FDA/EPA联合呼吁妇女儿童摄入更多鱼类产品

美国食品药品管理局（FDA）和美国国家环境保护局（EPA）为促进妇女儿童健康，联合倡导孕妇、准孕妇、哺乳期妇女及幼儿摄入更多的鱼类食品，并首次设置了鱼类产品消费下限。

在6月10日公布的指南草案中，两家机构呼吁女性每周摄入2～3次各种汞含量较低的鱼类，共8～12盎司（约226.8～340.2克）；草案还列出了建议的含汞量较低的鱼类，主要包括鲑鱼、虾、狭鳕鱼、金枪鱼（罐装）、罗非鱼、鲶鱼和鳕鱼。

Lynda Banzi

虽然FDA鼓励孕妇多摄入海鱼，

但也同时提醒不要摄入方头鱼、鲨鱼、旗鱼和鲭鱼。

美国农业部建议6岁以下儿童每周摄入3～5盎司（约85～141.7克）鱼类，6～8岁则每周摄入4～6盎司（约113.4～170.1克）即可。而随着年龄的增长，儿童摄入鱼类的总量可参考成人的摄入量，另外，该机构认为，6月龄以下的婴儿不应摄入鱼类产品。

由于汞含量超标，所有机构均不建议摄入以下4种鱼类：墨西哥湾方头鱼、鲨鱼、旗鱼和鲭鱼。同时，他们还限制了白色（长鳍）金枪鱼的摄入量，成人每周不超过6盎司（约170.1克），儿童必须低于成人摄入量。

另外，各机构还建议在购买本地水域出产的鱼类时应该听从地方水域监管部门的建议，如无更多警示，则应限制本地水域的鱼类消费，孕妇每周不得超过6盎司（约170.1克），幼儿则在1～3盎司（约28.3～85克）范围内。同时，指南强调，孕妇及幼儿应避免食用生鱼片。

联合机构指出，他们颁发此指南草案是因为近期有有报道称2010年美国农业部指南“认为美国许多孕妇不建议摄入鱼类”，因此联合机构补充到，已有“长期摄入鱼类的营养价值的证据，鱼类含有优质蛋白质、多种维生素和矿物质、ω-3脂肪酸以及大多数低饱和脂肪，一些鱼类则含有维生素D。鱼类的营养价值对胎儿、母乳喂养的婴儿以及儿童的生长发育尤为重要。”

FDA对1000多名孕妇的海产品消费数据进行了分析，并指出，21%的孕妇在过去的一个月内并没有摄入鱼类，而那些未达到USDA指南建议的消费标准的孕妇中，50%每周摄入不到2盎司（约56.7克），75%每周摄入不到4盎司（约113.4克）。

该草案将取代2004年3月由FDA/EPA联合颁布的指南，先前的指南简单地建议每周摄入量达12盎司，避免摄入高汞含量的4种鱼类与此次建议一致，但并未设置消费下限。

联合机构于6月11日开始受理新指南的意见。

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By: GREGORY TWACHTMAN, Ob.Gyn. News Digital Network

The Food and Drug Administration and the Environmental Protection Agency are encouraging pregnant women, as well as women who may become pregnant or are breastfeeding, and young children to eat more fish, setting for the first time a recommended lower limit of fish consumption to promote health.

In draft guidance released June 10, the agencies are calling for women to consume 8-12 ounces of a variety of fish that are lower in mercury; that amount works out to an average of two to three servings per week. Among the types of fish highlighted that are lower in mercury are salmon, shrimp, pollock, tuna (light canned), tilapia, catfish, and cod.

The U.S. Department of Agriculture suggests an amount of 3-5 ounces per week for children under the age of 6 and 4-6 ounces per week for children aged 6-8, the agencies said in an accompanying question-and-answer set. Appropriate amounts of fish for older children would increase up to the adult recommendation. Children should not be given fish until they are at least 6 months of age.

The agencies recommend four types of fish to avoid because of mercury content: tilefish from the Gulf of Mexico, shark, swordfish, and king mackerel. They also recommend limiting white (albacore) tuna to 6 ounces per week for adults and even less for children.

In addition, the agency is advising that those eating fish caught in local waters should listen for local advisories regarding those fish and, if no advice is available, fish consumption from those sources should be limited to 6 ounces per week in pregnant women and 1-3 ounces for young children. The recommendation reiterates that pregnant women and young children should avoid eating raw fish.

The agencies noted that they are issuing this draft guidance because recent reports "show many pregnant women in the United States are not consuming fish recommended" by 2010 United States Department of Agriculture guidelines. The agencies added that there is "longstanding evidence of the nutritional value of fish in the diet. Fish contain high-quality protein, many vitamins and minerals, omega-3 fatty acid, and are mostly low in saturated fat, and some fish even contain vitamin D. The nutritional value of fish is especially important during growth and development before birth, in early infancy for breastfed infants, and in childhood."

Citing its own analysis of seafood consumption data from more than 1,000 pregnant women in the United States, the FDA noted that 21% ate no fish in the previous month and those who ate fish consumed far less than recommended in USDA guidelines, with 50% eating fewer than 2 ounces per week and 75% eating fewer than 4 ounces per week.

This draft guidance would replace similar recommendations issued by the FDA/EPA in March 2004, with a recommendation of simply up to 12 ounces of a variety of fish per week (two average meals), avoiding the same four identified types of fish because of their high mercury content. Previous guidance did not set a recommended lower limit of consumption.

The agencies will begin accepting comments on new guidance June 11.