In this episode of Steeped In Wellness, we sit down with Dr. Aly Cohen, a triple board-certified physician in rheumatology, internal medicine, and integrative medicine, and one of the nation’s leading voices on environmental health. We explore how toxic chemical exposures in our daily lives affect our immune systems, hormones, and long-term health — and what we can actually do about it without panicking.
Dr. Cohen shares her origin story, which began not with a patient, but with her own dog’s mysterious illness. That incident sparked a deep dive into chemical exposures in water, food, and household products. She quickly discovered the shocking lack of regulation over the 350,000+ synthetic chemicals in our environment, many of which have never been tested for safety. From there, her mission evolved: educating both physicians and everyday people about how these exposures can disrupt hormones, immune systems, and contribute to chronic diseases, including autoimmune conditions and even breast cancer.
We talk about the word “toxins” and how the more accurate term is “toxic chemicals” — synthetic compounds not naturally found in the body. Dr. Cohen explains how these compounds, introduced post-WWII to improve convenience, were never required to undergo rigorous testing before ending up in our cosmetics, food packaging, cleaning supplies, and water. She breaks down how endocrine disruptors like BPA mimic hormones even at extremely low doses, and why that’s a problem for both kids and adults.
The conversation then shifts to empowerment through action. Dr. Cohen walks us through her “Four A’s of Environmental Health”: Assess, Avoid or Swap, Add, and Allow. She emphasizes the need to assess exposure without guilt, swap out harmful products with vetted alternatives, add in healthy habits like hydration, sleep, and nutrient-rich food, and allow some flexibility to avoid overwhelm.
From deodorant dilemmas to plastic bath toys, we reflect on the practical side of reducing exposure while balancing the realities of daily life and parenting. Dr. Cohen encourages us to focus on the controllable: reduce plastic, avoid synthetic fragrances, choose safer personal care products, and invest in a home water filtration system — preferably reverse osmosis. She recommends using apps like EWG’s Healthy Living, Yuka, and Clearya to make better product choices easily and quickly.
Despite the seriousness of the topic, Dr. Cohen remains optimistic. She believes in the power of education, especially among younger generations, and shares how kids — when empowered with knowledge — often outpace adults in making better health decisions. As we wrap up, we talk about perspective, self-compassion, and using our energy wisely — taking inspiration from the Serenity Prayer and the classic poem Desiderata.
More:
The Smart Human – https://thesmarthuman.com
EWG (Environmental Working Group) – https://www.ewg.org
EWG’s Healthy Living App – https://www.ewg.org/apps/
Yuka App – https://yuka.io
Clearya App – https://www.clearya.com
Dr. Aly Cohen’s Practice – https://alycohenmd.com
00:00 – Intro & Guest Welcome
01:17 – Why Toxins Matter as a Health Concern
02:15 – Dr. Cohen’s Personal Journey into Environmental Health
06:52 – What “Toxins” Really Means
09:32 – How Chemical Exposure Impacts the Body
12:26 – Hormone Disruption Explained
15:07 – It’s Not About Perfection
17:08 – The Four A’s of Environmental Health
21:30 – Top Toxins to Avoid at Home
27:16 – Using Apps to Vet Your Products
40:43 – The Drinking Water Deep Dive
46:19 – Medical System Gaps & the Rise of Misinformation
49:53 – What Gives Dr. Cohen Hope
51:17 – Life Lessons & Final Thoughts
Speakers: Jon Gay, Diana Weil, Elara Hadjipateras, & Aly Cohen
[Music Playing]
Voiceover (00:01):
Welcome to Steeped In Wellness, brought to you by matcha.com. Here, we spill the tea on wellness trends, personal growth, and the latest health news. Now, here are your hosts, licensed dietician, Diana Weil and medical journalist, Elara Hadjipateras.
Diana Weil (00:18):
Hello everyone, welcome to this week's episode.
Elara Hadjipateras (00:22):
We are super excited to have Dr. Aly Cohen as our guest. Aly Cohen is a triple board-certified physician in rheumatology, internal medicine, and integrative medicine, and to top it off, a leading expert in environmental health.
She is the founder of Integrative Rheumatology Associates in Princeton, New Jersey, where she combines conventional medicine with holistic approaches like nutrition, acupuncture, and toxin awareness counseling.
Dr. Cohen teaches communities how to reduce everyday chemical exposures and live healthier, more sustainable lives. She's also the co-author of the books, Non-Toxic: A Guide to Living Healthy in a Chemical World, and Detoxify: Your Guide to Reducing Chemical Exposure and Optimizing Health.
Dr. Cohen frequently lectures at medical schools and conferences on endocrine disruption, immune health and environmental wellness, and she lives in New Jersey with her husband and two sons.
Welcome, Dr. Cohen.
Aly Cohen (01:17):
Thank you, ladies, glad to be here.
Diana Weil (01:19):
We need you. Environmental toxins (were) always something that I thought about, and then I had a kid, and I was like, “This is terrifying (laughs).”
Aly Cohen (01:30):
It's terrifying enough that you can't have your favorite sushi. And I had to get that all cooked up every time I went to get sushi, or I couldn't have deli meat or … there's a whole list. And then to throw this into the mix is really great for your stress level as you're stepping into this new arena.
So, yeah, I mean, it's a big topic but it's actually very manageable. And that's my whole work, is to really teach people that yes, it's a big topic, but guess what, here's some very reasonable ways to work on this and how you can reduce risk for a whole bunch of issues.
Elara Hadjipateras (02:05):
Aly, before we kind of get into: what are these everyday toxins that we're exposed to and how do we reduce them, how did you first kind of get interested in toxic exposure?
Aly Cohen (02:15):
Well, similar to Diana's concern in the very beginning, I have an 18-year-old who just went off to college right now. So, 18 years ago, more or less, I actually was very concerned about the world that I was living in and having young kids. But what really started this whole ball in motion actually was that my dog got sick and he was a four-and-a-half-year-old Golden Retriever.
And he got really sick, young dog, and he developed something called autoimmune hepatitis, which is just so unusual for dogs, but particularly Golden Retrievers. And believe it or not, because I was already practicing out of training immunology and rheumatology as my field, this was so shocking that I had to sort of do a deep dive into what might have triggered his immune system against him and create this sort of sickness that shouldn't have happened.
So, my heartbreak over my dog getting sick really launched me into looking at his water, his water quality, his food quality, his flea and tick, stuff I would put on between his scapula, his back and I would just never even wash it off. I mean there was just so much I didn't know, and the more I learned about his exposures, believe it or not, the more I was learning about human exposures, and then that took off.
Diana Weil (03:29):
That is so interesting. I never even thought — I mean, I have two Golden Retrievers, and they are so deeply ingrained, I love them and they're my family members, and I didn't actually think about the ways our environmental exposures impact them.
Aly Cohen (03:46):
You have to remember, this is so long ago, and I assumed like everyone else, even now that everything's been regulated. We are protected. There's something out there that's checking ingredients of our cosmetics and lotions and creams and our baby products and even our cleaning products that end up on surfaces and on kids with their dust and on paws.
I assumed very naively that there was this whole rigorous, robust testing process- because why would it be on a shelf in the store and available to humans if it hadn't gone through all those processes? But it turns out that pretty much nothing in the products that we use are tested for safety in terms of ingredients, which is such an unbelievable shocker that it took me years of looking at all these papers and all the authors and contacting them, and being like, “Are you serious? Is this real?”
And it really took me down the path because once I started learning a lot, locally, I was giving local lectures because I just could not believe it. And then I started connecting with people like Environmental Working Group and I reached out to them, I said, “Listen, I have slides and I'm educating people, but I don't know if I'm right.”
I don't even know if this is how these chemicals work in terms of being hormone disrupting, even immune disrupting back then, but more so now, we have so much more data and that's what I write about my new book.
But they were so surprised that a physician was interested in this topic, that we started working together and creating CME programs for grand rounds. So, I lectured at 23 hospital systems after a year of learning from them, they were basically teaching me and sending me papers. The Chief Science Officer was just amazing, Johanna Congleton.
So, the idea was that I had to learn what I should have learned in med school, I had to learn what every consumer should be aware of that no one does, and then I had to apply it to the medical community because there was no way I was going to get it to consumers at that point because they didn't know enough.
So, it was really this 16-year journey of figuring out how to understand it, be sure about the science that I was aware of, and then how to communicate it to people that I wanted to learn about it, and that was such a journey.
Jon Gay (06:05):
And just to clarify, CME, that's continuing education for medical professionals, right, Aly?
Aly Cohen (06:09):
Yes. And CME is continuing medical education, CME for physicians. And so, that was my goal was to really get into the minds of people that had a lot of reach. But then I decided since none of these CME programs and grand rounds were really overwhelmed by what I was sharing, that I would go directly to consumers.
And that was because my babysitter wanted to know more about my work and I thought, this is it. This is the group. And so, yeah, I started doing high school teaching and pilot projects and got data for a TED talk from Princeton High School that opened their doors to me, and so it all just kind of came together.
Elara Hadjipateras (06:52):
So, when we hear this word “toxins,” what are we really talking about? What does that mean?
Aly Cohen (06:56):
Toxins, actually, believe it or not, is not the real word for … toxic chemicals is a better way to describe chemicals that are synthetic, human made. Toxins by actual formal definition is something that would come from a living creature such as a plant or a snake or think snake venom, that kind of thing.
But it's become sort of the mainstream way of discussing this topic, which is things that are not natural to the human body. So, toxins is just a term we always use because people are familiar with it, but real scientists use toxic chemicals or toxics just to give you the semantics.
But basically, it's things that really in terms of my work is really how did we get to this place where we have over 300,000 industrial or human-made compounds, and how do they go into all the products that we use every day, and who's vetting those chemicals, and how did it happen? So, really that came out of World War II, after around World War II.
So, only about 75 years by the way, in all of human existence, which is a whole anthropologic thought in my mind is how did we get here and why are we doing this to our bodies in a short period of time. But it's really that we had this explosion of compounds for a lot of very altruistic reasons.
We wanted to save on materials like wood and stainless steel and we wanted to protect soldiers after World War II from pesticides, from malaria, we wanted to make aircraft lighter with plexiglass, we wanted plastics, to not break dishes in the 1950s, God forbid.
But we wanted to make life easier and convenient, but that was a problem because there was no regulations that really stuck in our history that required testing for safety or toxicity for these compounds that would go into these products that we use for everyday use.
So, that's how we got into this pickle, is just we never set up the laws properly, and now, we're sort of putting the genie back in the bottle years later, trying to get these chemicals to be mandated for safety testing before they go into the products.
In Europe, they do a much better job of this, they've also removed lots of compounds that were found to be questionable or had the research to show that. So, it's just one of those things that we're sort of behind the eight ball, which is why we have to do it ourselves, and that's where my work comes from. I'm not waiting for regulation from anybody, I think we need to think about it for ourselves, and we can really do this.
Diana Weil (09:32):
Can you walk us through some of the issues that you see in your practice or are just aware of from these chemicals that we're exposed to?
Aly Cohen (09:40):
So, it turns out that many of these chemicals -and they're classified — remember 350,000 more or less is sort of a running number. But they're classified in different ways, either by what they're designed to do such as pesticides or solvents for paints and building material, those kinds of things, fragrance this way of classifying, and they're also classified by how they hurt the human body. So, there's neurotoxins and there's liver toxins, there's lots of different ways to parse out those chemicals.
But what was discovered about 25 years ago and really not even earlier than that, but around that time was how many of the compounds that were being tested, and the first one was Bisphenol A or BPA, which was actually removed from plastic baby bottles around 2012 from my co-author actually for two books.
He was really largely responsible for gathering the data and working with colleagues on that. But BPA was the first compound that was really found to disrupt hormones and act as sort of a low-level estrogen mimicker. In fact, it was found to do that, and it was utilized to actually fatten chickens.
So, BPA was actually added to chicken feed to make their meat bigger, to make them stronger — whatever you want to call it, they were messing with their hormones to make them have more meat per chicken back in the day.
Diana Weil (11:03):
Wow, I had no idea about that.
Aly Cohen (11:05):
There was lots of things that they used BPA knowing what it could do. And there were even medications that were used instead of BPA that were similar, like DES, Diethylstilbestrol that was actually given to women to prevent miscarriage in the 1970s that was also found to be very much an endocrine disrupting chemical.
So, there's a lot of similarities in where these chemicals come from and what they're used for back in the day. But the fact of the matter is that was sort of the first one to come out and then there were like, “Well, how could this work?” Because hormones actually work at teeny tiny levels, like parts per trillion, parts per billion, and they could have exponential effects, even very small doses.
So, that was a really big finding and it went against the classic toxicology premise that the dose makes the poison, meaning the more you're exposed, the more likely you're going to see a problem. Turns out that many of these hormone disrupting chemicals can work at very tiny doses and cause some of the same things that very high doses do.
It was such an uphill climb for these researchers because they were really trying to show how compounds really can be problematic, way below any testing that could be done on toxicity.
Elara Hadjipateras (12:26):
I know. When you mention the BPA, the thing that comes to mind Aly, something I've heard, and you can tell me if this is accurate or not, is that in Puerto Rico, back in the 1980s, there was this huge link to BPA being used to feed chickens, to fatten them up along with phthalates, which then led to an increased birth weight to females because it was affecting their hormones.
In the countries, now there's this ratio of there's a lot more women compared to men in Puerto Rico. Is there any truth to that?
Aly Cohen (12:54):
Yeah, I mean it could vary. I haven't seen any of that work specifically. There's so much work now on this, which is so great because it's so much more empowering to know there's science behind the recommendations I make and others make.
But here's the thing, hormone disruption, if you just go back to the title of that class of endocrine disrupting chemicals and immune disrupting chemicals because they can do both. It depends on the class and which chemical. But the idea is that you can upregulate receptors, you can downregulate receptors, you can disrupt signaling between say one organ to another or one gland to another, you can do a lot of disruption.
And when I had some of the researchers on my podcast that were sort of the forefathers and mothers of this whole area of science, I was saying how amazing it was they called it endocrine disrupting chemicals, because “disrupting” kept the door open for so many more discoveries than maybe if they had sort of narrowed their labeling and kind of lost their way.
But disruption implies a lot of different things. And so, not to get into the weeds because I want to get into solutions of course for your community, but I just want people to understand sort of the precursor problems that led to where we are now.
Because back to your question, Diana, I'm a rheumatologist of 22 years and I was really starting to wonder why am I seeing so many people getting sicker with immune and autoimmune diseases, younger and also those with no family history.
So, these are sort of de novo cases of getting sick where there was no explanation that we could blame it on a cousin, a mother or father, or whatever as part of our genetics. Because it turns out that these chemicals can actually have effects that change the proteins that allow these genetics to come out.
So, we can also, in some ways, really prevent that from happening. So, food can do this, and certain behaviors can change the destiny of our health because we now know the problems that got us into this are also something that we can affect with lifestyle, and diet and just making smarter product choices.
Jon Gay (15:07):
Speaking of which Aly, I know they don't put the BPA in the chicken feed anymore, but you're really making me want to have steak instead of chicken for dinner tonight (laughs).
Aly Cohen (15:14):
I mean, look, everything in life, you're sitting here talking to me with colored hair, I highlight my hair for like 30, 40 years. My kids play lacrosse on really toxic turf; I've even done podcasts with researchers on sports turf — life is about having flexibility. I've come full circle from being on the ledge to being … listen, I'm a mom, I work, life is not easy.
You have to work around all of that and do the best you can because it's really not about perfection, it's really about doing the best you can and making changes that fit into your lifestyle, understanding why to make them, because I want people to understand the why before they do the what. But really, it's not about panicking, it's a process.
I'm learning every day. I'm still learning every day about how to make little choices. I mean, I had a blender like a month ago that I was like, “Why am I using a blender that's plastic?” I've been doing this for 16 years and all of a sudden, I look down, and my blender is plastic. And I thought, you know what, I can get a $25 glass Pyrex blender at the local supermarket, literally in the aisle.
So, the idea is that when we start to see things differently, we start to make different changes. So, that's how I work on it. But it's not perfection; it's a journey.
Diana Weil (16:30):
To me, I look at this world and I shut down because I get so overwhelmed, and it seems like it's in our drinking water, it's in everything that we're eating, and we do exist in this world.
I think Elara and I did an episode on this a while ago that we were talking about plastic bath toys and you shouldn't have plastic bath toys, and I have plastic bath toys now. Because it's like what else are you going to do?
So, I think we removed BPA only to replace it with potentially more toxic chemicals. So, how do we exist in this world and do our best, and also not have a panic attack every day?
Aly Cohen (17:08):
Your questions, they resonate because I have patients who have never heard of what I'm talking about- all the way to people who could school me left, right, and up, down, you know what I mean? So, I think there's just so much out there.
But I will say this, the reason I wrote this new book was because I was practicing out the recommendations based on the science for so long that I had to say, “I’ve got to get this out there in a way that's reasonable.
So, one of the things I designed for even students and other doctors that I train on environmental health is I came up with just a very simple “Four A’ss of environmental health navigation. So, it's called the four As, keep it simple stupid.
So, the first A of the four A’s of environmental health navigation is assess. And I've always believed you want to know the data; you want to kind of see what you're up against before you can make all those changes.
So, I put together a 50-question questionnaire, not judgmental, just very reasonable. Like do you drive through city air? Do you dry clean your clothes? Do you look up your cosmetics for any chemicals on any of the free apps — whatever, you wanted to get a baseline of starting points. So, that's assess.
Then the second A is avoid or swap. So, do we always need 20 different cleaners in our kitchen? I mean we've been marketed to for so many years that we have to be so clean, we have a window cleaner, a door cleaner, a sink cleaner, carpet cleaner, you name it; a drain cleaner, it goes on and on and on. Why do we need all that when we could use vinegar and sea salt and lemon juice, or even look up our products that we want and not make them like I did back in the day.
So, the idea is “avoid and swap” gives you this flexibility of can I cut back where I can (and save money by the way in doing so), and can or do I want to swap out to things that are just safer versions of things I like, and that gives you the resources to do so and look them up from people who do this for a living that are vetted.
The third A is so critical to not only detoxifying your body, which is the name of the book; clean drinking water, how do we get clean drinking water which serves and washes our body and has done so for millions of years, we're made up of 85% water human beings. So, I felt very strongly you have to get that right in some level, depending on what you choose, but thinking about what we add.
So, third is add. So, adding water, adding great sleep, which allows us to remove chemicals, great science behind this while we sleep. So, pushing the sleep hygiene information. But exercise, sweating, sauna, mental health, how that works on the gut, the gut microbiome effects. The add is the piece that you can take all the chemicals in the world away but you really want to add in things that make human beings thrive and have done so.
And so, that was a big piece of the add- plus nutritional components that actually offset some of those genetic and harmful effects of the environmental chemical. So, that's important too, which ones and how much and all that.
The last piece of the four A’s is allow, and allow was travel and kids and colored, frosted hair and turf and my kids' dreams of being lacrosse superstars. It's about allowing yourself wiggle room so that you can do maybe 80% right at home or you can control the environment or your workspace. So, you want to be able to have allow so that you keep moving on your journey in a positive way.
Elara Hadjipateras (20:39):
I think that kind of leads me to my next question, Aly, which is, obviously, there's chemicals everywhere, we're exposed to so many different things every day, it's inevitable. Like you said, there's going to be some things that we allow our children to play with.
Like the other day my almost 2-year-old was screaming in the car. He really wanted my Poland Springs water bottle, which first off, I shouldn't have, but I was thirsty. I need to hydrate, I'm nursing and I give it to him and he's just crunching in his mouth and stuff, and I'm like, “Oh my God, soft plastics.”
But he stopped crying, so what are you going to do?
Aly Cohen (21:09):
Survival, okay.
Elara Hadjipateras (21:11):
It's survival. So, I'm just wondering what are the top most harmful things I should be avoiding that are very often found in a typical household or maybe I'll encounter on a day-to-day basis. What are the big no-nos if we were going to do an, “Okay, we really need to avoid this” list?
Aly Cohen (21:30):
And I will tell you one thing that's important is that if you're really struggling and people listening, and I know I sound kind of like a used car salesman, but there is a 21-day plan in here that is so simple and it kind of cuts through some of the noise and fear.
But I want people to know that that actually got a lot of attention which I didn't expect it to, because people were just so overwhelmed that it was really helpful to have this 21-day plan, which is actually spread out through this assess, avoid, add and allow. So, you can kind of tie all those concepts together.
But here's the thing, it's survival in terms of just kind of pushing through your day and making things work. So, I would tell people that some of the big things that are the easiest things to do in general is that we buy less; buy less cleaning products, maybe fewer cosmetics and hair products, or you can simply look up the ones you really like and just get safer versions.
I'll give some examples because people love this. I get massages occasionally, I'm stressed out, I need some massages. So, I now bring my baby massage oil that I vetted on Environmental Working Group’s list. It's a one; it has no phthalates and fragrance chemicals, it has nothing in it that's harmful, and I just bring it with me and hope that they won't mind using something cleaner.
A self-tanner I grabbed a couple summers ago, that was a one … shampoo, conditioner, all of this can be looked up. But when I talk about taking in less to your home, when you don't buy as much junk, you're not bringing into your home where it actually makes its way around the home, and then will make its way into our bodies.
And this goes for whether it's pets or kids or anyone, those chemicals don't really go away very easily. You want to get them out of your home by not bringing them in the first place as best you can.
Jon Gay (23:25):
Is this a bad time to mention Elara's makeup and skincare fridge? It might be time to call some of the ingredients in there, Elara.
Elara Hadjipateras (23:31):
For the record, Jon, I do not wear makeup. Notice, exhibit A, everyone, listeners, videos, I have not used concealer. The most I do is eyeliner, but I am totally guilty of having an excessive amount of face care products.
Aly Cohen (23:46):
And you know what, you're not unusual. I mean, this is the product. I mean look, I'm in my 50s and I'm seeing stuff to make me look younger, and you don't think that appeals to a human being on some level. I'm just trying to say that there's a human factor in all of this, but we want to fight this urge to sort of just lop on stuff without understanding.
Because essentially, when I talk to high school students, I'm like, “You guys are sponges.” We're all sponges. We absorb everything we put in, on and around our bodies. Women, you might want to think about tampons and feminine care products because we're absorbing into the vaginal canal very rapidly, because that's how we design medications.
Same with our skin, we think it's okay to put Dramamine and all these things on our body for medication purposes, but guess what, a lot of these chemicals in our cosmetics cross that barrier and into our bloodstream too. So, it's just a matter of getting kind of used to the idea of being aware, and then acting on that in a very reasonable way for choices.
But you said the top few things: don't buy as much. Thinking about drinking water, which is my favorite topic because it took so long for me to get a handle on it. Now, I have a chapter on it so people really get it because water's such a big item that we consume, same with food, personal care products you work through carefully.
Get rid of things like non-stick pans that have PFAs, polyfluoroalkyl, because it's easy. You just go over and get a stainless steel one, or I got rid of plastics. I talk about all these different journeys along in the book because I wanted people to understand how personal it was. I took a drawer of plugin air fresheners that I had like a hundred and I just tossed them all one day, it was so freeing.
Back in the day, we used to get free samples from all the big box stores like Macy's and whatever, and I had an entire drawer of samples of junk and I took the whole thing and I put it all over the floor and took a picture of it and then I just threw it all away. So, it just takes a little motivation sometimes.
Jon Gay (25:51):
I've gotten rid of almost all my haircare products, just so you know, Aly.
[Laughter]
Elara Hadjipateras (25:56):
You know what's great about having young children is obviously we have all the stuff that's safe for babies. So, then it got me thinking, what's safe for baby, it's probably safe for me. I probably shouldn't be using what's not safe for a baby. So, I stopped kind of using all these more expensive and aromatic lotions, and I just use Aquaphor because that's what I use on them.
Aly Cohen (26:16):
Yeah, for sure. And that's a really good thought process because even when I was looking for sunscreens for a while and trying to figure out that debate, I realized that the baby ones tend-
Elara Hadjipateras (26:27):
(Tend is the) Keyword, right?
Aly Cohen (26:28):
Very much so because I still look up everything. It only takes a second by the way and I have my students do it in their classes. They download the health-
Elara Hadjipateras (26:35):
Is there an app that you recommend or website that we could-
Aly Cohen (26:39):
There's two of them. And again, these are a bunch of resources in the book, but Yuka, Clearya, Healthy Living is from EWG. You could do this on the go, it costs nothing. And I have the students do this. They just download it or they pick up their phone, and I take bags of a hundred different products and I toss it on all these kids and they just do it themselves.
So, once you get used to doing it, it takes two seconds, and then you start to have a repertoire of what you like, and then you can shop in two minutes because now you don't have to be all over the place. You can go into a supermarket, know exactly the products you like and what you want to eat or what you want to buy, it actually cuts down a lot of noise in your life.
Jon Gay (27:16):
And we'll link to some of those resources in our show notes as well.
Diana Weil (27:19):
Quick question about the app and then I want to get into drinking water because drinking water is a big one for me that I haven't figured out yet. For the app ones, do you only go for ones that are green? Or one, two? or what's your cutoff for being an okay product?
Aly Cohen (27:34):
So, I try to go for ones and twos because the market is so different-
Elara Hadjipateras (27:38):
What does one, two mean for those who don't even know? You guys are saying … I'm like, I don't know what 1, 2 … one out of a hundred?
Aly Cohen (27:44):
Great question, great question. So, Environmental Working Group, they're all different but once you learn the rules of sort of that app and how they're grading the toxicity level or the harmful ingredients level, you get a handle for that particular app.
So, Environmental Working Group, who I work with very closely, I'm very happy to work with them for years, they developed probably the first app and the first website. They've been doing this a very long time.
So, it's called Healthy Living. And when you look up the products and they have cleaning products, they have personal care products, they have food products — it will have a rating system where zero or one would be the best, or they have EWG verified, which sort of is muddled in that zero to one, two area instead of giving you an actual number.
But the point is, is that you can choose those, and then it goes all the way up to 9, 10 so to speak in terms of toxicity. And at this point, 20 years in, they have grown, I should say the market has grown for so many good companies doing so much good work. Whereas 16 years ago, you could not find probably majority of the stuff that I can get now which is really great and gives everyone a less excuse I think to do a little bit of work. So, I always say, stick to 0, 1, 2 EWG verified for that particular app.
Now, my kid, my son went to summer camp and he wanted to look really cute and smell really good for the ladies, big summer. And I said to him, I said, “Listen, you either learn how to do this and find the products that you want and you have to choose …” I gave him three or below, I could have said two and below, but I wanted to have some flexibility. And I said, “You find those products that you want and you make a case for them and you can get them.”
And so, then he became really good at it, and then he taught all his friends. The idea is that this stuff has ripple effects in the hallways of school, in the lunchroom, it's remarkable because then kids have empowerment, which is what I found from doing the TED talk and all the data collection — kids want this.
So, even if the parents, you're learning and you're doing and you're going to train your kids on some level and you're going to show them sort of that influence, but they're going to be off on their own one day. And that's the kind of thing as a parent, at least in my world, that's kind of the greatest gift you can give them, is the ability to have agency over their own bodies.
Jon Gay (30:05):
And if we can (as a bonus) get these 16-year-old boys away from using things like Axe body spray, that's a win for everybody.
[Laughter]
Elara Hadjipateras (30:11):
Yeah, yeah. We all benefit, we all benefit.
Aly Cohen (30:13):
And let me tell you also how it doesn't always work out for you. My kids ignore a lot of what I say. They jump in the car smelling worse than a department store.
[Laughter]
They are trading cologne in the back rooms, behind cars when I go to pick them up, there's like some kind of … let me tell you, there's all different phases, and you have to decide what battles you're going to pick. I've decided that cologne is better than crack cocaine. So, I'm just really …
[Laughter]
I'm kind of weighing it out, arguably. But I will say that there's plenty of mom fails, parent fails, and I think it's just a matter of deciding how much you're going to fight and push them so that they can actually make some of these choices on their own.
Diana Weil (31:00):
What do you say for men's deodorant? Jon, you talking about Axe body spray. I feel like, “Okay, I want to go get one of these cleaner products, but they don't work as well.”
Aly Cohen (31:10):
Ah, good question.
Diana Weil (31:12):
Do you have anything to say to that? (Laughs)
Elara Hadjipateras (31:14):
I deal with that. Like right now, I have nursing BO. And so, it's like, basically, I just have to shower three or four times a day in order to not smell, and also not have to put on a product that has aluminum or something, and it's going to put me at risk.
Jon Gay (31:28):
And before you ask, yes, I've used the same big brand deodorant that I've been using as long as I can remember, probably since puberty. So, I'm anxious for your answer on this one, Aly.
Aly Cohen (31:37):
Okay, so, well, let's go back to the problem. So, say for instance, deodorant, it's always – I used like aluminum-based all my life. I didn't know any better. I loved the commercials, I think it was Sure or whatever it was.
Jon Gay (31:49):
“Raise your hands if you're Sure!”
[Laughter]
Aly Cohen (31:52):
I mean, you guys are too young for Perk, but needless to say, all these different products that I grew up with, they smelled like new fallen rain and raspberry fields, and you were just, “woo,” you were taken with them.
But the fact of the matter is, is that at least for … let's talk about antiperspirant. Antiperspirant versus deodorant. Antiperspirant was designed with aluminum in them so that they're tiny, tiny aluminum. So, they get kind of pulled into your sweat glands, and it keeps the water in the sweat glands instead of coming out to make you feel wet under your armpits.
So, the mechanical use of these micro pieces of aluminum were very effective at keeping people not to sweat. And then they threw on the phthalates and some of these fragrances so that you would not just not sweat, you would also smell pretty decent. So, they were a winning combination for years.
But it turns out that we don't really want stuff being absorbed into our sweat glands. Because technically, that is able to get into your bloodstream. Your sweat glands are connected to your microvascular armpits.
So, you really want to move away from antiperspirant. And there hasn't been a great copy of that process entirely. So, at least that was a change when they started making deodorant where you could still smell pretty good, but you would still be pretty wet under your armpits.
And as we speak, my armpits are not exactly the driest desert, but the idea is that you don't have that smell because you're using safer ingredients, like a baking soda combination. We actually have do-it-yourself for making your own personal care products in the book, cleaning products.
So, it's like tons of do-it-yourself if you want to do that as well as resources to look up the ones so you don't have to make them up. But they're really like three ingredients that are really in the safest products anyway.
And that's the kind of the way to think of it, is that we're never going to get a perfect system, at least as of yet. But I will tell you this, I came up with some good hacks. There are some tops that you can buy that actually have some padding in the armpit.
And so, I wear those with shirts that I don't want to feel too kind of wet under my armpits and nice shirts and stuff like that. So, there's always workarounds, but you have to kind of walk through them and see what's available.
Elara Hadjipateras (34:13):
So, when I worked in broadcast television, Aly, one of the things all of the on-camera talent did (because they're sitting there, millions of people are watching, they're sweating, lights), Botox injections in your armpits to keep you from sweating.
Diana Weil (34:24):
I’ve heard that too, and fillers. I want to talk-
Elara Hadjipateras (34:26):
Worse, worse than deodorant with aluminum or better?
Aly Cohen (34:29):
I'm not a Botox filler person. I'm telling you this because as an immune disease specialist, I mean, let's go back to basics. Our bodies, we have not been here – we've been here 4.5 million years, and our bodies are incredibly capable of trying to protect itself. And the way it does that is through the immune system reactions.
We are beautifully designed. We talk about autoimmune disease being an epidemic, really, it's rising remarkably around the world. Rheumatoid arthritis, 1% of the world population, all of these Hashimoto's, rheumatoid, lupus — all of these are my bag, but I'll tell you, it's growing around the world.
So, when I tell you this, what I'm saying is that when you have foreign bodies in your body, there's always going to be a potential to have a reaction that's actually designed beautifully through evolution. Because your body doesn't want foreign bodies, which includes chemicals. And it can include some of these synthetic components. Medications can cause these things.
This is why we have Stevens-Johnson reactions. There's that, there's also food components. But the idea is that when you're purposely putting some stuff into your body where there may be alternatives (again, this is a personal choice), you could experience an immune reaction because your body's doing its actual job.
And so, I'm always leery of that because when you talk about botulism (which is Botox), which is actually a toxin made from bacteria that we've known for a long time. We have cans. Cans actually have plastic interiors of BPA because it protects from having botulism from food.
When you dent the cans, you can actually have a risk of infection. It's a natural substance, but guess what, it also comes with other components. There are other things that are brought into that formulation to make it last longer, make it work. So, we don't know what those are, they're not revealed.
So, it's one of those things where I don't want people to feel bad about what they're doing. I just want people to understand that the immune system is actually designed to make a reaction to these things. Whether it's a big reaction or no reaction is really more genetic and your makeup, your personal makeup, but I just don't want to chance it.
And I have my own concerns about aging and other things that have to do with aesthetics, but I'll probably end up doing a facelift at some point as opposed to having things put into my body. Because I'd rather do that at some point if I ever decide to do it, I wouldn't necessarily want to put stuff in my body that can change its reactivity.
Elara Hadjipateras (37:14):
Have you heard about the growing popularity of (they call it) “the lunch-time boob job” or like “the 24-hour boob job”?
Aly Cohen (37:22):
No.
Elara Hadjipateras (37:23):
Where instead of going for proper boob job where you're implanting the silicone implants, it's like they go and just inject a ton of Restylane into your boobs to just make them a bit more perky.
I mean, it's already bad enough thinking you're going to be putting, I don't know, however much in your cheeks, but just imagine you're filling up your chest and then that's just dissolving over years’ time, and then you're just getting these lunchtime boob jobs once or twice a year.
Aly Cohen (37:47):
I mean, look, you know what I was going to say to that. But here's the thing, I was just at a baby shower, and every single young woman around those tables was like nose, face, skin.
And to be honest with you, like I said, I don't want to judge because it's not my business to judge, but it shows me sort of how there's such a push towards aesthetics in such a way that 10-year-old, 12-year-old, 14-year-old girls are getting Botox and fillers. It's really run crazy.
And again, if we don't understand how the immune system works and connect that to what we're seeing epidemiologically in terms of how some of these chemicals work — they don't just work on the immune system. Potentially, they work on breast cancer risk, we know that environmental chemicals and environment is the cause of 90% of breast cancer cases. Only 10% is a genetically connected cause of breast cancer.
So, when you're talking about young women being – and African-American women, by the way, are at much higher risk of having younger cases of breast cancer before even screening comes about. They have products for Black women that actually have placenta and some of the estrogenic chemicals we don't want to have on our skin and in our body.
You're talking about a real movement. We have to teach our daughters and teach the women around us that there are health effects from these short-term goals of feeling perky. I mean, come on guys, this is what we did back in my day.
Jon Gay (39:23):
There's like a peer pressure, “keeping up with the Joneses” aspect, you're describing, Aly. And it sounds like we need to flip that on its head and create an environment where we're encouraging young women and probably all young people to not put these toxic chemicals in their body.
Aly Cohen (39:38):
Yeah, or at least be thoughtful. And it's not about judging, I don't feel that way because again, I color my hair, so who am I to say that? But I will say that I think when we think about it, we often might have a second guess about doing some of the stuff we're doing to ourselves.
And I just would love people to feel better in their own skin. It's one of those things I hope for my own children and for myself as I age. But I feel pretty good about it. And I'm proud of seeing some of these actors and actresses that are kind of carrying the torch on that, that makes me feel good.
But it's also tied to a lot of what I know. And what I know, I don't want any of this stuff in my life. And I want to teach people how to make those decisions with the right information, not out of fear.
Diana Weil (40:28):
Okay, can we shift gears a little bit to drinking water? Because I don't want to not touch on this because it's such a big – like you said, we all drink water. And I've been going really down a rabbit hole on drinking water. So, I would love to learn from you.
Aly Cohen (40:43):
So, fun facts, I'll start with, and then I'm going to get you right to the point of what I think everyone wants to hear. So, first of all, in the United States, water is either tap water, municipal tap, you get a water bill, you know it's coming from the municipal systems, or it's well water. So, those are the big choices.
80% of the humans in the US drink tap water. Only about 20% really drink well water. And they both have different issues involved. But here's the thing, the tap water, the municipal tap water, there's about 160,000 wastewater treatment plants (as they're called) that clean our water.
They follow a law from 1976 called the Safe Drinking Water Act, which hasn't changed in 50 years. And so, we've had this huge amount of chemicals that are created for all sorts of products, we have sewage that becomes drinking water in those wastewater treatment plants.
We have manufacturing runoff; we have air pollution that becomes water. We have chlorination that's added, which needs to be added, or else we'd be back in the Middle Ages. We also have fluoride, which I would tell you is actually a neurotoxin without any fanfare. It's not good for the human body or particularly the brain. In pregnant women especially, is something I would really like people to think about because I have all those studies in the book.
But the idea is that when you take municipal tap water, it's also traveled maybe 10, 13, 15, 20 miles from the wastewater treatment plant to your home. And that's PVC piping, which is the replacement for lead. That's old lead piping. That's any breaks in the piping. I live in farmland, so I’m always worried about pesticide breaks in the piping.
Needless to say, here's the punchline: whether it's well water or it's municipal treatment plant with all its issues and laws that are old and outdated, you're going to control the water quality when it hits your home. Because when it hits your home, it doesn't matter whether it came up from a well, it doesn't matter whether it came from a wastewater treatment plant, you're going to control that at the point of use.
So, what I'm recommending people think about, first of all, any filtration, whether it's a pitcher (which is carbon block) or a refrigerator door, which is a big carbon block, water goes through quickly. Or what I really have people think more about is called reverse osmosis.
Because reverse osmosis, which is now very much available at a very reasonable price, $275, you can get a really vetted reverse osmosis water filter. Very reasonable and worth putting in because they last longer. They don't have as many expensive replacement carbon block filters like you do with the pitchers and the refrigerator door.
They take off more stuff that you don't want in your body, including mostly fluoride and some other stuff. But really, they work the best. And reverse osmosis is now available to the masses. It used to not be. In fact, they use it for dialysis. My dad's a kidney specialist, and he's still practicing nephrology. They have an entire room, which is a reverse osmosis room for these patients who are on dialysis because they have to really clean the water.
Us mere mortals, not dialysis patients, we get to have the benefit of 15 years of innovation. Now, I even bought one for my son at the college, which sits on his countertop. He doesn't even have – I have mine plumbed, and same here, we had a plumber. (He or she) comes in an hour, that's it, takes an hour, no big deal.
But he has one that's on his countertop. You could put toilet water in the back for all anyone cares. And it cleans the water so well that the front makes a pitcher of water in like two minutes. It's so cool. It's so cool.
Jon Gay (44:42): 8 seconds
Elara, I muted you, start over again.
Elara Hadjipateras (44:46):
I got to unmute myself. What's the specific mechanism that you got for your son? I'm interested in knowing.
Aly Cohen (44:45):
Oh, that's reverse osmosis too. So, here's the thing, reverse osmosis, I'll explain what that means. Water has to go through a lot of different materials to clean it up. You’ve got large particles, you’ve got small particles, and you have teeny tiny particles you can barely see.
Reverse osmosis is a material that the pore size is so tiny that it catches everything. It's a sieve, it just catches everything. In the old days of my dad and dialysis back in the ‘70s when they were first designing it, it was really designed to keep single-celled organisms like bacteria, mold, yeast, and viruses from making those patients sick.
Because they're the most immune-compromised in sickest patients. They have no kidney function, so they have to use machines called dialysis machines, which are great. So, the original RO filters that were huge were really designed so small to catch those single-celled organisms.
It turns out that all these compounds and chemicals that we've made, since that time, are bigger in size than those. So, now, we get this miracle that we are catching all of this junk in that reverse osmosis filtration material.
And that's the beauty of it, is that it's just designed to catch more junk. And you don't have to know what your junk is for your town. I don't encourage a lot of testing anymore because it's always going to change. Whether it's your water, your town, whether it's your blood.
Believe it or not, I don't want people to spend money on testing, I want people to actually spend money on the solutions.
Diana Weil (46:19):
There's a big movement of labeling everything as toxic. And that's become a very trendy word, and because of it, I think that the larger medical community has lost a lot of trust because where things are outdated, we're following old guidelines. There are a lot of doctors who maybe aren't aware of this stuff.
What do you think the balance is of being aware of this stuff, educating patients, but also how do we gain, still keeping medical professionals respected? Because there is a lot of education that goes into being a doctor. Do you have any thoughts on that?
Aly Cohen (46:54):
This goes to why I went into integrative medicine. That's the punchline here, is that we're missing so much great science in our medical school training, in our healthcare training for healthcare professionals, not just doctors.
We're just missing this huge piece of environmental health, how environment plays a role on human health. In a variety of ways, metabolically, sugars and different hormones that affect different processes. Weight gain is connected to a lot of these chemicals or inability to lose weight. They're called obesogens.
But the point is, is that we're missing so much great information that I had to learn outside of my traditional training, just like nutrition is often left out in any big way. We use like five to 10 hours max in any modern-day medical school training, which is a shame.
So, I think what I'm navigating myself personally is trying to train doctors — right now, I think there's four programs that I'm educating on environmental health, which took years to get into. I'm trying to do my best in my lane.
I'm talking as a rheumatologist who's Western-trained, who uses all the medications, in the same breath as guess what, maybe we want to consider changing our water filters or less cosmetics. It's all tools to helping the human body thrive.
So, to your point, I think the trust issue has become a big problem because patients are becoming savvy. They have more information than they've ever had, and they're really asking for questions and answers. Answers to many of their health conditions, also preventative questions. And they're not really getting that information from the people they're supposed to trust the most.
And I think that's where we run into problems. Because if we could just train people better, then they would have that information to share. Otherwise, they're going to go to influencers that I might not agree with, or they might go to TikTok and have everyday people talking, and then we get into a whole bunch of stuff that has to do-
Jon Gay (48:57):
(Sarcastically) Everybody's a doctor on TikTok.
Aly Cohen (49:00):
I mean, look, it's worrisome for me because we're getting into real issues like measles outbreak, and we're getting into Tylenol being bad for pregnant women, which is … we know that the least amount of medicine over the shortest amount of time to do the effect, and that's what I was taught.
But when you have a fever and you are pregnant, you need to take something to get that fever down, or else it can be really harmful for the fetus. So, it's, again, being judicious about everything is the way to go. Just be judicious and consult doctors and really think about the science. But yeah, it's a problem, that's why we have to fight back with more education, like podcasts like yours, I hope. So, this is how we do it.
Elara Hadjipateras (49:44):
So, I know there's a lot of doom and gloom on this topic, but as we round things out in the podcast, what gives you hope about the future of environmental medicine?
Aly Cohen (49:53):
Yeah, I'm hopeful. I'm telling you this because the trajectory of this material has really escalated to the point where it's, like I said, we have a lot of integrative medicine fellowships, even functional medicine fellowships.
I literally have four doctor programs of people who, beyond medical training, have now vested their time into learning more about nutrition and environment and Ayurvedic medicine and traditional Chinese, all these different ways to heal for the human body. I am hopeful because it's far more movement I've ever seen in 16 years of doing this.
I am very hopeful that kids who are now empowered, who are proactive, who know how to look products up, they are just going to blow all their parents away in terms of what they're able to do, that their parents might not have bought into because they sort of had that window where they're in between generations.
So, I'm very hopeful, and the more I teach high school, the more I see these kids, just they get it. They really do get it. So, yeah, I'm actually a lot more surprised to be hopeful than I thought I would be. But then again, I believe in empowerment.
I believe as an individual, we need to start to think about how to work on these things as best we can on our own and to ask the right questions, but to get the right sources and the voices that matter and are educated on them.
Diana Weil (51:17):
Well, it makes me feel hopeful that you are hopeful (laughs). So, thank you for that and all of the information that you've shared. So, we like to end our podcast with two questions. And the first one is, what is a life lesson that you have had to learn the hard way?
Aly Cohen (51:34):
God, a life lesson. Alright, I would say look, I think people can change. I used to not believe they couldn't. And I had someone who bullied me in sixth grade who I never got over, and all of a sudden, they're one of my biggest supporters.
And I teach this to my kids, things like this, is that I really believe that people can change, and I want to give them benefit of the doubt. So, I'm always looking for the good kernels in everybody. I think everyone has something to offer. And I have to hang my hat on that because I like to believe that people are good innately. So, that keeps me going to do the work I do.
Diana Weil (52:17):
I love that. Well, and I feel like that really ties into your last answer too, where this is a doom and gloom topic, and you do have hope, and that's obviously a – yeah, you have a positive outlook on life, which I think is really important.
Aly Cohen (52:30):
Yeah, I mean, I do because my kids are full of humor, and they have their lives ahead of them, and we're still here. When you're here, you got to enjoy life. So, I think cut off the noise and the negativity, stay with people and hang out with people that bring you up. Be educated enough to not be fearful.
There's a poem called the Desiderata, I don't know if you guys have heard that. It is the poem I live by, so if you get a chance, it's everywhere, it's been around forever. But when you get a chance, look up the poem, Desiderata. And I look at it all the time just to remind myself why we're here, what to think about, and put it all in perspective. So, I hope you'll check it out.
Elara Hadjipateras (53:18):
No, it sounds incredible. It kind of, honestly, is almost an answer to my follow-up question today, and it’s just kind of like, is there any sort of mantra, saying, poem, something that is inspiring you at the moment?
Aly Cohen (53:30):
Yeah, that one is always, it's forever. I even copied it and shrunk it and keep it in my wallet. But Serenity Prayer. We've heard of the Serenity Prayer, and of course, I'm trying to think of – have the courage to know what you can change, the something to die and the wisdom to know the difference so that you spend … I used it for my second book, Non-Toxic, it’s the poem in the front.
But the idea is that we have to use our energies wisely. You guys are new moms, we got to be thinking about how do we use our energy wisely so we don't burn out on any level: work, family, anything. And the idea is to know the difference between what worrying is going to do for you and where you could put that positive energy into things that are going to be more helpful to you.
So, I'm a big fan of the Serenity Prayer. I think it applies to everything, especially now when everyone's stressed out and you have so many world problems. I think it's a really good way to bring perspective back into our lives.
Jon Gay (54:30):
Couldn't do it from memory either, so I Googled it while you were speaking, Aly: “Grant me the serenity to accept the things I cannot change, courage to change the things I can, and the wisdom to know the difference.”
Diana Weil (54:42):
Yeah, that's a good one (laughs). Alright, Aly, this has been incredible. Thank you so much. I personally feel inspired to go change my husband's deodorant, which is the classics, smelly … what's the one that all men wear?
Aly Cohen (54:58):
Old Spice?
Diana Weil (55:00):
Yes.
Aly Cohen (55:01):
Has marshmallows with the-
Diana Weil (55:09):
He wears those.
Aly Cohen (55:10):
There are ones that are slower in toxicity.
Elara Hadjipateras (55:06):
SALT & STONE.
Diana Weil (55:08):
Oh, okay, I have used SALT & STONE, I'm going to go switch it out. But (laughs), can you tell us where people can find you?
Aly Cohen (55:14):
Yeah, so people can find me … I'm in Princeton, if you're interested and you want to be a patient, I'm here in Princeton. But I also do telemedicine. So, that's alycohenmd.com. But The Smart Human is my baby, my third baby out of my two human babies.
So, it is on TikTok, Twitter, Instagram, Facebook. The Smart Human Podcast, thesmarthuman.com, has all my recent posts, newsletter. And also, The Smart Human Academy, where I'm posting a bunch of really cool courses for people.
So, it's really become my educational gift, my baby. So, that's another place to reach me. And yeah, I hope people will follow because I post nuggets of useful information, nothing negative. I shouldn't say nothing negative. Nothing negative without a solution.
I'm all about give the information but always post with a solution, or else I don't really post on it if it doesn't have a solution.
[Music playing]
Voiceover (56:09):
Sip, savor, and live well with new episodes of Steeped In Wellness every Wednesday. Follow our show for free on Apple, Spotify, YouTube, or wherever you're listening right now. Leave your questions and comments below. Find us on Instagram at Steeped In Wellness Podcast, or for more, click on matcha.com.