You’ve got IBD. Will your kids get it too? We know that there’s a hereditary and a genetic link for IBD. Does that mean that your kids are destined to get the dreaded and often complicated Crohn’s or colitis too?
As moms, we all worry about what our IBD will mean for our kids. And these worries might even cause you to get stressed, anxious, or even have a freak out moment every time your kiddos get a stomach bug. Is that Crohn’s creeping up? Maybe it’s not just a virus… maybe it’s colitis. I’ve definitely had those moments as a mom with IBD.
Scary, consuming stuff!
After experiencing way too much mom guilt about the possibility of putting this “curse” on my kids, and my clients telling me they’ve had similar freak outs, I decided it was time to stop my negative future casting and actually learn the truth.
So, what’s the deal with our kids and IBD? Are they destined to get it? That’s what we’re going to find out together on this week’s podcast.
We’re talking about:
And so much more!
After the episode, I hope you’ll leave behind the stress and anxiety we often feel about our kid’s future and instead feel hope and positivity, when it comes to your kid’s gut health and overall health as well.
Episode at a Glance:
Mentioned in This Episode:
Additional Resources from the Episode:
INTRO: You are listening to The Cheeky Podcast for Moms with IBD, a safe space for moms with Crohn’s and colitis, connect, explore powerful tools for healing and transform our lives to thrive in motherhood and in life. I’m your host, Karyn Haley, IBD health coach, integrative wellness enthusiast, and mom to three outstanding kids. After having Crohn’s disease for 30 years and working as a health advocate exclusively with IBD clients for the last 10 years, I know it’s time to bring the types of candid conversations I have with my clients out into the open. It’s our time to go on an IBD healing journey and do it like only a mom can. Let’s do this.[music]
[00:51] Hey dear listener, how are doing you today? We’ve got so much to get to on the podcast. So many juicy nuggets I know you’re going to love, so let’s dive in.
First off, I have to say that the thing that I love most about my health and nutrition consulting practice is that about 95% of my clients are moms. I set up my practice that way on purpose. I’m a mom of three and everything I do in my life is from the lens of a mom. My family life, my friendships, my work, how I handle my disease … No matter what I do, where I go, all of my thoughts, they come from the bent of being a mom, first and foremost. Can you relate to that?
So, when I set up my practice, I knew I wanted to help moms. And since mostly I work with moms who have IBD, one of the biggest questions I get asked from those moms is will my child get Crohn’s or colitis?
GIVE IT TO ME STRAIGHT. WHAT ARE THE NUMBERS?
Of course, we know I don’t have a crystal ball and I can’t see into the future, so I don’t have the definitive answer to that question. But what I do know about Crohn’s and colitis is that they both have a hereditary and genetic link. About 15% of people who have Crohn’s also have a family member who also has Crohn’s. And when scientists look at twin studies, they see that when one twin has Crohn’s, 50% of identical twins will also have Crohn’s. Interestingly, with fraternal (non-identical) twins that number goes down to less than 10%. With ulcerative colitis, somewhere between 10 to 25% of people with UC have a relative who also has colitis. Twin studies for colitis show that 16% of identical twins also have a twin with colitis. With fraternal twins that number goes down to 4%.
So, when it comes to inheritability, the research is clear. There is a familial link. There is a possibility that our children will develop Crohn’s or colitis. But what my clients are really asking when they ask this question is, does this have to happen? Is it inevitable? Does everything I go through, the abdominal pain, the multiple trips the bathroom, the embarrassment, the challenges of everyday life with a chronic illness, everything we go through on a daily basis, does that have to be my child’s reality?
I know when I was thinking about having children, and in fact I gave it a ton of thought, because I even resorted to fertility treatments to conceive my first child. I know that my doctor said that the risk of my children getting Crohn’s or colitis wasn’t worth me not having children. Your doctor probably told you something similar. Yes, there is a hereditary link, but it’s not strong enough to not have children. But we can’t ignore that there is a risk factor here. The research is clear on that. There is a possibility of you passing Crohn’s or colitis to your child. So, the question that I keep getting over an over from mom clients, will my child end up getting diagnosed with Crohn’s or colitis is very understandable and very valid.
I DON’T KNOW, ISN’T A GOOD RESPONSE.
Beyond the statistics I just shared with you, I didn’t really know the answer to this question, but I really wanted to figure it out. I was getting it so often that I felt like I don’t know wasn’t an OK response. And if you listen to this podcast regularly, you know I’m a research gal, and I knew there had to be research and enlightened wisdom out there tackling this very topic. I knew that I could at least I could do some digging and have more information to give you.
So that’s what I set out to do. And this episode of The Cheeky Podcast is the culmination of all of my research pertaining to your kids and IBD. Are they destined to get it, or are there things we can do to lower our kids’ risk?
[05:26] The first thing I found out about IBD that I thought was really interesting is that the prevalence of IBD is growing throughout the world. According to the CDC, in 1999 .09% of Americans and that’s about 2 million, were diagnosed with IBD. By 2015, the percentage of adults with IBD was 1.3%, that’s about 3 million Americans. In Europe, the prevalence of IBD is anywhere from .5 to 1% of its population, a number that’s gone up in recent years as well. It used to be that cases of Crohn’s and colitis were found mostly in the developed world—countries who were highly industrial, with modern agriculture. Now, IBD is growing in the developing world as well. It doesn’t matter where you live, the prevalence of IBD is not declining, it is increasing.
And it seems that many people who I meet with Crohn’s and colitis also know a relative who has IBD too. Personally, I have a third and fourth cousin with Crohn’s. Although my kids, and two of my brothers and my dad have never been diagnosed with IBD, they all have some sort of G.I. issue, whether it’s gluten sensitivity or dairy intolerance, or some form of IBS.
20TH CENTURY MEDICAL WISDOM PAVES A CHALLENGING PATH FORWARD.
Now, the really cool thing in my opinion about the 20th century is that it meant an explosion of medical and scientific exploration. The 20th century found genetics and DNA research at the forefront of discovering the causes of many diseases. Scientists discovered the helix structure of DNA and the complete sequence of the human genome. While this research and these findings were extraordinary, they also left medical practitioners and scientists with the belief in biological determination—the thought that we are controlled by our genes, period.
BUT THAT WAS ONLY ONE PIECE OF THE PUZZLE.
What scientist didn’t realize at the time, is that genetic factors are only one piece of the puzzle. I want to say that one more time for you mama, if you are out there worried and stressed every day that your child is going to develop inflammatory bowel disease. Genetic factors are only one piece of the puzzle. We know this now. And this is the information that can help us sleep better at night. Help us stress less about our children developing Crohn’s or colitis.
Today, we look at other factors besides genes to determine our risk for disease. We look at the microbes or the bacteria throughout our body, and we look how genes and the microbiome interact with our environment around us. We know that it isn’t just genes that control whether we get Crohn’s or colitis. There’s many other factors that come into play as well and some of these factors we have control over.
SO, WHAT ARE THOSE NON-GENETIC FACTORS?
Scientist have discovered several non-genetic risk factors for developing IBD. Factors that include environmental and lifestyle choices. Factors like smoking and the use of oral contraceptives, factors like the health of your diet and the overuse of nonsteroidal anti-inflammatory drugs or NSAIDS.
When it comes to diet, and you know I’m super passionate about the power of a healthy diet, a Japanese study found an increase in ulcerative colitis in people who consumed a Western diet. And we all know what that term western diet means. We’re talking about a diet high in processed food, chemicals, lots of canned, packaged, and processed foods, fast food, etc.… another study found an increased risk in developing IBD with the consumption of sucrose, animal fat, high cholesterol, and soft drinks. Sounds like a Western diet to me!
So, genes are not the only factor at play. There is more going on and that more going on, we have some control over. As a mom who has IBD, we have some control over these additional factors and that helps me breathe a sigh of relief.
THE SURPRISING FACT ABOUT HOW MUCH OUR GENES ACTUALLY CONTROL OUR RISK OF DISEASE.
More modern, 21st-century research shows that our genes account for only about 10% of human disease. And those extra factors that I just mentioned, factors like lifestyle and environment have led scientists to begin new research in fascinating fields of medicine. This is where, in my IBD and kids research, I really began to geek out and I hope this fascinates you as much as it does me.
2 SCIENTIFIC THEORIES THAT MIGHT JUST CHANGE YOUR KID’S LIFE.
[11:10] Have you heard about the study of Epigenetic’s? How about the concept of the Exposome? This is where our thoughts about our children’s determined disease truly goes out the window. In 2005, a doctor named Dr. Christopher Wilde coined the concept of the Exposome as the primary reason for health as well as the primary reason for disease. The Exposome is the total of all non-genetic exposures that impact health, and this exposure starts at conception. Cool, right? It includes everything we eat, drink, our air, or social interactions, our lifestyle, even the health of our parents at conception. If genetics play only 10% of the role in human disease, this is the other 90%. And this is the part that we have control over when it comes to raising healthy kids.
Besides the Exposome, I also mentioned the concept of Epigenetics. According to the CDC, Epigenetics is the study of how our behaviors and environment can cause changes that affect the way genes work. These changes don’t affect our DNA sequencing, but it’s more like the changes in how your body reads that information. I just have to say wow, mind blown. Our behaviors and the environment around us can actually change how our body reads our DNA. And when it comes to IBD, the thought here when we take this idea of Epigenetics a step further because it appears that it can mediate factors between our environment and our genome particularly what our IBD genes are saying. Epigenetics says we can affect the development and the progression of IBD.
Can our kids benefit from these new ideas about the Exosome and Epigenetics? You bet they can.
HOW YOU CAN RAISE A HEALTHY KID, NO MATTER WHAT LIFE THROWS AT THEM.
[14:01] Even though your child, because they are your child, has a hereditary linked to inflammatory bowel disease, how can we help to positively impact their health? And that’s the way that I think of it. I don’t think about it in terms of how can I prevent my child from having Crohn’s or colitis? I think of it more in terms of how can I help my child be as healthy as humanly possible? Because it isn’t just about protecting them from Crohn’s or colitis. It’s about raising a healthy child. The healthiest child that they can be. How can we as parents do that knowing that their genes are actually only 10% of the picture?
Environmental factors in that 90% include things like a healthy diet, physical activity, the products you bring into your home, the lifestyle choices that you and your child child make regarding not smoking, the chemicals in your food, getting as healthy as you possibly can before you even have children—and dad too because his health matters as well. Children born vaginally get a built-in dose of bacterial benefit by passing through the birth canal, children who bond with their parents and their siblings are healthier, children with healthy social interactions, children who are psychologically well-adjusted, children who have lower stress levels, higher levels of education, and children who get quality sleep are all healthier for it.
We know that breast-feeding also matters. We know that human breast milk contains substances that may influence the growth and development as well as the function of the gastrointestinal tract. There is a difference in colonic flora (those healthy gut bugs) between breast-fed and bottle-fed babies. Several studies also show breast-feeding to be a protective factor in developing inflammatory bowel disease.
I absolutely love how Dr. Chris Kresser, if you’re familiar with him, he is a functional medicine expert, talks about this topic of genetics, Epigenetics, and the Exposome and how they come together. He has a great analogy to help us understand this. He says that genes are like a script, a script for a film or a theater performance. Your genes are the words and what’s on the page. The Exposome and the epigenome are the performance which changes depending on who’s in the cast, who is directing, who is producing… So good, right? It just helps the complicated concept make more sense.
Or more simply put, as Dr. Francis Collins, the Director of the National Institutes of Health says, “genes load the gun, but environment pulls the trigger.”
And that’s what these positivity factors I mentioned are about. They are the environmental mitigating factors that can jump in and change the genes at any given moment.
WHAT IF I CAN’T BREASTFEED OR BREASTFEEDING IS CUT SHORT?
And what I really love about this list of factors that I just dished out is that there’s so many of them. You may not be able to do all of these. They may not fit for your health or your lifestyle, but there are so many that we can choose from. It’s not about perfection here, it’s about doing the best we can as moms.
Let’s take breast-feeding for example. Already having IBD, breast-feeding may be challenging for you. Breast-feeding was definitely a challenge for me. With my first two children I was not in a good place with my Crohn’s disease. I was able to nurse both of them, but not nearly as long as I wanted to. With my first child, I had to have bowel surgery four months after he was born and had to stop breast-feeding. With my second child, I wasn’t able to produce enough milk to sustain breast-feeding while I was going through a flare after giving birth to him.
So, for me, breast-feeding didn’t go as I would have liked it too, but that doesn’t mean I wasn’t able to do other things for my kids. This is a list of positive things you can do for your kids to improve their overall health, it isn’t about shaming you or making you feel guilty for the things you didn’t do. It’s about giving you tools so that you can complete as many as possible. As many as work for you without feeling guilty because there’s something you didn’t do.
THROW AWAY YOUR MOM GUILT!
So, throw away that mom guilt my friend. We are focusing on what we can do today, not what we can’t or what we didn’t already do.
I know, I just basically threw up a ton of information on you today. It’s a lot, and it can be overwhelming. What do you do with all of this? How can you actually put this information into practice in your own life? What can you specifically do today mama?
I’m so glad you asked because I have you specifically covered. I’m going to tell you right now where to start with your kids. If you want to, not only try to help with their best chance at not getting Crohn’s and colitis, but if you’re like me and you just want to help them to be overall healthy, as healthy as they can possibly be whether they develop IBD or not, what do you do? Where is your starting place?
LET’S BRING IT HOME, MAMA. WHAT CAN YOU DO?
I’m going to propose 4 areas, 4 areas that are most important, not just to decrease your kid’s risk of getting IBD, but to also increase their overall health. And that’s how I’d love for you to look at this opportunity too.
Sure, you might end up being the reason that your child is gluten sensitive or dairy sensitive, but that doesn’t mean they have to get IBD. And whether they do or not, your goal can still be to raise them as healthy as they possibly can be, in all areas of their life. Like I always say when my kids complain about a consequence or doing a chore they deem unfair: I don’t care about fair, my job is to raise you as a fully functioning, independent, productive member of society. And to me, that fully functioning part doesn’t just include academics. It includes health– healthy mind, healthy body, healthy soul.
[21:45] Using these 4 factors that stem from the Exosome and Epigenetic ideas we talked about today, these 90% non-genetic factors that influence our well-being, can ensure that you raise healthy kids, no matter what life throws at them.
THE ROLE OF DIET IN CREATING A WHOLE, HEALTHY CHILD.
Factor #1- Diet
Always first in for most, and especially for moms with IBD. We must teach our kids the importance of finding the best diet for their body type. And that diet may be different for all your kids, but at the heart of it, it should include whole foods in their natural state. Whole fruits, whole vegetables, unprocessed food that doesn’t come in a can, a box, or a package.
Strive for 80% of your kid’s diet that comes from a healthy food, a healthy microbiome, healthy immune system, and low inflammation in the body approach. When it comes to diet, the biggest disruptors to our gut and overall health are sugar and high levels of carbohydrates. Limit the starches and the processed sugar and you will ensure a healthy child.
DOES IT HAVE TO BE EXERCISE, OR IS ANY MOVEMENT OK?
Factor #2- Movement
And just like diet, this works best if it’s tailored to the child’s best interests. Notice I didn’t say exercise and that is purposeful. Some kids are born athletes and they love organized sports, teams, clubs, competitions. Other kids prefer less organized movement, running outside, playing with friends, biking, hiking, or walking. Some kids like weightlifting or yoga. There is no one movement that’s better in my opinion. Just get them off their devices and moving.
And remember their interests might change over time. Be as supportive as you can of that change. I remember my middle son loving soccer from the time he was three years old. He grew into an incredible soccer player and flourished there. By high school, he was the captain of his soccer team. But in his senior year, without much warning, he gave it up. He had gotten burnt out. Soccer had been his life for so long and that Division I college soccer dream that had been his life, disappeared. I admit, it still makes me a little sad because I had this trajectory in my mind for him, but that wasn’t his dream anymore and so I supported him as he moved into other movement passions that fed his soul.
[25:01] No matter what they do, and especially when your kids are young, there’s nothing better than getting them outside in nature, with fresh air. It nourishes a child’s spirit. I always encourage my kids to practice something called earthing. It’s where you take off your shoes and socks and walk around outside connecting with the natural ground and the Earth’s energy. It’s very powerful energetically, but it’s also a great way to get organisms that are in the soil of the grass into your body. Dirt has wonderful bacterial properties that diversify the microbiome, it’s so, so, so important for those of us with IBD to help our kids diversify their microbiome. Mud pies, encouraging them to grow a garden and get their hands dirty in the soil, and earthing. Great for overall health.
THE SLEEP FACTOR: THERE’S ACTUALLY LOTS GOING ON WHILE WE SHUT DOWN FOR THE NIGHT.
Factor #3- Sleep
Adequate sleep is a huge factor for overall health. There’s so much going on when we sleep. It’s not a shut down for our body and our organs. It’s a necessary time for a body to repair and reset. If kids don’t have enough sleep, they can’t repair and reset.
We know that kids who get enough sleep have improved attention, behavior, learning, memory, increased mental and physical health, decreased blood pressure, less obesity, anxiety and depression. We also know that sleep deprivation leads to an increase in microscopic inflammation of the bowel and overtime this can lead to more serious gastrointestinal challenges.
According to Johns Hopkins sleep specialists, infants less than one year need 12 to 16 hours of sleep a night, 1 to 2-year-olds need 11 to 14 hours, 3 to 5-year-olds need 10 to 13 hours, 6 to 12-year-olds need 9 to 12 hours, and 13 to 18-year-old need 8 to 10 hours of sleep at night.
How are your kids doing with their sleep? Are they getting enough?
Back in episode 8 of the podcast, we talked all about sleep hygiene. If getting enough sleep is an issue for you or for your kids, you might find it helpful to go back and listen to that episode. I’ll leave a link for it in the show notes. I‘ll also link to a great article in the show notes from the Stanford Children’s Health Center where they recommend eight ways to help your child sleep better. This is a really great article if you’re finding it challenging to stick to a bedtime routine or your child or if they are having any sleep difficulties. I found this article helpful and I hope you will too.
IT’S NOT ABOUT STRESS BUSTING, IT’S ABOUT STRESS RESILIENCY.
Factor #4- Stress Management
Of course, we all want our kids to have less stress, from the emotional to the physical effects of stress. But stress, as it turns out, actually has a specific impact on the digestive system.
When we are stressed, our body prioritizes getting rid of the stress over proper digestion. Stomach and intestinal activity is reduced and the body decreases blood flow to our gut to give more blood flow to our stress hormones. Peristalsis, the moving of food along the G.I. tract, is stalled. That’s why when a child is stressed, it’s not uncommon for them to have digestive troubles. It creates the perfect storm for G.I. challenges. Stomach aches, constipation, even diarrhea is common. Chronic stress creates a chronic strain on the G.I. tract and the chronic strain on the G.I. tract causes dysbiosis and inflammation in the gut—the perfect breeding ground for a G.I. disorder.
[31:22] So, what can we do? What can we do to help not reduce stress because sometimes that’s an impossibility, but we want to do is help our kids learn how to manage the stress in their life? The #1 thing we can do goes back to diet. Eating food that’s fresh and whole gives our body the right nutrients to keep our digestive tract strong and healthy. Another thing we can do as parents to help our kids manage stress at the emotional level is to help them build emotional resilience. This is a huge health factor for our kids. Helping them to combat stress with resilience as a child helps them be set up for lifelong success when stress hits in adulthood.
Children who have an opportunity to vent frustration in a healthy way, end up dealing with life stressors better. Children who exercise or move on a regular basis release more endorphins in the brain. Endorphins have a tranquilizing effect and increased feelings of pleasure. This equals less stressful feelings for our kiddos. See how all of these factors are inter-related. The diet we talked about and the movement or exercise we talked about as being factors come back into play when we talk about helping our children manage stress. It’s all a part of the circle of health.
When talking about helping our children to manage the stress in their lives, there’s three tools that I love using with kids the most. The first tool is a book called The Big Life Journal. I’ve mentioned this before in the Gut Love Community so it might sound familiar to you. The Big Life Journal is a fabulous addition to your kid’s book collection. It takes them through imaginary exercises to help build their strength and character.
Another stress tool I love for kids is Insight Timer. Insight Timer is an app with the most wonderful visualizations and meditations for kids. These fun and engaging story sessions are wonderful at calming for kids when they are anxious. They also help kids with sleep troubles to sleep at night. Lastly, and probably my most favorite stress buster tool for kids is the 4-7-8 breath. You’ve probably heard me talk about this technique before because it’s great for IBDer’s too. Ask your child to breathing through the nose for 4 seconds, hold their breath for 7 seconds, and then breathe out through their mouth for 8 seconds. They can repeat this as many times as they need to help them feel centered, grounded, and help them calm down in difficult situations.
These three tools are all about teaching your child to be mindful and about the mind body connection. They are some of the best tools around to raise resilient, strong, and thoughtful kids. I’ll provide links for all of these resources in the show notes.
So, there you have the 4 factors that can help you create healthy kids: mind, body, and spirit.
THE MOM-SIZED RECAP IF YOU ONLY HAVE 5 MINUTES.
We started out this episode talking about the genetic and hereditary link between you, your IBD and your child. And yes, the hereditary link is real. When you have IBD, there is a risk that your child may develop Crohn’s or colitis too. But it isn’t a foregone conclusion. There’s so much that we can do as parents to raise healthy children. Remember genetics only plays a 10% role. To look at the complete picture, we must look at environmental and lifestyle factors as well.
As moms, there’s so much we can do to raise kids who put their health first, so that no matter what life throws at them, IBD or any other challenge (physical or emotional), they have the skills and the tools they need to overcome. In my mind, that’s the best thing we can do for our kids.
From teaching our kids to eat healthy, to showing them the power of movement, exercise and being outside in nature, to encouraging them to have healthy sleep habits and finding ways to manage challenges with stress, there’s a lot we can do to raise kids who are not only healthy in childhood, but healthy throughout life. Even if they do step away from it a bit in the teen years, take it from me, it’s in there.
Thanks so much for sharing this time with me today. I hope this topic was helpful for you to hear about today. If it’s something that you’ve been wondering about like I know so many of my clients have, I hope it answered at least some questions you have about how to raise healthy kids when you’re a mom with IBD.
If this information fascinates you like it does me and you want to know more, you’ll definitely want to check out the show notes for this episode. There are several links to scholarly articles and research studies so you can learn more. And if your IBD has really become a challenge in your life, if you’re finding it difficult to be the mom you know that you deserve to be, I want you to get in touch. There’s so much we can do when we work together to help you find IBD remission. Email me at firstname.lastname@example.org Let’s get you started on a path to recovery. I can’t wait to hear from you.
Until we meet again and wishing you a cheeky and healthy IBD healing journey.
[38:46] Thank you so much for joining me today and for listening to today’s episode. When it comes to IBD, I know there’s a lot of resources out there, and I’m truly honored that you chose the Cheeky Podcast to get your IBD information today. If you found this information helpful, please give us a rating and review. It helps other moms find the podcast and see what we’re doing over here to help IBD moms everywhere. And if you feel called feel a call to do it, share this podcast with an IBD mom who you know could really use an uplifting message today, ’cause that’s what we’re all about over here at the Cheeky Podcast.
One last thing, if you’re still with me, and if you are, you’re definitely my kind of gal. We have to get to know each other better. If you’re tired of living on the hamster wheel of IBD with all the ups and downs between flares and remission, if you’re struggling to get control of your abdominal pain, gas, bloating, diarrhea and other troubling IBD symptoms, go to my website. It’s karynhaley.com, and my mom had to be just a little bit different, she spelled my name with the Y. So it’s K-A-R-Y-N H-A-L-E-Y.com and schedule your very own free 30-minute IBD root cause trouble-shooting session with me where we discuss the challenges you’ve been having, we set goals to help you move forward, and we talk about how we can work together to help you get your life back. It’s a power packed 30 minutes. You don’t have to live in IBD status quo. There’s so much that can be done to transform your life so you can thrive in motherhood and thrive with IBD. I’ve seen my clients walk this path and it gives me so much joy to take that journey with them.
My entire coaching practice is run online, so you never have to leave your house and you never have to get out of your jammy or yoga pants for us to work together. You know I’m wearing them to. If you’re ready to take your first amazing step towards healing, I’m ready to chat with you. Schedule your free 30-minute IBD root cause trouble shooting sesh today at karynhaley.com. Click on the work with me tab and I’ll see you soon. It’s important to note that the information in this podcast and in this episode is for general information purposes only and not intended to be a substitute for professional medical advice. The statements made in the Cheeky Podcast for moms with IBD, either by me or my guests, is not intended to diagnose, treat, to cure, or prevent any disease. Before implementing any new treatment protocols, do yourself a favor and consult your physician first.
Thank you so much for listening, for being here, for saving this space for us to spend some time together. Until we chat again, I’m wishing you a cheeky and healthy IBD journey.
These statements have not been evaluated by the Food and Drug Administration.
This podcast, video, and blog post is not intended to diagnose, treat, cure, or prevent any disease.