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A new study from a team led by researchers at the Johns Hopkins Bloomberg School of Public Health found that signs of common infections in a sample of middle-aged and older adults were associated with poorer performance on a test of global cognitive function.
The results add to a growing body of evidence suggesting that infections in mid- and late-life can worsen cognitive performance and may increase the risk of Alzheimer’s disease and other dementias.
For their analysis, the researchers examined antibody levels to five common pathogens in 575 adults, ages 41 to 97. The adults were recruited from East Baltimore in 1981, as part of the Epidemiologic Catchment Area Study started that year by the National Institute of Mental Health. Baltimore study participants donated blood for testing and took cognitive tests during the same study period. Antibody tests for pathogens were conducted, including four herpes viruses — herpes simplex virus type 1, cytomegalovirus, varicella zoster virus (chickenpox and shingles viruses), and Epstein-Barr virus — and the parasite Toxoplasma gondii. The latter often spreads to humans from cat feces or from eating undercooked meat.
The research team compared participants’ blood test results to their performance on the Mini-Mental State Examination — a global cognitive test that assesses things like orientation, attention, verbal comprehension, memory, and visual perception — and on a word recall task, which tested memory for a list of words after a 20-minute delay. The researchers found that elevated antibodies to either herpes simplex virus type 1 or cytomegalovirus were individually associated with worse performance on the global cognitive test. Further, participants with a higher number of positive antibody tests tended to miss a larger number of items on the global cognition test.
The study was published online April 7 in the journal Alzheimer’s & Dementia.
“The idea that common infections could contribute to cognitive decline and perhaps Alzheimer’s disease risk was once on the fringe and remains controversial, but due to findings like the ones from this study, it’s starting to get more mainstream attention,” says senior author Adam Spira, PhD, professor in the Bloomberg School’s Department of Mental Health and a core faculty member of the Johns Hopkins Center on Aging and Health. “After accounting for participants’ age, sex, race, and the largest genetic risk factor for Alzheimer’s disease, the data in our study showed that a greater number of positive antibody tests related to five different infections was associated with poorer cognitive performance. To our knowledge, this kind of additive effect of multiple infections on performance on a cognitive test has not been shown before.”
The cause of Alzheimer’s disease remains unclear. Prior research has made the connection with infections, including studies linking herpes simplex virus type 1 and cytomegalovirus to greater Alzheimer’s risk. There is also evidence that the protein fragment amyloid beta, which forms insoluble plaques in the brains of people with Alzheimer’s, functions as an antimicrobial peptide, and is secreted at higher levels by brain cells in response to infections.

Since the 2003-2004 wave, ECA study researchers at Johns Hopkins have conducted periodic follow-up interviews in Baltimore, including standard cognitive tests and taking blood samples. The two most recent waves of the study, funded by the National Institute on Aging, have focused on Alzheimer’s disease and related outcomes.
The pathogens assessed in the study are often encountered in childhood and are either cleared or turned into suppressed, latent infections. As such, the researchers considered significant levels of antibodies against them in the middle-aged and older study participants as likely indicators of their reactivation due to immune system weakening with age.
The study’s first author, Alexandra Wennberg, PhD, who completed her doctoral training in Spira’s research group, is currently a postdoctoral research associate at Sweden’s Karolinska Institutet. The co-authors include faculty in the Johns Hopkins School of Medicine and collaborating scientists at the National Institute on Aging Intramural Research Program.
Co-author Brion Maher, PhD, a geneticist and professor in the Bloomberg School’s Department of Mental Health, also analyzed the results for participants who had a common Alzheimer’s risk factor, the Ɛ4 variant of the apolipoprotein-E (ApoE) gene. The link between positive antibody count and cognitive status was present in both the Ɛ4 and non-Ɛ4 groups, but was stronger in the non-Ɛ4 group.
“That was a surprise, finding a weaker link in the Ɛ4 group,” says Maher. “It’s something that should be followed up with larger studies.”
Spira, Maher, and their team, with funding from the National Institute on Aging, are following up with analyses of the Baltimore ECA data from the 2016 to 2022 wave. The researchers will also be collecting another round of data from this cohort.
“Association of Common Infections with Cognitive Performance in the Baltimore Epidemiologic Catchment Area Study Follow-Up” was co-authored by Alexandra Wennberg, Brion Maher, Jill Rabinowitz, Calliope Holingue, Ross Felder, Jonathan Wells, Cynthia Munro, Constantine Lyketsos, William Eaton, Keenan Walker, Nan-ping Weng, Luigi Ferrucci, Robert Yolken and Adam P. Spira.
Funding was provided by the National Institute on Aging (R01AG075996, U01AG052445), the National Institute of Mental Health (MH 47447), and the Stanley Medical Research Institute.

Sleep disturbances can be an early sign of Alzheimer’s disease. Many people eventually diagnosed with Alzheimer’s start experiencing difficulty falling and staying asleep years before cognitive problems such as memory loss and confusion emerge. It’s a vicious cycle: Alzheimer’s disease involves changes to the brain that disrupt sleep, and poor sleep accelerates harmful changes to the brain.
Researchers at Washington University School of Medicine in St. Louis have identified a possible way to help break that cycle. A small, two-night study has shown that people who took a sleeping pill before bed experienced a drop in the levels of key Alzheimer’s proteins — a good sign, since higher levels of such proteins tracks with worsening disease. The study, which involved a sleeping aid known as suvorexant that is already approved by the Food and Drug Administration (FDA) for insomnia, hints at the potential of sleep medications to slow or stop the progression of Alzheimer’s disease, although much more work is needed to confirm the viability of such an approach.
The study is published April 20 in Annals of Neurology.
“This is a small, proof-of-concept study. It would be premature for people who are worried about developing Alzheimer’s to interpret it as a reason to start taking suvorexant every night,” said senior author Brendan Lucey, MD, an associate professor of neurology and director of Washington University’s Sleep Medicine Center. “We don’t yet know whether long-term use is effective in staving off cognitive decline, and if it is, at what dose and for whom. Still, these results are very encouraging. This drug is already available and proven safe, and now we have evidence that it affects the levels of proteins that are critical for driving Alzheimer’s disease.”
Suvorexant belongs to a class of insomnia medications known as dual orexin receptor antagonists. Orexin is a natural biomolecule that promotes wakefulness. When orexin is blocked, people fall asleep. Three orexin inhibitors have been approved by the FDA, and more are in the pipeline.
Alzheimer’s disease begins when plaques of the protein amyloid beta start building up in the brain. After years of amyloid accumulation, a second brain protein, tau, begins to form tangles that are toxic to neurons. People with Alzheimer’s disease start experiencing cognitive symptoms such as memory loss around the time tau tangles become detectable.

Lucey and colleagues were among the first to show in people that poor sleep is linked to higher levels of both amyloid and tau in the brain. The question remains as to whether good sleep has the opposite effect — a reduction in amyloid and tau levels, and a halt in or reversal of the progress of Alzheimer’s disease — but mouse studies with orexin inhibitors have been promising.
As a first step to assess the effect of orexin inhibitors on people, Lucey and colleagues recruited 38 participants ages 45 to 65 and with no cognitive impairments to undergo a two-night sleep study. The participants were given a lower dose (10 mg) of suvorexant (13 people), a higher dose (20 mg) of suvorexant (12 people) or a placebo (13 people) at 9 p.m. and then went to sleep in a clinical research unit at Washington University. Researchers withdrew a small amount of cerebrospinal fluid via spinal tap every two hours for 36 hours, starting one hour before the sleeping aid or placebo was administered, to measure how amyloid and tau levels changed over the next day and a half.
Amyloid levels dropped 10% to 20% in the cerebrospinal fluid of people who had received the high dose of suvorexant compared to people who had received placebo, and the levels of a key form of tau known as hyperphosphorylated tau dropped 10% to 15%, compared to people who had received placebo. Both differences are statistically significant. There was not a significant difference between the people who received a low dose of suvorexant and those who received the placebo.
By 24 hours after the first dose, hyperphosphorylated tau levels in the high-dose group had risen, while amyloid levels remained low compared to the placebo group. A second dose of suvorexant, administered on the second night, sent the levels of both proteins down again for people in the high-dose group.
“If we can lower amyloid every day, we think the accumulation of amyloid plaques in the brain will decrease over time,” Lucey said. “And hyperphosphorylated tau is very important in the development of Alzheimer’s disease, because it’s associated with forming tau tangles that kill neurons. If you can reduce tau phosphorylation, potentially there would be less tangle formation and less neuronal death.”
The study is preliminary, since it only looked at the effect of two doses of the drug in a small group of participants. Lucey has studies underway to assess the longer-term effects of orexin inhibitors in people at higher risk of dementia.
“Future studies need to have people taking these drugs for months, at least, and measuring the effect on amyloid and tau over time,” Lucey said. “We’re also going to be studying participants who are older and may still be cognitively healthy, but who already have some amyloid plaques in their brains. This study involved healthy middle-aged participants; the results may be different in an older population.
“I’m hopeful that we will eventually develop drugs that take advantage of the link between sleep and Alzheimer’s to prevent cognitive decline,” he continued. “We’re not quite there yet. At this point, the best advice I can give is to get a good night’s sleep if you can, and if you can’t, to see a sleep specialist and get your sleep problems treated.”

If you are between the ages of 40 and 60, The Times wants to answer your questions.Around the time you turn 40, surprising things may begin happening to your body. Chin and nose hairs start to sprout while other hairs decide to stop growing. Skin sags or gets dry or suddenly you have acne again. Your back, shoulders and knees may ache and belly fat may appear. Perhaps you find yourself squinting at restaurant menus.Those are only physical examples. The midlife mind has a whole other set of issues, from memory deficits to mood changes. And because you are in the thick of adulthood, your stress and anxiety from work, parenting and care-taking can run especially high.Getting older is not all bad, of course. It takes time and practice to build skills. Confidence comes with age, too. Still, one thing most people can agree on is that this time period called midlife is a mysterious and wild ride.If you are between the ages of 40 and 60, The Times wants to know what you are confused, concerned or frustrated about when it comes to your mind and body. What questions do you have about health at midlife that you wish someone could answer?To submit your question(s), just fill out the form below. We will use some responses in an upcoming article, but your name and likeness will not be printed unless you agree to be interviewed further by a reporter. If we do choose to include your question, a reporter will be in touch.Submit your questions about midlife

Researchers at UNSW Sydney and Neuroscience Research Australia (NeuRA) have developed and evaluated a tool for assessing dementia risk, with promising initial results.
Currently, over 55 million people are living with dementia around the world, with that number set to increase to 78 million by 2030, and the focus on dementia research increasingly shifting towards prevention.
The online tool takes approximately 20 minutes to complete and provides a personalised dementia risk report that patients can discuss with their doctor.
Since developing the risk tool — known as CogDRisk — in 2022, the team has been evaluating the success of the tool, by trialling it on four existing datasets, with the results published recently in The Journal of Prevention of Alzheimer’s Disease.
On their analysis, they found that CogDrisk is effective at predicting dementia.
“There’s lots of information about the risk factors for dementia in the academic literature,” says Professor Kaarin Anstey from UNSW’s School of Psychology and NeuRA.

“But there’s a gap between just knowing the risks and actually being able to assess whether or not you have the risk, and then knowing what to do about it. CogDrisk was developed to address this.”
Collating the risk factors for dementia
Unsuccessful clinical trials for dementia treatment have led to urgent calls for dementia prevention.
“Prevention is now recognized by the World Health Organization as one of the key areas of research. Alzheimer’s Disease International and most of the National Dementia action plans include dementia risk reduction,” says Prof. Anstey.
But while there are a lot of different studies on risk factors for dementia across the world, there’s not necessarily always agreement on what the risk factors are. To address this problem, the team used statistical methods to combine all the risk factors cited in the existing literature.

“So we did a systematic review, to get all the different risk factors for dementia — those which were robust, and those which were modifiable and could be assessed through a self-report instrument,” says Prof. Anstey.
Some of the key modifiable risk factors that increase someone’s risk of dementia include insufficient physical activity, obesity in middle age, high blood pressure in middle age, smoking, and poor diet. “That whole process took several years, we published the review, and then we had to develop the risk assessment tool itself.”
Assessing the tool on different cohorts
Often risk assessment tools are developed on a single cohort and therefore fit a particular dataset and population, which doesn’t work well when applied to other populations.
This study analysed four different cohorts from existing medical studies, with varying demographics and a total of over 9500 participants.
The cohort data was matched against the key risk and protective factors assessed in the CogDrisk tool, including whether individuals have diabetes, depression and insomnia, information on their diet and eating habits and how much they engaged in physical activity.
The team were then able to match these to a record of dementia cases that developed within the same cohort.
“Our statistical analysis shows it’s a very robust and generalisable tool,” says Prof. Anstey. “It works across different countries and different data sets. And it’s also quite comprehensive, it includes a lot of the newer risk factors that weren’t previously included.”
Challenge with predicting dementia and future uses of CogDrisk
Predicting dementia is more difficult than predicting some other diseases, partly because it progresses over two or three decades and there can be a strong genetic component.
“It’s a multi-causal disease. But there are some modifiable risk factors. Most people want to know what their risk factors are and want to do something about them once they know,” says Prof Anstey. The team who developed the tool are hoping that in can be used in healthcare settings to make it easier for GPs and patients to get information on risk reduction.
“Not only are there lots of risk factors, but dementia itself is very complex, and GPs are very busy. So we’re trying to develop ways of making it easier for the public and GPs to get the right information.”
Next, Prof. Anstey is looking to translate the online tool into different languages, so it’s accessible to more people. “And we’re also looking at developing a short form of the tool. So there’s a lot of happening in the research translation, as well as language translation space that we’re working on.”

Drinking cranberry juice has long been a mythical prevention strategy for women who develop a urinary tract infection — and new medical evidence shows consuming cranberry products is an effective way to prevent a UTI before it gets started.
A global study looking at the benefits of cranberry products published in Cochrane Reviews has determined cranberry juice, and its supplements, reduce the risk of repeat symptomatic UTIs in women by more than a quarter, in children by more than half, and in people susceptible to UTI following medical interventions by about 53%.
Cranberry juice and healthcare supplements that commonly include the fruit, such as capsules and tablets, have long been promoted as a readily available solution to ward off the infection but the most recent review in 2012, with evidence from 24 trials, showed no benefit from the products.
The medical scientists behind this updated review from Flinders University and The Children’s Hospital at Westmead aimed to update these findings, as an important step in determining the effectiveness of cranberry products by looking at 50 more recent trials that included almost 9000 participants.
“This incredible result didn’t really surprise us, as we’re taught that when there’s more and better evidence, the truth will ultimately come out. UTIs are horrible and very common; about a third of women will experience one, as will many elderly people and also people with bladder issues from spinal cord injury or other conditions,” says the study lead author Dr. Gabrielle Williams.
“Even back in 1973, my mum was told to try cranberry juice to prevent her horrible and frequent UTIs, and for her it’s been a saviour. Despite me niggling in her ear about evidence, she’s continued to take it daily, first as the nasty sour juice and in recent years, the easy to swallow capsules. As soon as she stops, wham the symptoms are back. As usual, it turns out that mum was right! Cranberry products can help some women prevent UTIs.”
Flinders University epidemiologist Dr. Jacqueline Stephens, a co-author of the study, says if the UTI persists untreated it can move to the kidneys and cause pain and more complications, including sepsis in very severe cases, so prevention is the most effective way to reduce risks.

“Most UTIs are effectively, and pretty quickly, treated with antibiotics, sometimes as little as one dose can cure the problem. Unfortunately, in some people UTIs keep coming back. Without being sure if or how it works, some healthcare providers began suggesting it to their patients. It was a harmless, easy option at the time. Even centuries ago, Native Americans reportedly ate cranberries for bladder problems, leading somewhat more recently, to laboratory scientists exploring what it was in cranberries that helped and how it might work.”
“The studies we looked at included a range of methods to determine the benefits of cranberry products. The vast majority compared cranberry products with a placebo or no treatment for UTI and determined drinking cranberries as a juice or taking capsules reduced the number of UTIs in women with recurrent cases, in children and in people susceptible to UTi’s following medical interventions such as bladder radiotherapy.”
“It’s also important to consider that few people reported any side effects with the most common being tummy pain based on the results. We also did not find enough information to determine if cranberry products are more or less effective compared with antibiotics or probiotics in preventing further UTIs.”
The data also doesn’t show any benefit for elderly people, pregnant women or in people with bladder emptying problems.
Senior Author, Professor Jonathan Craig, Vice President and Executive Dean of the College of Medicine & Public Health at Flinders University, says the real benefits of cranberry products became clear when the researchers expanded the scope of the review to include the most recently available clinical data.
“This is a review of the totality of the evidence and as new evidence emerges, new findings might occur. In this case, the new evidence shows a very positive finding that cranberry juice can prevent UTI in susceptible people,” says Professor Craig.
“We have shown the efficacy of cranberry products for the treatment of UTIs using all the evidence published on this topic since the mid-nineties. The earlier versions of this review didn’t have enough evidence to determine efficacy and subsequent clinical trials showed varied results, but in this updated review the volume of data has shown this new finding.”
The study authors conclude that while cranberry products do help prevent UTIs in women with frequent recurrence, more studies are needed to further clarify who with UTI would benefit most from cranberry products.

Cedars-Sinai investigators have identified a genetic variant that increases people’s risk of developing perianal Crohn’s disease, the most debilitating manifestation of Crohn’s disease.
The variant generates changes to DNA that lead to a loss of protein function, which in turn, alters how the body recognizes and handles bacteria, making it less effective at fighting infections.
The discovery is published in the peer-reviewed journal GUT.
“Fistulizing perianal Crohn’s disease can be a really miserable condition,” said co-senior author of the study Dermot McGovern, MD, PhD, director of Translational Research in the Cedars-Sinai F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute and the Joshua L. and Lisa Z. Greer Chair in Inflammatory Bowel Disease Genetics. “Our current therapies are really not very good at treating it, consequently this study addresses a very significant area of unmet medical need. By gaining an understanding about the underlying causes, we can begin to develop new treatment strategies for patients diagnosed with this chronic inflammatory condition, the majority of whom currently require surgery and often require multiple surgeries.”
Perianal Crohn’s disease is a complication of Crohn’s disease, a chronic inflammatory disorder that affects the digestive tract. The complication causes inflammation and ulceration of the skin around the anus, as well as other structures in the perianal area. Perianal Crohn’s disease occurs in up to 40% of people with Crohn’s disease and has limited treatment responses, resulting in a poor quality of life.
“We have become much more successful in identifying genetic variants associated with risk of developing diseases, but what we did here is specifically focus on a very complicated and severe manifestation of Crohn’s disease. And that’s an unusual approach in genetic research,” said Talin Haritunians, PhD, a research assistant professor who is part of the McGovern Laboratory and co-first author of the study.

To discover genetic variants with a direct tie to this severe manifestation, investigators analyzed genetic data from three independent cohorts of patients with Crohn’s disease. The groups included a Cedars-Sinai cohort, an international genetics cohort recruited from over 20 countries, and a cohort recruited from seven academic research medical centers throughout the United States. The three groups totaled 4,000 patients with perianal Crohn’s disease and more than 11,000 Crohn’s disease patients without this complication.
The team of scientists compared the cohorts to see if they could detect genetic loci, which are areas of the genome associated with developing this manifestation.
The team identified 10 novel genetic loci and 14 known inflammatory bowel disease loci to be associated with the development of perianal complications.
During the functional characterization analysis, the team focused on a single change in a specific gene, called a SNP, that was associated with perianal Crohn’s Disease. This genetic variant affects a protein called Complement Factor B (CFB), which leads to a loss of function of this protein that is important for fighting infections, which may be why patients with this genetic change are more likely to have the condition.
The investigators performed multiple analyses to confirm that there really is a loss of function in CFB, which can have a dramatic impact in the body.

“In the case where you have this mutation that leads to a nonfunctional protein, you don’t get the normal signaling cascade, and the body doesn’t recognize the bacteria as being harmful, and thus those bacteria are not eliminated,” said co-senior author of the study Kathrin Michelsen, PhD, a research assistant professor of Medicine and Biomedical Sciences at Cedars-Sinai. “So, for those patients who have perianal Crohn’s disease, there are connections that form from the rectum to the skin area. And those tunnels are full of bacteria that are not being eliminated.”
Michelsen also noted the study demonstrates an important role for the alternative complement pathway and CFB in the development of perianal Crohn’s disease. The findings also suggest that targeting the alternative complement pathway may be a novel therapeutic approach for treating this disabling manifestation of Crohn’s disease.
This genetic variant can also be associated with other diseases.
“These genetic variants often predispose to more than one condition, and we believe this discovery potentially has ramifications for other diseases as well, not just Crohn’s disease,” said McGovern.
Investigators are now working on identifying the function of additional genetic variants associated with perianal Crohn’s disease and other areas of unmet medical needs in the inflammatory bowel diseases.
Marzieh Akhlaghpour, PhD, a former graduate student at Cedars-Sinai, was the co-first author of the study. Other Cedars-Sinai authors include Shyam K. More, Lisa S. Thomas, Dalton T. Stamps, Shishir Dube, Dalin Li, Shaohong Yang, Carol J. Landers, Emebet Mengesha, Hussein Hamade, Ramachandran Murali, Alka A. Potdar, Andrea J. Wolf, Gregory J. Botwin, Michelle Khrom, Gil Y. Melmed, Eric A. Vasiliauskas, Christina Ha, Gaurav Syal, Nirupama N. Bonthala and Stephan Targan.

In people with no thinking and memory problems, a simple test may predict the risk of developing cognitive impairment years later, according to a study published in the April 19, 2023, online issue of Neurology®, the medical journal of the American Academy of Neurology.
“There is increasing evidence that some people with no thinking and memory problems may actually have very subtle signs of early cognitive impairment,” said study author Ellen Grober, PhD, of Albert Einstein College of Medicine in the Bronx, New York. “In our study, a sensitive and simple memory test predicted the risk of developing cognitive impairment in people who were otherwise considered to have normal cognition.”
The study involved 969 people with an average age of 69 with no thinking or memory problems at the start of the study. They were given a simple memory test and were followed for up to 10 years.
The test includes two phases. For the study phase, people are shown four cards, each with drawings of four items. They are asked to identify the item belonging to a particular category. For example, participants would name the item “grapes” after being asked to identify a “fruit.” For the test phase, participants are first asked to recall the items. This measures their ability to retrieve information. Then, for items they did not remember, they are given category cues. This phase measures memory storage.
The participants were divided into five groups, or stages zero through four, based on their test scores, as part of the Stages of Objective Memory Impairment (SOMI) system. Stage zero represents no memory problems. Stages one and two reflect increasing difficulty with retrieving memories which can precede dementia by five to eight years. These participants continue to be able to remember items when given cues. In the third and fourth stages, people cannot remember all the items even after they are given cues. These stages precede dementia by one to three years.
A total of 47% of the participants were in stage zero, 35% in stage one, 13% in stage two and 5% in stages three and four combined.

Of the participants, 234 people developed cognitive impairment.
After adjusting for age, sex, education and a gene that affects a person’s risk of Alzheimer’s disease, APOE4, researchers found when compared to people who were at SOMI stage zero, people at stages one and two were twice as likely to develop cognitive impairment. People who were at stages three and four were three times as likely to develop cognitive impairment.
After adjusting for biomarkers of Alzheimer’s disease including brain amyloid plaques and tau tangles, the SOMI system continued to predict an increased risk of cognitive impairment.
Researchers estimated that after 10 years about 72% of those in the third and fourth stages would have developed cognitive impairment, compared to about 57% of those in the second stage, 35% in the first stage and 21% of those in stage zero.
“Our results support the use of the SOMI system to identify people most likely to develop cognitive impairment,” said Grober. “Detecting cognitive impairment at its earliest stages is beneficial to researchers investigating treatments. It also could benefit those people who are found to be at increased risk by consulting with their physician and implementing interventions to promote healthy brain aging.”
A limitation of the study was that most participants were white and well educated. Grober said more research is needed in larger and more diverse populations.
The study was funded by the National Institutes of Health, Alzheimer’s Association, Cure Alzheimer Fund and the Leonard and Sylvia Marx Foundation.

Studies have shown that consuming alcohol during pregnancy can alter the brain and behavioral development of gestating offspring. Currently, the Centers for Disease Control and Prevention advises against maternal alcohol consumption during pregnancy and state that there is no known safe level of consumption. What are the consequences, however, of mothers consuming alcohol while breastfeeding?
A research team at the University of California, Riverside, performed a mouse study to find out.
Led by Kelly Huffman, a professor of psychology, the team found that infants’ exposure to alcohol through breastmilk can have long-lasting effects on their development. Specifically, young mice that were exposed to alcohol during early development show smaller body and brain growth, as well as decreased cortical lengths — a measure of brain size. The study appears in Frontiers in Neuroscience.
Research shows approximately 36% of breastfeeding mothers in the United States consume alcohol. In Canada and Australia, the numbers are 20% and 60%, respectively. Women who consume alcohol during pregnancy are more likely to drink while breastfeeding. Also, many women who choose to abstain from drinking during pregnancy report beginning to drink again shortly after giving birth.
The researchers focused on lactational ethanol exposure, or LEE, and developed a novel postnatal alcohol exposure model in breastfeeding mice. In this mouse model, offspring were exposed to ethanol via nursing from postnatal day (P) 6 through P20 (weaning), a period equivalent to infancy in humans.
Compared to controls, LEE mice had reduced body and brain weights, as well as decreased neocortical lengths at wean continuing through to early puberty (age P30). Brain weights were reduced in both ages for males, and at P20 for females; however, P30 female brain weights recovered to control levels. This discovery provides evidence towards sex-specific differences due to LEE.

“The reduced body weights in both males and females at P20 and P30 are reflected in human studies in which children exposed to ethanol through contaminated breast milk have lower body weights and growth trajectories,” Huffman said. According to her, the reduction of body and brain weights may be explained by the gut’s inability to efficiently extract nutrients when alcohol is ingested. A decrease in protein synthesis in the small intestine may block absorption of micro- and macronutrients.
With regard to how the behavioral development of the LEE mice is affected, Huffman said behavioral tests her team performed on LEE mice suggest they engage in higher risk-taking behavior and show abnormal stress regulation and increased hyperactivity.
“Thus, women should refrain from consuming alcohol during breastfeeding until more research can help recommend safe maternal practices in early infancy,” she added.
Although researchers also advocate for women abstaining from alcohol consumption also during the prenatal period, Huffman said there are conflicting views about appropriate, safe drinking behaviors during the breastfeeding period.
“We are aware of the disconnect between conclusions drawn from scientific literature and behaviors in many new mothers,” she said.
Fetal alcohol exposure, from maternal consumption during pregnancy, has been a subject of investigation for about 50 years. Huffman’s laboratory at UCR has made groundbreaking discoveries, including that Fetal Alcohol Spectrum Disorders, or FASD, can be heritable, passing transgenerationally to at least the third generation.
“We hope our work will increase public awareness of safe maternal practices,” Huffman said.
Huffman was joined in the study by Roberto F. Perez Jr., Kathleen E. Conner, Dr. Michael A. Erickson, and Mirembe Nabatanzi.
The research was funded by internal grants from UC Riverside.

During pregnancy, women are more susceptible to severe respiratory infections from multiple viruses, including influenza A virus (IAV), respiratory syncytial virus (RSV) and severe acute respiratory syndrome coronavirus (SARS-CoV-2). Additionally, pregnant women are disproportionately affected by influenza, resulting in a more than 10-fold increase in hospitalization risk.
A new study led by Dr. Natalie Johnson, associate professor in the Texas A&M University School of Public Health’s Department of Environmental and Occupational Health, shows that exposure to ultrafine particles (UFPs) during pregnancy enhances respiratory viral infection risk. The results of the study were published recently in Particle and Fibre Toxicology.
“We know that air pollution affects the pulmonary immune system, making individuals more susceptible to viral infections,” Johnson said. “We also know pregnant women are already at increased risk for severe flu. Surprisingly, studies have not interrogated the combined effects of pregnancy, air pollution and influenza. Our findings demonstrate the need to further study these interactions in order to prevent short and perhaps long-term impacts on maternal health.”
In the study, Johnson and her co-authors point out that there are several physiological characteristics that explain maternal susceptibility to viral infection. Among those are increased cardiac output and decreased tidal volume — the amount of air that moves in or out of the lungs with each respiratory cycle — as well as immunological changes such as selective modulation of immune cell subsets to protect the developing fetus.
The research team also highlights that vaccination compliance during pregnancy is generally below 50 percent, despite vaccination against influenza being safe and effective, leading to increased risk for developing respiratory infection.
As a result, air pollution, which is a worldwide environmental health issue, is responsible for one in nine deaths with an annual premature mortality of more than 7 million. A mixture of gases and tiny airborne particulate matter, which is categorized as UFPs, are critical to recognize and identify, especially to protect vulnerable populations.
The research team says these findings support future clinical and regulatory interventions for protecting pregnant women and controlling UFPs. According to the researchers, it is imperative that pregnant women in urban cities, where influenza and UFPs are more prevalent, are provided vaccinations and preventive measures limiting UFP exposure to protect maternal health.
“Air pollution is a pervasive environmental health issue,” Johnson said. “Strategies to protect the most vulnerable, like pregnant women, are of high priority to decrease adverse health effects.”
Additional authors include Nicholas L. Drury, Texas A&M Department of Environmental and Occupational Health and Texas A&M Department of Nutrition; Toriq Mustapha, Texas A&M Department of Environmental and Occupational Health; Ross A. Shore, Texas A&M Department of Environmental and Occupational Health, Jiayun Zhao, Texas A&M Department of Chemistry; Gus A. Wright, Texas A&M Department of Veterinary Pathobiology; Aline Rodrigues Hoffmann, University of Florida Department of Comparative, Diagnostic, and Population Medicine; Susanne U. Talcott, Texas A&M Department of Nutrition; Annette Regan, University of San Francisco School of Nursing and Health Professions; Robert M. Tighe, Duke University Department of Medicine; and Renyi Zhang, Texas A&M Department of Chemistry and Texas A&M Department of Atmospheric Sciences.

Published11 hours agoShareclose panelShare pageCopy linkAbout sharingThis video can not be playedTo play this video you need to enable JavaScript in your browser.By Nadine Yousif & Robin Levinson-KingBBC NewsThe US Supreme Court has extended until Friday a temporary block on limits to access of a popular abortion pill. A Texas judge suspended approval of abortion drug mifepristone on 7 April, questioning its safety. Parts of that decision were upheld on appeal, prompting the Biden administration to make an emergency request to the Supreme Court. It’s the most significant such case since the Supreme Court last year ended the nationwide right to abortion.The pill – used in more than half of abortions in the US – was first approved by the Food and Drug Administration (FDA) more than two decades ago. Here’s how we got here.What has happened so far?Earlier this month, a federal judge in Texas issued a preliminary injunction revoking the FDA’s approval for the drug while he hears a lawsuit brought by a group of anti-abortion health professionals against the agency challenging the safety of mifepristone. In the ruling, the Texas judge said the FDA had rushed the approval and did not properly consider side effects. The FDA and several leading health organisations, such as the American Medical Association, say the drug is safe and effective.Minutes later, a federal judge in Washington state issued an opposing ruling, ordering the FDA to make no change to the drug’s availability and preserving access to mifepristone in 17 US states.With these two rulings directly contradicting each other, the government appealed to the New Orleans-based 5th Circuit Court of Appeals.It also asked for the court to put the Texas order on hold while the appeal was heard, keeping mifepristone available.The appeals court agreed to keep the drug on the market – but with additional restrictions.Image source, Getty ImagesWhat is the Supreme Court ruling about?Last week, the US justice department and Danco Laboratories, which manufactures the drug, called on the Supreme Court to intervene, asking it remove restrictions from the pill while the lower appeals court continues to review the case as a whole.On Friday, US Supreme Court Justice Samuel Alito, who oversees emergency matters for 5th Circuit, ordered a temporary block on the restrictions until Wednesday evening, when it would issue a decision on whether to keep mifepristone on the market while the Texas ruling works its way through the appeals process.But by late Wednesday afternoon, the Supreme Court extended this deadline until Friday at 23:59 EST on Friday (04:59 BST on Saturday), keeping mifepristone on the market in interim without restrictions.The court – which has a 6-3 conservative majority – did not offer an explanation as to why.Could access to abortion pills change?Access to the abortion pill mifepristone across the US will hinge on what the Supreme Court decides to do. If it sides with the 5th Circuit Court of Appeals or issues no ruling by the end of Friday, mifepristone will remain available but conditions on its access will be imposed immediately. These conditions include requiring that the drug be taken in the presence of a physician, that patients cannot receive the pill by post, and that the window for use of the pill shortens from up to 10 weeks of pregnancy to seven.What might this all mean for other drugs?Critics say that by overriding the FDA’s approval, the court in Texas has usurped the federal health agency’s remit to regulate food, medicine, and medical devices. The Food, Drug, and Cosmetic Act of 1938 gives the FDA the authority to determine whether drugs are safe and effective, and typically, courts have deferred to the agency when it comes to scientific and medical decision-making.Legal experts warn the ruling opens the door for challenges to other approved medicines in the US and could also stifle development of future drugs.I. Glenn Cohen, a Harvard Law School professor, told BBC News the pharmaceutical industry could be wary of more legal challenges, particularly to treatments that have become political flashpoints in the US, like transgender medical treatment and Covid-19 vaccines.”It’s possible in any space, but … it’s going to trickle down in some ways and play out to be the worst for drugs that are needed sometimes by discrete and insular minorities,” Prof Cohen said.How safe is the abortion pill mifepristone?How ‘judge shopping’ led to abortion-drug showdownImage source, ReutersWhat happens next?The Supreme Court is only deciding whether to put on hold the Texas ruling revoking access to mifepristone. At the moment, it is not debating the case itself. That is currently being decided on by the 5th Circuit court, although it eventually could make its way to America’s top court, too. Earlier this week, the Alliance Defending Freedom, a conservative Christian legal advocacy group that filed the initial lawsuit against the FDA, submitted a brief to the Supreme Court asking it to let the restrictions on mifepristone go into effect. Their request has been supported by 147 Republican lawmakers, who submitted their own brief to the court, calling the removal of conditions on access to the drug “a dangerous game with the health and safety of women and girls.” On the opposing side, a group of 253 Democratic lawmakers also weighed in, asking the Supreme Court to pause the original Texas ruling and leave mifepristone on the market as the case makes its way through the courts.The Democrats argued the Texas ruling would restrict access to abortion nationwide.Both briefs indicate that abortion remains a politicised debate in the US. More on this storySupreme Court keeps abortion pill available for now5 days agoHow ‘judge shopping’ led to abortion-drug showdown5 days ago