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Something Fishy About Mothers and Fish Story

Health editor Joe Neel sent me this note about a story the science desk has been looking into today:

When they picked up The Washington Post this morning, NPR's science editors wondered if there might be something fishy going on in a front-page story about how much fish pregnant women and new mothers should eat. As NPR reported last summer, the Institute of Medicine recommends that these women eat no more than 12 ounces of fish and seafood per week. That's because of concerns about mercury contamination of fish and the effects it can have on fetal and infant brain development.

But the Post was reporting about a new recommendation telling pregnant women and new mothers to eat at least 12 ounces a week. The advice came from a nonprofit group calling itself Healthy Mothers, Healthy Babies. It's been around since 1981, according to its Web site, and as of this morning, it listed 150 rather august members, including the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, the March of Dimes, the Centers for Disease Control and Prevention, the National Institutes of Health, some big drug companies and a few community groups, among others. So you'd tend to trust them...

But something wasn't right. We get to look at scientific studies early here, before they are released to the public — and there wasn't anything new about fish safety that we were aware of. So the editors assigned NPR's consumer health reporter Allison Aubrey to find out what was going on.

And as it would happen, as she cast about, Aubrey started netting some big ones.

At the same time, across town, a panel of doctors representing HMHB's Maternal Nutrition Group were outlining the new advice. Then, in the question-and-answer session, someone put Betty Jordan of HMHB on the grill. She asked Jordan if there was any link between the more-fish-is-good-for-you recommendations and the National Fisheries Institute, an industry-funded group. The answer from Jordan: Yes, the HMHB did take $60,000 from NFI specifically to design a "micro" Web site to promote the new guidelines and to produce other "educational" materials. On further probing, the docs said they hadn't taken any money — though a couple said they'd taken "honorariums" for coming to coalition meetings. At deadline this afternoon, the HMHB still hadn't returned NPR's phone calls seeking more information.

Meanwhile, Aubrey's calls were turning up other problems. The American Academy of Pediatrics told her that the group had no idea it was being associated with the guidelines, with which it disagrees. Strongly. Ditto the March of Dimes, CDC and at least one agency at the NIH. By 2 p.m., we noticed that the list of members on HMHB's Web site was shrinking — the pediatricians were no longer there. (We're still watching.) And the Web archiver at the Wayback Machine was reporting that past versions of the page had been blocked — so we couldn't see for sure who else might be cutting bait.

Update: While HMHB didn't return our calls in time for a story on All Things Considered, Judy Meehan of HMHB did give us a ring in time for the Central and Western feeds of the show. She clarified that the fish industry didn't pay for the new scientific research cited by the panel of doctors making the recommendations, only for their travel expenses to a Chicago meeting, where they came up with their new advice.

- Joe Neel

 

Comments (Send a comment)

Wow! Good job, Joe Neel & NPR!

Sent by MB | 11:31 PM ET | 10-04-2007

Oops, sorry, meant to add Tom Regan to earlier comment.

Sent by mb | 11:33 PM ET | 10-04-2007

I am involved in aquaculture and marine science (PhD level) and am familiar with the health issues, good and bad, of seafood consumption. As a father, I have paid great attention to this. (Guess I should have been a sea horse.) Depressing but necessary and very informative reporting.

I haven't looked beneath the oh-so-shiny surface of the following wildly upbeat and arm-flailingly enthusiastic website, but further intriguing investigations may await:
http://www.cleanfish.com/index.html

And how do company owner profits compare to producers? Should it matter? Wonder how they'd respond to an invitation to strut their stuff on live (and maybe a tiny bit but healthfully skeptical) national radio?
Perhaps the singing above is simply intoxicating marketing poetry, but the blending (outright transposition??) of objective reporting and advertising below is disturbing and not news at all:
http://www.prnewswire.com/cgi-bin/stories.pl?ACCT=109&STORY=/www/story/10-01-2007/0004673270&EDATE=

Where are we going? How do we turn back? Or turn at all? "Jane!! Stop this craxy thing!! JAAAAAAANE" - George Jetson

Preferring anonymity on record,
kevinbootes@hotmail.com

PS
http://www.cleanfish.com/product.htm
Hmm... would any of the 'artisans' find 'poverty-level' a better label? What is the actual path from market back to farm? Is it as truly impeccable as it appears? Gosh, pardon my skepticism, but is it inspired by the marketing industry? Where I shop, orange juice labeled '100 percent juice' actually contains a mixture of ingredients that a child could easily discern from orange juice. Water for instance, as the unreadably small print of the ingredients list indicates. Marketers are increasingly corrupting logic and truth for their and clients' benefit and everyone else's deception and loss. I remember a company owner going to prison many years ago for selling apple juice that was actually painted, flavored sugar water. Now these people get rich? At what point does it become more healthy to live in a different country?

Sent by anonymous (kevin bootes) | 3:35 AM ET | 10-05-2007

Great work NPR. This stuff really drives me batty.

Sent by concerned mom | 9:22 AM ET | 10-05-2007

Thank you, NPR! I thought the story was fishy as soon as I read it. I rely on diligent investigations like this to...well, to stay alive and healthy! It seems that the truth about nutrition rarely makes the headlines, and it requires constant undercover investigation and scrutiny.

I'd like to add that even the supposedly established safety advice is riddled with corruption: Tuna is not mentioned as one of the high-mercury fish to completely avoid, only to eat smaller amounts of it. The absence of tuna on the "No" list dates back to 2003, when the FDA submitted to tuna lobbyists, favoring cash over science, as revealed in The Wall Street Journal ("Fish Line
Mercury and Tuna: U.S. Advice Leaves
Lots of Questions"). That article reports on a young boy who develops a "mixed learning disability" and suffers mercury poisoning, during the time he eats a high amount of tuna. His brain damage reverses or recedes dramatically when he stops eating tuna, and his blood-mercury level drops to zero.

These days one must constantly piece together how science breaks down from lab to mainstream media.

In this case, your team makes it look like a total scam that fell apart just hours after the Post reported it. Why didn't the Post do the simple research either? Now this bogus advice is all over the Internet.

Sent by Doreen | 12:51 PM ET | 10-05-2007

I now strongly suspect that Chinese producers learned their marketing ethics from Uncle Sam's corporations.

Sent by John R. Otten | 1:26 PM ET | 10-05-2007

Any scientifically rational recommendations on the amount, species and age of fish consumed by pregnant women or children must factor in the difference in mercury levels of different species at different ages (sizes) along with the very positive benefits of the long chain omega-3 fatty acids contained in fish but not in most other lipid sources (butter, lard, and vegetable oils). The variation between species and sizes is well over a factor of ten. If you want low Hg fish, try farmed salmon from Chile or Canada. Even wild salmon is much, much lower than caned albacore. Young albacore such as fresh albacore caught on the west coast of the US is also much lower than the adult canned albacore.

That fact that the government recommendations on fish consumption don't always include the details points to the political nature of the dietary recommendations of the government agencies and NGO's.

Sent by Dallas E. Weaver, Ph.D. | 2:47 AM ET | 10-06-2007

Has there ever been a single case (even one?) of Americans being mercury-poisoned from eating fish? No? I didn't think so. Can we all just stop this craziness now? Fish is a HEALTH FOOD.

Sent by Carleton Gregoire | 10:54 AM ET | 10-06-2007

Has there ever been a single case (even one?) of Americans being mercury-poisoned from eating fish? No? I didn't think so. Can we all just stop this craziness now? Fish is a HEALTH FOOD.

Sent by (National Fisheries Institute plant) | 9:43 AM ET | 10-07-2007

Here's a real-life sample of why this duplicity is so serious: I overheard a pregnant woman celebrating that now for the rest of her pregnancy she could eat all the fish she liked.
People really do take these announcements to heart, and believe that they are unbiased medical fact.

Sent by Gloria | 10:25 AM ET | 10-07-2007

Great Job NPR. Washington Post didn't do it's homework and ought to print a retraction. This is not the first time that the National Fishing Institute and it's member The Tuna Foundation has manipulated science to suit its own ends - at the expense of the most mercury-sensitive among us, women of childbearing age and kids. It's a pattern and they have a multi-million dollar PR budget (as reported in the news).

For those of us relying on the news to accurately report science here are two things to keep in mind.

1) The agencies that deal with food safety and toxics are the FDA and EPA and they advise women of childbearing age and kids to limit fish consumption to 12 oz. per week, with no more than 6 oz of it being albacore (chunk white) tuna or tuna steaks (yes, that would include sushi). This advice has not changed and there is no "new government advice." They also say those same groups should NOT EAT swordfish, king mackerel, tilefish or shark, a.k.a. "high mercury fish." You can eat fish, and get the benefits, by avoiding high mercury fish.

2) Science does not happen overnight. These recommendations are based on assessment and considertion of hundreds of studies in mercury in fish. A "new study" is one study. It doesn't change the whole body of understanding, it mererly contributes to it. And certainly, a meeting in which scientists or doctors are paid by the industry to come and develop a new recommendation is even less convincing.

NPR, please keep up this important work.

Sent by Jackie Savitz | 1:44 PM ET | 10-07-2007

Carleton Gregoire:
Yes, there has. Please think before you post.

From the Wall Street Journal, 8/1/05

Toxic Traces: New Questions About Old Chemicals --- Fish Line -- Mercury and Tuna: U.S. Advice Leaves Lots of Questions --- Balancing Interests, Agencies Issue Guidance at Odds With EPA Risk Assessment --- A Schoolboy's Sudden Setback

The first few paragraphs:

SAN FRANCISCO -- One by one, Matthew Davis's fifth-grade teachers went around the table describing the 10-year-old boy. He wasn't focused in class and often missed assignments, they said. He labored at basic addition. He could barely write a simple sentence.

"Our jaws dropped," says his mother, Joan Elan Davis, describing a teachers' meeting she had requested in late 2003, when her son abruptly lost interest in homework. Matthew had always excelled in school. In the fourth grade, he had written and illustrated a series of stories about a superhero named Dog Man.

Ms. Davis noticed something else: Her son's fingers were starting to curl, as if he were gripping a melon. And he could no longer catch a football.

A neurologist ordered tests. They showed Matthew's blood was laced with mercury in amounts nearly double what the Environmental Protection Agency says is the safe level for exposure to the metal. Matthew had mercury poisoning, his doctors said.

The Davises had pinpointed the suspected source: tuna fish. For a year or so, starting in late 2002, Matthew had gobbled three to six ounces a day of white albacore tuna. Based on Food and Drug Administration data for canned albacore, he was consuming a daily dose of mercury at least 12 times what the EPA considered a safe level for a 60-pound child. The Davises' doctors' prescription was simple: Matthew should stop eating canned tuna.

Sent by Mark | 10:07 PM ET | 10-07-2007

"Carleton Gregoire," Zabasearch doesn't recognize your name. That is unusual. Usually any real name that has left the usual paper trail may easily be located by Zabasearch. One wonders why, it appears, you are using a pseudonym.

Sent by Laura Bien | 9:13 AM ET | 10-08-2007

The Healthy Mothers Healthy Babies organization should be utterly ashamed of itself. Even if there were 'mixed' result as to the dangers of increased levels on mercury for expectant mothers, who would not err on the side of caution. Judy Meehan, Executive Director of HMHB should be ashamed, as should any affiliated health organizations that lend credence to this Fish Industry paid for 'study.'

Sent by Brendan Gallagher | 10:04 AM ET | 10-08-2007

Yes. There have been plenty of studies of mercury in fish harming human health at high and low levels. Stop spouting nonsense and get yourself over to pubmed.com

Search "mercury, pregnancy, fish"

You'll find 202 studies. One recent one, "Maternal fish consumption, mercury levels, and risk of preterm delivery" in EHP the leading public health journal surveyed Michigan mothers and found:

"Compared with women delivering at term, women who delivered before 35 weeks' gestation were more likely to have hair mercury levels at or above the 90th percentile (> or = 0.55 microg/g), even after adjusting for maternal characteristics and fish consumption (adjusted odds ratio = 3.0; 95% confidence interval, 1.3-6.7)."

So while you might wait for "poisoning" to take action, the rest of us (including public health officials and most clinicians) see respond to these 100s of studies showing mercury toxicity in more subtle ways, and warn our friends and family members to choose low-mercury fish while pregnant and nursing.

Sent by concerned_mom | 11:14 AM ET | 10-08-2007

Thank you NPR. It's a shame that many women are following this dangerous advice without questioning the sources.

Sorry, Gregoire, fish isn't so healthy- if you're snacking on swordfish, shark, and other predators high up on the food chain, it's likely that they have significant amounts of mercury.

it's something that happens over a long period of time. it's correlative.

From Commondreams.org article:


The FDA advice is clear. Pregnant women, and women who are thinking about becoming pregnant should eat no more than 12 ounces of fish per week, no more than 6 ounces of albacore tuna, and no shark, tuna, mackerel, or swordfish at all. In stark contrast, this study actually recommends unlimited consumption of two fish on FDA's do not eat list, and still most of the media did not bother to check whether the FDA, CDC or the American Academy of Pediatrics had any concerns with the findings.

"Under these standards for reporting, cigarettes don't cause cancer," said Wiles.

Sent by fishfood | 2:21 PM ET | 10-08-2007

I hope the Fish is not from my Holy Ganges!!!. They used to swim before but now they just float! Chinese rivers are the same since the so called industrial revolution in two big old civilization. We will ahve everything cars, big bridges, TVs, roads,etc but at the cost of only two things: clean water and clean air!! What a bargain!!

anser azim, chicago

Sent by anser azim | 5:00 PM ET | 10-08-2007

As this group made clear, none of the research was funded by the National Fisheries Institute. Also, Joe Neel seems to have completely missed the important subtex of the group's message, which is that pregnant women are not eating any fish as a result of the vague nature of the original FDA recommendations. HMHB and the FDA are in agreement that 12 ounces of fish a week is acceptable. Whether or not promotional funding by the NFI compromises the validity of HMHB's message is debatable. However, what is clear is that none of the available information is rock-solid and more research is needed.

Sent by rmacbai | 10:10 AM ET | 10-09-2007

Why has neither your news story nor any of the blogs you have chosen to post mentioned the science behind the new recomendations on fish consumption during pregnancy? The study, published in the "Lancet" vol 369, issue 9561 Feb 2007 is titled "Maternal Seafood Consumptiion in Pregnancy and Neurodevelopmental outcomes in childhood: an observational study" by Joseph R Hibbelin et al. This is the largest and most carefully done study on the subject to date. It was done with funding from the National Institute of Health, It was not funded by Industry. I would hope interested persons, including NPR science reporters, would read the report themselves, But in summary it found that women who stayed within the EPA-FDA guidelines for fish consumption had an increased risk of neurological problems in their children when compared with women who exceeded the guidlines. In other words, the current guidlines are appearently harming children. The widely reported San Francisco cases fall short of science, and are better considered anecdotal. Anecdotal evidence is not unimportant, but if we are going to base our discussion on it why not discuss Japan, where women eat much more fish than Americans and have children that consistently out score Americans on tests of mental development?
If one wanted to dig further into this issue, there is some very interesting work being done on the interaction of mercury and selenium that offers a plausable explaination of the seemingly condradictory evidence .

Sent by John LaGrange | 4:09 PM ET | 10-09-2007

I have to correct Johnlagrange's promotion of the Lancet study. The Lancet study has been challenged by Alan Stern and Deborah Rice for poor mercury ascertainment. (http://www.thelancet.com/journals/lancet/article/PIIS0140673607611179/fulltext)

"In light of this inability to draw reliable inferences about the relation between methylmercury exposure and developmental outcomes, we believe that Hibbeln and colleagues' advice implying the inappropriateness of existing US FDA guidance on fish consumption is irresponsible. The responsible advice should be to eat fish, but to choose those low in mercury."

I could go on, but I imagine that most of your informed readership understands the bottomline. There are plenty of ways for pregnant and nursing mothers to get Omega-3s from low mercury fish and non-fish sources. No one should be advising we add more tuna and mackerel to our diets.

Sent by concerned_mom | 2:57 PM ET | 10-12-2007

I too would like to correct John LaGrange's advice.

Again, eat as much fish as you like, as long as it is low-Hg (& low PCB) fish, like salmon.

For examples of studies indicating Hg impairments see:
Jedrychowski
http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=17708016&ordinalpos=4&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
Stewart
http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=17185286&ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
Gao
http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=17655840&ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
Chuek
http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=17177150&ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
Xue
http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=17366817&ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

Also, there has already been lots of work done on selenium & Hg. The overwhelming scientific opinion was well put in the expert consensus of the Madison Declaration on Mercury Pollution from the 2006 Eighth International Conference on Mercury as a Global Pollutant:

"Mercury and Selenium. There is some evidence from animal studies showing that selenite protects against inorganic mercury toxicity. However, there is almost no evidence showing protection against methylmercury toxicity by organo-selenium compounds, such as selenomethione or selenocysteine, the forms of selenium commonly found in the human diet. There are no human data demonstrating a protective role for selenium against the neurotoxicity of mercury, including developmental neurotoxicity. (69% support)."

See: http://www.precaution.org/lib/madison_declaration.070315.pdf

Sent by salmon supporter | 1:06 PM ET | 10-16-2007

In response to your story (10/04), our Maternal Nutrition Group would like to restate that it is necessary to reconsider the benefits of eating recommended fish during pregnancy and while breast feeding. Coldwater, ocean seafood is a rich source of essential nutrients, such as protein, long-chain omega-3 fatty acids, minerals and micronutrients, important for developing babies and maternal health.

In June 2007, the Group met to review scientific research from peer-reviewed publications. Our review showed there are benefits from eating fish for mothers and children. Public health bodies recommend pregnant women should eat coldwater, ocean seafood. Our recommendations correct a misperception among women who are now avoiding fish during such an important time. We recommend that pregnant women consume at least 12 ounces per week of seafood like salmon, tuna, sardines and mackerel. The FDA/EPA advisory suggests up to 12 ounces per week. Plant sources of omega-3 fatty acids, such as leafy green vegetables, walnuts and flaxseed oil, are less biologically active for brain development than marine sources.

Multiple European countries have fish consumption recommendations for pregnant women consistent with those of the Maternal Nutrition Group. The UK 2004 Scientific Council on Nutrition recommended at least 2 portions of fish per week for pregnant women. Our recommendations for early life nutrition also parallel the American Heart Association, the American Cancer Society and the American Psychiatric Society recommendations for preventive health nutrition during adulthood.

Our Maternal Nutrition Group is an independent group composed of clinicians and scientists who are committed to ensuring optimal health and nutrition for mothers and babies. Many within the Group have been meeting for more than five years in a Nutritional Special Interest Group within the Society for Maternal Fetal Medicine to evaluate the benefits and risks of fish consumption during pregnancy. We are all concerned that women are avoiding fish altogether as a result of the confusion surrounding the FDA/EPA advisory, which focused heavily on seafood as a potentially toxic food source, without a full perspective on benefit. The current peer-reviewed science strongly supports the benefits of recommended seafood consumption during pregnancy, and the Maternal Nutrition Group decided to publicize our conclusions because of the necessity to clarify this important message.

To build a public consensus on the best way to communicate with pregnant and lactating women, we approached the National Fisheries Institute (NFI) to finance our one-day meeting in Chicago to review the science on fish consumption during pregnancy.

Readers, family members, policy makers and mothers should examine updated, peer-reviewed published evidence and formulate their own opinions on the importance of recommended ocean seafood as part of a balanced, varied, nutritious diet for optimizing the developmental potential for each child. We welcome ongoing discussions of differing viewpoints with the shared overall goal of improving maternal and neonatal well-being.

J. Thomas Brenna, Ph.D.
William H. Goodnight III, MD
Calvin J. Hobel, MD
Barbara Luke, ScD., MPH, RN, RD
James A. McGregor, MDCM
Roger B. Newman, MD
Patricia A. Nolan, MD, MPH
Paul L. Ogburn, Jr. MD
Ashley Roman, MD, MPH
Steven S. Witkin, Ph.D.

Sent by Ashley Roman | 9:10 PM ET | 10-18-2007

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