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Immune System During Pregnancy
Pregnancy changes the maternal immune system to help your body tolerate and support the foetus. Immunity changes may affect how your body fights against infections, especially those caused by foodborne bacteria and parasites. Hormonal changes induced by pregnancy make pregnant women more susceptible to certain bacteria compared to non-pregnant individuals. Foodborne illnesses don't cause major discomfort to non-pregnant adults. However, during pregnancy, the same illness can lead to infections and complications that affect the growing foetus and placenta. Foodborne pathogens and parasites can cross the placental barrier, infect the amniotic acid, and trigger inflammatory responses.
Raw food during pregnancy is generally not recommended, as the immune system is already in a vulnerable state.
Sushi Risks in Pregnant Women
Sushi made with raw fish contains bacteria and parasites that can exacerbate pregnancy discomforts. Raw fish used in sushi, like tuna, salmon, and yellowtail, are stored in cold storage, and some bacterial contaminants thrive in such an environment. Pregnancy also increases the likelihood of food-related allergic reactions, which can be difficult to predict or manage across different trimesters.
- Parasite Exposure: Raw fish used in sushi may contain a parasitic worm called Anisakis, which is commonly found in marine fish. Proper freezing only reduces the parasite and does not fully kill it. Parasites burrow into the gastrointestinal tract and trigger infection, sharp stomach cramps, nausea, vomiting, and allergic reactions.
- Foodborne Bacteria: Raw and undercooked fish contain Listeria monocytogenes, which thrives in cold environments. Listeria is very dangerous during pregnancy and can lead to miscarriage, stillbirth, and preterm labour. Salmonella and Vibrio vulnificus from shellfish trigger preterm labour, diarrhoea, fever, and dehydration.
- Mercury: Mercury is a neurotoxin and can disturb neuronal migration and synapse formation in the fetal brain. Fishes used in sushi naturally accumulate mercury levels through their position in the food chain. Even a small amount of mercury exposure can impair cognitive development, language skills, attention and memory.
- Other Hazards: Raw shellfish, such as scallops and uni, may contain the Hepatitis A virus, which increases the risk of infection. Norovirus is a pathogen found in raw shellfish and can cause foodborne illness.
Can You Eat Sushi During Pregnancy?
Sushi can be enjoyed during pregnancy without concern, provided it avoids raw and undercooked ingredients. You can choose fully-cooked or plant-based sushi options. Raw fish should be completely avoided due to bacteria, parasites, and toxins. From a clinical standpoint, it is better to avoid raw sushi during pregnancy, as managing infections or allergic responses alongside trimester-related changes can be challenging.
However, cultural variations exist. If a person has consumed sushi regularly since childhood or belongs to a culture in which sushi consumption is common, this may be considered on an individual basis after evaluating the risks and benefits.
Safe Sushi Options to Consider
- Fully Cooked Sushi Rolls: These are risk-free, and the heating kills bacteria and pathogens. The California roll consists of imitation crab, avocado, and cucumber. One roll packs 20g of protein and 300 calories. Tamago rolls give choline for brain health.
- Tempura Rolls: The deep-fried tempura rolls kill off pathogens and bacteria and make a delightful, harmless indulgence during pregnancy. Shrimp tempura rolls contain high levels of selenium, which helps combat toxins. Vegetables provide beta-carotene and fibre for constipation relief.
- Eel: It is a freshwater sushi ingredient which carries low mercury and is packed with vitamin A for vision, B12 for never functioning, and iron for preventing anaemia. Traditionally Japanese steam seal and then grill it. Taking cooked eel during pregnancy increases maternal haemoglobin.
- Imitation Crab: It is made from fully-cooked and pasteurised fish (pallocck). Since it is fully cooked, it kills harmful bacteria and is safe to enjoy during pregnancy.
- Plant-based Sushi: Swapping fish with vegetables and fruits provides fibre, vitamins and antioxidants. Adding cucumber, avocado, carrot, spinach, and fried vegetables supports digestion, fights constipation, and boosts energy.
Sushi You Must Avoid During Pregnancy
- Raw Fish: Nigiri is a slice of raw tuna, salmon, or yellowtail placed on top of rice. These fish stay in the fridge for preparation, and Listeria monocytogenes multiply in cold storage. Anisakis parasites infest wild salmon, which burrow into the gut, triggering pain and inflammation during pregnancy.
- High-Mercury Sushi: Bigeye tuna, yellowtail hamachi, and swordfish kajiki contain mercury that directly affects the fetal brain, impairs cognition and motor skills.
- Undercooked Fish: A lightly grilled exterior and a raw interior can retain pathogens and bacteria.
- Refrigerated or Ready-to-Eat Sushi: If the ready-to-eat sushi packets are made with raw fish, they should be avoided. These cold-stored packets create a habitable environment for pathogens, and when eaten, they can increase fetal risks such as miscarriage and preterm birth.
Benefits of Seafood During Pregnancy
When you choose seafood safely, it packs multiple nutritional benefits during pregnancy. Fish provide omega-3 fatty acids, protein, iodine, iron, zinc, selenium, vitamin D, and B12, which are essential for neural development and immune function. It is recommended to consume 2-3 servings per week to improve pregnancy outcomes.Salmon is a fatty fish that contains abundant DHA, which is essential for fetal brain lipids, neuronal growth, synapse formation, and visual development. Intake of DHA during pregnancy increases IQ and reduces ADHD risks.EPA reduces the risks of inflammation, preterm birth and eases maternal depression symptoms.
When pregnant, you don’t have to completely give up sushi, but caution is essential. Sushi preparation involves raw fish, shared knives, cutting boards, and rice exposed to contaminants. Certain bacteria thrive in cold storage. Always confirm that ingredients are thoroughly washed and fully cooked before consumption; when in doubt, choosing cooked or plant-based options is the safest approach.
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FAQs on Can Pregnant Women Eat Sushi? Potential Risks and Safe Alternatives
- Can I eat salmon while pregnant?
Salmon is safe, and you must eat fish while pregnant. It's a low-mercury, omega-3-rich source that supports a baby’s brain development. Fully cook salmon until it flakes easily. During pregnancy, it's safe to eat 2-3 servings of salmon every week. You can also include trout, shrimp, and sardines. But avoid high-mercury fish like shark, long mackerel, swordfish, marlin, and tilefish. - How much fish can you eat when pregnant?
Pregnant women should have 2-3 servings of fish every week. Salmon, shrimp, sardines, pomfret, cod, and catfish are low-mercury fish that pack proteins, iron, zinc and omega-3 fatty acids essential for fetal and maternal health.