reference : Fish intake, contaminants, and human health: Evaluating the risks and the benefits

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reftype Journal Article
Abstract 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.
Author Mozaffarian, D.; Rimm, E. B.
DOI 10.1001/jama.296.15.1885
Date Oct 18
ISSN 0098-7484
Issue 15
Journal JAMA: The Journal of the American Medical Association
Keywords Animals; Carcinogens; *Diet; Fatty Acids, Omega-3; *Fishes/metabolism; *Food Contamination; Humans; Mercury Poisoning/etiology; Risk Assessment; *Seafood/adverse effects; Water Pollutants, Chemical/metabolism
Language eng
Notes 1538-3598 Mozaffarian, Dariush Rimm, Eric B K08-HL-075628/HL/NHLBI NIH HHS/United States Journal Article Research Support, N.I.H., Extramural Review United States JAMA. 2006 Oct 18;296(15):1885-99.
Pages 1885-1899
Title Fish intake, contaminants, and human health: Evaluating the risks and the benefits
Volume 296
Year 2006
Bibliographic identifiers
.reference_type 0
_record_number 18435
_uuid 020368aa-a84a-48ae-b990-69a23d136915