The Food Debate

By Nicolette Ferreira

SushiCheeseSushi (hmmm!), biltong, camembert… mayonnaise, chocolate mousse, soft scrambled eggs… These are just some of the foods that women are often told to avoid during pregnancy.

In my own experience during pregnancy I have found that some medical professionals strongly believe that certain foods should be avoided during pregnancy while others seem to be sure that pregnant women can consume all foods – even a glass of alcohol a day.

Oh, isn’t it utterly frustrating when professionals have different viewpoints on serious issues such as these, because how, then, is a mom to know?! What is myth and what is fact? Why do medical professionals have different opinions about this matter? And what on earth is Listeria and Salmonella?

Word from a Professional

Lize Bredell, a qualified dietician from Jeffreys Bay, agrees that the following foods are unsafe to eat during pregnancy: “Raw meats, such as biltong or sushi, can contain Salmonella or the Toxoplasmosis Parasite, both which can cause food poisoning that is understandably harmful to both a mother and developing baby.

“Raw egg, and this includes home-made mayonnaise, chocolate mousse or any other sauces made from raw egg, is another source of Salmonella.

“Soft cheeses (which are less acidic than hard cheeses and contain more moisture), unpasteurised milk and pates can all contain Salmonella and/or Listeria, which can lead to blood stream infection. Such infection is a serious threat to an unborn baby’s healthy growth and development.”

Listeria?

Listeria monocytogenes is a bacteria that is the agent of Listeriosis a serious infection caused by eating food contaminated with the bacteria. The disease affects primarily pregnant women, newborns, and adults with weakened immune systems. The two main clinical manifestations are sepsis and meningitis.[1]

How serious should we take Listeriosis? According to one source [2], there was an outbreak in 1981 in Canada that involved over 100 people. Thirty-four of these infections occurred in pregnant women, among whom there were nine stillbirths, 23 infants born infected, and two live healthy births. The source of the outbreak was coleslaw produced by a local manufacturer. In a more recent case, in 2013, an outbreak in four states in America led to five people being hospitalized, of which one died and another, a pregnant woman, had a miscarriage (as a result of the Listeria infection).[3]

Which foods put a pregnant woman at risk to get Listeriosis? Listeriosis is usually associated with unhygienic kitchen habits and the ingestion of milk, meat or vegetable products that have been held at refrigeration temperatures for a long period of time.[4]

Salmonella?

Salmonella, the other worrying bacteria for pregnant women, is a group of bacteria that can cause, when ingested in very large numbers, amongst other illnesses, food poisoning.

Eating food or drinking water that has been contaminated by faeces containing the bacteria causes most human infections of Salmonellosis.[5] Foods that are most commonly infected are:

Uncooked meat, seafood and poultry – contamination most commonly occurs during the slaughtering process. Seafood harvested in contaminated waters is a frequent cause.

Uncooked eggs – if the chicken is infected, the Salmonella are usually present in the eggs when laid.

Fruits and vegetables – fruit and veggies washed in contaminated water poses a risk, as well as certain kitchen practices, such as when a person handling raw meat touches fruit or vegetables in the kitchen (so wash your fruit and veggies!)

A Counter Arguement: Listeria Hysteria?

Research has shown that cases of Listeriosis in pregnant women are quite few and that in order to get infected with Salmonella the concentration of this bacterium should be quite high.

One source [6] states that the incidence of Listeriosis in pregnancy is 12 per 100,000. Available statistics for 2007 shows that of 800 cases in the United States in 2007, about 200 cases occurred during pregnancy. The same source indicates that the incidence of Listeriosis in the newborn is estimated at a rate of 8.6 per 100,000 live births. More recent statistics have been difficult to obtain (do see, however, this article on ‘Do We Really Need to Worry About Listeria in Newborn Infants?’ http://journals.lww.com/pidj/Documents/April%20ESPID%20Do_We_Really_Need_to_Worry_About_Listeria_in.23.pdf)

It is such information (statistics that suggest a low risk of pregnant women becoming infected with Listeria) that leads certain professionals to feel that pregnant women are scared half to death by the improbable. Doctor George Du Toit, Stellenbosch Obstetrician and Gynecologist, says that there are no reported Listeria cases in pregnant women in South Africa. According to him, only imported food may present a danger. With regards to Salmonella, he says: “theoretically, Salmonella is present on all foods – there has even been a case where rooibos tea was infected with Salmonella. Health standards determine the criterion to which foods we buy and consume must adhere to, and therefore foods such as biltong and sushi are safe to eat during pregnancy.”

Another source [7] claims that the incidence of Listeriosis cases in South Africa is unknown as no valid system for reporting cases are in place: “Information regarding the prevalence and genetic diversity of this micro-organism in South Africa is limited.”

The Salmonella and Listeria debate seems to be a question of: do we dare take a chance?

And Fish?

Dietician Lize Bredell says that certain fish that contain high levels of mercury can, once in your bloodstream, be harmful to your baby. “Certain predatory fish like shark, king mackerel, swordfish, deep sea tuna and tilefish may contain high levels of mercury, which could interfere with your baby’s developing brain and nervous system. It is recommended to not eat more than 1 tuna steak or 2 tins of tuna per week.”

Fish is a major source of omega 3 fatty acids, essential for a baby’s brain and eye development, and therefore it should not be omitted from the pregnant women’s diet. Fish is also a great source of Vitamin D, protein and other nutrients that can aid a healthy pregnancy. A few examples of fish that are low in mercury include: anchovy, herring, mackerel, salmon, sardines and whitefish.[8]

How About Some Tea?

Pregnant women will often hear that they should avoid herbal teas during pregnancy. The tea-issue ‘boils’ down to caffeine intake (harmful for baby’s development in large quantities). For more information on some quite extensive lists of teas that you may and may not drink during pregnancy, go to http://www.bellybelly.com.au/ and search ‘teas to drink and teas to avoid’ and go to www.everydayhealth.co and search ‘what kinds of tea are safe for pregnant women’.

Rest Assured!

Rest assured you may still have a little bit of coffee! According to Lize Bredell, research shows that a small amount of caffeine does not affect your baby. It is advisable to minimise your caffeine intake to 150 – 300 mg per day, which is equal to 2-3 cups of coffee per day. It is important to remember, however, that chocolate and certain cooldrinks also contain caffeine (and this is why women often hear they may not eat chocolate at all, which is not true – the caffeine content should just be monitored and healthy, nutritional foods not be omitted from their diets). Below is the caffeine content of certain foods and drinks:

  • one mug of instant coffee: 100 mg
  • one mug of filter coffee: 140 mg
  • one mug of tea: 75 mg
  • one can of cola: 40 mg
  • one can of energy drink: 80 mg
  • one 50 g bar of plain (dark) chocolate: around 50 mg

The pregnant woman’s diet is indeed a matter of debate! Hopefully this article has served as a guideline for foods to avoid and hygienic habits to adapt, whilst also warning against being over-anxious that we might still contract Listeriosis or Salmonellosis in spite of hygienic habits (consider statistics and probability). Have some coffee and a chocolate on the side, but leave the celebratory sushi or cheese platter for your first date out with hubby after baby’s birth!

 


Sources:

[1] http://www.thistle.co.za/pdf_files/education/microbiology/microbiology_legends/Cycle_23/Cycle%2023%20Organism%209%20-%20Listeria%20monocytogenes.pdf

[2] http://www.thistle.co.za/pdf_files/education/microbiology/microbiology_legends/Cycle_23/Cycle%2023%20Organism%209%20-%20Listeria%20monocytogenes.pdf

[3] http://www.cdc.gov/listeria/outbreaks/cheese-07-13/index.html

[4] http://www.thistle.co.za/pdf_files/education/microbiology/microbiology_legends/Cycle_23/Cycle%2023%20Organism%209%20-%20Listeria%20monocytogenes.pdf

[5] http://www.medicalnewstoday.com/articles/160942.php

[6] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2621056/

[7] http://scholar.sun.ac.za/handle/10019.1/17912

[8] http://www.babycenter.com/0_eating-fish-during-pregnancy-how-to-avoid-mercury-and-still_10319861.bc?page=2

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