• Evaluating preschool and school-age children exposed to EPA/ DHA in utero and postnatally, at ages beginning around 4 years when executive function is more developed; and

• Evaluating development of school-age children exposed to variable EPA/DHA levels in utero and postnatally with measures of distractibility, disruptive behavior, and oppositional defiant behavior, as well as more commonly assessed cognitive outcomes and more sophisticated tests of visual function.

Recommendation 7: Additional data are needed to better define optimum intake levels of EPA/DHA for infants and toddlers.

Recommendation 8: Better-designed studies about EPA/DHA supplementation in children with behavioral disorders are needed.

Recommendation 9: In the absence of meta-analyses that systematically combine quantitative data from multiple studies, further meta-analyses and larger randomized trials are needed to assess outcomes other than cardiovascular, in particular total mortality, in order to explore possible adverse effects of EPA/DHA supplementation.

Recommendation 10: Additional clinical research is needed to assess a potential effect of seafood consumption and/or EPA/DHA supplementation on stroke, cancer, Alzheimer’s disease, and depression.

Recommendation 11: Future epidemiological studies should assess intake of specific species of seafood and/or biomarkers, in order to differentiate the health effects of EPA/DHA from the health effects of contaminants such as methylmercury.

Recommendation 12: More complete data are needed on the distribution of contaminant levels among types of fish. This information should be made available in order to reduce uncertainties associated with the estimation of health risks for specific seafoodborne contaminant exposures.

Recommendation 13: More quantitative characterization is needed of the dose-response relationships between chemical contaminants and adverse health effects, in the ranges of exposure represented in the general US population. Such information will reduce uncertainties associated with recommendations for acceptable ranges of intake.