title: Which fish should I eat? Perspectives influencing fish consumption choices.
abstract: BACKGROUND
  Diverse perspectives have influenced fish consumption choices.
  
  
  OBJECTIVE
  We summarized the issue of fish consumption choice from toxicological, nutritional, ecological, and economic points of view; identified areas of overlap and disagreement among these viewpoints; and reviewed effects of previous fish consumption advisories.
  
  
  METHODS
  We reviewed published scientific literature, public health guidelines, and advisories related to fish consumption, focusing on advisories targeted at U.S. populations. However, our conclusions apply to groups having similar fish consumption patterns.
  
  
  CONCLUSIONS
  There are many possible combinations of matters related to fish consumption, but few, if any, fish consumption patterns optimize all domains. Fish provides a rich source of protein and other nutrients, but because of contamination by methylmercury and other toxicants, higher fish intake often leads to greater toxicant exposure. Furthermore, stocks of wild fish are not adequate to meet the nutrient demands of the growing world population, and fish consumption choices also have a broad economic impact on the fishing industry. Most guidance does not account for ecological and economic impacts of different fish consumption choices.
  
  
  CONCLUSIONS
  Despite the relative lack of information integrating the health, ecological, and economic impacts of different fish choices, clear and simple guidance is necessary to effect desired changes. Thus, more comprehensive advice can be developed to describe the multiple impacts of fish consumption. In addition, policy and fishery management interventions will be necessary to ensure long-term availability of fish as an important source of human nutrition.
authors.affiliation: Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, Massachusetts, USA. emily_oken@hphc.org
authors.forename: Emily
authors.initials: E
authors.lastname: Oken
authors.forename: Anna L
authors.initials: AL
authors.lastname: Choi
authors.forename: Margaret R
authors.initials: MR
authors.lastname: Karagas
authors.forename: Koenraad
authors.initials: K
authors.lastname: Mariën
authors.forename: Christoph M
authors.initials: CM
authors.lastname: Rheinberger
authors.forename: Rita
authors.initials: R
authors.lastname: Schoeny
authors.forename: Elsie
authors.initials: E
authors.lastname: Sunderland
authors.forename: Susan
authors.initials: S
authors.lastname: Korrick
mesh_terms: D000818:Animals; D017756:Aquaculture / Q000191:economics / Q000379:methods*; D004032:Diet; D004785:Environmental Pollutants / Q000633:toxicity*; D005399:Fishes; D005518:Food Preferences / Q000523:psychology*; D017408:Guidelines as Topic; D006801:Humans; D009747:Nutritional Physiological Phenomena / Q000502:physiology*; D018570:Risk Assessment; D014116:Toxicology / Q000379:methods / Q000639:trends*; D014481:United States
chemical_list: D004785:Environmental Pollutants