Coalition's Fish Consumption Recommendations For Pregnant Women Not Endorsed By Some Members

Main Category: Pregnancy / Obstetrics
Also Included In: Nutrition / Diet
Article Date: 12 Oct 2007 - 1:00 PDT

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Some members of the National Healthy Mothers, Healthy Babies Coalition have declined to endorse recommendations released last week by the coalition that pregnant and breast-feeding women should consume at least 12 ounces of fish and seafood per week for optimal brain development of fetuses, infants and young children, USA Today reports. Research for the recommendations was conducted by the coalition's Maternal Nutrition Group and funded in part with a $60,000 grant from the National Fisheries Institute, a fishing industry trade association, according to USA Today (Weise, USA Today, 10/11).

The coalition is a not-for-profit group with nearly 150 members, including the American Academy of Pediatrics, March of Dimes, CDC and the National Institute of Child Health and Human Development. The coalition's guidelines conflict with current FDA and Environmental Protection Agency guidelines. FDA and EPA in 2005 issued separate warnings that advise young children, pregnant women, nursing women and women of childbearing age to avoid consuming swordfish, king mackerel, shark and tilefish because of high mercury levels. The warnings also recommended that those groups consume no more than 12 ounces of fish weekly and eat no more than six ounces of canned albacore tuna weekly.

The federal guidelines were prompted by some studies that showed that high levels of mercury -- which accumulates in the environment, as well as in the flesh of fish and the bodies of those who eat fish -- contribute to birth defects and other health problems. Several studies also demonstrated a subtle loss of mental acuity in the offspring of women who consumed fish during pregnancy. Fish and seafood are the major dietary sources of omega-3 fatty acids, which are important nutrients for the brain and nervous system in developing fetuses, infants and young children.

Coalition Guidelines
The Healthy Mothers guidelines recommended eating 12 ounces or more of fish and seafood weekly to ensure healthy brain development. The guidelines recommended eating ocean fish, such as salmon, tuna and sardines, which are highest in omega-3s. Fish is high in the mineral selenium, and the panel of experts that created the guidelines said "there is a growing body of evidence that selenium in ocean fish may also counteract the potential negative influence of mercury exposure." The new guidelines also recommended higher fish and seafood consumption to protect women's health (Kaiser Daily Women's Health Policy Report, 10/4).

Dissenting Members, Reaction
According to USA Today, the disagreement over the recommendations surrounds the coalition's "silence" on consumption of "high-mercury" swordfish, shark, king mackerel and tilefish. Such fish can develop high levels of mercury because they generally have long life spans and are top-of-the-food-chain predators, USA Today reports. Ashley Roman -- an assistant professor of obstetrics at New York University's School of Medicine who helped draft the recommendations -- recently called mercury concerns "overblown."

The March of Dimes on Tuesday in a statement said, "We continue to recommend that pregnant and nursing women eat no more than a maximum each week of 12 ounces of fish that are low in mercury." NICHD, CDC and the Health Resources and Services Administration issued a statement saying they did not assist in drafting the recommendations and learned about them only after they were released. The American College of Obstetricians and Gynecologists, one of the coalition's founding members, also said it agrees with FDA's guidelines. A disclaimer on the coalition's Web site says that any recommendation or position statement supported by its board "in no way implies that it has been endorsed by [it's] member organizations" (USA Today, 10/11).

NPR's "All Things Considered" recently reported on concerns from some coalition members about the recommendations. The segment includes comments from Frank Greer, chair of the AAP's Committee on Nutrition; Christina Pearson, an HHS spokesperson; Elizabeth Jordan, director of Healthy Mothers, Healthy Babies; Caroline Smith DeWaal, director of food safety for the Center for Science in the Public Interest; and Judy Meehan, executive director of Healthy Mothers, Healthy Babies (Aubrey, "All Things Considered," NPR, 10/4). Audio and a partial transcript of the segment are available online.

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.