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Many women of childbearing age, and pregnant and nursing women in particular, do not consume enough seafood to derive optimal health benefits for themselves and their children. We sought to identify how seafood consumption advice could be designed to encourage pregnant women to eat recommended amounts of seafood. In three focus groups with pregnant or recently pregnant American women, we examined reactions to three aspects of seafood consumption advice. First, we found focus group participants preferred gain-framed statements emphasizing benefits of taking action vs. loss-framed statements emphasizing costs of failing to take action. Many participants indicated the gain-framed statements would encourage them to eat seafood and increase their consumption. Second, we compared responses to a recommendation to eat seafood and a recommendation to eat lower mercury seafood because fear of mercury is a known barrier to seafood consumption by pregnant women. We found no clear preference in our focus groups for either message, suggesting potential value of both messages in communication. Lastly, we examined preferences for systems of categorizing seafood into different consumption categories where the number of categories and the number of species listed in each category varied. We found shorter, dichotomous lists of species to eat and avoid were preferred by some participants for their clarity and ease of use. Longer, more comprehensive lists with additional species and consumption categories (e.g., eat once a week), however, were preferred by many participants because they provided more options and were more likely to be used as a reference. These findings suggest using a layered approach to communication might be helpful by providing short, dichotomous lists of best seafood to eat and seafood to be avoided followed by a link to a longer, more complete list of recommended seafood to be eaten and seafood that should be avoided., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Women of childbearing age (WCBA) are advised by state, tribal, and federal agencies to limit their consumption of certain fish, in part, because of concerns about the ingestion of methylmercury and its impact on the development of fetuses. We studied the fish-eating habits of WCBA who had a fishing license and lived near the Great Lakes, where mercury in locally-caught fish is a concern, as these women were likely at greater risk of elevated mercury exposure than the general population. We used a web-based diary method to gather fish consumption data from WCBA anglers over a 4-month period in the summer of 2014. We estimated mercury intake based on reported mercury content of species consumed, frequency of consumption, and meal portion size, and calculated percent exceeding the USEPA reference dose (RfD). Based on these calculations, we estimated that study participants (n = 1395) ingested 0.031 ± 0.002 (95% CI) ug/kg/d of methylmercury (arithmetic mean). We also found that 3.4% of study participants exceeded the RfD when we averaged estimated intake over the 4-month study period. While most (82%) of the fish meals WCBA anglers ate were purchased fish meals generally low in mercury, study participants ingested a disproportionate amount of mercury from locally-caught fish meals (18% of meals contributed 37% of mercury intake). We estimated 11% of WCBA anglers who did not follow state and federal guidelines in effect at the time of our study exceeded the mercury RfD, whereas fewer than 1% of WCBA anglers who followed the guidelines exceeded the RfD. These findings highlight the importance of encouraging WCBA to follow guidelines from agencies for locally-caught fish, in combination with guidelines for purchased fish., (Copyright © 2019 Elsevier Inc. All rights reserved.)

The U.S. Environmental Protection Agency and many state advisory programs consider urban anglers at high risk of being exposed to contaminants through fish consumption because the urban poor may be dependent on fish they catch for food and lack access to non-contaminated fishing sites. Past research has supported this characterization of urban anglers, but most studies have been site-specific and limited to subsets of urban anglers. We used a mail survey and focus groups to (a) explore how urban anglers living in the Great Lakes region of the United States differed from rural and suburban anglers and (b) characterize their fishing patterns, fish consumption, factors influencing their fish consumption, and response to fish consumption advisory messages. Although we detected some differences between licensed urban, suburban, and rural anglers, their magnitude was not striking. Lower income urban anglers tended to consume less purchased and sport-caught fish than higher income urban anglers and were not at high risk as a group. Nevertheless, focus group data suggested there may be subpopulations of urban anglers, particularly from immigrant populations, that consume higher amounts of potentially contaminated fish. Although urban anglers in general may not require a special approach for communicating fish consumption advice, subpopulations within this group may be best targeted by using community-based programs to communicate fish consumption advice., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Fish consumption advisories are issued by the federal government for women of childbearing age (WCBA). These advisories make recommendations about the amount and types of fish that should be consumed to provide the greatest health benefits to women and their children while avoiding risks from chemical contaminants. We used diary methods to study fish consumption patterns of 1395 WCBA in the Great Lakes coastal region who purchased fishing licenses, a group which has significant opportunity to eat larger quantities of fish. Very few members of this group reported exceeding the federal recommendations for total fish consumption (between 3% and 5% depending on assumptions about portion sizes), consumption of canned "white" tuna (0%), or consumption of "do not eat" species (4%). They did report eating more fish on average than recent national study estimates, but they did not report consuming as much fish as is recommended to obtain the greatest health benefits of fish consumption. Only 10-12% of study participants reported eating within the recommended range of 8-12oz. of fish per week, with 84-87% eating less than the recommended amount. Additional efforts are likely needed to encourage WCBA to eat more low-risk fish, even among this group of higher-than-average fish consumers., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Several studies show that most women do not consume enough fish during pregnancy (and afterward) to derive the maximum health benefits for themselves and their babies, according to the USDA guidelines. We engaged in a two-part study to better understand what might be done to encourage women of childbearing age to eat healthy fish-a mail survey of women who recently gave birth in Minnesota, Wisconsin, and Pennsylvania, and six focus groups with women of childbearing age living in the Great Lakes region. Similar to other studies, we found that many women changed their behavior and consumed less fish during pregnancy than before. Most women reported receiving information, primarily during pregnancy, about the types of fish and how much fish to eat. As a result, increasing access to information during pregnancy likely would not result in increasing many women's fish consumption. Based on our examination of factors influencing women to try to follow the recommendations, the strongest connection with trying to follow the recommendations was receiving enough information to decide and believing that eating fish was good for the baby. Focus group participants also reported that messages about the specific health benefits of fish consumption for their children were particularly influential. These findings suggest that refining messages through testing might be a valuable approach toward increasing women's consumption of less-contaminated fish., (Copyright © 2014 Elsevier Inc. All rights reserved.)

The levels of dioxins/furans, polychlorinated biphenyls (PCBs), and chlorinated pesticides were determined in farmed salmon for eight regions in Europe, North America, and South America, in salmon fillets purchased in 16 cities in Europe and North America, and in five species of wild Pacific salmon. Upon application of US Environmental Protection Agency (USEPA) methods for developing fish consumption advisories for cancer from mixtures of all of these substance for which USEPA has reported a cancer slope factor, the most stringent recommendation, for farmed salmon from northern Europe, was for consumption of at most one meal every 5 months in order to not exceed an elevated risk of cancer of more than 1 in 100,000. Farmed salmon from North and South America triggered advisories of between 0.4 and one meal per month. Retail market samples, in general, reflected levels found in regionally farmed fish, although much of the US salmon comes from Chile, which had somewhat lower contaminant levels than the North American farmed samples. Upon consideration of all of these organochlorine compounds as a mixture, even wild Pacific salmon triggered advisories of between one and less than five meals per month. The advisories are driven by the non-dioxin-like PCBs and pesticides and not by dioxins/furans and coplanar PCBs. For noncancer effects for contaminants where USEPA has provided a reference dose only endrin and PCBs triggered any significant advisory. For both of these in the worst case, farmed salmon from northern Europe, the advice was not more than three meals per month.

Contaminants in farmed Atlantic and wild Pacific salmon raise important questions about the competing health benefits and risks of fish consumption. A benefit-risk analysis was conducted to compare quantitatively the cancer and noncancer risks of exposure to organic contaminants in salmon with the (n-3) fatty acid-associated health benefits of salmon consumption. Recommended levels of (n-3) fatty acid intake, as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), may be achieved by consuming farmed or wild salmon while maintaining an acceptable level of noncarcinogenic risk. However, the recommended level of EPA+DHA intake cannot be achieved solely from farmed or wild salmon while maintaining an acceptable level of carcinogenic risk. Although the benefit-risk ratio for carcinogens and noncarcinogens is significantly greater for wild Pacific salmon than for farmed Atlantic salmon as a group, the ratio for some subgroups of farmed salmon is on par with the ratio for wild salmon. This analysis suggests that risk of exposure to contaminants in farmed and wild salmon is partially offset by the fatty acid-associated health benefits. However, young children, women of child-bearing age, pregnant women, and nursing mothers not at significant risk for sudden cardiac death associated with CHD but concerned with health impairments such as reduction in IQ and other cognitive and behavioral effects, can minimize contaminant exposure by choosing the least contaminated wild salmon or by selecting other sources of (n-3) fatty acids.