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Fish and Fish Oil's Benefits
Far Outweigh Risks
People looking for safe, healthy eating
should focus first on fish, according to two
government-funded reviews that weighed the
pros and cons of eating the finned food.
The verdict: "Fish is likely the single
most important food to eat for health, based
on the evidence," said the co-author
of one of the studies, Dr. Dariush Mozaffarian,
an instructor in the department of epidemiology
at the Harvard School of Public Health.
That study was funded by the U.S. National
Heart, Lung, and Blood Institute, and is published
in the Oct. 18 issue of the
Journal of the American Medical Association.
Mozaffarian said that while a few species
do contain worrisome levels of mercury and
other contaminants, "when both risks
and benefits are considered for the general
population, the benefits of fish intake far
outweigh the possible risks."
The second major analysis, funded by the
Institute of Medicine (IOM), found similar
results based on a review of the literature.
The IOM panelists agreed that while certain
long-lived species may pose a mercury risk
to women and young children, fish on the whole
is good for Americans. Those results, contained
in a report titled Seafood Choices: Balancing
Benefits and Risks, were announced at
a Washington, D.C., news conference on Tuesday.
"Both studies come out with the same
conclusion -- seafood is safe and nutritious
and Americans should incorporate a variety
of seafood in their diets to reduce risk of
death from heart disease. In fact, there's
a bigger health risk associated with not eating
seafood among adults due to coronary heart
disease, the primary cause of death among
Americans," William T. Hogarth, director
of National Marine Fisheries Service, said
during the news conference.
One nutrition expert agreed with the findings,
especially when it comes to the omega-3 fatty
acids found in oily fish such as mackerel,
salmon and sardines.
"Omega-3s are, right now, the superstars
of the nutrition world," said Katherine
Tallmadge, a Washington, D.C., nutritionist
who's a spokeswoman for the American Dietetic
Association. "There's no question about
it -- this is a really critical nutrient that
we need, and hardly any Americans are getting
enough."
By now, most Americans have heard of the
health benefits of omega-3 fatty acids, which
are found in greatest abundance in oily, cold-water
fish such as herring, mackerel, sardines,
salmon and anchovies. There are two main omega-3s
-- eicosapentaenoic acid (EPA) and docosahexaenoic
acid (DHA).
Among other benefits, these compounds are
thought to aid in fetal, infant and child
neurological development and also protect
adults against cholesterol and heart disease.
But oily fish have a darker side. Industrial
toxins can make their way into the water supply
and end up in concentrated form in the flesh
of these fish. Methylmercury, especially,
has been linked to developmental problems
in newborns and heart, nervous system and
kidney damage in adults. For this reason,
the U.S. Environmental
Protection Agency and the U.S.
Food and Drug Administration have each
issued warnings about the consumption of a
few -- but certainly not all -- fish species
by women of childbearing age.
So, is regular fish consumption still good
for most people? To find out, Mozaffarian
and co-researcher Eric Rimm pored over dozens
of studies on the subject conducted up to
the spring of this year.
They found that the benefits of fish for
heart health far outweighed any risks for
the vast majority of consumers. For example,
even modest consumption of fish -- one to
two servings a week -- cut the overall death
risk by 17 percent and deaths from coronary
causes by 36 percent, especially if those
fish were of the more oily varieties.
Even 250 grams a day of omega-3 fatty acids,
considered a relatively low level, were sufficient
to start protecting the heart, the researchers
said. Ideally, this level of intake could
come from just one 6-ounce serving a week
of wild salmon or other oily fish. Alternatively,
it could come in the form of a fish-oil supplement,
the researchers said.
The IOM report agreed with those findings.
The agency said it is not yet clear whether
the cardiac benefits of fish stem from omega-3
fatty acids, or whether people are simply
"substituting the lean protein of seafood
for fatty cuts of meat" in their diet.
Caveats remain, however. The Harvard team
said that, due to high mercury content, pregnant
women or women who believe they could become
pregnant are still advised to avoid four fish
species: King mackerel (not Atlantic
mackerel); shark; swordfish; and golden bass
(also known as tilefish). The IOM said another
species, white albacore tuna, should only
be consumed in amounts under 6 ounces per
week.
Because omega-3s are so beneficial for the
developing fetus, pregnant women are strongly
encouraged to eat all other fish species,
Mozaffarian said.
In its recommendations, the IOM panel also
suggested that pregnant women and children
under 12 years of age consume up to 12 ounces
per week of all seafood species except shark,
swordfish, tilefish or king mackerel. They
especially recommended those species rich
in omega-3 fatty acids.
The IOM report did have its critics, however.
One consumer advocacy group questioned the
IOM's decision to lump small children in with
pregnant women as it drew up its recommendations.
"They seem to be unaware that children
are smaller than adults," Jean Halloran,
director of food safety at Consumers Union,
told the Associated Press. "That
advice, which they featured prominently, could
result in young children getting excessive
doses of mercury."
Mozaffarian also noted that not all fish
dishes are created equal.
"The average fried fish in the U.S.
-- a commercially prepared, fried-fish meal
-- does not have significant cardiovascular
benefit, and may even harm you," he said.
The unhealthy oils used in deep-frying appear
to cancel out any benefits from the fish,
which, in any case, are usually non-fatty
species such as cod.
Tallmadge agreed, adding that "canned
salmon is probably a nice economical choice,"
however. "It's usually [caught] wild.
The wild salmon is leaner and has proportionally
higher levels of omega-3s than farm-bred varieties,"
she said.
The American Heart
Association currently recommends that
heart patients take in 1,000 milligrams of
omega-3s daily, and healthy individuals consume
between 500 and 1,000 milligrams a day. For
comparison purposes, Tallmadge noted that
a typical 3.5 ounce serving of sardines in
sardine oil contains about 3,300 milligrams
of omega-3 fatty acids; a similar serving
of Atlantic mackerel has 2,500 milligrams;
Atlantic herring has 1,600 milligrams; Atlantic
salmon, 1,200 milligrams; brook trout, 500
milligrams; and shrimp or flounder, 300 milligrams.
And what about fish-oil supplements? According
to Tallmadge, the labeling on many popular
supplements can be misleading.
"On the front of the bottle, they'll
announce, '1,200 milligrams' of fish oil,"
she said, "but then when you read the
fine print on the back, what's important to
look for is the amount of EPA and DHA."
Often, that amounts to just 20 or so percent
of the pills' volume.
Tallmadge tells her clients to go for an
FDA-regulated, prescription omega-3 pill,
Omacor (900 milligrams per pill). Then, at
least, they know what they're paying for,
she said.