Eating fish during pregnancy – is it safe?

I was recently reading through one of my old nutrition manuals from 10 years ago when I did my dietetic internship, and it advised women to avoid fish oil supplements and eat fish during pregnancy because supplements were too contaminated.  How nutrition recommendations change!  In 2004 the FDA recommended that pregnant women and those trying to conceive consume no more than 12oz (2 servings) of low-mercury fish per week, and those recommendations still stand.  But as far back as 2007 scientific studies were indicating that women should eat at least 12oz in order to reap the health benefits of fish!

So what’s a mother-to-be to do?  In 2008 a nice review of the scientific literature concluded with the recommendations that we eat up to 12oz of low-mercury fish, consume high-quality vegetable oils, and take omega-3 supplements.  It also gave an EPA/DHA target: “During pregnancy, the dietary goal for omega-3 fatty acids is 650 mg, of which 300 is DHA.

One decade after my internship, it appears that the debate over fish safety has gone by the wayside and we are focusing on fish oil supplements as the safer way consume DHA, EPA and other healthy fats.  Now the debate is over which form (triglyceride or ethyl ester), how much EPA and DHA, and what are the health benefits and risks of taking these supplements.  Now that supplement and pharmaceutical companies are footing the bill for research, we know much more about the healthful impact of EPA in preventing pre-eclampsia, of DHA on baby’s neurodevelopment,  and how  they reduce mothers’ risk of postpartum depression.  Just this month another study on DHA supplements claimed that taking DHA supplements during pregnancy could ward off babies’ colds!  And the research continues, not just for pregnancy but how omega 3’s help everything from cancer to heart disease to joint pain.

The DHA-EPA Omega-3 Institute has summarized the current recommendations for various life ages and stages, indicating that moms-to-be should consume at least 1.4g/day of omega 3’s and at least 300mg of that should be DHA.

In the real world, what does this look like?

1) Eat some fish!  Low-mercury, low-PCB fish that is.  I prefer baked or poached wild-caught salmon, and sardines on crackers.  Fish is also a great source of protein, and sardines are a rich source of calcium too.

2) Eat vegetable sources of omega-3’s as well:  walnuts and flaxseed are great additions to granola or waffles to start your day out right.

3) Choose grass-fed beef and organic eggs to improve your omega 3 to omega 6 ratio in these animal products.

4) Consider a supplement with DHA.  Make sure it is certified by USP or another reputable organization to be free from mercury and other contaminants.  The jury is still out on whether the triglyceride form is truly better than the ethyl ester form, but it does appear to be slightly more bioavailable according to more recent studies.

other references

 

http://www.sciencebasedhealth.com/Fish-Oil-EE-vs-TG-omega-3s-which-is-better-W119.aspx

http://www.omega-research.com/researchview.php?ID=2190&catid=28

http://water.epa.gov/scitech/swguidance/fishshellfish/outreach/advice_index.cfm

http://www.nrdc.org/health/effects/mercury/walletcard.PDF

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