Prescriptions
Some seafood may do harm to your fetus
By Amy Tousman
It's well known that eating a variety of healthy foods can improve the chances of a positive pregnancy outcome.
But what some people may not realize is that there also are foods that women who are pregnant or trying to conceive need to approach with caution. Experts worry that those foods may contain harmful chemicals, bacteria or parasites, any of which could cause problems for the growing fetus.
Recently the U.S. Food and Drug Administration released an advisory to women who are pregnant or trying to conceive, warning them of the risks of eating large, predatory fish. The reason: Shark, swordfish and king mackerel contain high levels of a substance called methylmercury.
Mercury occurs naturally in small concentrations in the environment and is of little concern. If it enters the water, however, it is transformed into methylmercury and becomes highly toxic. Regularly eating large amounts of fish containing methylmercury can harm an unborn child's nervous system and affect the child's learning ability.
Sheryl Pollack, nutritionist for the Women, Infants and Child program at the state Department of Health, said she suspects that some locally caught deep-sea fish may have even higher concentrations of methylmercury than those sold on the Mainland and cited in the FDA advisory. Mako shark, thresher shark, bigeye tuna and Pacific blue marlin may have significant amounts of methylmercury. Unfortunately, the information available on local fish is 10 years old and may not reflect today's conditions. Let's hope the FDA advisory will generate more research on Hawai'i's fish.
Considering that we eat lots of fish here, it would be prudent for women trying to conceive and those who are pregnant or nursing to consume no more than six ounces of these fish a week. Since fish is a heart-healthy food, with substances that help develop a baby's vision, it should not be eliminated completely. The consensus is that shrimp, crab, scallops, canned fish, smaller ocean fish, salmon and any farm-raised fish can be safely eaten.
Opinions differ among health professionals regarding the safety of eating sushi, sashimi, poke and other raw seafood. Pollack and her colleagues at the WIC program recommend pregnant women avoid these foods since there is potential for food poisoning when uncooked seafood is eaten.
Straub Clinic and Hospital obstetrician/gynecologist Dr. Simon Chang says "food poisoning can affect the fetus." Pregnant or not, there is some risk in eating uncooked foods, he says. However, there is no known incidence in Hawai'i of food poisoning from sushi or sashimi. Chang recommends buying sushi from a reputable place where the fish is fresh and proper food-handling procedures are used.
Dr. Amos Grunebaum, a New York-based obstetrician /gynecologist writing for webmd.com, notes that "in Japan, women eat sushi while pregnant without ill effects. There are no studies showing harm to the fetus from sushi. Even so, raw fish may contain worms or bacteria. The only way to kill these things is by proper cooking."
Bacteria in raw seafood may cause only mild flu-like symptoms in the mother, but can be harmful to the fetus. Raw fish may contain a bacteria which can cause birth defects or miscarriage. Some cases of hepatitis A from raw seafood have also been reported. Although the risks from sushi, sashimi, and poke are minimal, it seems sensible to avoid these foods during pregnancy.
Fish and seafood are not the only foods with potential for food poisoning in pregnant women. Runny eggs, homemade Caesar dressing and hollandaise sauce may carry salmonella and listeria.
Soft cheeses such as brie, feta and blue cheeses, hotdogs, undercooked meat and smoked fish also may contain listeria.
Toxoplasma gondii, a parasite carried by cats, can get into food from contaminated soil.
Raw and undercooked meat, unwashed fruits and vegetables, and unpasteurized juices, can carry T.gondii. It can be detrimental to the fetus, potentially leading to miscarriage, mental retardation and blindness.
To prevent exposure to listeria and T. gondii:
• Reheat leftovers and ready-to-eat foods, such as hot dogs, sausage and Spam, until they are steaming.
• Wash fruits and vegetables.
• Wear gloves and wash hands, after cleaning a cat litter box, gardening or doing activities that involve dirt.
• Cook meat until well done.
If you think you have been exposed to listeria or T. gondii, talk to your physician immediately. Antibiotics are used to treat these infections.
Although it may seem difficult to avoid some foods, remember it is only temporary. Taking a few precautions to give your unborn baby a healthy start is well worth the effort.
Amy Tousman is a registered dietitian at Straub Clinic & Hospital Inc. and a member of the Hawai'i Dietetic Association.
Hawai'i experts in traditional medicine, naturopathic medicine, diet and exercise take turns writing the Prescriptions column. Send your questions to: Prescriptions, 'Ohana Section, The Honolulu Advertiser, P.O. Box 3110, Honolulu, HI 96802; e-mail ohana@honoluluadvertiser.com; fax 535-8170. This column is not intended to provide medical advice; you should consult your doctor.
