Wearing a Mask During Indoor Exercise Can Be Fatal

June 17, 2022

Published at The Brownstone Institute 10 June 2022

 

A recent article from the Technical University of Munich published in PNAS  reached national  newspapers  in  several   countries  worldwide. The team showed that aerosol emissions increase exponentially with intense physical exertion, indicating that indoor sporting activities result in higher risk of infectious diseases as COVID. The authors suggested the use of face masks, social distancing and ventilation to prevent viral infections during (vigorous) indoor exercise. 

 

 

However, the study as presented in the newspaper article does not yet prove a higher risk for viral infections by aerosols emitted by healthy persons during indoor sports. The recommendation wearing face masks during vigorous exercise has not been argued to be safe and effective.

 

Current available information supports a potential risk of long-term from frequent wearing face masks while there is very low to no beneficial effect in preventing the transmission of a virus. Moreover, based on historical information, the transmission of a respiratory virus by persons without symptoms is questioned. 

The way the article is presented in the newspapers may result in even stricter protocols during indoor sports while a possible increased risk for death wearing masks during vigorous exercise cannot be ruled out. 

 

Vigorous indoor exercise: larger and more aerosols emitted 

In the  study  well-trained athletes show significantly higher aerosol emissions than untrained persons due to their higher minute ventilation which indirectly means a higher risk for infection. The authors state that SARS-CoV-2 virus and other respiratory viruses are transmitted via respiratory particles while breathing or speaking. Transmission of these viruses will depend in part on the rate with which these particles are emitted.

Based on their results and  gyms  being a potential risk for  super-spreading events , the authors recommend special protective measures in indoor sports. In cases of high community infection rates with a low vaccination rate testing, using plastic shields, proper distance, high-quality ventilation systems and wearing masks by fit and young athletes during high-impact training in indoor gyms is recommended. At low workloads only distancing and ventilation systems would be needed.

Another study that was recently published in  Communication Medicine  found that aerosol mass emission during vigorous exercise is not different from speaking at a conversational level. Though speaking generates larger particles and exercise generates smaller particles. Face masks could be used with very vigorous exercise as larger particles are produced with increasing intensity of training. Social distancing is suggested as a preventative measure for COVID-19 for non-exercise-based social interaction and most low-impact exercises as the aerosol particles emitted are too small and could penetrate through the mask. During the experiment five healthy and fit young people of the 25 participants (both sexes) could not complete the very vigorous exercise testing period due to exhaustion.

How super-spreading events were defined 

Using cell phone data of 98 million US people, researchers found the indoor public places  most responsible  for the spread of COVID-19, showing that restaurants and gyms were the places at most risk for super-spreading events. In Chicago, 10% of the places people visited accounted for 85% of the infections, with higher infections in lower income neighborhoods.

Super-spreading events  are characterized by venues when one positive-tested person is traced to many other people testing positive. Several super-spreading events have been in the news where a group of people were tested positive for the SARS-CoV-2 virus after indoor exercising. Remarkably, in most cases the identified index person was either mildly symptomatic or had not yet developed symptoms.

A potential role of  airborne transmission  of the virus by aerosols (droplets < 5 um) in indoor venues is now broadly acknowledged. The smaller lighter aerosols can linger and accumulate in the air and travel long distances on air currents. Previously the dominant view was that respiratory viruses are transmitted by larger droplets that fall on surfaces within about 2 meters or are transferred by people’s hands. Catching the virus from  surfaces  – although plausible – seems to be rare.

Researchers presume  super-spreading events might become larger and more frequent as more transmissible SARS-CoV-2 variants are becoming more prevalent. Smaller, more densely occupied venues could be at greater risk when visited for longer periods and being poorly ventilated.

Testing and infection transmission of asymptomatic people questioned

More than two years into the pandemic, there are  many questions  about an asymptomatic SARS-CoV-2 infection left. Interesting to notice is that in China, at the start of the pandemic, infected individuals weren’t immediately causing exponential local outbreaks. Similarly, many health care workers treating patients at a time that personal equipment was not routinely used remained seronegative. Also living closely together in one house will not assure one will get a positive PCR test and/or symptoms.

It became complex when doctors found  disease symptoms  in asymptomatic people. One example is from Wuhan early in the pandemic, which showed that about one-third of persons with asymptomatic infections had lung changes that were visible on computed tomography scans indicating end organ damage. Another example is the US FAIR Health study that found 19% of cases of Long COVID have resulted from asymptomatic infections. However, symptoms like  Long Covid  or  a loss of smell  could have other origins as well.

To determine the extent to which people without symptoms  testing  positive with either the  PCR test ,  rapid antigen test  or  antibody test  contribute to the COVID-19 pandemic remains a challenge. Especially since the term asymptomatic can be used in various ways. Strictly the definition would be a laboratory confirmed SARS-CoV-2 infection as determined by PCR or serology but with no symptoms related to COVID-19 for the duration of the infection.

The  highly sensitive PCR test  may result in high numbers of  false positive s and false negatives when asymptomatic people are tested. The PCR test can detect the presence of a piece of RNA of the SARS-CoV-2 virus. However, the RNA alone may remain detectable for months after a previous infection resulting in  a positive test. Unfortunately, materials and methods of published articles and reports do not always present the number and type of gene probes and  Ct values  used in PCR tests and could therefore lead to different data among various studies.

Furthermore, it is unknown whether tests used are correctly validated  against viral infectivity  in culture; e.g. detecting a virus that might be able to transmit to another person and cause infection. In many countries a variety of PCR tests have been used with  Ct values > 30  with a risk for high percentages of false positives. Depending on the gene probes used, cross-reactivity with other  (corona)viruses  may occur. Rapid antigen tests have been validated across PCR tests and are therefore prone to high numbers of false positives and false negatives for people without symptoms as well.

Other problems have been in the news, like contamination at sampling and  laboratory sites  where large quantities of tests were handled, shortness in materials using only one gene probe for PCR testing, inexperienced personnel and  unreliable tests  adding up to a possible low quality of diagnosis used, based on which data have been analyzed and presented.

Researchers propose that 20-40% of global infections are asymptomatic .  These data are mostly based on diagnostic tests without analysis  of symptoms  by a medical doctor. A qualification between symptomatic or asymptomatic can be questioned and is in many cases  not notified.  

The discussion continues, as it is  very hard  to detect aerosols outside the laboratory and show that they contain and  transmit the virus  to another person and  cause COVID-19  symptoms.

SARS-CoV-2 virus is one of the most extensively studied immune targets that led to reappraisal of former textbooks. Up to now, a possible cause of symptoms by long-term wearing of masks, frequent use of disinfectant and testing which has never been seen in history before, has not been evaluated.

Wearing of masks during exercise can be fatal

Harvard Medical School , the  Mayo Clinic  , the  Cleveland Clinic ,  Bangkok hospital  and several medical doctors and  researchers  in the  UK  recommend wearing masks during sports. While face masks may not be comfortable, they can protect against COVID-19 and won’t interfere with your efforts to stay fit during the pandemic, so they say.

The  CDC  urges gym goers to wear masks while working out at fitness centers even during high-intensity exercise, but it’s okay for people who are fully vaccinated to exercise indoors without a mask. However, the  WHO  does not recommend  wearing a mask  during sports. A serious warning was given by  Cambridge news  and other  news outlets  when two Chinese children died while running while wearing a mask.

Results of the poorly studied impact of covering mouth and nose with face masks or other respiratory devices on the physiological and perceptual responses during exercise have been controversial. The small cohorts of participants of those studies were mostly selected persons with athletic abilities, as those with cardio-pulmonary and other disorders were not included.

As a   25% rise  in emergency cardiovascular events among under 40 population in Israel during vaccine rollout and the third COVID-19 wave is noticed, safety and effectiveness for wearing masks (during sports) is an important topic .

Up to now more than  150 studies  do not allow the conclusion that without any doubt the wearing of masks can protect against infection and prevent transmission of a virus. A report of the  ECDC  concludes there is no real evidence in favor of face masks. Furthermore, the number of peer-reviewed publications suggesting the potential harms by frequent and long-term wearing masks, which have been neglected earlier, are piling up.

A recent  study  (not peer-reviewed yet) showed the increase of CO2 while wearing a mask. The CO2 content reached levels above the set risk level of 5,000 ppm (acceptable threshold for workers) for 40.2% of the people wearing medical masks and for 99.0% of the people wearing a FFP2 mask. A  special article  COVID-19 and masks in sports also found an enhancing effect on pCO2 in case of intense physical exercise.

The use of masks in  athletes  causes hypoxic and hypercapnic breathing as evidenced by increased effort during exercise. Another  study  found that wearing a face mask during exercise intensity mostly affects perceptual responses, causing an increase in the rate of perceived breathlessness and overall exertion with limited influence on pulse oxygen, blood lactate, and heart rate responses.

Participants wearing masks  reported marked discomfort , such as feeling hot, humid, and breathing resistance and claustrophobia with higher exercise intensity. While other researchers could  not measure   significant detectable   differences , these signs need to be taken seriously.

Both oxygen and carbon dioxide are the primary gaseous substrate and product respectively, of oxidative metabolism. Variations in the levels of these  gases  outside the physiological range can lead to pathological conditions including respiratory and heart problems, permanent injury, immune suppression, increased aging, and altered gene expression for fertility and death.  Carbon dioxide poisoning  is recognized as an often-forgotten cause of  intoxication  in the emergency department.

A change in these gases, albeit small, may influence a disbalance in the microbial flora, resulting in a weakened immune system that may be noticed by  mask acne  and  mask mouth  with an increased risk for infectious diseases and chronic diseases.

Authors from a study published in  Frontiers in Physiology  raised particular concern for individuals exercising in a hot and humid environment, which can break down the mask and lose the ability to block outgoing viruses and germs, and experience a hot facial temperature and difficulties with breathing.

The results from an observational study published in  Medicine  strongly suggest that mask mandates caused 50% more deaths compared to no mask mandates. It is theorized that hyper-condensed droplets caught by masks are reinhaled and introduced deeper into the respiratory tract could be responsible for the increased mortality rate ( The Foegen effect ).

Also, a  peer-reviewed study  published in April 2022 on mask usage across Europe noted a moderate positive correlation between mask usage and deaths in Western Europe.

A recent review concluded a potential risk for developing  MIES (Mask Induced Exhaustion Syndrome)  by long-term wearing of masks.

The safety of masks used by the general public cannot be guaranteed.  Toxic compounds  like nanoparticles ( graphene oxide , titanium dioxide, Silver, Zinc oxide) and microplastics have been found. Masks delivered by governments have been retracted from the market in The Netherlands, Canada, Germany and Belgium. Recent studies demonstrated the presence of microplastics and nanoparticles in  blood ,  deep lung tissue  and the  liver. Microplastics and nanoparticles deplete the body, by forming bio corona, from essential nutrients, proteins and cells which the body needs to function properly. A recent review assessed the potential  carcinogenicity  of increased exposure to microplastics and nanoparticles in humans.

At this moment there is no proof that long-term wearing of masks during normal life is safe and effective. With a lack of evidence of the transmission of an infectious virus by an asymptomatic person and the effectiveness of wearing masks, mask mandates should be  banned immediately. There is a serious indication for irreversible harm which might increase when people have been vaccinated and might be more sensitive to oxidative stress.

Exercise Can Prevent Infectious Disease

For many years it is known that individuals with a  regular exercise  habit report fewer symptoms associated with upper respiratory illnesses. Data from  epidemiological studies  suggest that regular exercise can protect the host organism from infections like COVID-19 such as influenza virus, rhinovirus, varicella zoster and herpes simplex virus. The remarkable low prevalence of COVID-19 in a Sub-Saharan Africa region is thought to be related to  moving more and sitting less

Instead of focusing on the level of aerosol production and arguing for mask wearing, testing without symptoms, and social distancing, it would be much more beneficial to support exercise in a ventilated environment (with the right humidity and temperature) and healthy living. This would be a better way to manage successfully the next seasonal outbreak of respiratory diseases and prevent a  tsunami of chronic diseases  and  suicides.

Journalists of prominent newspapers/channels could play a supportive role in rebuilding trust in health by delivering honest and balanced science-based information to the public based on critical analyses.

A Hidden Post-Pandemic Decline of Female Health

By Carla Peeters • January 23, 2026
As women used to live longer than men even during severe famines and epidemics, a continued post-pandemic increase in female mortality and disabilities can’t stay hidden or neglected. During the Covid pandemic in many High-Income Countries, injuries, disabilities, and all-cause mortality started to rise above expectations. In 2020, the gender gap in mortality widened due to an observed increased mortality in men. While in 2021 male health seemed to bounce back to earlier trends, mortality and disabilities in women continue to rise above earlier trends and are not expected to solve themselves soon. This might cause a fundamental and permanent change in the dynamics of the gender mortality gap. Recent decisions on austerity measures for budgets on female health and welfare will exacerbate this hidden disaster. Instead, Public Health Experts and CEOs of insurance companies need to take their moral responsibility and turn to smart investments in female health, addressing all gender disparities, to reverse a downward spiral in global population health. A Sudden Rise in Excess Mortality and Disabilities In September 2024, Swiss Re published in their annual report, “Many countries worldwide still report elevated death in their population today.” This impact appears independent of healthcare system or population health. In the pessimistic model, Swiss Re would expect excess deaths to continue for another decade. There is also likely a degree of excess mortality underreporting. CFOs from other life insurance companies confirmed that experienced mortality rates are broadly in line with this report. A skyrocketing increase in disability claimants since 2020 is another puzzling factor why CEOs of insurance companies are facing major problems with their financial model. The growth in demand is much lower, and the number of people making claims is much higher than expected. Declining revenues may soon hit the corporate bottom line. For the first time in 80 years, the stocks from insurer Centene Medicaid plummeted in July 2025 by 41% after the insurer had to withdraw its full financial guidance because previous estimates were way off. The analysis from insurance companies is comparable with earlier reports from Phinance Technologies , which analyzed publicly available data from the US and UK using various methods. Other independent analysts observed similar trends. In recent years, hundreds of peer – reviewed articles discuss excess mortality and adverse events of special interest in various countries of pandemic measurements and after Covid-19 vaccinations. Boston University just published the all-cause mortality in the US as compared to other High-Income Countries and showed that excess death rates peaked in 2021 and declined in 2022 and 2023 but remained substantially higher than pre-pandemic rates, especially in the age group 25-44 years. Mortality among US adults aged 25-44 years was 2.6 times higher as compared to other High-Income Countries. A recent opinion from Kakeya et al. describes a significant increase in excess deaths after repeated Covid-19 vaccinations. Japan is the country with the highest per capita rate of messenger ribonucleic acid mRNA vaccination doses in the world. A systematic review on Covid-19 mechanisms of injury and death compiled with autopsy confirmation by a physician application suggests there is a likelihood of a causal link between Covid-19 vaccines and deaths. While there are studies that conclude there is no significant increase in stillbirths when women were vaccinated with the Covid-19 mRNA vaccine during pregnancy, a study based on VAERS data shows a significant increase. Another, not yet peer-reviewed, study indicates that Covid-19 vaccination with dose 1 during weeks 8-13 of pregnancy was associated with 3.9 fetal losses above expected for every 100 exposed pregnancies. A study in the Czech Republic on live births of vaccinated versus non-vaccinated women demonstrated a substantially lower successful conception rate among vaccinated women than for those who were not vaccinated. The fertility rate in the Czech Republic dropped from 1.85 births per 1,000 women in 2021 to 1.62 in 2022 and 1.45 in 2023. Births in the EU fell to 1.38 births per woman. Also the US reported a historically low birth rate in 2023. Many Western countries are facing a similar problem with dropping fertility rates as the health of young women declined during the pandemic and post-pandemic economic instability. Furthermore, maternal mortality rates accelerated at an alarming rate, especially from 2019-2022 in the US and UK, mainly caused by cardiovascular problems. The sharp spike in maternal death could not be explained by older age. Pregnancy-related maternal deaths are getting worse. In the UK, suicide remains the leading cause of direct maternal death in the first postnatal year. Pandemic measures resulted in a collapse of women’s health and income, especially for those with the lowest wages working in healthcare, social services, education, and retail. During this period, the number of female healthcare worker suicides and fatal overdoses increased . ‘When the health of those who look out for people’s health is at risk the whole population and economy are at risk.’ Furthermore, it is well known that women respond more strongly and may experience a higher risk for complications after vaccinations. An age and sex associated difference in immune cell population might explain this. Observations from vaccination trials in Guinea-Bissau suggest increased female-male mortality ratio associated with inactivated polio and diphtheria-tetanus-pertussis vaccine. There is precedent for the observation that infant girls experience increased mortality following receipt of vaccines. People in healthcare (80% women) have been recommended and sometimes mandated a yearly flu vaccine and several boosters with Covid vaccine. While not tested, a flu vaccine and Covid vaccine were mostly given at the same moment. A recent British study among 1,745 healthcare workers showed booster vaccinations did not contribute to the protection of the healthcare workforce in a post-pandemic setting. The Covid-19 vaccination may even temporarily increase the likelihood of symptomatic infection and workday loss. A study of a large cohort of 3805 healthcare workers in Sweden confirmed that adverse reactions after Covid 19 vaccination can lead to a substantial amount of missed work shifts that can cause organizational disturbances in staffing. Risks were found to differ by vaccine type and regimen used, age, and sex, with young female healthcare workers experiencing more adverse reactions. The recently published British and Swedish studies are in line with a few earlier studies. Recommending a combined use of four vaccines that prior to use had not been tested together during pregnancy when the immune system is following a precious time clock for the survival of both mother and child has been a risky approach. Clinical trials with the Covid mRNA vaccine during pregnancy have shown data with serious worries that should have been openly discussed with pregnant women. Moreover, long-term effects for both mother and child remain unknown. After the Netherlands and the UK, the US only recently said that Covid-19 vaccines are no longer recommended for healthy people under the age of 65 years and pregnant women. Whereas Covid-19 vaccines are still recommended for immunocompromised people, unfortunately they might be more at risk for experiencing Covid-19 infections after booster immunizations. Although a causal relation remains difficult, the effects of repeated mRNA vaccination in combination or shortly before or after other vaccinations and/or using (psychiatric) medicine need to be elucidated. Sex differences in cost-effective harm analysis will help future decision -making. Last week Robert F Kennedy, Jr stopped financing 500 million subsidiaries for the mRNA vaccine platform. Also the director of the NIH Dr Jay Bhattacharya wrote an opinion piece for the Washington Post: “Why the NIH is pivoting away from mRNA vaccines.” As a vaccine for a broad public use mRNA technology has failed to earn public trust. A Post-Pandemic Increase of Female Mortality In nearly all populations, women live longer than men. The ubiquity of female survival advantage for all ages, even during famine or epidemics, when mortality is extraordinarily high is changing. Unfortunately, there is limited information available on sex differences in excess mortality from major respiratory infectious diseases. A peer-reviewed study on the first wave of the Covid-19 pandemic in Italy observed that gender differences in excess risk of death existed, but with a nuanced and non-consistent picture. The general finding of this study is that males up to 75 have been suffering more excess deaths as compared to females. However, this picture is less clear-cut at older ages when more women are living in nursing homes which during the Covid pandemic showed the highest mortality rates. A study from the Netherlands on sex differences in Covid-19 mortalities skipped the data from healthcare workers and people living in nursing homes (mostly females) to confirm that male sex is a predisposing factor for severe Covid-19 independent of age and comorbidities. Some other studies and a recent study (preprint) suggest Covid-19 did not produce lasting shifts in pre-pandemic sex differences in mortality in High-Income Countries and did not change the fundamental dynamic of the sex mortality gap. The authors observed that the male disadvantage in the Covid-19 mortality based on absolute death counts was concentrated in the pre-vaccine phase and declined over time. Relative increases in mortality were often similar between sexes, and in some cases, greater among women. Another study on excess mortality of 561 regions and 21 countries in Europe indicate that in many European regions, where drops in life expectancy were more moderate, more pronounced life expectancy losses were found for women. The authors suggest that the degree of mortality deterioration is not necessarily linked to biological sex. A cohort study of the overall impact of the Covid-19 pandemic on mortality in France observed four consecutive years of excess mortality and a growing impact on people from 20-60s, particularly men. Unfortunately, no peer-reviewed publications on sex differences and excess mortality cover the years 2024-2025. Yet, during the International Conference of Actuaries in 2025 Nationale Nederlanden, a Dutch insurance company, presented a continued rise in female excess mortality in the Dutch population from 2024-2025, while male excess mortality tended to decline. Furthermore, analysis showed a much higher degree of female excess mortality as compared to EU countries in general, while the Dutch male population experienced a better life expectancy as compared to EU countries.

The (Lack of) Health in Young Women

By Carla Peeters • March 13, 2025
Many countries now face a growing problem with an aging population and declining childbirths. Too many infants still die unnecessarily before the age of five years. Countries increasingly struggle to keep their economies stable. While Public Health experts communicate to focus on healthier future generations, declining health in young females is ignored. The healthiest generation with a flourishing economy is achieved by a holistic strategy addressing Young Women’s Health as a Public Health priority. The Healthiest Generation of the World in 2040 A Federation of Organizations involved in Public Health in the Netherlands has the ambition to reach the healthiest generation of the world in 2040 . Health is aimed at all levels; mental, social, and physical. To achieve this goal, the Netherlands needs the healthiest young females of the world. In contrast, data analysis from the Netherlands shows the opposite; the health of young women is declining fast. In other Western countries, it won’t be much better. The health of young women has worsened worldwide; it is time to face reality. Women’s bodily functioning and metabolism differ from men and need specific female-adapted health support. While many health problems in a population could be prevented when young females are supported for optimal health prior to pregnancy, this is not a priority of Public Health Agencies. Good health for the next generation starts with a strong and resilient immune system before pregnancy and during the first 1,000 days around pregnancy, birth, and postpartum breastfeeding. Childbirth and children’s health are declining; the number of women dying during pregnancy (within 42 days after labor) is increasing, as well as the number of abortions. Without change, these conflicting trends may develop into a disaster touching all levels of society. The Public Health Future Outlook of the Netherlands predicts that close to 12 million people will have a chronic condition by 2050. Young Women’s Health Is Declining Around half of the young people aged 6-25 years in the Netherlands experience mental health problems. Moreover, 47% of the people aged 15-44 years are diagnosed with at least one chronic disease, with young women more often diagnosed than men. When diagnosed with a chronic disease, people work less, experience more sick leaves, and are less productive. Unfortunately, not being able to work contributes to poorer health and income. An even larger percentage of young people (79%) still suffer from a negative impact of the pandemic, with women and lower-educated individuals hit hardest and experiencing mental problems like emotional exhaustion, stress, and hyperactivity. A recent study published in PNAS showed a faster aging of the brains of young females as compared to young males, which might be related to chronic stress exposure. Students experience more stress than before due to worries about inflation and the high costs of living. Within the EU, the Netherlands has grown into the most expensive country to live in. Unfortunately, there is much more that is troubling the health of young females. Increased Drug Use and a Dangerous Beauty Myth During the pandemic, the use of antidepressants increased by 16% for those aged 16-24 years and for children. Women are prescribed antidepressants earlier and take them twice as much as men. While the positive effects of SSRI have been criticized repeatedly and women report more side effects than men, these medicines are still frequently prescribed by medical doctors. One in four young people in the Netherlands use Ritalin or Concerta ( methylphenidate ) without a medical prescription to improve concentration and study results. Most people are unaware of the potential risks, like sudden death, that are well-known as a potential side effect. Research has shown that 5.5-22.5% of the young have used ADHD medication without a doctor’s prescription. Furthermore, in mid-2023, a worrisome increase in NSAID like paracetamol (Tylenol or Acetaminophen) and ibuprofen use was observed, especially in young girls, increasing the risk for poisoning. The use of antibiotics like amoxicillin increased for children 0-10 years (55%) and for those aged 11-20 years with 50%. As 2023 was the first year after the pandemic with all festivals open to the public, an increased use of party drugs (like ecstasy ) among those aged 16-35 years was noticed with regularly registered symptoms of poisoning. The online and interconnected world exposes the risk of cyberbullying among young people. Ironically, many are feeling lonelier than ever before and are struggling with their weight and self-confidence, setting them up for poor health as adults. The beauty myth is another danger. During the years 2019-2022, the use of fillers increased by 80%, and the use of Botox doubled among young women. Exposure to microplastics, nanoplastics, and nanoparticles has increased. Furthermore, the concentration of PFAS/PFOA in Dutch drinking water is found to be above the norm and may decrease the fertility of both women and men. On the other hand, the use of oral hormonal contraceptives by young girls diminished in the Netherlands, with only a slight increase in the use of an intrauterine hormonal device. Recent studies showed that there is an increased risk, although small, of myocardial infarction or stroke when using hormonal contraceptives. The use of an intrauterine device with levonorgestrel did not show the risk. Given the extensive and ongoing reliance of millions of young women on these drugs, ensuring their safety remains a critical responsibility of the medical community. As well as medical doctors informing young women of potential harm based on the latest scientific literature by informed consent. Over the past 4 years, girls and young women have been exposed to repeated HPV vaccinations and Covid-19 mRNA vaccines within a short period of time, for both of which side effects in women have been reported to be more frequent and severe. Possible interactions and/or interference with these vaccines and long-term effects on the immune system and microbiome have not been investigated beforehand. Neither was knowledge available when it started in 2021 on the possible risks and short- and long-term effects when four vaccines before 22 weeks of pregnancy were introduced. Nutritious Food Not Affordable for Many The importance of daily consumption, as recommended by the WHO, of 400 grams of fresh fruit and vegetables, meat, milk products, and eggs for a healthy life and joyful social and working life is unknown by many young people. For most of them, it has become unaffordable . (Ultra)processed foods are the cheapest satisfying foods with a well-designed composition of low-cost ingredients, sugar, fat, and salt that change the microbiome. Home, school, commercials, social media, influencers, mobile phones, and retail environments are driving obesity and being overweight in children and adolescents, often concurrent with undernutrition and anemia. A growing body of evidence shows that the billions of microorganisms present in our body are intimately involved in weight gain and loss and immune training and modulation, as well as overall host homeostasis. Around 33% of the population in the Netherlands does not consume fruit and vegetables daily. As of 2024, 7.1% of Dutch children live in poverty, and this number is still growing . More children might be undernourished, which is associated with impaired growth, neurodevelopment, and increased infectious morbidity and mortality. To reverse the problem of malnutrition, the delivery of free meals has recently started at primary schools. Unfortunately, this does not make a difference for the children at secondary schools. While sending funding to developing countries to prevent malnutrition, a similar problem appears in front of our eyes in the Netherlands. The young generation predominantly eats more plant-based foods, as it would improve climate change. Almost 30% of young women prefer to shop for vegetarian food, and 0.7% of the Dutch population is vegan. In addition, the EU introduced novel food products such as insects and worms, lab-grown meat, and Bovaer for cows to reduce methane production, which might affect the human immune system. Almost one in five adolescents vape. Long-term effects are yet unknown. In the Netherlands, vapes with synthetic liquids that taste like cola, vanilla, apricot, etc., have now been forbidden . Although smoking is declining in adults, young women more frequently smoke than boys but drink less alcohol. All internal and external environmental factors may contribute to weakening or strengthening the resilience of the immune system and may therefore influence the period of pregnancy, labor, nursing, and the health of mother and child for future generations. Pregnancy Is Regulated by a Unique Complexity of the Immune System Pregnancy is a unique immunological state. The changes of the immune system in the three stages of pregnancy (very early, mid, and late stage) are meticulously timed. In the very early stage, the immune system adjusts to prevent her body from rejecting the fetus while at the same time still being strong enough to keep out foreign pathogens. In the late stage, the body is preparing for labor, which is driven by an inflammatory response. A full-term pregnancy will follow an immunological clock . Changes in this immune profile could help to predict and possibly prevent preterm labor. Studies show that pathologically-driven inflammation might trigger pre-term birth (before 37 weeks). In the Netherlands, 14.8% of the children born are preterm with 9.7% low birth weight for the duration of the pregnancy (Big2). Interestingly, in the case of a preterm child labor, the inflammatory reaction is more heated as compared to a full-term child labor. Preterm birth is an important indicator of a risk for early death, chronic and infectious diseases, sepsis, stunting, and delayed neurological and brain development. This may manifest throughout one’s lifespan. Very early birth and extreme early birth occur in only 1.5% of the Dutch baby population and are responsible for 50% of the deaths of newborn babies. The number of abortions jumped in two years in 2023 to 39,000, with most by women aged 25-34 years of age. Abortion in the Netherlands is allowed until 24 weeks of pregnancy. The number of childbirths has declined dramatically to 167,504 in 2022. That is 1.49 children per woman, with a mean age of 30.3 years. The number of women breast-feeding is also decreasing. At 6 months, women feeding breast milk lowered from 60% to hardly 30% of the young mothers. Each year, around 661 babies in the Netherlands die. Mothers dying within 42 days after labor are around 11 persons a year with an additional 5 women dying by suicide each year, and not counting women who died from cancer. Over the past years, mothers’ deaths have been increasing worldwide, with the leading cause being heart diseases and blood clots. Pregnant women with stress , depression , or anxiety , as well as obese women with gut inflammation and chronic disease, have altered immune systems and, as a consequence of malnutrition, have an altered microbiome. A weakened immune system suggests an increased risk for preeclampsia, high blood pressure, HELLP syndrome, gestational diabetes, preterm labor, and/or low birth weight. ‘Gut Feeling’ a Turmoil for Healthy Future Generations The gut presents 70-80% of the immune cells in the human body. In the mucosal layer of the intestine, neuronal cells, endocrine cells, and immune cells cooperate to manage its metabolism and bodily functioning. Recent studies in mice showed villi of the mucosal layer expanding twice its volume during pregnancy and breastfeeding, slowing food passage, improving digestion for an optimal use of available nutrition. The intestinal mucosal layer is strongly connected to various stages of pregnancy with altered gut microbiota, metabolites, and cytokines. These bioactive metabolites modulate and change the ‘innate’ and ‘adaptive’ immune system. Together, the microbial composition and the mucosal layer of the intestine determine long-term health. Mothers’ intestines influence the biodiversity of the microbiome and the resilience of the immune system, which is transmitted to the baby during pregnancy, labor, and nursing. Earlier periods in life facing hunger, extreme stress, or severe diseases may influence health during pregnancy and may transmit to the baby throughout one’s lifespan and even with intergenerational effects. Specific nutrients may have positive effects during pregnancy, labor, and nursing. Sufficient vitamin D , present in sunlight, nutrition (fish, milk products), or supplements, is a prerequisite during this precious time in life for both mother and child. For young women who wish to become pregnant, it is important to learn how to balance the immune system and the microbiome. The immune system of young women could be the most important regulator of the healthiest generations and a population’s workability and income. Author: dr. Carla Peeters First published at Brownstone Institute
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