When I was pregnant I had a ton of questions about what was safe -- and I wasn't even the most super-cautious pregnant woman I know. Lots of topics come up around here in Pregnancy, and what's safe to eat is a big one. Several moms who love it have wondered if fish is safe -- it's one of those good-for-you foods people tell you to eat when you're not pregnant, so what's the deal if you are? And what's up with the whole mercury question?
I spoke to Martica Heaner, M.A., M.Ed., exercise physiologist and nutritionist, and columnist on Health.MSN.com, about pregnant women and fish (she's also the co-author of Lean Mommy). Here's what she had to say about whether or not you should cook up some fish tonight.
So, is it OK for pregnant women to eat fish?
It depends. On the one hand, fish is a great source of protein and the "good fats" known as Omega 3 fatty acids. On the other, some fish has high levels of the mineral mercury which can be harmful to anyone in high doses, but pregnant women and their developing baby, and women who are nursing and young children are especially vulnerable.
What kinds of fish should pregnant women eat, and how often?
The US FDA (Food and Drug Administration) recommends that pregnant women average around 12 ounces of fish per week.
The American Dietetic Association in their 2008 position statement on Nutrition and Lifestyle for a Healthy Pregnancy Outcome recommends choosing fish and shellfish that are lower in mercury like shrimp, canned light tuna, salmon, pollock, and catfish. Since albacore tuna has more mercury, they recommend limiting intake to 6 ounces or less per week.
The recommendations are said to be an "average" weekly amount by the FDA. So that means that you can eat more some weeks, and less others as long as the total amount averages out.
There is no established recommendation as to the number of times per week to eat fish, but generally a serving is around 3 to 6 ounces, so that suggests eating it 2 to 4 times a week max, depending on the portion (but keep in mind that restaurant portions may be larger.)
What types of fish should pregnant women avoid?
The types of fish known to have high levels of mercury are shark, swordfish, king mackerel, and tilefish.
But it's really important to pay attention to the mercury levels in fish in your local area. Some lakes and rivers are contaminated with higher than normal levels of mercury. Often you might see signs posted in local fishing areas (like on a bulletin board at the start of a hiking trail, for example) warning not to eat fish, or to only consume it in small amounts.
Likewise, you may be able to eat more of the types of fish in your area that are low in mercury. You can check with your local health department for recommendations on the mercury levels in fish local to you.
What about sushi? Do pregnant women really have to give it up? Surely women in Japan don't, right?
First, the FDA advises that pregnant women NOT eat raw fish because of potentially harmful bacteria and parasites, although some people claim that the type of fish, whether it's frozen first, and how it's prepared, etc. can mitigate some of these risks.
As far as the mercury in sushi, it depends on the type of fish or seafood used in the sushi. Also, apparently American "sushi" is different from Japanese sushi, and what plays a big role is the status of the waters the fish come from.
One thing that emerged last year -- 25 percent of all New York City adults have high mercury levels, and nearly 50 percent of Asian New Yorkers do. Higher income white women also apparently have high levels, apparently from eating lots of sushi.
Anything else moms should keep in mind when it comes to the fish/mercury issue?
There are pro-industry groups out there trying to under-inflate the scare about mercury in fish. They cite alternative studies that may show no negative effects, or they claim that there are smear campaigns against seafood. These groups are paid to promote these alternative arguments and prevent a decline in fish sales.
Most research, as flawed or as inconclusive as it might be, is not done for pure financial gain. And clearly if the FDA has issued warnings: there is a risk, and it's better to be more conservative than less so, especially when it comes to a developing baby.
+++ What about you? What does your doctor say? And are you eating fish while pregnant?