The Biden administration recently issued a new report showing causal links between alcohol and cancer, and it’s about time. The link has been long-known, but alcohol carcinogenic properties have been waved away with ‘use in moderation’ rhetoric. We don’t tell young people to use cigarettes ‘in moderation’, even though nicotine doesn’t cause cancer, only cigarettes smoke does, so that alcohol has gotten political free pass shows science is always second to politics.

Realistically, while any cell mutation can happen any time, you are unlikely to get cancer caused by an occasional drink, but US culture always has pregnant women and new mothers on blast, so they are told to abstain from alcohol, coffee, too many foods to count, etc.(1)

What we should really be cautioning pregnant women about is vegetarian diets. While some epidemiological data on alcohol can be critiqued on merit, people who believe claims about PFAS in water, GMOs, pasteurized milk, vaccinated chickens, Scotchguard, or cancer-causing spatulas absolutely cannot deny the risks of a vegetarian diet. This is far more rigorous than any of the epidemiology in those claims.

The legendary John Stossel, 19-time Emmy Award winner for journalism, once told me I take “too damn long to get to the point” in articles, and he’s right so I will be succinct and get right to the heart of the paper in Metabolism Open by Papadopoulou  et al. “Strict vegetarian diets during pregnancy are associated with an increased risk of small-for-gestational-age infants and lower birth weights.”

Credit: 10.1016/j.metop.2024.100338

Not by a little. Their systematic review and meta-analysis included 72,284 participants in numerous countries using a contemporary diet who all stated they followed a stricter plant-based diet and were pregnant. Indicators of a healthy baby were consistently lower among strict vegetarians, with up to 300% incidence of having a small-for-gestational-age child, and nearly 8.5 ounces lower birth weight.(2)

How much risk is acceptable is up to you. science shows that women who have a glass of wine on a Friday are fine but they avoid sushi. If a woman is vegetarian, maybe supplements of B12, calcium, iron, and omega-3 fatty acids will be enough, but the differences between vegetarian and a regular human diet are so glaring when it comes to infants they should just forgo ideology for nine months. A lot of women went without coffee, Chardonnay, and sushi and they can’t have been happy about it, but it wasn’t about them.

NOTES:

(1) In the case of alcohol, that claim only derives from a 1970s of severe binge-drinking women who were overwhelmingly more likely to have a child with fetal alcohol syndrome. So American social authoritarians targeted pregnant women who had a glass of wine with the same fervor they attacked working women, those who could not breastfeed, or express enough milk about how dumb their kids will be if they use infant formula. Yet pregnant women in France who have the occasional glass of wine have no more birth defects than women who abstain.

(2) One included study found no benefit when it came to gestational diabetes mellitus but others did, to varying degrees. Incidence of high gestational weight gain and excessive weight gain were lower than a normal human diet, it was instead more likely they had insufficient weight gain. Preterm birth rates were statistical noise so no inference can be drawn.