Report of the Joint FAO/WHO Expert Consultation on the Risks and Benefits of Fish Consumption. Rome, 25-29 january 2010

FAO Fisheries and Aquaculture Report. No. 979

Report of the Joint FAO/WHO Expert Consultation on
the Risks and Benefits of Fish Consumption

Rome, 25–29 January 2010

Food and Agriculture Organization of the United Nations
World Health Organization
2011

ABSTRACT

FAO/WHO.
Consultation on the Risks and Benefits of Fish Consumption. Rome, 25–29 January 2010.
FAO Fisheries and Aquaculture Report. No. 978. Rome, FAO. 2011. 50p.

The Food and Agriculture Organization of the United Nations and the World Health Organization convened a Joint Expert Consultation on the Risks and Benefits of Fish Consumption from 25 to 29 January 2010. The tasks of the Expert Consultation were to review data on levels of nutrients (long-chain omega-3 fatty acids) and specific chemical contaminants (methylmercury and dioxins) in a range of fish species and to compare the health benefits of fish consumption and nutrient intake with the health risks associated with contaminants present in fish. The Expert Consultation drew a number of conclusions regarding the health benefits and health risks associated with fish consumption and recommended a series of steps that Member States should take to better assess and manage the risks and benefits of fish consumption and more effectively communicate these risks and benefits to their citizens. The output of the Expert Consultation is a framework for assessing the net health benefits or risks of fish consumption that will provide guidance to national food safety authorities and the Codex Alimentarius Commission in their work on managing risks, taking into account the existing data on the benefits of eating fish. The Expert Consultation concluded the following:

Consumption of fish provides energy, protein and a range of other important nutrients, including the long-chain n-3 polyunsaturated fatty acids (LCn3PUFAs).

Eating fish is part of the cultural traditions of many peoples. In some populations, fish is a major source of food and essential nutrients.

Among the general adult population, consumption of fish, particularly fatty fish, lowers the risk of mortality from coronary heart disease. There is an absence of probable or convincing evidence of risk of coronary heart disease associated with methylmercury. Potential cancer risks associated with dioxins are well below established coronary heart disease benefits from fish consumption.

When comparing the benefits of LCn3PUFAs with the risks of methylmercury among women of childbearing age, maternal fish consumption lowers the risk of suboptimal neurodevelopment in their offspring compared with the offspring of women not eating fish in most circumstances evaluated. At levels of maternal exposure to dioxins (from fish and other dietary sources) that do not exceed the provisional tolerable monthly intake (PTMI) of
70 pg/kg body weight established by JECFA (for PCDDs, PCDFs and coplanar PCBs), neurodevelopmental risk for the fetus is negligible.

At levels of maternal exposure to dioxins (from fish and other dietary sources) that exceed the PTMI, neurodevelopmental risk for the fetus may no longer be negligible.

Among infants, young children and adolescents, the available data are currently insufficient to derive a quantitative framework of the health risks and health benefits of eating fish. However, healthy dietary patterns that include fish consumption and are established early in life influence dietary habits and health during adult life.

Table of Contents


Preparation of this document
Acknowledgements
Abstract
Declaration of Interests
Further Information
Acronyms and Abbreviations
EXECUTIVE SUMMARY
	Background to the Expert Consultation
	Scope
	Conclusions
	Recommendations
1. INTRODUCTION
	1.1 Background
	1.2 Terms of reference of the Expert Consultation
	1.3 Scope, objectives and target populations
		1.3.1 Scope and objectives
		1.3.2 Target populations
2. RISK–BENEFIT ASSESSMENT
	2.1 Introduction
	2.2 Health outcomes
		2.2.1 Identification of suitable data sets
		2.2.2 Risks
		2.2.3 Benefits
	2.3 Existing risk–benefit assessments
		2.3.1 BRAFO tiered approach for benefit–risk assessment of foods
		2.3.2 BENERIS and QALIBRA
		2.3.3 EFSA tiered approach for benefit–risk assessment of foods
		2.3.4 Risk–benefit analyses using the DALY approach: method development with acid folic as an example
		2.3.5 Risk–benefit analyses of fish consumption using the QALY approach
		2.3.6 Fish risk–benefit assessment by the Institute of Medicine in the USA
		2.3.7 Quantitative risk–benefit assessment of fish consumption by the USFDA
	2.4 Approach taken by the Expert Consultation
		2.4.1 Balancing risks of methylmercury and dioxins with benefits of EPA/DHA: rationale
		2.4.2 Analyses used to estimate dose–response
			2.4.2.1 Methylmercury and neurodevelopment
			2.4.2.2 DHA and neurodevelopment
			2.4.2.3 EPA plus DHA and mortality from coronary heart disease
			2.4.2.4 Dioxins and mortality
	2.5 Data on the composition of fish
	2.6 Risk–benefit comparison
		2.6.1 Neurodevelopment in newborns and infants
		2.6.2 Comparison of the effects of methylmercury and DHA on children's IQ: results and discussion
		2.6.3 Mortality from coronary heart disease
		2.6.4 Comparison of the effects of DHA and dioxins on coronary heart disease mortality: results and discussion
3. SUMMARY OF FINDINGS
	3.1 Consumption of fish, LCn3PUFAs, methylmercury and dioxins in women of childbearing age, pregnant women and nursing mothers
	3.2 Consumption of fish, LCn3PUFAs, methylmercury and dioxins in the general adult population
4. RESEARCH PRIORITIES AND DATA GAPS
5. CONCLUSIONS AND RECOMMENDATIONS
	5.1 Conclusions
	5.2 Recommendations
6. REFERENCES
APPENDIX A: ARITHMETIC MEAN CONTENT OF TOTAL FAT, EPA PLUS DHA, TOTAL MERCURY AND DIOXINS IN 103 SPECIES OF FISH
APPENDIX B: MEETING PARTICIPANTS

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