Can Eating Asian Food Be Dangerous During Pregnancy?
How this common ingredient in Asian dishes can be threatening to you and your baby’s life.
By: Mindy Dinh on May 10, 2018
Cravings. It’s something that happens a lot during pregnancy. They range from sweets, like chocolate, to junk food, like potato chips, but some of the most popular cravings during pregnancy involve the greasiest most delicious takeout from Asian restaurants. I speak from the experience of working in a Vietnamese restaurant back in high school where, in countless instances, pregnant women would stumble in during the weeknights demanding immediate Phố soups or pan-fried noodles.
Asian food is a seemingly harmless craving, yes, but it might just shock you that this isn’t always the case. I’m not saying no Asian dishes are safe, because some are, but there are a lot of Asian dishes that have raw bean sprouts in them and those dishes should be off limits to anyone bearing a child.
There are ranges of pregnancy hazards that exist and those who are pregnant must be extra cautious about what they do and especially what they eat. When a woman is expecting, it’s safe to say that they already know that what they eat and drink matters. They already know what foods to avoid, what drinks to dismiss, and what kind of diet they should practice. However, most people’s knowledge of a healthy diet during pregnancy only covers the basics: no alcohol, no raw or undercooked meat, no seafood with high mercury, etc. Their knowledge of a healthy diet during pregnancy does not cover everything, even the most common ingredient in one of the most popular cravings during pregnancy.
A few examples of popular Asian dishes include Chow Mein, Fried Rice, Pad Thai, Chop Suey, Phố, Bibimbap, most stir-fries, and more. Guess what? This is only a small fraction of Asian dishes with raw bean sprouts. But what’s so bad about raw bean sprouts, you ask? Here are a few ways this common ingredient in Asian dishes can be threatening to you and your baby’s life.
Before we begin, you might also wonder now why not just bean sprouts but rather raw bean sprouts? There is an emphasis on raw because, other than certain fish, meat, milk, and cheese that might be harmful to a mother and baby during pregnancy, raw foods can undoubtedly be harmful. A few examples of harmful raw foods, aside from bean sprouts, can include raw meats, fish, or undercooked eggs- all of which contain bacteria harmful during pregnancy. Raw and unpasteurized fruits and vegetables are just as hazardous as the previous examples for they, too, contain disease-causing bacteria. (Likis, 2004). These examples are just to emphasize that a pregnant women’s diet really should exclude raw items but the focus in this article is specifically the dangers of raw bean sprouts.
I’ll break down the dangers of raw bean sprouts in 4 sections: Listeria monocytogenes, Salmonella, Escherichia coli, and Cryptosporidiosis. These four subjects are either a bacteria genus or a parasitic disease within raw bean sprouts and there are different forms of consequences they each have on pregnancy.
Listeria Monocytogenes
Listeria monocytogenes is a genus of bacteria that is the main conductor for a bacterial disease named Listeriosis and is one of the top leading causes for foodborne illness. According to food safety researcher, Robert Buchanan (2016), there have been better preventative measures to reduce outbreaks of Listeriosis since the 1990’s but those preventative measures were mainly for meat and meat products. It was not until much recently an outbreak of Listeriosis discovered there are now food vehicles that were not recognized as ever being a traditional association to Listeria monocytogenes and that was raw bean sprouts. This is especially a concern because although rates of listeriosis has remained low in the population within the last decade, it does not take into account these outbreaks associated to new forms of listeriosis driven by food vehicles not traditionally associated with listeriosis such as raw bean sprouts.
Incidences of listeriosis are much higher in vulnerable individuals; pregnant women and their fetus were the most susceptible followed by the elderly and then the remaining population (Buchanan et al., 2016). Data from this article showed that a study performed in 2015 examined 35 individuals affected by listeria. Out of the 35 individuals, 11 were pregnant and hospitalized, with one illness resulting in a miscarriage/fetal loss.
Most pregnant women with listeriosis will not even notice they have been exposed to listeria since it is an asymptomatic disease so getting a serological test is suggested to detect the presence of listeria (Pucci et al., 2017). Not everyone has the means to be tested, which goes to show how important it is for pregnant women to be aware of the presence of raw bean sprouts in their meals.
Salmonella
Salmonella is another genus of bacteria. Once it enters the bloodstream, it too can lead to threatening bacterial diseases such as Typhoid fever, requiring intensive care and without care, can lead to septic shock, hepatic dysfunction, myocardial failure and more. In 2011, Official Control Laboratories in England and Northern Ireland did a study on the presence of Salmonella in raw bean sprouts. 554 samples were tested and it was later reported that salmonella was detected in 7% of these samples (Sadler-Reeves et al., 2016).
In addition to the consequences of getting typhoid fever from salmonella, such as septic shock, myocardial failure etc. that can be experienced from a non-pregnant woman, pregnant women and their fetus face other consequences: pregnancy loss, intrauterine fetal demise, and preterm labor, just to name a few (Guirguis et al., 2017). Salmonella can enter the maternal bloodstream and cross paths with the placenta, which may enable a baby in utero to swallow or breathe the fluid into the birth canal, infecting their lungs and blood with bacteria and viruses. This can all lead to the occurrence of neonatal infection.
To minimize this risk, it is encouraged that pregnant women practice strict food hygiene and avoid uncooked foods such as raw bean sprouts or they can get vaccinated. Ty21a is live vaccine that can reduce the risks of contacting salmonella and the Vi capsular polysaccharide vaccine is another option. Due to the Ty21a being a live vaccine, it is often preferred that pregnant women get the Vi capsular polysaccharide vaccine. However, not everyone has the means to be vaccinated so it is encouraged to avoid raw bean sprouts altogether.
Escherichia coli
Escherichia coli is a seemingly harmless genus of bacteria. While safe, most of the time it is consumed, it may lead to food poisoning/contamination. Although the risk of developing food poisoning/contamination is much less severe than Listeria or Typhoid fever, it may still persist to be hazardous, even more so for women that are pregnant.
A recent research was done to detect the existence of Escherichia coli in ground beef and mung bean sprouts. Mung bean sprouts are one in two forms of raw bean sprouts that exist. Through the use of a multiplex real-time polymerase chain reaction assay, the detection of Escherichia coli in mung bean sprouts was successful (Amagliani et al., 2018).
Bacterial infections during pregnancy remain a pertinent difficulty and are now the most common cause of maternal death, with every 3 to 7 incidences of bacteremia for every 1,000 pregnancies. Escherichia coli is among the top common bacteria to be present when the general population is infected by bacteremia and is even more common within the population of pregnant women. In fact, a recent study conducted that 44% of pregnancies infected by bacteremia were from Escherichia coli (Surgers et al., 2014). Considering that there are a variety of bacteria that can be present during bacteremia, 44% of it being Escherichia coli for pregnant women in this study is a substantial amount. The present of this bacterium during pregnancy is life threatening to fetuses and this study shows just that. It examined 22 pregnant women infected by Escherichia coli and within these 22 pregnancies, 6 fetuses died. 5 out of the 6 fetuses that died were caused by prelabour rupture of the membranes.
With the detection of the presence of Escherichia coli within raw bean sprouts, pregnant women should take into account that it is best to be aware of this ingredient when consuming any dishes that commonly contains it.
Cryptosporidiosis
Cryptosporidiosis is a form of parasitic disease most often driven by a genus of protozoan parasites such as Cryptosporidium oocysts. Very much like Escherichia coli, Cryptosporidiosis does not lead to any severe issues such as Typhoid fever or Listeriosis. It may lead to watery diarrhea, stomach cramps, or unexplained coughing. Sounds harmless, but also very much like Escherichia coli, Cryptosporidiosis does more harm to pregnant women than it does to the general population and can lead to hazardous consequences beyond just coughing or stomach cramps.
A study done in Norway was aimed to analyze parasite contamination within fruits and vegetables. Out of the 475 fruits and vegetables analyzed, 6% contained Cryptosporidium oocysts. Among the samples affected by Cryptosporidium oocysts, the most affected were raw bean sprouts. To be exact, 74% of the fruits and vegetables contaminated with Cryptosporidium oocysts were just from raw bean sprouts, followed by lettuce, which was the remaining 26% of the fruits and vegetables contaminated with Cryptosporidium oocysts (Robertson et al., 2001). Although this study was done in Norway, take into account the vegetables and fruits grown in Norway remain contaminated when imported to other countries for consumption. It’s also important to note that Norway is a developed and wealthy country yet their vegetables and fruits can still be detected with parasites such as Cryptosporidium oocysts. It is not only the pregnant women in less developed regions at risk but pregnant women in developed regions must be cautious of the vegetables and fruits, namely raw bean sprouts, in their meals.
The populations most susceptible to developing Cryptosporidiosis are young children but especially pregnant women. Developing Cryptosporidiosis may lead to diarrhea or a weakened immune system, which does not sounds too hazardous, but a weakened immune system with sever symptoms puts pregnant women at risk of losing their baby. Pregnant women with cryptosporidiosis experience rapid loss of fluids and that is incredibly life threatening to babies, especially since there are fluids that are necessities for their stability and development. Although there is medicine to slow down the immense amount of fluid loss from a pregnant woman with Cryptosporidiosis, it is much safer to consult with a health care provider beforehand.
A huge downside to identifying cryptosporidiosis is that, although it’s frequently diagnosed in the U.S., huge amounts of U.S. obstetrician-gynecologist have very little knowledge of cryptosporidiosis and the risk it has to pregnancy. A study conducted in 2013 showed that out of 431 obstetrician-gynecologists, only 44.4% could correctly identify the risks of pregnant women consuming food items containing Cryptosporidium oocysts (Domjahn et al., 2013). The fact that less than half of the U.S. obstetrician-gynecologists in this study knew the risks of Cryptosporidium is significant. Way more significant than allowed for pregnant women to feel safe about the health care they’ll receive in the U.S. if they ever come into contact with Cryptosporidium oocysts.
With the overwhelming amount of cryptosporidium oocysts detected in raw bean sprouts and the absence of familiarity obstetrician-gynecologists have with it, it is best for women to not include raw bean sprouts in their diet during the months they are pregnant.
My gathering and reviews of the literatures regarding raw bean sprouts and its effects on pregnant women says yes, consumption of raw bean sprouts can result in tremendously hazardous effects towards a pregnant women and their developing fetus. In short, stay away from them. Here’s how: ask for no raw bean sprouts when you order Asian food or any other food containing it. Pretty simple, right? That’s really all you have to do to reduce exposure in fact, by doing so, you’re eliminating all exposure. The simple task of asking for no raw bean sprouts is easy, practical, and cost-effective (it doesn’t even cost a penny).
Raw bean sprouts, while a common ingredient in many popular Asian dishes, encompass a variation of bacteria and parasites that often times have very little consequence on those that are not pregnant but produces harmful outcomes on those that are which is why pregnant women must be aware of the effects. I hope that by reading this, you’ve become more aware and more considerate of the consumption and preparation of certain foods, like raw bean sprouts, by evaluating microbiological risks to ensure safety for you and the development of your fetus.
References
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