You asked, we answered. Here are responses to our readers'’ questions about pregnancy nutrition.
Before you were pregnant, you probably didn't think twice about enjoying a tuna-fish sandwich, a salad sprinkled with blue cheese or a glass of red wine. After all, tuna is brimming with protein, blue cheese contains bone-building calcium, and red wine in moderation can benefit your heart. But now that you're expecting, these foods could pose a health risk to you and your growing baby, which is why it's important to know exactly which foods and beverages you should avoid.
These important food facts will help you make safe choices.
(Q) I love sushi, but isn't raw fish bad for a growing fetus?
(A) Yes. When you are pregnant, eating any raw seafood, including sushi that contains uncooked fish, is a bad idea, says American Dietetic Association spokesman Keith-Thomas Ayoob, Ed.D., R.D. That's because raw foods can carry harmful bacteria, such as listeria, which can cause flulike symptoms as well as miscarriage or stillbirth. They can also contain parasites, toxins and viruses, including hepatitis A and B.
Raw or undercooked meat, poultry and eggs also should be avoided because they can contain listeria, salmonella and E. coli. To help protect yourself from these bacteria, cook meat to 160° F and poultry to 180° F. Undercooked hot dogs or deli-style lunchmeats also can contain listeria, so the U.S. Food and Drug Administration (FDA) recommends that pregnant women avoid eating them unless they are heated until steaming hot.
(Q) I'm diabetic. Are sugar substitutes safe to eat now that I'm expecting?
(A) Based on years of research, sugar substitutes, such as saccharin and aspartame, appear to pose no health problems for pregnant women or their growing babies, Ayoob says. If you do choose to include them in your diet, consider eating them in healthful foods, such as sugar-free yogurt, rather than in diet soft drinks, which contain no nutrients.
(Q) I'm a vegetarian. Can I get all the nutrients I need without eating meat?
(A) Yes, as long as you make sure you get enough vital nutrients such as calcium, iron, zinc, vitamin D and the B vitamins, says Elizabeth Somer, M.A., R.D., author of Nutrition for a Healthy Pregnancy (Henry Holt and Co., 2002). Eggs, milk products, legumes, whole soy foods, vegetables and nuts are all excellent sources of these nutrients.
(Q) I've heard that I should stay away from soft cheese. Which ones fit that description, and are they safe to eat if cooked, such as on a pizza or in a cheese sauce?
(A) Pregnant women should avoid soft cheeses because they can contain listeria. Brie, Camembert, Mexican-style cheeses (such as queso blanco), goat cheese and feta made with either cow's or sheep's milk all fall into the soft-cheese category.
Even pasteurized soft cheeses are risky, says Erin Coffield, R.D., a registered dietitian with the New England Dairy and Food Council, because they tend to have a low pH level, which puts the cheese at risk for contamination. You should also avoid blue-veined cheeses such as Gorgonzola.If you do decide to eat soft cheese, be sure to heat it until it's bubbling hot.
(Q) I can't start the day without my morning cup of java. What's the lowdown on caffeine?
(A) Although there is little evidence that moderate amounts of caffeine will harm your growing baby, research has shown that it can increase the baby's heartbeat, particularly in the last trimester, Somer says. Also, consuming more than 300 milligrams of caffeine a day (the amount in two 5-ounce brewed cups) increases the risk of miscarriage, fetal growth problems and low birth weight. To be safe, switch to decaffeinated coffees, teas and colas, and drink smaller amounts, during your pregnancy.
(Q) Before I became pregnant, I enjoyed an occasional glass of beer or wine or a martini. Now that I'm expecting, will drinking alcohol really hurt my baby?
(A) Yes. Drinking alcohol has been linked to fetal alcohol syndrome, a condition characterized by mental retardation, physical defects and behavioral problems, according to the March of Dimes. Instead, try fruit nectar mixed with seltzer or nonalcoholic sparkling cider. (Nonalcoholic beer contains trace amounts of alcohol and should be avoided.)
(Q) I hate milk, but I know I need calcium. What are some other sources to get the 1,000 milligrams I need daily?
(A) "Try calcium-fortified orange juice or soy milk fortified with calcium and vitamin D," says Johanna Dwyer, D.Sc., R.D., a professor at the Friedman School of Nutrition Science and Policy at Tufts University in Boston. Other good sources of calcium include bok choy, white beans, canned salmon with bones, hard cheeses, yogurt and fortified oatmeal, such as Quaker Instant Oatmeal Nutrition for Women.
(Q) Last night I ate ahi tuna for dinner. Now I'm wondering: Could the possible high level of mercury hurt my growing baby?
(A) That amount of ahi was unlikely to contain enough mercury to cause any health problems, Somer says. However, to be safe, the FDA says that women who are pregnant or breastfeeding should avoid certain fish that are likely to contain high levels of mercury, which can affect the baby's developing brain and nervous system.
Fish that the FDA has flagged as containing unhealthy amounts of mercury include shark, king mackerel, swordfish and tilefish (sometimes called golden snapper or golden bass). Safe choices include shellfish, cod, flounder and canned tuna, but limit them to 12 ounces a week.
(Q) I love pí¢té and smoked salmon, but my friend told me I should avoid them now that I'm pregnant. Is she right?
(A) Pí¢té and foie gras made from undercooked goose or duck liver should not be eaten when you are pregnant because these foods could contain listeria, Ayoob says.
The FDA also warns pregnant women against eating refrigerated smoked seafood, such as salmon, trout, whitefish, cod, tuna and mackerel (often labeled as nova style, lox, kippered, smoked or jerky) because they are cured, not cooked. However, canned versions of these foods are considered safe, as is vegetable pí¢té.
(Q) I'm excited about being pregnant, but I've got morning sickness all day, every day and greasy foods make me feel worse. Is there anything I can eat to alleviate the nausea?
(A) "Morning sickness is a universal problem without a universal answer," says Miriam Erick, M.S., R.D., senior perinatal dietitian at Brigham and Women's Hospital in Boston and author of Managing Morning Sickness (Bull Publishing, 2004). "One food does not fit all." What alleviates one woman's nausea may not help you. That said, ginger and citrus fruits help many women, as do dry, salty foods, such as crackers and pretzels. Starchy foods, such as rice and potatoes, may also help; you can boost their nutrient content by folding in vegetables and chicken.
(Q) Now that I'm pregnant, I can't wait to dig into all those goodies I've been depriving myself of for years, such as doughnuts, ice cream and French fries. I need the calories, right?
(A) Occasional treats are fine as long as you enjoy them in moderation and as part of a healthy diet. The reality is, now that you're pregnant, you need only 300 additional calories a day—and only in the last two trimesters. (During your first trimester, you need 2,000 to 2,200 calories a day, the same amount recommended for nonpregnant women.) So instead of blowing those calories on greasy, sugary snack foods, many of which contain additives, try reaching for a healthy, homemade treat.
(Q) I've read that pregnant women aren't supposed to eat soy. Is this true?
(A) Controversy has arisen recently because a small study showed that when pregnant female rats were fed a diet enhanced with genistein, a substance found in soybeans, the male offspring developed reproductive problems. Although further research is under way, many health experts, including Somer and Dwyer, feel you can enjoy soy foods such as tofu and soy milk in moderation (one serving per day) when you are expecting.