Getting an Infection during the period of "Morning Sickness", poses Higher Risks of Congenital Heart Disease?

One of the most unexpected parts of the conversation was Jimmy Carr’s discussion of morning sickness. 🫣

It sent me down a rabbit hole because there is an interesting evolutionary theory behind why morning sickness tends to occur during this particular period of pregnancy.

The Maternal and Embryo Protection Hypothesis, an evolutionary theory about morning sickness, where:

1. Organogenesis: Morning sickness typically peaks between weeks 6 and 14 of pregnancy. When the embryo’s major organs (including the heart, brain, and limbs) are forming and are most vulnerable to damage from toxins or pathogens.

2. The "Shield" Effect: Because pregnancy naturally suppresses a woman's immune system (to prevent her body from rejecting the fetus), she becomes more sensitive to foodborne pathogens. Evolutionary biologists believe nausea and vomiting evolved to force mothers to avoid or expel potentially toxic or bacteria-laden foods during this window.

3. The Shift: Once the organs are fully formed (around the second trimester) and the baby enters the growth-only phase, morning sickness usually stops for most women.

EVIDENCE for Infection & Congenital Heart Disease ﮩ٨ـﮩﮩ٨ـ🫀ﮩ٨ـﮩﮩ٨ـ

A link from two meta-analyses, between First Trimester Maternal Infections and Fetal Congenital Heart Defects has been found, especially in regards to rubella virus, coxsackievirus, respiratory infections, and influenza.

⚠️ Though there is an important distinction here to make:

This does NOT mean that morning sickness itself is linked to congenital heart defects.

But the same period of pregnancy in which morning sickness may have evolved to reduce exposure to potentially harmful substances is also a period when the developing embryo is particularly vulnerable to certain environmental insults, including infections.

Claim: The “Living Carnivore” Diet is Good for Weight Loss

Verdict: Broadly true, but misleading

“Within 30 days I lost 20 pounds. JD Vance is also on the diet and you can see how different he looks.”

“The way that you're supposed to eat it is bite for bite. You take a bite of the meat, you take a bite of the sauerkraut”

RFK Jr.

After Vice President JD Vance credited his weight loss to RFK Jr’s recommended “meat and sauerkraut” diet, the “Living Carnivore” diet has been under the spotlight. But does it really work?

The Good News: Weight Loss is Reasonable

For the goal of weight loss – without considering other issues – and despite no direct evidence on the Living Carnivore diet specifically, it doesn't seem too bad. This largely comes down to the benefits of eating fermented foods. Generally speaking, there are multiple benefits to consuming fermented foods, as shown by a study using data from the National Health and Nutrition Examination Survey (NHANES) from 2001 to 2018.

The study found that each 100 g of microbe-containing foods was associated with reduced BMI, waist circumference, systolic blood pressure, C-reactive protein, plasma glucose and triglyceride, and increased high density lipoprotein cholesterols. The mechanisms of action get a little complicated, but generally include influencing gene expression, slowing gastric emptying and modulation of the gut microbiome.

The carnivore side of the diet is where the problems come in. Purely for weight loss, there is some evidence that they can lead to weight loss and increased satiety.

The Bad News: Nutrient Deficiencies and Cholesterol

A 2026 scoping review focused on the carnivore diet noted these benefits for weight loss, but stressed the “substantial risks” of nutrient deficiencies. Overall, the carnivore diet can lead to deficiencies in thiamine, vitamin C, vitamin D, magnesium, iodine, potassium, calcium and fibre. The deficiency in fibre is also pretty extreme, at less than 1/25th of the adequate intake. It's debatable whether you could rectify these issues by adding fermented foods.

Perhaps unsurprisingly, low-density lipoprotein cholesterol and total cholesterol generally increase, carrying risks of heart disease, and some versions have high sodium, potentially leading to high blood pressure and more.

And it should go without saying that eating “bite for bite” is probably useless, it takes a long time to digest food, relative to actual eating process. It all hits your stomach basically simultaneously anyway.

Overall, the diet – especially fermented foods – could help weight loss, but it’s terrible as an overall diet.

Arsenic in Brown and White Rice

I recently added more rice into my diet and wanted to understand the nutritional value of switching from white to brown rice. Then I recalled hearing about the potential risk of more arsenic so I dug into the research.

This 2016 risk assessment from the FDA provided baseline numbers of the amount of arsenic in rice and rice products as well as a quantitative estimate of lung and bladder cancer risk from long-term exposure of these products.

We found that average concentrations of inorganic arsenic – the more toxic form of arsenic – were as follows:

• 92 parts per billion (ppb) in white rice

• 154 ppb in brown rice

• 104 ppb in infants’ dry white-rice cereal

• 119 ppb in infants’ dry brown-rice cereal

The primary culprit of damage is inorganic arsenic in foods, which I learned in not a traditional heavy metal but a "toxic metalloid". The good news is this means inorganic arsenic doesn't bioaccumulate the same way other heavy metals do. The risk however is still continuous exposure over a long period of time which can damage DNA, the skin, and the vascular system.

Dr. Michael Greger also provides a good summary and insights in his video

Which Rice Has Less Arsenic: Black, Brown, Red, White or Wild?Evaluating differences in rice, we can observe:

• brown rice contains more arsenic than white rice

• long grain contains more than shorter grains, though this may be due more to where these grains are grown

• arsenic accumulates in the rice bran, which is why brown rice contain so much more arsenic

• many of the varieties of colored rice were worse than white rice for the reason above

• children under 6 should almost definitely avoid rice AND rice products, with regulations in the EU now adding more conservative limits on the amount of acceptable arsenic in rice products for infants

One bit of good news is brown rice MAY make the arsenic less bio-available as shown in this population study. As Dr. Greger says:

So, if you test the urine of thousands of Americans who don’t eat rice at all, they’re still peeing out about eight micrograms of toxic, carcinogenic arsenic a day. It’s in the air; it’s in the water; there’s a little bit in nearly all foods. But, eat just one food—a cup or more of white rice a day—and your exposure shoots up 65%.

Okay. But, what about those who eat a cup or more a day of brown rice, which technically contains even more arsenic? Your exposure shoots up the same 65%. No difference between the urine arsenic levels of white rice-eaters compared to brown rice-eaters. Now, this was not an interventional study, where they feed people the same amount of rice to see what happened, which would have been ideal. This was a population study. So, maybe the reason the levels are the same is that white rice-eaters eat more rice than brown rice-eaters. So, that’s why they ended up with the same levels? We don’t know, but it should help to put the minds of brown rice-eaters at rest.

So what is the risk? This analysis from the EPA used a Bayesian approach to estimate the dose response of inorganic arsenic exposure from water. It found a linear relationship of more arsenic exposure with bladder and lung cancer. If we extrapolate the EPA's 2025 upper-bound estimate: one daily cup of brown rice for life adds up to 0.42 percentage points of bladder or lung cancer risk (+5.5% relative to a 7.6% baseline); white adds 0.25 (+3%). At three cups: 1.45 (+19%) for brown and 0.8 (+10%) for white.

A more direct causal study would need to prove out this relationship, but this definitely took me aback. For rice staple cultures, three cups of rice daily is pretty normal. These upper bound figures begin to look similar to increased risk of cancer from a daily beer or alcoholic drink.

Unfortunately rinsing rice does little to remove arsenic, especially in brown rice. But researchers did find a parboil method could dramatically reduce the amount of arsenic, removing 54% & 73% iAs from brown & white rice. This is a specific method that requires a lot water that is then tossed out but it does retain a lot of the same nutrients.

My takeaway? We are exposed to arsenic across a number of ways; through our air, water, and food. The increased cancer risks are linear from continued exposure, which means the amount of arsenic consumption scales with risk. If I was a regulatory body in a country where rice is a staple food, I would set significantly stricter regulations to evaluate and limit the amounts in rice and rice products.

Personally, it doesn't seem worth eating rice regularly, especially brown rice. I'll probably try to have less than 3 to 4 servings a week and mix in other grains. I'd be especially careful with infants and rice products that may concentrate the arsenic levels.