 99 degrees Fahrenheit, something like that.

    And if the baby is colder than that, then immediately what they'll do is they'll rub him, cover him in blankets, put a hat on it, maybe put it under a heater if they're really worried. And there's some really nice data, if you go back to the '50s and '60s, where they just take a baby and it comes out, it's covered in goo, you just give it a wipe and then the mom gives it a hug. And that's what would have happened for hundreds of thousands or millions of years.

    And after birth, the temperature of the baby naturally drops below 70 degrees Fahrenheit or 36 degrees Celsius. And then over the next 24 hours, it starts to come up and gets just over 98 degrees Fahrenheit by 24 hours. And that is completely normal. And when babies have any problems or they're starved of oxygen during childbirth, they'll drop down even further, and I think that's part of a normal protective mechanism. It basically turns down your metabolism in response to not having enough oxygen.

    

    And then as things get normal again and get better then that will slowly start to come back to normal. Especially in that sort of first 24 hours of life, it's okay to be a bit cold and babies are very good at telling you when they're not comfortable. I think erring on the side of no hats and just a blanket or something like that or being with the parents is definitely the optimal way to be.

Christopher:    Can I just have you restate those temperatures again? Because I think this is important. And then also it's also easy for people to check this at home. It's very easy to measure your temperature or a baby's temperature. What were those temperatures again?

Tommy:    I mean, this is obviously just in the first 24 hours. Within the first hour or so of birth, if you take a baby's core temperature, it will be below 97 degrees Fahrenheit.

[0:30:05]

    So probably about 96.5 degrees Fahrenheit. And then it will slowly start to come up towards 98 degrees Fahrenheit over that first day. And that's completely normal.

Christopher:    Okay. What do you think might be the mechanism there? Obviously, the brain is like running the show here. What do you think the brain is trying to do by lowing the temperature?

Tommy:    I mean, obviously, that's part of the fact that your body has a set point in terms of temperature. When you're sat inside your mom, she's regulating the temperature around you and you're basically relying on her to give you the temperature that you should be at. And then you obviously lose that as soon as you come out. Your temperature will drop both because you're wet and you're exposed to the environment and suddenly this huge surface area that's exposed to air rather than a nice warm uterus.

    So then I think it takes some time for your body to realize exactly where it is and then start to turn up the heat in the hypothalamus and then it slowly comes up. But actually, like we talked about earlier, your mom might not be able to give you any food for the first day, three days of life or something like that. So actually having a low metabolism during the first day which you would have if your temperature was lower is probably a good thing, actually. Because then your food demand is less.

Julie:    That's really interesting. I think it's hugely important too because I'm sure there's also some hormonal signaling pathways that are turned on by that drop in temperature as well that we just don't know about. And that's one of the things that I think, a point that needs belaboring with more people is that a lot what we see, I mean, a huge proponent of going back to basics in terms of childbirth, moving more towards with low risk or no risk pregnancies, more home birth and more midwives and things like that, going back to the way things used to be done before a lot of interventions.

    What other interventions do you see causing a lot of problems? What about caesarian section and are there any neonatal outcomes that you think we need to be paying more attention to with that? What can we do to bolster our baby if they've been born via C-section?

Tommy:    I think C-section thing is incredibly important especially as people are starting to do more and more of them electively, so they don't need them, whatever would be that cosmetic or they don't want the pain or whatever. I think a lot of that is coming through a change in the microbiome which people is always talking about a lot at the moment, the gut microbiome. It was exposed to a lot of bacteria on your way out if you're born vaginally.

    And in babies who have had or been born by C-section, they have an increased risk of allergies and celiac disease and inflammatory bowel disease. You obviously have to look at why they were born by caesarian section. If you were born and the membranes ruptured and you just go stuck, then you'd probably already been exposed to all of those vaginal bacteria and that maybe is not necessarily a bad thing and you got your dose.

    But if you were taken out before the membranes ruptured as an elective C-section, then you obviously have another chance to be exposed to any of that. And then, of course, anybody who's born via C-section will also get a nice big dose of antibiotics. So the minute you come out, you basically had a large part of your natural microbiome wiped out. So it might not be that the C-section is the problem. It might actually be the fact that they're getting a dose of antibiotics on the way out essentially.

    And it's very difficult to say how you can mitigate those things. I've even heard people talk about if the baby comes out via C-section, you just make sure that you get something from the area it should come through and you just sort of give it a dose of that by rubbing on the skin or something. But, obviously, this is something that hasn't been tested in trials or anything, so I can't really speak to the efficacy of that at all.

Christopher:    Let me tell you about I did an interview yesterday with the CEO of a new San Francisco company. And they have a product called Equilibrium. It's a new probiotic and it's a spinoff from the NIH funded human microbiome project. What they've done is look -- So they sequenced the genome of 300 people and then they figured out which of the pathogens, which of the things that are doing some good, what are the deltas between the people that are healthy and the people that are sick?

    And so, they've then chosen, used this information to select specific strains, 115 of which have ended up freeze-dried in this new probiotic. They're doing some trials at the moment.

[0:35:02]

    But the results are really exciting. And I wonder if that could be a potential, not solution, that could mitigate the harmful effects of caesarian by women loading up on probiotics. I mean, there's others too, not just this one like Saccharomyces boulardii. I know it does some good things. So what are your thoughts? Do you think that's a potential solution or something that you'd ever suggest?

Tommy:    I think it's probably going to be beneficial and at least I wouldn't imagine it doing any harm. Because we know we already put them at a disadvantage by being born by caesarian section. I think before you can tell people to stop taking all this stuff, then obviously, it would be nice to see some kind of data. The thing that worries me about certain -- I mean, I think in the right context, probiotics are very important and can be very beneficial.

    But they can be quite a narrow spectrum and you're just not getting that huge safari of bacteria that you should normally be exposed to. And then we don't really know the downstream effect of having such a narrow colony of bacteria that you're being inoculated with. There's definitely pros and cons there.

Christopher:    Yeah. That association seems quite clear at this stage. There's lots of things they don't know but I'm pretty sure that this point, the variety, more variety is better. So when you look at some of the sickest people, those are the people that only have 31 different types of bacteria living in their gut. That's not a good thing.

Julie:    What are some of the other things environmentally or in our surroundings? One of the things we mentioned before we start recording was certain exposures to radio frequency, the Wi-Fi and things like that? What are some of the other things in our environment that should be of concern for pregnant women and also young children in terms of brain development?

Tommy:    I think we can talk about electromagnetic radiation first, so things like Wi-Fi and cellphones which has become quite a hot topic in the Paleo community recently. And there's been some studies that come out that you should really minimize your exposure to it particularly as a baby as much as you can. And if anybody remembers back to high school biochemistry and they remember what a mitochondria does, so it's the powerhouse of the cell.

    They're basically moving electrons to generate energy and then what happens is as those electrons move across, you create an electromagnetic field. So essentially, we are run by electromagnetic field just through the process of moving electrons though the cell membranes of our mitochondria. And you also know that electromagnetic fields interact with each other and can inhibit one another. So that's why people [0:38:08] [Indiscernible] on top of an old television set you warp all the colors. Because the magnetic field interact and you get those changes.

    If you think about it like that, then it's obvious there must be some effect of surrounding ourselves with electromagnetic fields all the time. There must be an effect on a cellular level just because we know that electromagnetic fields interact. And actually, in 2011, the World Health Organization declared microwave radiation as a potential class B carcinogen and all the things that sit in that list include chloroform, DDT, lead, diesel and gasoline.

    These are things that we know we really shouldn't be exposed too much on a daily basis. And in that microwave radiation, in terms of frequency, it depends on exactly who is giving the definition. But it will always include cellphone frequencies and Wi-Fi router frequencies.

Christopher:    Excuse me. That's so interesting to me especially I used to work for a company that manufactured instrumentation for measuring radiation. And one of the physicists that we employed at that time was a coworker on the board of advisers to the National Radiological Protection Board. He understood a thing or two about the cellular biology and how EMF and other electromagnetic stuff could affect cellular life.

    And he was always adamant. It was in the early days of mobile phones actually that I knew him. I'd love to meet him again and speak to him about this. But he was adamant that the frequencies and the energy were not even close to what it would take to do some harm. But I'm just wondering now looking back on this whether you really need to define what's harm, right?

[0:40:02]

    So we're not talking about a radiological, so ionizing radiation that could potentially damage or even make a cell die. We are just talking about the disruption in the way in which the cell produces energy which is a lot more subtle than just like killing the cell.

Tommy:    Yeah.

Christopher:    Do you think that the children in particular are more susceptible to this type of exposure?

Tommy:    Yes. They have done some studies on this and they've shown that children absorb two to three times more microwave radiation than adults do. And that's because their skulls are thinner, their skin is thinner. If they're actually the ones using the phones, say the mobile phone, then obviously they got to hold it closer to their bodies because their arms are shorter. Everything there means they'll be getting higher doses per kilo of body weight.

    And they've done things like they've taken -- These are adult rats. They've taken rats and they basically exposed them to the equivalent of going to work and sitting next to a Wi-Fi router for five hours a day for a couple of months. And the amount, the dose that they were getting is much less than what's considered the maximum from any kind of electrical device. They sort hyperactivity, mild abnormalities, so that's abnormalities in the sheath around neurons that makes sure that they fire properly.

    And they've seen the same things in rabbits and guinea pigs and that's just by exposing them for just a few hours a day to the exact frequency that we see from a Wi-Fi router.

Christopher:    This is really scary because it's so ubiquitous. It's really scary to me for a number of reasons actually. But because it's so ubiquitous. And then the other thing, of all the objects in the world, our 14-month old daughter loves the mobile phone. It's like at the very top of the list. She sees us messing with them all the time. It's an object of interest to us and, therefore, to her. I mean, it's one of the few things she'll really get in sting if you try and stop her from having it. And the first thing she does with it, of course, is put in her mouth, which is probably the worst place it could be.

Tommy:    Again, they've done studies in pregnant mice and they had just a regular cellphone on an active call. You get a much higher dose if it's during a call. And it's put above the cage on an active call while the mouse is pregnant. All the babies that came out were more anxious, hyperactive, worse memory, worse glutamate signaling. Worse, they're not able or less able to talk between neurons in the brain.

    Even though we don't have a huge amount of direct adult data, you can see that this really does affect biology on some scale, that we should probably be worried about. And even if it's just you put the phone on airplane mode when you give it to your kids to play a game or you just make sure that the Wi-Fi router is at the other end of the house or you turn it off at night.

    I think just the amount, if you can minimize the exposure, I know that we don't have robust adult human data, but you just think about the physics, you think about the biology and it would make sense that there's something potentially bad going on there.

Christopher:    Yeah. I mean, we'd been doing some bad stuff. We have this proprietory Apple wireless. It's called AirPort Extreme. I'm sure some people have heard of it. I'm pretty sure it works by actually locating the device that it's talking to and then it directs the power of the beam--

Tommy:    The beam.

Christopher:    Exactly. So you just put the phone in the kid's mouth and now the Wi-Fi router found it and it's just--

Tommy:    Beamed the laser at your baby.

Christopher:    My god. Although she seems okay so far. I mean, it's depressing. One of the things that's so empowering and uplifting about the Paleo diet is you're like, "Oh, yes, I can do something about this. I can just make some simple changes to the food I eat and I'm going to be much healthier and get rid of some of my symptoms." But the Wi-Fi and the electromagnetic radiation thing is not like that. Maybe I can turn off my Wi-Fi router but in America the houses are made of cardboard and there's no way that this wall is attenuating next door signal in any way.

    And then I know in London, even though the houses are brick, might attenuate the signal a little bit more. It's crazy. Like if you ride a bicycle down the street in London, like show the Wi-Fi networks, literally, they scroll off the end of the phone before you've even had the chance to select them, it's crazy.

Tommy:    And if you live in an apartment block like I do, it's literally coming at you from every direction. You're getting it from across the road even if it's through the window or something and from above and below and next door. It's impossible to escape it.

[0:45:04]

Christopher:    Yeah. It's really frightening. And I had a really interesting conversation with a woman called Jill Escher who I discovered at the ancestral house symposium. She has a website called GermlineExposures.org. We had a really interesting conversation. That's her hypothesis for autism. It has nothing to do with vaccines or anything like that. It's related to exposures, to things like EMF to the gamete cells in the unborn child.

    You get exposed to things like this and somehow alters these gamete cells that go on to be the next set of egg and sperm. And it's not the child that was exposed in utero that is affected by this. It's the next generation. It was all of her kids. Her mom was exposed to a ton of stuff like this and then she was just fine. But her kids have all gotten non-verbal autism. That's some really good evidence mounting. It seems like we're doing a giant experiment right now.

Tommy:    Absolutely.

Christopher:    But we'll probably have more in 50 years or something.

Tommy:    I mean, you guys have probably heard of Jack Kruse.

Christopher:    Yes. I can't understand him. I can't follow him at all.

Tommy:     I really want to just ring him up and say, "Look, Jack, you need to write a book. Please let me translate what you're saying so that other people can understand it." Because 90% of what he writes, I can't follow it.

Christopher:    Even you can't follow it?

Tommy:    No. It takes a long time. And once you've read 4,000 words of blog post of which only 3,000 words you barely understand then you have to read all these references and stuff. It takes a long time to get where he's coming from. But he's obviously, I mean, he's very passionate about EMFs. And he talks about the fact that in the Russian military, they have a maximum exposure to EMF that's literally fractions of what we're told we can get away with.

    They make sure that there's nothing like this that gets to their soldiers because they know the effect that it has in the body. And there's a huge body of Russian literature on a number of subjects, not just EMFs, that we don't have access to in the Western World because they don't put it on public med. They know a lot more about this than we do because they've been studying it for a lot longer.

Christopher:    Okay. The takeaway message from this conversation is then -- The phone has a Wi-Fi mode, use it. And maybe think twice about giving any of these devices to a child. I mean, obviously, people know that the kids love these things because they make toy versions of these. They're everywhere. It's one of the most popular toys if like a model version of an iPhone. That's common. Shifting gears a bit, we first heard about -- She's a doula, isn't she? A doula.

    About placental encapsulation. What they're doing here is they're taking the placenta and freeze drying it and putting it in a capsule and then the idea is you take that as a dietary supplement after the baby is born. And it helps with postpartum depression or something like that. At that time, I thought this woman is nuts. We don't want to do this. This is craziness. Then afterwards, I just stumbled by accident into a paper that described the placenta as an endocrine organ.

    They showed that the removal of that organ at birth led to massive drops in all kinds of hormones, not just the ones you'd associate with gestation, estrogen, for example, but also cortisol and just everything dropped basically. I wonder with you if you'd seen also any research that backed up this practice or had any thoughts about it.

Tommy:    I haven't seen actually but it doesn't -- I mean, it doesn't surprise me, of course, because there's a lot of things that the placenta accumulates as it gets closer to childbirth for a number of reasons like birth nutrients and for hormonal things. But the only thing that I would say about that is that we would never traditionally have freeze-dried or frozen chopped up bits of placenta. I wouldn't have been surprised if we ate it because, obviously, that's a lot of calories that we'd be giving up.

    I think that would have been something that we'd have eaten over a short period of time rather than a longer period of time after birth, if that makes sense. So it would have been something that came out and I wouldn't be surprised that people ate it traditionally because, obviously, it's a large meaty object that you wouldn't necessarily want to throw away.

    I can understand why people do it. But I've heard more people eating it much closer in one go to birth or a couple of goes rather than over a longer period of time.

Julie:    Interesting. Is there anything else environmentally that…

[0:50:01]

    We like to talk about the lowest hanging fruit, the things maybe not environmentally but nutritionally or things that people can do to either prepare for pregnancy, during pregnancy, after pregnancy, the window of time that has the most effect on brain development. I feel like that's a pretty important window. What else are some things that people can do to either prepare or during pregnancy or after pregnancy to, I don't know, hedge their bets they're doing everything that they can to ensure proper brain development or just preventing any kind of over distress on brain development in a fetus or a baby?

Tommy:    Yes. I think most of it is the really obvious stuff, which maybe doesn't need to be said but things like don't smoke. I'm sure that most people on a Paleo lifestyle do not smoke. But that's really the most important thing you can do for your baby is not smoke. And then breastfeeding is incredibly important. I know that we haven't talked about that. But the risk of infections, diabetes, obesity, allergies, sudden infant death syndrome, these are all reduced by breastfeeding.

    And I know it's not necessarily brain development but I think it's one of the best possible things that you can do for your baby. And a lot of the studies into breastfeeding are slightly confounded because women who are of a higher social economic class are more likely to breastfeed and we know that that converts other benefits. But I think that's incredibly important and something that people should try to do for the first four to six months, if they can.

    In terms of other things, I think the most important stuff is going to be staying active, maintaining activity during pregnancy. And there's a lot of evidence to suggest that if you have better strength or aerobic fitness which you can get by just brisk walking or maybe some light strength training during pregnancy, you reduce your risk of things like preeclampsia, which then reduces your risk of further problems during childbirth.

    But will also reduce your risk of having problems during childbirth probably because you just have a stronger body that's better able to push things out. So the maintaining activity during pregnancy is incredibly important. And it's not a pathological state. You are a healthy woman who's bearing a child as many people think had been assigned to. So you can stay active and walk, lift, carry, squat. Obviously, within whatever your pelvis allows because they will start to loosen and get weaken the further you get into pregnancy. But you should stay as active as you can.

Julie:    I think that's true.

Tommy:    Yeah. No, absolutely. They've even done bed rest for severe problems during pregnancy. And it doesn't improve any outcomes. And I think that's because you lose that strength and you're less able to get that baby out when you actually have to. So maintaining activity, I think, is a huge thing. Again, modern society treats pregnant women like they're sick. But they're not.

    They are the peak of their health because they are doing something they're designed to do and they're doing it well. I think maintaining activity is incredibly important.

Julie:    Yeah. I think those point alone is extremely important. They're not looking at this as a pathology, especially when you look at something as a pathology and then you're hit in the context of western medicine, modern medicine where every problem is a nail and your only tool is a hammer. There are just extreme interventions that we're seeing over things that are probably natural and very important to the process of birth and a successful and healthy birth outcome.

    When you prevent those things from happening because you're afraid of them or you're looking at them as a pathology instead of a part of a normal function.

Tommy:    Absolutely.

Julie:    We tend to get so involved that I think we're creating a lot of the problems that are worst than what would have just happened on its own. So it's a good point.

Christopher:    Well, this has been a fantastic discussion. I would really like to use it a jumping off point for people to listen to and then send us questions and then maybe we could fill some of those. It's a bit unfair that obviously we're parents and we have tons of ideas but I'm sure other people that are listening to this and thinking, "Hey, why do I get to ask about this?"  So, it would be great if we could get you back on and talk to some more because you're obviously a wealth of information. It's wonderful to extract. Yeah, it will be great.

Tommy:    I'll be happy to do that, absolutely.

Christopher:    Excellent. Thank you so much for your time today then.

Tommy:    Thank you. Bye.

Christopher:    Tommy has actually teamed up with Paleo Britain to start his own podcast which is called the Eat Better Podcast. If you Google that, then the word iTunes or I will link to it in the show notes, then I would highly recommend it. I think that Dr. Wood is the new Chris Kresser and has a ton of information that everybody can learn from. So, yeah, go check out his podcast. It's great stuff.

[0:55:38]    End of Audio

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