There are many food taboos during pregnancy, and every Malaysian surely has a story or two about them. While some of these can be backed by science, many of these taboos are traditional beliefs that have been passed from one generation to another or old wives’ tales. We talked to Dato’ Dr Siti Zaliha, consultant obstetrician & gynaecologist in order to separate the facts from the myths regarding pregnancy food in Malaysia.
To Eat or Not to Eat: A Closer Look at Pregnancy Food Myths
1. Pregnant Women Should ‘Eat for Two’
Healthy eating is very important when you are pregnant.1 But, “eating for two” does not mean eating twice as much as you did before.1, 2, 3 Let’s take a closer look at actual nutritional requirements:
- In the first trimester, you need an extra 80 kcal/day from the normal recommended energy intake of 1,840 kcal/day.4
- During the second and third trimester, your energy needs increase by 280 and 470 kcal/day, respectively.4
You can achieve these extra energy requirements by consuming nutrient-dense food instead of doubling down on serving size. These include food that is rich in essential nutrients such as carbohydrates, protein, as well as vitamins and minerals that are important for both you and your developing baby.3, 5
In cases where you are pregnant with twins (or multiples), your nutritional demands will be magnified as the presence of multiple foetuses causes a rapid depletion of your nutritional reserves.6 The American College of Obstetricians and Gynecologists recommended a daily intake of 3,500 kcal/day calories for twin gestations. That’s more than 1,000 kcal/day additional calories as compared with single pregnancies.4, 6
2. Cooling Foods Are Harmful During Pregnancy
Avoiding pineapple, watermelon, cabbage, cucumber, and other food that is considered cold or cooling is another food taboo among pregnant Malaysian women.7 This is due to the belief from traditional Chinese medicine that consuming cooling food is linked to miscarriage, excessive bleeding during labour, or deformities in childbirth.7, 8, 9
Generally, pineapple is safe to be consumed during pregnancy.10 There are even benefits to be had, as fruits such as pineapple and watermelon are high in fibre and contain important nutrients such as vitamins A, B1, B12 and C, copper and manganese.10, 11
3. Eating Liver Contributes to Foetal Eyesight Development
Vitamin A is good for the eyesight, but for pregnant women, it can be dangerous. Eating liver can potentially harm the foetus as it contains high levels of vitamin A.12, 13 Pregnant women should avoid consuming too much liver or products containing liver (e.g. liver pâté, liver sausage or haggis) as excessive intake may result in toxic effects for the mother and foetus.12, 13
4. Eating Nuts During Pregnancy Will Give Your Child a Nut Allergy
In a recent study, it was revealed that children whose mothers had the highest consumption of peanuts (more than five times a week) during pregnancy, had the lowest risk of peanut allergy.14 This was especially true among pregnant mothers who are non-allergenic (or have no allergic reaction to peanuts).12, 14 Therefore, unless you are allergic to peanuts or your doctor advises you not to, it should be safe to eat peanuts or food containing peanuts during pregnancy.12
5. Pregnant Women Should Avoid Raw or Partially Cooked Food
Eating raw and undercooked meat may expose pregnant women to toxoplasmosis, an infection caused by the Toxoplasma parasite commonly found in raw and undercooked meat, untreated water and cat’s stool.12, 15, 16
On the other hand, it is safe for pregnant women to eat raw or lightly cooked fish, provided that any raw wild fish used to make it has been frozen beforehand.12 Freezing kills the small parasitic worms that are normally found in wild fish.12
Uncooked eggs should be avoided. Raw or partially cooked eggs may contain Salmonella bacteria, and this may cause food poisoning. If you have symptoms such as diarrhoea, nausea and vomiting12, 15, 17, consult a doctor immediately.
6. Pregnant Women Should Avoid Products Made from Unpasteurised Milk
Unpasturised milk may contain Listeria bacteria which is associated with abortion or premature delivery.15, 16, 17 It is safe to eat commercially manufactured ice cream as they are made with pasteurised milk and eggs, therefore eliminating the risk of bacterial food poisoning.12, 15 However, you should steer clear of soft serve ice cream if you are pregnant, as there is a high chance of bacterial (Listeria) contamination due to poor hygiene and inadequate cleaning of the soft serve dispensing machines.18 Opt for hard frozen ice cream or gelato instead as they are usually stored frozen, stopping any bacterial growth.18 You should also avoid soft cheeses such as feta, Brie and Camembert; however processed cheese slices and hard cheeses (for example cheddar cheese) are acceptable.15, 16
7. Drinking Coffee Is Harmful
Caffeine is commonly found in coffee and other beverages such as tea, chocolate, soft drinks and energy drinks.12 According to the United Kingdom National Health Services and American Pregnancy Association, pregnant women should limit their caffeine intake to less than 200mg per day (about one cup of filtered coffee plus one can of cola).12, 15
Too much caffeine can result in miscarriage and an increased risk of low birthweight.12 15 In addition, polyphenolic compounds found in coffee are responsible for poor iron absorption, which may lead to iron deficiency19. You can cut down your caffeine intake by switching to decaffeinated coffee and tea, or non-caffeinated drinks like mineral water, milk or fruit juices12 15.
8. Eat Plenty of Vegetables but Do Not Touch Salad
Fruits and vegetables are essential during pregnancy.15 However, it is important to make sure that fruits and vegetables that are normally eaten raw, such as lettuce and carrots, are properly washed to remove soil and dirt that could expose you to toxoplasmosis.15, 16
Pregnant women should also stay away from pre-prepared salads or salads from salad bars in restaurants, delis and supermarkets.20 These chilled, ready-to-eat salads may be contaminated with Listeria bacteria due to the handling involved in their preparation.20, 21 Furthermore, Listeria can continue to grow even in refrigerated foods.20
If you are craving for a salad, try your best to eat only salads that have been thoroughly washed and freshly prepared.20 Also, avoid all sprouts (for example alfalfa, snow pea, clover, radish and mung bean).21, 22, 23 Sprout seeds are often contaminated with harmful bacteria such as Salmonella, Listeria and E. coli that are impossible to wash out and could lead to foodborne illness upon consumption.21, 22, 23
9. Avoiding Dark-Coloured Food Will Give My Child Fair Skin
According to traditional beliefs, it is thought that eating dark-coloured foods (such as soy sauce, chocolate, coffee and cola) is associated with having a child with dark skin.8 Meanwhile, eating light-coloured foods such as tofu and soybean products is thought to be related to having a child with fair skin.24, 25
This is, in fact, an old wives' tale because no food can alter your child's genetic make-up.24, 25, 26 Skin colour is a genetic trait (inherited from parents) and is affected by the amount and distribution of melanin pigments in the skin.26
10. Eating Street Food/Hawker Food Is Dangerous
During pregnancy, you are more susceptible to food poisoning as a result of hormonal changes that lower your immune system.17, 27 Listed below are some precautions that will allow you to maintain enjoying your favourite hawker foods.
- Choose food items that are prepared fresh or cooked only after you have placed your order.28
- You should also opt for hot foods (60°C and above) and foods that are well-cooked such as well-done meat and deep-fried foods.27, 29
- Avoid dishes with raw fruits and vegetables or uncooked meat to prevent food poisoning or water-borne infections.27, 29, 30
- It is best to avoid foods with sauces or condiments that have been left out at room temperature for a long time to eliminate the risk of foodborne illnesses such as listeriosis.28, 29
- Stay away from eating ais kacang during pregnancy as the ice used may not have been made from safe drinking water. Also, at times, the vendors use bare hands when shaving the ice.31
- Street foods are normally loaded with mono sodium glutamate, cheap oil and food colourings which are known to cause headache, allergy and water retention. It is best that you limit your street food intake during pregnancy.30
11. Eating Spicy Food Triggers Labour
There is no scientific proof that eating spicy food can trigger labour or have any impact on your pregnancy and your developing baby.32, 33 However, you may experience heartburn and digestion problems if you consume too much spicy food, especially in the third trimester.33 During this time, your growing foetus may cause acid reflux (backward flow of stomach acid into the oesophagus) and consumption of spicy food could worsen this situation.33
12. Drinking More Water Increases Amniotic Fluid
The volume of amniotic fluid is influenced by the status of maternal hydration.34, 35 Several studies show that pregnant mothers who consumed 1.5 to 2 litres of water two to six hours before their amniotic fluid volume was measured had a significant increase of amniotic fluid volume. This increase ranged from 16 to 30%.34, 35, 36
It can be an uphill challenge to separate fact from fiction as expecting mothers are constantly faced with a barrage of information from all cylinders. Simply follow the aforementioned tips for a well-rounded pregnancy diet.
Article contributed by Dato’ Dr Siti Zaliha, Consultant Obstetrician & Gynaecologist
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