Fish intake, contaminants, and human health: evaluating the risks and the benefits.

By D. Mozaffarian, E. Rimm. Journal of the American Medical Association (JAMA), 2006

2,076 citations recorded by the source corpus.

CONTEXT 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. EVIDENCE ACQUISITION 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. EVIDENCE SYNTHESIS 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). CONCLUSIONS 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.

Subfields: Environmental Chemistry, Health, Toxicology and Mutagenesis

View Paper: https://www.semanticscholar.org/paper/59f2d49a9e53c465d7a92b6f7d2f62687f476abd

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Citations in the corpus

National Lipid Association Recommendations for Patient-Centered Management of Dyslipidemia: Part 2. (2015, background): “Mechanisms for ASCVD benefits of long-chain omega-3 fatty acids Long-chain omega-3 fatty acids may influence ASCVD event risk through a number of mechanisms, including altering susceptibility to ventricular arrhythmia, lowering heart rate and blood pressure, and reducing platelet activation and infl”
Microplastics in fisheries and aquaculture (2017, background): “Some studies (EFSA, 2015b; Mozaffarian and Rimm, 2006) have tried to balance the positive and negative sides of consuming foods of high nutritional value which may also be a source of contaminants.”
Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity – A Comprehensive Review (2016, positive): “farmed salmon have similar or higher levels of omega-3 fatty acids(201) and likely similar net health benefits.(200)”
Alternative dietary indices both strongly predict risk of chronic disease. (2012, background): “and may lower the incidence of other CVD (43,74).”
The Ecosystem Services of Marine Aquaculture: Valuing Benefits to People and Nature (2018, background): “With high levels of omega-3s, selenium, and other essential nutrients, seafood is of particular value to human health, in some instances protecting against cardiovascular diseases and improving fetal and infant development (Mozaffarian and Rimm 2006).”
Considering Plant-Based Meat Substitutes and Cell-Based Meats: A Public Health and Food Systems Perspective (2020, result): “In contrast to the health concerns associated with red and processed meat consumption, regular consumption of seafood—particularly “oily” fish and certain mollusks rich in omega-3 fatty acids—has been associated with many health benefits, including a reduced risk of cardiovascular disease in adults ”
Exploring dietary guidelines based on ecological and nutritional values: A comparison of six dietary patterns (2014, background): “Note that a high consumption of fish (more than 5 servings) can have negative impacts on health due to contaminants such as heavy metals (Mozaffarian and Rimm, 2006) but it is safe to eat less than 50 g per day (DGAC, 2010).”