What to expect when you're expecting (43 page)

“Enriched” and “fortified” are also banners to be wary of. Adding a few vitamins to a not-so-good food doesn’t make it a good food. You’d be much better off with a bowl of oatmeal, which comes by its nutrients naturally, than with a refined cereal that contains 12 grams of added sugar and a few pennies’ worth of tossed-in vitamins and minerals.

“Sushi is my favorite food, but I heard you’re not supposed to eat it while you’re pregnant. Is that true?”

Sorry to say, sushi and sashimi will have to go the way of sake (the Japanese wine often served with them) during pregnancy—which is to say, they’re off the table. Same holds true for raw oysters and clams, ceviche, fish tartares or carpaccios, and other raw or barely cooked fish and shellfish. That’s because when seafood isn’t cooked, there’s a slight chance that it can make you sick (something you definitely don’t want to be when you’re pregnant). But that doesn’t mean you have to steer clear of your favorite Japanese restaurants. Plenty of other options exist there, even at the sushi bar. Rolls that contain cooked fish or seafood and/or vegetables are, in fact, healthy options. (But don’t worry about any raw fish you’ve eaten up to this point.)

“I love spicy food—the hotter, the better. Is it safe to eat it while I’m pregnant?”

Hot mamas-to-be can continue to challenge their taste buds with four-alarm chilis, salsas, and stir-fries—as long as you can tolerate the almost inevitable heartburn and indigestion that follow. There’s no risk from spicy foods during pregnancy, and, in fact, since peppers of all kinds (including hot ones) are packed with vitamin C, many of these foods are extra nutritious. So enjoy—just make sure you save room for Tums.

“I ate a container of yogurt this morning without realizing that it had expired a week ago. It didn’t taste spoiled, but should I worry?”

No need to cry over spoiled milk … or yogurt. Though eating dairy products that have recently “expired” is never a particularly good idea, it’s rarely a dangerous one. If you haven’t shown any ill effects from your postdate snack (symptoms of food poisoning usually occur within eight hours), there’s obviously no harm done. Besides, food poisoning is an unlikely possibility if the yogurt had been refrigerated continuously. In the future, however,
check dates more carefully before you buy or eat perishables, and, of course, never eat foods that appear to have developed mold. For more on food safety, see the box on
page 116
.

“I got food poisoning from something I ate last night, and I’ve been throwing up. Will that hurt my baby?”

You’re much more likely to suffer from the food poisoning than your baby is. The major risk—for you and your baby—is that you’ll become dehydrated from vomiting and diarrhea. So make sure you get plenty of fluids (which are more important in the short term than solids) to replace those that you’re losing. And contact your practitioner if your diarrhea is severe and/or your stools contain blood or mucus. See
page 501
for more on stomach bugs.

“I’m trying not to gain too much weight, but I love sweets. Can I use sugar substitutes?”

It sounds like a sweet deal, but the truth is that sugar substitutes are a mixed bag for expectant moms. Though most are probably safe, some research is still inconclusive. Here’s how sugar substitutes stack up at the moment:

Sucralose (Splenda).
Made from sugar, but chemically converted to a form that’s not absorbable by the body, sucralose appears right now to be the best bet for pregnant women seeking sweetness with no calories and little aftertaste. You can sweeten your coffee or tea with sucralose, and use it in cooking and baking (unlike other sugar substitutes, it doesn’t lose its sweetness when heated), or buy products that have been sweetened with it (including drinks, yogurts, candy, and ice cream). Keep in mind that moderation’s probably smart. Even though it seems to be safe, the product is relatively new, and no long-term data are available to confirm that.

Aspartame (Equal, NutraSweet).
Aspartame is used in beverages, yogurt, and frozen desserts but not in baked goods or cooked foods (the sweetness doesn’t survive when heated for long periods). The jury is still out on the safety of this widely used sugar substitute. Many practitioners consider it harmless and will okay light or moderate use in pregnancy. Others are less convinced of its safety and suggest that, until more is known, pregnant women be cautious in their use of this sweetener. Check with your practitioner for his or her aspartame bottom line. (Women with PKU must limit their intake of phenylalanine and are advised never to use aspartame.)

Saccharin.
Not much research has been done on saccharin use in human pregnancy, but animal studies show an increase in cancer in the offspring of pregnant animals who ingest large quantities of the chemical. Whether a similar risk exists for human offspring is unclear (especially because animal studies don’t always correlate well to human reality—after all, you’re not pregnant with a baby rat). Still, combined with the fact that the sweetener crosses the placenta in humans and is eliminated very slowly from fetal tissues, most practitioners advise minimizing its use during pregnancy. Don’t worry, however, about saccharin you had before finding out that you were pregnant because, again, there are no documented risks.

Acesulfame-K (Sunett).
This sweetener, 200 times sweeter than sugar, is approved for use in baked goods, gelatin desserts, chewing gum, and soft drinks. The FDA says it’s okay to use in moderation during pregnancy, but since few studies
have been done to prove its safety, ask your practitioner what he or she thinks before gobbling the stuff up.

Sorbitol.
This is a relative of sugar found naturally in many fruits and berries. With half the sweetness of sugar, it is used in a wide range of foods and beverages and is safe for use in pregnancy in moderate amounts. But it does present a problem in large doses: Too much can cause bloating, gas pains, and diarrhea—a trio no pregnant woman needs.

Mannitol.
Less sweet than sugar, mannitol is poorly absorbed by the body and thus provides fewer calories than sugar (but more than other sugar substitutes). Like sorbitol, it is safe in modest amounts, but large quantities can cause gastrointestinal unrest.

Xylitol.
This sugar alcohol, which is produced as a sugar substitute from plants (but is also naturally occurring in many fruits and vegetables and is even created by the body during normal metabolism), is found in chewing gum, toothpaste, candies, and some foods. One of its benefits is that it can prevent tooth decay (which is why chewing gum made with xylitol can be a very good thing). Xylitol has 40 percent fewer calories than sugar and is considered safe during pregnancy in moderation (so in other words, it’s fine to chew one pack of xylitol gum—but you might not want to chew five).

Stevia.
Derived from a South American shrub, stevia has not been approved by the FDA as a sweetener (it’s considered a dietary supplement). No clear research proves stevia is safe during pregnancy, so before you dip into this sweetner, check with your practitioner for his or her recommendation.

Lactose.
This milk sugar is one sixth as sweet as table sugar and adds light sweetening to foods. For those who are lactose-intolerant, it can cause uncomfortable symptoms; otherwise it’s safe.

Honey.
Everyone’s all abuzz about honey these days because of its high levels of antioxidants (darker varieties, such as buckwheat honey, are the richest in antioxidants). But it’s not all sweet news. Though it’s a good substitute for sugar, honey is definitely not low-cal. It’s got 19 more calories per tablespoon than sugar does. How’s that for sticky?

Fruit juice concentrates.
Unquestionably nutritious, fruit juice concentrates, such as white grape and apple, are a safe (if not low-calorie) sweetener to turn to during pregnancy. They’re surprisingly versatile in the kitchen (you can substitute them for the sugar in many recipes) and they’re readily available in frozen form at the supermarket. Look for them in a host of commercial products, too, from jams and jellies to whole-grain cookies, muffins, cereals, and granola bars, to pop-up toaster pastries, yogurt, and sparkling sodas. Unlike most products sweetened with sugar or other sugar substitutes, the majority of fruit-juice-sweetened products are made with nutritious ingredients, such as whole-grain flour and healthy fats. How sweet it is.

“I drink a lot of herbal tea. Is it safe to keep drinking it while I’m pregnant?”

Should you take (herbal) tea for two? Unfortunately, since the effect of herbs in pregnancy has not been well researched, there’s no definitive answer to that question yet. Some herbal teas are probably safe, some probably not—and some, such as red raspberry leaf, taken in very large amounts (more than four 8-ounce cups a day), are thought to trigger contractions (good if you’re 40 weeks and impatient, not good if you haven’t
reached term). Until more is known, the FDA has urged caution on the use of most herbal teas in pregnancy and during lactation. And though many women have drunk lots of herbal teas throughout pregnancy without a problem, it is probably safest to stay away from, or at least limit, herbal teas while you’re expecting—unless they’ve been specifically recommended or cleared by your practitioner. Check with your practitioner for a list of which herbs he or she believes are safe and which are pregnancy no-no’s.

To make sure you’re not brewing up trouble (and an herb your practitioner hasn’t cleared) with your next cup of tea, read labels carefully; some brews that seem from their names to be fruit based also contain a variety of herbs. Stick to regular (black) tea that comes flavored, or mix up your own by adding any of the following to boiling water or regular tea: orange, apple, pineapple, or other fruit juice; slices of lemon, lime, orange, apple, pear, or other fruit; mint leaves, cinnamon, nutmeg, cloves, or ginger (a great alleviator of the queasies). Chamomile is also considered safe in small amounts during pregnancy and can be soothing to a pregnancy-unsettled tummy. The jury’s still out on green tea, which can decrease the effectiveness of folic acid, that vital pregnancy vitamin—so if you’re a green tea drinker, drink in moderation. And never brew a homemade tea from a plant growing in your backyard, unless you are absolutely certain what it is and that it’s safe for use during pregnancy.

“With additives in packaged foods, pesticides on vegetables, PCBs and mercury in fish, antibiotics in meat, and nitrates in hot dogs, is there anything I can safely eat during pregnancy?”

Take heart—and take it easy. You don’t have to go crazy (or hungry) to protect your baby from food hazards. In spite of anything you might have read and heard, very few substances found in food have been absolutely proven harmful to the unborn.

Still, it’s smart to reduce risk whenever you can—particularly when you’re reducing risk for two. And it’s not that difficult to do, especially these days. To feed yourself and your baby as safely as you can, use the following as a guide to help you decide what to drop into your shopping cart and what to pass up:

Choose your foods from the Pregnancy Diet. Because it steers away from processed foods, it steers you clear of many questionable and unsafe substances. It also supplies Green Leafies and Yellows, rich in protective beta-carotene, as well as other fruits and vegetables rich in phytochemicals, which may counteract the effects of toxins in food.

Whenever possible, cook from scratch with fresh ingredients or use frozen or packaged organic ready-to-eat foods. You’ll avoid many questionable additives found in processed foods, and your meals will be more nutritious, too.

Go as natural as you can, when you can. Whenever you have a choice (and you won’t always), choose foods that are free of artificial additives (colorings, flavorings, and preservatives). Read labels to screen for foods that are either additive free or use natural additives (a cheddar cheese cracker that gets its orange hue from annatto, instead of red dye #40, and its flavor from real cheese, instead of artificial cheese flavoring). Keep in mind that although some artificial additives are considered safe, others are of questionable safety, and many
are used to enhance foods that aren’t very nutritious to start with. (For a listing of questionable and safe additives, go to
cspinet.org/reports/chemcuisine.htm
).