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— BY MICHAEL ROIZEN, M.D., AND MEHMET OZ, M.D.

Q: My sister is having a baby (yes, we read your book “YOU: Having a Baby”), but she hasn’t taken the info in the book to heart, and she’s gaining a lot of weight. She was a big girl to start with. and I told her to watch her weight for the unborn child’s sake. What would you tell her? -- Sandra F., Manchester, New Hampshire

A: If you’ve already read our book, you both should be aware that while she is pregnant, her health and lifestyle choices, before and during pregnancy, can affect her health and the health of her yet-to-be-born. She should know that she’s eating for 1.1 people, not two, and she needs just 10 percent more calories, not 100 percent more. Being overweight while pregnant can cause neural tube defects in the fetus that impair development of the brain and spine. It can also cause elevated blood glucose in the mother, and that can trigger other problems. For instance ...

New research shows that when Mom has pre-diabetes, gestational diabetes or Type 1 or 2 diabetes, the signaling pathways in the fetus’s developing heart may be altered or interrupted. The result is congenital heart disease, the leading cause of infant death. Exactly what develops depends on the amount of Mom’s weight gain and the degree of elevated blood glucose that happens in each trimester. Overall, the risk of CHD is increased four or five times.

Pregnant overweight moms-to-be also threaten their own health with preeclampsia, high blood pressure, kidney and liver complications. Delivery also may be complicated. The baby may be born oversized, making a C-section necessary (tough on Mom and baby’s gut biome). The child may then develop weight, learning and speech problems down the road.

So, the smart step for your sister (and any pregnant, overweight woman) is to work with a nutritionist and exercise specialist recommended by her OB/GYN.

Following a healthy routine will help her and her baby have a healthy and happy life together.

Q: My son is a 10th-grader, and I think he’s vaping. The problem is my husband is using e-cigs to quit tobacco cigarettes, so they’re vaping the same stuff for different reasons. How do I address this problem at home? -- Stephanie R., Syracuse, New York

A: First off, tell your husband to skip the e-cig and to ask his doc about using nicotine gum or patches, and perhaps the antidepressant bupropion to stop cravings. Also good: nightly walks with a buddy. Dr. Mike’s Wellness Center offers free tobacco cessation classes, and so do many other medical centers across the country.

So, ask your doc to find someplace your husband can get the support he needs to quit. Remind him, he doesn’t want his son to go through the misery of quitting that he’s experiencing.

Now, as for your son, chances are he’s surrounded by peers who are vaping. U.S. Surgeon General Dr. Jerome Adams just declared that e-cigarette use is “an epidemic among our youth.” Among middle- and high-schoolers it increased 900 percent from 2011 to 2015. Upward of 1.3 million more teens were vaping in 2018 than 2017.

There’s big money in it. Since our last column on the topic, the largest e-cigarette manufacturer, Juul, sold 35 percent of its company to the leading U.S. cigarette manufacturer Altria (which owns Phillip Morris) for $12.8 billion. Dr. Mike fears vaping is a gateway habit to smoking regular cigarettes.

Research in JAMA Pediatrics shows that when students use an e-cigarette with nicotine concentrations over 18mg/mL it leads to an increased use of e-cigarettes and regular cigarettes.

So here are a few ideas: At home, talk to your son about the risks of vaping. Nicotine affects an adolescent’s still-developing brain and can damage lungs. Take time together to visit Dr. Mike’s Cleveland Clinic website about vaping (health.clevelandclinic.org/parents-could-your-teens-be-juuling).

At school, make sure administrators have information about the dangers and hazards of vaping. Check out Toolkit For Schools at makesmokinghistory.org.

•••

(Mehmet Oz, M.D. is host of "The Dr. Oz Show," and Mike Roizen, M.D. is chief wellness officer and chair of Wellness Institute at Cleveland Clinic. Email your questions to Dr. Oz and Dr. Roizen at youdocsdaily(at sign)sharecare.com. Distributed by King Features Syndicate, Inc.)

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