More than 15 percent of young adults used e-cigarettes in 2023
To determine trends in vaping, data was drawn from the 2019-2023 National Health Interview Survey, a nationally representative household survey of the U.S. civilian noninstitutionalized population. Collected continually throughout the year by the NCHS, interviews are conducted face-to-face in respondents' homes.
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Medscape
11-08-2025
- Medscape
Rural Parents See More Care Gaps and Delays After Pregnancy
TOPLINE: Parents in the year following birth residing in rural areas experienced more healthcare barriers, including reduced access to obstetric care and increased emergency department visits, than their urban counterparts. While infant care was similar between rural and urban areas, postpartum parents reported delays in medical care compared with their infants in both settings. METHODOLOGY: Researchers conducted a cross-sectional analysis using data from the National Health Interview Survey to examine rural-urban differences in healthcare access in postpartum parents and infants. They included nonpregnant women aged 18-49 years who had infants aged 1 year or younger. A total of 2019 postpartum parents (mean age, 27.1 years) and 2191 infants residing in rural areas, and 12,112 postpartum parents (mean age, 29.2 years) and 13,088 infants residing in urban areas were included in the study. Self-rated health was assessed on a five-point scale ranging from excellent to poor for both postpartum parents and infants. Healthcare utilization was evaluated based on the location where the care was received, the number of office or emergency department visits in the prior year, visits to specific clinicians, and the number of hospitalizations. Barriers to care were categorized into insurance coverage issues (such as gaps in coverage, losing coverage after pregnancy, or changes in care location) and reasons for delayed medical care. TAKEAWAY: Parents residing in rural areas were less likely to see an obstetrician-gynecologist (P = .002), visited the emergency department more frequently (P = .030), and had more hospitalizations (P = .041) than those residing in urban areas. Parents residing in rural areas experienced more disruptions in medical care, gaps in insurance coverage, and loss of Medicaid coverage after pregnancy than their urban counterparts. Delays in medical care were also more prevalent among parents residing in rural vs urban areas (20.3% vs 15.8%; P = .009); this pattern was not observed among infants. Among both rural and urban parent-infant dyads, adults were more likely to experience uninsurance and delayed medical care than their infants. Cost was a more common reason for delayed care among postpartum parents than among infants in the same household, regardless of where they lived. IN PRACTICE: 'Investments in rural health care infrastructure may support rural families,' the authors wrote. 'Integrating and incentivizing care for postpartum parents alongside their infants may address differential use and access to care in this critical period.' SOURCE: The study was led by Sara C. Handley, MD, MSCE, of the Perelman School of Medicine at the University of Pennsylvania in Philadelphia. It was published online on August 3, 2025, in The Journal of Rural Health. LIMITATIONS: The analysis did not include specific weighting to represent the US population of parent-infant dyads. The cross-sectional design did not specify the age of the infant, which could have affected the reported number of visits and limited comments on completeness of the care. DISCLOSURES: The study received support through grants from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the University of Minnesota Foundation Rural Health Research Center Fund, and the Federal Office of Rural Health Policy. The authors reported having no conflicts of interest. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
National Geographic
08-08-2025
- National Geographic
How cutting out certain foods can trigger new allergies
Bagels, which often include gluten, are one of many foods often excluded in elimination diets. But for allergy-prone individuals, cutting out foods for too long may disrupt immune tolerance and trigger dangerous reactions. Photograph by Rebecca Hale, National Geographic Elimination diets are everywhere—from parents managing eczema to influencers cutting out gluten and dairy in pursuit of 'clean eating.' But research shows that removing foods from your diet can subtly change how your immune system reacts when you eat them again. In some people, especially those with conditions like eczema or past food allergies, that loss of tolerance can spark dangerous reactions—even life-threatening anaphylaxis—when the food returns. This risk is often overlooked in the growing popularity of elimination diets. According to the CDC's National Center for Health Statistics, Americans are cutting more from their plates than ever. Some do it to manage celiac disease or irritable bowel syndrome, others to reduce bloating, fatigue, or joint pain. Social media trends like #cleaneating have only amplified the appeal. By 2024, more than half of Americans reported following a specific diet or eating pattern, compared to just 38 percent in 2019. Yet for the immune system, regular exposure to food proteins helps maintain a state of tolerance—one that can be disrupted when those foods disappear from the menu for too long. Understanding how and why that shift happens is key to knowing when elimination diets help, and when they might put you at risk. The science of oral tolerance and food allergies 'The intestine has an unenviable task,' says Brian Vickery, chief of allergy and immunology and director of the food allergy program at Emory's Children's Healthcare of Atlanta. 'It has to identify and respond to a constant barrage of environmental stimuli that can be both dangerous and beneficial.' (Is gluten really that bad for you? Here's what happens when you stop eating it.) The gastrointestinal tract, which has more immune lymphocytes than any other body part, encounters trillions of microbes and more than 30 kilograms of food proteins each year. Yet, it manages to defend against harmful invaders while ignoring harmless foods and friendly bacteria. This balancing act relies on oral tolerance, a process in which immune responses to ingested food proteins are actively suppressed, which in turn prevents harmful reactions like food allergies. While the underlying immune mechanisms are not entirely understood, the latest studies indicate it begins with specialized antigen-presenting cells that capture food antigens in the gut and instruct nearby T cells to stand down. This signal gives rise to antigen-specific regulatory T cells, which calm the immune response to food proteins. (As food allergies rise, new treatments are on the horizon.) 'The gut is important in the initial establishment of tolerance,' says Michael Pistiner, director of Food Allergy Advocacy, Education and Prevention, Food Allergy Center at the MassGeneral Hospital for Children. 'If you're not already allergic, early introduction to foods can help promote tolerance and protect infants from developing a food allergy.' That protection doesn't end in childhood. Regular, ongoing exposure to foods helps maintain oral tolerance throughout life. Recent research in food allergy patients treated with oral immunotherapy, where gradually increasing doses of the culprit food are given orally, highlights how continued ingestion is often needed to maintain a desensitized state. Conversely, there's evidence that elimination diets for some can disrupt oral tolerance and encourage the immune system to develop allergies. When elimination diets increase allergy risk For parents of children with eczema, it's common to suspect certain foods are worsening flare-ups. Many turn to elimination diets in hopes of finding the culprit. But research has uncovered a hidden risk. Anne Marie Singh, professor and chief of Division of Allergy, Immunology, and Rheumatology at the University of Wisconsin-Madison, and her colleagues evaluated almost 300 children with eczema on elimination diets. (How a tick bite can cause food allergies in humans.) 'We found that if you removed the food from their diet, upon reintroduction there was a significant increase in the risk of allergic reactions, including potentially severe immediate allergic reactions,' says Singh. The results were striking: almost one in five children (19 percent) developed new immediate allergic reactions when the eliminated foods were reintroduced, even though they had no previous history of such responses. Most were mild, but alarmingly, 30 percent of reactions were severe, classified as anaphylaxis. The danger isn't limited to children. In a separate study of 30 adults who developed allergies to foods they had previously tolerated, 70 percent had been on elimination diets beforehand. Half experienced anaphylaxis, and the vast majority (80 percent) had pre-existing allergic conditions such as environmental allergies, asthma, or eczema. For people without a history of allergies, the risk appears much lower. If you're thinking about trying an elimination diet, experts say the safest approach depends on your risk level. If you're at higher risk (children or anyone with pre-existing allergy conditions), consult with a healthcare professional before starting an elimination diet. 'The more allergic you are, an elimination diet could potentially be a problem,' says Singh. Pistiner adds that 'in infants with eczema, elimination diets can be detrimental, especially at this very important time of early introduction.' Experts also recommend that children following elimination diets have close medical supervision to ensure nutritional adequacy and healthy growth. (What scientists are learning about how to prevent allergies in kids.) Duration matters, too. A shorter elimination phase gives less time for oral tolerance to break down. Singh notes that 'two to four weeks of elimination should be enough time to know if it makes a difference and also short enough to not risk an allergic reaction when you try it again.' In some cases, completely cutting out a food isn't necessary. If symptoms are mild, keeping small, tolerable amounts in the diet may help maintain oral tolerance while still easing discomfort, adds Singh.
Wall Street Journal
07-08-2025
- Wall Street Journal
Ultraprocessed Foods Make Up More Than 50% of American Calories
Ultraprocessed foods make up the majority of calories Americans are eating, according to a report released Thursday by the federal government. But there are signs this consumption might be declining. Sandwiches, baked goods, salty snacks and other ultraprocessed foods accounted for 55% of the calories Americans age 1 and older consumed from August 2021 to August 2023, according to the Centers for Disease Control and Prevention's National Center for Health Statistics study.
