July 17, 2007

Sushi During Pregnancy? You're Eating For Two; Get The Platter.

Asian food writer Steven A. Shaw guts, skins, and filets the American medical community's warped recommendations about eating sushi during pregnancy. Then he slices them into tasty, bite-sized morsels and serves them up in the New York Times today:

WHEN my wife was pregnant with our son, her obstetrician gave her a list of food dos and don’ts. Chief among the don’ts: alcohol, unpasteurized cheeses and raw fish. Meanwhile, every French mother I know consumed alcohol and unpasteurized cheese in moderation during her pregnancy, and my friends in Japan laugh at the notion of avoiding sushi when they’re expecting.

Indeed, in Japan, eating raw fish is considered part of good neonatal nutrition. The Japanese government is fanatical about public health, and Japanese medical scientists are among the best in the world. You can be sure that, were there documented complications resulting from pregnant women eating sushi in Japan, there would be swift government intervention. Yet, in the United States, it is taboo for a pregnant woman to eat raw fish.

But this isn’t because scientific research has concluded that unborn children have been damaged by sushi. Rather, it’s because the speculative risk of food-borne illnesses, especially parasites, has captured the public imagination.

There are several reasons, however, that these fears are unfounded.

And if you want to celebrate by taking Shaw to Nobu, I'm sure he's game.

Op-Ed: Chicken Of The Sea [nyt via my wife]


The Japanese and the French have a reverence for food that North Americans do not have and this reverence starts from the initial growing/harvesting and extends all the way to the final preparation. As such, I would be more willing to trust the "purity" of sushi in Japan and unpasteurized cheese from France than I would the same product produced by a "company" in North America. I'm not saying that all North American companies are like this, but it's hard to separate the good from the bad in an atmosphere motivated by lowest cost for highest profit.

[it turns out that like 75% of the sushi in the US is distributed by the Unification Church, so yeah, good point. -ed.]

Dear Steven,

Here is scientific research from Harvard which concludes that unborn children have been damaged by sushi(mercury):

[He does give short shrift to the mercury question, I noticed that, too. But that study does NOT talk about sushi. It was a study of mothers on the Faroe IIslands [!] who "eat seafood an average of three times a week, including an occasional meal of mercury-rich whale meat" and who had blood mercury levels 10x the US EPA standards. Also, their result showed those kids had a detectable slowing of nerve impulses from the ear to the brain, but without other measurable impairments like hearing loss, which are socioeconomically correllated. So yeah, eating "mercury-rich whale" three times a week while pregnant = bad. But what's the mercury level in sushi, and what's the impact of having it occasionally? -ed.]

Well that report linked above settles it: no mercury-rich whale meat for my wife when she's pregnant.

(Still chuckling about "via my wife." Good band name.)

The fish article is good, but it studied a group of women with high overall fish and seafood consumption (probably no sushi at all), not women who might have a kamikaze roll every month.

In a quest for a sane pregnancy, I bought two French pregnancy books at the start of this adventure. Well, from this limited sampling, I learned that the French have now banned the consumption of alcohol (with a warning in one of the books that if this proved too hard, a visit to AA might be recommended), of terrines and pâtés as well as unpasteurised cheeses...

[those wimps! what'll they give up next, socialism? -ed.]

It is more about food poisoning issue than mercury poisoning when it comes to eating raw fish during pregnancy.

The regulations the Japanese Health dept and USDA are different. The regulated temperature to store raw fish is lower in Japan than USDA.

Still we should avoid (or eat less)large fish, cooked or uncooked to prevent mercury poisoning.

[his point about seafood and food poisoning is that 85% of cases are with shellfish, and almost all cases involve the temperatures restaurants and stores keep food at. There are 10x the number of chicken-related poisonings than fish. I'd be more worried about eating seconds at a picnic than I would about sushi. Unless it was sushi at a picnic, which is probably the worst. -ed.]

For concerns about mercury intake, you can go to gotmercury.org. I can eat 4 pounds of salmon a week and still be in the "moderate" exposure range. Yellowfin tuna? Not so much.

I ate sushi all through my first pregnancy, and had no idea you weren't supposed to. My baby came out fine. I also went on a sushi picnic for my birthday when I was in Barcelona :)
Other than the already mentioned mercury and fish related food poisoning, issues with sushi may also be due to the rice which crazily enough is a common source of food poisoning if left hanging around lukewarm/reheated etc. Not that I ever had food poisoning from rice but it apparently happens...
All this pregnancy stuff generally comes down to common and sense and hygiene though. I didn't eat sushi in my second pregnancy, but only because I didn't feel like it!

I'm sorry to report that a very good friend of mine lost a baby at 5 months due to - you guessed it Listeria from Sushi she ate. This was not in NYC, but in a middle sized city in the North East US. It isn't the raw fish you need to worry about - it is bacteria - and trust me, I am not a germophobe, just a friend of someone who was devastated at the loss of a girl she never met.

[that's horrible. According to the USDA, pregnant women account for 25-30% of the 2,000 cases of listeriosis each year. The main things to avoid to prevent listeria include hot dogs, soft cheeses, salad bars, and leftovers. The AU and NZ Food Authorities also suggest avoiding salad bars, "smorgasbords," and yes, sashimi. It's a common bacteria that can survive refrigeration, but not cooking. No one mentions freezing, though, but the infection threat comes during and after food is prepared. -ed.]

It's not just the US as Finland also tells you not to eat raw fish, moderate often mercury-rich tuna and to avoid many Baltic fish such as herring since the levels of dioxin and such are high.

I enjoy sushi but given the potential for food poisoning at the very least and toxic buildup in fish themselves, it is something you want to make sure is freshly made and enjoy in moderation. I would also avoid anything that is a product of China.

[dioxin and China, two more good ones to watch out for. If Wal-Mart opens an all-you-can-eat sushi buffet, run away as fast as your belly permits, ladies. -ed.]

We tend to steer toward "everything in moderation" around our house. Oddly though, now that my wife is pregnant, "moderation" has pretty much become "no thanks"...at least when it comes to alcohol, caffeine and sushi. Very enlightening article indeed...it just seems like, "why take the risk?" Is there a strong "upside?"

[he's a little dismissive of the "why risk it?" stance, because I think you're right, people get a little more risk averse during pregnancy. I would count that as a good thing. The upside, according to Shaw, is the fatty acids found in fish, and not being "insulting to Japanese culture." Meh. Coupled with his complaint about America's "Puritanical impulses," Shaw sounds a bit like a cranky ex-pat enamored with his adopted Asian homelands. Maybe if there were a real *upside* to eating sushi during pregnancy, Japan might have a higher birth rate. -ed.]

The reason that pregnant women account for so many cases of listeria is that when pregnant, your immune system is suppressed (I think it is so that you do not abort the baby as a foreign intruder). Hence, while the raw milk cheeses, when properly produced and stored, are normall very safe, they are not safe when you are pregnant. Avoiding paté is a different matter: it contains liver, which is very high in vitamin A, and high doses of vitamin A can cause birth defects. I am surprised that more pregnant women in North America are not warned about the dangers, but I guess liver consumption is not very high...

I was in Tokyo a few weeks after conception, ate sushi and had identical twins!

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