New advice on fish for pregnant women: Eat more of the good stuff

On June 10, the U.S. Food and Drug Administration (FDA) and the U.S. Environmental Protection Agency (EPA) together issued a draft of updated advice on fish consumption for women of childbearing age, pregnant or nursing women, and young children. What’s new in this update: recommendations for minimum as well as maximum intake. Eat more fish is the new advice, as long as it’s of the safe variety.

The most recent joint recommendations on this topic were issued in 2004. In them, the guidance from the FDA and the EPA focused on maximum amounts of fish that were safe to consume, but did not provide advice on a minimum amount.

“For years many women have limited or avoided eating fish during pregnancy or feeding fish to their young children,” said Stephen Ostroff, MD, the FDA’s acting chief scientist, in a June 10 press release. “But emerging science now tells us that limiting or avoiding fish during pregnancy and early childhood can mean missing out on important nutrients that can have a positive impact on growth and development as well as on general health.”

The updated advice recommends that pregnant women eat at least 8 oz and up to 12 oz (2-3 servings) per week of a variety of fish that are lower in mercury to support fetal growth and development. The advice also cautions pregnant or breastfeeding women to avoid four types of fish that are associated with high mercury levels: tilefish from the Gulf of Mexico; shark; swordfish; and king mackerel. In addition, the draft updated advice recommends limiting consumption of white (albacore) tuna to 6 oz a week.

NEXT: DR. LOCKWOOD COMMENTS >>

Contemporary OB/GYN Editor-in-Chief Charles J. Lockwood, MD, MHCM, welcomes the updated advice. “There is a growing appreciation of the benefits of fish consumption by pregnant women,” he said. (See Dr. Lockwood’s editorial on this from December 2007.) “However, the maternal health and fetal development benefits of fish oils and protein must be balanced with the risk of in utero mercury exposure.

“To strike such a balance, the FDA wishes to transition from warning pregnant women to limit consumption to 8-12 oz of seafood per week to encouraging consumption of up to 8-12 oz of seafood per week. The admonition against consuming fish with the highest mercury concentrations continues. I strongly endorse this approach.”

Choices lower in mercury, says the FDA, include some of the most commonly eaten fish, such as shrimp, pollock, salmon, canned light tuna, tilapia, catfish and cod.

Before issuing final advice, the agencies will consider public comments, seek the advice of the FDA’s Risk Communication Advisory Committee, and conduct a series of focus groups.

The American College of Obstetricians and Gynecologists (ACOG), which supported previous FDA and EPA recommendations on fish consumption, is reviewing the proposed update.

In a June 10 press release responding to the draft advice, ACOG encouraged women to follow the updated FDA recommendations. 

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