Cohen Joshua T, Bellinger David C, Connor William E, Kris-Etherton Penny M, Lawrence Robert S, Savitz David A, Shaywitz Bennett A, Teutsch Steven M, Gray George M
Harvard Center for Risk Analysis, Harvard School of Public Health, Boston, Massachusetts 02115, USA.
Am J Prev Med. 2005 Nov;29(4):325-34. doi: 10.1016/j.amepre.2005.07.003.
Although a rich source of n-3 polyunsaturated fatty acids (PUFAs) that may confer multiple health benefits, some fish contain methyl mercury (MeHg), which may harm the developing fetus. U.S. government recommendations for women of childbearing age are to modify consumption of high-MeHg fish, while recommendations encourage fish consumption among the general population because of nutritional benefits. To investigate the aggregate impacts of hypothetical shifts in fish consumption, the Harvard Center for Risk Analysis convened an expert panel (see acknowledgements). Effects investigated include prenatal cognitive development, coronary heart disease mortality, and stroke. Substitution of fish with high MeHg concentrations with fish containing less MeHg among women of childbearing age yields substantial developmental benefits and few negative impacts. However, if women instead decrease fish consumption, countervailing risks substantially reduce net benefits. If other adults (mistakenly and inappropriately) also reduce their fish consumption, the net public health impact is negative. Although high compliance with recommended fish consumption patterns can improve public health, unintended shifts in consumption can lead to public health losses. Risk managers should investigate and carefully consider how populations will respond to interventions, how those responses will influence nutrient intake and contaminant exposure, and how these changes will affect aggregate public health.
尽管某些鱼类富含n-3多不饱和脂肪酸（PUFAs），可能带来多种健康益处，但有些鱼类含有甲基汞（MeHg），这可能会损害发育中的胎儿。美国政府对育龄妇女的建议是调整高甲基汞鱼类的消费量，而对普通人群的建议则是鼓励食用鱼类，因为其具有营养益处。为了调查鱼类消费假设性变化的总体影响，哈佛风险分析中心召集了一个专家小组（见致谢部分）。所调查的影响包括产前认知发育、冠心病死亡率和中风。育龄妇女用含甲基汞量较低的鱼类替代含甲基汞量高的鱼类，会产生显著的发育益处且负面影响较小。然而，如果妇女反而减少鱼类消费，抵消风险会大幅降低净效益。如果其他成年人（错误且不恰当地）也减少鱼类消费，对公众健康的总体影响则为负面。尽管高度遵循推荐的鱼类消费模式可改善公众健康，但消费的意外变化可能导致公众健康损失。风险管理者应调查并仔细考虑人群将如何应对干预措施、这些反应将如何影响营养摄入和污染物暴露，以及这些变化将如何影响总体公众健康。
