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.

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    • "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). "
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    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
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    • "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). "
    • "The toxic effects of MeHg are irreversible and severe enough that the potential risk to the United States population from consuming a variety of fish should be reviewed on a continuing basis (Mahaffeya and Merglerb, 1998). At the same time, it is important to note that eating fish has many health benefits (Daviglus et al., 2002; Mozaffarian and Rimm, 2006). "
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    ABSTRACT: Exposure assessment and risk management considerations for tribal fish consumption are different than for the general U.S. population because of higher fish intake from subsistence fishing and/or from unique cultural practices. This research summarizes analyses of available data and methodologies for estimating tribal fish consumption exposures to methyl mercury (MeHg). Large MeHg fish tissue data sets from the Environmental Protections Agency's (EPA's) Office of Water, USGS's EMMMA program, and other data sources, were integrated, analyzed, and combined with fish intake (consumption) data for exposure analyses using EPA's SHEDS-Dietary model. Results were mapped with GIS tools to depict spatial distributions of the MeHg in fish tissues and fish consumption exposure patterns. Contribution analyses indicates the major sources for those exposures, such as type and length of fish, geographical distribution (water bodies), and dietary exposure patterns. Sensitivity analyses identify the key variables and exposure pathways. Our results show that MeHg exposure of tribal populations from fish are about 3 to 10 times higher than the US general population and that exposure poses potential health risks. The estimated risks would be reduced as much as 50%, especially for high percentiles, just by avoiding consumption of fish species with higher MeHg concentrations such as walleye and bowfin, even without changing total fish intake. These exposure assessment methods and tools can help inform decisions regarding meal sizes and frequency, types of fish and water bodies to avoid, and other factors to minimize exposures and potential health risks from contaminated fish on tribal lands. Published by Elsevier B.V.
    Science of The Total Environment 07/2015; 533:102-109. DOI:10.1016/j.scitotenv.2015.06.070 · 4.10 Impact Factor
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