• FDA requires warning for CAR-T therapy over concerns about blood cancer risk.
• CAR-T — or chimeric antigen receptor T-cell — therapy harvests a person’s own immune cells, altering them genetically, to treat cancer.
• About 27,000 people have undergone CAR-T therapy, and at least 25 of those people have developed a rare blood cancer, according to the FDA.

A recent warning by the FDA about CAR-T therapy suggests that the treatment can increase the risk of certain rare blood cancers. The agency required makers of the drug to put a boxed warning, its strongest safety notice, on the prescription information for the therapy.

CAR-T — or chimeric antigen receptor T-cell — therapy harvests a person’s own immune cells, altering them genetically, and putting them back into the person’s body to treat blood cancers like leukemia, multiple myeloma and lymphoma. The process, which was approved by the FDA in 2017, adds a gene for a receptor to the T cells, allowing them to attach to the specific cancer’s antigen; each type of cancer requires tailoring the genes to that particular antigen.

According to the FDA, about 27,000 people have undergone CAR-T therapy, and at least 25 of those people have developed a rare blood cancer. An abstract published last year also suggested the risk of this kind of therapy, stating that several cases of lymphoma had resulted from it. Scientists have also been researching the use of CAR-T therapy for other diseases, such as autoimmune diseases and viral infections like HIV and hepatitis C.

Four manufacturers of CAR-T therapy drugs — Bristol Myers Squibb (Abecma and Breyanzi); Gilead Sciences’ Kite Pharma (Yescarta and Tecartus); Johnson & Johnson (Carvykti); and Novartis (Kymriah) — were notified by the FDA that they must submit proposed label changes in the next month that state CAR-T therapy can increase the risk of rare blood cancers. 

What’s the risk involved with CAR-T therapy?

The risk of CAR-T therapy is known, but statistically very rare, and the benefits of the treatment still outweigh those potential downsides, Dr. Wael Harb, board-certified hematologist and medical oncologist at MemorialCare Cancer Institute at Orange Coast and Saddleback Medical Centers in Orange County, CA, told Healthline.

“This risk is associated with the use of a virus (usually a lentivirus) to integrate the gene encoding the CAR into the T cells’ DNA. The concern is that this integration could potentially activate oncogenes if it occurs near cancer-associated genes,” Harb said. “The overall benefits of CAR T-cell therapy, especially in cases of blood cancers where patients have few other options, are still considered to outweigh these risks.”

While the FDA warning will raise some concerns for doctors and physicians, it’s still not clear that the rare blood cancers in some people were directly caused by the therapy, according to Dr. Naveed Wagle, neuro-oncologist at Pacific Neuroscience Institute in Santa Monica, CA and Associate Professor of Translational Neurosciences at Saint John’s Cancer Institute in Santa Monica, CA.

“CAR-T therapy is still very early in its clinical development. The approval of these medications was warranted based on the clinical trial efficacy they showed,” Wagle said. “The new data in post-approval use is correlative and does not show a direct causal relationship. However, it does raise concerns and warrants close surveillance.”

Harb echoed the need for monitoring, pointing out that the FDA warning doesn’t suggest that CAR-T therapy should be suspended.

“Given the transformative impact of this therapy in treating blood cancers, especially in patients with relapsed or refractory disease, it’s likely that many doctors will continue to consider it a valuable treatment option,” Harb said. “The actual impact on the use of CAR T-cell therapy will depend on individual assessments of risk versus benefit, further findings from ongoing investigations, and possible updates to treatment guidelines or protocols.”

Are there other options for treating blood cancer?

According to the National Cancer Institute, CAR-T therapy leads to long-term survival in only roughly half of people who undergo it, and the cost — hundreds of thousands of dollars — can be prohibitive. There are still multiple forms of treating cancer, although they need to be tailored to a person’s needs through consultation with their physician — but there are still risks to those as well, Harb said.

“These include traditional treatments like chemotherapy, radiation, and small molecule drugs, each of which also carries its own risks and benefits. For multiple myeloma patients, treatments such as alkylators, immunomodulatory drugs, and autologous stem cell transplantation are alternatives, though they too are associated with a risk of secondary cancers,” Harb said. “The choice of treatment should be a decision made in consultation with healthcare providers, considering the individual patient’s situation, the type of cancer, previous treatments, and overall health.”

Takeaway

The FDA has ordered the manufacturers of six CAR-T therapy drugs to put a warning on their prescription information that a rare form of blood cancer is a risk of the treatment.

CAR-T therapy, which is used to treat blood cancers like leukemia, multiple myeloma and lymphoma, involves taking cells from a person’s body, altering them genetically to bind to the antigens of cancer cells, and then reinfusing them into the person.

Statistically, the risk of rare blood cancer from CAR-T therapy is low, but physicians say more monitoring and testing is needed.

• Azurity Pharmaceuticals, who produce a medication known as Zenzedi, have issued a voluntary recall due to a manufacturing error.
• The medication is used to treat ADHD and narcolepsy.
• Experts say that, if the incorrect medication is consumed, it could have significant side effects. 

A type of ADHD medication is being recalled after a Nebraska pharmacist opened a container for ADHD medication and discovered it contained the wrong pills.

Zenzedi is a drug that is used to treat attention deficit hyperactivity disorder (ADHD) and narcolepsy. Azurity Pharmaceuticals, the company that produces the medication, announced the nationwide action—which affects one lot—on January 24. 

“To date, Azurity has not received any reports of serious adverse events related to this recall,” the company said in its recall announcement.

ADHD medication is already in short supply

According to a statement published by the company, and publicized by the US Food and Drug Administration, the pharmacist opened a bottle intended to contain Zenzedi, but which was actually filled with carbinoxamine maleate, an antihistamine.

Dr. Bryan Shapiro (MD, MPH), an assistant clinical professor of psychiatry at the University of California-Irvine, says that this recall is hitting patients when they are already struggling to obtain their ADHD medication due to shortages.

“We’re at a time right now where patients are having a hard time getting their ADHD medications in general…there’s been this milieu of frustration, and challenges getting the medication they need for ADHD.”

Shapiro’s other concern is that those who may have taken the incorrect medication, which is a sedative and an antihistamine, could be facing the impacts of not taking the correction medication while also dealing with issues stemming from taking a different pill that provides the opposite effects.

“So the patient could be experiencing withdrawal from stimulants, while at the same time being exposed to a drug that decreases alertness, increases sedation,[and] a variety of other side effects that can increase the risk of a variety of things like vehicle accidents or other potential problems,” Shapiro said.

Dr. Farah Khorassani (PharmD), associate clinical professor at the University of California-Irvine and a psychiatric pharmacist, said safety measures at the pharmacy mean the pills were flagged early.

“When verifying medications, many pharmacists compare the pills counted in the vial to an image of a pill that is available through different softwares or databases.  If that doesn’t match, the pharmacist would identify it,” Khorassani said.

She said it’s unclear how the wrong pills could have been put in the bottle.

“This is hard to answer without knowing their manufacturing process.  My guess would be that they were also bottling the other medication found in the bottle at the same facility and that there was an error.  But it’s hard to tell,” Khorassani said.

Azurity Pharmaceuticals is urging patients who are concerned that they may be affected by the recall to contact their health provider. The lot of medication that has been recalled was shipped to wholesalers between Aug. 23 and Nov. 29 last year. The incorrect tablets are white and round while Zenzedi are light yellow and hexagon-shaped. 

The recalled lot number is F230169A.

The medication affected is the 30mg dose and anyone who is concerned that they may have ingested the incorrect medication is urged by the company to contact them.

What to know if you take ADHD medication

If you are someone affected by the recall, Shapiro says that it’s important people understand that there are other options available other than Zenzedi.

“Zenzedi is not a unique medication formulation. It’s dextroamphetamine. And there are other generic forms of dextroamphetamine that should be available as a substitute while this recall process is addressed.”

Name brands of these replacement drugs include Dexedrine and Dextrostat. 

Khorassani says that, if you are concerned that you have been impacted by the recall, that you should contact your pharmacy for confirmation and next steps. 

“If there is a concern that their current medication could be the mislabeled batch, contact your pharmacy to confirm the medication you received is correct. Those filling prescriptions for this medication should double-check with their pharmacist to ensure the pills in the bottle are the correct medication.”

Zooming out, Shapiro says he’s worried, as more medications come on the market to treat ADHD that further issues could surface. 

“The more new forms of the same drug you introduce, the more chances there are for error because it’s just an additional product that’s being brought.”

Takeaway

A lot of ADHD medication is being recalled after a pharmacist opened a pill bottle containing the wrong pills.

• A new study shows how exposure to junk food content on Instagram increases cravings for salty or fatty foods and leads to feelings of stress, sadness, and exhaustion.
• Repeated exposure to unhealthy content on social media may have negative psychological consequences.
• Advertising on social media can influence a person’s decision-making and food choices.
• To consume social media content in a healthy way, follow reputable, trusted sources.
• Experts recommend limiting time spent on social media to preserve your mental health.

Advertising on social media has become increasingly popular across all industries, including food brands.

However, there is growing evidence to show that some food-related content is having harmful effects on users’ mental health.

According to a new study, young adults who were exposed to junk food content on Instagram experienced cravings for unhealthy foods and negative mental health effects. The findings were recently published online in the journal Appetite.

Researchers observed 63 participants ages 18 to 24 years old who were separated into two groups. One group looked at a standard Instagram feed and the other looked at a feed with junk food images for 15 minutes. 

Next, participants answered a survey, which included questions about body image perception, mood, and food cravings. Then 7 days later, they looked at the other Instagram feed and answered the survey questions again.

Results showed participants who were exposed to junk food content had increased cravings for salty and fatty foods. They also experienced increased feelings of stress, sadness, exhaustion, and hunger. 

Neither Instagram feed affected body image perception, the study notes. 

How social media affects your relationship with food

“Constant exposure to food advertisements on social media certainly can impact our perception and relationship with food,” said Dr. Nicole Avena, nutrition consultant, assistant professor of neuroscience at Mount Sinai School of Medicine, visiting professor of health psychology at Princeton University, and author of “Sugarless.”

“Seeing your favorite celebrity enjoying a specific junk food through a paid advertisement may incline you to choose similar food options. Similarly, seeing your favorite influencer enjoying healthy and nutritious foods may influence you to choose healthier options,” Avena added.

Social media may also impact our relationship with food through comparison. 

“Social media typically focuses on highlights and near-perfect content and advertisements; however, this is not an accurate representation of real life,” Avena explained.

“For consumers, it can become easy to compare what is on your plate to what is on the plate of people that you follow on social media. Comparing your food choices to others can negatively impact your relationship with food and may even impair your body image.”

In addition, social media can influence what foods and lifestyle habits you try. And the more you’re exposed to certain types of content, the greater the psychological impact.

“From direct, delectable food cooking content to fashion and fitness influencers, our perceptions and relationship with food are in some way indelibly impacted by social media,” said Dr. Uma Naidoo, a nutritional psychiatrist, professional chef, and author of “Calm Your Mind with Food.”

“Social media is ever a highlight reel of sorts: beautiful recipes with ASMR-style sound effects may convince us to try new dishes or recipes, while ‘fitness experts’ — who may, in reality, be any level of expertise — may convince us that a particular lifestyle is the way to go. And the constant nature of such stimuli only deepens its impact,” Naidoo said.

Exposure to junk food content may harm mental health

Advertisements are often designed to have a psychological effect on the viewer. 

“Visual food cues induce a dopamine response in reward areas in the brain,” said Dr. Mireille Serlie, professor of internal medicine at Yale School of Medicine.

“Some foods trigger higher responses than others. It has been shown that pictures of food high in fat and sugar lead to a higher dopamine response and to more brain activity in reward brain areas. The intensity of that response predicts the subsequent amount of food intake. Repeated consumption of unhealthy food might affect the wiring of the brain, leading to more cravings and higher food intake,” Serlie noted.

For food advertisements, the goal is often to make it look appealing and delicious to increase the desire to buy and eat it.

“Food brands often use psychology-based marketing techniques to manipulate consumers into making specific decisions surrounding their food choices,” Avena said.

“Junk food content can activate the dopamine system in the brain, which produces feelings of pleasure. For example, if a bag of chips appears on your social media feed, it may increase your cravings for chips due to triggering the feeling of pleasure that your brain typically associates with eating a bag of chips,” Avena added.

Naidoo explained that many factors may be at play in why social media makes us feel negative or craving emotions. 

“Firstly, it’s important to understand that a lot of basic human behaviors stem from a drive to survive,” she said. “When we see attractive foods, products, and people on social media, the most unconscious instinct is to want to ‘be like them’ — and if it’s difficult, we can develop negative feelings towards them, or about ourselves.”

“Feelings of impulsivity may be mediated by both the amygdala — or our ‘fear and aggression center’ in the brain, as well as possible dopamine dysregulation associated with addiction. All of this also drives anxiety where we feel unsettled and worried about our food and other choices,” Naidoo noted.

Tips for healthy social media use

“When navigating Instagram and other social media platforms, it is best to follow accounts that produce positive content and promote feelings of confidence and motivation surrounding your food choices,” said Avena.

“Following accounts that post negative content can be detrimental to our mental health and relationship with food.”

Avena also recommended limiting time on social media to reduce exposure to content that may cause feelings of unease.

As for content in the nutrition space, it’s advisable to view content from registered dietitians and nutrition experts who have a thorough understanding of the science behind nutrition recommendations, Avena added.

“Social media sites use cookies and other algorithms to give us more of what we tend to be seeing,” Naidoo said. “We can turn off cookies or recommended functions to prevent some of this from happening and showing up in our individual social media accounts,” she recommended.

It may also be helpful to follow trusted sources like physicians and even professional chefs on social media to help ensure you’re getting your food content from responsible creators, Naidoo said.

Takeaway

A new study shows that looking at junk food content on Instagram increases cravings for unhealthy foods and leads to feelings of stress, sadness, and exhaustion.

Experts say social media marketing can influence our desires and decisions, including what we eat. 

When considering food-related content on social media, it’s recommended to follow nutritionists and dietitians who are reputable and credentialed. 

• Bariatric surgery is an extremely effective tool for obesity.
• The procedure’s effects on various forms of cancer is not well understood.
• A new review now sheds some light on the relationship between bariatric surgery and cancer.

Bariatric surgery appears to decrease the risk of certain forms of cancer, but may increase the risk of others, according to a new scientific review. The authors say their findings underscore the need for more research on the issue before making confirmatory statements about the effects of the procedure on cancer risk.

In the fight against the obesity epidemic, bariatric surgery is one of the most effective, evidence-based treatments available. The procedure is known to improve outcomes related to numerous other health problems, including heart disease, type 2 diabetes, and high blood pressure.

Treating obesity is commonly viewed as an “upstream” way of preventing other more serious conditions later on. Since bariatric surgery is so effective for obesity, it might stand to reason that it could be effective at helping to prevent the many forms of cancer associated with obesity.

But the truth is more complicated. 

Mixed findings on bariatric surgery and cancer risk

Bariatric surgery’s association with increased cancer risk is not well established. In a review published today in JAMA Surgery, researchers found differing results for how the procedure affects different forms of cancer.

“Our review found that the quality of the studies and its findings are heterogenous and might be susceptible to bias,” said Dr. Zhi Ven Fong, a Surgical Oncologist at Mayo Clinic Arizona and author of the review told Healthline.

“The data where there has been good consistency is the reduction of breast, ovarian, and endometrial cancer risk with bariatric surgery. However, there have been concerning signals from preclinical and epidemiological studies that bariatric surgery may be associated with a higher risk of developing colorectal cancers,” he added.

However, it is important to note that the review doesn’t prove a causal link between bariatric surgery and cancer risk. Nor does it cast doubt on the overall effectiveness of bariatric surgery.

“This review makes the point that there are consistent positive associations and negative associations for certain types of cancer as they relate to bariatric surgery, and then there is a gray zone where there are conflicting results from different studies,” said Dr. Cindy Kin, an Associate Professor of Surgery at Stanford Medicine who was not involved in the research, told Healthline.

Bariatric surgery may reduce risk of breast, ovarian, and similar cancers

Researchers found that bariatric surgery had the greatest association with lowering the risk for cancers associated with hormones, including breast cancer, ovarian cancer, and endometrial cancer. In one study of nearly 7,000 patients, those who received bariatric surgery “demonstrated a significant reduction in breast cancer risk” at an average 5-year follow up period, compared with those who did not.

In what the researchers call “the largest study to date,” of more than 300,000 female patients, individuals who underwent the procedure and lower rates of breast, endometrial, and ovarian cancer.

Scientists believe that the mechanisms for how bariatric surgery affects these cancers has to do with the role of how fat, adipose tissue, affects hormones in the body, like estrogen and insulin. Adipose tissue produces excess estrogen, which is associated with the above-mentioned cancers.

Obese individuals also tend to have more insulin in their bodies, which can also lead to the development of certain cancers.

Leptin, a hormone that is key to metabolism, reproduction, and satiety, is produced in fat cells. However, when it is produced in abundance due to obesity, it too can lead to “aberrant cell proliferation” then cancer.

Conflicting findings on other forms of cancer

The relationship between bariatric surgery and other forms of cancer is far less obvious. Historically, esophageal and gastric cancer were believed to be at increased risk due to their physical effects on the digestive tract and the potential to exacerbate acid reflux. 

However, the review found that this was not the case: cancer risk was actually similar or slightly improved.

Findings on pancreas and liver cancer were inconsistent.

For colorectal cancer, results were, again, mixed. But the authors note two studies in which colorectal cancer found an increased risk following bariatric surgery.

“Given the potential increased risk of colorectal cancers, caution should be exercised when considering bariatric surgery in patients with increased baseline risk of colorectal cancers such as those with inflammatory bowel disease,” said Fong.

Other experts interviewed by Healthline pushed back on these findings.

“This association of increased incidence of colorectal cancer would not trump all the benefits that are actually causally linked to bariatric surgery.  For patients who meet the standard criteria for bariatric surgery, the potential benefits of the surgery outweigh the risks,” said Kin.

Dr. Dan Azagury, section chief of Minimally Invasive and Bariatric Surgery and medical director for the Bariatric and Metabolic Interdisciplinary clinic at Stanford Health was also cautious about the findings.

“We should be very careful about drawing too strong conclusions on the topic of colorectal cancer: as the authors mention, the data is very contradictory,” he said.

The 13 obesity-related cancers

Obesity is a comorbidity for many serious health conditions, including diabetes, high blood pressure, and heart disease. It is also associated with an increased risk of 13 different forms of cancer including:

• Breast
• Kidney
• Ovarian
• Pancreatic
• Colorectal
• Liver

Bariatric surgery, sometimes called “weight loss surgery”, modifies the digestive system to reduce the amount of food a patient consumes and helps them feel more full. There are several procedures, such as a gastric sleeve and gastric bypass, that all fall under the name bariatric surgery, but there are others as well.

These procedures are only recommended for those who have class III obesity (a BMI of 40+) or class II obesity (a BMI of 35+) and at least one comorbidity, such as high blood pressure or diabetes.

Bariatric surgery has demonstrated weight loss as much as 77% of body weight. Patients also tend to keep the weight off, averaging 50% of weight loss at five years after the initial operation.

As with any major healthcare decision, patients should discuss the risks and benefits of bariatric surgery with their healthcare provider.

“Healthcare providers should include the potential associations with increased or decreased cancer risk in their discussions with patients as part of the shared decision-making process. Only about 1% of patients who are eligible for bariatric surgery actually undergo the operation, so clearly there is an opportunity here to improve education and counseling for patients with obesity regarding their options,” said Kin.

The bottom line

For many forms of cancer, including liver, pancreas, gastric, and esophageal, the effects of bariatric surgery are unclear, heterogenous, or inconclusive. 

There appears to be a strong association between bariatric surgery and decreased risk of hormone-related cancers including breast, endometrial, and ovarian.

Some studies have indicated an increased risk of colorectal cancer after bariatric surgery, however others did not. 

Experts agree that for the appropriate candidate, bariatric surgery’s health benefits far outweigh the risks.

• A new study shows consuming up to three servings of kimchi each day is linked to a lower rate of obesity among men.
• As an observational study, it’s difficult to know kimchi’s specific impact on weight loss.
• Health benefits of kimchi include being high in antioxidants, the ability to improve gut health, reduce inflammation, and boost immunity.
• To incorporate more kimchi into your diet, you can add it as a topping to many dishes you already like to add some spice or crunch.

Eating up to three daily servings of kimchi could reduce men’s risk of obesity. Also, radish kimchi is associated with a lower prevalence of abdominal obesity in both men and women, according to a new study.

The findings were published in the journal, BMJ Open.

Researchers looked at data from the Health Examinees (HEXA) study, which included 115,726 participants (36,756 men, 78,970 women who were 51 years old, on average). HEXA examines environmental and genetic risk factors for chronic health conditions among Korean adults over 40.

Participants answered a 106-item food frequency questionnaire, sharing how frequently they ate certain foods, from never to 3 times a day. Height, weight and waist circumference were also measured.

Results showed consuming as many as 3 daily servings of total kimchi was associated with an 11% lower prevalence of obesity compared with less than 1 daily serving.

For men, 3 or more daily servings of baechu kimchi was linked to a 10% decreased prevalence of obesity and a 10% decreased prevalence of abdominal obesity compared to 1 serving. 

For women, 2 to 3 daily servings of baechu kimchi (napa cabbage kimchi) was linked to an 8% decreased prevalence of obesity, whereas 1 to 2 servings each day was linked with a 6% lower prevalence of abdominal obesity. 

In addition, consuming below-average quantities of kkakdugi kimchi (cubed radish kimchi) was associated with approximately a 9% lower likelihood of obesity in both men and women. 

Kimchi and obesity risk

“This is an observational study, so it doesn’t show that eating kimchi causes a reduction in obesity risk,” Samantha Cassetty, MS, RD, nutrition and wellness expert and co-author of Sugar Shock. “But it suggests a link between the two, which raises the possibility. It’s in line with previous research with similar findings–that kimchi intake is associated with a lower risk of obesity and may help reduce body weight and waist size. That said, the study was limited to Korean participants, so the association between kimchi and protection against obesity might not hold up in other populations.”

Cassetty continued: “If you want to try this, it’s healthy for most people, however, kimchi is high in sodium, and most people are already overdoing. So, find ways to reduce the sodium in your diet by replacing ultra-processed foods with whole foods–especially plant foods, which contain potassium that helps counter the effects of sodium.”

It’s also notable that in this study, just eating more kimchi was not necessarily linked to a smaller waistline.

“The authors note this may be because of how kimchi is often eaten–with rice,” Cassetty stated. “So, higher intakes might come with eating more in general, particularly more ultra-processed foods, which are also linked with higher rates of obesity.”

Since this is an observational study, it’s hard to know the extent of the role kimchi played in weight loss. There are numerous factors to take into consideration including overall diet and lifestyle.

“Kimchi is made from pickled cabbage and cabbage is a healthy cruciferous vegetable that has fiber, Vitamin C and Vitamin K,” said Natalie Rizzo, MS, RD, author of Planted Performance. “Kimchi is made by fermenting cabbage, which means it has ‘good’ bacteria, or probiotics. The authors of this study hypothesize that the bacteria strains in kimchi aid in weight loss, but since it’s an [observational] study, there’s no way to know if the weight loss is from those bacteria strains or something else.”

Furthermore, “kimchi is a low-calorie food, and eating it may help you reduce your calorie intake and lead to weight loss. Since it’s rich in fiber, it may help keep you full without adding many calories to a meal,” Rizzo added.

Health benefits of kimchi

Fermented foods like kimchi are rich in gut-nourishing bacteria that promote the growth of beneficial organisms in your gut microbiome. This ecosystem plays a part in regulating numerous bodily functions–from mood and weight to cholesterol and blood pressure levels to inflammation and immune functioning, Cassetty explained.

Eating kimchi can help create a healthy balance of gut bacteria, allowing the good bacteria thrive while getting rid of the bad bacteria. 

“Because of its role in your gut microbiome, kimchi may promote better gut and heart health,” said Cassetty. “Kimchi is also being studied for its potential role in supporting brain health and preserving memory. Your enteric nervous system is located in the gut, so what’s good for the gut is also good for your brain. It’s all connected.”

Kimchi also has antioxidant properties that contribute to its health benefits. 

“Antioxidants help stabilize damaged cells that initiate diseases like cancer and heart disease,” Cassetty noted. “So, upping your antioxidant status can help protect you from developing chronic conditions.”

The probiotic properties of kimchi might also help treat yeast infections. 

“We also see that kimchi might help protect against obesity,” said Cassetty. “Besides contributing beneficial bacteria to your gut, kimchi is a low-calorie way to add spice to meals. When your meals are flavorful and enjoyable, and you eat mindfully, it’s easier to eat healthier portion sizes, which can help you manage your weight without feeling deprived.”

However, it’s also important to consider that kimchi is high in sodium, and most people are already overdoing this. So, if you’re thinking about adding kimchi to your diet, cut back on sodium elsewhere by choosing whole foods over heavily processed ones and limiting the use of salt in your kitchen, Cassetty added.

Healthy ways to incorporate kimchi into your diet

“Many people are unfamiliar with kimchi, but you don’t have to branch out of your comfort zone to try it,” Cassetty stated. “Kimchi is a great way to add a kick to familiar foods like turkey burgers, eggs, whole grain bowls (such as brown rice or quinoa bowls), and roasted veggies. You can also try it as a sandwich condiment.”

Rizzo recommends adding kimchi to any food that needs a little crunch. “Top a stir fry or grain bowl with kimchi. Add it to a sandwich for a spicy crunch. You can even top your eggs with kimchi to add texture and crunchiness,” she said.

Takeaway

Eating up to three servings of kimchi each day is linked to a reduced rate of obesity among men, according to a new study.

This study is observational so it’s difficult to measure kimchi’s direct effect on weight loss. Overall diet and lifestyle also play a role.

There are many health benefits of kimchi such as promoting gut health, lowering inflammation and improving immunity.

To add more kimchi to your diet, it can be used as a tasty topping for many meals.

• RSV is a common and highly contagious respiratory virus that can cause infections ranging from mild to severe.
• It can lead to bronchiolitis, pneumonia, respiratory failure, and death in some cases.
• Pregnant people can get the RSV vaccine late in their pregnancy to provide protection for their infants after they are born.

Hospitalizations for respiratory syncytial virus (RSV) surged during the holiday season and remain high in the new year — with young infants hit particularly hard by RSV-related illness.

RSV is a common and highly contagious respiratory virus that can cause infections ranging from mild to severe. It can lead to bronchiolitis, pneumonia, respiratory failure, and death in some cases.

“RSV usually causes mild cold-like symptoms in adults, [but] it can be severe and lead to hospitalization in infants and older adults,” Dr. Adi Katz, Director of Obstetrics and Gynecology at Northwell Lenox Hill Hospital in New York City, told Healthline.

“It is estimated to result in 6,000–10,000 deaths among seniors and 100–300 deaths among children younger than 5 [years old] annually [in the United States]. During the 2022–23 season, children were hospitalized with RSV-related illness at an overall rate of 605.6 per 100,000, more than 10 times the rate of the general population,” Katz said.

To help protect young infants from RSV illness, the U.S. Centers for Disease Control and Prevention (CDC) encourages people who are 32–36 weeks pregnant during RSV season to get a single dose of Pfizer’s bivalent RSVpreF vaccine (Abrysvo). This is sometimes known as the maternal RSV vaccine.

“The take home message is that this [vaccination] is a simple step that a pregnant individual can take to protect their newborn baby,” said Katz. “It can be a life saving measure.”

How the RSV vaccine can provide key protection for newborns

The U.S. Food and Drug Administration (FDA) approved the Abrysvo vaccine for pregnant people in August 202, after researchers found it was safe and effective for preventing lower respiratory tract infections in newborns.

“We now have an RSV vaccine that can prevent serious RSV infection in infants when received during pregnancy,” Dr. Jennifer Thompson, FACOG, an associate professor in the Division of Maternal-Fetal Medicine at Vanderbilt University Medical Center told Healthline.

“By receiving the RSV vaccine during pregnancy, maternal antibodies cross the placenta and provide protection to the newborn. These antibodies help prevent the development of severe RSV lower respiratory tract infection in infants up to 6 months of age,” Thompson said.

The vaccine is made from an inactivated protein from the surface of RSV, known as the fusion glycoprotein, or protein F.

When the vaccine is given to a pregnant person, their immune system responds by producing antibodies against protein F. This allows their immune system to recognize and attack RSV if it encounters the virus later on.

It takes about 2 weeks for the pregnant person’s immune system to produce antibodies following vaccination.

The pregnant person passes the antibodies onto the developing fetus across the placenta, which provides protection against RSV that continues for at least 6 months after birth.

Reducing the risk of severe illness in infants

It’s still possible for infants to contract RSV after their birthing parent has received the Abrysvo vaccine in pregnancy. However, the vaccine significantly reduces the newborn infant’s risk of developing RSV infection in general and severe RSV infection mainly.

Researchers found that when pregnant people received the Abrysvo vaccine during weeks 32–36 of pregnancy, it reduced their baby’s risk of lower respiratory tract disease from RSV by 34.7% within 90 days following birth and 57.3% within 180 days after birth.

The vaccine provided even greater protection against severe lower respiratory tract disease, lowering the risk by 91.1% within 90 days after birth and 76.5% within 180 days after birth.

“RSV can be such a devastating disease for some families,” said Thompson, “and to now have a vaccine to offer patients that is safe and effective at preventing severe RSV in infants is wonderful.”

Low risk of severe side effects

The risk of serious side effects from the Abrysvo vaccine is low. Most side effects are mild and short-lasting.

“The main side effects that have been reported are similar to other vaccines and include pain at the injection site, headaches, and muscle pain,” said Thompson.

Researchers found the rate of preeclampsia was slightly higher among pregnant people who received the vaccine: 1.8% of those who received the vaccine in a clinical trial developed preeclampsia, compared with 1.4% of pregnant people who received the placebo. The overall rate of preeclampsia remained low.

Researchers also found the rate of preterm birth was slightly higher among pregnant people who received the vaccine (5.7%, compared with those who received a placebo (4.7%). However, they could not determine whether this difference was caused by the vaccine or something else.

The FDA has taken steps to manage the potential risk of preterm birth by approving the Abrysvo vaccine for only those pregnant people who are 32–36 weeks pregnant.

People who have a history of severe allergic reactions to any component of the vaccine shouldn’t receive it. Severe allergic reactions to vaccines are rare.

Taking steps to prevent infection

Pregnant people can speak with their obstetrician to learn more about the potential benefits and risks of getting the RSV vaccine or other immunizations during pregnancy.

Abrysvo is specifically recommended for people who are 32–36 weeks pregnant during RSV season, which lasts from September through January across much of the United States but may vary in some regions. Speak with your doctor if you live in Alaska, Florida, or outside the continental United States to learn about the timing of RSV season in your region.

If you recently gave birth and didn’t receive the Abrysvo vaccine at least 2 weeks before delivery, talk with your doctor to learn whether your baby should receive immunization against RSV with the monoclonal antibody nirsevimab (Beyfortus).

Beyfortus can lower the risk of serious RSV infection among infants, but it’s available in the United States only in limited supplies. It may be given to an infant as a single injection shortly before or during their first RSV season — and in some cases, shortly before their second RSV season.

Most babies who are born to a birthing parent who received the Abrysvo vaccine at least 2 weeks before delivery don’t require immunization with Beyfortus later on.

But some babies with high risk factors for severe infection may benefit from immunization from Beyfortus, even if their birthing parent did receive the Abrysvo vaccine.

This includes certain infants who:

• were born prematurely and have chronic lung disease
• have cystic fibrosis with severe disease
• have severe immunocompromise
• are American Indian or Alaska Native

A physician may also recommend immunization with the monoclonal antibody palivizumab (Synagis) in rare cases. This immunization is only given to children under the age of 24 months who have certain health conditions that raise their risk of severe RSV disease.

Limiting contact with people who are sick, washing hands regularly with soap and water or alcohol-based hand cleanser, and wearing face masks in public may also help prevent RSV or other respiratory infections.

Talk with your doctor to learn more about strategies to prevent and manage RSV infections.

Takeaway

To help protect young infants from RSV illness, the CDC encourages people who are 32–36 weeks pregnant during RSV season to get a single dose of Pfizer’s bivalent RSVpreF vaccine (Abrysvo). This is sometimes known as the maternal RSV vaccine.

• This month the FDA has approved a treatment for an inherited blood disorder.
• The Casgevy treatment was developed through CRISPR gene-editing technology and involves modifying a person’s own blood stem cells and then transplanting them back.
• The treatment can now be used for a type of blood disorder that results in anemia.

After an initial approval in December of the cell-based gene therapy Casgevy for sickle-cell disease (SCD), the U.S. Food and Drug Administration last week approved the therapy to treat another blood disorder.

The FDA approved the therapy to treat a condition called transfusion-dependent beta-thalassemia (TDT), an inherited blood disorder that results in anemia and frequent blood transfusions.

Casgevy, a treatment developed through CRISPR gene-editing technology, involves modifying a person’s own blood stem cells and then transplanting them back. Those altered cells then attach and multiply in the person’s bone marrow and facilitate the production of fetal hemoglobin, which can help with oxygen delivery. This approval makes the treatment the first of its kind for TDT.

“Today’s approval is an important step in the advancement of an additional treatment option for individuals with beta-thalassemia, a debilitating disease that places individuals at risk of many serious health problems,” said Dr. Nicole Verdun, director of the Office of Therapeutic Products within the FDA’s Center for Biologics Evaluation and Research. “The approval of a cell-based gene therapy for this condition using CRISPR/Cas9 technology reflects FDA’s continued commitment to supporting safe and effective treatments that leverage the most promising and cutting-edge medical technologies.”

What’s the difference between sickle cell disease and TDT?

Sickle cell disease, also known as sickle cell anemia, is a genetic disease in which red blood cells have an abnormal crescent shape — hence the “sickle” part of the name. This makes them sticky and unable to bend, meaning they can get trapped in small vessels and block the flow of blood to different parts of the body. This can result in debilitating pain episodes and organ damage.

Symptoms of sickle cell anemia may appear in babies as early as 4 months old, but generally occur around the 6-month mark.

Symptoms include:

• excessive fatigue or irritability, from anemia
• fussiness, in babies
• bedwetting, from associated kidney problems
• jaundice, which is yellowing of the eyes and skin
• swelling and pain in hands and feet
• frequent infections
• pain in the chest, back, arms, or legs

Transfusion-dependent beta-thalassemia, also known as beta thalassemia major, is one of three variations of beta-thalassemia. At least 100,000 people globally have the disease, with an estimated 1,200 in the United States, according to the Boston Children’s Hospital. It manifests in genetic mutations that reduce hemoglobin production, which results in lifelong anemia and a series of other complications, Dr. Sonali Chaudhury, the section head for the Stem Cell Transplantation and Cellular therapy Program at the Ann & Robert H. Lurie Children’s Hospital of Chicago, told Heathline.

“It manifests clinically as jaundice, growth retardation, hepatosplenomegaly, endocrine abnormalities, and severe anemia requiring life-long blood transfusions. Life-long transfusions also result in iron overload,” said Chaudhury.

Before this new gene therapy the treatment for the condition was a stem cell transplant or supportive care.

What are the advantages of Casgevy?

Casgevy, which will be produced by Vertex Pharmaceuticals and administered via authorized treatment centers, should be available to patients 12 years and older early this year.

With this cell therapy there is greater potential for a person to be cured for TDT and SCD with less short- and long-term side effects compared to a stem cell transplant.

And stem cell transplants that would have been stymied or delayed by a wait for appropriate donors can now be accelerated by using a person’s own cells through Casgevy, Chaudhury said.

“Before these therapies, the only available curative therapy was allogeneic stem cell transplant, which may have complications and was not accessible to all due to lack of appropriate donors,” Chaudhury said.

What are any potential drawbacks of Casgevy?

Chaudhury explained that some short- and long-term toxicities can occur with this treatment, which can result in nausea/vomiting, mucositis, risk for infections, hair loss, liver toxicity, pulmonary toxicity and infertility. And the cost — Vertex has listed it at $2.2 million for a single course of treatment — will likely create some significant issues with access for people who need it.

“The product is very expensive and will be accessible only to patients with insurance benefits. Will be cost prohibitive and likely inaccessible to patients in low income/low resource countries,” Chaudhury said, adding that there are also potential issues that could stem from other medical conditions. “Casgevy has not yet been tested in patients with stroke and neurological involvement in SCD or patients with TDT with severe iron overload with liver damage.”

Takeaway

Casgevy, a new gene-editing therapy for blood disorders, has been approved as a treatment for sickle cell disease and transfusion-dependent beta-thalassemia.

The potential for curing these two blood disorders, which can result in frequent blood transfusions and lifelong anemia, is enormous.

But the cost of a single course of treatment — $2.2 million — ultimately raises questions about accessibility.

• Researchers have found that mood interventions can help reduce inflammation.
• Mood interventions include such things as psychotherapy and antidepressants.
• In people with IBD, levels of inflammatory biomarkers were reduced by 18%.
• Experts say they could help because there is a link between the gut and the brain.
• Mood interventions could provide a cost-effective treatment alternative for IBD.

According to research published on January 24, 2024, in eBioMedicine, interventions that improved mood also brought down inflammation in people with inflammatory bowel disease by 18%.

Inflammatory bowel disease (IBD) is an umbrella term including the autoimmune conditions Crohn’s disease and ulcerative colitis.

Both conditions involve chronic inflammation of the gastrointestinal tract, eventually leading to damage.

Symptoms include bloody stools, diarrhea, fatigue, pain, and weight loss.

Treatment for IBD currently involves medications, surgery, and various diet and lifestyle changes.

However, the researchers at the Institute of Psychiatry, Psychology & Neuroscience at King’s College London believe that mood interventions could provide a cost-effective alternative to these treatments.

Mood interventions linked to reduced inflammation in IBD

The systematic review and meta-analysis included 28 randomized controlled trials involving more than 1,700 people. The studies examined were related to cases where people with IBD were treated with some sort of mood intervention.

Dr. Garry Spink, a pain psychologist in Liverpool, New York, who was not involved in the study, explained that mood interventions are treatments that focus on addressing underlying psychological and sociological factors that impact mood.

Some of the types of interventions that the researchers looked at included psychotherapy, antidepressants, and exercise.

The studies selected for analysis also provided measures for inflammatory biomarkers such as C-reactive protein and fecal calprotectin.

The team found that psychotherapy performed better than antidepressants and exercise. Cognitive behavioral therapy, acceptance and commitment therapy, and mindfulness-based stress reduction were the most effective forms of psychotherapy.

Additionally, the more the treatments improved mood, the more they also improved levels of inflammatory biomarkers.

The scientists said these findings suggest that treatments that improve mood are capable of treating inflammation in IBD as well as inflammation in general.

Why mood interventions might help reduce inflammation

Spink said the short answer as to why mood interventions appear to be beneficial in inflammatory diseases like IBD lies in the mind-body connection.

“In short, our minds and bodies are connected and influence each other,” he explained. “So, the way you view a situation, the behaviors you engage in, and how you perceive your environment influences your body’s reaction and your experience of that environment.”

Spink went on to discuss how increasing depression leads to changes in the immune system, which affects levels of inflammatory markers, which, in turn, leads to high levels of inflammation. 

“More specifically related to inflammatory bowel disease, there is a gut-brain connection that is composed of a large number of neural connections from the gut and the brain that communicate both ways,” he added.

“Thus, the gut can affect your mood, and your mood can affect your gut. That is why we sometimes feel ‘sick to our stomachs’ when stressed.”

Spink further explained that this two-way communication plays an important role in directing resources away from the gut in times of stress when we might need them to deal with a threat in our environment.

Melanie Murphy Richter, MS, RDN, who is a Registered Dietitian Nutritionist as well as the Director of Communications and a Medical Science Educator for Prolon, added that any sort of stress, whether real or perceived, is enough to affect the gut lining.

“When stress goes unmodulated, over time, it will cause an imbalance in our gut flora, cultivating a friendly environment for pathogenic (harmful) fungi like yeast and mold to live and grow,” she stated.

“The overgrowth of these microbes can also lead to gut inflammation and can also be a root cause of IBD.”

Implications of these findings for the future

“More and more practitioners are finding that by focusing on improving mood and mental health, we can significantly reduce inflammatory biomarkers and even CRP levels, a measure of inflammation in the body,” said Richter.

“Other research is diving into the impact of mindfulness practices like meditation on the reduction of inflammation and disease.”

Richter added that mood interventions are “incredibly important” when it comes to managing inflammatory conditions like IBD.

“Even if future research finds that these interventions are only moderately helpful in reducing inflammation and disease progression, the positive impact they play on a person’s outlook on their health conditions and state of life is worth the time and energy spent pursuing them,” she concluded.

The study authors additionally note that IBD medications can be quite expensive, whereas mood interventions, in particular psychotherapy, tend to be relatively affordable. They believe that mood interventions may help make treatment for IBD less expensive as well as more effective.

Takeaway

Researchers have found that mood interventions — including psychotherapy, antidepressants, and exercise — can help reduce the inflammation associated with IBD by 18%.

This might be because there is two-way communication between the gut and brain, allowing resources to be directed away from the gut in times of stress when we need to be able to respond to threats.

In the future, mood interventions could be a less expensive alternative to the medications currently used to treat IBD.

• Walking has long been recommended to improve physical and mental health outcomes.
• Traditionally, people put one foot in front of the other. However, a new TikTok trend shows people gravitating toward walking backward.
• Experts say that walking backward activates different muscle groups and even works the mind in other ways, giving way to potential health benefits. 

Racking up millions of views on TikTok is a new fitness trend that’s not-so-new: walking backward.

Simply walking is a commonly recommended way to get exercise that has several health benefits and can aid with weight loss.

For instance, a 2023 meta-analysis indicated that walking 2,337 steps daily could decrease a person’s risk of dying from cardiovascular disease, and 4,000 steps could lower the chances of all-cause mortality. 

In all likelihood, the participants in these studies mostly walked forward. Yet, head over to TikTok and search “walking backward,” and you’ll see videos that have already been viewed a combined 24 million times.

However, research shows this trend may actually have some health benefits, too.

“Movement is healthy for a person,” says Dr. Peter Morelli, MD, a pediatric cardiologist and medical director of the Fit Kids for Life Program at Stony Brook Children’s Hospital. “Walking backward is a way to mix it up and cross-train in a sense. Anything like that is always a positive thing.”

In addition to Morelli, Healthline spoke with two certified personal trainers who discussed walking backward, why it’s trending, the potential benefits, and how to do it safely.

Exactly what is the walking backward trend on TikTok?

This one is pretty straightforward.

“Walking backward is generally exactly as it sounds,” says Rebecca Stewart, CPT, a personal trainer and the founder of MovementFX. “Most viral TikToks show backward walking on a treadmill, but it can be done on a path or outdoors, too.”

Walking backward, also called “retrowalking,” isn’t new.

Coaches and physical therapists have used backward training as a means for cross-training and rehabilitation since before the rise of TikTok. However, experts credit the platform for its newfound popularity.

“It’s not just another run-of-the-mill exercise — it’s something that makes you stand out, which is a big deal on social media platforms like TikTok where unique and eye-catching content is king,” says Mike Julom, ACE, CPT, the founder of ThisIsWhyImFit.com.

Potential benefits of walking backward

Typically, taking steps back (figuratively speaking) has a negative connotation. Yet, walking backward stands out to professionals for another reason that has nothing to do with its TikTok-friendliness: It could have some benefits, primarily because of the additional muscles you need to engage in order to perform the movement.

Experts share that benefits of walking can include improvements in:

• Strength 
• Cardiopulmonary fitness and health
• Posture
• Balance 
• Coordination
• Pain, specifically in the back and knee
• Mobility
• Mental well-being
• Focus and cognition

Fitness improvements

Because walking backward puts more emphasis on the quads than walking forward, Julom says adding it to a fitness routine for strength-building purposes might be beneficial.

“Strengthening [quad] muscles can lead to better overall leg strength and can be especially helpful for people recovering from certain types of knee injuries,” Julom says.

The quads aren’t the only ones getting a workout.

“Your calves and ankle muscles get a better workout, too, as they work harder to stabilize your steps,” Julom says. “Plus, your core muscles, including your abs and lower back, are more actively involved in keeping you balanced and upright.”

Stewart says walking backward also requires energy.

In a small 2021 study of 20 people experiencing chronic strokes, participants walked backward on a treadmill for 30 minutes per day, three times per week, for four weeks. 

The research indicated that the potential benefits of walking backward included improved pace and cardiopulmonary fitness. Balance was a third potential perk. 

Balance and posture 

“Walking backward demands more balance and coordination because you can’t see where you’re going — it challenges your body to maintain stability,” Julom says. “It encourages you to straighten your back to maintain balance, which can help correct posture over time.”

Julom adds that this effect can benefit people who spend long periods sitting and may be more prone to slouching.

A small 2016 study of 33 people indicated that walking backward on a treadmill for 20 minutes five times weekly for four weeks could improve balance and gait control.

A systemic review and meta-analysis published in 2019 indicated that walking backward could be a tool to improve balance in individuals at high risk for falls.

Pain and injury recovery and prevention

Julom points out that regularly walking backward can boost someone’s range of motion in the knees, hips, and ankles.

“This is because walking backward forces these joints to move in ways they aren’t typically used to, which can help in loosening up and stretching out the surrounding muscles and tendons,” he says.

Additionally, it’s often gentler on the knees, especially if a person is going downhill. Julom says this aspect of walking backward makes it a solid potential option for people with knee issues. The reduced pressure on the lumbar spine might aid in back pain reduction.

A study of almost 70 people from 2019 indicated that participants who partook in a six-week retrowalking program saw a more significant reduction in knee pain (and improved quad strength) than those who walked forward.

A 2020 study of men with nonspecific chronic back pain suggested that retrowalking might be therapeutic.

Mental benefits

Walking backward is also different from walking forward because it requires more mental energy.

“New motion like that makes you think,” Morelli says. “It engages your mind, helps you focus, and there might be a mental benefit.”

Since it’s fun, a person might stick with it, providing an additional way to get steps in, Morelli says, which may also aid with weight loss.

Stewart adds that walking backward requires a person to be “more mindful” about their motions, helping them focus on the task, not stressors. Additionally, she says it can aid in cognitive function, including short-term memory.

Research published in 2019 also indicated that backward locomotions like backward walking could boost a person’s recall function.

Safety considerations and how to get started

While walking backward is generally safe, Stewart says some individuals should exercise increased caution and speak with a doctor, including people experiencing:

• vertigo
• limited mobility
• Parkinson’s disease
• balance issues

Other recommendations from the experts Healthline spoke with include:

• Choose the right space. Morelli suggests an open, empty space, like an uncrowded track. Julom suggests a self-powered treadmill that allows a person to control the belt speed and reduces the risk of bumping into something or someone.
• Start with small increments. Julom recommends trying 5 to 10 minutes per session three times a week and working up to 15 to 20 minutes at least five times a week. 
• Go slow. Stewart suggests starting with 1.0 to 2.0 as a speed setting on the treadmill with no incline.
• Maintain posture. Julom reminds people to keep their backs straight and to avoid leaning too far back or forward. “Your head should be up and your gaze slightly forward,” he says.

Takeaway

Walking backward may provide several health benefits. It activates different muscle groups than when a person steps forward — mainly the quadriceps.

Other muscles, such as those in the core, are needed to maintain balance and stability.

According to health experts, this muscle engagement might help improve fitness, strength, balance, and posture.

Additionally, experts share walking backward requires focus, which might help with cognitive function.

Research is limited, and the studies often include smaller sample sizes. Perhaps the best perk? It’s different, which might help people spice up — and stick to — a fitness regimen, which can aid with weight loss.

• A new study shows women who follow vegan diets during pregnancy may have a greater risk of developing preeclampsia and giving birth to babies with lower birth weight.
• Getting enough nutrients for the pregnant person and baby can be challenging when food choices are limited due to dietary restrictions.
•  Important nutrition considerations on plant-based diets include fruits and vegetables, complex carbohydrates, plant-based proteins, healthy fats and hydration.

Women who follow vegan diets during pregnancy could encounter an increased risk of developing preeclampsia (a pregnancy-related blood pressure condition) and of giving birth to newborns with lower birth weight, according to a new study.

The findings were published this week in Acta Obstetricia et Gynecologica Scandinavica.

How vegan and vegetarian diets are linked to health conditions

A questionnaire was given to 65,872 women mid-pregnancy who identified themselves as omnivorous, 666 as fish/poultry vegetarians, 183 as lacto/ovo vegetarians, and 18 as vegans. 

Results showed that protein consumption was lower among lacto/ovo vegetarians (13.3%) and vegans (10.4%) than omnivorous participants (15.4%). In addition, micronutrient consumption was lower among vegans.

Vegan mothers showed a higher incidence of preeclampsia and their newborns weighed an average of 240g less.

“It is a large cohort study, and our finding that offspring of vegan mothers had on average 240 g lower birth weight compared to omnivorous and a significantly lower birthweight z-score is noteworthy,” corresponding author, Dr. Signe Hedegaard, Department of Obstetrics and Gynecology, University of Copenhagen in Denmark, told Healthline. “We found that vegetarian and especially vegan mothers had substantially lower protein intake than omnivores, and for around half of our vegan participants it was below the current recommendation.”

Hedegaard continued: “This might be a plausible explanation for lower birth weight, but we are aware that this cannot be concluded from an observational study. For micronutrients dietary intake of vitamin B12, vitamin D, and calcium were lower among those adhering to plant-based diets, but when intake from dietary supplements was added to the dietary contribution, the median intake of all vitamins and minerals was well above the recommended nutrient intake for most participants, independent of their diet.”

Although the number of vegans is very small, and that data was collected 20 years ago and may reflect different habits compared to those following vegan diets today, their findings on lower birth weight among infants born to mothers adhering to plant-based diets are consistent with more recent studies. 

“The low intake of proteins and other micronutrients is in line with what has been reported in other more recent studies of vegan populations,” said Hedegaard. 

It’s important to note that meeting protein requirements while maintaining a vegetarian and vegan diet can be difficult.

“Moving forward we must be aware that for pregnant women adherent to vegetarian and vegan diet obtaining sufficient protein intake can be a challenge,” Hedegaard explained. “During pregnancy and the period of breastfeeding they should be advised of having an adequate protein intake and consider appropriate vitamin supplements; especially vitamin D and vitamin B12. It might be recommended to consult a dietician, for individualized guidance.”

Further research is needed for improving evidence-based guidelines and recommendations. Due to environmental as well as animal welfare concerns there is a growing interest in a plant-based diet, and therefore this is relevant.

How a vegan diet affects pregnancy

As the study mentioned, pregnant people who follow vegan diets may face an increased risk of developing preeclampsia and of giving birth to newborns with lower birth weight.

“These characteristics may coexist for one pregnant individual, but they may not be causal (or directly related to one another),” Joy Cornthwaite, a registered dietician specializing in women’s care at UTHealth Houston, stated. “Preeclampsia has many possible causes including placenta proteins that control the health of existing and newly formed blood vessels, genetics, age at pregnancy, history of chronic hypertension, obesity, and/or nutritional deficiencies.”

Being an observational study, this research cannot prove causation but rather a potential association between a vegan diet and preeclampsia or lower birth weight. More research is needed to determine if there is a causal relationship

Moreover, research on plant-based diets have shown improvement in many of the risk factors that may contribute to preeclampsia. 

“The key to optimizing the benefits of plant-based diets, especially vegan diets, is to structure meal options and eating routines to achieve nutrient-dense intake and to appropriately plan and monitor micronutrient supplementation – both during and after pregnancy,” said Cornthwaite.

The contribution of dietary restrictions to nutrition deficiencies and nutrients is not singular to veganism.  

Any dietary restriction can pose a risk to the health of pregnant people and their babies, i.e. iron is necessary for oxygenation; calcium is vital to bone and blood vessel health, Cornthwaite explained.  Because their diet does not include traditionally known sources of calcium like milk and other dairy products, vegans must remain consistently intentional about choosing plant sources of calcium and/or taking supplements daily. 

Regarding birth weight, the study indicated that babies in the study born to vegan mothers were 240g smaller than other study participants.  

“This amounts to less than half of a pound and still remains in line with average weight for babies,” said Cornthwaite. “Again, birth weight is influenced by many factors including maternal weight and genetics. Ultrasounds and regular prenatal visits allow Obstetricians to determine and personalize what weight gain is appropriate for their patient and track trends for fetal weight gain.”

Vegan mothers had a higher prevalence of preeclampsia

Achieving adequate intake of nutrients during ever-changing appetite, tastes, and aversions is more difficult when food choices are limited due to dietary restrictions, Cornthwaite explained. This could result in lower opportunities for intake, lower frequency if intake – which limits calorie intake and nutrients; and limits maternal and fetal weight gain. 

“All pregnant mothers can benefit from assessment and supportive nutrition counseling. Oftentimes vegan and vegetarian mothers are not referred to an RD because plant-based diets are assumed to be more healthful, but something as small as a plan for one additional low volume, nutrient dense snack at 3pm, i.e. dried apples + nuts/seeds + almond milk, can contribute valuable calories and nutrition for mothers and babies,” Cornthwaite added.

Is one diet better than another for pregnancy?

The researchers studied four diet types:  fish/poultry vegetarians,  lacto/ovo vegetarians, vegans and omnivores.

“Food culture and choice is highly personal,” said Cornthwaite. “The diet that is most appropriate for a pregnant person is the diet that they choose to consume, optimized for pregnancy. This can be achieved with the help of a Registered Dietitian who will work closely with the pregnant mother and her physician to assess intake and develop a meal plan that address any challenges to achieving adequate macro and micronutrient goals based on individual needs.”

General diet recommendations for pregnant people and their newborns 

Ask for a referral to a registered dietitian to assess the current intake. 

“Meal plans that may be sufficient for a non-pregnant person will not be sufficient for pregnancy,” Cornthwaite stated. “Pregnant mothers are often prescribed prenatal vitamins and whenever indicated, through pregnancy labs, may be prescribed additional supplements.”

Pregnancy can also mark the beginning of food sensitivities and/or aversions. An RD can assist with personalizing substitutions that decrease nausea or other discomforts like reflux or fatigue, Cornthwaite explained. 

Scheduling follow-up visits with your RD for the duration of pregnancy (and post-partum) will allow proactive discussions around taste and appetite changes to prevent deficiencies, maintain health for mother and baby, and may prevent nutrition-related complications.

“Every pregnant person should feel supported and safe to discuss her personal beliefs, culture, and needs around food. I often begin to work with mothers by encouraging a self-assessment of intake based on a plant-based plate method – no judgement, just establishing a baseline,” said Cornthwaite. “This allows the pregnant mother to identify areas and options for improvement and to practice shared decision-making when having conversations with her clinical team.”

She explained, that important nutrition considerations on plant-based diets can be grouped by food and nutrient sources: 

• Fruit and Vegetables – valuable sources of water-soluble vitamins, sources of hydration, calcium, magnesium, potassium, and other blood pressure-improving nutrients, as well as protein. 

• Complex carbohydrates for fiber and energy.  
• Dairy substitutes for calcium.
• Plant-based proteins like beans and legumes
• Healthy fats
• Hydration

Takeaway

Women who follow vegan diets during pregnancy may have a greater risk of developing preeclampsia and giving birth to babies with lower birth weight, a new study showed.

Meeting proper nutrient requirements for the pregnant person and baby can be hard if dietary restrictions are too strict. However, it is important to note that the diet is not the problem, but the ability to maximize the benefits of a plant-based diet.

While diet is a personal choice, there are certain nutrition guidelines on plant-based diets that should be taken into consideration. That includes eating fruits and vegetables, complex carbohydrates, plant-based proteins, healthy fats and staying hydrated.