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Is carbonara OK when pregnant?

Eating a healthy, balanced diet is important for everyone, but it becomes especially critical when pregnant. Pregnancy increases nutrient needs, and eating the right foods can promote a baby’s growth and development. Many pregnant women wonder if indulging cravings for foods like carbonara is OK or if they should avoid it.

What is carbonara?

Carbonara is a classic Italian pasta dish made with eggs, cheese, bacon or pancetta, and black pepper. The ingredients are tossed together with hot pasta so that the heat cooks the raw egg into a creamy sauce. Traditional carbonara contains:

  • Spaghetti or other long pasta
  • Eggs
  • Pecorino Romano or Parmesan cheese
  • Guanciale or pancetta (cured pork cheek or belly)
  • Black pepper

The rich, indulgent flavors of carbonara make it a beloved pasta dish. However, its high fat and cholesterol content may cause some pregnant women to have concerns about eating it.

Is it safe to eat carbonara when pregnant?

For most healthy pregnant women, enjoying carbonara occasionally should be fine. Here are some things to consider about the ingredients:


Carbonara relies on raw eggs being cooked gently by the hot pasta. Consuming raw or undercooked eggs does carry a small risk of salmonella infection. However, the risk is very low, especially when Grade A/AA eggs are used. To minimize any concerns:

  • Use pasteurized eggs
  • Make sure the pasta is hot enough to fully cook the eggs
  • Don’t make carbonara with a recipe using more than 2-3 egg yolks per serving

As long as they are fully cooked, eggs are very nutritious. They provide protein, vitamin A, folate, choline, and iron.


Authentic carbonara uses hard, aged cheeses like Pecorino Romano or Parmesan. Aged cheeses are considered safe in pregnancy as they have low moisture content, which doesn’t allow listeria to grow. Listeria is a type of harmful bacteria that can cause illness.

Ricotta cheese or other soft cheeses could pose a small listeria risk. Use an aged cheese instead.


Traditionally, carbonara includes guanciale, an Italian cured pork. However, many recipes substitute bacon or pancetta. The main safety concern with cured pork products is the risk of toxoplasmosis infection.

Toxoplasmosis is caused by a parasite sometimes found in raw or undercooked meat. It’s most dangerous in early pregnancy when it can cause miscarriage or birth defects.

To enjoy carbonara safely:

  • Use cooked bacon or pancetta
  • Opt for a fully cooked ham instead of an uncooked cured pork
  • Cook the cured pork thoroughly until crispy

Some women choose to avoid cured pork altogether while pregnant. Leaving out the meat entirely or substituting cooked chicken, shrimp, or mushrooms will eliminate the toxoplasmosis concern.

Nutrition profile of carbonara

Here is the nutritional information for one serving of carbonara (based on a typical recipe):

Nutrient Amount % Daily Value
Calories 670 33%
Total Fat 36g 55%
Saturated Fat 16g 80%
Cholesterol 285mg 95%
Sodium 820mg 34%
Total Carbohydrate 55g 18%
Protein 27g 54%

As the table shows, carbonara is very high in calories, fat, saturated fat, and cholesterol compared to general nutrition recommendations. The American College of Obstetricians and Gynecologists (ACOG) provides these guidelines for pregnant women:

  • Average total calories needed per day: 2,200-2,900
  • Total fat: 25-35% of calories
  • Saturated fat: Less than 10% of calories
  • Cholesterol: 300 mg per day

One serving of carbonara provides about 1/3 of the recommended total daily calories and exceeds the recommended amounts of fat, saturated fat, and cholesterol.

The salt content is also fairly high. The ACOG recommends limiting sodium intake to 2,300 mg per day, whereas this one carbonara meal provides over a third of that amount.

However, an occasional indulgence in carbonara will not harm an otherwise healthy diet. To make the meal more balanced, enjoy a salad with it and avoid adding extra cheese or salt.

Weight gain concerns

Many women worry about gaining too much weight in pregnancy. A high calorie meal like carbonara contributes to excess weight gain if eaten frequently.

How much weight gain is considered normal in pregnancy? Recommendations vary based on pre-pregnancy body mass index (BMI):

  • Underweight: 28-40 lbs
  • Normal weight: 25-35 lbs
  • Overweight: 15-25 lbs
  • Obese: 11-20 lbs

Gaining within or just below the guidelines promotes healthy fetal growth and development. It also reduces the risk of complications like preeclampsia, gestational diabetes, and cesarean delivery.

Eating too little is not advised as it may result in a low birth weight baby. But gaining substantially above the recommendations increases risks for maternal obesity, gestational diabetes, high blood pressure, and cesarean delivery. It also predicts postpartum weight retention.

An occasional indulgent meal will not cause major weight gain issues. But frequent carb and calorie-heavy meals like carbonara can contribute to excessive gain if making up a large part of the weekly diet. Enjoying carbonara in moderation as part of an overall balanced diet based on vegetables, fruits, lean proteins, whole grains, and healthy fats can allow for the indulgence while supporting a healthy pregnancy weight gain.

Heartburn and constipation

Two common pregnancy complaints are heartburn and constipation. Carbonara’s high fat, cheese, and heavy cream content can exacerbate both issues.

Heartburn is caused by pregnancy hormones relaxing the esophageal sphincter, allowing stomach acid to reflux up. High fat meals sit in the stomach longer, increasing the chance of this reflux. Aged cheeses are also triggers for many women.

Constipation is promoted by low fiber, high fat meals. The lack of fiber in pasta, cheese, and fatty pork slows intestinal motility. Dehydration from high sodium intake compounds this effect.

If carbonara triggers uncomfortable heartburn or constipation, there are some modifications to consider:

  • Use milk instead of cream
  • Limit cheese or choose lower fat versions
  • Increase vegetables like broccoli or spinach
  • Add high fiber whole wheat pasta or side salad
  • Cook pancetta until crispy instead of leaving it fatty
  • Drink plenty of fluids to stay hydrated

Making one or two of these adjustments may help the meal digest more comfortably.

Gestational diabetes risk

Gestational diabetes is high blood sugar that develops during pregnancy. The main risk factors include obesity, advanced maternal age, family history, and a high carbohydrate diet. Consuming large, frequent portions of refined carbs can increase the risk.

Carbonara is made from refined wheat pasta and contains very little fiber or protein to help blunt the blood sugar spike. The creamy sauce also slows down gastric emptying, resulting in a sustained blood sugar rise.

For women diagnosed with gestational diabetes, carbonara would be a very poor meal choice. It would likely cause a major spike and then rapid crash in blood sugar.

However, for women not diagnosed with gestational diabetes, an occasional indulgence in carbonara is unlikely to be an issue. Eating it 1-2 times per month as part of an overall healthy diet based on whole foods poses little risk. But eating large serving sizes of carbonara multiple times per week could potentially increase gestational diabetes risk. Moderation is key.

Food safety tips

Pregnant women are at higher risk for food poisoning from bacteria like salmonella, listeria, and E. coli. These tips can help make carbonara safe to eat during pregnancy:

  • Use pasteurized eggs and cook the dish thoroughly until eggs are set.
  • Don’t use raw or undercooked meat. Cook bacon, pancetta, and ham fully.
  • Stick to aged, hard cheeses like Parmesan to avoid unpasteurized soft cheeses.
  • Wash all vegetables thoroughly before using.
  • Boil pasta thoroughly to avoid any raw flour. Undercooked pasta can harbor E. coli.
  • Don’t use cream after the expiration date.
  • Avoid cross-contamination by using separate cutting boards for meat and produce.
  • Discard any leftovers after 4 days in the refrigerator.

Being meticulous about food prep hygiene is important during pregnancy when immune defenses are weaker.

Healthier carbonara alternatives

For a more balanced, nutrient-dense take on carbonara, consider lightening it up with these healthy modifications:

  • Whole wheat or legume pasta for more fiber
  • Zucchini noodles instead of regular pasta
  • Milk or reduced fat cheese instead of heavy cream
  • Turkey bacon, sliced chicken, or crumbled sausage instead of pork
  • Lots of vegetables like peas, broccoli, or spinach
  • Olive oil or avocado instead of cheese or cream sauce

Making one or more of these substitutions can allow you to satisfy a carbonara craving in a healthier way.


An occasional indulgence in carbonara is unlikely to harm a healthy pregnancy as long as you take precautions. Use fully cooked meats, pasteurized eggs, and aged cheeses to minimize any risks. Keep portion sizes moderate, limit high fat ingredients, and round out the meal with veggies or salad. Making this luxurious pasta dish safely at home can be a nice treat during pregnancy–just don’t overdo it! Focus on an overall balanced diet with plenty of less indulgent meals based on lean proteins, whole grains, fruits, vegetables, and healthy fats. This allows room for a few special craving-satisfying meals like carbonara without excess weight gain or nutrition issues.