Can You Eat Chicken Salad While Pregnant? Is it Safe?

Salad sounds healthy, and chicken is a high-protein healthy food as well, so is chicken salad safe? Chicken salad can mean a lot of different variations and dishes. Although salads have become popular nowadays, they may not be entirely safe (Söderqvist, 2017), especially during pregnancy.

Chicken salad can be safe for pregnant women to eat, depending on the ingredients used and manner of preparation done. Prepacked raw vegetables, undercooked chicken, and salad dressings containing raw eggs or unpasteurized dairy can harbor harmful pathogens and are not safe for consumption during pregnancy. Making your own chicken salad at home can be safer, as long as fresh vegetables were thoroughly washed, chicken is cooked to a safe temperature, and salad dressings used have safe ingredients as well.

Jesmarie Macapagal, RN, MD, DPPS

In this article, we will find out what chicken salads are made of and how they are prepared. Then, we will talk about the risks associated with consumption of chicken salads. Finally, we will provide some recommendations about eating chicken salad safely during pregnancy.

What is in a Chicken Salad?

Salads contain combinations of raw leafy vegetables and tomatoes, and processed products, such as chicken, salmon, ham, pasta or couscous (Söderqvist, 2017). Chicken salad is any salad that has chicken as the main ingredient. It can be made using chicken with egg, a variety of vegetables, mayonnaise and mustard as ingredients.

Ready to eat (RTE) salads are typically prepared by an outside manufacturer, but some may also be prepared inside the store where it is sold. These are commonly packaged in plastic bowls and are readily available in chill cabinets of supermarkets, cafes and convenience stores. They can be stored for a few days before consumption and can be eaten as whole meals (Söderqvist, 2017).

Some people prefer to make their own chicken salad at home. A variety of ingredients can be used with different spices or dressings to add to its flavor.

Risks of Eating Chicken Salad While Pregnant

From 1998 to 2002, a total of more than 6 thousand outbreaks of food borne disease has been reported by the Centers for Disease Control and Prevention (CDC). Among those that have a determined etiology, bacterial pathogens caused the largest percentage (55 percent) of outbreaks. Salmonella enteritidis (S. enteritidis) accounted for the majority of the cases, while Listeria monocytogenes (L. monocytogenes) infections led to the highest number of deaths (Lynch et al., 2006).

Similarly, over two thousand food borne outbreaks were reported from 1992 to 2006. 4 percent of these outbreaks were associated with consumption of salads (Little & Gillespie, 2008).

Salad dishes generally contain raw vegetable cuts with other cooked or smoked ingredients. Their preparation involves extensive handling processes, therefore leading to higher risk of exposure to microbial contaminants (Chau et al., 2017).

Contamination of salads can happen through several ways (Söderqvist, 2017):

• Contamination of raw vegetables can occur at any step of the production chain.
• Meat ingredients like ham and chicken may be contaminated after heat treatment during dicing or slicing.
• Mixing together several ingredients can lead to cross-contamination.
• The requirement for human handling to prepare the mixed ingredients poses an additional risk of bacterial contamination.
• The high-protein ingredients, such as cooked meat, are an excellent substrate for bacterial growth.

Raw Vegetables

RTE leafy vegetables have been associated with many food borne bacteria, viruses and parasites. Most common bacterial pathogens include Salmonella, Escherichia coli (E. coli), Campylobacter, Yersinia enterocolitica and L. monocytogenes. Viruses include Norovirus and Hepatitis A. Protozoan parasites include Cryptosporidium, Giardia and Toxoplasma gondii (EFSA Panel on BIOHAZ, 2013).

Between July 2015 and January 2016, a multistate outbreak of listeriosis occurred in the United States and was associated with packaged leafy green salads (Self et al., 2019). In 2019, Sapkota et al. revealed that out of over 200 samples of raw vegetable salads served at hotels and restaurants, 35.2 percent showed the presence of Salmonella, while 13.4 percent were seen to harbor E. coli. A significant percentage of both bacteria was also detected to be multi-drug resistant.

After cutting, fresh vegetables are often packaged in deli containers or plastic wrap, then stored in retail display cabinets. Proper refrigeration temperature is not maintained, thus further increasing the risk of bacterial proliferation (Carstens et al., 2019). This is in concordance with the growth rates of L. monocytogenes being significantly higher on fresh produce stored in deli containers at 10 degrees Celsius, compared to those stored at 5 degrees Celsius (Salazar et al., 2017).

Soil, fertilizers and animal manure are all potential sources for vegetable contamination. L. monocytogenes is ubiquitous in soil and can readily contaminate produce that are grown underground or close to the ground. Farm animals, including cows, sheep, pigs and chickens, shed pathogenic E. coli and Salmonella enterica (S. enterica) in their feces, with prevalence rates as high as 70 percent in fecal samples.

Irrigation water has been proposed as the major source of pathogen contamination in leafy vegetables (Pachepsky et al., 2011). Fresh vegetables can be exposed to pathogenic bacteria through water runoff containing animal feces (Carstens et al., 2019).

Lynch et al. in 2009 noted that fresh produce can become contaminated at the processing plants, through use of unclean water for washing, chilling or as shipping ice, and at the retail stores, where cross-contamination can happen because of improper segregation of utensils used for raw and cooked ingredients, poor hygiene, or inadequate chilling.

Ravishankar et al. in 2010 showed that cross-contamination with S. enterica can occur when the same knife and cutting board used to cut raw chicken were then used for fresh lettuce without washing.

Chicken

Surveys have shown that consumption of poultry is one of the major sources of infection with Salmonella (Jeong et al., 2018). In 2012, Kim et al. gathered a total of 210 samples from 7 chicken meat brands from retail supermarkets and found a total overall Salmonella prevalence rate of 22.4 percent.

In England, Campylobacter species are the most common bacterial cause of enteritis, accounting for more than 40 thousand reported cases per year. Several studies have implicated the consumption of chicken as a significant risk factor for infection with Campylobacter (Tam et al., 2009).

Chickens are also important hosts for the transmission of Toxoplasma gondii infection to humans. They are efficient sources of infection for cats that excrete the resistant Toxoplasma oocysts. Likewise, humans become infected after consumption of undercooked infected chicken meat. The prevalence of Toxoplasma in chickens raised in backyards and in free-range organic locations were found to be up to 100 percent and 30 to 50 percent, respectively (Dubey, 2010).

Salad Dressing

Eggs are one of the most common causes of infection with Salmonella (Lynch et al., 2006). Bacteremia from Salmonella infection during pregnancy can lead to intrauterine sepsis. Therefore, pregnant women should avoid eating raw or undercooked eggs, unless they have been pasteurized (Tam et al., 2010).

Mayonnaise and Ceasar salad dressings often contain raw eggs, especially those that were homemade. Commercial products are safer to consume because they are more likely to use pasteurized eggs (Tam et al., 2010).

Recommendations for Eating Chicken Salad During Pregnancy

According to Foodsafety.gov by the U.S. Department of Health and Human Services, pregnant women should not eat prepacked chicken salad commonly found in delis, as this may contain Listeria. Also, all poultry should be thoroughly cooked before consumption.

A food thermometer should be used to ensure that the meat has reached a minimum safe internal temperature. The U.S. Department of Agriculture (USDA) recommends that all poultry, including breasts, whole bird, legs, thighs, wings and ground meat, be heated to at least 165 degrees Fahrenheit (or 74 degrees Celsius).

When making your own chicken salad at home, do not buy packaged vegetable salads. Buy fresh vegetables instead, and wash them thoroughly. If you buy raw chicken, cook it according to the required temperature, store it properly in the refrigerator, and consume within 2 to 3 days. If you choose to use RTE slices or pieces of chicken, make sure that you reheat them to a safe temperature before adding them to your salad.

Be careful with the salad dressings that you will use. Ceasar salad dressing and mayonnaise can contain raw egg or unpasteurized dairy, and should not be consumed during pregnancy. Check the label if the ingredients used are pasteurized and safe.

When eating at a hotel or restaurant, ask if their salad is prepared on-site and whether the vegetables have been cleaned thoroughly. If their vegetables are prepacked and shipped from a distribution center, the risk of Listeria would be higher and it would be safer to avoid eating them. Also request for your chicken to be reheated until steaming hot so as to be sure that there are no pathogens that can cause illness.

Final Thoughts

Chicken salad can be a safe and nutritious food option during pregnancy. Just make sure that everything you put into your salad is a safe ingredient and has been prepared or cooked properly.

Food borne illnesses can cause significant discomfort for pregnant women or lead to serious harm to an unborn baby. Prevention of these diseases is of utmost importance.

Consult with your physician to receive detailed, individualized and professional advice regarding your dietary concerns during pregnancy.