Pepperoni

Safety Status: Avoid (Unless Heated)

Cold, uncooked pepperoni should be avoided during pregnancy.

As a dry, cured sausage, pepperoni is typically prepared by mixing ground meat with spices, fermenting it with lactic acid bacteria, and drying it. While this fermentation and drying process lowers the pH and moisture content to make it shelf-stable, the U.S. Department of Agriculture (USDA) and the Centers for Disease Control and Prevention (CDC) caution that it does not guarantee the destruction of stubborn foodborne pathogens.

However, pepperoni is completely safe to consume if it has been thoroughly heated or baked until steaming and bubbling hot right before consumption.

Pathogens of Concern: Toxoplasma & Listeria

Eating cold pepperoni poses two major food safety risks:

• Toxoplasmosis: Caused by the parasite Toxoplasma gondii, which can reside in the muscle tissue of pork and beef used to make pepperoni. Fermentation and drying do not reliably kill Toxoplasma tissue cysts. If contracted during pregnancy, Toxoplasmosis can cross the placenta, leading to serious fetal complications such as brain damage, hydrocephalus, and vision loss.
• Listeriosis: Listeria monocytogenes can contaminate cured meats during slicing and packaging. Listeria can survive and grow in dry, salty environments. A Listeria infection during pregnancy can lead to miscarriage, stillbirth, premature labor, or severe newborn sepsis.

Safe Reheating & Portion Guidelines

To enjoy pepperoni safely during pregnancy, apply the following safety standards:

• Bake on Pizza: The most common and safest way to eat pepperoni is baked on a pizza. Ensure the pizza is cooked at a high temperature (such as 400°F / 204°C or higher) and served hot, with the pepperoni slices curling up and sizzling.
• Heat in the Microwave: If you want to add pepperoni to a sandwich, wrap the slices in a paper towel and microwave them on high for 15 to 30 seconds until they are hot and steaming. This also helps remove excess grease and sodium.
• Limit Nitrates and Sodium: Pepperoni is cured with sodium nitrite, which can form nitrosamines. It is also extremely high in sodium and saturated fats. High sodium intake can contribute to fluid retention, swelling (edema), and gestational hypertension. Limit pepperoni to an occasional treat rather than a daily food source.
• Kitchen Hygiene: Wash hands with soap and water after handling cold pepperoni slices to prevent cross-contaminating other foods in your kitchen.