Episode Transcript
Dr. Jennifer Schriever (guest):
Electrolytes are all those, you know, sports beverages like Gatorade or Powerade. A lot of the powdered little packets of supplements that will talk about how much they hydrate you. In general, most people don’t need those.
Matt Holsen (announcer):
This is the Health and Wellness podcast brought to you by Sanford Health. The conversation today is about TikTok nutrition trends, what’s safe versus a scam. Our guest is Dr. Jennifer Schriever, family medicine physician specializing in obesity medicine, Sanford Weight Management Center, Sioux Falls, South Dakota. Our host is Alan Helgeson with Sanford Health News.
Alan Helgeson (host):
Dr. Schriever, thank you for joining us today.
Dr. Jennifer Schriever:
Oh, thank you for having me.
Alan Helgeson:
Dr. Schriever, why don’t you tell us a little bit about your clinic and what your role is at Sanford Health?
Dr. Jennifer Schriever:
Sure. I’ve been a family physician at Sanford for 22 years, but then starting three years ago I helped develop a weight management clinic where I work full-time now. We help take care of patients in a comprehensive fashion and I work with a lot of dieticians and other physicians and advanced practice providers as well as some counselors to help guide people toward a healthier lifestyle, better metabolic health, weight loss, of course, coordinate some care with the gym next door.
Alan Helgeson:
Well, Dr. Schriever, we had the honor of talking with you a little while back, and it doesn’t seem like that long ago, but I was looking here and gosh, it was almost a couple of years ago, we were talking about some of the latest trends on TikTok, and I guarantee you that we’re doing an update on that, that by the time we get done with the podcast and what we’ve set out to talk about, there’ll be new trends. It moves that fast on social media it seems. So as we talk about these nutrition trends, let’s jump right in with both feet and what are people saying about amino acids and BCAAs? So people are drinking amino acids like it’s their morning coffee. What’s the science behind all of this and what are your thoughts?
Dr. Jennifer Schriever:
So amino acids are the building blocks of protein, and we have essential amino acids and non-essential amino acids. So essential amino acids mean you need to get them from your food and the non-essential, really your body can make those up. Essential amino acids can easily be obtained through a balanced nutrition diet. They’re in a lot of protein and dairy products as well as some nuts and plants and that sort of thing, but you really need a balanced diet to get all of them. Our diet in general tends to be deficient in protein. We haven’t had good guidelines of how much protein to get. So essential amino acids can be used to increase the amount of essential amino acids that your body needs for the day. But amino acids are really important for skeletal muscle. So as you break down muscle throughout the day, if your calories are not high enough, you’re gonna break down muscle. If you’re working out, you’re gonna break down muscle. The muscle needs the protein or the amino acids to build that back up. So there’s pretty good evidence to support muscle building from essential amino acids as a supplement if your protein is inadequate. There are some more and more data developing that maybe it helps with brain health cognition. It might help support and prevent dementia. So that’s I think where the big growth is coming there. And there are also benefits in certain populations, but it just really does come down to how efficient is your body at using the protein that you’re getting, how balanced is your nutrition as far as protein content, and then whether or not you’re using that amino acid as a supplement to that. So it could be very useful. You could be also going maybe a little bit over and beyond of what you need for the day when taking a supplement.
Alan Helgeson:
So like anything, I mean there’s a lot of good stuff behind it, but people go a little bit farther. And then with that we’re starting to see some things where people are giving the amino acids and electrolytes to their children. What’s the expert advice on that?
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Dr. Jennifer Schriever:
I would really hesitate to give any supplements to children and also just caution in general with supplements. You wanna be sure it’s regulated, it’s third party tested, to be sure it’s safe. In general, we’re gonna do a lot of studies on adults before we ever do any studies on children. So I’d be really cautious about giving a supplement to a child, including amino acids, even though they’re the building blocks to protein, without some direct guidance of a dietician or a doctor who is finding that useful for your child based on your child’s certain situation. And I don’t think that’s gonna be very common that you’re gonna wanna do that to your child.
Alan Helgeson:
Well, let’s talk about some of the differences then, Dr. Schriever. Like the difference between essential amino acids, BCAA’s, EAA’S, who should take what, when and why?
Dr. Jennifer Schriever:
So branch chain amino acids are made up of three of the essential amino acids. If you’re buying a branch chain amino acid, that’s all you’re getting in that supplement. And often those are in flavored powders, so you can use them to flavor your water. Essential amino acids also just for short, are called EAAs. So that’s the same thing. It’s just a matter of what is on the label. In general, EAAs is probably gonna be what’s in big type, but then somewhere else on the label you’re gonna find that it’s an essential amino acid. So branch chain amino acids may have been out first or were really popular for a while, especially around a workout, where they could be found to be pretty beneficial, but so are essential amino acids. So I’m seeing less and less branch chains available just because they’re not providing the complete picture, of those essential amino acids are not found to be as valuable. That’s the main difference there is just the difference branch chains are just three of the essential amino acids.
Alan Helgeson:
As we’re working through all these different trends. And like I said, they keep updating and updating, new ones coming along all the time. Now this next one, we’ve heard about this for a long time. Let’s talk about colostrum. Claims around immune support and gut health. Is there legitimate research around this to back it up? Do you recommend people take this and if so, who should and why? I know I threw a lot of questions at you, so gotta start wherever you want to jump in on that Dr. Schriever.
Dr. Jennifer Schriever:
Colostrum. You know, there isn’t good definitive evidence for benefit in any case for sure. Certainly there are lots of studies showing that it may help like diarrhea in HIV patients or in another specific situation like that. The studied doses of colostrum aren’t even what is available over the counter. So then what is the benefit of taking something less? People are hoping it will help immune support and the only studies that are more convincing are in very high intense athletes because they’re so physically active in their sport or events that they might have less immune system, that it might support and help that sort of person. But in general, most people there is not definitive evidence that it is supportive. So the science is based on the benefit of colostrum for newborns, but obviously we aren’t going to get a lot of colostrum from that source, and these are coming from cows. So anyone who has any sort of allergy to dairy or you can have a specific allergy to cows, really should avoid any of these supplements. Certainly wouldn’t gear them again towards children. I wouldn’t use them for treatment of that. Are they being studied, certain populations? Absolutely. Because it’s interesting to see. But you’d want that in a very controlled, safe environment with people that really understand what they’re doing.
Alan Helgeson:
Well I think you talked about some of the side effects and risks with that. Are there even things beyond what you may have mentioned there, Dr. Schriever?
Dr. Jennifer Schriever:
When producing the colostrum, you know each cow is probably going to produce different amounts of immune support or whatever else we’re going for in their growth hormone, and that sort of thing. So you can’t even count on stability from, probably, dose to dose or supply to supply. You’d also worry about any contaminants. So you’d wanna a reliable source or some third party testing of those supplements. Side effects could probably still be G.I., especially if you have any lactose intolerance or other things that might make you more reactive to something that comes from a dairy product. But in general, there doesn’t appear to be still a lot of evidence supporting benefit.
Alan Helgeson:
Well, we’ve been talking about colostrum. We’ll make the jump now to raw milk, and as somebody that grew up on a dairy farm, it wasn’t uncommon to hear about consuming raw milk, but that is showing up now as a trend, and wanting you to address that. What are the risks of consuming raw milk?
Dr. Jennifer Schriever:
The biggest risk of raw milk is the bacterial contamination and the significant gastrointestinal illnesses that can come from those bacteria. Some of them are just, you know, gonna cause severe G.I. distress, but sometimes that becomes a much more serious condition. Just like with any diarrhea or illness you can have, you know, shut down of your kidneys. And listeria is a particular bacteria that could be present that could be very harmful to a pregnant woman, cause a miscarriage or even death of that baby. So those are various serious conditions, and we certainly don’t want to expose any child under five to something that is not pasteurized, including raw milk. The pasteurization process kills all those bacteria and doesn’t change the nutritional value of the milk.
Alan Helgeson:
Are there any nutritional advantages to raw milk over the pasteurized milk? Because there must be something that somebody grabbed onto something to make this a thing and a trend, right?
Dr. Jennifer Schriever:
I think the thought is that people may have thought that raw milk would cure lactose intolerance. There’s no evidence to support any advantage of that sort of thing. Or might they become less allergic to milk or not have an allergy if it’s not pasteurized? And there’s no evidence to support anything like that.
Alan Helgeson:
Dr. Schriever, let’s talk about what parents might need to know about giving raw milk to their children.
Dr. Jennifer Schriever:
Parents should really know that there’s a high risk of a bacterial infection with raw milk that can make a child very seriously ill. They are at more risk just to their developing body and organs than an adult who’s more developed and maybe more stable. So a child would be at higher risk for very severe illness, end up in an ICU from a diarrhea illness, and even hemolytic uremic syndrome is one thing that’s really specific and related to that, that can cause severe harm to the kidneys. So we want to really avoid anything not pasteurized in young children for sure under age five.
Alan Helgeson:
Alright, that’s raw milk and we’ve talked about that one as a trend. One of those things that’s bubbling up right now on social media. Let’s move on to daily electrolytes. You can’t pick up a bottle of water in the convenience store that doesn’t say something about electrolytes. And people are giving these with aminos and electrolytes to their kids now too. So expert advice on electrolytes and aminos to kids.
Dr. Jennifer Schriever:
Sure. So electrolytes are all those, you know, sports beverages like Gatorade or Powerade. A lot of the powdered little packets of supplements that will talk about how much they hydrate you. In general, most people don’t need those. If you have balanced nutrition from your food and you aren’t out there in really hot weather exercising or sweating a lot, your body is going to manage its electrolytes just fine. Most kids in sports, just typical soccer games and that sort of thing, are gonna do fine with water rehydration. You really want to not necessarily give them these electrolyte products that can be very high in sodium, which can be detrimental to one’s health, and you just don’t need the added sugar or other ingredients that may come in a lot of those electrolytes. So you just really have to watch that. And some of them are gonna be higher in potassium, which you wanna be sure you’re not getting too high on that. Most people with healthy kidneys are gonna do just fine, but why do something you don’t need? So examples of people, or a situation, that really might need those electrolyte drinks: Really heavy duty exercise or physical activity requiring a lot of sweating; it’s really hot out causing a lot of sweating, a marathon runner, that sort of thing. If one had an unrecognized health condition or were on a medication that affected their sodium levels or their potassium levels, and you really escalated your intake, or just had such a consistent intake of an electrolyte beverage, you could cause too high of levels of sodium or potassium. Or maybe the opposite by having so much of one you lower another. Sodium levels being off can cause significant confusion, or a potassium level being way off could cause a heart arrhythmia or, you know, cause some harm to your kidneys if there was something in there, or a medication you were on, that affected how you metabolize those sort of electrolyte things. Also, some of those are gonna have a lot of sugar in them and you really just don’t need all that added sugar most of the time. So that, of course, in someone who is diabetic or pre-diabetic, at least not make them not feel well after a while depending on how it’s affecting their blood sugar level. You know, most people with more significant conditions like that are gonna be aware and recognize those foods, but if you had someone developing diabetes, then you could really put them into a bad situation.
Alan Helgeson:
Well, thank you, I appreciate you sharing more and offering clarification on daily electrolytes. And as we wind down the update on these trends that we’re seeing on TikTok, Dr. Schriever, we can’t wrap things up without getting to GLP-1s. I know something that is part of your daily work and the people that you get to see and work with each day. And there isn’t a daily newscast that doesn’t include a story about GLP-1s. What we’re seeing a lot now is day-in-the-life videos that are focusing on what people eat while on GLP-1s. So let’s talk a little bit about that. What do you recommend for a day of eating if you can? And I know that’s a lot to unpack in a short amount of time. Is there anything that you maybe want to do to address that in just a short amount of time?
Dr. Jennifer Schriever:
It still remains very important when you’re on a medication that’s gonna suppress your appetite like that, to still eat enough. The amount should still be balanced as far as the content. So it’s really important. We give out a handout, but it’s still important to get enough protein. We still need some carbohydrates and fiber on board. It’s best to fuel your body still throughout the day. Your body will recognize if it’s starving. And if we really are trying to create some long-term maintenance of weight, then we don’t want to disrupt our metabolism, cause lower metabolism. It’s very easy to feel comfortable with lack of hunger because then we know historically in our past, that helped us lose weight. But then that’s not sustainable weight loss if we’re losing a lot of muscle. In that process of weight loss, we’ll lose water fat and muscle. So it’s really important to keep it balanced. And so we’ll tell people “always eat your protein first” and give them a goal of how much to eat. And then your vegetable, so you get your fiber on board. Then a healthy fat. Save your starch for last. And then that will also help maintain that fullness that you’re going for with those products. If your appetite is so suppressed and you’re struggling with that, then we’ll work with patients on, you know, maybe some sort of protein shake or supplement, or how do we increase the density of calories in your food with healthy food choices, not processed food choices, so that you can get enough nutrition in smaller amounts, or maybe smaller frequent meals throughout the day.
Alan Helgeson:
Are there things that you would say people should really work towards avoiding, Dr. Schriever?
Dr. Jennifer Schriever:
Yes, good point. So the GLP-1s, or the injectable medications for weight, or even diabetes, are gonna slow your stomach from emptying. So food is gonna sit in there longer. So if you have a food that is gonna cause heartburn or upset your stomach, it’s sitting in there longer. So you really want to avoid something like that. When you’re on these medications too, then you’re more likely to have side effects. If you’re picking some of those extra foods that you really tend to enjoy once in a while. So something that’s more fatty or higher in sugar, then I’m going to warn you that you’re at higher risk for side effects. You might have more nausea, you might have more heartburn. Instead of constipation, maybe you’re gonna get diarrhea, or just feel really bloated or like a big gas bubble, or that sort of thing. So those are the foods to eat less of. Or if you’re at an occasion where there’s just gonna be something that you want to at least have a small amount, then let’s fill your stomach with some protein and vegetables first to create a good base there, that you slow the digestion of those other foods.
Alan Helgeson:
Well Dr. Schriever, thank you for joining us and giving us the updates on what’s going on. And like we talked about at the beginning of the program, they’re gonna change probably nine times before we meet again, right? So we’ll have you back again real soon. Dr. Jennifer Schriever joining us on this episode of the Health and Wellness podcast series. Thanks, Dr. Schriever.
Dr. Jennifer Schriever:
Thank you.
Matt Holsen:
This episode is part of the Health and Wellness series by Sanford Health. For additional podcast series by Sanford Health, listen wherever you hear your favorite podcasts. And on news.sanfordhealth.org.
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Posted In Family Medicine, General, Health Information, Health Plan, Healthy Living, Sioux Falls, Weight Loss, Women's
