Safe eating for pregnancy

Dietary restrictions for pregnancy affect your whole day but lunch can be particularly challenging -especially with sushi, the deli counter, even leftovers, all off the menu. OHbaby! nutritionist Anna Hansen suggests ways to get safe and satisfying nutrition into your lunchbox.

The 'off-limits' and 'consume-with-caution' foods
Nutrition advice in pregnancy can seem bewildering with so much conflicting information at our fingertips. The most important thing to focus on when it comes to food is to eat a variety of whole foods, cutting as much processed food out of the equation as possible. Fruit and vegetables, whole grains, lean well-cooked meats, well-cooked eggs, yoghurt, beans and legumes, and nuts and seeds are the best foods to reach for. These foods are packed with nutritional goodness for both you and your baby.

There are, however, many foods we recommend you steer well clear of during pregnancy – some of them because of the risk of food poisoning and some to avoid potential adverse effects on your baby.

THE BADDIES
In an effort to avoid food poisoning, the NZ Ministry of Health recommends you don't eat the following:

• Processed meats, such as pâté, salami, ham and luncheon. Note, however, that these foods are safe to eat if heated thoroughly until piping hot –above 70°C
• Soft pasteurised cheeses like brie, camembert, feta, blue, mozzarella and ricotta. Again, these are also safe when they are heated above 70°C
• Hummus (store-bought) and other dips that contain tahini
• Soft-serve ice cream
• Cream or custard in pre-made cakes or pastries from a bakery or café. Fresh cream and freshly-made custard used in home baking can be safe, as can pre-packaged cream and custard products, so long as they are eaten within two days of opening

A lot of pre-prepared (non-fresh) foods, including leftovers, can be dangerous.

Don’t eat:

• Cold pre-cooked meat like corned beef and chicken (plain or smoked). Heated above 70°C, however, these meats are safe to eat
• Pre-cooked fish or seafood, including smoked salmon, marinated mussels or oysters, and sushi
• Pre-prepared or unrefrigerated salads, including rice or pasta salad, coleslaw, roasted vegetable and green salads

The following raw foods are also strictly off the menu:

• Raw (unpasteurised) milk and products made from raw milk
• Raw fish or seafood, including sushi
• Foods containing raw egg, including mayonnaise, hollandaise sauce and desserts such as mousse

But why?
These food groups are more susceptible to bacteria (like listeria and salmonella) and parasites that cause food-borne illnesses (food poisoning). Contamination of the food can occur during either the production or storage of these foods. You're more susceptible to food-borne illness during pregnancy because your immune system changes as your body adapts to carrying another life. This means the risk of potential infection in your baby, and also yourself, is higher –which can, at worst, lead to serious illness, miscarriage, premature birth or stillbirth.

Is it okay to eat hummus in pregnancy?THE 3 QUESTIONS I GET ASKED THE MOST

Store-bought hummus has been on the ‘what not to eat’ list in recent years, due to a salmonella outbreak in New Zealand in 2014, which was attributed to hummus containing contaminated tahini. Tahini is a nutritious sesame paste, and it is a key ingredient in hummus, which is why it is currently recommended that you don't eat hummus while you are pregnant due to the risk of food poisoning.

Having said that though, hummus is incredibly good for both you and your baby and makes a tasty snack coupled with carrot sticks or crackers. Plus, it’s simple to make –so well worth making at home if you have the time and energy. Simply omit the tahini altogether or replace the tahini with ground (or whole) sesame seeds. As with many foods, if you do make hummus at home, it has to be eaten within a couple of days.

How much coffee can I drink in pregnancy?
We are a café-loving nation, so coffee is a hot topic. Do you have to curb the habit when you find out you're expecting? Experts don’t always agree on this subject and the effects of caffeine in pregnancy are still being researched. What is agreed on is that caffeine crosses the placenta, ending up in your baby's bloodstream – and it takes longer for your baby to get rid of caffeine than it does for an adult. It is also widely agreed that caffeine may affect baby’s growth in the womb.

As your pregnancy progresses, your body will take longer to process caffeine. This means there will be more caffeine in your bloodstream for longer, therefore much more of this stimulant is going to cross the placenta.

I'm inclined to recommend avoiding the flat whites during pregnancy, but in saying that, the NZ Ministry of Health recommend reducing your intake to no more than three single espressos or one double espresso a day during pregnancy.

If you decide to simply limit your intake, it’s best to only have a single shot coffee in any one sitting, as it is worse for your baby to get a huge hit of caffeine all at once than small amounts more regularly.

It’s also best to limit other caffeinated drinks such as tea. Also, avoid drinking tea with your meals as the tannins stop you from absorbing nutrients in food, such as iron. It is also very strongly recommended that you don't go near energy drinks or energy shots due to the high levels of caffeine, sugar and other ‘undesirable’ ingredients they contain.

With experts still debating how much tuna is too much, I am inclined to very strongly recommend steering completely clear of this food. The NZ Ministry of Health recommends eating no more than three 150g servings of tinned tuna per week in pregnancy. I think it is also best to stay away from trout and game fish like shark and marlin. These larger fish are also known to contain very large amounts of mercury.

What’s the issue with tinned tuna in pregnancy, and what fish can I eat?
Tinned tuna is a concern because it is known to contain mercury levels that are probably far too high for a growing unborn baby. Tuna contains higher levels of mercury than other fish as it is higher up on the food chain –and, in general, the bigger the fish, the greater the toxic load. High concentrations of mercury can impair your baby's growing brain and nervous system, along with your baby’s cognitive skills (like memory and attention). Language, motor skills, and vision may also be affected.

The NZ Ministry of Health recommends that you eat meals containing these types of fish no more than once every fortnight, but preferably it is recommended they are not eaten at all during pregnancy.

Bluff and Pacific oysters, along with scallops, are also best avoided as they contain high levels of cadmium, which is unsafe for your unborn baby.

On the flip side, experts agree that eating well-cooked fresh fish during pregnancy is beneficial for your growing baby, so it's about choosing the right fish, rather than avoiding fish altogether. The best choices are fish that are lower down the food chain, especially white fish such as terakihi, snapper and gurnard. Oily fish, such as sardines and salmon, are also fantastic options because they will provide your body with plenty of the omega-3 fats that are essential at this stage of your unborn baby's life. 

BONNIE AND CLYDE
The two other baddies to avoid when you are pregnant are alcohol and processed foods, which you are no doubt well versed in already.

It is worth giving alcohol a really wide berth as soon as you know that pregnancy might be on the cards. This is because your baby is sensitive to the effects of alcohol. Alcohol crosses the placenta into baby’s bloodstream, and like caffeine, it is much harder for your growing baby to process. Although the full effects are still unknown, we do know that alcohol may affect the development of your baby in all sorts of ways, especially baby’s growing brain. It is known that there are windows during your pregnancy when your baby is more susceptible to being harmed by alcohol, but the exact timing of those windows is also unknown, hence avoiding alcohol for the duration of pregnancy is recommended.

And you know what I’m going to say now – as much as possible, stay away from processed and/or sugary foods. If you aim to eat a range of fresh whole foods, you will be giving your unborn baby a great start.

The lunchtime-friendly foods
The reality for pregnant women is that there is a limited variety of safe food on offer at lunchtime. In fact, dining out for any meal can be fraught. It becomes so much more straightforward when you're close to a kitchen around midday. 

THE GOODIES
If you do have a kitchen available at lunchtime, here are some great options:

• Freshly made green salad
• Vege sticks (carrot, capsicum, cucumber) with homemade hummus or plain Greek yoghurt
• Pita bread pizza
• Sourdough bread with poached eggs (well cooked)
• Fresh fruit or a green smoothie
• Hot soup
• Hot meals with a serve of lentils, chicken or fish and freshly made rice
• Baked kumara with freshly opened cottage cheese or sour cream
• Freshly cut orange or sliced apple
• A bowl of oats, fruit and seeds – this doesn't just have to be a breakfast dish
• Courgette ribbon pasta with freshly cooked fish
• Quinoa salad with spinach
• Beans on toast
• Sardines or tinned salmon on wholegrain crackers
• A bowl of frozen berries

If your workplace doesn’t have a kitchen and you are not close to home, these are some good options for re-fuelling:

• Fresh fruit – bananas and apples are easy options
• Greek yoghurt with fruit and seeds
• Savoury scone
• Hard cheese and crackers with fresh tomato
• A handful of seeds and nuts
• Freshly cut avocado on sourdough bread or wholegrain crackers 

If you’re lucky enough to be at a café for lunch, these are reliable menu options:

• Freshly made smoothie
• Savoury scone
• Hot soup
• Well-cooked eggs on toast
• Steaming hot meals with freshly cooked rice

It always pays to have snacks on hand if you are out and about. Stash some of these easy-to-transport choices in your handbag:

• Seeds and nuts (almonds, cashews and pumpkin seeds are great options)
• Fresh fruit
• Crackers
• Popcorn

It's best to be safe
I know there can be a lot of confusing information out there. Experts sometimes give conflicting advice and other countries and cultures can be seen eating food that we have been warned about. In my opinion, as an expert and as a mother, it is wise to err on the side of caution and avoid all potentially unsafe foods for the short time that you are pregnant. In the case of a new life being created, it's much better to be safe than sorry.