Hotdogs are also called frankfurters, franks, wieners, tube steaks, or sausages. They are among the most popular foods in America. However, being a ready-to-eat meat product, pregnant women are cautioned against eating them.
Uncooked hot dogs are unsafe for pregnant women to eat because of the risk of Listeria. But hot dogs can be safely eaten during pregnancy as long as they are reheated to an internal temperature of 165 degrees Fahrenheit or until steaming hot. Still, hot dogs should be consumed sparingly as they contain high concentrations of sodium and saturated fat.Jesmarie Macapagal, RN, MD, DPPS
What are Hot Dogs?
Hot dogs are ready-to-eat (RTE) meat products that are usually made with meat trimmings, from the same type of meat that makes ground meat, steaks and roasts. According to the Food and Agriculture Organization of the United Nations (FAO), “the raw meat materials used for precooked-cooked products are lower-grade muscle trimmings, fatty tissues, head meat, animal feet, animal skin, blood, liver and other edible slaughter by-products.”
The trimmings are ground up very finely to achieve a homogenous texture. Salt and water are then added to the meat. The resulting mixture is added with preservatives, artificial coloring, and sodium nitrate, which give the hot dog its distinct color and flavor. Each hot dog company will have its own specific recipe to make their hot dog taste unique.
At present, many hot dogs are made of only one type of meat, either beef, pork, chicken or turkey. There are vegetarian hot dogs, too, that do not contain any meat. Most hot dogs, however, are made from specific recipes containing a mixture of various ingredients. These include meat, meat fat, fillers (like flour or bread crumbs), egg whites, and spices, including salt, pepper, onion and garlic.
The hot dog mixture is then stuffed into long tubes of plastic casing by machines that twist the casing into links. These casings are often made of synthetic collagen or cellulose. Afterward, the hot dog is pre-cooked inside their casings, generally by boiling for 15 minutes. Once cooked, the hot dog mixture takes the shape of its casing, giving it a round shape.
Hot dogs with cellulose casings are run through a peeler machine that removes the artificial casings and leaves the natural casings on. Natural casings are made of animal intestine that has been thoroughly cleaned and processed.
Hot dogs are an inexpensive source of protein. They can be consumed with or without additional heating. Hot dogs can be cooked again by boiling, microwaving, steaming, frying, grilling, or roasting.
Risks of Eating Hot Dogs During Pregnancy
Listeria monocytogenes is a food borne pathogen that causes listeriosis. Listeriosis causes a spectrum of manifestations, ranging from benign febrile gastroenteritis to the more serious invasive disease, characterized by bacteremia, sepsis and meningoencephalitis (Hernandez-Milian & Payeras-Cifre, 2014). The Centers for Disease Control and Prevention (CDC) reported that for every year, 2500 illnesses and 500 deaths are being caused by L. monocytogenes (Vijayakumar & Muriana, 2017).
Listeriosis results in hospitalization rates of over 90 percent and mortalities from 20 to 30 percent in large outbreaks. Mortality is high in spite of early and appropriate antibiotic treatment (Hernandez-Milian & Payeras-Cifre, 2014).
L. monocytogenes is transmitted to humans mainly through consumption of contaminated food (Hernandez-Milian & Payeras-Cifre, 2014). High risk populations include the elderly, the immunosuppressed, pregnant women and infants (Vijayakumar & Muriana, 2017).
L. monocytogenes is ubiquitous on a lot of raw animal food products and ingredients, including meat and poultry, as well as in processing facilities. It also has the ability to form biofilms that are able to resist sanitation efforts, thereby allowing the bacterium to be a persistent contaminant (Vijayakumar & Muriana, 2017).
RTE meats have been constantly contaminated by L. monocytogenes. RTE meat products heavily rely on salt, curing agents and refrigerated storage for their safety. However, Listeria can grow in conditions with low temperatures and high salt concentrations (Vijayakumar & Muriana, 2017).
Hot dogs remain to be a high-risk RTE meat for acquiring listeriosis because of increased rates of contamination. Possible routes of pathogen entry include the processing steps of peeling and packaging. Contamination may also occur on the surface of the finished product during after-process exposure (Vijayakumar & Muriana, 2017).
In 1998, a multistate outbreak of listeriosis occurred in the United States, which caused 108 cases of illness, 14 deaths, and 4 miscarriages. The source of the outbreak identified were contaminated hot dogs manufactured at a specific food processing facility (Graves et al., 2005).
Pregnant women, in particular, have 18 times greater risk of infection with listeriosis, compared to the general population. This is due to pregnancy-related suppression of cell-mediated immunity and placental tropism of L. monocytogenes (Madjunkov et al., 2017).
Listeriosis in pregnancy encompasses maternal, fetal and neonatal disease. While maternal listeriosis usually presents as a simple febrile illness, fetal listeriosis can have serious consequences and has a high mortality rate (miscarriage or spontaneous abortion) of 25 to 35 percent. Neonatal listeriosis can present as sepsis or meningitis, also with severe sequelae and a high case fatality rate of 20 percent (Madjunkov et al., 2017).
High Sodium Content
Processed meat products are one of the major sources of sodium in the diet of most adults today. Sodium chloride (salt) is a necessary additive in the production of processed meat. Salt encompasses a lot of functions in meat products, including improved flavor, texture and shelf-life (Desmond, 2006).
Adding salt to processed meat products improves the texture and maintains a stable form of meat mixture (Choi et al., 2015). Salt also enhances the processed meats’ flavor and juiciness (Tamm et al., 2016). Moreover, salt inhibits growth of microorganisms during storage of processed meat products by regulating water activity, osmotic shock and electrolyte imbalance (Kim et al., 2021).
However, all the added salt makes hot dogs contain elevated concentrations of sodium. According to the U.S. Department of Agriculture (USDA), an unheated beef frankfurter contains a whopping amount of 872 milligrams of sodium per 100 grams. Meanwhile, a regular 1.5 oz (43 grams) beef hot dog contains 572 milligrams of sodium and 6 grams of saturated fat, which delivers already 25 and 29 percent of the recommended values for sodium and fat, respectively.
High intake of sodium is associated with elevated risk of developing chronic illnesses, including hypertension, stroke and cardiovascular disease (Choi et al., 2015). Therefore, the World Health Organization (WHO) recommends that sodium intake for adults be reduced to less than 2 grams per day, which is equivalent to only 5 grams of salt (Bhana et al., 2018).
How to Safely Consume Hot Dogs During Pregnancy
Hot dogs can be safely consumed during pregnancy when reheated to a minimum internal temperature of 165 degrees Fahrenheit (75 degrees Celsius). Another way to check is when the hot dog is steaming hot and not just warm.
Pregnant women should avoid eating the following:
- Any hot dog that is raw and straight out of the packet
- Hot dogs from street vendors or hot dog stands, where they are kept warm but not steaming hot
- Any hot dog that has been cooked, then has been left to cool down at room temperature
Pregnant women should remember to eat their hot dogs soon after cooking. Hot dogs should not be left cooling down for too long as bacteria can rapidly grow. When cooking from being frozen, make sure that the hot dog was cooked all the way through.
Hot dogs are high in fat and sodium, and may contain nitrates, hence are not exactly a nutritious choice for a pregnancy diet. Although they can be made safe from Listeria contamination through appropriate recooking, they should not be made a regular component of a pregnant woman’s diet.
Hot dogs can be enjoyed safely, albeit meagerly, during pregnancy. For professional health advice, pregnant women must seek the consult of their obstetricians or dietitians.