From Our 2007 Archives

FDA Fish Recommendations Challenged

Group Urges More, Not Less, Consumption for Pregnant Women

By Todd Zwillich
WebMD Health News

Reviewed By Louise Chang, MD

Oct. 4, 2007 -- A coalition of nutrition experts and groups, including several federal agencies, on Thursday challenged government warnings that pregnant women limit their fish consumption because of contamination.

The group is criticizing a March 2004 advisory from the Environmental Protection Agency (EPA) and the Food and Drug Administration (FDA) urging young children and also women who are nursing, pregnant, or who could become pregnant to limit consumption of fish low in mercury to 12 ounces, or about two meals, per week.

The advisory also recommended those groups not to eat shark, swordfish, king mackerel, or tilefish because they contain high levels of methylmercury. For albacore tuna, up to 6 ounces per week is acceptable.

But experts representing the coalition Thursday recommended that women eat no less than 12 ounces of fish per week. They also recommend that 6 of those ounces can be from albacore tuna.

The group criticized the government for discounting the benefits of seafood consumption. They said while some fish is contaminated with mercury, the risk is outweighed by fish's benefits for fetal and neonatal development. But the impact of the 2004 advisory is that women are eating less fish, especially during pregnancy.

"The intent of the FDA advisory was a good intention," said Roger B. Newman, MD, director of obstetrics at the Medical University of South Carolina and spokesman for the Maternal Nutrition Group. "The unintended consequence has really been a major public health issue."

"We're concerned that there is, in a sense, an overreaction to those recommendations," said J. Thomas Brenna, PhD, a professor of human nutrition at Cornell University.

Risk and Benefits

Fish contain high levels of long-chain omega-3 fatty acids, nutrients known to be important for normal neural development in fetuses and young children.

Methylmercury can interfere with proper development of the nervous system of unborn and young children.

A statement emailed by the FDA Thursday said the agency "is carefully reviewing the scientific basis for the recommendations."

The Maternal Nutrition Group issued the recommendations along with the Healthy Mothers, Healthy Babies Coalition, an umbrella group including the March of Dimes, several drug companies, and federal agencies including a division of the CDC.

Representatives of the Maternal Nutrition Group said it received $60,000 in grants from the National Fisheries Institute, a seafood industry group, to promote the recommendations. Two experts representing them also said they had received individual honoraria by the seafood industry.

While the group recommended a minimum amount of weekly fish consumption, it urged no maximum.

Confusion for Women

Still, the challenge poses another potential source of confusion for women over the benefits and risks of eating fish, especially while pregnant.

"In a sense, what people are saying today is not all that different than what is in the [2004] advisory," says Gary Myers, MD, a professor of neurology, pediatrics, and environmental health at Rochester University and lead scientist on a major fish consumption study ongoing in the Seychelles.

While the EPA and the FDA recommended women and children eat up to 12 ounces of fish that are lower in mercury per week, Thursday's group is recommending at least 12 ounces per week.

"It just changes the emphasis around," Myers said.

English Study

Experts Thursday pointed to one large British study published in February that concluded the FDA's 12 ounces-per-week limit posed a potential net harm to women and their children.

The data were based on pregnant women's self-reported fish consumption at 32 weeks of pregnancy. The British researchers tracked the developmental progress of the children born to the women through age 8.

The study showed that children born to women who ate 12 ounces or less were at increased risk for low verbal IQ, compared with those who ate more than 12 ounces of fish a week during pregnancy.

"We clearly and unequivocally showed that using that limit, there's always a benefit to women eating more than 12 ounces of fish per week," Joseph R Hibbeln, MD, an NIH scientist and the study's lead author, tells WebMD.

Myers called the experiment "a very good study."

The FDA pointed out Thursday that its 2004 advisory identifies fish and seafood as "an important part of a healthy diet."

SOURCES: Roger B. Newman, MD, director, obstetrics, Medical University of South Carolina. Thomas Brenna, PhD, professor of human nutrition, Cornell University. Maternal Nutrition Group. What You Need to Know About Mercury in Fish and Shellfish, FDA/EPA, March, 2004. Gary Myers, MD, professor of neurology, pediatrics, and environmental health, Rochester University. Joseph R Hibbeln, MD, National Institutes of Health.

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