In this “carefully researched, compellingly written game-changer for children’s health” (Mark Hyman, MD), Maya Shetreat-Klein, MD, reveals the shocking contents of children’s food, how it’s seriously harming their bodies and brains, and what you can do about it. And she presents a nutritional plan for getting and keeping children healthy—that any family can follow.
Chronic diseases in children are rising dramatically—from allergies and ADHD to mental illnesses and obesity. A traditionally trained pediatric neurologist and a parent herself, Dr. Maya encountered the limits of conventional medicine when her son suffered a severe episode of asthma on his first birthday and hit a developmental plateau. Treatments failed to reverse his condition, so Dr. Maya embarked on a scientific investigation, discovering that food was at the root of her son’s illness, affecting his digestive system, immune system, and brain. The solution was shockingly simple: Heal the food, heal the gut, heal the brain…and heal the child.
Recent changes in growing and processing food harm kids’ gut microbiomes, immune systems, and brains, contributing to chronic disease. Dr. Maya “convincingly argues the case for a dirt-filled but chemical-free life” (Publishers Weekly). She used fresh foods and nature to heal not only her son but chronically ill patients from around the world from the inside out and the outside in—and now makes it available in The Dirt Cure. “Full of scientific information presented in a fun and informative way, [with] concrete evidence that good food can transform one’s life,” (Publishers Weekly), The Dirt Cure shares success stories from Dr. Maya’s practice and her tips as a working mother of three on stocking healing foods (from veggies to chocolate!), reading labels, and getting even picky eaters into the new menu. “Reader-friendly” (Kirkus Reviews), this paradigm-shifting “tour de force prescription…to fight and prevent chronic disease” (Robert K. Naviaux, MD, PhD) empowers you to transform your child’s health through food and ensure the long-term wellbeing of your kids and the entire family.
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Maya Shetreat-Klein, MD is an integrative pediatric neurologist with a medical degree from Albert Einstein College of Medicine. Board certified in adult and child neurology as well as pediatrics, she completed the University of Arizona’s two-year Fellowship in Integrative Medicine, founded by Andrew Weil, MD, and now serves as faculty. She lectures internationally to medical professionals and laypeople on environmental health and toxins, and healing with food and nature. Dr. Shetreat-Klein lives with her family in New York City, where she runs Brainmending, her healing practice and urban farm.
Dirt Cure CHAPTER 1 Where True Health Begins
I love to work with soil. During my pediatrics residency, I gained local notoriety for the melons, tomatoes, peppers, cucumbers, arugula, and beans that burst from the small raised bed I’d built next to our hospital housing. Even though our new apartment in the Bronx overlooked a park, I had yet to find a space of my own where I could grow.
Miraculously, I found an office for my practice that had a lot behind the building. The grumpy landlord confirmed that the building did indeed have a “backyard” and agreed to include it in my lease. Key to padlocked gate in hand, I emerged into a desolate space nothing like the verdant Eden I’d imagined. Between the dying tree, the mass of thigh-high weeds and vines as thick as small tree trunks (not to mention sizable piles of what appeared to be petrified dog excrement), I had my work cut out. Despite all the overgrowth aboveground, the hard-packed, dusty earth revealed little below—no “potato” bugs, spiders, or garden snakes, and, worse, not one worm. I could barely fathom how to help this sick land get well.
I enlisted an extra set of hands—Jesse, a young artist who wanted to plant a permaculture food forest in each borough of New York City. We spent the next few months working side by side, covered in dirt, using straw, broken cardboard boxes, and a hilariously named manure called Chickity-Doo-Doo to build soil that would retain moisture and nutrients and invite worms and bugs. Over time, the terrain began to heal. As the soil became rich and substantial, worms returned, which meant that their invisible communities—beneficial bacteria and fungi and organic matter in the soil that fed the plants—were returning, too. We installed laying hens and honeybees as residents. My plants—beans, melons, kale, tomatoes, kiwi, berries—grew abundantly. I learned that even urban gardens invited delicious edible wild plants like dandelion greens and lamb’s-quarters. When pests came, I resisted the (powerful) urge to poison them with pesticides. Instead, we picked off what we could, but more important, fed the soil with kelp, bone meal, and rich, black compost from kitchen and garden scraps . . . and the pests decreased considerably. While pests never disappeared altogether, the plants were able to mount an effective defense without my help and live in equilibrium with various critters. I discovered that a nourished terrain rich in microbes and minerals yielded healthy, resilient plants.
This brought to mind a famous old rivalry between two scientists: Louis Pasteur, father of “germ theory” and pasteurization, and his colleague Claude Bernard disagreed about which played a bigger role in disease: the germ or the person who had the germ. Pasteur pinned human disease on the presence and action of certain germs. According to his theory, the fewer microbes the body is exposed to, the better. Bernard said that a person’s internal environment plays the more important role in health. He maintained that most common microbial diseases are caused by organisms present in the body of a normal individual. Normally, these microbes help with cellular and metabolic processes—unless the body is out of balance, which allows these same microbes free rein to cause illness. For Bernard, the health of the host—and not the power of the microorganism—instigates most disease. And the story goes that Pasteur conceded on his deathbed: “The microbe is nothing. The terrain is everything.”
In the tradition of Pasteur, my own medical training taught the paradigm that disease could strike anyone at any time, which I call the “sitting duck” theory. In that sense, disease is bad luck and the ideal preventive steps would be to eliminate exposure to as many microbes as possible with the strongest treatments available. This philosophy has been a guiding principle of modern medicine, and has extended into animal husbandry, agriculture, and food production. While incorporating practices like hand washing with soap and quarantining the ill has indeed helped to reduce the risk of spreading infection, the story is actually more complex.
My garden experience broadened this picture by illustrating the truth in Bernard’s theory. There, healing the terrain—indeed, adding more microbes, bugs, and worms—powerfully strengthened plants in the face of stressors like infection and pests. Any number of pests could be attacking the plants in my neighbor’s garden just ten feet away without making much of a dent in my plants. The most effective strategy was not declaring war on bugs. I learned that a balanced terrain acts as powerful protection from whatever challenges nature doles out. This unexpectedly resonated for me as a physician. These observations from the plant world translated to my work with children.
In my practice, as in my garden, the health of a child’s inner terrain reflects the health of the child’s outer terrain. In other words, the elements of nature make all the difference to a child’s resilient health. For this reason, growing healthy children cannot occur in a sterile terrain, but only a richly diverse one.
Germ theory pits microbe against terrain, but we are learning that in large part, diverse and abundant microbes are our terrain. To maintain health, both plants and children need to be in contact with—not protected from—the full array of living elements: sunshine, truly fresh food, soil, all sorts of microbes, even critters. Both need to be actively nourished with living food, minimal toxins, rich in dirt. Their health depends on it.
THE BODY IS ALWAYS LEARNING
Our bodies are not intended to be islands. We are built to be challenged. Indeed, these challenges come from every one of our diverse interactions with nature—food, dirt, microbes, animals, people—as well as synthetic chemicals, pharmaceuticals, heavy metals, and the like. Our bodies are complex information processing centers, and each interaction serves as another bit of information that educates the body. Every small challenge teaches our bodies what to do when bigger challenges come along. This is why it’s normal—even important—for kids to be exposed to the outside world and to get occasional runny noses, fevers, coughs, and so on. As they recover from these mild infections, kids’ bodies and immune systems begin the lifelong process of learning to navigate the world in all its complexity.
Somehow, we’ve lost trust in the body’s ability to heal itself. Instead, we use frequent rounds of Tylenol, ibuprofen, and antibiotics at the first hint of symptoms because we are afraid the body won’t know what to do. Paradoxically, each time we unnecessarily interfere with our bodies’ natural survival mechanisms—even out of a desire to protect—the body becomes less able to recover on its own. A body that is constantly shielded from fighting and recovering from small illnesses may not respond effectively when bigger challenges inevitably arise. How could it? If you want your child to learn to play the violin, you can’t bring someone else in to practice the violin for him (or slap his hand away every time he tries to practice on his own!). Allowing children to overcome small illnesses without interfering strengthens their immune systems. It also provides opportunities for the body to evaluate whether challenges are benign or dangerous, when to live and let live, and when to pick a fight. These are skills critical for your child’s lifelong health.
Take fever. We’re so fearful of the body malfunctioning that we’ve come to mistake the body’s healthy immune response for something inherently dangerous. Some of the sickest kids I see—like those with severe chronic disorders—rarely get fevers. But this isn’t necessarily a good thing. Fevers allow the immune system to expel organisms and compounds from the body. These kids don’t even mount a response. Even my own son—with all of his “runny noses” and coughing—never developed a fever as a young child. He ran his first fever when he was seven. And when he finally did, we were thrilled. I understand it sounds weird, but his immune system finally could do what it was supposed to do: fight and overcome infection.
I’m not suggesting that kids should live in misery when they’re sick. But avoiding all exposures or interfering with the body’s normal response is not the answer. This book will discuss ways you can strengthen your child’s body and immune system to enhance his or her ability to recover.
Fever: The Body Knows What to Do to Heal
Fever itself is not a disease; it’s a remedy to disease. Fever is a component of a complex inflammatory cascade that the body launches in response to infection. Fever acts as a natural “antibiotic,” raising internal temperature to make it inhospitable for unhealthy elements. Yet during the past 30 years, many parents have come to believe that they must immediately administer antipyretics—fever-lowering medications such as acetaminophen or ibuprofen—for any fever or no fever at all.1 Yet according to the American Academy of Pediatrics, fevers below 104°F are not damaging. In fact, fevers may well allow children to get over infections more quickly.2 Antipyretics reduce the body’s purposeful rise in temperature and also interrupt the inflammatory response that helps to vanquish the infection.
Sometimes fevers reflect dangerous infections, in which case your child may appear very ill and should be evaluated and treated by a medical professional. Otherwise, the best approach is to support the immune system and keep your child comfortable with cool cloths, lukewarm baths, hydration, and plenty of rest.3 I recommend giving your child elderberry syrup, thyme-infused honey, a cup of licorice tea, and loads of chicken soup infused with sliced gingerroot, maitake and turkey tail mushrooms, and astragalus root to promote immunity and fight infection. Yarrow tea or tincture can help initiate sweating, which can mitigate a high fever without interfering with the immune system’s job. A mug of peppermint tea or a compress dunked in ice water infused with a few drops of peppermint essential oil is also soothing.
LET’S GET (REALLY, TRULY) HEALTHY
What does it mean to be healthy? Many people define being healthy simply as “not being sick.” Yet health is more than the absence of illness; it’s the dynamic relationship between us—our bodies and minds—and the world around us. Homeostasis is a term that describes the tendency of the body to maintain internal equilibrium by normalizing function at every moment and at every level. It’s the driving force that keeps everything from heart rate to blood sugar to white blood cell levels in balance with the world around us. When our internal terrain is in alignment with our external terrain, we are healthy. When it’s out of alignment, we become sick. And by the time severe illness rears its head, there likely have been ongoing signs that things were out of balance for some time.
Yet more and more, these ongoing problems that indicate children are not in balance are not recognized as problems. For example, I might ask, “How many ear infections has your child had in the past year?” The answer is usually something along the lines of, “Oh, no more than normal.” Or “How often does your kid poop?” “The normal amount.” Beware: The prevailing definitions of normal may not be all that normal.
For example, one really smart, lovely mom came in with her five-year-old daughter for learning disabilities. I asked about her child’s stool, and she said, “Oh, it’s normal.” But her child volunteered enthusiastically, “I clog the toilet every time I poop!” Her mom recoiled: “Honey, the doctor doesn’t need to know that!” I told her that’s exactly what I need to know. Not only did this little girl clog their toilet, her mom carried a plastic knife in her purse so she could break up her poop to avoid clogging toilets at other people’s houses. “I call her my super pooper!” she declared. She represents her child’s stool as “normal,” yet she carries a sharp utensil in her bag to slice up her kid’s poop. That’s how thoroughly we can justify our kids’ conditions as normal—even to ourselves!
Similarly, parents often say no when I ask whether their child has any medical history. I review all the systems: eyes, ears, nose, throat, lungs, heart, belly, skin, and so on? Nope. He almost never gets sick; he’s really healthy! So I’ve learned to collect medical history backward, by asking if their child has ever been on common medications like antibiotics. Oh, no more than normal. “How many times is normal?” Maybe six or seven times a year. “How about steroid cream?” Oh, yes, he needs that for his eczema all winter long. “Allergy medication?” Of course, he takes those every spring and fall or he can’t breathe! Three plus medications and counting in a “healthy” child—that’s how blurred the line between healthy and unhealthy has become. Each of these is a warning sign that a child’s body is out of balance.
Our normalizing of chronic illness in kids has extended to all kinds of problems: recurrent headaches, eczema, allergies, asthma, gastric reflux, anxiety, depression, explosive behavior or irritability, chronic diaper rash, “ants in the pants,” trouble sleeping, or trouble gaining or losing weight. Even families in constant struggle due to their children’s health conditions may deny that their children have a “chronic illness” until symptoms become so severe that they’re forced to visit numerous doctors or the hospital. The new normal for children’s health has become chronic illness, with chronic symptoms and chronic medications to treat them.
What if I told you that these conditions aren’t healthy or “normal”? That some kids never get ear infections, ever? That skin inflammations like eczema and even diaper rash are ways that the body—especially the gut—asks for help? Despite what we’ve been led to believe, babies with eczema aren’t born with a topical steroid deficiency! ADHD isn’t a stimulant deficiency. And constipation isn’t a Miralax deficiency. Each of these conditions is a symptom of a depleted and overloaded body—a body in distress.
Every symptom happens for a reason. Sometimes the reason remains a mystery, but often we can act as detectives to uncover triggers by asking: Why is this happening? What recently changed for my child? What might be my child’s triggers? How can I alter these triggers to change the course of his or her health? Often it has to do with the interaction between what’s inside our bodies—including our genes—and the world outside our bodies.
Signs of a Dysregulated Body
Here are two ways we know that the body isn’t working as it should:
1. A child begins to struggle when exposed to foods, trees, or flowers with which we evolved, side by side, for thousands of years. When the familiar becomes so unfamiliar that the body treats it as a potentially deadly enemy, the body is out of balance with its environment.
2. The most fundamental and necessary functions of a child’s body—eating, breathing, pooping, sleeping, running, laughing, speaking, thinking, learning, playing, and, most important, healing—are disrupted.
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