Can I eat hummus in pregnancy?
If you are pregnant, you have likely heard you should avoid hummus (and other tahini products). Why is this the case? What is the food safety risk? Are there ways to safely include this nutritious food in pregnancy? Read on to find out some answers…
An excerpt from the NSW Food Authority guidelines for pregnancy - 'Foods to eat or avoid when pregnant'. Tahini and hummus were added to this list in 2021. This is probably the number one guide given to women in Australia when they fall pregnant, from GP's or the hospital.
What is classified as a sesame seed product?
There are many sesame seed products, however not all of them are classified as high risk. According to the Department of Agriculture, Fisheries and Forestry, it is the are ready-to-eat products that pose a risk (DAFF 2022).
This includes:
Tahini (sesame seed paste)
Baba ghanouj (eggplant dip made with tahini)
Halva (a dessert made from tahini)
Hummus (chickpea dip made from tahini)
Sesame flour or powder
Exclusions:
Bakery products where sesame seeds are used as a topping or garnish
Sesame seed products that are cooked or baked
Sesame seed products that are retorted and shelf stable
Sesame seed oil
Why is eating sesame seeds and it's products in pregnancy a risk?
Sesame seeds and it's products have been linked to Salmonella infection. Contamination of sesame seeds with Salmonella can occur during growth, storage or processing (Podolak 2010). Please note, however, that contamination of sesame seed products is very rare and is unlikely to occur in Australian made products.
A statement from the Food Standards Australia New Zealand (FSANZ) during the period from 1990 – 2016 reported the following outbreaks of Salmonella infection from sesame products (FSANZ 2016):
- 2002/2003: Three outbreaks across Australia and New Zealand with a total of 68 cases linked to consumption of hummus and tahini imported from Egypt and Lebanon.
- 2012: One outbreak in New Zealand with 16 cases of salmonellosis linked to consumption of hummus made from tahini sesame paste imported from Turkey.
- 2001: An international outbreak with 23 cases in Australia. The outbreak strain was isolated from a number of halva products manufactured in Turkey.
- There were no outbreaks associated with domestic tahini products (ie. Australian made products).
I could not find any recent Australian data after 2016 so I looked at some statistics from America. The Centers for Disease Control and Prevention (CDC) reported just 3 outbreaks of Salmonella from tahini in the past 10 years from 2012 - 2022 (CDC 2022). To give you some context of how rare this is, the CDC reported salmonella outbreaks from 27 animal products and 23 fruit and vegetables products in this same time period from 2012 - 2022.
I could not find one incidence of a pregnant women who had become infected with Salmonella from tahini or it's products.
What other foods are associated with Salmonella infection?
Salmonellosis is usually associated with contaminated fresh fruits and vegetables, bean sprouts or animal products such as eggs or poultry/meat. In 2016, a report by OzFoodNet (Australia's foodborne diseases surveillance) declared that the majority of salmonella outbreaks in Australia come from eggs, mung bean sprouts, bagged salad products and rockmelon (Bell et al. 2016).
What I would like to point out, however, is that any food could technically become infected with Salmonella in the right environment. After searching through the FSANZ food recalls and reports from the CDC, I found many everyday foods where Salmonella had been detected - frozen berries, apricots, soy milk, dried coconut, peanut butter, vegan protein bars, chocolate, pistachios, powdered infant formula - the list goes on (FSANZ 2021, CDC 2022). That doesn't mean you have to avoid all of these foods, I'm simply trying to explain that almost any food could be contaminated, and there are ways to reduce this risk.
How can the Salmonella risk be lowered in sesame seed foods?
By using tahini made from roasted sesame seeds, buying Australian products and using good personal hygiene and food storage practices.
Roasting of sesame seeds
Several studies have shown that the roasting of sesame seeds inactivates Salmonella. This roasting step is very common when making tahini, as it enhances the flavour, colour and texture. A study in 2013 by Torlak et al. examined the efficiency of the roasting process. Complete inactivation of Salmonella in sesame seeds (which had been inoculated with 5.9 log cfu/g), was achieved by roasting at 110 °C for 60min, 130 °C for 50min or 150 °C for 30min. Results of this study demonstrated that the standard roasting process is sufficient to inactivate Salmonella in sesame seeds and the low water activity of tahini prevents microbial growth (Torlak et al. 2013).
Buying products that are made in Australia
All of the Salmonella outbreaks that I came across in Australia and New Zealand were from sesame seed products that were imported from overseas (namely Lebanon, Turkey and Egypt). It would therefore be wise to avoid imported products. As a few studies have noted, the likely cause of the Salmonella outbreaks linked to sesame seed products is cross contamination of the products after heat treatment (Torlak et al. 2013, Brockmann et al. 2004). Australia has very high food standards and manufactures need to abide by strict sanitation and regulatory practices. Hence the risk of contamination will be much lower if the product is Australian made.
*Please note that many tahini products will state that the ingredients are imported, but the product is made in Australia. This is fine and usually means that the sesame seeds may be grown in another country, but they are roasted and manufactured in Australia. Check with the food company if you are unsure.
Personal hygiene and food storage
The risk of Salmonella infecting your sesame seed product does not stop at manufacturing. You still need to do your bit when it comes to personal hygiene and food storage. Here are some ways you can minimise cross contamination at the consumer level:
- Store all sesame seed products in the fridge
- Always wash your hands prior to and after using sesame seed products
- Use clean utensils when using sesame seed products and don't double dip
- Consume sesame seed products within their use best before dates
Note: These strategies apply to any food. I discuss much more about food safety in my book, Nurture the Seed, where there is a whole chapter on lowering your risk of contracting a food borne illness during pregnancy.
Will these strategies reduce the risk of Salmonella contamination entirely? No, you can never eliminate the risk altogether. However as FSANZ state:
"Good manufacturing practices and good hygienic practices in food manufacturing and food handling will minimise Salmonella contamination of sesame seed products." (FSANZ, 2016)
Why do I care that tahini and hummus are on the 'avoid list' for pregnancy?
Tahini is a wonderfully nutritious food especially when it is made into hummus which is how most people consume it. Hummus, thanks to the chickpeas and tahini, is rich in protein, iron, fibre and antioxidants - plus it counts towards your daily servings of vegetables. Not many pregnant women I see in clinic are meeting their protein or vegetable intakes. Hummus is a very simple way of increasing these, especially when it is paired with carrot or cucumber sticks. It's also a food that many women can actually tolerate when they are in the depths of morning sickness. Like most things in pregnancy, it's a matter of weighing up the risk verse benefit. Avoiding every food on the list can make it very difficult to meet the increased nutritional needs for pregnancy. An Australian study in 2012 found that pregnant women who limited their intake of 'high-risk' foods were more likely to have inadequate nutrient intakes (Pezdirc et al. 2012). It's your decision at the end of the day, but I hope you now realise that there are measures you can put in place to reduce your chance of Salmonella infection from sesame seed products.
Cashew hummus - recipe in my book, Nurture the Seed
Photo by Anna Wiewiora
Take home messages
Check that your tahini is made from roasted sesame seeds and manufactured in Australian
Store sesame seeds, tahini and hummus in the fridge
Don't buy hummus from a market stall
If buying store bought hummus, ensure it is pasteurised and kept cold and eaten within 24 hours of opening
Look out for current food recalls - you can add your name to the FSANZ 'Food recall alerts' - https://www.foodstandards.gov.au/media/pages/subscriptionservice.aspx
If topping your salads or muesli with sesame seeds (or any seed), roast or toast your seeds first, rather than adding them raw
If you prefer to avoid tahini and tahini products, make your hummus without the tahini (chickpeas, lemon juice, olive oil, cumin). This is still a delicious and nutritious snack.
Avoid hummus at a restaurant or at friends house when you can't ensure it has been made and stored properly, and when cross contamination is likely
Further information on food safety can be found in my book, Nurture the Seed. I pick apart the evidence around eggs, fish, deli meats, cheese and more.
Disclaimer:
Salmonellosis is a very unpleasant experience during pregnancy, and in rare cases it may trigger a miscarriage. By no means do I want women to become complacent around food when they are pregnant. In fact, I advocate for the safety of all food, which involves practising good personal hygiene, kitchen hygiene and proper food storage.
The information in this article is not intended to replace professional medical advice. I, Renee Jennings, accept no liability for the use, application or interpretation of the material in this blog.
References:
NSW Food Authority, Pregnancy, Foods to eat or avoid when pregnant, accessed 8/11/22, https://www.foodauthority.nsw.gov.au/consumer/life-events-and-food/pregnancy/foods-to-eat-or-avoid-when-pregnant
Department of Agriculture, Fisheries and Forestry. Biosecurity and trade, Sesame seeds and sesame seed products 2022, https://www.agriculture.gov.au/biosecurity-trade/import/goods/food/type/sesame-seeds (accessed 22/11/22)
Podolak, R., Enache, H., Stone, W., Black, D.G., Elliot, P., 2010. Sources and risk factors for contamination, survival, persistence, and heat resistance of Salmonella in low moisture foods. Journal of Food Protection 73, 1919–1936.
Food Standards Australia New Zealand, Imported food risk statement, Sesame seeds and sesame seed products and Salmonella spp., 2016
Centers for Disease Control and Prevention, Reports of Selected Salmonella Outbreak Investigations, 2022, https://www.cdc.gov/salmonella/outbreaks.html (accessed 22/11/22)
Bell R, Draper A, Fearnley E, Franklin N, Glasgow K, Gregory J, Harlock M, Hope K, Kane S, Miller M, Pingault N, Sloan-Gardner T, Stafford R, Ward K, Wright R; OzFoodNet Working Group. Monitoring the incidence and causes of disease potentially transmitted by food in Australia: Annual report of the OzFoodNet network, 2016. Commun Dis Intell (2018). 2021 Sep 30;45. doi: 10.33321/cdi.2021.45.52. PMID: 34587876.
Food Standards Australia New Zealand, Food Incidents, 2021, accessed 8/11/22, https://www.foodstandards.gov.au/industry/FoodIncidents/Pages/default.aspx
Food Standards Australia New Zealand, Food Recalls, 2021, accessed 8/11/22, https://www.foodstandards.gov.au/industry/foodrecalls/recalls/Pages/default.aspx
Torlak E, Sert D, Serin P. Fate of Salmonella during sesame seeds roasting and storage of tahini. Int J Food Microbiol. 2013 May 15;163(2-3):214-7. doi: 10.1016/j.ijfoodmicro.2013.03.010. Epub 2013 Mar 21. PMID: 23562834.
Brockmann, S.O., Piechotowski, I., Kimmig, P., 2004. Salmonella in sesame seed products. Journal of Food Protection 67, 178–180.
KB Pezdirc, AJ Hure, ML Blumfield & CE Collins, 'Listeria monocytogenes and diet during pregnancy; balancing nutrient intake adequacy v. adverse pregnancy outcomes', Public health nutrition, 2012, 15(12):2202–2209, doi:10.1017/S1368980012000717.
