health and wellness
What parents need to know about Tylenol, autism and the difference between finding a link and finding a cause in scientific research
The article discusses the ongoing debate regarding the potential link between prenatal acetaminophen (Tylenol) use and autism. While some studies show weak associations, establishing causation remains challenging. Factors like dosage response and sibling outcome comparisons are critical for understanding this complex issue, highlighting the need for more thorough research and consulting healthcare professionals.
What parents need to know about Tylenol, autism and the difference between finding a link and finding a cause in scientific research
Claims from the Trump White House about links between use of the painkiller acetaminophen – often sold under the brand name Tylenol in the U.S. – during pregnancy and development of autism have set off a deluge of responses across the medical, scientific and public health communities.
As a father of a child with level 2 autism – meaning autism that requires substantial support – and a statistician who works with such tools as those used in the association studies cited by the White House, I find it useful to think about the nuances of association versus causation in observational studies. I hope that this explanation is helpful to parents and expecting parents who, like me, are deeply invested in the well-being of their children.
Association is not causation, but …
Most people have heard this before, but it bears repeating: Association does not imply causation.
An often-cited example is that there is a very strong association between ice cream sales and incidents of shark attacks. Of course, it goes without saying that shark attacks aren’t caused by ice cream sales. Rather, in the summertime, hot weather drives more appetite for ice cream and beach time. The increased number of people at the beach does, in turn, cause the likelihood of shark attacks to increase.
Yet pointing this out on its own is neither intellectually satisfying nor emotionally appeasing when it comes to real-life medical concerns, since an association does suggest potential for a causal relationship.
In other words, some associations do end up being convincingly causal. In fact, some of the most consequential discoveries of the past century in public health, like the links between smoking and lung cancer or the human papillomavirus (HPV) and cervical cancer, started out as findings of very strong association.
So when it comes to the issue of prenatal acetaminophen use and autism development, it is important to consider how strong the association found is, as well as the extent to which such an association could be considered causal.
Establishing causal association
So how do scientists determine if an observed association is actually causal?
The gold standard for doing so is conducting what are called randomized, controlled experiments. In these studies, participants are randomly assigned to receive treatment or not, and the environment where they are observed is controlled so that the only external element that differs among participants is whether they received treatment or not.
In doing this, researchers reasonably ensure that any difference in the outcomes of the participants can be directly attributed as being caused by whether they received the treatment. That is, any association between treatment and outcome can be considered causal.
Yet oftentimes, conducting such an experiment is impossible, unethical or both. For instance, it would be highly difficult to gather a cohort of pregnant women for an experiment and extremely unethical to randomly assign half of them to take acetaminophen, or any other medication for no particular reason, and the other half not to.
So when experiments are simply infeasible, an alternative is to make some reasonable assumptions on how observational data would behave if the association was causal and then see if the data aligns with these causal assumptions. This can very broadly be referred to as observational causal inference.
Parsing what the studies mean
So how does this apply to the current controversy over the potential for acetaminophen use during pregnancy to affect the fetus in a way that could result in a condition like autism?
Researchers who try to understand causal roles and links between one variable and potential health outcomes do so by considering: 1) the size and consistency of the association across multiple attempts to estimate it, and 2) the extent to which such association has been established under observational causal inference frameworks.
As early as 1987, researchers have been working to measure possible associations between acetaminophen use during pregnancy and autism. A number of these studies, including multiple large systematic reviews, have found evidence of such associations.
For instance, a 2025 review of 46 studies that examined association between acetaminophen use and an array of neurodevelopmental disorders, including autism, identified papers with five positive associations between acetaminophen and autism.
In one of those studies, which examined 73,881 births, the researchers found that children who were exposed to acetaminophen prenatally were 20% more likely to develop borderline or clinical autism spectrum conditions. Another examined 2.48 million births and reported an estimated association of only 5%.
Both of those are weak associations. For context, estimations of increased lung cancer risk from smoking in the 1950s were between 900% to 1,900%. That is, a smoker is 10 to 20 times more likely than a nonsmoker to develop lung cancer. By comparison, in the two autism studies above, a pregnant woman who takes acetaminophen is 1.05 to 1.20 times more likely than one who does not take the drug to have a child who would be later diagnosed with autism.
It’s also important to keep in mind that many factors can affect how well a study is able to estimate an association. In general, larger sample sizes provide both greater power to detect an association if one does exist, as well as improved precision over estimating the value of the association. This does not mean that studies with smaller sample sizes are not valid, only that from a statistical perspective, researchers like me place greater confidence in an association drawn from a larger sample size.
Once an association – even a small one – is established, researchers then must consider the extent to which causation can be claimed. One way to do this is through what’s called dose-response. This means looking at whether the association is higher among women who took higher doses of acetaminophen during pregnancy.
The study mentioned above that looked at 2.48 million births shows an example of dose-response. It found that pregnant women who reported taking higher doses have higher autism risk.
Another way to examine possible causality in this context is to analyze sibling outcomes, which that same paper did. Researchers looked at whether associations between acetaminophen and autism persisted within families with more than one child.
For example, in a family with two children, if the mother used acetaminophen during one pregnancy and that child was later diagnosed with autism, but she did not use it during the other pregnancy and that child was not diagnosed, then this strengthens the causal claim. Conversely, if acetaminophen was used during the pregnancy of the child who was not diagnosed with autism and not used during the pregnancy of the child who was, then that weakens the causal claim. When this was included in the analysis, the dose-response disappeared, and in fact the overall 5% increased risk mentioned before likewise disappeared. This weakens the claim of a causal relationship.
Consult your doctor
At present, there is clearly not enough evidence to establish a causal association between prenatal acetaminophen use and autism.
Yet as a parent who wonders if my daughter will ever be able to write her name, or hold a job or raise kids of her own, I understand that such explanations may not appease the fears or concerns of an expecting mother who is suffering from a fever.
Naturally, all of us want absolute certainty.
But that’s not possible when it comes to acetaminophen use, at least not at this time.
Your doctor will be able to provide you with much sounder advice than any existing study on this topic. Your OB-GYNs are very likely aware of these studies and have much better judgment as to how these results should be considered in the context of your personal medical history and needs.
Researchers, meanwhile, will continue to dig deeper into the science of this critically important issue and, hopefully, provide greater clarity in the years to come.
Mark Louie Ramos, Assistant Research Professor of Health Policy and Administration, Penn State
This article is republished from The Conversation under a Creative Commons license. Read the original article.
Dive into “The Knowledge,” where curiosity meets clarity. This playlist, in collaboration with STMDailyNews.com, is designed for viewers who value historical accuracy and insightful learning. Our short videos, ranging from 30 seconds to a minute and a half, make complex subjects easy to grasp in no time. Covering everything from historical events to contemporary processes and entertainment, “The Knowledge” bridges the past with the present. In a world where information is abundant yet often misused, our series aims to guide you through the noise, preserving vital knowledge and truths that shape our lives today. Perfect for curious minds eager to discover the ‘why’ and ‘how’ of everything around us. Subscribe and join in as we explore the facts that matter. https://stmdailynews.com/the-knowledge/
Food and Beverage
Beyond Protein: 2 Nutrients Your Plate Might Be Missing
Nutrients: Everyone is talking about protein these days whether watching their weight or managing a disease like type 2 diabetes. However, fiber and healthy fats are nutrients many people are overlooking. One food that makes it easier to invest in your health, according to nutrition experts: avocados.
Beyond Protein: 2 Nutrients Your Plate Might Be Missing
(Feature Impact) Everyone is talking about protein these days whether watching their weight or managing a disease like type 2 diabetes. However, fiber and healthy fats are nutrients many people are overlooking. The latest reports show most Americans already meet or exceed recommendations for protein while nearly all (about 95%) do not eat enough fiber, and many people consume too much saturated fat versus unsaturated fat, according to the 2025 Dietary Guidelines Advisory Committee. Prioritizing ways to get more fiber and healthy fats on your plate could be key to managing weight and type 2 diabetes goals this summer.
One food that makes it easier to invest in your health, according to nutrition experts: avocados.
A growing body of research and materials from Avocados – Love One Today, a science-based resource, suggests fresh avocados offer weight management benefits, help with type 2 diabetes management and are good for blood sugar management.
According to a study* of more than 27,000 adults published in the journal “Internal Medicine Review,” people who ate just over half of an avocado per day weighed 7.5 pounds less, had smaller waist sizes and tended to have healthier overall eating habits, including higher intakes of fiber and healthy fats, compared to people who didn’t eat avocados. Among the list of benefits, this delicious and healthy fruit uniquely contains fiber and healthy fats in each nutrient-dense bite which slows digestion, helping you feel satisfied and fuller longer which can help you consume fewer calories overall. In fact, if you’re using a GLP-1, avocados are one of the foods to add to your menu to make small meals feel more filling and satisfying while supporting nutrient needs.
Scientists also recently took a second look at the largest study* about avocado consumption to-date involving close to 1,000 adults, per the journal “Current Developments in Nutrition,” and found that consistently eating one avocado every day for six months (no other diet changes required) significantly reduced dietary glycemic load (GL) by nearly 14 points, a metric that evaluates how what you are eating is affecting your blood sugar levels. GL may be an important consideration in the management of chronic diseases like type 2 diabetes. By slowing digestion, fiber and healthy fats also support stable blood sugar levels.
There are many ways to enjoy avocados, including chopped, sliced, mashed, blended, in baked goods or even frozen. Avocados add flavor, variety and nutrition across the day.
Try these recipes for Avocado and Blueberry Chia Pudding, Avocado Breakfast Bowl with Leafy Greens for your next breakfast or snack.
*Remember: Small, consistent food choices can add up over time. Research suggests regularly eating avocados may support weight management and blood sugar targets while providing the fiber and healthy fats that many Americans are overlooking. These studies were supported by the Avocado Nutrition Center. While these findings are encouraging, the studies highlighted show an association, not cause and effect, and thus more research is needed to confirm these findings in other populations.
To explore evidence-based avocado nutrition information, along with practical tips and easy recipes, visit Avocados – Love One Today, a leading resource for avocado nutrition information.
Avocado and Blueberry Chia Pudding
- 1 1/2 cups plain, unsweetened soy milk (or milk of choice)
- 1 ripe, fresh avocado, halved, pitted and peeled
- 3/4 cup frozen blueberries
- 1/2 cup unsweetened vanilla Greek yogurt
- 1 tablespoon maple syrup
- 1/3 cup chia seeds
To Serve:
- 1/3 cup granola
- 1/3 cup fresh blueberries
- 1 kiwi, chopped
- 1/2 fresh, ripe avocado, halved, pitted, peeled and chopped
- In blender, puree soy milk, avocado, blueberries, yogurt and maple syrup until smooth. Pour mixture into storage container or bowl and add chia seeds. Whisk well to combine. Cover with lid or plastic wrap and refrigerate 4 hours or overnight, until thickened.
- To serve, divide into bowls and top with granola, fresh blueberries, kiwi and avocado.
- Notes: Use any milk (dairy or non-dairy) that you prefer in pudding. Use fresh blueberries or conventional frozen blueberries. Other topping options include: nuts, seeds, hemp hearts, sliced banana or strawberries, or nut butter.
Avocado Breakfast Bowl with Leafy Greens
Bowl:
- 1 medium sweet potato, chopped (about 1 3/4 cup)
- nonstick cooking spray
- 1/4 teaspoon smoked paprika
- 1/4 teaspoon garlic powder
- 1/4 teaspoon salt
- 1/2 cup quinoa
- 1 cup water, plus additional for boiling eggs, divided
- 2 eggs
- 2 cups arugula
- 1 ripe, fresh avocado, halved, pitted, peeled and chopped
- 1/4 cup pickled red onions
Avocado Tahini Dressing:
- 1/2 large avocado
- 1/4 cup tahini
- 1 lemon, juice only (2 tablespoons)
- 3/4 cup water
- 1 tablespoon fresh chives
- salt, to taste
- pepper, to taste
- Preheat oven to 400 F. Add chopped sweet potato to baking sheet. Spray with cooking oil then add smoked paprika, garlic powder and salt. Toss to coat in spices. Bake 22-25 minutes, or until tender.
- In medium saucepan, add quinoa and water. Bring to simmer and cover, cooking 12-15 minutes, or until quinoa is tender and fluffy.
- Fill small saucepan with water and bring to boil. Use slotted spoon to lower eggs into water. Cook 8 minutes then transfer eggs to bowl of ice water to cool before peeling.
- To make dressing: In small blender, puree avocado, tahini, lemon juice, water and fresh chives until smooth. Add more water, 1 tablespoon at a time, if needed, to thin until pourable. Season with salt and pepper, to taste.
- Assemble bowls, each with 1/2 sweet potato, 1/2 cup quinoa, 1 egg, 1 cup arugula, 1/2 avocado, 2 tablespoons pickled red onion and 3 tablespoons dressing. Reserve remaining dressing in refrigerator.
Heart-Healthy Frozen Avocado Banana Paleta
- 1 ripe, fresh avocado, halved, pitted, peeled and diced
- 4 cups orange juice
- 2 medium bananas, peeled and sliced
- 1 tablespoon lime juice
- 8 paper cups (5 ounces)
- 8 wooden craft sticks
- In blender, blend avocado, orange juice, bananas and lime juice on high until smooth. Divide into paper cups. Cover cups with aluminum foil. Insert one stick through center of each foil. Freeze 4 hours until firm.
SOURCE:
🍴 What’s your favorite food, recipe, or dining spot? Tell us in the comments! Then subscribe to the STM Daily News newsletter for fresh recipes, restaurant news, food trends, and delicious stories delivered straight to your inbox. Join our growing community of food lovers today!
health and wellness
Zepbound Linked to Lower Healthcare Costs in Adults 55+ With Obesity, Real-World Study Suggests
A new real-world study of adults over age 55 with overweight or obesity found that sustained use of Zepbound (tirzepatide) for weight management was associated with lower healthcare costs over time compared with similar adults who were not treated. Eli Lilly and Company said the findings were driven in part by lower rates of hospital admissions and emergency department visits, and were published in Diabetes, Obesity and Metabolism.
What the study found
According to Lilly, researchers estimated healthcare cost differences over time (excluding the cost of Zepbound itself) using two established analytic methods. Across both approaches, monthly healthcare costs were lower, on average, among older adults who stayed on Zepbound.
Key estimates reported in the release include:
- At six months: costs were up to 15% lower (up to $181 per patient, per month).
- At 12 months: the estimated difference widened to as much as $607 per patient, per month, reflecting up to 38% lower costs than those not treated (estimates varied by model).
In the primary analysis, adults over 55 treated with Zepbound had lower rates of hospital admissions and emergency department visits across every follow-up period, along with numerically higher rates of routine outpatient and office visitsa pattern the company said was consistent with greater engagement in routine care.
Why Medicare is part of the conversation
Lilly said the cost findings may be relevant for older adults, including those in Medicares GLP-1 Bridge program. The company noted that beginning at six months, estimated healthcare savings nearly covered the programs monthly treatment cost of $195 per patient, per month, and by 12 months the estimated savings exceeded the reported monthly treatment cost.
Its important to note the release also emphasizes a limitation: claims data do not capture Zepbounds net price, and the study excluded the cost of Zepbound from total treatment costs. That means the reported differences reflect potential savings elsewhere in care that could offset treatment costs, not the full net cost impact.
Who was included in the analysis
The retrospective observational cohort study used Komodos Healthcare Map, a database of de-identified claims data from more than 330 million individuals enrolled in U.S. healthcare plans. The analysis included 15,843 adults over age 55 (mean age 64.5) with obesity or overweight plus at least one obesity-related complication who initiated Zepbound between November 2023 and September 2025. Each Zepbound user was matched 1:1 with a control participant who met the same eligibility criteria but did not initiate GLP-1 or GIP/GLP-1 receptor agonist medication.
What Zepbound is
Zepbound (tirzepatide) is a dual GIP and GLP-1 receptor agonist indicated for adults with obesity, or some adults with overweight who also have at least one weight-related medical problem, to lose weight and keep it off. Lilly also noted Zepbound is FDA-approved to treat adults with moderate-to-severe obstructive sleep apnea and obesity, and should be used alongside a reduced-calorie diet and increased physical activity.
Safety summary (high level)
The release includes an indications and safety summary with warnings. Among other risks, Lilly notes Zepbound carries a warning about thyroid tumors, including thyroid cancer, and may cause serious side effects such as severe stomach problems, dehydration leading to kidney problems, gallbladder problems, pancreatitis, serious allergic reactions, and low blood sugar (especially when used with certain diabetes medicines). Patients should talk with a healthcare provider about risks and whether the medication is appropriate for them.
Related Links
- Zepbound (official product site): https://zepbound.lilly.com/
- Lilly newsroom: https://www.lilly.com/news
- Journal page (publisher hub): https://dom-pubs.onlinelibrary.wiley.com/journal/14631326
- Medicare (official): https://www.medicare.gov/
- FDA MedWatch (side effect reporting): https://www.fda.gov/medwatch
Source
- PRNewswire / Eli Lilly and Company press release (Aug. 26, 2026): Zepbound linked to lower healthcare costs in adults over age 55 with obesity according to a real-world study
💪 Your health journey starts here! Explore the latest health news, fitness tips, wellness trends, and healthy living advice. Share your thoughts in the comments and subscribe to the STM Daily News newsletter to stay informed and inspired every day.
(Feature Impact) When it comes to stroke, time matters. Recognizing the warning signs and calling 911 quickly can help with receiving time-sensitive, life-saving treatment. Recovery should begin early, too.
Having a stroke can divide life into a stark before and after, affecting many aspects of daily life. While it’s easy to focus on the things a stroke can take away, it’s important to remember there’s life after stroke. Recovery isn’t just about relearning skills. It’s about adapting to new challenges, finding purpose in a different reality and continuing to move forward.
Navigating the aftermath of a stroke means balancing short-term and long-term plans. Once medically stable, rehabilitation should ideally begin within 48 hours, according to the 2026 Guideline for Adult Stroke Rehabilitation and Recovery from the American Stroke Association. Recovery doesn’t have a fixed end. Meaningful progress can continue for months or years after survivors leave the hospital or complete formal therapy.
“Stroke rehabilitation is complicated,” said Lorie Gage Richards, Ph.D., FAHA, volunteer chair of the new guideline, associate professor at the University of Utah and an occupational therapist. “Each person faces a different set of challenges and care should be personalized to fit each person’s needs. The goal is to help individuals gain as much independence as possible to perform everyday activities while improving their overall quality of life.”
Approximately 800,000 people have a stroke each year in the U.S, according to the American Heart Association’s 2026 Heart Disease and Stroke Statistics. Whether you’re navigating recovery yourself or supporting someone you love, connecting with a coordinated healthcare team is an important first step. Ask about a comprehensive assessment, develop a rehabilitation plan based on what matters to you and set small, achievable goals throughout recovery.
Building Skills and Independence
After a stroke, familiar parts of a daily routine may take more effort or require a new approach. A rehabilitation team can assess how stroke has affected movement, communication, thinking, vision, hearing and other abilities then develop a plan based on individual needs and goals.
Recovery doesn’t look the same for everyone. For one person, a meaningful goal may be dressing independently. For others, it could be returning to work, driving safely or participating in favorite activities. Start with manageable goals, evaluate progress and reassess the plan as needs change.
Understanding the Invisible Impacts
Some of the most challenging parts of recovery may be the ones others can’t see. For instance, you might lose confidence or sense of identity, have trouble concentrating or experience anxiety or depression. Along with mental and emotional changes, you may notice ongoing physical symptoms like pain, difficulty sleeping, changes in sexual function or difficulty with bladder control.
Invisible challenges don’t have to stay that way. Ask your healthcare team to assess your physical and emotional health, including depression and anxiety, during the hospital stay and throughout recovery. Speaking up about new or changing symptoms can help identify appropriate treatment and support.
Navigating Changing Relationships
When you have a stroke, your life isn’t the only one that changes. A partner, parent or friend may suddenly take on new responsibilities, making honest conversations about support especially important.
Family responsibilities may also look different. Parenting young children, supporting loved ones or balancing work and family can bring new challenges during recovery. Give yourself permission to slow down, accept care and connect with the people who matter most.
Finding Purpose and Redefining Success
Recreation, hobbies, social connections and other meaningful activities are an important part of recovery and can help people regain confidence, participate in their communities and improve quality of life. That may mean returning to music, art, exercise or time with friends. It could also mean modifying favorite activities, discovering new interests or connecting with a support group.
Life after stroke may look different, but different doesn’t mean less meaningful. Recovery isn’t measured by how closely someone returns to who they were before. It’s about finding new ways to pursue what matters most and continuing to move forward.
Learn more about recognizing stroke, preparing for rehabilitation and adjusting to life after stroke by visiting Stroke.org.
Photos courtesy of Shutterstock
SOURCE:
Please subscribe to the STM Morning News brief Newsletter!
