The existence of multiple pieces of advice, without a balancing of benefits and risks, may lead to consumer misunderstanding. As a result, individuals may under- or overconsume foods relative to their own health situations.
There is inconsistency between current consumer advice in relation to portion sizes. For example, the FDA/US EPA fish advisory uses a 6-ounce serving size whereas nutritional advice from some government agencies uses a 3-ounce serving size.
Evidence is insufficient to document changes in general seafood consumption in response to the 2001 or 2004 methylmercury advisories.
It is apparent that messages about consumption often have to be individualized for different groups such as pregnant females, children, the general population, subsistence fishermen, and native populations.
Involving representatives of targeted subpopulations (e.g., Arctic Circle campaign) in both the design and evaluation of communications intended to reach those subpopulations can improve the effectiveness of those communications.
There are models for designing guidance, e.g., using full programs, that some individual communities (e.g., Arctic Circle campaign) have contributed to understanding the effects of different modes of health communication and modifying messages to achieve the desired community and/or individual response.
Recommendation 1: Appropriate federal agencies should develop tools for consumers, such as computer-based, interactive decision support and visual representations of benefits and risks that are easy to use and to interpret. An example of this kind of tool is the health risk appraisal (HRA), which allows individuals to enter their own specific information and returns appropriate recommendations to guide their health actions. The model developed here provides this kind of evidence-based recommendation regarding seafood consumption. Agencies should also develop alternative tools for populations with limited access to computer-based information.
Recommendation 2: New tools apart from traditional safety assessments should be developed, such as consumer-based benefit-risk analyses. A better way is needed to characterize the risks combined with benefit analysis.
Recommendation 3: A consumer-directed decision path needs to be properly designed, tested, and evaluated. The resulting product must undergo methodological review and update on a continuing basis. Responsible agencies will need to work with specialists in risk communication and evaluation, and tailor advice to specific groups as appropriate.