Womens Health Associates Blog

Empowering Women Through Health

LET THEM EAT CHEESE By KIM MORSE, M.D. September 2, 2011

Filed under: Pregnancy — womenshealthassociatesblog @ 2:03 pm

Recently I’ve noticed an increase in questions regarding food precautions and recommendations during pregnancy.  I’ve had many patients ask me if it’s safe for them to eat nachos while they are pregnant.  The answer is yes.  I started looking at where this misconception stems from and thought that a quick review of what the American College of Ob-Gyn and the FDA recommends would help clear things up.

Listeria monocytogenes is a bacteria that can be found in soil, water, sewage plants and food.  It is considered an important public health problem due to the fact that infection with this bacteria most often occurs in people with a weakened immune system- such as pregnant women, newborns, the elderly and people on chemotherapy.  In this population the infection can have severe consequences. 

Symptoms of infection with Listeria usually include diarrhea or other gastrointestinal symptom followed by fever, body and muscle aches.  The symptoms usually develop one to a few days after eating the contaminated food.  It is diagnosed by blood testing.  Treatment with antibiotics cures the infection and can prevent pregnancy complications so it is important to contact your physician if you develop these symptoms or have consumed food known to be contaminated

The actual risk of contracting Listeria in the United States is quite low.  The incidence given by the CDC is 3 per 1,000,000 (.3/100,000).  Reported cases were down 38% in 2010.  Of the cases reported, 16% occurred in pregnant women.  Of those pregnant women 28% were Hispanic.  This leads many to believe that the most common source of infection is soft, non-pasteurized Mexican cheeses like queso fresco and queso blanco.

As with any bacteria that is naturally present in our environment, it is impossible to completely eliminate the risk of infection.  There have been reports of Listeria isolated from many types of food including contaminated vegetables, hummus, even milk contaminated after pasteurization. (In other countries it has been isolated from soft serve ice-cream, but not in the US).  Common sense food safety guidelines and avoiding high-risk foods are the best ways to avoid infection.

Food safety guidelines include washing all utensils and surfaces used in preparation of raw meats and storing uncooked meats separately from vegetables and cooked foods. 

Foods considered high-risk include unpasteurized soft cheeses, such as brie, feta, or queso blanco.  Cold deli meats and uncooked hotdogs are also considered to be high risk unless they are cooked before eating.  All hard cheese (like cheddar), semi-soft cheese (like mozzarella) and pasteurized cheeses are completely safe.

Most feta and brie that is made in the United States has undergone the pasteurization process- just check the label.




 The great news is that most nachos are made with monterey  jack or cheddar.  If there is any doubt, just ask the cook.  Now you can just sit back and enjoy your meal.



Women’s Health for Healthy Women: Exercise in Pregnancy by Matt Borgmeyer, MD May 3, 2011

Filed under: Fitness During Pregnancy,Pregnancy — womenshealthassociatesblog @ 7:05 pm

                I am reminded this time of year of the profound effect a warm day in the middle of February has on the psyche of people.  As soon as the snow melted enough to expose the sidewalks and trails, the opportunity to get outdoors and get active became contagious.  It seemed as if everyone had a bigger spring in their step and pregnant women are no exception.  Along with the change in weather and eagerness to get outside, I tend to get more questions about exercise in pregnancy.  Is it safe to exercise in pregnancy?  Can I do too much?  Is there any reason not to exercise in pregnancy?  Is there anything I should avoid?

                While some women may be apprehensive to do anything strenuous during pregnancy, for a majority of women, exercise is just fine and actually beneficial during pregnancy.  If you are used to exercising when you are not pregnant, there is a very good chance you can exercise during pregnancy as well.  While it may not be the best time to make the jump to train for a marathon, most women can continue what they were doing prior to pregnancy.  If you aren’t used to exercising prior to pregnancy, you can still start, just take it slow and steady. 

                The American Congress of Obstetrics and Gynecology supports doing 30 minutes or more of moderate exercise during pregnancy in the absence of obstetric complications.  There is also data to suggest regular exercise during pregnancy can reduce the risk of gestational diabetes and postpartum depression.  The primary modification I tell patients to focus on is to avoid any sport where you are more likely to get hurt (downhill skiing, rugby, soccer, etc) and to pay attention to their bodies.  During pregnancy, your exercise tolerance is lower so you will probably have to adjust the intensity you are used to.  Instead of pushing yourself to go that extra ten minutes when you feel fatigued, you should probably slow it down.  It is also important to remember that your center of gravity changes quickly during pregnancy which will affect your balance (important to keep in mind for yoga fans).  

                While there are very few reasons not to exercise, there are some individuals who need to talk with their doctor prior to starting a routine.  If you have a history of preterm labor, seizures, heart disease, lung disease, high blood pressure, vaginal bleeding or concern you’re leaking amniotic fluid, it is a good idea to have a discussion with your doctor first.  However, for most people, you have just as much reason to enjoy the warm weather as the next person.