Abstract
In 2001 the U.S. Food and Drug Administration (FDA) issued precautionary advice to pregnant women to limit fish consumption over concern that the methylmercury content might harm their children's neurodevelopment. This concern was based largely on results from an epidemiological study of mothers primarily exposed to methylmercury from consuming pilot whale. Subsequently, FDA and the World Health Organization/Food and Agriculture Organization (WHO/FAO) undertook independent assessments of fish consumption that considered net effects from both fish nutrients, primarily omega-3 fatty acids, as beneficial and methylmercury as harmful. Both assessments estimated that when mothers regularly consume fish during pregnancy, their children are likely to have improved neurodevelopment compared to children of non-fish eaters despite their exposure to methylmercury. These estimated improvements included gains of two to over five full scale IQ points from levels of maternal consumption that are achievable in most of the world. Consistent with those estimates, human research on fish consumption and child neurodevelopment from more than 200,000 mother-child pairs now collectively reports 51 beneficial associations with neurodevelopmental outcomes and three adverse associations, the latter with no discernable pattern. These associations include full scale IQ gains similar to, or somewhat higher than, those estimated by FDA and FAO/WHO. Also consistent with the FDA and FAO/WHO estimates, research has reported beneficial associations with fish consumption when pregnant women are exposed to methylmercury from fish in excess of the U.S. Environmental Protection Agency's (EPA) Reference Dose (RfD). Our analysis evaluates how the net effects approach as utilized by FDA and FAO/WHO provides a holistic explanation for these results with implications for public health policy. This concordance of net effects modeling and empirical scientific evidence supports a clarification of current public health recommendations to focus on greater fish consumption by pregnant women for their children's neurodevelopment.
| Original language | English |
|---|---|
| Pages (from-to) | 195-205 |
| Number of pages | 11 |
| Journal | Neurotoxicology |
| Volume | 99 |
| Early online date | 20 Oct 2023 |
| DOIs | |
| Publication status | Published (in print/issue) - 3 Nov 2023 |
Bibliographical note
Funding Information:We express our deep appreciation to the following individuals who reviewed the manuscript during development and offered suggestions and encouragement: Jean Golding, Emeritus Professor of Paediatric and Perinatal Epidemiology, Center for Academic Child Health, Bristol Medical School, University of Bristol, U.K. and Founder of the Avon Longitudinal Study of Parents and Children; Susan E. Carlson, A.J. Rice Professor of Nutrition and University Distinguished Professor, Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, MO, USA; Sonja L. Connor, Research Associate Professor, Endocrinology, Diabetes and Clinical Nutrition, Oregon Health Science University, Portland OR, USA; William S. Harris, Professor, Department of Internal Medicine, University of South Dakota, SD, USA; Penny M. Kris-Etherton, Even Pugh University Professor of Nutritional Sciences, Distinguished Professor of Nutrition, Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA; Michael Landa, retired former Director, Center for Food Safety and Applied Nutrition, U.S. Food and Drug Administration. Author Caroline M. Taylor acknowledges that she was supported by a Medical Research Council (MRC) Career Development Award (grant number MR/T010010/1 ) and author Edwin van Wijngaarden is funded by NIH grant R24 ES029466 . Authors Philip Spiller, P. Michael Bolger, Clark Carrington, and Kara M. Morgan acknowledge that they were involved in the development of the FDA assessment of net effects. Additionally J.J. Strain chaired the Expert Consultation that developed the FAO/WHO risk and benefit assessment and P. Michael Bolger and Clark Carrington participated in that assessment.
Funding Information:
We express our deep appreciation to the following individuals who reviewed the manuscript during development and offered suggestions and encouragement: Jean Golding, Emeritus Professor of Paediatric and Perinatal Epidemiology, Center for Academic Child Health, Bristol Medical School, University of Bristol, U.K. and Founder of the Avon Longitudinal Study of Parents and Children; Susan E. Carlson, A.J. Rice Professor of Nutrition and University Distinguished Professor, Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, MO, USA; Sonja L. Connor, Research Associate Professor, Endocrinology, Diabetes and Clinical Nutrition, Oregon Health Science University, Portland OR, USA; William S. Harris, Professor, Department of Internal Medicine, University of South Dakota, SD, USA; Penny M. Kris-Etherton, Even Pugh University Professor of Nutritional Sciences, Distinguished Professor of Nutrition, Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA; Michael Landa, retired former Director, Center for Food Safety and Applied Nutrition, U.S. Food and Drug Administration. Author Caroline M. Taylor acknowledges that she was supported by a Medical Research Council (MRC) Career Development Award (grant number MR/T010010/1) and author Edwin van Wijngaarden is funded by NIH grant R24 ES029466. Authors Philip Spiller, P. Michael Bolger, Clark Carrington, and Kara M. Morgan acknowledge that they were involved in the development of the FDA assessment of net effects. Additionally J.J. Strain chaired the Expert Consultation that developed the FAO/WHO risk and benefit assessment and P. Michael Bolger and Clark Carrington participated in that assessment.
Publisher Copyright:
© 2023 Elsevier B.V.
Keywords
- Fish
- Methylmercury
- Net effects
- Neurodevelopment
- Omega-3
- Pregnancy
