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Until then, there had been few signs that anything was amiss for Felix and her unborn baby, other than some swelling in her feet. “I wasn’t too alarmed by that, but I found out I was spilling protein and all these things about my blood pressure. It was terrifying. But our family got to go home,” she says.

While Camryn is now a healthy five year old, Felix is all too keenly aware of similar stories which have resulted in a far more tragic ending. In April 2023, her long-time team-mate Tori Bowie, a former world 100m champion and relay gold medallist at the Rio 2016 Olympics, died in childbirth from complications linked to pre-eclampsia. She was just 32.

“We were on numerous relay teams together, we competed against each other, with each other, and that was extremely shocking,” says Felix. “Someone that I’ve spent so much time with, it was really devastating.”

Worldwide, pre-eclampsia is thought to be responsible for more than 70,000 maternal deaths and 500,000 foetal deaths every year, with many fatalities resulting from stroke or prolonged fitting as a result of the elevated blood pressure. It can occur without warning at any time during pregnancy, with some women developing early-onset pre-eclampsia before 34 weeks, and others experiencing late-onset forms of the condition. Women can even suffer from postpartum pre-eclampsia in the six weeks after giving birth.

Scientists have uncovered a few clues as to why this happens. Excessive inflammation, beginning in the uterus, disrupts the delicate communication patterns taking place between the mother’s body and the foetus. In particular, it impacts the reshaping of blood vessels within the uterus to form the placenta, the organ created to provide the foetus with the nutrients and oxygen it needs.

Because the flow of blood through the placenta is abnormal, it ultimately interferes with how the mother’s body controls blood pressure, gradually leading to hypertension and ultimately pre-eclampsia.

“When a woman becomes pregnant, her heart’s got to pump extra for the baby and the placenta,” says Ian Wilkinson, clinical pharmacologist and professor of therapeutics at the University of Cambridge, who is leading a UK-based population study of pre-eclampsia called Poppy. “The amount of blood she’s pumping each minute goes up one-and-a-half to two times [in normal pregnancy].”

Women with existing autoimmune disorders, those aged over 40 and women with a larger body mass index are known to be at greater risk, perhaps because they are unable to adapt as well to the physical toll that pregnancy places on a woman’s body.

But there are still many mysteries about why certain women develop pre-eclampsia, often without warning, and why others do not. In particular, rates are as much as 60% higher in black women, who are also more likely to experience severe forms of the condition.

Some researchers believe that the latter could be linked to poorer access to good nutrition and health insurance. “There’s structural racism, where certain patients and communities don’t have the same access to early interventions, detection screening, primarily because of where they get their healthcare,” says Garima Sharma, director of cardio-obstetrics and cardiovascular women’s health at the healthcare company Inova Health System in Fairfax, Virginia.

At the same time, Sharma says that this does not explain exactly why the condition begins in the first place. While doctors still rely heavily on clinical risk factors such as age, ethnicity and medical history to assess who might develop pre-eclampsia, the accuracy of predictions based on these factors is notoriously poor. “The sensitivity of clinical risk factors on their own is low,” says Sharma.

But with newer and improved diagnostics beginning to emerge, scientists may soon be able to shed more light on who is at risk and why.

While specialists treating other diseases such as cancer or chronic infections can often take a biopsy of a patient’s internal tissues for further analysis, there is no easy way of studying the changes taking place in a pregnant woman’s uterus.

“We can’t just routinely go in and collect a sample of placenta [from a pregnant woman], because that can really increase the risk of miscarriage,” says Lana McClements, associate professor at the University of Technology Sydney. “And animals actually don’t develop pre-eclampsia, so rodent models, for example, are very difficult to create.”

Launched in 2022, the new path threads Québec’s bucolic villages and lake-laced landscapes, passing more than 100 culinary stops from Montréal to Sherbrooke.

Once, in 2019 – uncomfortably perched on a borrowed, oversized bike – I rode 42km on a windswept, gravel causeway built atop an old train line that cuts through the waters of New England’s Lake Champlain.

Based on that experience, and a leisurely 32km pedal near my Vermont home recently, I decided to hop on a Greyhound bus to Montréal with my sister, a more experienced biker, and spend five days tackling the Véloroute Gourmande: a 235km paved and gravel cycling trail connecting Montréal and the city of Sherbrooke in southern Québec.

That’s how I found myself sopping wet from unrelenting rain, wearing padded bike shorts beneath running tights, multiple shirts under a rain jacket and dripping onto the wooden floorboards of one of the most charming coffee shops I’ve ever entered, Yamaska Café in Farnham, Québec. I’m not yet an intermediate rider, but I’m certainly a stubborn beginner. And a hungry one.

Luckily, I was – quite literally – on the right track. Launched in April 2022, the Véloroute Gourmande passes more than 100 culinary stops, from farmers’ markets and vineyards to casual pubs and elegant farm-to-table restaurants, as it threads through the region’s bucolic villages and lake-laced landscape. As a food writer, goose farmer, cooking teacher and restaurant chef, I was keen to turn my attention from the woods where I forage for wild mushrooms and my garden, which abounds with heirloom tomatoes, uncommon herbs and edible flowers, north to explore the culinary heritage of the Québecois countryside.

Much of the trail follows a portion of the Route Verte, whose 5,300km crisscross Québec and comprise the longest network of cycling paths in North America. But aside from its length, the main difference between the two routes is that the Véloroute Gourmande was essentially designed as a slow travel food tour. While pedalling across Québec’s countryside, cyclists can stop to refuel on gravy-slicked French fries, tarts filled with blueberry jam, coffee gussied up with maple syrup or booze flavoured with boreal herbs, forest mushrooms or wildflowers.

The Véloroute’s interactive map features 120 icons – including tiny forks, beer glasses and squat jam jars – that denote places to stop for things like golden panini stuffed with house-cured ham and bloomy rind cheese, dark ale delicately scented with spruce tips or wedges of cheese to squash into one’s panniers and nosh by the side of the road.

Despite its name, this “Gourmande” trail isn’t merely culinary. Organisers also offer suggestions on elegant hotels and charming B&Bs, culturally important sites – such as a Le Vieux Clocher concert hall in Magog and a defunct copper mine that offers underground tours – and every bike shop along the way, in case your derailleur gets derailed on the rail trail.

Although it’s possible to tackle the route in either direction, the Véloroute website suggests starting in Montréal and riding east. Given that Montréal is the most likely arrival point for out-of-towners and the biking closest to the city is easiest (read: flatter), allowing cyclists to build up to the longer, hillier days, this makes good sense. Riding east also provides a better chance at a tailwind, although it does increase the climbing by 150m.

The initial segment, a 45km pedal from Montréal to the city of Saint-Jean-sur-Richelieu, contains 55 of the route’s 120 culinary pit stops. In order to pack in more dining, we gave ourselves an extra day to cover the first leg.

As a chef, I’ve typically planned my travels around culinary explorations. Over time, I’ve developed strategies for sniffing out the finest fare, from comforting and casual to exquisite. However, I’ve never before been limited to the places I could get to with only pedal power.

I narrowed down the options in two ways. First, I eliminated places that would be closed when I passed by, including farmers’ markets that are open for just four hours per week. Next, I looked for stops that highlight the best of what Québec has to offer, ignoring otherwise appealing ramen shops and Italian restaurants. The region’s modern cuisine leans heavily on its French-occupied history – think buttery pastries, French onion soup and crêpes rolled around sweet or savoury fillings. These items are complemented by fare that might be fit to take along while logging or fur trapping, such as long-lasting hard cheeses and charcuterie, and spiced meat hand pies.

As a rule, restaurants with massive menus often rely on frozen and premade goods, so I nixed those, even if they tantalised with mentions of Québecois fare such as poutine, steak or salmon tartare or custard-y maple syrup pie. Briefer menus that mentioned the use of local or seasonal ingredients, and featured those same classic items, made the list.

Once I had my itinerary, we set out. Biking east, we travelled along the mighty St Lawrence River, passing decaying factories, building-sized cruise ships and the two islands that make up Parc Jean-Drapeau, which features a ferris wheel, a geodesic dome that looks like a massive soap bubble and Montréal’s slick Formula 1 racing circuit.