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Increasing Fish Consumption for Healthy Development
By Leesha Lentz

A Review of the FDA’s Draft Updated Advice Plus Strategies to Help Clients Boost Fish Intake

In June, the FDA and the US Environmental Protection Agency (EPA) issued a press release containing draft updated seafood recommendations for pregnant and breast-feeding women and young children. The draft recommendations state that pregnant and breast-feeding women and young children should increase their fish intake to two to three times per week. Fish consumption is important, according to the new guidelines, because it provides nutrients such as omega-3 fatty acids that are necessary for proper growth and development, especially in babies and young children.

The new recommendations follow what the FDA and EPA issued in 2004, which included the maximum amount of fish these target groups should consume. However, research has found the problem isn’t whether this population eats more than the maximum amount; it’s whether this population eats fish at all.

According to the press release: “An FDA analysis of seafood consumption data from over 1,000 pregnant women in the United States found that 21 percent of them ate no fish in the previous month, and those who ate fish ate far less than the Dietary Guidelines for Americans recommends—with 50 percent eating fewer than 2 ounces a week, and 75 percent eating fewer than 4 ounces a week.”

In light of these data, the FDA and EPA issued the updated draft advice, providing the minimum amounts of fish intake for pregnant and breast-feeding women and young children. Jennifer McGuire, MS, RD, of the National Fisheries Institute, says the FDA and EPA established the minimum amounts from a compilation of research, including the 2010 Dietary Guidelines for Americans, a 2011 Food Agriculture Organization/World Health Organization report on the risks and benefits of seafood consumption, and a 2014 peer-reviewed FDA assessment of the net effects of seafood.

Mercury Levels
The reason pregnant and breast-feeding women and young children may have limited their fish consumption over the past several years was the fear of ingesting damaging levels of mercury, which can lead to mercury poisoning. The FDA and EPA singled out four fish that pregnant women and children should avoid: tilefish from the Gulf of Mexico, shark, swordfish, and king mackerel. The organizations also cautioned against eating too much white (albacore) tuna, which has more mercury than canned light tuna, and recommended limiting consumption to 6 oz per week.

However, the four fish the FDA and EPA warned against aren’t eaten regularly in the United States, said Stephen Ostroff, MD, the FDA’s acting chief scientist, in an FDA Voice blog post. Moreover, these types of fish only represent 2% of the market share.

Most of the commonly eaten fish in the United States are lower in mercury. Shrimp, pollock, salmon, canned light tuna, tilapia, catfish, cod, flatfish, and haddock are all good options so there should be “little difficulty in selecting fish to meet the optimal weekly amount of fish consumption,” Ostroff said.

Following the Guidelines
“Seafood is now among things like folic acid and exercise, which health care professionals have a responsibility to promote among their pregnant clients,” McGuire says.

She suggests RDs offer the following tips to clients and patients to help them meet the new FDA and EPA recommendations:

• Put fish on the grocery list. “ChooseMyPlate.gov has resources including grocery lists, sample meal plans, and recipes for creating meals that include fish and seafood,” McGuire says.

• Replace conventional protein in a favorite recipe with fish instead. Burgers can be made with salmon. Tacos can be made with tilapia instead of beef or chicken, and tuna can be added into quesadillas.

• Keep a cheat sheet of seafood preparation basics in the kitchen for easy cooking.

• Eat seafood as a snack. “Try snacking on triangles of whole wheat pita and salmon, tuna, or crab salad with some of these creative and craveable mix-ins: avocados; nonfat plain yogurt; diced apples, grapes, celery, carrots, or jalapeno; Balsamic vinegar; and dried fruit such as cherries or cranberries,” McGuire says.

— Leesha Lentz is an editorial assistant for Today’s Dietitian.