Pregnant women are oftentimes given conflicting information such as, “This food is very good for you and your baby’s health, but be careful eating it.” One food at the center of such controversy is fish, replete with nutrients and benefits for the baby, but caught and sold with warning labels.
With a rising concern for the welfare of our future generation’s brain development and now obesity risks associated with an imbalanced ratio of omega-6/omega-3 fats in pregnancy, an FDA News Release dated January 18, 2017 clarifies what the U.S. Food and Drug Administration and the U.S. Environmental Protection Agency suggest for pregnant women, as well as women wishing to become pregnant and breastfeeding women, regarding fish consumption. 62 types of fish have been separated into “Best Choices”, “Good Choices” and “Fish to Avoid” categories. (The chart can be found here.)
The recommendations for pregnant women are quite specific; eat 2 to 3 servings (8 to 12 ounces) of lower-mercury fish per week. This advice is particularly strong since 50% of pregnant women were found to eat fewer than 2 ounces of fish per week. Perhaps this disinterest in eating fish is due to the conflicting message also found in the body of the news release that states, “However, all fish contain at least traces of mercury, which can be harmful to the brain and nervous system if a person is exposed to too much of it over time.”
In one observational study, researchers weighed the balance of contaminant risk and nutritional benefit from pregnant women consuming fish for child cognitive development. They found a higher fish intake (more than 2 servings/week) associated with better child cognitive test performance, but also higher mercury levels associated with poorer scores, confirming the reality of that risk/benefit ratio. Another study assessed the detriment of limiting fish consumption in pregnant women and found eating less than 340 grams of fish (approximately 3 servings) per week increased the risk of their children being born in the lowest quartile for verbal intelligence quotient (IQ).
Again, fish is really good for you and your baby, but be careful.
The good news is that 90% of the type of fish Americans eat can be found on the “Best Choices” list (some favorites include salmon, crab and cod), but is this messaging of “Best Fish Choices” working?
One study confirmed that pregnant women do, in fact, consume even less omega-3 essential fatty acids, eicosapentaenoic acid (EPA) and docohexaenoic acid (DHA), than the general population because of the concern over mercury in seafood, in spite of an increased need for omega-3 fatty acids during pregnancy.
In addition to the mercury concern, there is also a rising awareness of toxins such as organochlorine pesticides (OCPs) and polychlorinated biphenyls (PCBs) found in the muscle tissues of various fish species. A simple PubMed search pairing the words “fish” and “toxicity” yields a soaring 21,265 results.
This issue is of contamination is also addressed by the FDA:
For fish caught recreationally, consumers are urged to check for local advisories where they are fishing and gauge their fish consumption based on any local and state advisories for those waters. If no information on fishing advisories is available, eat just one fish meal a week from local waters and also, avoid other fish that week. Consumers should clean and trim the fish they catch of fat and skin, since locally-caught fish may contain contaminants besides mercury that can be reduced by proper trimming and cooking, (e.g. broiling instead of frying can reduce some contaminants by letting fat drip away from the fish).
Sufficient amounts of omega-3 fatty acids, EPA and DHA, found in fish, are critical for the healthy brain development of the fetus. Supplementation with DHA and EPA may help in supporting neurological health, and visual and motor functions, and mounting evidence indicates that DHA supplementation during pregnancy, lactation and childhood plays an important role in neurological development. Indisputably, pregnant women need omega-3s. However, many pregnant women are also afraid to eat the primary source of omega-3s – fish.
One solution to the problem would be to supplement with a high-quality fish oil. Although many fish oils on the market may not even contain fish, or the labeled omega-3 fatty acid amounts, many are purified and tested to assure the highest quality.
When choosing a fish oil, check for the following criteria:
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