Navigating Food Restrictions During Pregnancy (in ED Recovery)

If you’re pregnant and have a history of eating disorders or disordered eating, it can be challenging to face the long list of “foods to avoid during pregnancy” without it triggering feelings of restriction. Foods like soft cheeses, deli meats, raw fish, caffeine, and runny eggs are all on the “do not eat” list. Of course, moms-to-be want to make sure that they and their baby stay healthy. But what does the scientific evidence actually say?

The reason why most of these foods are not recommended to eat during pregnancy is due to the risk of contamination by pathogens, which can cause foodborne illness. For the average person, food poisoning is unpleasant but usually not life-threatening, but food poisoning can potentially have serious effects on pregnant women and their babies.

So how do you balance food safety with food freedom? First, remember that it is always an individual decision. We believe it is important for women to have the scientific knowledge of the real risk of eating potentially “risky” foods during pregnancy and what nutritionally they may be deficient in if forfeiting these foods from their diet versus the benefits (nutritionally, mentally and recovery-wise) of keeping them in their diet. Only a mama knows what feels right for her - and it is critically important to feel empowered in that choice. 

Take this example: pregnant women are advised to only eat completely cooked eggs - no runny or raw eggs. But eggs are also a nutritionally dense, protein-packed, convenient food that is one of the largest sources of choline - a nutrient that is important for fetal development and growth. The risk of salmonella in raw eggs is only 1 in 20,000. So if you only like eating your eggs runny, you may decide for yourself that the benefit of eating eggs every day outweighs the small risk of getting sick. 

Deli meat is another no-no due to risk of listeria contamination, but only 2,500 people get sick from listeria each year. If avoiding a good old cold-cut sandwich for the entirety of your pregnancy feels too restrictive, you might want to weigh the small risk of getting sick versus the benefit of being able to eat unrestricted. Similarly, the same logic can apply to a variety of other foods that do have small risks, like smoked fish, and unpasteurized cheese. Again, weighing the choice of cutting out vs. keeping this food in your diet, is YOUR choice. 

Finally, most of us enjoy a morning cup of coffee or tea, but conventionally the advice has been to cut the caffeine while pregnant. However, this advice is now changing, as there is no evidence to suggest a cup or two of coffee or tea a day will have any negative effects on mom or baby’s health.

If you’re still worried about food safety, but don’t want to have a limited or negative mindset around food, you can also find ways to enjoy these foods while mitigating the risk. For example,  buy pasteurized eggs so you can enjoy your over-easy or sunny-side-up eggs, or make a panini or hot-pressed sandwich for lunch, since heating up deli meats to 165F rids them of any pesky listeria.

It may also be helpful to remember that leafy vegetables actually account for the greatest percentage of foodborne illnesses in the US - yet these foods never make it on the “do not eat” lists during pregnancy. This knowledge may also help put into perspective the relative risks of eating or not eating certain foods during pregnancy (and is a good reminder to wash your produce if you really want to reduce risk of foodborne illness)! 

Of course, these are all individual decisions that are up to you (and your OB, if you want to include them). You don’t need to treat all of these foods as off-limits - especially if you feel that that mindset might be more harmful than helpful, as it feels reminiscent of your eating disorder. At Tory Stroker Nutrition, we always aim to empower you to make decisions for yourself, and make sure you know that you have choices when it comes to your body and your health.