Are Pregnancy Diets Too Strict?

Expectant women hear plenty about what they eat and drink—but should they believe it all?

Are Pregnancy Diets Too Strict?

No longer fare of the un-pregnant? (Photo: wendyness/Flickr)

Steve Holt is a regular contributor to TakePart. He writes about food for 'Edible Boston,' 'Boston Magazine,' 'The Boston Globe,' and other publications.

When a woman announces to her friends and family that a baby is on the way, she should prepare herself for a barrage of unsolicited advice regarding what foods and drinks to go for and which ones to avoid. You’ve heard most of these: absolutely no soft cheese, deli meats, sushi. You can’t eat too much or too little; “the baby gets what it needs,” regardless. And the list goes on.

Americans hold fast to their myths regarding pregnancy food and drink, and for many women, there’s no straying from them. (To test this premise, get your most pregnant friend to answer the door at her next dinner party holding a big glass of wine, and watch the fireworks that ensue.)

Well, last week, a Wall Street Journal article that questions the restrictive pregnancy-diet status quo made the rounds. In the piece, economist Emily Oster describes how, while expecting a child, she became disillusioned with much of the popular wisdom regarding pregnancy prohibitions. So she collected and studied the medical research pertaining to the effects of certain foods and drinks on pregnancies and childhood outcomes. Oster then calculated the statistical likelihood of the various risks associated with consuming certain foods while pregnant. Her conclusion: There’s more room for choice than many pregnant women think. (Go read the entire article, then come back for some analysis…we’ll wait.)

“When I asked my doctor about drinking wine, she said that one or two glasses a week was ‘probably fine.’ But ‘probably fine’ isn’t a number,” Oster wrote. “In search of real answers, I combed through hundreds of studies—the ones that the recommendations were based on—to get to the good data. This is where another part of my training as an economist came in: I knew enough to read the numbers correctly. What I found was surprising.”

What she found about drinking alcohol was that there’s “no credible evidence that low levels of drinking (a glass of wine or so a day) have any impact on your baby’s cognitive development.” What about coffee, which has been linked to a greater risk of miscarriage? Same story. (In moderation, of course)

Down the list, from soft cheese to deli meats (the risks from which Oster calculates can be traced back to one or two specific types of each food), Oster appears to put the popular myths surrounding eating and drinking while pregnant in their proper context. And it’s worth noting that Oster’s now-two-year-old daughter is happy and healthy.

But absent a degree in economics, how is the ordinary mother-to-be to navigate all the seemingly schizophrenic information about pregnancy diets? We put that question to a couple of registered dietitians based in New York.

Samantha Lynch (who has a two-year-old herself) says she, like Oster, looked at the research during her pregnancy, weighed the pros and cons, and then made her own informed decisions. That said, Lynch points to a recent client who contracted listeria in her third trimester and was rushed into an emergency caesarian section. So, just to be on the safe side, Lynch advises her pregnant clients to microwave deli meats before consuming them.

Her other big departure from Oster’s research is in the area of pregnancy weight gain. Oster presents a complicated picture of recommendations surrounding how much weight women should gain while pregnant, observing that risks associated with weight gain center mostly around the size of the baby at birth. Risks exist both for babies born too heavy, as well as those born too small, Oster writes, but her research led her to believe “that I should be more worried about gaining too little weight than too much.”

But Lynch disagrees. Gaining too much weight puts mothers at a higher risk of pre-eclampsia, as well as diabetes, Lynch says. The baby is at a higher risk of obesity later in life, too. A new study suggests the problem may be even worse than previously thought. The number of overweight newborns—some as large as 15 pounds—has increased by 15-25 percent in the last two or three decades, according to a study published in the medical journal The Lancet. The culprit, doctors believe, is the declining quality of diets among pregnant women.

Despite Oster’s conclusions—and gradually shifting popular attitudes—alcohol consumption remains a controversial topic among medical and nutrition experts. A midwife in Boston may advise an expectant mother to drink a glass of wine as she is going into labor to relieve her anxiety, but Elaine Tang, a dietitian at Mount Sinai Hospital in New York, maintains it’s safer just to omit the booze altogether while with child.

“It appears to be more common in areas of Europe to have up to one glass of wine a day while being pregnant,” she says, “but in the U.S., research has not concluded its safety level.”

Regarding caffeine, Tang advises her clients to reduce their intake to the equivalent of two cups of coffee per day—which is more than popular knowledge (zero caffeine) but less than what Oster drank (unlimited caffeine).

At the end of the day, though, the dietitians appear to err on the cautious side with regard to popular prohibitions. “Pregnancy lasts nine months,” she says, “and it isn’t worth pushing the limits.”

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