FDA, EPA: Pregnant women should eat more fish

The move bucks years of advice that such individuals limit how much fish they eat. | Getty

Pregnant women should take fish off the list of things to worry about eating, according to updated advice from the Food and Drug Administration and Environmental Protection Agency.

The two federal agencies are now advising women who are pregnant or may become pregnant, those breast feeding, and young children to eat way more fish than they are currently, pointing to new science that shows the developmental and brain benefits of increased fish consumption outweighs the risk of methylmercury exposure.

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The move bucks years of advice from FDA and EPA that such individuals limit how much fish they eat. The agencies for the first time are now recommending a minimum amount of seafood to consume.

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FDA analyzed seafood consumption data and found that two in 10 moms reported eating no fish in the past month. Half of respondents ate two ounces or less per week and three-fourths ate less than four ounces per week.

“These results show a large proportion of pregnant women are simply not eating enough fish,” Stephen Ostroff, the FDA’s acting chief scientist, told reporters Tuesday.

“As the science has evolved, it’s become clear there are significant benefits [of fish consumption] for the fetus and young children,” Ostroff said. “Based on the surveys that showed so few women were eating a sufficient amount to get those benefits, we thought it was very important to indicate there should be a minimum amount consumed as well.”

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The draft updated advice from FDA and EPA recommends pregnant women eat at least eight ounces and up to 12 ounces per week “of a variety of fish that are lower in mercury to support fetal growth and development.” That comes out to about two to three servings of fish per week – and in some cases six times more fish than expectant moms are currently eating.

The agencies said several of the most commonly consumed fish, including shrimp, pollock, salmon, canned light tuna, tilapia, catfish and cod, are good low-mercury choices and officials emphasized that variety is key.

Fish that are known to be higher in mercury, including tilefish from the Gulf of Mexico, shark, swordfish and mackerel, should be avoided, the agencies said. They also advised albacore tuna be limited to 6 ounces per week.

The agencies said the draft advice essentially retains the established evidence on methylmercury, while updating the new science on the developmental benefits of fish consumption for infants and young children, in particular. The advice is also in line with the fish consumption recommendations in the 2010 Dietary Guidelines.

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It also runs counter to the messages expectant moms have been hearing about fish – that it’s risky and should largely be avoided. Instead, FDA and EPA are suggesting that federal advice should promote minimum fish consumption.

“This beneficial effect is much more likely to occur than harm from methylmercury,” said Elizabeth Southerland, director of the Office of Science and Technology in EPA’s Office of Water.

The National Fisheries Institute, which has long urged the government to update its science, praised the new advice saying that it “clears the water on outdated seafood guidance for pregnant and breastfeeding women.”

Because data shows seafood consumption is low among pregnant women, NFI said in a statement that “most expectant moms should aim to quadruple the amount of fish they eat to meet the newly proposed draft recommendation.”

“FDA is working to translate years of important nutrition science into updated advice, and that’s exciting,” said Jennifer McGuire, NFI’s manager of nutrition communication. “Expectant moms and health professionals alike have been confused about seafood advice during pregnancy and FDA has begun the process of setting the record straight that fish should be a pregnancy staple.”

The Center for Science in the Public Interest and the Mercury Policy Project have petitioned and sued FDA to try to get the agency to impose mercury information labels at seafood counters and on some seafood packages, arguing that expectant moms and other consumers need them to make more informed choices.

However, when asked why the agency did not propose such labels with its announcement, FDA spokeswoman Theresa Eisenman said, “We’re not able to speak to pending litigation.”

“The focus of what’s being put out is the actual advice itself,” said Ostroff.

On the call with reporters, EPA fielded questions about why the advice doesn’t take into account other contaminants found in fish, like PCBs.

“We really find that tends to be a problem for local water bodies, not for big commercial fisheries,” Southerland said. She said EPA works closely with health departments to ensure health advisories are in place for fish from local streams, rivers and lakes.

Both FDA and EPA will be accepting comments on the draft advice, which will also be reviewed by FDA’s Risk Communication Advisory Committee.

The federal health officials said they are also considering holding public meetings on the topic.