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One Study Calls Fish a Lifesaver, Another Is More Cautious
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NY Times
By MARIAN BURROS
Published: October 18, 2006
WASHINGTON
A REPORT about the risks and benefits of eating seafood, released yesterday by the Harvard School of Public Health, said consumption of fish reduces the risk of coronary death by 36 percent and total mortality by 17 percent.
A similar report released simultaneously by the Institute of Medicine, part of the National Institutes of Health, was not as optimistic, concluding that there is only enough evidence to say that consumption of fish, especially fatty fish like salmon and mackerel, "may" reduce the risk of cardiovascular disease.
The Harvard study, to be published in the Journal of the American Medical Association today, said the benefits of eating fish high in omega-3's strongly outweighs risks from contaminants like PCB's and dioxin found in high concentrations in fish like farmed salmon. Calling those risks "greatly exaggerated," Dr. Darius Mozaffarian, one of the two authors, said, "Seafood is likely the single most important food one can consume for good health."
Dr. Marion Nestle, a professor of nutrition, public health and food safety at New York University, who described the "very sunny Harvard study" as "astonishing," remains unconvinced. "The report's conclusion that the risk of death can be reduced by 36 percent is just stunning," she said. "It would indeed make eating fish the single most important decision you can make for your health. But those of us who have been in nutrition for a long time have seen miracle foods come and go: vitamin E for heart disease, beta carotene to prevent cancer; now it's fish."
Dr. Jose M. Ordovas, a member of the institute's panel and a professor of nutrition at Tufts, agrees with Dr. Nestle and said the 36 percent figure "is based on circumstantial evidence that does not provide definite proof."
Dr. Mozaffarian agreed that, because the evidence is based on observational studies and clinical trial data, it is not definitive, but he added, "It's the best evidence we have." As for the study's finding that total mortality could be cut by 17 percent, he said, "While one can argue over the precise size of benefits, even if the benefit is only one-half or one-quarter as large, it still greatly outweighs the risk."
The report from the Institute of Medicine tells the government that much more research is needed. Dr. Malden C. Nesheim, chairman of the institute's committee and a provost emeritus at Cornell, said, "We are quite cautious because the studies we looked at are not controlled for all the variables, and we can't distinguish between the effects from omega-3's or replacement of other foods in the diet."
The National Oceanic & Atmospheric Administration had requested the institute's report because it said consumers were confused about how much and what kind of fish they should eat. The two studies, which conflict in important aspects, seem unlikely to provide much clarity. "The high degree of certainty in one report and the extreme caution in the other," said Rebecca Goldberg, a senior scientist with Environmental Defense, an advocacy group, "will make people more confused than ever."
To the surprise of Institute of Medicine officials, NOAA sponsored the hastily called press conference at which the Harvard report was released, even though that study conflicted with the one prepared by the institute. "We're just trying to make consumers feel good," said William T. Hogarth, assistant administrator for fisheries of the National Marine Fisheries Service, part of NOAA.
Both reports have come under criticism from environmental groups and from the Consumers Union. "In addition to being concerned about the failure of the JAMA and I.O.M. reports to address the risks of mercury in tuna," said the consumer organization, "we are also concerned that both reports dismiss concerns about PCB's in most fish."
"These reports are urging Americans to eat more seafood as if it were a crisis," Dr. Goldberg said. "According to NOAA's own statistics, per capita consumption of seafood has risen from 14.8 pounds in 2001 to 16.6 pounds in 2004."
Jane Houlihan, the research director of the Environmental Working Group, another advocacy group, said, "The Harvard study reads like an advertisement for the seafood industry."
Both studies reinforce advice from the Food and Drug Administration and the Environmental Protection Agency in 2004, to eat about six ounces of fish a week, preferably high in omega-3's, with a caveat for women of childbearing age and children under 12 not to eat swordfish, shark, tile fish or king mackerel and to limit their intake of albacore (white meat) tuna to six ounces a week to avoid mercury. For those who eat more fish, both reports advise eating a variety of species to reduce the level of contaminants.
"Once again pregnant women are being told it's O.K. to eat tuna," Ms. Houlihan said. "The reality is, 90 percent of women would exceed government's level for a safe dose of mercury if they ate six ounces of albacore tuna every week as the F.D.A., E.P.A and now I.O.M. recommend."
Dr. Nestle finds the situation so confusing "no rational person can possibly figure out how to make sense of it," she said. "Fortunately, Environmental Defense and Monterey Bay Aquarium, who specialize in both health and environmental fish issues, provide advisory cards for choosing fish, and no one can manage this without one."
Report: Benefits of Fish Outweigh Risks
By THE ASSOCIATED PRESS
Published: October 17, 2006
Filed at 8:17 p.m. ET
WASHINGTON (AP) -- The heart-healthy benefits of eating fish overshadow any risk posed by mercury or other dangerous contaminants, the Institute of Medicine reported Tuesday.
Still, consumers are perplexed and need help figuring out which fish and shellfish they should eat, according to the institute, which advises the government on health policy.
''The confusion may have scared people out of eating something that is beneficial for them and maybe for their offspring,'' said Jose Ordovas, a Tufts University researcher and member of the report committee.
''Our goal was to put both things in perspective and see where is the balance,'' Ordovas said.
Findings from the institute are in line with widely accepted government advice that eating fish and shellfish may reduce people's risk of developing heart disease, the leading cause of death in the United States.
Similar conclusions are being reported in Wednesday's Journal of the American Medical Association.
That study concluded thousands more deaths from heart disease could result annually from avoiding fish because of confusion about the risks and benefits. Heart disease is the leading cause of death for adults in the United States.
Interestingly, the institute said it's unclear how eating fish fights heart disease. It may be that beneficial omega-3 fatty acids offer some protection. Or the answer may be simpler, that people eat less saturated fat and cholesterol when they choose leaner seafood instead of fatty cuts of meat.
Americans generally eat too much saturated fat and cholesterol and too little of the good omega-3 fatty acids, the report said. And evidence shows that eating seafood rich in omega-3s can contribute to vision and cognitive development in babies and help expectant moms carry babies to term, researchers said.
The Tuna Foundation and other industry groups issued a statement saying the report tells consumers not to let fears of mercury exposure stop them from enjoying the nutritional benefits of regular fish consumption.
Critics contend the report will only worsen confusion about which people should avoid which fish.
''The study hyped up the benefits of Omega 3s, but paid mere lip service to the threat of harmful contaminants found in both wild and farmed fish,'' said Gerald Leape of the National Environmental Trust.
Environmental and consumer groups say it should have listed ''good fish'' and ''bad fish,'' which the researchers said would be too difficult.
Seafood is the main source of people's exposure to methylmercury, which is linked to learning disabilities and developmental delays in children and to heart, nervous system and kidney damage in adults.
Critics were also alarmed the report offers similar guidance for pregnant women as well as young children.
''They seem to be unaware that children are smaller than adults,'' said Jean Halloran, director of food safety at Consumers Union, which publishes Consumer Reports magazine. ''That advice, which they have featured prominently, could result in young children getting excessive doses of mercury.''
For pregnant women and children younger than 12, the report said:
--They may benefit from eating seafood, especially seafood with higher amounts of omega-3 fatty acids.
--They may eat six to 12 ounces of seafood a week, including up to six ounces of albacore tuna. For children, a reasonable intake is two 3-ounce servings ''or age-appropriate servings,'' but they can safely eat 12 ounces a week.
--They should avoid big predatory fish such as shark, swordfish, tilefish or king mackerel, which have higher mercury levels.
For healthy teenagers and adults and those at risk of heart disease, the report said eating seafood may reduce the risk of heart disease. And if people eat more than two servings of seafood a week, they should be sure to eat different kinds of seafood to reduce the risk of exposure to contaminants, the report said.
While the report does not list ''good'' or ''bad'' fish, it does describe broad categories:
--Fatty fish like salmon have the highest omega-3 levels but also have more saturated fat and cholesterol and can have higher levels of dioxin and PCBs. They tend to have less mercury.
--Shellfish and crustaceans are low in saturated fat but can have moderate amounts of cholesterol and present the greatest risk of microbial infection if eaten raw.
--In all seafood, levels of dioxin, PCBs and other contaminants do not pose health risks when eaten in government-recommended amounts.
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