Pregnancy and Nutrition: To Eat or Not To Eat...That is the Question

One of the most common topics that obstetricians are asked about is that related to nutrition and pregnancy.  There is so much information “out there”.  It is difficult to know what to believe.
There are a few websites that I use frequently to find up-to-date, reliable information on medical topics related to women.  One of these websites is the U.S. Food and Drug Administration (www.fda.gov).  They have a nice resource entitled “Food Safety for Moms-to-Be”.  I would like to share a few highlights of very valuable information that they provide.

Question #1
So, what is the deal about fish? Is it safe to eat fish or not when I am pregnant?  The answer to this question is…it depends.

Fish is a great source of protein and other nutrients.  The big concern with eating fish, when you are thinking of becoming pregnant, pregnant or breastfeeding, is the presence of mercury in the fish.  Almost all fish, including shellfish, has mercury.  The goal is to avoid those fish with high levels of mercury.  Mercury can affect your developing baby’s neurologic system.  Women who are trying to become pregnant, who are pregnant or breastfeeding should avoid 4 main types of fish – Shark, Swordfish, King Mackerel and Tilefish.  These are the types of fish that contain the highest levels of mercury.

If you are trying to become pregnant, pregnant or breastfeeding, it is permissible to include fish in your diet.  Moderation is the key.  You can eat up to 12 ounces a week of fish or shellfish that have lower amounts of mercury.  Examples of these types of fish include shrimp, canned tuna, salmon, pollock and catfish.  The FDA points out that albacore (“white” tuna) is commonly eaten and has more mercury than tuna.  If you choose to eat albacore, limit the amount to 6 ounces per week.

This link provides a chart published by the FDA.  The chart identifies common fish and shellfish with their associated mercury concentration. 

Question #2
I have been hearing a lot about listeria in the news.  Should I be concerned about listeria during my pregnancy?

Listeriosis is a part of a category of illnesses called foodborne illness or “food poisoning.”  It is caused by a bacterium called listeria monocytogenes.  It is found in nonpasteurized milk and milk products as well as “ready to eat” foods including meat, seafood and poultry.  Vegetables may also be a source of listeriosis if they were grown in soil contaminated with Listeria.  The FDA states that the Centers for Disease Control and Prevention indicate that pregnant women are approximately 20 times more likely to get listeriosis compared to healthy, non-pregnant adults.  Additionally, 1/3 of all cases of Listeria are diagnosed in pregnant women.

Interestingly, some pregnant women with listeriosis do not have symptoms.  For this reason, listeriosis can be passed from the mother to the unborn baby.  However, it is important to know about common symptoms that you should share with your health care provider, such as fever, chills, muscle aches, diarrhea, headache, confusion and stiff neck.  This is not a complete list of symptoms.  Some ways that Listeria can affect pregnancy include but are not limited to, miscarriage, preterm labor, delivery of a low-birth weight infant or infant death.

At this point, you might be reading this and feeling a little scared.   Do not fear!  Listeria can be prevented.  Here are a few of the tips that the FDA provides:
1. Your refrigerator temperature should be 40 degrees Fahrenheit (4 degrees Celsius).  Your freezer should be maintained at zero degrees Fahrenheit.
2. Clean your refrigerator regularly.
3. Do not eat hot dogs or deli meats unless they have been heated until they are steaming hot.
4. Avoid certain cheeses, such as Feta, Brie, Camembert, “queso blanco” or “queso fresco” unless the label specifically says the cheese has been made with pasteurized milk.
5. Do not eat meat spreads unless they are “shelf-stable” meaning they do not require refrigeration.
 

All of the information that I have discussed is available on the FDA website – www.fda.gov.  I encourage you to browse the website.  You can click on links with keywords related to consumers, women, pregnancy and food safety.

Always remember that this information should not take the place of advice from your health care provider.  If you have questions and concerns related to this topic, you should seek out specific advice from your health care provider.