Mozaffarian D, Rimm EB. Fish intake, contaminants, and human health: evaluating the risks and the benefits. JAMA 296, 1885-1899

Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, Mass 02115, USA.
JAMA The Journal of the American Medical Association (Impact Factor: 35.29). 11/2006; 296(15):1885-99. DOI: 10.1001/jama.296.15.1885
Source: PubMed


Fish (finfish or shellfish) may have health benefits and also contain contaminants, resulting in confusion over the role of fish consumption in a healthy diet.
We searched MEDLINE, governmental reports, and meta-analyses, supplemented by hand reviews of references and direct investigator contacts, to identify reports published through April 2006 evaluating (1) intake of fish or fish oil and cardiovascular risk, (2) effects of methylmercury and fish oil on early neurodevelopment, (3) risks of methylmercury for cardiovascular and neurologic outcomes in adults, and (4) health risks of dioxins and polychlorinated biphenyls in fish. We concentrated on studies evaluating risk in humans, focusing on evidence, when available, from randomized trials and large prospective studies. When possible, meta-analyses were performed to characterize benefits and risks most precisely.
Modest consumption of fish (eg, 1-2 servings/wk), especially species higher in the n-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), reduces risk of coronary death by 36% (95% confidence interval, 20%-50%; P<.001) and total mortality by 17% (95% confidence interval, 0%-32%; P = .046) and may favorably affect other clinical outcomes. Intake of 250 mg/d of EPA and DHA appears sufficient for primary prevention. DHA appears beneficial for, and low-level methylmercury may adversely affect, early neurodevelopment. Women of childbearing age and nursing mothers should consume 2 seafood servings/wk, limiting intake of selected species. Health effects of low-level methylmercury in adults are not clearly established; methylmercury may modestly decrease the cardiovascular benefits of fish intake. A variety of seafood should be consumed; individuals with very high consumption (> or =5 servings/wk) should limit intake of species highest in mercury levels. Levels of dioxins and polychlorinated biphenyls in fish are low, and potential carcinogenic and other effects are outweighed by potential benefits of fish intake and should have little impact on choices or consumption of seafood (women of childbearing age should consult regional advisories for locally caught freshwater fish).
For major health outcomes among adults, based on both the strength of the evidence and the potential magnitudes of effect, the benefits of fish intake exceed the potential risks. For women of childbearing age, benefits of modest fish intake, excepting a few selected species, also outweigh risks.

36 Reads
  • Source
    • "The teratogen MMHg is most dangerous to the developing fetus and continued elevated exposure to MMHg in the uterus may lead to central nervous system damage (Korbas et al., 2010). A major source of exposure to MMHg for humans is seafood which at the same time also provide important sources of energy, protein and a range of essential nutrients not easily found in other food (Kuntz, Ricco, Hill, & Anderko, 2010; Mozaffarian & Rimm, 2006). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Eight laboratories participated in an inter-laboratory method-performance (collaborative) study of a method for the determination of mono methylmercury (MMHg) in foodstuffs of marine origin by gas chromatography inductively coupled plasma isotope dilution mass spectrometry (GC–ICP-IDMS) after dissolution, derivatisation and extraction of the species. The method was tested on seven seafood products covering both a wide concentration range and variations in the MMHg concentrations as well as matrix compositions. The samples were mussel tissue, squid muscle, crab claw meat, whale meat, cod muscle, Greenland halibut muscle and dogfish liver (NRCC DOLT-4), with MMHg concentrations ranging from 0.035 to 3.58 mg/kg (as Hg) dry weight. Repeatability relative standard deviations (RSD r) for MMHg ranged from 2.1% to 8.7%. Reproducibility relative standard deviations (RSD R) ranged from 5.8% to 42%. All samples showed HorRat value below 1.0, except for the sample with the lowest MMHg content, mussel tissue, with a HorRat value of 1.6.
    Food Chemistry 03/2016; 194:424-431. DOI:10.1016/j.foodchem.2015.08.041 · 3.39 Impact Factor
  • Source
    • "The n-3 highly unsaturated fatty acids (HUFA; ≥20 carbons, ≥3 double bonds) eicosapentaenoic acid (EPA, 20:5n-3) and docosahexaenoic acid (DHA, 22:6n-3) can potentially act through molecular and physiological mechanisms to promote cardiovascular health [1] [2]. While there is no distinct Dietary Reference Intake for EPA and DHA, various groups have made intake recommendations that range from 0.25 g/d to <1 g/d EPA + DHA for healthy individuals [3] [4] [5] [6] [7] and ≥1 g/d EPA + DHA for 2° coronary heart disease prevention and triacylglycerol lowering [4]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Blood levels of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have been related to coronary heart disease risk. Understanding the response of EPA + DHA in blood to dietary intake of EPA + DHA would facilitate the use of blood measures as markers of adherence and enable the development of dietary recommendations. The objective of this study is examine the blood response to intakes of EPA + DHA ≤1 g/d with an intervention designed for dietary adherence. It was hypothesized this relationship would be linear and that intakes of EPA + DHA <1 g/d would result in blood levels below those associated with the highest level of protection for cardiovascular events. Background EPA + DHA intake of men and women (n = 20) was determined by food frequency questionnaire and adherence was monitored by weekly fingertip blood sampling for fatty acid determinations. Participants consumed nutraceuticals to achieve intakes of 0.25 g/d and 0.5 g/d EPA + DHA for successive four-week periods. A subgroup (n = 5) had intakes of 1.0 g/d EPA + DHA for an additional 4 weeks. Fatty acid composition of whole blood, erythrocytes, and plasma phospholipids were determined at each time point. Blood levels of EPA and DHA increased linearly in these pools. A comprehensive review of the literature was used to verify the blood-intake relationship. Blood levels of long chain omega-3 polyunsaturated fatty acids reached blood levels associated with the highest levels of primary cardiac arrest reduction and sudden cardiac death risk only with intakes of 1.0 g/d of EPA + DHA. The blood biomarker response to intakes of EPA + DHA ≤1 g/d is linear in a small but highly adherent study sample and this information can assist in determining adherence in clinical studies and help identify dietary intake targets from associations between blood and disease.
    Nutrition research 10/2015; DOI:10.1016/j.nutres.2015.09.016 · 2.47 Impact Factor
  • Source
    • "A study regarding to fish oil, sixty four healthy Danish infants from nine to twelve months of age received either cow's milk or infant formula alone or with fish oil. It was found that those infants supplemented with fish oil had improvement in immune function maturation with no apparent reduction in immune activation (Mozaffarian et al., 2006; Naliwaiko et al., 2004). "
Show more

Preview (2 Sources)

36 Reads
Available from