The long shadow of early sugar consumption. Plus a reality check on FDA approval

Welcome to Health(y) Discourse.

Last week, we looked at a major milestone for personalized mRNA cancer vaccines, asked whether FDA-authorized medical AI is actually improving patients’ health and broke down a trio of public health alerts involving contaminated sprouts, recalled eye drops and Cyclospora.

This week, we’re looking at how the sugar you ate as a baby may shape your health decades later, what Florida’s rollback of school vaccine requirements actually changes and why more new drugs are reaching FDA approval with less evidence.

Other stories that caught my eye this week:

• The Ebola outbreak in the Democratic Republic of Congo has now surpassed 6,000 confirmed cases and 2,900 deaths. Health officials are vaccinating frontline workers with Ervebo — a vaccine designed for the Zaire strain of Ebola, not the Bundibugyo strain causing the current outbreak. Officials hope it may provide some cross-protection.
• At least six Frankfurt Airport employees contracted malaria and two died in a rare outbreak. Local health officials believe infected mosquitoes were carried into Germany aboard an aircraft.
• Homeowners are increasingly suing homebuilders, blaming mold for symptoms ranging from headaches to brain fog. But doctors say there’s little evidence that mold causes the broad range of symptoms often labeled “toxic mold syndrome,” even though it can trigger allergies, worsen asthma and cause some respiratory illnesses. 

Peer Review

Rehashing the week’s health headlines

 🍭 Worth Watching

The sugar you ate as a baby may affect your health now, study finds 

How much sugar you were exposed to before you could even remember eating it may have helped shape your health decades later.

Researchers took advantage of a rare natural experiment created by the end of sugar rationing in the United Kingdom in 1953. They analyzed nearly 65,000 people born around that period, comparing those who spent more of their first 1,000 days — from conception through about age 2 — under sugar rationing with those exposed to the more sugar-rich environment that followed.

The differences were striking. People who experienced sugar restrictions early in life had lower rates of several cancers decades later, including breast, prostate, lung, rectal and liver cancers. They also had longer telomeres — protective structures at the ends of chromosomes that tend to shorten with age — equivalent to roughly two fewer years of biological aging.

People exposed to rationing as babies still consumed less sugar and ate healthier, more diverse diets some 50 years later, raising the possibility that our earliest diets don’t just affect our developing bodies, they may also help shape our food preferences throughout life.

There are some important caveats. Researchers didn’t randomly assign babies to high- or low-sugar diets. They used the abrupt end of rationing as a natural experiment, and other foods and aspects of life were changing during this period as well. The study also can’t tell us whether cutting sugar today would reverse any effects of greater exposure early in life.

Bottom line: This doesn’t mean eating sugar as a baby determines whether you’ll develop cancer decades later. But it adds to growing evidence that nutrition during the first few years of life may have surprisingly long-lasting effects, potentially influencing both our biology and adult eating habits.

💉 Public Health Watch

Florida to drop 4 required vaccines

Florida’s Department of Health announced plans to eliminate school vaccination requirements for hepatitis B, chickenpox, Haemophilus influenzae type b (Hib) and pneumococcal disease.

But Florida isn’t eliminating all school vaccine requirements. State law still requires immunizations against measles, mumps, rubella, polio, diphtheria and tetanus. Last year, Florida Surgeon General Joseph Ladapo announced that the state wanted to eliminate all school vaccine mandates. That broader effort would require lawmakers to change state law; the four requirements being removed were established through state health department rules and can therefore be changed administratively.

The proposal would also broaden the state’s religious exemption form to explicitly include moral and ethical beliefs.

The change isn’t final quite yet. The state department of health published the proposed rule Aug. 24 and opened a 21-day public comment period through Sept. 14. 

The move comes as childhood vaccination rates are already falling. Nationally, a record 4.2% of kindergartners had an exemption from at least one required vaccine during the 2025–26 school year, while the country is experiencing its worst measles resurgence in decades.

Bottom line: Florida hasn’t eliminated its school vaccine mandates, but it is taking a significant step in that direction. Four vaccines would no longer be required under the proposed rule, while requirements written into state law would remain in place.

💊 Under the Microscope

How much evidence does it take to approve a drug? 

You might assume a new FDA-approved drug has been tested successfully in several independent clinical trials. 

Increasingly, that’s not the case.

In a new analysis, researchers found that drug approvals in 2016 were supported by an average of 3.4 studies. By 2024, that had fallen to 1.4. Nearly 70% of products approved in 2024 were supported by a single study, while just 5.6% were supported by three or more.

That doesn’t mean those drugs weren’t adequately tested. The FDA has long been able to approve drugs on the basis of one sufficiently strong, well-controlled trial, and a single large, rigorous study can sometimes provide more useful evidence than several weak ones. Allowing greater flexibility can also bring promising treatments to patients faster.

But replication matters. A second independent study can reveal whether an initial finding holds up in different patients and circumstances. It can also protect against bias. The researchers also found that drug companies themselves funded a growing share of the studies used to support FDA approvals, rising from 45% in 2016 to about 80% of studies associated with approvals in 2024.

Bottom line: FDA approval still means the agency determined a drug met its standards for safety and effectiveness. But this study shows the evidentiary landscape has changed substantially, making it increasingly important for both drug makers and independent researchers to continue studying drugs after they’ve been approved and start to reach patients in the real world. 

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What else I’m WATCHING

Get in Touch

That’s all for this week. If you have questions about a health-related story or study you saw in the wild, send me an email at jcraig@san.com or share them below.
— Jess