Pregnant Women Should Eat Fish After All, Experts Urge

The recommendations come at a time when the debate about mercury in fish and an FDA/EPA advisory have created confusion for pregnant women, causing a reduction in their fish consumption. This leads to inadequate intake of omega-3 fatty acids resulting in risks to their health and the health of their children. This inadequate intake of fish is confirmed by data from the National Health and Nutrition Examination Survey (NHANES), which shows that 90 percent of women are consuming less than the FDA-recommended amount of fish.

The Group recommended that women who want to become pregnant, are pregnant or are breastfeeding should eat a minimum of 12 ounces per week of fish like salmon, tuna, sardines and mackerel, and can do so safely. The Group found that eating fish is the optimal way to gain the benefits of long-chain omega-3 fatty acids docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). Seafood is the richest dietary source of DHA and EPA in Americans' diets. The Group also recognized that selenium, an essential mineral found in certain ocean fish, accumulates and appears to protect against the toxicity from trace amounts of mercury.

"The Group reviewed recent scientific studies and found a link between ocean fish consumption and advanced cognitive and motor skill development in children," said Group member Ashley S. Roman, MD, MPH, assistant professor of Obstetrics & Gynecology at the New York University Medical Center, who is also a mom. "Some data also shows a connection with reduced pre-term labor and post-partum depression in mothers who ate ocean fish when pregnant."

With data increasingly showing that pregnant women are eating less fish, the risks of nutritional deficiencies are growing. "Eating adequate amounts of fish during pregnancy is a nutritional and public health issue," said Judy Meehan, Executive Director of HMHB. "Patients and doctors alike must be better educated about the safety and importance of maternal food choices in optimizing pregnancy and childhood outcomes."

In order to better understand the impact of the FDA/EPA advisory on pregnant women's seafood consumption, a study by Dr. William Goodnight et. al. was conducted in 2007 at the Medical University of South Carolina (MUSC). The research found that awareness of the advisory's warning drove 56 percent of pregnant women to needlessly reduce fish consumption - to levels well below beneficial amounts - out of fear it may harm their developing baby.

On a national level, HMHB surveyed women who are pregnant for the first time about their attitudes regarding consumption of fish during pregnancy. The findings, which were similar to those of MUSC's, show that 53 percent of these women are eating less fish during pregnancy because of warnings about mercury.

"We know from our research that pregnant women are concerned about eating seafood and hope that our science-based recommendations will give women who are pregnant, nursing or planning to become pregnant, the confidence that they are doing the right thing for their health - and the health of their children - by including fish in their diets," said Dr. Roger Newman, Maternal Nutrition Group member, Professor and Vice Chairman for Academic Affairs & Women's Health Research Department of Obstetrics and Gynecology, Medical University of South Carolina.

The following general guidelines are provided by the National Healthy Mothers, Healthy Babies Coalition.

Diet during pregnancy

An optimal pregnancy diet includes a balance of healthy meals and snacks, including frequent choices from among the following:

• Lean nutrient-dense protein sources, such as fish, eggs, beef, poultry, and dried legumes paired with brown rice.
• Complex carbohydrates that are sources of Vitamin A, C and B-complex (including folic acid), such as fruit, vegetables and whole grains (cereals and breads).
• Low-fat dairy products that are sources of protein, calcium, magnesium, phosphorus, and Vitamins B-12 and D, such as milk, yogurt and cheese.
• Long-chain omega-3 essential fatty acids, such as fish.

Conversely, pregnant women should limit high glycemic foods that can cause wide fluctuations in blood sugar and insulin levels. These include white bleached flour, quick-cooking rice, oatmeal or other instant grains, and refined carbohydrates such as sugar, soda, white bread, cookies, cakes and pies.