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clee03m
Jul 30, 2009, 8:10 PM
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I was researching sushi and pregnancy because I knew Japanese women ate sushi all the time and seem to do OK. And this guy articulates so well what I have been thinking about wanting to climb/lead while pregnant that I decided to high light it and post here.
Op-Ed Contributor
Chicken of the Sea
STEVEN A. SHAW
Published: July 15, 2007
WHEN my wife was pregnant with our son, her obstetrician gave her a list of food dos and don’ts. Chief among the don’ts: alcohol, unpasteurized cheeses and raw fish. Meanwhile, every French mother I know consumed alcohol and unpasteurized cheese in moderation during her pregnancy, and my friends in Japan laugh at the notion of avoiding sushi when they’re expecting.
Indeed, in Japan, eating raw fish is considered part of good neonatal nutrition. The Japanese government is fanatical about public health, and Japanese medical scientists are among the best in the world. You can be sure that, were there documented complications resulting from pregnant women eating sushi in Japan, there would be swift government intervention. Yet, in the United States, it is taboo for a pregnant woman to eat raw fish.
But this isn’t because scientific research has concluded that unborn children have been damaged by sushi. Rather, it’s because the speculative risk of food-borne illnesses, especially parasites, has captured the public imagination.
There are several reasons, however, that these fears are unfounded.
While Americans tend to associate raw fish with sushi and Japan, we have been eating raw seafood for centuries — namely, oysters and clams. And it is these raw mollusks, not the fish typically used in sushi, that are responsible for the overwhelming majority, about 85 percent, of seafood-related illnesses. As the National Academy of Sciences Institute of Medicine concluded in a 1991 report on illness from eating seafood: “Most seafood-associated illness is reported from consumers of raw bivalve mollusks. ...The majority of incidents are due to consumption of shellfish from fecally polluted water.”
If you take raw and partly cooked shellfish out of the equation, the risk of falling ill from eating seafood is 1 in 2 million servings, the government calculated some years back; by comparison, the risk from eating chicken is 1 in 25,000. (Over all, 76 million cases of food poisoning are reported a year.)
The main risk of illness from non-mollusks isn’t from eating them raw. Rather, as the Institute of Medicine reports, the problem is “cross-contamination of cooked by raw product,” which is “usually associated with time/temperature abuse.” In other words, no matter what you order in a restaurant, if it’s not kept at a proper temperature and protected from contamination, you’re at risk.
Conversely, if the restaurant follows good food safety practices, there is little to worry about. Having been inside the kitchens of dozens of restaurants of all kinds for research, I can say that Japanese kitchens are, on the whole, the cleanest, the most careful and the most conscientious in the business. Moreover, sushi bars are out in the open for all to see, and anybody who has spent a few minutes observing a sushi bar and a typical American diner’s griddle area can tell you which type of restaurant has higher standards of cleanliness.
Sushi may not be cooked, but it has, for the most part, been frozen. Food and Drug Administration guidelines require that before being served as sushi or sashimi (or in any other raw form), fish be flash-frozen to destroy parasites. While the fish you see in the sushi-bar display case looks fresh, it has almost certainly been frozen at some point in the distribution system. This freezing kills any parasites as sure as cooking would.
Most species used for sushi don’t have parasites anyway, though. Fish like tuna are not particularly susceptible to parasites because they dwell in very deep, very cold water, and sushi restaurants typically use farmed salmon to avoid the parasite problems wild salmon have. Most of the fish likely to have parasites, like cod and whitefish, aren’t generally used for sushi. Nor does pregnancy increase susceptibility to parasites. Healthy women who’ve been eating sushi are not at increased risk when they become pregnant. The same resistance and immunities function before, during and after pregnancy.
But rational analysis doesn’t hold sway with the pregnancy police.
“Why take any risk?” they ask. The medical establishment and the culture at large have twisted logic around to the point where any risk, no matter how infinitesimal, is too much. So powerful is this Puritanical impulse that, once a health objection is raised, however irrational the recommended behavior, it’s considered irresponsible to behave any other way.
There’s a temptation to say there’s no harm in this type of thinking. Women should simply not eat sushi for nine months; surely that’s no big deal.
But there are problems with this approach. For one thing, between the warnings about parasites in sushi and about mercury in certain species of fish, pregnant women are being scared off fish altogether. And that’s bad news, since the fatty acids in fish are the ideal nourishment for a developing baby.
For another thing, the sushi ban is insulting to Japanese culture. It speaks of ignorance and prejudice to reject one of that culture’s basic foods based on unfounded health claims. And perhaps most important, pregnancy should be a time of joy, not stress. The result of an over-regulated pregnancy is fear and negativity. Perhaps the best antidote would be to relax with a salmon roll and a nice sake.
Steven A. Shaw is the author of “Turning the Tables on Asian Restaurants: The Insider’s Guide to Chinese, Japanese, Indian, Korean and Southeast Asian Dining.”
And I hold my breath for the firing squad.
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wonderwoman
Jul 30, 2009, 8:27 PM
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My concern would be more about mercury contamination. This is more of a problem with the larger predator, and longer living, fish like tuna, swordfish, tilefish, king mackeral and shark.
But I neither intend to become pregnant and I don't eat fish! 
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wjca
Jul 30, 2009, 8:33 PM
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When my wife was pregnant with our first child, the only real craving she had was for sushi. We would meet every Friday afterwork at the best sushi place I've every been to, Sushi Sono in Columbia, MD. Before she was pregnant, she didn't eat nearly as much raw fish as I did. Being pregnant did make her eat even less raw fish, but I think she still ate some.
Oh and she climbed in the gym on top rope until she was about 6 months. She never fell, but had no problems "taking" while mid climb. She quit after that because her balance was all screwy and she couldn't hold on to the wall any more. As someone mentioned in the other thread, the further into pregnancy one gets, the more hormones are produced that cause the ligaments/tendons to loosen. This enables the pelvic bones to hinge open a bit. This was one of my primary concerns because it affects all ligaments and tendons in the whole body, including hands.
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lena_chita
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Jul 30, 2009, 9:29 PM
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O.K., I don't know of specific numbers for raw fish, but here is the information for listeria, since the article mentions the unpasterized cheese as another thing that doctors recommend that pregnant women avoid, but the author of the article (and apparently you) consider it not dangerous enough to be an issue:
american Pregnancy Association wrote: According to the Center of Disease Control (CDC), an estimated 2,500 persons become seriously ill each year in the United States and among these, 500 will die. According to research, pregnant women account for 27% of these cases. CDC claims that pregnant women are 20 times more likely to become infected than non-pregnant healthy adults.
Given this information, does it make sense to decrease you potential for exposure to Listeria, or not?
2500 people a year is nothing, statistically speaking.
If the statistics above is right, about 850 of them are pregnant women. A very very small percent of all women getting pregnant every year.
More people die in car crashes.
And yet... it is an entirely preventable risk.
If I lose a child as a result of Listeria poisoning, it doesn't matter to me that thousands of other women have enjoyed a nice glass of desert wine with raw cheese over the past year, and had nothing worse than slight heartburn to report as a result. Since I can have as much enjoyment out of having pasterized Brie for my cheese platter, I will stick to that. Having lost a child, this is not theoretical to me, this is not about percentages and possibilities. I would not wish this sort of pain on any woman, so yes I would advise any friend of mine to minimize the risk, no matter how small.
The women in France might be eating lots of raw cheeses, and women in Japan might be eating lots of raw sushi, but you are not living there. You don't actually know if the foodborne illnesses are more prevalent in the United States than in other developed nations (I believe they are, but I can't find the statistics at the moment). There are also other variables. There is a reason why Americans traveling abroad are prone to GI illnesses, while indigenous people living there appear to eat the exact same foods without any ill effects...
The doctor's recommendation is meant to make you aware of additional risks that pregnant women face from food poisoning. Just as it is to make you aware that changes in balance, weight gain and tendon/ligament stretching will make you more clumsy and prone to falls, and the possibility of anemia and blood pressure changes can make a chance of fainting and subsequent fall more significant.
The doctor has to tell you, b/c the above information is statistically significant. But a difference being statistically significant doesn't mean that the difference is actually BIG. It is not.
The recommendation above is also rather generic. Some people are more prone to GI illnesses and seem to come down with diarrhea at the slightest upset. Others can eat unwashed fruit and carrots straight from the garden with no ill effects whatsoever. Some people are naturally clumsy and get even clumsier with pregnancy, others are not. The doctor likely doesn't know which group you belong to, so he tells you the generic guidelines.
It is up to you to make a decision about what to do with that information. You can pay attention to it, or you can ignore it, ignore some parts, but not the others, and otherwise do what you want about it.
Statistically speaking, you will run a very small risk that your actions will negatively affect your baby. IF something happens -- and that is a very big if, b/c most likely nothing will -- it will haunt you.
I hope this is only theoretical and you will sail through your pregnancy with no problems whatsoever, lead climbing at your limit until the day you start having contractions, and then delivering a healthy baby and going right back to climbing while your husband watches the baby and feeds it with the milk you have pumped ahead of time, or your belay partners are happily entertaining your baby while you send in between feedings, whichever situation you have in mind.
You obviously have made up your mind about what you are and aren't going to do, and how things will work out, and I do sincerely hope that this is exactly how things will turn out. For the sake of our friendship, I won't say anything more on the subject, and will await the announcements of future baby clee in the future.
(This post was edited by lena_chita on Jul 30, 2009, 9:32 PM)
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Toast_in_the_Machine
Jul 31, 2009, 3:38 PM
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The original article is correct; there are cultural biases in the recommendation.
Hamburger is statistically far more likely to cause food borne illness than sushi. Have any pregnant women seen anything on avoiding hamburger or chicken?
My wife ate sushi and drank soy milk all thru the first pregnancy. Our son was known as “sushi boy” because raw seafood was one of the first solid foods he ate. Miso soup and a plate of sashimi is his birthday meal.
For our second child, my wife had an aversion to raw seafood and drank no soy milk. Our daughter didn’t like sushi and barely likes any fish. Her meal is rice with soy sauce with miso soup.
Both are very healthy and extremely active. I have a whole ‘nother recommendation on “exercise as a form of parental control”, but that is a different thread.
Most of the information in “What to freak out about When Expecting” is old. Most of the numbers are from the 1960’s and do not take into consideration active women. Age information on there is particularly dated.
When in doubt use the great god google and look up the facts; much of the preg stuff is a myth. And don’t even get my wife started on VBAC.
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wonderwoman
Jul 31, 2009, 4:05 PM
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Toast_in_the_Machine wrote: Hamburger is statistically far more likely to cause food borne illness than sushi. Have any pregnant women seen anything on avoiding hamburger or chicken?
I'm a vegetarian and have had food poisoning twice within the last 4yrs. I was traveling both times, and my best guess is that it probably had to do with cross contamination on cutting boards at restaurants. Oh-the-irony of contracting salmonella during a week long training at the Centers for Disease Control and Prevention!
I could definitely see how someone of a lesser constitution could die from food poisoning. But me? Strong like ox!!!
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lena_chita
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Jul 31, 2009, 6:03 PM
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Toast_in_the_Machine wrote: Hamburger is statistically far more likely to cause food borne illness than sushi. Have any pregnant women seen anything on avoiding hamburger or chicken?.
Actually, yes. My doctor never said "don't eat sushi". SHE-- a midiwife, to be precise, not a doctor -- said something along the lines of: "Eat a varied and healthy diet. Make sure foods are cooked, stored and handled properly, especially ground meats, rinse all vegetables well, and essentially, just be mindful of good practices to avoid food contamination". I was told to limit tuna and other big fish to one serving a week due to mercury concerns, eat plenty of fruits and vegetables, and otherwise enjoy a variety of foods in moderation. I was also told that a glass of wine here and there won't be harmful, by the way...
I guess I had a smart midwife. But then again, I knew what i was looking for when I picked her.
Toast_in_the_Machine wrote: My wife ate sushi and drank soy milk all thru the first pregnancy. Our son was known as “sushi boy” because raw seafood was one of the first solid foods he ate. Miso soup and a plate of sashimi is his birthday meal. For our second child, my wife had an aversion to raw seafood and drank no soy milk. Our daughter didn’t like sushi and barely likes any fish. Her meal is rice with soy sauce with miso soup.
Interesting. I actually noticed a correlation in my kids, too, in terms of what I ate during pregnancy and what sort of foods they seem to enjoy. Though i think it isn't just during pregnancy, but also post-partum, during breeastfeeding, where my diet might have influenced their food preferences b/c of the flavors they got exposed to.
With my older, I did not like the smell of coffee, so I didn't drink any during the entire pregnancy or for at least a year afterwards. I have never been a coffee drinker, so it wasn't something I gave up for pregnancy -- I always drank tea. I also felt like eating lots and I mean LOTS- much more than usual-- fruits and vegetables, but didn't feel like anything spicy or hot, I wanted milder flavors, I also didn't eat a lot of meat at the time. My son finds the smell of coffee disgusting, doesn't like spicy foods, prefers raw veggies, and is in general a rather unadventurous eater.
With my younger one, I did enjoy coffee once in a while, and really craved spicy foods and hearty meat dishes. She finds the smell of coffee delicious-- I have to fend her off, literally, or she would gulp a whole cup. I have let her try a bit of black unsweetened coffee thinking that she won't like the taste-- boy, was I in for surprize! And she is a very adventurosome eater, she eats spicy and strong-flavored foods and liked them even as a toddler.
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macherry
Jul 31, 2009, 8:29 PM
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that's funny about kid's preferences. with my son i craved ice cream. i must have eat my weight's worth of dairy queen products before luke was born. when he was 5 years old e discovered he had a dairy allergy. it was quite frightening because it came on so fast. we cut out dairy products, but there was a couple times he ate food with cheese products. his throat started to swell and close........very scary.
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lena_chita
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Aug 1, 2009, 1:25 AM
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Yeah, that's scary, especially b/c it must have been so unexpected! I know kids with severe dairy allergies, but they were allergic from the get-go, the first time they tried dairy, they had a really bad reaction. It is pretty rare to be just fine with it unil 5 yo, and then get severely allergic.
My friend is convinced that her older son is allergic to eggs b/c she literally ate 2 eggs a day every day while pregnant. Who knows...
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macherry
Aug 1, 2009, 1:35 AM
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lena_chita wrote: Yeah, that's scary, especially b/c it must have been so unexpected! I know kids with severe dairy allergies, but they were allergic from the get-go, the first time they tried dairy, they had a really bad reaction. It is pretty rare to be just fine with it unil 5 yo, and then get severely allergic. My friend is convinced that her older son is allergic to eggs b/c she literally ate 2 eggs a day every day while pregnant. Who knows...
it started out as being stuffed up after drinking milk or eating cheese. luke would feel sick, so we just kind of cut it out of his diet. we didn't have him tested until about 5 years. his worst reaction came after eating soy cheese product that contained casein protein, it triggered the biggest reaction other than some tater tots given to him that contained cheese.
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Toast_in_the_Machine
Aug 3, 2009, 11:44 AM
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wonderwoman wrote: Toast_in_the_Machine wrote: Hamburger is statistically far more likely to cause food borne illness than sushi. Have any pregnant women seen anything on avoiding hamburger or chicken? I'm a vegetarian and have had food poisoning twice within the last 4yrs. I was traveling both times, and my best guess is that it probably had to do with cross contamination on cutting boards at restaurants. Oh-the-irony of contracting salmonella during a week long training at the Centers for Disease Control and Prevention! I could definitely see how someone of a lesser constitution could die from food poisoning. But me? Strong like ox!!!
One of the interesting "food illness" trends is that foods that were considered safe (think peanut butter) are now turning out to be a risk. The concern with meat was that the animal was badly butchered or the meat wasn't handled properly. Clams had the risk of being served from poluted water or were dead when cooked.
Now, sanitation concerns are being rased for all kinds of food products. And part of this is because of better tracking. My intuition says that lots of peole get sick from food, it just isn't easy to get to the origin of food in a complex food system. The CSA helps doesn't answer all sourced issues.
Are home E. coli tests the wave of the future? And yes, I bet doctors and midwives would recommend them to pregnant women.
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lhwang
Aug 4, 2009, 6:51 PM
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I think about the issues you bring up with all the time. A few random thoughts...
You're a doctor too, so I'm sure you know what it's like... so much of medicine is about mitigating risk. Even tiny risks. I view part of my role as a doctor as being a source of information for my patients. If there's a risk associated with eating raw meat and fish during pregnancy, no matter how small or theoretical, I have to tell women about that. And then it's up to them as to what they do with that information. I'm not going to judge them either way.
I don't think that avoidance of certain things during pregnancy and "the joy of pregnancy" are mutually exclusive.
You really can find data to find whatever position you want to support. I've seen patients who knew emotionally what they wanted, and then simply consulted umpteen different doctors until they found one who agreed with what they wanted.
My personal view is that our society is too judgmental and critical when it comes to being a mother. There's this whole concept of needing to sacrifice yourself at the altar of motherhood and if you don't, you're *gasp* a bad mother. I think ultimately, you just have to make decisions that you can be at peace with. You don't need to convince other people of the rightness of your decisions, nor do you need to defend yourself. There's really no point or need to look for validation of your decisions outside of yourself.
A few minor errors I noticed in the article: the immune system definitely does change during pregnancy. Just look at how women with autoimmune disorders often go into remission during pregnancy, or how the flu affects pregnant women vs non pregnant women. And, in reference to the article you posted about climbing in pregnancy, I find it surprising that they made no mention of falling and the risk of abruption. Most guidelines recommend 4 to 24 hours of continuous fetal monitoring after a fall or trauma, no matter how minor (if you hit your hand with a hammer, fine, that's different but if you slip on a rug and land on your knees, you still need monitoring).
(posted with the usual caveat that this shouldn't be considered a substitute for medical advice.)
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clee03m
Aug 4, 2009, 9:52 PM
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For gear heads out there, how does a chest harness work? From pictures I've seen, it seems that the pressure would still be on the seat harness unless you buy super expensive rescue harness that would apply the pressure to the shoulders. Am I way off?
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clausti
Aug 5, 2009, 4:01 PM
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in the other preggo thread, there are some pics of a full body harness, one from CAMP and a "rigger" harness that are basically identical. on a chest+seat harness, you have to tie in at your regular tie-in point, plus the chest tie in point. on some full body harnesses, there is still a waist belt, but on some there are not. because either way, the weight is on your leg loops and the 'basket" of webbing in the back, because the tie-in point is at your chest. i've worn a rigger's harness (not exactly the same kind) and i don't imagine it'd put pressure on your belly.
(This post was edited by clausti on Aug 5, 2009, 4:01 PM)
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crackrn
Aug 16, 2009, 5:28 PM
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clee03m wrote: For gear heads out there, how does a chest harness work? From pictures I've seen, it seems that the pressure would still be on the seat harness unless you buy super expensive rescue harness that would apply the pressure to the shoulders. Am I way off?
The one I wore had some pressure on the seat but more across the back. Since the tie in was at chest level, the pull came from there and the webbing between my shoulder blades.
ETA: and now I'm realizing there's a difference between a chest harness and a full body. I used the full body. Sorry!
(This post was edited by crackrn on Aug 16, 2009, 5:34 PM)
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samroberts
Mar 15, 2011, 4:42 AM
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lena_chita wrote: More people die in car crashes. And yet... it is an entirely preventable risk.
So is driving, the leading cause of accidental death in infants.
http://en.wikipedia.org/wiki/Micromort
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enigma
Mar 16, 2011, 7:16 AM
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Toast_in_the_Machine wrote: wonderwoman wrote: Toast_in_the_Machine wrote: Hamburger is statistically far more likely to cause food borne illness than sushi. Have any pregnant women seen anything on avoiding hamburger or chicken? I'm a vegetarian and have had food poisoning twice within the last 4yrs. I was traveling both times, and my best guess is that it probably had to do with cross contamination on cutting boards at restaurants. Oh-the-irony of contracting salmonella during a week long training at the Centers for Disease Control and Prevention! I could definitely see how someone of a lesser constitution could die from food poisoning. But me? Strong like ox!!! One of the interesting "food illness" trends is that foods that were considered safe (think peanut butter) are now turning out to be a risk. The concern with meat was that the animal was badly butchered or the meat wasn't handled properly. Clams had the risk of being served from poluted water or were dead when cooked. Now, sanitation concerns are being rased for all kinds of food products. And part of this is because of better tracking. My intuition says that lots of peole get sick from food, it just isn't easy to get to the origin of food in a complex food system. The CSA helps doesn't answer all sourced issues. Are home E. coli tests the wave of the future? And yes, I bet doctors and midwives would recommend them to pregnant women.
The Vons supermarket in California, I have been told by the manager who quit, uses old meat mixed in with fresh meat. The e.coli and that mad cow disease is very real and a risk.
As for peanut butter, have you ever seen how a squirrel goes for peanuts?
Places like markets with containers of nuts, are constantly having to contend with mice and rats.
I have also got food poisoning from clams once , maybe 10 years ago in the Florida Keys. It was awful.
I also like sashimi, but here in California, it not high quality, its from Tawian or farmed. I still have no idea why they don't get it from Hawaii.
Best to grow you own organic garden, and when eating out be wary.
Cute title for thread!! I guess its safer than in general from attack.
Clever idea, who would go after a pregnant climber who was a doctor? Lets hope. No-one
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kiwiprincess
Mar 16, 2011, 8:38 PM
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Cold rice is a bad one for food poisioning but like all these things it all depends on safe food handling and storage. If you make your own sushi etc it will be safe.
To be cautious I'd be careful about any cold food bought out.
Buy fish from the farm or buy from a source that ships daily and direct (not a supermarket).
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clee03m
Mar 18, 2011, 6:55 AM
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enigma wrote: Cute title for thread!! I guess its safer than in general from attack. Clever idea, who would go after a pregnant climber who was a doctor? Lets hope. No-one
Me fail English? That is unpossible.
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enigma
Mar 22, 2011, 5:33 AM
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clee03m wrote: enigma wrote: Cute title for thread!! I guess its safer than in general from attack. Clever idea, who would go after a pregnant climber who was a doctor? Lets hope. No-one Me fail English? That is unpossible.
Are you a medical doctor? Where?
I might have written a post when I was exhausted.
What's your excuse? 
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wonderwoman
Mar 22, 2011, 2:00 PM
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enigma wrote: clee03m wrote: enigma wrote: Cute title for thread!! I guess its safer than in general from attack. Clever idea, who would go after a pregnant climber who was a doctor? Lets hope. No-one Me fail English? That is unpossible. Are you a medical doctor? Where? I might have written a post when I was exhausted. What's your excuse?
Ralph Wiggum
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Khoi
Mar 26, 2011, 6:54 PM
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Some people in this thread don't know what sushi is.
Hint: it's not the fish, or even seafood
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kickasssoprano
Apr 25, 2011, 4:53 PM
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When I was pregnant, I did everything "by the book" but I still miscarried at 14 weeks. Even though I knew logically that I did everything "right" I still racked my brain looking for what I could have done to cause my pregnancy loss. While the risks may be small, do you really want to beat yourself up wondering if eating sushi or lead climbing caused you to miscarry?
As a doctor, you would know that it would most likely not be anything you did, but your brain goes a bit crazy after a trauma like pregnancy loss. I even feel a bit guilty about the fact that I was top roping during my pregnancy and and not sure if I'm going to be able to get past that and climb during my next pregnancy.
That being said, I do think it's important to relax and do what you feel is safe. I think your child is already born, but if not I wish you a safe and healthy pregnancy.
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smallclimber
Apr 25, 2011, 5:02 PM
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Sorry to hear about your miscarrage, I saw posts from you earlier when you had just become pregnant.
I had one miscarage before having my daughter, and yes it is hard. Stay positive, I am sure that next time you will be fine. Good luck and I'm sure all the RC.com ladies are thinking about you.
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