Voordelen
van vis veel groter dan nadelen door vervuiling.*
Een
uitgebreide studie in Amerika over de voor- en nadelen van vis geeft aan de
grote voordelen van de in vis aanwezige omega-3 vetzuren ruim opwegen tegen de
nadelen van de aanwezigheid van zware metalen, hoofdzakelijk kwik, in vis als
gevolg van de vervuiling van het water. Voorwaarde is dat men geen vis eet die
het zwaarst vervuild is.
Zelfs
vrouwen die in verwachting zijn kunnen gewoon deze vis eten. Het mogelijke
gevolg voor de baby kan zijn dat het IQ 0,1 punt lager is, doch de omega-3
vetzuren zijn zo belangrijk. Een verlaging van de visconsumptie met 1/6 geeft al
80% verlies aan voordelen van de omega-3 vetzuren.
Study
finds government advisories on fish consumption & mercury may do more harm
than good
A
comparison of the risks and benefits of fish consumption suggests that
government advisories warning women of childbearing age about mercury exposure
should be issued with caution. The study warns that if advisories cause fish
consumption in the general public to drop out of fear about the effects of
mercury, substantial nutritional benefits could be lost. The study will appear
as a series of five articles in the November issue of the American Journal of
Preventive Medicine.
"Fish are an excellent source of omega-3 fatty acids, which may protect
against coronary heart disease and stroke, and are thought to aid in the
neurological development of unborn babies," said Joshua Cohen, lead author
and senior research associate at the Harvard Center for Risk Analysis at HSPH.
"If that information gets lost in how the public perceives this issue, then
people may inappropriately curtail fish consumption and increase their risk for
adverse health outcomes."
Fish are a major source of mercury exposure, a neurotoxin that may cause subtle
developmental effects in utero, like the loss of a fraction of an IQ point, even
at the modest exposure levels typical of the American population. As a result,
the U.S. Food and Drug Administration (FDA) and Environmental Protection Agency
(EPA) have issued advisories warning women of childbearing age about mercury in
fish.
Because fish are also a good source of omega-3 fatty acids, the advisories have
had to walk a fine line. The most recent U.S. government advisories emphasize
that other adults need not worry about mercury in fish. They even advise women
of childbearing age to keep eating fish, although they caution that group to
keep away from some species (shark, swordfish, king mackerel, and tilefish)
likely to contain more mercury and to limit total fish intake to about two meals
a week.
The Harvard project looked at whether the benefits of lower mercury exposure to
pregnant women justified the loss of omega-3 fatty acids from decreased fish
consumption. The project also went one step further, asking what would happen if
the public did not follow the government's recommendations exactly as they were
intended. Although evidence on how people actually react to advisories is
limited, one study found that pregnant women cut their fish consumption by
one-sixth following a 2001 government advisory. Nor is it difficult to imagine
that other adults, not targeted by the advisory, cut back on fish based on
misperceptions about the risks.
In order to synthesize the available evidence, the Harvard project convened a
panel of experts, chaired by Steven Teutsch, a medical epidemiologist formerly
with the U.S. Centers for Disease Control and Prevention and now at Merck and
Company. Other panel members included David Bellinger (Harvard University),
William Connor (Oregon Health Sciences University), Penny Kris-Etherton (Pennsylvania
State University), Robert Lawrence (Johns Hopkins University), David Savitz (University
of North Carolina), and Bennett Shaywitz (Yale University). The panel identified
important health effects to consider, assessed the dose-response relationships
between fish consumption (or its constituents) and health outcomes, and
developed an overall health effects model. In addition to Joshua Cohen, Harvard
scientific staff included Colleen Bouzan and Ariane König, and principal
investigator, George Gray, executive director of the Harvard Center for Risk
Analysis.
The study found that if pregnant women were to eat the same amount of fish but
replace fish high in mercury with fish low in mercury, cognitive development
benefits, amounting to about 0.1 IQ points per newborn baby, could be achieved
with virtually no nutritional losses. However, if pregnant women were to
decrease their fish consumption by one-sixth, the loss of omega-3 fatty acids
during pregnancy would cut the nutritional benefit by 80%. If other adults were
to also decrease their fish intake by one-sixth, then risks from coronary heart
disease and stroke would increase. For example, among 65 to 74 year old men, the
annual mortality risk would increase by nearly 1 in 10,000.
The study also found that increasing fish consumption among individuals who were
not going to become pregnant would substantially decrease stroke and coronary
heart disease risks. Much of this benefit appears to be associated with getting
people to eat at least some fish (e.g., one meal a week), rather than no fish at
all.
Cohen explained that the problem with fish advisories is that we do not know
what their overall impact on the population might be. "Depending on how the
population reacts, that impact could very well be negative." Because of the
potential downside, Cohen urges the government to carefully evaluate the pros
and cons. He concluded, "Before the government issues advisories, it needs
to gather data on how people actually will react, how those changes in behavior
will influence nutrient intake and exposure to contaminants, and how those
changes in intake and exposure will translate into changes in health. In other
words, before we put an intervention into action, we need to estimate its real
world impacts - both its benefits and its countervailing risks."
The work was funded by a grant from the National Food Processors Association
Research Foundation (now the Food Products Association Research Foundation) and
the Fisheries Scholarship Fund.
The five articles and the introductory article from the American Journal of
Preventive Medicine will be available as PDFs shortly.
"A Quantitative Analysis of Fish Consumption and Stroke Risk" by
Colleen Bouzan, MS, Joshua T. Cohen, PhD, William E. Connor, MD, Penny M.
Kris-Etherton, PhD, George M. Gray, PhD, Ariane König, PhD, Robert S. Lawrence,
MD, David A. Savitz, PhD, and Steven M. Teutsch, MD
"A Quantitative Analysis of Fish Consumption and Coronary Heart Disease
Mortality" by Ariane König, PhD, Colleen Bouzan, MS, Joshua T. Cohen, PhD,
William E. Connor, MD, Penny M. Kris-Etherton, PhD, George M. Gray, PhD, Robert
S. Lawrence, MD, David A. Savitz, PhD, and Steven M. Teutsch, MD
"A Quantitative Analysis of Prenatal Methyl Mercury Exposure and Cognitive
Development" by Joshua T. Cohen, PhD, David C. Bellinger, PhD, and Bennett
A. Shaywitz, MD
"A Quantitative Analysis of Prenatal Intake of n-3 Polyunsaturated Fatty
Acids and Cognitive Development" by Joshua T. Cohen, PhD, David C.
Bellinger, PhD, William E. Connor, MD, and Bennett A. Shaywitz, MD
"A Quantitative RiskBenefit Analysis of Changes in Population Fish
Consumption" by Joshua T. Cohen, PhD, David C. Bellinger, PhD, William E.
Connor, MD, Penny M. Kris-Etherton, PhD, Robert S. Lawrence, MD, David A. Savitz,
PhD, Bennett A. Shaywitz, MD, Steven M. Teutsch, MD, and George M. Gray, PhD
Harvard School of Public Health is dedicated to advancing the public's health
through learning, discovery, and communication. More than 300 faculty members
are engaged in teaching and training the 900-plus student body in a broad
spectrum of disciplines crucial to the health and well being of individuals and
populations around the world. Programs and projects range from the molecular
biology of AIDS vaccines to the epidemiology of cancer; from risk analysis to
violence prevention; from maternal and children's health to quality of care
measurement; from health care management to international health and human
rights. For more information on the school visit: http://www.hsph.harvard.edu
Kevin C. Myron
kmyron@hsph.harvard.edu
Harvard School of Public Health (November
2005) (Opm. Voor meer informatie over
vetzuren en vis kijk hier).