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Nothing in biology is random. Not growth. Not metabolism. Not disease. What we will explore today is the reality that the earliest inputs in life: nutrition, environment, signaling, don’t just influence outcomes… They shape them. They write the first draft. And if you understand that, if you truly let that land, then everything about how we approach pregnancy, childhood, and prevention begins to shift. From reaction…to intention. From downstream management…to upstream design. Why This Conversation Matters This episode is not just another discussion. In many ways, it is ground zero. Because if you don’t understand this layer, the imprinting, the epigenetic programming, the responsiveness of biology to environment, then everything that follows in this podcast…becomes harder to fully see. But once you do see it, the picture sharpens. You begin to understand:why trajectories diverge early, why children present so differently and why the same diagnosis can have completely different roots. This is the beginning of a new map. And maps matter. Gratitude to Today’s Guests I want to take a moment to acknowledge the voices you heard today—because this kind of thinking doesn’t happen by accident. Lucia Aronica Dr. Aronica is a Stanford scientist and a global authority in nutritional epigenetics, helping clinicians understand that food is not simply fuel—it is biological information that actively programs gene expression. She created Stanford’s first courses in nutritional epigenetics and pioneered the Epinutrition framework, a clinical model that reframes nutrition as signaling, not supplementation. You may recognize her from the Netflix documentary You Are What You Eat: A Twin Experiment, and she is now launching the world’s first Clinical Epinutrition Certification, training health professionals to use food as epigenetic medicine. Emily Stone Rydbom Emily is a clinical nutritionist, researcher, and digital health founder working at the frontier of precision maternal nutrition. As Founder and CEO of GrowBaby Health, and through her work with GrowHealth Technologies, she is building AI-enabled systems that integrate nutrition directly into standard obstetric care. With over 14 years of clinical experience, she has helped pioneer the “Standard of Care PLUS” model, demonstrating meaningful reductions in preterm birth and gestational diabetes in high-risk populations. She is also a co-investigator on the ROOT Study—bringing this work directly into real-world maternal care here in North Carolina. Samantha N. Fessler Dr. Fessler brings a deep scientific lens to the intersection of metabolism, inflammation, and perinatal nutrition. With a PhD in Exercise and Nutritional Sciences from Arizona State University, her work has focused on how nutritional strategies can modulate the interplay between immune signaling and metabolic function to improve outcomes for mothers and children. As Director of Scientific Affairs at Needed, she helps translate rigorous science into actionable, evidence-based approaches that clinicians and families can actually use. Randy L. Jirtle And finally, Dr. Randy Jirtle—joining us again—whose work, quite simply, changed how we understand biology. A pioneer in epigenetics and genomic imprinting, Dr. Jirtle’s research on the agouti mouse model demonstrated for the first time that environmental inputs—particularly nutrition and chemical exposure—could directly alter gene expression across generations. His work reframed the gene from a fixed sentence…to a responsive system. In fact, Time Magazine once described it this way:“A gene represents less of an inexorable sentence and more of an access point for the environment to modify the genome.” He is a Professor of Epigenetics at North Carolina State University and Senior Scientist at University of Wisconsin–Madison and remains, at his core, a deeply curious thinker. And that curiosity… is what moved this field forward. Final Thought: If there is one takeaway from today, it is this: The environment is not acting on the child. The child is responding to the environment. And that response…is being written into biology. Dr. M

THE FUNCTIONAL MEDICINE STORY DR. JEFF BLAND  "Change occurs from the outside in" Dr. Bland Medicine has a habit of believing it has arrived. Every generation of physicians looks around the room, surveys the white coats and microscopes and MRI machines, and quietly assumes the puzzle is mostly solved. History laughs at that assumption. The truth is that medicine is always mid-sentence in a very long story. Dr. Jeff Bland has spent decades helping rewrite that sentence. In a recent conversation on The Root Cause Business of Medicine Podcast, Dr. Bland’s life work comes into focus. Not as a rebellion against medicine, but as an expansion of it. His influence on nutrition science, biochemical individuality, and what we now call functional medicine has helped move the field away from the narrow idea that disease is simply something to suppress or worse just name. Instead, he has pushed a more interesting question forward: why did the disease appear in the first place? That sounds obvious. It is so far from obvious that most physicians do not ask the question. Bland’s career sits at the intersection of nutrition, biochemistry, genetics, and what he calls systems biology. Over the decades he has authored more than 100 peer-reviewed papers and written many books aimed at both clinicians and the public. But numbers don’t tell the story. What matters is the conceptual shift he helped introduce. For most of modern medical history, the dominant model has been reductionist. And reductionism is the scientific approach of breaking complex systems into their smallest parts. It has given us antibiotics, vaccines, and surgical techniques that save lives every day. But it has also left a blind spot. When we zoom too far in, we sometimes lose the map of the entire ecosystem. Human biology is not a machine made of replaceable parts. It is a network. It is supremely interconnected.... and a literature review Dr. M

Elk Antlers - What a Story  After returning from Jackson Hole, Wyoming this week, I was struck by the beauty of the Elk refuge, a place where thousands of elk relax in the winter lowlands. Staring at them, I pondered a question: why do the elk shed their antlers yearly? Seems like a lot of wasted energy in a resource scarce world. The answer, mating. Nature has a peculiar sense of theater. When reproduction is the goal, evolution doesn’t whisper, it builds costumes, props, and entire stage productions. Sometimes expensive ones. Across the mammalian world, attracting a mate often requires a spectacular display of biological investment. Energy is spent not just surviving, but advertising survival. The elk might be the most dramatic example. Every year, a male elk grows a massive set of antlers, sometimes weighing 30–40 pounds. These structures are not permanent. They are built from scratch annually, making them one of the fastest-growing tissues in the entire animal kingdom. At peak growth, antlers can elongate nearly an inch per day. To accomplish this feat, the animal diverts enormous metabolic resources into bone growth, calcium mobilization, and vascular supply. Then, after the breeding season, the antlers are shed and the process begins again. From an engineering standpoint, it seems wildly inefficient. Why build something so energetically expensive only to discard it months later? Because in evolutionary terms, reproduction is the ultimate metric of success. If an animal fails to reproduce, its genes disappear from the story entirely, Darwinian failure. Antlers function as a biological billboard: I am strong enough to waste energy....and more Dr. M

Screenshot On today’s episode of Dr. M’s Women and Children First Podcast, we welcome Halie Hauser, a pediatric clinician, storyteller, and quiet architect of early childhood connection. Halie is the creator of Storytime Explorers, a storytelling platform designed for toddlers and preschoolers that sits at the intersection of language, emotion, and human development. With a Doctor of Nursing Practice focused on pediatric primary care, she brings both clinical depth and creative intuition to the way she reaches children—and just as importantly, their parents. \ Her work lives in the small moments: friendship struggles, big feelings, daily routines, the courage to try again. The ordinary terrain of childhood—where, if we’re paying attention, the most important wiring is happening. Halie understands something we often forget in modern pediatrics: before a child can regulate, they must feel safe; before they can learn, they must feel connected; and before they can speak, they must be spoken to in a language that meets them where they are. Through storytelling, she’s building that bridge. This is a conversation about early brain development, emotional scaffolding, the power of narrative in shaping behavior—and how something as simple as a story can become a tool for resilience, attachment, and lifelong learning. Dr. M

Why Don't They Win  There are moments, usually late, usually quiet, when honest thinking can be had. When you zoom out and see the ecosystem around children not as a collection of caring institutions, but as a set of incentive machines. And incentive machines, unlike grandmothers, do exactly what they’re built to do. MAKE MONEY Tonight I sat with some difficult thoughts about the state of primary services for children in the United States. The deeper I look, the clearer it becomes that money, not well-being, drives most decisions shaping a child’s life. And the imbalance is not trending in a positive direction. Children Continue To Lose From My Viewpoint Approximately two-thirds of a child’s daily nourishment comes from school food programs, which too often rely on ultra-processed, calorie-dense, nutrient-poor products. Outside of school, the dominant food environment is similarly saturated with highly engineered foods that optimize profit, shelf life, and palatability rather than health. Kids are micronutrient starved, but calorically overfed. Biological systems begin to fray early. Biochemistry no longer meets cellular needs. Children develop disease and we are asked to medicate or worse rationalize away that this is NORMAL..... Enjoy Dr. M

Finding Relational Balance  Relational balance falters when one person needs the other to feel safe or whole. A parent in a strained marriage or carrying childhood wounds may lean on a child for comfort. The child, loyal and loving, tries to meet that need. Over time, this can harden into dysfunction. Years ago, I cared for a mother and son locked in a budding enmeshed relationship. She could not draw boundaries. She absorbed his pain, projected her own trauma onto him, and smothered him with anxious love and control. She tightly managed his world yet set no limits on how he treated her or others. By four, he was out of control. She was exhausted and indignant, insisting he was sweet while enabling every behavior. Her fear of becoming her own restrictive parents left him both fused to her and furious. Therapy was suggested. It was rejected.... Enjoy, Dr. M

On today’s episode of Dr. M’s Women and Children First Podcast, we welcome a scientist whose work has quietly shaped the cardiovascular health of millions around the world. Dr. Sundeep Dugar is a pharmaceutical innovator, inventor, and industry leader with more than three decades at the forefront of drug discovery. He is best known as a co-inventor of ezetimibe — marketed as Zetia® — a landmark cholesterol-lowering medication that transformed lipid management by targeting intestinal cholesterol absorption. He also co-inventor of the combination therapy Vytorin® (ezetimibe plus simvastatin), expanding treatment options for patients at high cardiovascular risk. For this groundbreaking work, Dr. Dugar and his colleagues received the prestigious 2005 National Inventor of the Year Award from the Intellectual Property Owners Association and the Heroes of Chemistry award from the American Chemical Society. Across his career, Dr. Dugar has contributed to more than 140 patents and has authored over 70 scientific publications, reflecting a lifetime devoted to translating chemistry into real-world therapies. He is currently the founder of Aayam Therapeutics, where he leads efforts to develop innovative, accessible medicines through collaborative global research. He also serves as Co-Chief Executive Officer of Blue Oak Nutraceuticals, advancing a novel mitochondrial-targeted compound known as Mitokatlyst™, designed to stimulate mitochondrial biogenesis and cellular energy — with potential implications for muscle strength, metabolic health, cardiovascular function, and inflammation. He is the first one to decipher the mechanism by which exercise induces mitochondria levels. Mitokatlyst mechanism of action mimics this process. Dr. Dugar’s scientific journey spans continents and some of the world’s premier institutions. He earned both his Bachelor’s and Master’s degrees in Organic Chemistry from the University of Delhi, completed his PhD in Chemistry at the University of California, Davis, and pursued postdoctoral research at ETH Zürich in Switzerland and at Cornell University. Today, we’ll explore the story behind major pharmaceutical breakthroughs, the science of mitochondrial health, and what the future of therapeutics may look like when innovation meets global accessibility. Please join me in welcoming Dr. Sundeep Dugar.

Screenshot Literature Review: A) "Establishment of the gut microbiome during early life is a complex process with lasting implications for an individual’s health. Several factors influence microbial assembly; however, breast-feeding is recognized as one of the most influential drivers of gut microbiome composition during infancy, with potential implications for function. Differences in gut microbial communities between breast-fed and formula-fed infants have been consistently observed and are hypothesized to partially mediate the relationships between breast-feeding and decreased risk for numerous communicable and noncommunicable diseases in early life. Despite decades of research on the gut microbiome of breast-fed infants, there are large scientific gaps in understanding how human milk has evolved to support microbial and immune development." (Davis et. al. 2022) Main Takeaways: First 1000 days matter a lot for microbial and immune development: Infancy is a critical window when the gut microbiome is assembled and the immune system is learning to respond to microbes and external exposures. Patterns set early can ripple into infection risk, inflammatory diseases, and atopy later in life. Enjoy, Dr. M

Chapter 4 of Beyond Behaviors is often read as a continuation of the neuroscience laid out in the first three chapters. That’s understandable, but it slightly misses the point. By the time Dr. Delahooke gets to Chapter 4, she’s largely done making the physiological argument. She now pivots to a far more practical and, frankly, more uncomfortable question: What does this mean we actually do as caregivers? This chapter is less about how the nervous system works and more about how we work, how we observe, interpret, and respond to children in real time. It’s a chapter about attunement, not theory. About shifting from reflexive reactions to intentional caregiving. About learning to read the child in front of you, not the rulebook in your head. The first major move of Chapter 4 is the insistence on personalized attunement, ditching the plural child. Or better yet, focused on the N of 1 child. There is no “average child” in her framework. There is only this child, with this nervous system, in this moment, in this space and time. How beautiful! Integrative Functional Medicine's credo, treat the whole person as you find them and as they are biologically. Attunement here is not sentimentality. It’s data gathering. Dr. Delahooke asks caregivers to become skilled observers of patterns rather than judges of behavior. What time of day does dysregulation tend to show up? After which transitions? After eating? After playing video games? In which environments? With which sensory demands? With which people? It is sleuthing the underwater potion of the iceberg of behavior. Importantly, she pushes caregivers to stop assuming intent. The question is not “Why is my child doing this to me?” but “What is my child’s nervous system experiencing right now?” That single frame shift collapses an enormous amount of unnecessary conflict. It moves the adult from adversary to ally. It walks away from shame and blame towards love and support..... Enjoy, Dr. M

Welcome back to Dr. M's Women and Children Firsts Podcast. Today’s conversation sits at the crossroads of chemistry, skepticism, and clinical innovation. Our guest is Nayan Patel, a pharmacist with more than three decades inside the world of drug formulation and delivery. He is an alumnus of the University of Southern California School of Pharmacy, where he now serves as adjunct faculty, teaching advanced biochemistry and compounding science. Over the years, he has become an international educator on one molecule that refuses to stay quiet: glutathione. Dr. Patel is the founder of Auro Wellness, launched in 2011 with a specific mission—stabilize glutathione and solve its delivery problem. His work led to the development of the Auro GSH™ Antioxidant Delivery System, a topical approach designed to improve absorption of this notoriously fragile molecule. He is also the author of The Glutathione Revolution, a deep dive into how glutathione influences detoxification, aging, energy production, and immune resilience. If you’ve spent time in integrative medicine, you’ve heard glutathione called the “master antioxidant.” That phrase can sound like marketing, but the biology is real. Glutathione is a three–amino acid peptide central to redox balance, mitochondrial function, immune signaling, and cellular survival. It does not just neutralize oxidative stress; it regulates how cells respond to it. The challenge is delivery. Oral glutathione is largely broken down in the gut. IV glutathione works, but it’s impractical for most families. Precursors like NAC depend on intact metabolic pathways that may not be operating optimally in states of chronic stress or inflammation. Dr. Patel asked a disruptive question: what if the bottleneck isn’t production—but delivery? Today we unpack the science and the skepticism around transdermal glutathione. Can a molecule like this meaningfully cross the skin barrier? What does stabilization actually require? And how does independent pharmaceutical innovation differ from traditional drug development pathways, which are often constrained by economics as much as biology? For those of us caring for women and children—where oxidative stress, immune dysregulation, mitochondrial strain, and toxic burden intersect in everything from complicated pregnancies to neurodevelopmental challenges—this conversation matters. Not as a silver bullet. Not as a miracle spray. But as an exploration of foundational physiology and thoughtful delivery science. This is a discussion about how molecules move, how systems adapt, and how asking better questions can reshape clinical practice. Let’s dive in. Dr. M Auro Wellness

School Based Nutrition - Why is it happening this way? There is a quiet experiment happening in American childhood, and we should stop pretending it’s benign. In the 1970s and 1980s, when I attended school, school food was far from perfect, but it existed in the context of something essential: it was mostly prepared on site, minimally processed (but changing in that direction) and not laden with additives and chemicals (Yet). Oh, and most children still ate meals prepared at home at almost every other occasion. Dinner wasn’t aspirational or Instagram-worthy, but it was routine. Real food. Cooked by someone who knew the child, at a table where nervous systems could downshift. School lunch was a supplement to that structure, not the metabolic foundation of a child’s life. That has all changed in a short 50 years. Mirroring the change in weight and childhood disease prevalence. • 1970s – some processed foods begin to enter school cafeterias at scale • 1980s – preservatives and additives become routine • 1990s – ultra-processed foods dominate In 1994, new standards were added: This table lays out how much of each food group schools were supposed to offer over a week under the 1994 standards. These were the first nutrition-focused meal standards the USDA put into place: For Breakfast (all grades K–12): Fruit: 2.5 cups/week Vegetables: 0 cups/week Grains/Bread: 0–10 oz equivalent/week (depending on combinations of grains and protein) Meat/Meat-alternative: 0–10 oz equivalent/week Milk: 5 cups/week For Lunch (split by grade levels): Fruit: K–3 also 2.5 cups; grades 4–12 get 3.75 cups/week Vegetables: still 0 cups/week (no separate vegetable requirement yet) Grains/Bread: at least 8 oz eq/week Meat/Meat-alternative: 7.5 oz eq/week for breakfast; 10 oz eq/week for lunch Milk: 5 cups/week (Hopkins 2015) What’s notable, reflected in the structure of this table, is that vegetables weren’t required at all yet, and the standards were very much food-group based, not ingredient-level nutrient quality checks. That created space for schools to rely on industrially produced entrées and sides that technically met volumes of grains or proteins but could still be ultra-processed products with long ingredient lists, many of these foods would meet a NOVA class 4 classification (the worst type). Think fruit cup in sugary syrup..... Dr. M

Dr. Carrie Jones, ND, MPH Hormone Literacy Welcome back to Dr. M’s Women and Children First, where we step back from symptoms and ask a more interesting question: how does the female hormonal system actually develop, adapt, and sometimes struggle across a lifetime? Today’s conversation spans that entire arc, from early life, to puberty, to fertility and more with someone who has spent more than two decades living inside that complexity. My guest is Dr. Carrie Jones, an internationally recognized speaker, consultant, author, and educator in women’s health and hormones. Many know her as the “Queen of Hormones,” but what really defines her work is not titles, it’s her ability to translate very complex endocrinology into biology that actually makes sense. Dr. Jones is a naturopathic physician who completed a two-year residency focused on women’s health and endocrinology. She holds a Master of Public Health, was one of the very first clinicians to become board certified through the American Board of Naturopathic Endocrinology, and is a Menopause Society Certified Practitioner. She helped shape how an entire generation of clinicians think about hormone testing and interpretation as the first Medical Director at Precision Analytical, the creators of the DUTCH test, and later as the first Head of Medical Education at Rupa Health. She’s served on Under Armour’s Human Performance Council, consulted for multiple women’s health and laboratory companies, and now serves as Chief Medical Officer at NuEthix Formulations. Many of you will recognize her voice from the Root Cause Medicine Podcast, which reached more than ten million downloads, and she now hosts her own show, Hello, Hormones, where she continues to explore how hormones shape mood, metabolism, immunity, fertility, and aging. But what makes today’s conversation especially important is this: we’re not just talking about menopause, or cycles, or lab values. We’re asking a bigger question. How have female hormones changed across generations? How early life nutrition, stress, environment, and metabolic health shape the hormonal story from birth forward. And how modern exposures, from ultra-processed diets to endocrine-disrupting chemicals, may be quietly rewriting the biology of women long before symptoms ever appear. This is a systems-level conversation about development, resilience, and adaptation, and few people are better equipped to guide us through it than Dr. Carrie Jones. Dr. M @dr.carriejones @dr.carriejones https://www.youtube.com/@drcarriejones https://open.spotify.com/show/0QMOu9ma6Xljf5omizAhNz?si=4dbaaf83a8cf4508 https://podcasts.apple.com/us/podcast/hello-hormones-with-dr-carrie-jones/id1813934931 www.drcarriejones.com

Screenshot Chapter 3 - Individual Differences Dr. Delahooke starts Chapter 3 by allowing Margaret Mead to remind us that each child is absolutely unique: “Always remember that you are absolutely unique. Just like everyone else.” This is more than a witty paradox, it is the hinge upon which all effective pediatric care swings. When we take individual differences seriously as neurobiological fact, we can finally stop confusing adaptive survival responses with defiance, stop labeling children as problems, and begin the real work of supporting the mind body systems that shape behavior from the inside out. Let us review what we have learned in Beyond Behaviors so far - We are invited to descend below the waterline of the behavioral iceberg. What we see at the surface: the tantrum, withdrawal, rigidity, hyperactivity, the refusal to transition is merely a set of observable outputs from deeply personal internal variables. The sensory wiring, physiological states, immune triggers, thoughts, feelings, memories, and the child’s moment-to-moment sense of safety. Without diving into these subterranean layers, we risk treating smoke while ignoring the fire, which is the general state of current pediatric psychiatric medical therapeutics. We mostly treat the smoke. We don’t often ask about the fire. Her central thesis is simple, clinically robust, and profoundly humane: Children behave according to the state of their nervous system, and their nervous system is shaped by individual biological, emotional, and sensory differences. Once we understand this, behavior becomes not a moral test but a window into the child’s internal world..... Dr. M

The Year in Review - 2025 Articles and Points of Interest: 1) Microplastics in the Brain - From Science Advances: "Human health is being threatened by environmental microplastic (MP) pollution. MPs were detected in the bloodstream and multiple tissues of humans, disrupting the regular physiological processes of organs. Nanoscale plastics can breach the blood-brain barrier, leading to neurotoxic effects. How MPs cause brain functional irregularities remains unclear. This work uses high-depth imaging techniques to investigate the MPs within the brain in vivo. We show that circulating MPs are phagocytosed and lead these cells to obstruction in the capillaries of the brain cortex. These blockages as thrombus formation cause reduced blood flow and neurological abnormalities in mice. Our data reveal a mechanism by which MPs disrupt tissue function indirectly through regulation of cell obstruction and interference with local blood circulation, rather than direct tissue penetration. This revelation offers a lens through which to comprehend the toxicological implications of MPs that invade the bloodstream." (Huang et. al. 2025) 2) From Nature Medicine: "Brain insulin responsiveness is linked to long-term weight gain and unhealthy body fat distribution. Here we show that short-term overeating with calorie-rich sweet and fatty foods triggers liver fat accumulation and disrupted brain insulin action that outlasted the time-frame of its consumption in healthy weight men. Hence, brain response to insulin can adapt to short-term changes in diet before weight gain and may facilitate the development of obesity and associated diseases." (Pullman et. al. 2025).... Dr. M

Today, I’m joined by Dr. Maeve O’Connor, a board-certified allergist and immunologist practicing in Charlotte, North Carolina. Dr. O’Connor’s training reflects both rigor and range. She completed dual undergraduate degrees at the University of South Carolina Honors College with a Bachelor of Science in Biology and a Bachelor of Arts in Spanish before earning her medical degree at the University of South Carolina School of Medicine. She then completed her internship and residency at the University of Texas and its affiliated hospitals in Houston, where she served as Chief Medical Resident. Her subspecialty training in Allergy and Immunology was completed at the National Jewish Medical and Research Center in Denver consistently ranked the number one respiratory hospital in the United States where she developed deep expertise in asthma, allergic disease, and immune dysregulation. She further expanded her clinical lens through fellowship training in Integrative Medicine at the University of Arizona from 2013 to 2015. Clinically, Dr. O’Connor works at the intersection of pediatrics, immunology, and real family life where eczema isn’t just a rash, food reactions aren’t just labels, and immune symptoms rarely fit neatly into algorithmic boxes. Her work emphasizes careful diagnosis, evidence-based treatment, and avoiding both over-medicalization and missed pathology. In a time when allergy medicine is often reduced to test results and avoidance lists, Dr. O’Connor brings a grounded, thoughtful approach helping families and clinicians distinguish what’s truly allergic, what’s inflammatory, what’s developmental, and what’s simply noise. Today, we’ll explore how allergic disease actually presents in children, why mislabeling is so common, how early immune signals shape long-term health, and how pediatricians and specialists can collaborate more effectively without fear-based medicine. This is a conversation about immune literacy, clinical nuance, and doing better for children in a world where their immune systems are under increasing pressure. I’m excited to welcome Dr. Maeve O’Connor. Dr. M