Fish Consumption

American children eat relatively little fish and shellfish in comparison with other sources of animal protein; despite the health benefits that eating fish and shellfish may confer. At the same time, fish and shellfish may be sources of toxicants. This report serves to inform pediatricians about available research that elucidates health risks; and benefits associated with fish and shellfish consumption in childhood; as well as the sustainability of fish and shellfish harvests.

Fish and shellfish consumption should be encouraged for children; according to a technical report published online May 20 in Pediatrics. Aaron S. Bernstein, M.D., M.P.H., from Boston Children’s Hospital and Harvard Medical School; and colleagues informed pediatricians about research elucidating the health risks and benefits associated with fish and shellfish consumption among children.

Omega-3 long-chain polyunsaturated fatty acids (n-3 LCPUFAs)

The researchers note that fish and seafood have a favorable nutrient profile compared with other animal proteins and are a good source of lean protein, calcium, vitamin D, and omega-3 long-chain polyunsaturated fatty acids (n-3 LCPUFAs). Potential health benefits are associated with fish consumption, including prevention of allergic disorders.

The investigators found mixed or null results in studies that evaluated the effects of childhood fish consumption and/or n-3 LCPUFAs on the treatment of attention-deficit/hyperactivity disorder symptoms, depression symptoms, allergic disease, inflammatory bowel disease flares, cognitive development, hyperlipidemia, and prevention or treatment of hypertension.

For some diseases, fish oil supplementation may benefit children with below average levels of n3-LCPUFAs. Due to the presence of toxicants in fish, many accessible resources provide guidance on which species to limit or avoid. Certain species can be a source of methyl-mercury, which may damage the developing nervous system in utero. Fish captured in freshwater bodies may have high concentrations of pollutants. “We are encouraging pediatricians to ask families about fish and shellfish consumption,” Bernstein said in a statement. “For most types of seafood, the nutritional benefits far outweigh the risks.

Sources of low-fat protein

Fish and shellfish are, in general, good sources of low-fat protein rich in several essential vitamins and minerals as well as, in certain instances, the essential nutrients omega-3 long-chain polyunsaturated fatty acids (n-3 LCPUFAs). Some guidance is available and accessible to pediatric health care providers or families to assist them with navigating fish and shellfish choices.

But most sources focus on consumption by adults or pregnant women and do not directly address childhood consumption. This report provides an overview of the potential risks and benefits associated with childhood consumption of fish and shellfish. Whenever possible, it draws on research performed with children. However, in instances when such evidence is not available, it will examine prenatal and adult evidence.

This report also addresses the sustainability of fish and shellfish choices. Approximately 90% of fisheries worldwide are exploited at or above maximum sustainable yield. As a result, any guidance on fish consumption must consider sustainability to protect the viability of fisheries.