Pregnant women and sushi in Japan: questions

[Bond Girl]

A newly pregnant friend was told to stay away from raw fish. Is there the same belief in Japan as well, when eating sashimi is quite common?

[LaurieA-B]

Check out this thread:

Cheese, sushi, et al, while expecting

[Hiroyuki]

The issue with mercury in fish was unheard of when my wife gave birth to daughter in 1999. It was quite recently that we heard news about it.

In 2003, the Ministry of Health and Welfare released a document on this issue:

http://www.mhlw.go.jp/topics/2003/06/tp0613-1.html

(Japanese only)

[torakris]

Here is a little bit more about the warning Hiroyuki posted to but in English:

http://www.atimes.com/atimes/Japan/EF28Dh03.html

Most of the fish mentioned with the highest levels, whales and sharks aren't fish that the Japanese partake of that often. The two more common fish mentioned, the mekajiki (type of swordfish) and kinmedai (large eyed type of sea bream) are recommended to eat less than 2 times a week. Of course this is very recent information.

I have had 3 pregnancies in Japan and the only things they warn us about is alcohol, cigarettes, lowering your sugar and sweets intake and trying to eat more lean meats. I have never been told to avoid anything else.This was a good thing as I craved raw foods during all my pregnancies and lived on sushi, yuke (raw beef), and liver sashimi....

I think the warning in the US, is just that, a warning to be careful, improperly stored, handled or prepared fish can make you sick and served in the raw state you are even more susceptible. I would have no qualms about eating siushi in the US as long as Iw as sure of the freshness of the fish.

[torakris]

In a completely unrelated search I found a complete English translation of the paper that was posted above by Hiroyuki:

http://www.mhlw.go.jp/english/wp/other/councils/mercury/

[Fat Guy]

I'm working on a book chapter about Japanese restaurants in America (the topic about the book project is here) and was wondering if any of you could help me track down some official Japanese sources on the issue of sushi and pregnancy. For this particular project, I'm not going to be able to use any anecdotal reports ("My doctor said it was fine," "I ate tons of sushi when I was pregnant") or undocumented sources -- and so far that's all I've been able to find online. What I'm looking for is a Japanese government source, or a Japanese medical association source, saying that raw fish is (or is not) safe to eat during pregnancy. Anybody have any leads? English would be nice. Also interested in any studies, statistics, etc. Please post here -- don't reply by PM -- so everyone can see.

[Hiroyuki]

I'm extremely busy right now, so one pdf file in Japanese from the Ministry of Health, Labour and Welfare for now:

http://www.mhlw.go.jp/topics/bukyoku/iyaku...l/051102-2a.pdf

You may be able to get some info from the Ministry's English-language website

http://www.mhlw.go.jp/english/index.html

I'll be away from home for two days, starting tomorrow. I think I can provide some more info on Monday.

[Fat Guy]

Much appreciated.

[torakris]

I just read through both links and there is nothing said about eating raw fish. It is basically telling you how much of certain types is safe during pregnancy due mercury levels/etc.

I have looked through my pregnancy books (in Japanese) and there is no mention in any that raw fish is dangerous. During my 3 pregnancies in Japan I was never told to stop eating raw fish though it was suggested that I don't eat as much "western foods" as they tend to be high in fat and calories...

I will also take a look online and see what I can find.

[Hiroyuki]

Here is one pdf file on the subject in English:

http://www.mhlw.go.jp/topics/bukyoku/iyaku.../051102-1en.pdf

It should be noted that in Japan, raw fish is handled carefully, so that the cases of listeria infection due to eating raw fish are minimal, and eating raw fish is as safe (and unsafe) as eating cooked fish (due to the presence of organic mercury). As far as I have searched, the Ministry of Health, Labour and Welfare makes no distinction between raw and cooked fish when it comes to this subject.

[Fat Guy]

Thanks Hiroyuki!

[Hiroyuki]

Minamata Disease Archives

http://www.nimd.go.jp/archives/english/index.html

Not directly related to pregnancy and fish, but you can get some understanding of mercury.

[mjs]

I'm afraid this is anecdotal. While I have traveled frequently to Japan for many years, my wife's first chance was when we took a vacation to attend a friend's wedding 7 years ago. She was nearly 7 months pregnant and her OB agreed to let her eat raw fish in Japan. When we told various Japanese women that US doctors generally advise pregnant women not to eat raw fish, they all thought this was quite humorous.

The general consensus was that raw fish is healthy and that pregnant women should eat a higher percentage of healthier foods. Therefore, they all assumed it was better to increase one's consumption of raw fish while pregnant.

Since this seems to have been the practice for several generations, it might be you won't find any official government guidance on the subject. It would probably require a search of Japanese medical texts to find what Fat Guy is looking for.

[Fat Guy]

Thanks for all the information guys. I've written up a little essay on this issue, and will post the draft over on the book topic here in a few minutes.

[Fat Guy]

There's an op-ed in tomorrow's New York Times, by me, on Sushi and pregnancy, which developed out of the discussion here in the eG Forums. Thanks for all your assistance.

[SuzySushi]

Neat piece! Congratulations!

[Jensen]

This is probably too late but there is an abstract on PubMed linking consumption of raw fish by pregnant women to perinatal listeriosis.

Search using the parameters:

pregnant "raw fish"

[Fat Guy]

I believe that article, from 1984, is about an outbreak of listeriosis in Auckland, New Zealand, that was as far as I know never conclusively linked to anything. It probably wouldn't have been linked to sushi under any circumstances, since Japanese restaurants had barely gained a toehold in New Zealand in the early 1980s, and if Japanese living in New Zealand had been making sushi at home and getting sick the hospitals would have figured out that all the people coming in were ethnically Japanese. If raw fish was to blame for that outbreak, it was probably raw mollusks like oysters -- they tend to be responsible for the overwhelming majority of seafood-related foodborne illnesses, but are not particularly used in sushi.

[Jensen]

It was interesting that there wasn't much of anything on PubMed about "the dangers of eating sushi" though.

I ate a ton of sushi (and other Japanese food) when I was pregnant, as well as a large amount of Greek food. The only result I ever saw from it was that the Spawn loves Japanese and Greek food.

[Fat Guy]

In the course of working on the op-ed someone told me that, when she was pregnant in France, she was told to avoid ice cream and raw fruit. It seems as though every country, culture and obstetrician has different advice about what pregnant women should and shouldn't eat, and that very little of it rests on any sort of factual basis.

[Kiem Hwa]

Listeriosis during pregnancy aside, this study (Hibbeln et al, The Lancet, Feb 2007) concluded that mothers who ate >340g seafood/week during pregnancy had smarter kids:) I would still be careful about the mercury-level intake though........

"Seafood is the predominant source of omega-3 fatty acids, which are essential for optimum neural development. However, in the USA, women are advised to limit their seafood intake during pregnancy to 340 g per week.

Maternal seafood consumption of less than 340 g per week in pregnancy did not protect children from adverse outcomes; rather, we recorded beneficial effects on child development with maternal seafood intakes of more than 340 g per week, suggesting that advice to limit seafood consumption could actually be detrimental. These results show that risks from the loss of nutrients were greater than the risks of harm from exposure to trace contaminants in 340 g seafood eaten weekly.

Advice that limits seafood consumption might reduce the intake of nutrients necessary for optimum neurological development. Findings reported here are consistent with reports that lower omega-3 fatty acid intakes in pregnancy predict lower verbal IQ.38 and 39 Adverse outcomes associated with insufficient intakes of long chain omega-3 fatty acids during pregnancy include: intrauterine growth retardation,40 delayed or suboptimum depth perception,17 adverse neurodevelopmental measures,18 residual deficits in fine motor skills, speed of information processing in infants,41 and irreversible deficits in serotonin and dopamine release.42 Thus, other evidence suggests that omega-3 fatty acids in pregnancy could be directly responsible for the beneficial findings shown here. The 2004 US advisory8 however, aimed to reduce the potential harm from pollutants in seafood, specifically methylmercury. Although methylmercury undoubtedly has harmful effects on the developing brain, the harm is unlikely to be greater than the overall benefits of nutrients at the concentrations usually present in seafood. These data show that the risks from losing the benefits of nutrients essential to neurodevelopment exceeds the risk of exposure to trace concentrations of contaminants in 340 g seafood eaten weekly."

http://www.sciencedirect.com/science?_ob=A...dce4fe&ref=full

[Kiem Hwa]

The fish which have the highest levels is mercury are "shark, swordfish, king mackerel and tilefish". I usually buy my fish at the Japanese grocery store, so does someone know the Japanese (or any other common) names for those fish?

[SuzySushi]

The fish which have the highest levels is mercury are "shark, swordfish, king mackerel and tilefish".  I usually buy my fish at the Japanese grocery store, so does someone know the Japanese (or any other common) names for those fish?

←

Shark = same (pronounced sah-may)

Swordfish = kajiki, makajiki, or mekajiki (varieties of swordfish, broadbill swordfish, and marlin)

King mackerel = sawara

Tilefish = shirakawa and many other names

Here's a list of many Japanese names for fish.

[C. sapidus]

A recent Washington Post article indicates some new thinking on the subject at hand: Consumer Challenge: Making Head or Tail of Fish and Mercury.