1	Fish: The good and the bad Leslie E. Dorworth Illinois-Indiana Sea Grant College Program Purdue University Calumet Hammond, IN
2	Fish is Good Food! Source of protein and some minerals Source of Omega-3 fatty acids
3	Fish is Good Food! Easy to prepare Economical to catch locally Culturally important to many populations
4	U.S Fish Consumption - 2004 Shrimp Canned Tuna Salmon Pollock Catfish Tilapia Crab Cod Clams Flatfish 4.2 lbs/person 3.3 2.1 1.3 1.1 0.7 0.6 0.6 0.5 0.3 16.6 (Per Capita) H.M. Johnson & Assoc., 2005
5	What’s the Concern? Fish consumption is the major pathway for exposure to mercury and PCBs in the diet DeRosa, ATSDR 1998 http://water.usgs.gov/wid/FS_216-95/FS_216-95.html
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7	Overview Healthy Fats in Fish Mercury PCBs and TEQ Fish Advisories
8	Omega-3 Fatty Acids EPA – eicosapentaenoic acid – C20:5 n-3 DHA – docosahexaenoic acid – C22:6 n-3
9	Healthy Fats in Fish DHA – important for brain/eye development NAS, 2002 An estimated 250,000 Americans die each year from sudden cardiac death AHA “consumption of long chain omega-3 fatty acids [as found in fatty fish] may reduce the risk of coronary heart disease” ISSFAL, 1994
10	Possible Mechanisms Preventing arrhythmias Decreasing platelet aggregation Decreasing plasma triglycerides Moderately decreasing blood pressure Reducing atherosclerosis Small increase in HDL cholesterol Modulating endothelial function Decreasing pro-inflammatory eicosanoids NAS, 2002
11	Dietary Recommendations National Academy of Sciences (NAS) – 2002 EPA + DHA = 0.14 g/day for nursing and or pregnant women Dietary Guidelines Advisory Committee Report – 2004 8 oz fish/week American Heart Association (AHA) 2 servings (2-3 oz per serving) of fatty fish/week EPA + DHA = 1 g/d for heart disease patients
12	What % of the recommended levels do you get if you consume 8 oz/week?
13	Mercury
14	Mercury and Omega-3 Fatty Acids
15	Mercury Toxicity in Adults Patients living in San Francisco High-end consumers of higher Hg fish Symptoms including fatigue, headache, decreased memory, decreased concentration, muscle and joint pain Symptoms gone after diet changes
16	Methylmercury Crosses placenta and into breast milk Clearance from body ~ 1 year FDA Action Level (fish tissue) = 1 ppm Canadian Limit (fish tissue) = 0.5 ppm
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18	NHANES (1999–2002) - Mercury ~6% of U.S. women have mercury levels in their blood that exceed the RfD (>5.8 µg/L) CDC, MMWR. 2004. 53(43):1018-1029
19	EPA Projection 15% (630,000 babies of the 4 million born annually) may be exposed to excessive mercury when in the womb Mahaffey, EPA 2004
20	Mercury in Fish Sandwiches Fish in sandwiches from 6 restaurant chains Dairy Queen, McDonald’s Burger King, White Castle, Long John Silver’s and Subway 5 sandwiches from 4 stores for each chain Range 5-132 ppb hg – well below FDA Action Level for Hg of 1000 ppb…can exceed EPA’s RfD by 1.4x for 2 products Low in EPA/DHA (92-620 mg/sandwich) Shim et. al., 2005
21	Mercury in Canned Fish Canned tuna (n=240), salmon (n=16), and mackerel (n=16) All samples were well below FDA Action Level for Hg of 1,000 ppb Tuna (all types) = 188 ppb; salmon = 45 ppb; mackerel = 55 ppb Chunk light tuna in water = 54 ppb but also lower in EPA/DHA Shim et. al., 2004
22	Canned Tuna and Mercury Main source of dietary mercury exposure Served in school lunch programs and provided by WIC clinics to lactating women Consumer reports recommends women who are pregnant or nursing to not consume any canned tuna
23	PCBs & TEQ
24	Polychlorinated Biphenyls (PCBs) 209 Congeners Aroclors® include ~ 60 congeners Aroclor 12 68 12 represents 12 carbons 68 represents the % chlorine
25	PCBs ~ 6 years to clear from the body Passes throough the placenta and into milk U.S. and Canadian Limit (fish tissue) = 2 ppm (expected to increase cancer risk by 1 in 100,000) Infants exposed at high levels: Have altered postnatal development, lower birth weight, smaller head circumference, poorer short-term memory Safe 1992; EPA/823-R-93, 1993
26	Total PCBs in Coho Salmon Fillets (Lake Michigan)
27	Maximum Total PCB in Sportfish Creek Chub White Sucker Rock Bass White Crappie Spotted Bass Green Sunfish Black Bullhead Channel Catfish Carp PCB (ppm) 426 355 300 235 220 110 64 41 35
28	Sources of PCB (TEQ) in U.S. Diet
29	Fish Advisories
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31	FDA & EPA Advisory for Women of Childbearing Age and Children
32	Advice For Women Who Are Pregnant, Or Who Might Become Pregnant, and Nursing Mothers About Avoiding Harm To Your Baby Or Young Child From Mercury In Fish Do not eat Shark, Swordfish, King Mackerel, Tilefish Eat up to 12 oz. (2 average meals) of a variety of fish and shellfish that are lower in mercury. For recreationally-caught fish…check local advisories. Eat up to 6 oz. of Albacore/white tuna per week, and on other fish in the same week FDA/EPA 2004
33	Choose Fish Low in Mercury www.americanheart.org
34	For Advisory Information Current state and local advisories available at: http://fn.cfs.purdue.edu/fish4health/ http://www.idph.state.il.us/public/press06/2.2.06fishadv.htm
35	Other Educational Materials Sensitive populations: http://fn.cfs.purdue.edu/anglingindiana/FishAdvisory%2006.PDF (English) http://fn.cfs.purdue.edu/anglingindiana/FishAdvisory%2006%20Span.PDF (Spanish) http://fn.cfs.purdue.edu/anglingindiana/FishAdvisory%20Kosher%2006.PDF (Kosher)
36	Ways To Educate Others Local stakeholder involvement Translation of health education materials Signage Mass media Outreach at fairs and festivals One-on-one counseling Small grants for community programs FSNEP Fish Connection Collaboration with WIC
37	I would like to thank Dr. Charles Santerre of Purdue University for providing the bulk of the slides for this presentation.
38	Questions?