Many scientists believe women should eat fish during pregnancy

Should pregnant women eat fish?

That's a question that Lean Plate Club members often ask, that policymakers mull and scientists debate.

So when the nonprofit group National Healthy Mothers, Healthy Babies Coalition recently advised pregnant women to eat at least 12 ounces or more of fish per week, it appeared to be yet another shift in thinking. That is: Could the benefits of omega-3 fatty acids in fish outweigh the risks of methyl mercury?

The new advice was written for the coalition by a group of 14 scientists who spent five years reviewing the scientific findings about the risks and benefits of fish.

Critics said the recommendations were colored by the fact that the National Fisheries Institute paid the scientists an honorarium of as much as $1,500 each plus travel expenses to meet and to write the guidelines. Some also faulted National Healthy Mothers for seeking $60,000 from the institute to set up a Web site to inform consumers of the new advice.

The flap, however, made me wonder: What makes the debate about fish so heated? And if scientists are so at odds about eating seafood during pregnancy, what should consumers do?

To try to answer these questions, I've spent the past couple of weeks interviewing numerous experts and reading scientific papers and reports on methyl mercury, fish and pregnancy.

Much to my surprise, I found a lot of scientific reasoning that I hope will help you decide what type of seafood and how much to eat during pregnancy.

First and foremost, eat fish. Figure on two meals a week. There's wide agreement on this. The National Academy of Sciences, the American Heart Association and the 2005 U.S. Dietary Guidelines advise Americans to eat about two meals of fish per week to get a wide range of health benefits, from heart protection to weight control. That's also consistent with the guidelines from the Food and Drug Administration, the Environmental Protection Agency and, yes, the National Healthy Mothers coalition.

But what about the methyl mercury? Concerns about mercury contamination in seafood prompted the FDA and the EPA to issue consumer advisories in 2001 and again in 2004 about how much fish and what kind of fish to eat.

Breast-feeding women, those who want to become pregnant, and young children were told to eat no more than 12 ounces weekly of fish or seafood, an amount based on the risk for possible contamination with methyl mercury.

They also were told to avoid shark, swordfish, tilefish and king mackerel because of their high mercury content. And to limit albacore tuna to six ounces weekly.

Scientists and physicians are concerned that worries about methyl mercury contamination in fish have been misinterpreted by the public to mean eat less fish.

"What we don't want people to do is to stop eating fish," says Michael Bolger, a toxicologist who heads the FDA's division of risk assessment. "That is a big concern. Or that pregnant women would reduce their level of fish consumption during pregnancy. That is what we have always been concerned would happen with this advisory."

And there's evidence to suggest many benefits of eating at least 12 ounces a week of fish during pregnancy. Earlier this year, a team of British and American scientists reported in the Lancet that children of women who ate less than 12 ounces of fish during pregnancy had lower IQs and lower academic test scores at age 8, and more behavioral and social problems throughout early development, than youngsters whose mothers ate 12 or more ounces per week.

Until scientists sort out all the details, many think that the message to the public ought to be to just make sure you eat the kinds of fish lowest in methyl mercury. That means choosing salmon, sardines, tilapia, anchovies, shrimp and light tuna.

"I think so far this has been a false controversy," says Kathryn Mahaffey, senior scientist in the EPA's Office of Pesticides and Toxics. When Mahaffey's daughter was pregnant, Mahaffey said she encouraged her to eat fish that was lower in methyl mercury. "And now, I have two wonderful, healthy grandchildren."

Mahaffey notes that for vegetarians, vegans and those who don't like fish, there are fish oil dietary supplements, and foods naturally rich in omega-3s, such as flaxseed, and those fortified with it, including eggs and margarine.

Join Sally Squires online from 10 to 11 a.m. Tuesdays at www.leanplateclub.com, where you also can subscribe to the free Lean Plate Club weekly e-mail newsletter.