British Columbia Centre for Disease Control, Environmental Health Services, Vancouver, BC, Canada.
National Collaborating Centre for Environmental Health, Vancouver, BC, Canada.
Risk Anal. 2017 Nov;37(11):2041-2052. doi: 10.1111/risa.12769. Epub 2017 Mar 17.
Many and complex factors underlie seemingly simple decisions about what to eat. This is particularly so for foods such as fish, which present consumers with both risks and benefits. Advice about what type of and how much fish to consume is abundant, but that advice is often confusing or contradictory, reflecting the differing mandates and orientations of those advising. We survey a range of issues that can and should be incorporated into dietary advice, and offer tools for health agencies tasked with providing it. We argue that risks and benefits should not be limited to direct physical health. Rather, socioeconomic and community factors, unintended or indirect effects, and nonhuman-health outcomes such as animal welfare and planetary health should also be considered and weighed. We provide examples of existing fish consumption guidance to highlight the conflicting messages that emerge when different sources of advice with singular aims of avoiding risk, gaining nutritional benefit, or sustaining fish populations are juxtaposed. We then offer tools borrowed from health and other fields to guide health agencies toward developing more comprehensive advice and targeting that advice for specific populations.
看似简单的饮食选择背后，其实涉及诸多复杂因素。这在食用鱼类等食品时尤为明显，因为鱼类既存在风险，也有其益处。有关应食用何种鱼类以及食用多少的建议很多，但这些建议往往令人困惑甚至相互矛盾，这反映出给出建议的各方具有不同的任务和侧重点。我们调查了一系列可以且应当纳入饮食建议的问题，并为负责提供此类建议的健康机构提供了相关工具。我们认为，风险和益处不应仅限于直接的身体健康。相反，社会经济和社区因素、意外或间接影响，以及非人类健康结果，如动物福利和地球健康，也应予以考虑和权衡。我们提供了一些现有的鱼类消费建议，以突出当不同来源的建议以避免风险、获得营养益处或维持鱼类种群为单一目标并列时，所产生的相互矛盾的信息。然后，我们借鉴健康和其他领域的工具，为健康机构提供指导，帮助其制定更全面的建议，并针对特定人群提供相关建议。
