An issue on everyone's mind lately is the parasite Cyclospora. The good news is that, for the overwhelming majority of healthy people, this is more of an unpleasant gastrointestinal illness than a dangerous infection. Cyclosporiasis is an intestinal infection caused by the protozoan parasite Cyclospora cayetanensis, acquired almost exclusively by ingesting contaminated fresh produce or water. Humans are the only known reservoir. Unlike many enteric pathogens, the parasite'

The Medscape/Pediatric News article by Christine Bahls, "The Rise of Early-Onset Diabetes: A Looming Crisis," frames youth-onset type 2 diabetes as one of the most significant emerging pediatric health threats. Rather than viewing diabetes as an isolated endocrine disorder, the article emphasizes it as the downstream consequence of profound changes in childhood metabolism, nutrition, and environment. We are seeing this reality play out weekly in our clinic. We are diagnosing

Failing Them Why Are We? We are failing our children, the next generation. I have been spending an inordinate amount of time studying cellular biology and mitochondrial function in order to understand worsening disease trends. Thus, I want to revisit a landmark study that is one of the most comprehensive assessments of pediatric health ever conducted in the United States. Rather than examining a single disease or health outcome, Dr. Forrest and colleagues integrated d

Literature Review 1) The recent Journal of Pediatric Health Care study, highlighted by Medscape, reinforces that autism should be viewed as a condition affecting multiple body systems rather than solely a neurodevelopmental disorder. By comparing children and adolescents with autism to neurotypical peers, the investigators found significantly higher rates of numerous medical and psychiatric comorbidities, including anxiety, ADHD, depression, epilepsy, sleep disorders, gastroi

Do we listen to its signal? Pain: Your Body's Built-In Warning System Pain is one of the body's oldest and most important protective mechanisms. It isn't your enemy. It is a messenger. Imagine walking barefoot across your living room and accidentally kicking the corner of the coffee table. The sharp pain that shoots through your toe isn't there to punish you, it is there to protect you. Within fractions of a second, nerves carry a signal to your brain, telling you tha

Whitney McKnight's article in Medscape reminds me of many SPA newsletters covering inflammation. It is nice to see general medical literature exploring this rapidly emerging concept in pediatric medicine: that allergy, asthma, and depression may not be entirely separate conditions, but instead share a common biological driver: chronic inflammation. The article reviews growing evidence suggesting that inflammatory pathways may link these seemingly unrelated disorders and raise

Metabolites and Phenotypes In a brand new paper entitled. “Elevated Microbially-Derived Metabolites in Autism: A Possible Diagnostic Screening Test for a Distinct ASD Phenotype,” Dr. Flynn and colleagues investigated whether specific urinary metabolites produced by intestinal microbes could serve as predictive biomarkers for autism spectrum disorder. The study proposes that a large subset of children with autism may represent a biologically distinct phenotype characterized

"Because challenges are ubiquitous, resilience is essential for success in school and in life. ... We show that students who believe (or are taught) that intellectual abilities are qualities that can be developed (as opposed to qualities that are fixed) tend to show higher achievement across challenging school transitions and greater course completion rates in challenging math courses. New research also shows that believing (or being taught) that social attributes can be deve

or Better Yet, Live for Today Recently, there has been more death and morbidity in my life than usual. There is no easy way to discuss this topic. Death is finite and simultaneously infinitely painful for the survivors. Everyone learns in the moment how to deal with death. There is no on-the-job training. We are not born ready to accept this reality. It is simply thrust upon us. While I deal with illness and death more frequently than the average American, an occupational

Strengthen Your Lab Interpretation Skills Across Adult and Pediatric Care. Start with Basic & Advanced Blood Labs: A Functional Approach for Family Medicine, an on-demand course led by Drs. Chris Magryta and Erik Lundquist, then join the live Q&A on June 10 at 4:00 p.m. PST / 7:00 p.m. EST. Fullscript Academy's course-plus-live format pairs on-demand education with a live Q&A for practical training and direct instructor access. Course link You will learn how to: ·

1) Ultraprocessed Food and Behavior - Among 2077 participants, 1092 (52.6%) were male; 1376 children (66.2%) were White, 480 children (23.1%) were multiracial, and 221 children (10.7%) were identified as another ethnic group. At age 3 years, UPF contributed a mean (SD) of 45.5% (11.6%) of total energy intake. At age 5 years, the mean (SD) CBCL scores were 44.6 (9.1) for internalizing, 39.6 (9.4) for externalizing, and 41.2 (9.0) for total behavior. Each 10% increase in energy

One of the most misunderstood pieces of advice in our culture is the phrase "fake it until you make it." At face value, it sounds dishonest. It sounds like pretending to be something you are not. It sounds like confidence without competence. But after nearly three decades in medicine, I have come to believe there is a deeper truth hiding inside that phrase. Most success in life is not built on pretending. It is built on being willing to step into situations where you are

Strengthen Your Lab Interpretation Skills Across Adult and Pediatric Care. Start with Basic & Advanced Blood Labs: A Functional Approach for Family Medicine, an on-demand course led by Drs. Chris Magryta and Erik Lundquist, then join the live Q&A on June 10 at 4:00 p.m. PST / 7:00 p.m. EST. Fullscript Academy's course-plus-live format pairs on-demand education with a live Q&A for practical training and direct instructor access. Course link You will learn how to: ·

This Nature news article discusses emerging evidence that eating may acutely enhance immune responsiveness, particularly through effects on T cells, the learning part of the adaptive immune system. The paper centers on the old saying “feed a cold, starve a fever,” suggesting there may actually be biologic truth behind at least the “feed a cold” half of the proverb. The article reviews a new study in mice and humans showing that T cells, key adaptive immune cells responsibl

Pause before reacting. The Adult Chair lives in the pause. When emotionally triggered, stop before speaking, texting, emailing, or escalating. Reactivity usually comes from the Child or Adolescent Chair. A few breaths can prevent a five-hour cleanup operation. Ask: “How old do I feel right now?” This is one of Chalfant’s simplest and most powerful tools. If you suddenly feel abandoned, defensive, panicked, or desperate, you are probably not functioning from your grounded adul

The Adult Chair, the Adolescent Chair and the Child's Chair The Adult Chair by Michelle Chalfant is a practical framework for emotional maturity, self-awareness, and healing old patterns that unconsciously drive adult behavior. The central premise is that most people move through life reacting not from their grounded adult self, but from unresolved emotional states formed during childhood and adolescence. She organizes this idea into what she calls the “three chairs”: the Chi

Since we are talking about attachment this week in the podcast, I thought that I would give a brief description of it as a teaser for the incredible conversation with Duey. Attachment theory is one of the most important frameworks ever developed for understanding human behavior, emotional development, and mental health. At its core is a deceptively simple idea: human beings are biologically wired to seek safety and connection through relationships. The quality of those earl

Birth Order Is Biology, Not Birthright - so says a new paper in MedRxIV (Kramer et. al. 2026) Here is a short field guide to how sequence shapes the immune system, and maybe the brain in children. We’ve treated birth order like personality trivia. First-borns are “responsible.” Youngest are “free spirits.” Middle children… well, we forgot them. This paper suggests something more interesting: birth order is a biologic exposure. Not destiny. Not diagnosis. But signal. A

In a recent episode of the All in Podcast, David Friedberg discussed the new paper in Nature Medicine by Dr. Maas and colleagues which paints a modern picture of colon cancer and the why? It is super important as a stand alone study as well as a blueprint for further future analysis of chemical disease associations across the 80,000 chemicals in circulation. (Dept Tox Subst) Colorectal cancer used to be a disease of age. Now it’s a disease of timing. Over 20 years: >80% inc

A new 2026 Cell Metabolism study explores a compelling and increasingly central idea in modern biology: the gut/brain/immune/metabolism axis is not just associative, it is mechanistic. Specifically, Dr. Lu and colleagues investigate how the gut microbiota can directly influence depressive behavior by reshaping systemic and neural metabolism. This is another in a long running list of papers describing the amazing work that bacterial commensal microbes do for us. In this case,