Seafood and the 2010 Dietary Guidelines June 7, 2011 Presenter: Madeleine Sigman-Grant, PhD, RD Professor and Area Extension Specialist University of Nevada Cooperative Extension Moderator: James M. Rippe, MD – Leading cardiologist, Founder and Director, Rippe Lifestyle Institute Approved for 1 CPE (Level 2) by the American Dietetic Association Commission on Dietetic Registration Recording of the June 7, 2011 webinar and PDF download of complete PowerPoint available at: www.ConAgraFoodsScienceInstitute.com

Seafood and the 2010 Dietary Guidelines Nutri-Bitessm Summary Seafood and the 2010 Dietary Guidelines This webinar covered: Reasons seafood consumption is a recommendation in the 2010 Dietary Guidelines. Concerns associated with the consumption of seafood. Steps involved in assisting consumers to make an informed choice about personal seafood consumption. Four EPA/DHA rich seafood choices that are safe for pregnant women.

Source of protein and other nutrients High is oils: n – 3 FATTY ACIDS WHY SEAFOOD? Source of protein and other nutrients Low in solid fats High is oils: n – 3 FATTY ACIDS Seafood includes fish, shellfish and mollusks (marine and freshwater) So, why did the DGAC address seafood? In addition to being excellent sources of high-quality protein, seafood is low in saturated and trans fats. Even more important is the fact that seafood is an excellent source of n-3 fatty acids.

Seafood Specific Statements For Americans 2 years and older Choose a variety of protein foods, which include seafood, lean meat and poultry, eggs, beans and peas, soy products, and unsalted nuts and seeds. Increase the amount and variety of seafood consumed by choosing seafood in place of some meat and poultry. Women who are pregnant or breastfeeding Consume 8 to 12 ounces of seafood per week from a variety of seafood types. Due to the high methyl mercury content, limit white (albacore) tuna to 6 ounces per week and do not eat the following four types of fish: tilefish, shark, swordfish, king mackerel When you go to the Dietary Guidelines website and review the Executive Summary, you will note there is a section that lists foods and nutrients to increase. Included in the list are these seafood specific statements. This one and the next are found under the protein foods section.

Current food sources: DHA/EPA* 71% from seafood 53% other fish and fish mixed dishes 13% from shrimp and shrimp mixed dishes 5% from tuna and tuna mixed dishes 14% from chicken and chicken mixed dishes 6% from eggs and egg mixed dishes While these are the primary sources of n-3 fatty acids in the American diet, the amount consumed does not provide the suggested 250 mg/day needed for health. Indeed, it has been estimated that on a daily basis Americans only consume about 130-150 mg. *NHANES, 2005-2006

Top 10 Seafood Species/capita U.S. Intake, 2009 1) Shrimp 4.10 pounds 2) Canned tuna 2.50 pounds 3) Salmon 2.04 pounds 4) Alaska Pollock 1.45 pounds 5) Tilapia 1.21 pounds 6) Catfish 0.85 pounds 7) Crab 0.59 pounds 8) Cod 0.42 pounds 9) Clams 0.41 pounds 10)Pangasius (catfish) 0.36 pounds The information contained in this list was provided by the National Oceanic and Atmospheric Association, which is the federal agency responsible for the conditions of oceans. Seafood data obtained from National Oceanic and Atmospheric Association (NOAA), written communication Chicken – average annual amount eaten > 85 pounds American Meat Institute http://www.meatami.com/ht/a/GetDocumentAction/i/48781 )

Seafood Choices: Balancing Benefits and Risks, 2007 EPA+DHA (g) in 3-oz serving Source: IOM, Seafood Choices: Balancing Benefits and Risks, 2007 This is a chart taken from the IOM Committee’s work. The n-3 content is shown in grams ranked from highest to lowest. Cold water fish (salmon and trout) have the highest levels of n-3 fatty acids, although oysters (a mollusk) also contains a large amount. The list includes both wild and farm-raised types of seafood. The red bars indicate large predatory seafood containing high levels of methyl-mercury. This pollutant is a particular concern to pregnant and breastfeeding women and to children. However, as seen in the previous slides, these varieties are not frequently consumed by Americans. There is a variety of n-3 fatty acid containing fish that is frequently eaten in the US – albacore (white) tuna, represented by the yellow bar. We will be reviewing this chart later on in the presentation.

Seafood n-3 fatty acids and risk of CVD Compared with little or no fish intake, moderate consumption (~250 mg/d EPA plus DHA) is associated with reduced risk of cardiac mortality from CHD or sudden death in persons with or without CVD This level of intake equates to two (4-oz) servings /wk of high n-3 containing seafood Impact on CVD protection is not substantially further reduced by greater intake The conclusion of the DGA committee was that the strength of the new evidence warranted attention by adding a seafood recommendation. In fact, as sometimes the very first evidence of CVD appears as a fatality (from stroke or heart attack), it is critical to make the recommendation. Although, the absolute coronary heart disease (CVD) mortality rates vary more than 100-fold across different populations (due to differences in age, prior CHD, and other risk factors), the relative effects of intake of fish are consistent, whether for primary or secondary prevention, for cohort studies or randomized trials, or for comparing populations at higher or lower absolute risk. The DGAC assumed an intake of 250 mg/d of EPA plus DHA could be obtained by eating 2, 4-oz servings of high n-3 fish per week. They also concluded that eating any more n-3 fish/week would NOT enhance the protective effect.

Potential Risks of Seafood Environmental Contaminants (alone or simultaneously) – some are only of concern to pregnant or lactating women and young children; others impact all Food borne illnesses – concern to all, particularly pregnant and lactating women, children and those with compromised immune systems I have presented the benefits found with consuming seafood, and hence the rationale for the Committee to include seafood in its specific recommendations. But, as with most issues we face, little occurs without some risks. For seafood there are two main risks: contamination of seafood by environmental substances and food borne illness. Furthermore, some risks impact everyone and others may only impact a specific population. Both these categories of risk can be minimized but should not be neglected.

Barriers and Challenges to Seafood Consumption Depleting supplies Farm raised fish Availability Cost Acceptability When we get to the consumer level, the barriers to increasing seafood consumption reflect similar barriers for accessing other foods. Coastal communities or those near inland water supplies have greater access to seafood at lower costs. In these areas, seafood is common and quite acceptable. However, in many areas across the US, seafood is expensive and fresh seafood may not be available. In addition to unacceptable taste of some seafood, the smell and appearance may turn off many consumers.

Making Informed Seafood Choices Initial Determinations AGE GENDER If female, determine PHYSIOLOGICAL STATE Does consumer eat locally caught seafood Does consumer eat raw seafood Now you are ready to explain the Benefits Risks Now, find the accompanying paper and let’s assume you are addressing a patient or a group of consumers. They want to know what they should do. They have heard about increasing seafood consumption but have also heard about all the risks. The IOM committee put together this decision tree to help consumers make appropriate choices. I altered the original schema to reflect the 2010 DGAC recommendations. Let’s walk through the decision-making process systematically. First of all, the age of the patient or consumer must be determined. Once the age is established, gender must be considered. If the patient or consumer is female, further assessment must be made to determine if she is pregnant or breastfeeding. Once these factors are known, the next step is determining if the person eats locally caught seafood and/or eats raw or undercooked seafood. Now your can begin to counsel.

Minimizing Risks CHILDREN Avoid known sources of contaminated seafood Follow all fish advisories Choose a variety of species Avoid raw and undercooked seafood DO NOT EAT tilefish, shark, swordfish, king mackerel Eat only 6 ounces of white (albacore tuna) per week ADULT MALES Avoid known sources of contaminated seafood Follow all fish advisories Choose a variety of species Avoid raw and undercooked seafood If eating raw or undercooked seafood, choose seafood that was previously frozen (kills parasites) and handle safely WOMEN non pg/bf Avoid known sources of contaminated seafood Follow all fish advisories Choose a variety of species Avoid raw and undercooked seafood If eating raw or undercooked seafood, choose seafood that was previously frozen (kills parasites) and handle safely WOMEN – pg/bf Avoid known sources of contaminated seafood Follow all fish advisories Choose a variety of species Avoid raw and undercooked seafood Thoroughly cook all seafood (including refrigerated types of seafood, e.g. lox, smoked trout) DO NOT EAT tilefish, shark, swordfish, king mackerel Eat only 6 ounces of white (albacore tuna) per week But here is how these risks can be minimized.

DGAC Maximizing Benefits 250 milligrams per day of n-3 fatty acids from marine sources (DHA and EPA) Eat two servings of a variety seafood per week (4 oz. cooked, edible seafood/serving) Many of us work with families, or with the food purchasing gatekeeper. It is important that consumers understand that while there is a universal recommendation to increase seafood consumption, they must approach this in a thoughtful manner. Every family member will benefit; pregnant and lactating women and children under 12 need to be more selective than adults and older children. For consumers: Choosing a variety of seafood types and learning how to cook seafood properly to enhance the delicate flavors and reduce food-borne illness will reduce risk of chronic disease. For industry: Employing best practices in aquaculture will ensure healthy seafood can be readily available and affordable to all consumers.

For more information www.dietaryguidelines.gov http://www.iom.edu/Reports/2006/Seafood-Choices-Balancing-Benefits-and-Risks.aspx http://water.epa.gov/scitech/swguidance/fishshellfish/fishadvisories/advisories_index.cfm