“Safe food” in pregnancy and nutritional deficiencies

by | Mar 17, 2019 | Uncategorized

IN this article I want to explain to you why the guidelines on food safety in pregnancy make food choices too restrictive at the expense of the essential nutrients for pregnancy. I tell you how to prevent these nutritional deficiencies through conscious choices and good practices to be adopted to reduce the risk of contracting food-borne illness during food handling and storage.

Are you ready? Let’s go!

Nutrition is an important and critical aspect for everyone’s health and it is even more important for pregnant women. By paying attention to what you eat, how you manipulate, wash and store food, you can reduce the risk of contracting diseases related to pathogenic microorganisms present in food.

If you are pregnant surely you have met the recommendations and guidelines concerning food safety and a series of foods to avoid such as soft cheeses, fresh milk, raw or soft-boiled eggs, fresh meat and fish

But are these guidelines supported by scientific evidence? Or the precautions to be taken, to say are pushed to the extreme?

“Safe” food vs nutrient depletion

 You must be aware that if you avoid all potentially dangerous foods you may not be able to get all essential nutrients for your and your baby’s health. A study on 7,500 women in Australia showed that pregnant women who consciously reduced the consumption of foods that could potentially contain Listeria(a bacteria found everywhere in the environment that causes listeriosis which is a relatively rare disease that can have consequences on fetus causing congenital listeriosis, premature birth, miscarriage or fetal death due to ingestion of contaminated food) recorded nutritional deficiencies in folates, iron, vitE and calcium.

It is true that pregnant women are more susceptible to Listeria infection than the rest of the population, but the probability of contracting it is very low. As reported by the campaign carried out by the Istituto Zooprofilattico Sperimentale delle Venezie (IZSVe) in Italy “In Europe in 2013 1,868 Listeria contamination cases were reported, with a number of deaths equal to 191. In Italy, there is an average of about 200 cases per year of which 10% is for pregnant women”.

If the food is properly handled and stored, the risks are minimal and considering the very long list of all potentially dangerous foods due to Listeria (raw or undercooked meat, raw vegetables, lettuce, fresh mushrooms, raw milk, butter, soft cheeses, salted or smoked fish) the strict dietary rules seem too punitive.

Another consideration concerns the changes in nutrition that the pregnant woman decides to implement in order to avoid the risk of food poisoning.

Let’s take as an example the eggs. If a pregnant woman is advised not to eat soft-boiled eggs due to the risk of contracting Salmonella, following this advice,  she will alternatively choose to consume breakfast cereals (rich in sugars, additives, with few nutritional values). So at this moment, she changes her protein-based breakfast, rich in choline, DHA, iodine into something with zero benefits. However, she wasn’t told that the risk of contracting Salmonella from eggs is 1 case out of 30,000, so very very rare. And this risk is reduced 7 times if the eggs come from pasture-raised chickens.

The same applies to sushi consumption during pregnancy. Fish designated for human consumption is subjected to strict controls and fishery products intended to be eaten raw or practically raw and subjected to a preventive treatment by freezing and storage for at least 24 hours at a temperature not exceeding  -20° C. This stops all enzymatic and microbial activities. In Japan, the consumption of raw fish during pregnancy is not only recommended but is encouraged for optimal fetal development. It’s important that it is consumed from the safe source and stored in a proper manner and consumed immediately after purchase.

 On the website of the National Health Institute of Great Britain, there is an article entitled “It is safe to eat sushi during pregnancy?”. The article concludes that it is safe, you just have to make sure that the fish has previously been frozen

An exception to this rule is raw shellfish such as clams and oysters as the risk of contracting food poisoning from their consumption rises considerably and in my opinion, the game is not worth the candle. So consume them, but always well cooked, because they are incredibly rich in nutrients especially vitB12, zinc, selenium, iodine and omega3.

In reality, there are no 100% safe and 100% unsafe foods. Most recommendations on foods to avoid in pregnancy are related to products of animal origin but fruits and vegetables can also be at risk, certainly not 100% safe for consumption during pregnancy. For example, green leafy vegetables and fresh fruit are the cause of 41% of contaminations and the second leading cause of hospital admissions for food poisoning. Fruits and vegetables are the basis of a healthy diet, however, if they are consumed fresh and not cooked, they can be risky. The fact is that nobody tells pregnant women to avoid fruits and vegetables so why doesn’t this apply to meat, fish, soft cheeses or eggs?

My advice, therefore, is to always evaluate the REAL risks of food poisoning and benefits that you and your baby can lose if you don’t consume certain nutrient-dense food.  I’m not the one that recommends to strictly follow the guidelines which food to avoid or reduce during pregnancy, in my opinion, they are too restrictive and you risk only to be frightened and not consuming anything that could possibly be contaminated. It would be more reasonable to suggest moderate consumption of potentially dangerous foods than their total exclusion or considerable reduction.

Food safety precautions

Below I indicate the precautions and good practices to be adopted to reduce the risk to contract foodborne illness during handling and food storage:

  • Trust your nose. If it smells bad, don’t eat
  • Pay attention to products ready for consumption. Always buy them in a trusted source
  • Avoid buying pre-cut fruits and vegetables. Pre-cut foods are more at risk of contamination
  • Cook more often at home. Food poisoning is easier to contract in restaurants and bars
  • Always defrost the meat in the refrigerator (never outside). Always consume fresh meat within a maximum of 2-3 days
  • Wash your hands before handling food. Wash also cutting boards, counters, knives, so everything that has been in contact with food. You can use wine vinegar to sanitize the kitchen
  • Wash your hands after handling fresh meat or fish (ie before touching the countertop or salt)
  • In the refrigerator, separate the raw products (especially eggs, meat and fish) from each other and especially from vegetables and cooked foods ready for consumption to avoid cross-contamination
  • Avoid consuming raw shellfish
  • Put leftovers in the fridge within 2 hours after cooking
  • Consume pre-cooked or ready-to-eat products in a short time (max 3-4 days)

Final Considerations

As you can see, there is so much to consider when deciding which foods to limit or avoid in pregnancy. Considering the risks and benefits of certain foods, ask yourself the question “will their consumption help in the development of my baby?” Potentially any food that offers nutritional benefits, such as fresh vegetables and fish, can become risky to health if handled poorly. I hope I helped you at least in part to trust your mother instinct and make wisely choices