Nine months without sushi

http://www.haaretz.com/hasen/spages/648816.html

By Michal PaltiIn the eighth month of her pregnancy, A. works as a shift manager in a Japanese restaurant in Tel Aviv. As part of her work and as a personal preference, she has eaten sushi throughout her pregnancy: fresh and delicious vegetarian and fish sushi, a distant dream for pregnant sushi lovers, who, according to a sweeping recommendation, should keep away from the Japanese dish. The prohibition on sushi is a result of a widening of the "protective umbrella" regarding pregnant women's nutrition. During pregnancy, the immune system is weaker, and should a pregnant woman encounter a virulent bacterium, the results could be particularly unpleasant, especially for the fetus. Is A. a risk-taking adventurer then? Who makes these sweeping recommendations for pregnant women and are the forbidden foods on the ever-growing list really so dangerous to the health? Browsing and reading through the various Internet sites and forums shows that the list of no-nos is getting longer all the time. An article by a naturalist doctor forbids eating green peppers, and one can find warnings against spearmint and sage. One contributor keeps away from sunny-side-up eggs and another will not even touch a Krembo, an Israeli marshmellow candy, because it is made of egg whites. And who is willing to take a risk? If they nix sage, then no sage. Someone has heard about hummus too? Who wouldn't watch her step afterward with hummus?Watch out for meringueClinical dietitian Tova Krause, who specializes in nutrition for pregnant women, describes herself as quite strict, or at least as someone who takes appropriate cautionary steps, she says. She keeps herself current by periodically checking out the Web sites of the U.S. Food and Drug Administration and the Israeli Health Ministry. "From my experience, women prefer to widen the range of forbidden foods. I have encountered women who have eaten sushi, and that of course is their prerogative," she says, "but there is a danger of the presence of the Toxoplasma parasite in sushi, which is in raw and uncooked fish and meat. While the danger is not particularly prevalent, it does exist." Vegetarian sushi is also forbidden because it is usually cut using the same board and knife as the sushi containing raw fish.According to Krause, the Listeria bacteria also can be found in raw fish and meat, and the danger of encountering it is particularly low: five in a million. Nevertheless, she advises caution: "A low danger does not mean a nonexistent danger." Krause warns against eating uncooked eggs because of Salmonella. "Here, the danger is much greater: The Salmonella bacteria can be found in one in a thousand eggs in Israel. In the United States, the ratio is one in 20,000, but they are nevertheless careful there to avoid uncooked eggs and foods containing them: desserts, mousses and various sauces. One should even be careful of meringue because meringue, which is made of egg whites, is baked at a very low temperature for a long time." Krause also warns against various sausages and pastrami, which can also contain the Listeria bacteria. "If you boil the sausage, it can be eaten, but who boils sausage? Perhaps only in soup," she says. Similarly, she adds, it is a good idea to watch out for "crossover contamination." "If you place uncooked meat in the refrigerator, it is best to put it in closed container or in the bottom drawer so that it doesn't drip on to other items that you may not normally suspect." She even warns again herbal tea. "We don't have any studies that have examined the effect of various herbs during pregnancy, but that is exactly why I would be cautious. My recommendation is to drink herbal tea only made by the large commercial companies, where you can know what the tea contains, and not to drink a lot of herbal tea - no more than three cups a day."But there is good news, too: "You can eat Krembo. They are made of powdered eggs to which water has been added, and I happen to know that Krembos are tested for the presence of bacteria before they leave the factory." She is lenient regarding hummus and the fear of coliform bacteria: "It is of course important to eat in places where you trust the cleanliness and freshness, but eating hummus is like eating dairy products: You can always encounter spoiled cheese, you have to check carefully the date and its source. If you know this, there shouldn't be a problem. One should watch out for unpasteurized cheese, usually imported from France."Isn't this list of no-nos exaggerated? "One doesn't have to take it to the extreme," says Krause, "but I think that it is wise to be a little extra careful. After all, sushi and carpaccio are not exactly staples of Israeli cuisine. It's not that they are irreplaceable."Unique phenomenonNevertheless, this wide range of food prohibitions appears to be a uniquely Israeli phenomenon, like the numerous tests Israeli women taken during pregnancy, like the vast shopping industry for the newborn and like the pressure to nurse for many months. An article written by French doctor Beatrice Senemaud, published on the Web site www.doctissimo.fr, which publishes articles dealing with new trends in French and world medicine, lists the recommended prohibitions for the French pregnant woman. The range is of course far narrower. After all, no one would expect a French woman not to eat soft or hard cheeses at all. That is why they are told only to discard the outer layer of the cheese; to eat "well-cooked" meat and avoid tartar steak; to drink "only one glass of wine a day" (or seven glasses a week, an amount the typical Israeli woman could get intoxicated just thinking about); to avoid coffee as much as possible ("but it has not been proved to cause any damage," writes the author). French women are especially told not to eat food that is "too rich" that could cause them to gain weight rapidly and take in unnecessary calories, a prohibition that stems from an entirely different fear.But here in Israel, there are those who are even stricter than Krause. In an article Dr. Reuma Levi published on www.tevalife.co.il, the expert in natural medicine recommends not to eat green peppers, eggplant, garlic, spinach, peanuts and animal proteins. She explains in an interview that this list of pregnancy no-nos is only part of a much broader approach. "I am involved in an approach that is a way of life and encompasses far more than just nutrition," she says. "For example, I also deal with preparing for pregnancy: One should start cleaning the body and eating properly before you get pregnant, learn to breathe correctly and deeply, drink wheat grass juice and detoxify the body, and reduce the use of cosmetic products."It is also recommended to eat a lot of figs and sesame, and in general, I am in favor of babies being born in the spring - that way, when winter comes, their bodies will be more immune, after tanning in the sun. And I also recommend not taking iron pills under any circumstances - it is an artificial additive that the body expels, and there is far more iron in tahini, sesame and figs." And why is it forbidden to eat green peppers? "There is no such vegetable as a green pepper. It is merely an unripe pepper that would eventually turn orange or red. Its peel is toxic, like the peel of a potato that is still green. You shouldn't eat unripe foods. They are poisonous for people who aren't pregnant either."Keeping things in proportionConventional medical practitioners are more indulgent. Dr. Amos Bar, author of the book "Pregnancy and Birth" and an amateur chef, sounded undisturbed about the matter of pregnant women's nutrition."First, our menu as food lovers has become larger, and with it the list of prohibitions. Who even heard of sushi or carpaccio or tartar steak 15 years ago? With the greater supply, awareness has grown too, sometimes taken to an extreme," he says. "One should keep things in proportion," adds Bar. "Sushi is forbidden because the fish could be spoiled and carry parasites. But if you eat sushi in a good, reliable restaurant, rather than from a sushi stand that you don't know, what chance is there that the fish will be spoiled? As far as I'm concerned, eating sushi during pregnancy is as dangerous as eating fruit and vegetables in a salad. You have to wash them well with water, soap and a brush. How many women do you know who wash their fruits and vegetables that way? It would be wonderful if everybody did it, but that is the situation, and the same degree of risk is involved. My wife ate sushi during her entire pregnancy because she felt like it. I wouldn't recommend that women make a point of eating sushi or tartar steak during pregnancy, but if they eat it from time to time from a reliable source, what's wrong with that? "Now, the American health organization has come out with a sweeping recommendation not to drink alcohol during pregnancy," adds Bar. "But we all know that nothing will happen from a glass or two a week. A woman doesn't need to go around with a constant feeling that she is `harming the child.' That on its own is a very unhealthy feeling." Sausage no, figs yesWhat the various experts recommend not eating during pregnancy:l Completely uncooked meat: tartar steak, carpaccio, medium rare steak, raw fish, salted fish, ceviche, fish in sushi, vegetarian sushi (if cut on the same board as fish sushi), sausage.l Uncooked eggs: an omelet that is not cooked all the way through, mousses and various creams that contain eggs.l Herbs: spearmint, sage. One should limit the drinking of herbal tea to three cups a day, and only drink herbal tea from a known source.l Limit the intake of coffee and alcohol.l Naturalist experts add: peanuts (allergenic), green peppers, eggplants (members of the nightshade family, which have a problematic peel), garlic, spinach, proteins from animal sources.l On the other hand, one should eat: figs, sesame, tahini, beets, pomegranates, dates, avocado, grapes and papaya. (M.P.)