Index

A

α-linolenic acid. See Alpha-linolenic acid

AA. See Arachidonic acid

Aboriginal communities, 229

ACF. See Administration for Children and Families

“Action Levels for Poisonous or Deleterious Substances in Human Food and Animal Feed,” 175

ADA. See American Dietetic Association

Adequate dietary intake (ADI), 146

Adequate intake (AI), 21, 6970

ADHD effects.

See also Attention deficit hyperactivity disorder

case-control studies, 472473

in children supplemented with omega-3 fatty acids in foods, 462473

randomized controlled trials, 462471

review studies, 462463

ADI. See Adequate dietary intake

Administration for Children and Families (ACF), 269

Adolescent males, adult males, and females who will not become pregnant, specific guidance for healthy consumption, 8, 208, 210, 265

Adult chronic disease studies, 494677

adult asthma and allergies, 626627

aging and other neurological outcomes, 658669

arrhythmia, 612615

blood pressure, 602611

cancer, 628657

cardiac indicators, 616617

diabetes, 618625

lipid profiles, 582601

secondary prevention, with cardiovascular outcomes, 494559

stroke, 560583

Adults at risk for cardiovascular disease, specific guidance for healthy consumption, 8, 208

Adults at risk for chronic disease, research recommendations for, 14

Adverse health effects

associated with omega-3 supplementation, 174175

coronary heart disease, 67

of dioxins and dioxin-like compounds, 141

information available on, 199

of polybrominated diphenyl ethers, 148

of polychlorinated biphenyls, 143145

Advertising and promotion, and the current information environment influencing seafood choices, 225



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Seafood Choices: Balancing Benefits and Risks Index A α-linolenic acid. See Alpha-linolenic acid AA. See Arachidonic acid Aboriginal communities, 229 ACF. See Administration for Children and Families “Action Levels for Poisonous or Deleterious Substances in Human Food and Animal Feed,” 175 ADA. See American Dietetic Association Adequate dietary intake (ADI), 146 Adequate intake (AI), 21, 69–70 ADHD effects. See also Attention deficit hyperactivity disorder case-control studies, 472–473 in children supplemented with omega-3 fatty acids in foods, 462–473 randomized controlled trials, 462–471 review studies, 462–463 ADI. See Adequate dietary intake Administration for Children and Families (ACF), 269 Adolescent males, adult males, and females who will not become pregnant, specific guidance for healthy consumption, 8, 208, 210, 265 Adult chronic disease studies, 494–677 adult asthma and allergies, 626–627 aging and other neurological outcomes, 658–669 arrhythmia, 612–615 blood pressure, 602–611 cancer, 628–657 cardiac indicators, 616–617 diabetes, 618–625 lipid profiles, 582–601 secondary prevention, with cardiovascular outcomes, 494–559 stroke, 560–583 Adults at risk for cardiovascular disease, specific guidance for healthy consumption, 8, 208 Adults at risk for chronic disease, research recommendations for, 14 Adverse health effects associated with omega-3 supplementation, 174–175 coronary heart disease, 67 of dioxins and dioxin-like compounds, 141 information available on, 199 of polybrominated diphenyl ethers, 148 of polychlorinated biphenyls, 143–145 Advertising and promotion, and the current information environment influencing seafood choices, 225

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Seafood Choices: Balancing Benefits and Risks Advisories and warnings about seafood consumption, 21–24. See also Federal advisories about seafood consumption; State advisories about seafood consumption European Food Safety Authority, 25 outside the US, 24–26 UK’s Scientific Advisory Committee on Nutrition, 24 World Health Organization, 26 African Americans, in the MEC Study, 38–39 AGA. See American Gastroenterological Association Agency for Health Research and Quality (AHRQ), 67, 96, 250–251 Evidence Report/Technology Assessment No. 93, 98 Aging and neurological outcome studies, 104, 658–669 case-control studies, 666–669 cohort studies, 658–667 Agricultural Marketing Act, 223 Agricultural Research Service (ARS), 207 AHA. See American Heart Association AhR. See Arylhydrocarbon receptor AHRQ. See Agency for Health Research and Quality AI. See Adequate intake ALA. See Alpha-linolenic acid Alaska, 203, 207, 270 Alaskan Native populations, current seafood intake by, 40–41 Allergy and asthma studies, 103, 626–627. See also Food allergies case-control studies, 480–483 cohort studies, 626–627 cross-sectional studies, 626–627 ecological studies, 482–485 effects in children supplemented with omega-3 fatty acids in foods, 474–485 effects in infants and children of mothers who increase seafood and/or omega-3 fatty acid intake, 378–387 effects in infants supplemented with omega-3 fatty acids in formula, 458–461 immunity and benefits to infants from postnatal supplementation through formula, 88 randomized controlled trials, 474–475 review studies, 476–479 studies on adult, 626–627 Alpha-linolenic acid (ALA), 18, 21, 45, 48, 53, 69–70, 150, 290 dietary intake of fatty acid, 50–51 ALSPAC. See Avon Longitudinal Study of Parents and Children Alzheimer’s disease, 104 research recommendations on, 14, 108 American Dietetic Association (ADA), recommendations from, 20–21 American Gastroenterological Association (AGA), 166–168 American Heart Association (AHA) Dietary Guidelines, recommendations from, 19–20 American Indian populations, current seafood intake by, 40–41 Amnesic Shellfish Poisoning (ASP), 170 Analytic samples of the most common seafood types, research recommendations on obtaining larger, 13, 60 Analytical data, recommendations for consistently revising, 7, 178 Anglers, 41, 280 Animal studies, 144 on allergy effects in infants and children of mothers who increase seafood and/or omega-3 fatty acid intake, 418–419 on cognitive and motor development effects in infants supplemented with omega-3 fatty acids in formula, 452–457 on development effects in infants of mothers who increase seafood and/or omega-3 fatty acid intake, 370–377 Annual occurrence of parasitic infections due to consumption of seafood, 167 Antimicrobial/antifungal agents, used at some time for aquaculture production in the US, 171 Antimicrobial resistance in seafood, 176 Aquaculture, 149, 164, 171, 176, 213, 224, 253, 280 Arachidonic acid (AA), 75–76, 78, 86, 88 Arctic Circle campaign, 240 Aromatic compounds, chlorinated, 142

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Seafood Choices: Balancing Benefits and Risks Arrhythmia, 101–102, 280 Arrhythmia studies, 612–615 cohort studies, 614–615 cross-sectional studies, 614–615 randomized controlled trials, 612–613 review studies, 612–613 ARS. See Agricultural Research Service Arsenic, risks associated with seafood consumption, 138 Arylhydrocarbon receptor (AhR), 145 Asian American populations, current seafood intake by, 39–40 ASP. See Amnesic Shellfish Poisoning Asthma, 89. See also Allergy and asthma studies Atherosclerosis, carotid, 134, 280 Atopic disease, 84, 280 Atrial fibrillation, 101 Attention deficit hyperactivity disorder (ADHD), 89 effects in children supplemented with omega-3 fatty acids in foods, 462–473 Audience segmentation, 10, 238 Avoidance, of fish from polluted harvest locations, 169, 231 Avon Longitudinal Study of Parents and Children (ALSPAC), 78, 81–83, 132 B Balancing benefits and risks of seafood consumption, 2–9, 195–216 benefits associated with nutrients from seafood, 4–5 conclusions, 214–215 consumption of seafood in the US, 3–4 findings, 213–214 risks associated with seafood, 5–6 scientific benefit-risk analysis for seafood consumption, 198–213 selections for, 687–690 Bayesian hierarchical model, 129, 280 Bayley Psychomotor Development scores, 80 Bayley Scales of Infant Development Mental Index (MDI), 85–86 Beck Depression Inventory (BDI), 72 Beef, nutrients in, 46–47 Benchmark dose (BMD) modeling, 136, 280 Benchmark dose lower bound (BMDL), 123, 128, 136–137 Bender Visual Motor Gestalt Test, 127 Benefit-risk analysis, 198, 233, 280 identifying target populations for seafood consumption, 253 Benefits and risks of seafood consumption balancing for healthy consumption, 7–9, 197–198, 207–211, 248 decision pathways for balancing, 9, 212 designing communications to support informed decision-making, 250–271 guidance for healthy consumption for adolescent males, adult males, and females who will not become pregnant, 208, 210 guidance for healthy consumption for adults at risk of cardiovascular disease, 208 guidance for healthy consumption for children up to age 12, 207–210 guidance for healthy consumption for females who are or may become pregnant or who are breast-feeding, 207, 209 population groups and appropriate guidance in balancing, 8 for population subgroups, research recommendations, 13, 60 recommendations for balancing, 7 supporting consumer seafood consumption decisions, 10–13, 248–273 Benefits associated with nutrients from seafood, 4–5, 69–70 allergy and immunity, 88 cardiovascular disease, cardiovascular mortality, and all-cause morbidity and mortality, 91–106 to children, 89 cognitive and motor development, 85–88 development in infants and children, 77–84 duration of gestation and birth weight, 73–77 to the general population, 68–69 to infants and children associated with prenatal omega-3 fatty acid intake, 73–84

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Seafood Choices: Balancing Benefits and Risks to infants from postnatal supplementation through formula, 80, 84–89 for prevention of adult chronic disease, 91–107 recommendations on, 107 research recommendations on, 107–108 transfer of maternal DNA to the fetus or breastfeeding infant, 73 visual acuity, 85 to women, infants, and young children associated with omega-3 fatty acids, 71–90 Benefits to women during and after pregnancy, 71–73 postpartum depression, 71–72 preeclampsia, 71 summary of evidence, 73 Bioaccumulative pollutants in seafood, 281 of dioxins, 141 of PBDEs, 147–148 of PCBs, 142–143, 230 Biomarkers of contaminant exposures, research recommendations on, 15, 179 Biomonitoring, 151 Bioreactors, 54 Biosynthesis of long-chain fatty acids, 291 Birth weight case-control studies, 336–337 cohort studies, 330–335 effects in infants of mothers who increase seafood and/or omega-3 fatty acid intake, 322–337 randomized controlled trials, 322–329 Bis(methylmercuric)selenide (BMS), 153 Blood cholesterol, high, 20 Blood pressure, 99–101 high, 20 and protective factors in fish, 135 Blood pressure studies, 602–611 Cochrane reviews, 602–603 cohort studies, 608–609 cross-sectional studies, 610–611 meta-analysis, 602–603 observational studies, 100–101 randomized controlled trials, 100, 604–609 BMD. See Benchmark dose BMDL. See Benchmark dose lower bound BMI. See Body Mass Index BMS. See Bis(methylmercuric)selenide Body burdens, 281 of MeHg, 138 of POPs, 150–151 Body mass index (BMI), 100 Body weight, excess, 20 Boston Naming Test, 126–127, 131, 281 Brain vulnerability, 137 Brazil, 133 Breastfeeding, 132–133 Brominated compounds, potential hazards from, 139 Bruininks-Oseretsky Test of Motor Proficiency, 126 Brunet-Lezine’s developmental quotient, 85–86 C CAD. See Coronary artery disease Cadmium, risks associated with seafood consumption, 138, 152 California a “core state” for management plan to reduce Vibrio vulnificus illness, 159, 162 Proposition 65, 223–224 California Verbal Learning Test, 126–127, 131 Canada, 133, 143, 147, 228 Cancer, 104 liver, 144 research recommendations on, 14, 108 Cancer slope factor (CSF), 146 Cancer studies, 628–657 case-control studies, 654–657 cohort studies, 632–655 randomized controlled trials, 628–629 review studies, 628–631, 656–657 Carcinogenicity, 141 Cardiac indicator studies, randomized controlled trials, 616–617 Cardiac risk, reducing, 20 Cardioprotective effects, of EPA/DHA supplements, 92, 94 Cardiovascular disease (CVD), 91–106 aging and other neurological outcomes, 104 allergy and asthma, 103 arrhythmia, 101–102 blood pressure, 99–101

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Seafood Choices: Balancing Benefits and Risks cancer, 104 cardiovascular benefits to specific population groups, 91–92 clotting factors, 102–103 fibrinogen, 102 indicators of glucose tolerance in diabetes, 103 lipid profiles, 98–99 platelet aggregation, 103 risk of, 211 and seafood benefits for prevention of adult chronic disease, 91–106 seafood or omega-3 fatty acid consumption and coronary heart disease, 92–96 stroke, 96–98 summary of evidence, 104–106 toxicity of methylmercury, 133–135 Cardiovascular health, 138, 252 benefits of seafood consumption for, 25 benefits to specific population groups, 91–92 Cardiovascular Health Study, 98 Carotid atherosclerosis, 134, 280 Case-control studies, 281 on ADHD effects in children supplemented with omega-3 fatty acids in foods, 472–473 on aging and other neurological outcomes, 666–669 on allergy and asthma effects in children supplemented with omega-3 fatty acids in foods, 480–483 on cancer, 654–657 on development effects in infants of mothers who increase seafood and/or omega-3 fatty acid intake, 364–367 on gestation and birth weight effects in infants of mothers who increase seafood and/or omega-3 fatty acid intake, 336–337 on preeclampsia effects in women who increase seafood and/or omega-3 fatty acid intake, 306–311 on secondary prevention, with cardiovascular outcomes, 550–557 on stroke, 578–579 Catenation, 291 CDC. See Centers for Disease Control and Prevention CD4RO+ immune cells, 88 Center for Science in the Public Interest (CSPI), 153, 155 Centers for Disease Control and Prevention (CDC), 144, 153–155, 250 CFR. See Code of Federal Regulations Challenge to California’s Proposition 65, 223 Changes in benefits and risks associated with changes in consumption patterns, 200–207 substitution impact on selected contaminants, 202–203 substitution impact on selected nutrients, 201–202 uncertainties in substitution analysis, 203, 207 Changes in supply and demand, concerning future seafood supplies, 42–43 Charge to the committee, 26–27 approach to the task, 27 CHD. See Coronary heart disease Chemotherapeutants, risks associated with, 171–174 Child health outcomes, 67 Childbearing. See Women Children. See also Avon Longitudinal Study of Parents and Children with behavioral disorders, research recommendations on better designing studies about EPA/DHA supplementation in, 14, 108 benefits to, 89 research recommendations for, 10, 14 supplemented with omega-3 fatty acids in foods, 462–485 up to age 12, specific guidance for healthy consumption, 8, 207–210 Children’s studies, 298–493 on ADHD effects in children supplemented with omega-3 fatty acids in foods, 462–473 on allergy and asthma effects in children supplemented with omega-3 fatty acids in foods, 474–485 on allergy effects in infants and children of mothers who increase seafood and/or omega-3 fatty acid intake, 378–387 China, 138 Chlordane, 22 Chlorinated aromatic compounds, 142

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Seafood Choices: Balancing Benefits and Risks Cholera, 155 Cholesterol, 281. See also High-density lipoprotein cholesterol; Low-density lipoprotein cholesterol concentrations of, 94 high blood, 20 Chromium, risks associated with seafood consumption, 138 Chronic diseases, 67. See also Adult chronic disease studies Ciguatera, 168–170, 281 Clinical Guide to Preventive Services, 250–251 Clostridium botulinum, reducing risk of seafoodborne illness from, 165 Clotting factors, 102–103 Cochrane reviews, 85, 94, 281 on allergy effects in infants and children of mothers who increase seafood and/or omega-3 fatty acid intake, 388–389 on blood pressure, 602–603 on cognitive and motor development effects in infants supplemented with omega-3 fatty acids in formula, 420–421 on secondary prevention, with cardiovascular outcomes, 496–497 on stroke, 560–561 Code of Federal Regulations (CFR), 175 Coexposures, 152 Cognitive and developmental outcomes in infants, 73, 79–83, 87 and benefits to infants from postnatal supplementation through formula, 85–88 effects in infants supplemented with omega-3 fatty acids in formula, 420–457 research recommendations on, 13–14, 107–108 Cognitive decline, age-related, 104 Cohort studies on adult asthma and allergies, 626–627 on aging and other neurological outcomes, 658–667 on allergy effects in infants and children of mothers who increase seafood and/or omega-3 fatty acid intake, 386–387, 412–417 on arrhythmia, 614–615 on blood pressure, 608–609 on cancer, 632–655 on cognitive and motor development effects in infants supplemented with omega-3 fatty acids in formula, 450–451 on development effects in infants of mothers who increase seafood and/or omega-3 fatty acid intake, 350–365 on gestation and birth weight effects in infants of mothers who increase seafood and/or omega-3 fatty acid intake, 330–335 on lipid profiles, 600–601 on postpartum depression effects in women who increase seafood and/or omega-3 fatty acid intake, 314–319 on preeclampsia effects in women who increase seafood and/or omega-3 fatty acid intake, 304–305 on secondary prevention, with cardiovascular outcomes, 522–549 on stroke, 562–577 Collaborative approaches, 266 in federal coordination and communicating health messages through nontraditional partners, 269–270 Committee on EPA’s Exposure and Human Health Reassessment of TCDD and Related Compounds, 140–141 Committee on Nutrient Relationships in Seafood, 129 Committee on the Implications of Dioxin in the Food Supply, 146 Committee on the Toxicological Effects of Methylmercury, 128 Committee on Toxicity (COT) of Chemicals in Food, Consumer Products and the Environment, 24 Communication tools for information about seafood consumption research recommendations on developing more effective, 15, 241 supporting informed decision-making, pretest and post hoc evaluation of, 270 synergism in, 271 Confidence intervals, 130

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Seafood Choices: Balancing Benefits and Risks Confidentiality, 225 Confounding factors, 137, 282 multiple, 144 Congeners, 143, 282 patterns of, 148 Congenital Miamata Disease, 124–125 Conservation, of seafood, 689–690 Consolidated advice, need for, 12, 240–241 Consultation on Diet, Nutrition and the Prevention of Chronic Disease, 21 Consumer-based benefit-risk analyses needed, 12, 240 Consumer-centered information design, 259 Consumer decision-making as the basis for the design of consumer guidance, 10, 217–247 findings, 239–240 food choice behavior, 218–230 impact of information on, 230–238 recommendations on, 240–241 research recommendations on, 241 setting the stage for designing consumer guidance, 238–239 Consumer guidance, 10 example of decision pathways for, 254 prior fragmentation of, 11 tools regarding nutritional benefits, recommendations for using the decision pathway to develop, 12, 271 Consumer Reports, 259 Consumer seafood consumption decision-making as the basis for the design of consumer guidance, research recommendations on understanding, 241 decision path needed, tailored to individual circumstances, 12, 240, 254 developing a seafood information program, 248 recommendations for supporting, 11–13 research recommendations on designing better consumer advice, 15, 241 right-to-know perspective, 266 Consumption. See Seafood consumption Contaminants of concern in seafood, 17, 55–59. See also individual contaminants impact of toxicants on selenium status, 58–59 levels among types of fish, research recommendations on distribution of, 14, 178–179 methylmercury, 55–57 naturally occurring or introduced, 17 persistent organic pollutants, 57–58 waters known to contain, 37 Continuing Survey of Food Intake by Individuals (CSFII), 69, 146 Continuous Performance Test, 126–127 Cooperative Extension network, 270 Coordination, across agencies, 266 Cord blood, 76, 132 Core states, Vibrio vulnificus Management Plan, table of compliance for, 161 Coronary artery disease (CAD), 93 Coronary heart disease (CHD), 67, 91, 94, 135, 200 COT. See Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment Council for State and Territorial Epidemiologists, 155 Country of origin labeling, 223–224 Coxsackie virus, 292 Cross-contamination issues, 173 Cross-sectional studies on adult asthma and allergies, 626–627 on allergy effects in infants and children of mothers who increase seafood and/or omega-3 fatty acid intake, 418–419 on arrhythmia, 614–615 on blood pressure, 610–611 on development effects in infants of mothers who increase seafood and/or omega-3 fatty acid intake, 366–369 on diabetes, 624–625 on postpartum depression effects in women who increase seafood and/or omega-3 fatty acid intake, 71–72, 320–321 Crypthecodinium cohnii, 54 CSF. See Cancer slope factor

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Seafood Choices: Balancing Benefits and Risks CSFII. See Continuing Survey of Food Intake by Individuals CSPI. See Center for Science in the Public Interest Current information environment influencing seafood choices, 221–230 advertising and promotion, 225 improving, 249 labels and other point-of-purchase information, 222–224 Northern Contaminants Program, 228–230 summary of, 236–237 Web-based health information, 225–229 Current seafood intake by American Indian/Alaskan Native and First Nations populations, 40–41 by Asian American populations, 39–40 by the general population, 34–37 multiethnic cohort study of, 38–39 by population subgroups, 37–42 by sport and subsistence fishers, 41–42 Current seafood safety hazards, controls, and risks, 156–157 CVD. See Cardiovascular disease Cytokines, 83, 282 D DALY. See Disability adjusted life years Danish Diet, Cancer, and Health Study, 101 DART. See Diet and Angina Randomized Trial Data tables, 297–682 FDA and US EPA safety levels in regulations and guidance, 680–682 recommendations for seafood and EPA/DHA consumption, 678–679 studies on adult chronic diseases, 494–677 studies on women, infants, and children, 298–493 DDE. See Dichlorodiphenyl dichloroethane DDST. See Denver Developmental Screening Test DDT. See Dichlorodiphenyltrichloroethane Decision-making, knowledge about and interest in, 10 Decision pathways balancing benefits and risks associated with seafood consumption, 9, 11, 212 for consumer guidance, example of, 254 for seafood meal analysis, example of, 255 Decision support for consumers, communications to support informed decision-making, 251–258 Decision trees, 211 Denmark, 74–76, 91, 235 Denver Developmental Screening Test (DDST), 82–83, 127 Department of Agriculture (USDA), 18–19, 33, 153, 207, 228, 269 Department of Commerce, 26, 30 Department of Health and Human Services (DHHS), 7, 18–19, 21, 178 Depression, research recommendations on, 14, 108 Depression Era, 31 Designing communications to support informed decision-making, 250–271 collaborative approaches, 269–270 decision support for consumers, 251–258 embedding consumer advice within a larger consumer information program, 270–271 interactive health communication, 250–251 need for pretest and post hoc evaluation, 270 presenting quantitative benefit-risk information, 258–269 research recommendations on, 15 Detoxification mechanisms, 152 Development in infants and children, 77–84 associated with prenatal omega-3 fatty acid intake, 77–84 cognitive, 79–83 and infant and child allergies, 83–84 in infants of mothers who increase seafood and/or omega-3 fatty acid intake, 338–377 and sleep patterns, 83 visual acuity and sensory-motor development, 78–79

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Seafood Choices: Balancing Benefits and Risks Developmental Test of Visual-Motor Integration, 126 DGA. See Dietary Guidelines for Americans DGAC. See Dietary Guidelines Advisory Committee Report DHA. See Docosahexaenoic acid DHHS. See Department of Health and Human Services Diabetes, 174 Diabetes studies, 618–625 cross-sectional studies, 624–625 randomized controlled trials, 618–623 Diarrhetic Shellfish Poisoning (DSP), 170 Dichlorodiphenyl dichloroethane (DDE), 150 Dichlorodiphenyltrichloroethane (DDT), 22, 174 Diet, Nutrition and the Prevention of Chronic Diseases, 26 Diet and Angina Randomized Trial (DART), 100 Dietary guidance, 10 for the general population, 7, 107 receiving new, 218 Dietary Guidelines Advisory Committee (DGAC) Report, 19, 49, 201 recommendations from, 18 Dietary Guidelines for Americans (DGA), recommendations from, 19, 68, 70 Dietary practices, and vulnerable populations, 689 Dietary Reference Intakes (DRIs), 21, 69 Dietary Supplement Health and Education Act (DSHEA), 175 Dietary supplements. See also Fish oil supplementation as sources of EPA and DHA, 54–55 Dietitians of Canada, 20 Dioxins and dioxin-like compounds (DLCs), 21–22, 25, 58, 121, 139–141, 174, 203, 251, 282 adverse health effects, 141 bioaccumulation in seafood, 141 classified as “carcinogenic,” 141 exposure limits in foods, 146 exposures from seafood, 146–147, 199 impact on selenium status, 58 recent declines in, 140 “Dirty dozen” (of POPs in United Nations Environment Programme), 139–140 Disability adjusted life years (DALY), 196, 260 Distribution of seafood consumed, by place it was consumed, 38 DLCs. See Dioxins and dioxin-like compounds Docosahexaenoic acid (DHA), 18, 20–22, 26, 30, 45, 48–55, 67–80, 83–108, 134–135, 290. See also EPA/DHA dietary intake of, 50–51 food sources of, 53 supplementation with, 86 Docosapentaenoic acid (DPA), 72, 75, 135 Doctor diagnoses, 72. See also Health care providers Dopamine, 89 Dose-effect relationship curve, 143 Dose-response relationships, 95, 129, 282 between chemical contaminants and adverse health effects, research recommendations on, 14, 179 studies of EPA/DHA in pregnant and lactating women, research recommendations on, 13, 107 DPA. See Docosapentaenoic acid Draft Reassessment, 146 DRIs. See Dietary Reference Intakes DSHEA. See Dietary Supplement Health and Education Act DSP. See Diarrhetic Shellfish Poisoning Duration of gestation and birth weight, 73–77 associated with prenatal omega-3 fatty acid intake, 73–77 and EPA/DHA intake from seafood and other food sources, 75–77 and fish oil supplementation, 74–75 Dutch studies. See The Netherlands Dyslexia, 89 Dyslipidemia, 99 E EAR. See Estimated Average Requirement Ecological studies on allergy and asthma effects in children supplemented with omega-3 fatty acids in foods, 482–485 on secondary prevention, with cardiovascular outcomes, 558–559 on stroke, 580–581

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Seafood Choices: Balancing Benefits and Risks Economic considerations, associated with food choice behavior, 219, 221 Edinburgh Postpartum Depression Scale (EPDS), 72 EFSA. See European Food Safety Authority Eggs, nutrients in, 46–47, 52 eHealth, 225 Eicosapentaenoic acid (EPA), 18, 20–22, 26, 30, 45, 48–55, 67–80, 84, 87–108, 290. See also EPA/DHA dietary intake of, 50–51 food sources of, 52 Electrodiagnostic studies, 133 Electronegativities, 292 Ends objectives networks, developing, 196 Environmental chemical risks associated with seafood consumption, 121–151 arsenic, 138 cadmium, 138 chromium, 138 lead, 138 levels of POPs in seafood, 149–150 manganese, 138 methylmercury, 122–138 persistent organic pollutants, 138–150 Environmental influences, on food consumption decisions, 219 EPA. See Eicosapentaenoic acid; US Environmental Protection Agency EPA/DHA, 45–55, 195, 202–203, 252, 260, 265, 267–268 consumption of high compared to low EPA/DHA content seafood, 49–54, 238–239 intake from seafood and other food sources, and duration of gestation and birth weight, 75–77 non-animal sources of omega-3 fatty acids, 52–54 qualified health claims labeling, 222–223 sources of, 48–49, 199 EPA/DHA supplementation adverse effects associated with, 174 content of, 55–57 dietary, 54–55 research recommendations on the potential effect on various conditions, 14, 108 EPDS. See Edinburgh Postpartum Depression Scale EPIC. See European Prospective Investigation into Cancer and Nutrition Epidemiological studies, 282 assessing intake of specific species of seafood, research recommendations on, 14, 108 Faroe Islands Study, 126–127 on methylmercury, 126–127 New Zealand Study, 127 Seychelles Child Development Study, 126 Erythrocytes, 75, 282 Essentiality, of selenium, 292–293 Estimated Average Requirement (EAR), 69 Estimation of EPA/DHA in seafood portions, 261–264, 267–268 of methylmercury in seafood portions, 262–264, 267–268 of total cases for different foodborne bacterial illnesses based on actual reported cases, 158 European Food Safety Authority (EFSA), 25 advice on seafood consumption, 25 European Prospective Investigation into Cancer and Nutrition (EPIC), 100 Evidence-based recommendations, 11–12, 104, 240 Expenditure elasticity, 219 Experts distrusting, 252 identifying target populations, 251–252 F Factor VII activity, 102 Factor VIII activity, 102–103 Family Seafood Selection Scenario, 239, 686 FAO. See Food and Agriculture Organization Farmed fish. See Aquaculture Faroe Islands Study epidemiological study on methylmercury, 75–76, 125–128, 132–133, 136–137, 153 Fast-food restaurants, seafood consumption in, 36, 224

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Seafood Choices: Balancing Benefits and Risks Fatty acids. See also Highly unsaturated fatty acid; Long-chain polyunsaturated fatty acids; Omega-3 fatty acids; Saturated fats; individual fatty acids dietary intake of, 50–51 FDA. See Food and Drug Administration FDCA. See Food, Drug, and Cosmetic Act Federal advisories about seafood consumption, 21–23 committees on, 266 impact of, 232–234 Federal Register, 224 Fetal development, 77 benefits of seafood consumption for, 25 retardation in, 73–74 FFQ. See Food Frequency Questionnaire Fibrinogen, 102, 283 Findings on balancing benefits and risks of seafood consumption, 213–214 on benefits associated with nutrients from seafood, 4–5 on benefits for prevention of adult chronic disease, 106–107 on benefits to women, infants, and young children associated with omega-3 fatty acids, 89–90 on consumption patterns and composition of seafood, 3–4, 59–60 on health risks associated with seafood consumption, 6, 176–178 on understanding consumer decision-making as the basis for the design of consumer guidance, 11, 239–240 Finland, 134, 235 First Nations populations, 133, 283 current seafood intake by, 40–41 Fish, 17. See also Aquaculture carnivorous, 43 conservation and sustainability, 689–690 fatty, 21 feed from, 149, 203 freshwater, 17, 133–134, 166 locally caught, 22 nutrients in, 46–47 as traditional foods, 40 types consumed in the US, 48 types high and low in EPA/DHA, 49, 290 types high in methylmercury, 22 wild-caught, 149, 213 Fish advisories. See Advisories and warnings about seafood consumption Fish-oil supplementation, 4–5, 54–55, 67, 70, 71, 79, 83, 100, 101–102, 175, 258 contents of, 142 and duration of gestation and birth weight, 74–75, 77, 89 Fishery Management Councils (8 regional), 43 Flaxseed oil, 21, 46, 53, 150 feeding to hens, 52 Florida, 168 a “core state” for management plan to reduce Vibrio vulnificus illness, 159, 162 Fluorinated compounds, potential hazards from, 139 Focus groups, 250 Food, Drug, and Cosmetic Act (FDCA), 223 Food allergies, foods most commonly implicated in, 173 Food and Agriculture Organization (FAO) (United Nations), 21 Food and Drug Administration (FDA), 7, 21, 54, 146, 149, 167, 178, 199, 207 focus groups, 250 guidelines for voluntary point-of-purchase nutrition information program, 222 recommended controls to reduce or eliminate potential parasite hazards from seafood, 168, 174 and US EPA safety levels in regulations and guidance, 680–682 Food choice behavior, 10, 218–230 understanding consumer decision-making as the basis for the design of consumer guidance on, 218–230 Food consumption decisions, 218–219 economic considerations associated with food choice behavior, 219, 221 environmental influences, 219 identification of factors influencing, 218–219 impact of, 221 individual influences, 218

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Seafood Choices: Balancing Benefits and Risks risks associated with seafood consumption, 122–138, 152 in seafood, 55–57, 260 summary of evidence, 137–138 warnings of potential danger from, 18, 45 MFFT. See Matching familiar figures test MI. See Myocardial infarction Microalgae, 21 Microbiological hazards, 153–168 estimating frequency of seafoodborne illnesses, 154–155 reducing risk of seafoodborne illness, 155, 159–168 risks associated with, 153–168 Mini-Mental Status Examination, 133 Mollusks, 17, 154–155, 165, 176, 285 Monitoring of methylmercury and POPs. See also Biomonitoring by federal agencies, recommendations for increasing, 7, 178 Monte Carlo analysis, 137, 286 Mortality, all-cause, 93 Mothers. See Women MPCOMP. See Mental Processing Composite Multiethnic Cohort (MEC) Study, current seafood intake by, 38–39 Multipliers, 154, 286 Myocardial infarction (MI), 93, 100, 134, 138, 286 MyPyramid food guidance system, 19, 286 recommendations from, 19 N National Academies, 27, 135 National associations, 269 National Fish Meal and Oil Association, 175 National Food and Nutrient Analysis Program, 207 National Food Consumption Survey, 219 National Health and Nutrition Examination Survey (NHANES), 27, 33, 36, 49, 57, 123–124 National Institutes of Health (NIH), 207, 249 National Listing of Fish Advisories database, 22 National Marine Fisheries Service (NMFS), 26, 30–33, 43 disappearance data by seafood type, 32 Science Board, 26 National Oceanic and Atmospheric Administration (NOAA), 7, 26–27, 178 National Report of Human Exposure to Environmental Chemicals, 144 National Research Council (NRC), 128, 135, 140 National School Lunch Program, 19 National Shellfish Sanitation Program, 162 National Uniformity for Food Act, 223 Native American populations. See also Indigenous peoples current seafood intake by, 40–41 Native Hawaiians, in the MEC Study, 38–39 Naturally occurring toxins, 168–171 ciguatera and scombroid, 168–170 risks associated with, 168–171 shellfish toxins, 170–171 Navigator, 259 NCP. See Northern Contaminants Program The Netherlands, 72, 143 Neurodevelopmental effects, as children mature, 137, 143, 197 Neurological outcomes mechanisms of methylmercury impact on, 689 studies on, 104, 129, 658–669 Neurological toxicity of methylmercury, 124–133, 689 nutritional factors moderating, 137 Neurotoxic Shellfish Poisoning (NSP), 170 Neurotoxins, 55 Neurotransmitters, 89 New Jersey, 138 New Zealand Study, epidemiological study on methylmercury, 125, 127, 129, 136–137 Newark Bay Complex anglers, 41–42 NGOs. See Nongovernmental organizations NHANES. See National Health and Nutrition Examination Survey NIH. See National Institutes of Health NLV. See “Norwalk-like” viruses NMFS. See National Marine Fisheries Service

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Seafood Choices: Balancing Benefits and Risks No observed adverse effect level (NOAEL), 128, 148 NOAA. See National Oceanic and Atmospheric Administration NOAEL. See No observed adverse effect level Non-animal sources of omega-3 fatty acids, 52–54 Nongovernmental organizations (NGOs), 217 Norovirus, 155, 286 Northern Contaminants Program (NCP), and the current information environment influencing seafood choices, 228–230 Northern Dwellers, 40–41, 229, 286 Northern Finland Birth Cohort, 72 “Norwalk-like” viruses (NLV), 165 Norway, 74, 79 Novelty preference, 87 NRC. See National Research Council NSP. See Neurotoxic Shellfish Poisoning Numerical information, presenting graphically, 259 Nunavik, 76, 101, 286 Nurses’ Health Study, 97, 103, 286 Nutrient benefits from seafood, 689 Nutrient profiles of seafood compared to other foods in the diet, 45–55 beef, 46–47 eggs, 46–47 fish, 46–47 pork, 46–47 poultry, 46–47 sausages and luncheon meats, 46–47 Nutrient relationships in seafood dietary practices and vulnerable populations, 689 mechanisms of methylmercury impact on neurological outcomes, 689 nutrient benefits from seafood, 689 seafood as a dietary component, 688 seafood conservation and sustainability, 689–690 selections to balance benefits and risks, 687–690 Nutrition Business International, 54 Nutrition Facts panel, 222 O OA. See Oleic acid Observational studies, 104, 286 of blood pressure, 100–101 of seafood or EPA/DHA intake in the general population, 94–96 Oceans Alive, 225 OCs. See Organochlorine compounds Odds ratio (OR), 95, 134, 286 Oleic acid (OA), 78 Omega-3 fatty acids (n-3 fatty acids), 26, 30, 45, 67, 287, 289–290 AHA intake recommendations, 20 and coronary heart disease, 92–96 derivation of, 290 observational studies of seafood or EPA/DHA intake in the general population, 94–96 randomized controlled trials in high risk populations, 92–94 sources of, 199 WHO intake recommendations, 150 Omega-6 fatty acids (n-6 fatty acids), 26, 287 Online consumer information and advocacy sites which include mercury calculators, 226–229, 250 Online seafood information and advocacy, 225, 228 Open session agendas, 687–690 Open trials, on postpartum depression effects in women who increase seafood and/or omega-3 fatty acid intake, 312–313 Optimal intake levels for EPA and DHA, 69–70 better defining, 14, 108 Optimistic Bias, describing health behavior, food choice, and behavior change, 684 OR. See Odds ratio Organic mercury. See Methylmercury (MeHg) Organochlorine compounds (OCs), 58 Orkney Islands, 75 Oxford Centre for Evidence-based Medicine, 104–105 Oxidative stress, modulation of, 58

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Seafood Choices: Balancing Benefits and Risks P PAHs. See Polyaromatic hydrocarbons Paralytic Shellfish Poisoning (PSP), 170 Parasites and products involved in documented incidences of parasitic infection, 166 reducing risk of seafoodborne illness from, 166–168 Paratyphoid, 164 Partnerships, between federal agencies and community organizations and individual health care providers, recommendations for developing, 12–13, 271–272 PBDEs. See Polybrominated diphenyl ethers PCBs. See Polychlorinated biphenyls PCDDs. See Polychlorinated di-benzo-p-dioxins PCDFs. See Polychlorinated di-benzofurans PDI. See Psychomotor Developmental Index PEN-3, describing health behavior, food choice, and behavior change, 684 People’s League of Health, 74 Persistent organic pollutants (POPs), 121, 138–150, 251, 287 body burdens of POPs, 150–151 dioxins and dioxin-like compounds, 139–141 polybrominated diphenyl ethers, 147–148 polychlorinated biphenyls, 142–145 risks associated with seafood consumption, 138–150 in seafood, 57–58, 149–150 Stockholm agreement (2003), 139 toxicity and recommended intake limits for dioxins, DLCs, and PCBs, 145–147 Phospholipid (PL)-associated fatty acid, 72, 101 PHP. See Post-harvest processing “Pink Book,” 249 PL. See Phospholipid Plasma lipids, 98, 287 Platelets, 287 aggregations of, 103 Point estimates, 130 Point-of-purchase nutrition information, 10, 271 FDA guidelines for voluntary program of, 222, 224 Polyaromatic hydrocarbons (PAHs), 174 Polybrominated diphenyl ethers (PBDEs), 58, 147–148 adverse health effects, 148 bioaccumulation of, 147–148 Polychlorinated biphenyls (PCBs), 21–22, 25, 58, 76, 121–122, 142–145, 174, 199–200, 251 adverse health effects of, 143–145 bioaccumulation of, 142–143, 230 dioxin-like, 58 exposures to, 144 impact on selenium status, 58–59 Polychlorinated di-benzo-p-dioxins (PCDDs), 58 Polychlorinated di-benzofurans (PCDFs), 58 POPs. See Persistent organic pollutants Population subgroups balancing benefits and risks, 8 current seafood intake by, 37–42 Pork, nutrients in, 46–47 Portions. See also Seafood portions number needed to consume 100 mg EPA/DHA in animal protein foods, 202 Post-harvest processing, procedures, 160–161 Post hoc evaluation, need for, 270, 287 Postnatal supplementation through formula, benefits to infants from, 84–89 Postpartum depression and benefits to women during and after pregnancy, 71–72 in women who increase seafood and/or omega-3 fatty acid intake, 312–321 Postpartum depression studies, 312–321 cohort studies, 314–319 cross-sectional studies, 320–321 open trials, 312–313 randomized controlled trials, 312–313 review studies, 312–313 Poultry, nutrients in, 46–47 Precentral gyrus, 287 Preeclampsia, 288 and benefits to women during and after pregnancy, 71 effects in women who increase seafood and/or omega-3 fatty acid intake, 71, 298–311 Preeclampsia studies, 298–311 case-control studies, 306–311 cohort studies, 304–305

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Seafood Choices: Balancing Benefits and Risks randomized controlled trials, 298–303 review studies, 298–299 Pregnant women or women who may become pregnant, 10, 22, 45, 164, 238–239 benefits to, 71–73 case scenario, 683 recommendations for, 7, 107 research recommendations for, 13 Prenatal omega-3 fatty acid intake, benefits to infants and children associated with, 73–84 Presentation, of quantitative benefit-risk information, 258–269 Preterm delivery, 74 Pretest evaluation, need for, 270 Prevention of adult chronic disease, recommendations concerning seafood benefits for, 107 Previous seafood consumption guidance, 232–238 impact of federal fish advisories, 232–234 impact of state fish advisories, 234 labeling effectiveness and effects of health claims, 234–238 research on qualified health claims as applied to functional foods, 235–238 Previously cooked food, 164 Problem-solving, 87 Program evaluation, 249–250, 259 Project Viva, 80–81 Promotions, and the current information environment influencing seafood choices, 225 Proposition 65 (California), 223–224 challenge to, 223 Prospective cohort studies, 288. See also European Prospective Investigation into Cancer and Nutrition Protein sources, 198 Provisional Tolerable Weekly Intake, 148, 288 PSP. See Paralytic Shellfish Poisoning Psychobiological factors, 219 Psychomotor Developmental Index (PDI), 85–86 Public Health Service Act, 269, 288 Public Media Center, 224 Q QALYs. See Quality Adjusted Life Years Qualified health claims as applied to functional foods, research on, 235–238 labeling, 222–223 Quality Adjusted Life Years (QALYs), 196, 233, 260 Quantitative characterization of dose-response relationships, research recommendations on, 15, 179 risk information, 249 R Randomized clinical trials (RCTs), 84 Randomized controlled trials (RCTs), 71, 100, 104, 221 on ADHD effects in children supplemented with omega-3 fatty acids, 462–471 on allergy and asthma effects in children supplemented with omega-3 fatty acids, 474–475 on allergy effects in infants and children of mothers who increase seafood and/or omega-3 fatty acid intake, 378–385, 394–411 on allergy effects in infants supplemented with omega-3 fatty acids in formula, 460–461 on arrhythmia, 612–613 on blood pressure, 100, 604–609 on cancer, 628–629 on cardiac indicators, 616–617 on cognitive and motor development effects in infants supplemented with omega-3 fatty acids in formula, 424–447 on development effects in infants of mothers who increase seafood and/or omega-3 fatty acid intake, 338–347 on diabetes, 618–623 on gestation and birth weight effects in infants of mothers who increase seafood and/or omega-3 fatty acid intake, 322–329 in high risk populations, 92–94

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Seafood Choices: Balancing Benefits and Risks on lipid profiles, 582–599 on postpartum depression effects in women who increase seafood and/or omega-3 fatty acid intake, 312–313 on preeclampsia effects in women who increase seafood and/or omega-3 fatty acid intake, 71, 298–303 on secondary prevention, with cardiovascular outcomes, 500–515 Raw seafood, 162, 167–168, 176 RCTs. See Randomized clinical trials; Randomized controlled trials RDA. See Recommended Dietary Allowance Ready-to-eat (RTE) food, 164 Recalls. See 24-hour recalls of dietary intake Recommendations. See also Research recommendations on balancing benefits and risks, 7 better tools for consumers to be developed by federal agencies, 11–12, 240 for consistently revising analytical data, 7, 178 on consolidated advice needed to bring benefit and risk considerations together, 12, 240–241 for consumer-based benefit-risk analyses, 12, 240 for a consumer-directed decision path, tailored to individual circumstances, 12, 240 on developing an interagency task force to coordinate seafood issues, 12, 271 on developing partnerships between federal agencies and community organizations and individual health care providers, 12–13, 271–272 evidence-based, 11–12, 240 for health risk appraisals, 11–12, 240 on health risks associated with seafood consumption, 178 on inconsistencies in sampling and analysis methodology, 7, 178 on increasing monitoring of methylmercury and POPs by federal agencies, 7, 178 for pregnant females or females who may become pregnant, 7, 107 on seafood benefits for prevention of adult chronic disease, 107 on servings, 42 for supporting consumer seafood consumption decisions, 11–13 for testing consumer messages to identify spillover effects for non-targeted population segments, 12, 241 on understanding consumer decision-making as the basis for the design of consumer guidance, 240–241 on using the decision pathway to develop consumer guidance tools regarding nutritional benefits, 12, 271 Recommendations for seafood and EPA/DHA consumption, 18–21, 678–679 American Dietetic Association, 20–21 American Heart Association Dietary Guidelines, 19–20 consumption advice, on staying within applicable advisories, 7, 107 dietary advice to the general population, 7, 107 Dietary Guidelines Advisory Committee, 18 Dietary Guidelines for Americans, 19, 68, 70 MyPyramid food guidance system, 19 seafood as a component of a healthy diet, 7, 107 Recommended Dietary Allowance (RDA), 69, 222 Recreational fishery, 44, 170 “Red-amber-green” traffic light labeling, 259 Reference Dose (RfD), 128, 135–137, 146, 199, 235, 250, 288 Reference levels, for fetal exposure to methylmercury, 128 Regression coefficient, 130, 288 Regulated point-of-purchase information, 224 Relative rates, of laboratory-confirmed cases of Yersina, Escherichia coli, Campylobacter, and Salmonella, 159 Relative risk (RR), 95, 288

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Seafood Choices: Balancing Benefits and Risks Research recommendations, 13–15 for additional data needed to assess benefits and risks of consumption for population subgroups, 13, 60 for adults at risk for chronic disease, 14 on Alzheimer’s disease, 14, 108 on better defining optimum intake levels of EPA/DHA for infants and toddlers, 14, 108 on better designing studies about EPA/DHA supplementation in children with behavioral disorders, 14, 108 on biomarkers of contaminant exposures, 15, 179 on cancer, 14, 108 for children, 14 on cognitive and developmental outcomes in infants, 13–14, 107–108 on comparing outcomes for US women consuming EPA/DHA and those in other countries, 13, 107 on consumption patterns and composition of seafood, 60 on data needed on distribution of contaminant levels among types of fish, 14, 178–179 on depression, 14, 108 on designing better consumer advice, with understanding of consumer decision-making, 15, 241 on developing more effective communication tools for information about seafood consumption, 15, 241 on dose-response relationships between chemical contaminants and adverse health effects, 14, 179 for dose-response studies of EPA/DHA in pregnant and lactating women, 13, 107 for epidemiological studies assessing intake of specific species of seafood, 14, 108 on the health effects of contaminants like methylmercury, 14, 108 on health risks associated with seafood consumption, 14–15, 178–179 for infants and toddlers, 13–14 on meta-analyses needed to assess outcomes other than cardiovascular, 14, 108 on obtaining larger analytic samples of the most common seafood types, 13, 60 on the potential effect of seafood consumption and/or EPA/DHA supplementation on various conditions, 14, 108 for pregnant and lactating women, 13 on quantitative characterization of dose-response relationships, 15, 179 on seafood benefits for prevention of adult chronic disease, 107–108 on seafood consumption, 13 on stroke, 14, 108 on systematic surveillance studies of targeted subpopulations, 13, 60 on understanding consumer decision-making as the basis for the design of consumer guidance, 241 Restaurant information, 224 Review studies on ADHD effects in children supplemented with omega-3 fatty acids in foods, 462–463 on allergy and asthma effects in children supplemented with omega-3 fatty acids in foods, 476–479 on allergy effects in infants and children of mothers who increase seafood and/or omega-3 fatty acid intake, 388–389, 410–411 on allergy effects in infants supplemented with omega-3 fatty acids in formula, 458–459 on arrhythmia, 612–613 on cancer, 628–631, 656–657 on cognitive and motor development effects in infants supplemented with omega-3 fatty acids in formula, 420–423, 448–449 on development effects in infants of mothers who increase seafood and/or omega-3 fatty acid intake, 338–339, 346–349 on postpartum depression effects in women who increase seafood and/or omega-3 fatty acid intake, 312–313 on preeclampsia effects in women who increase seafood and/or omega-3 fatty acid intake, 71, 298–299

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Seafood Choices: Balancing Benefits and Risks on secondary prevention, with cardiovascular outcomes, 498–499, 520–521 on stroke, 580–581 RfD. See Reference Dose Rice oil, contaminated, 144 Risk of seafoodborne illness acute, 5–6, 153–176 adverse effects associated with omega-3 supplementation, 174–175 assessing, 288 and chemotherapeutants, 171–174 from Clostridium botulinum, 165 from Listeria monocytogenes, 164–165 from microbiological hazards, 153–168 from naturally occurring toxins, 168–171 from parasites, 166–168 reducing, 155, 159–168 “risk-relationship” analysis, 197–198 “risk-risk” analysis, 197 “risk-trade-off” analysis, 197 from Salmonella, 164 from seafood allergens, 172–174 summary of evidence, 175–176 from Vibrio-associated illness, 155, 159–162 from viruses, 165 Risk Specific Dose (RsD), 146 Ross Laboratories, 87 RR. See Relative risk RsD. See Risk Specific Dose RTE. See Ready-to-eat food S S-adenosylmethionine (SAM), 153 SACN. See Scientific Advisory Committee on Nutrition (UK) Safe Eating Guidelines (state), 22, 24 Salmonella spp., 288 reducing risk of seafoodborne illness from, 164 SAM. See S-adenosylmethionine Saturated fats, 288 content in commonly consumed animal food products, 69 Sausages, nutrients in, 46–47 SCDS. See Seychelles Child Development Study Schizochytrium sp., 54 SCID-CV. See Statistical Manual of Mental Disorders, Fourth Edition, Axis I Disorders—Clinical Version Scientific Advisory Committee on Nutrition (SACN), advice on seafood consumption, 24 Scientific benefit-risk analysis for seafood consumption, 198–213 acknowledging limitations of the benefit-risk analysis, 211–213 balancing the benefits and risks to arrive at specific guidance for healthy consumption, 207–211 evaluating changes in benefits and risks associated with changes in consumption patterns, 200–207 identifying and determining the magnitude of the benefits and risks, 198–200 identifying important benefits and risks in the balancing process, 200 Scombroid poisoning, 168–170, 288 Scotland, 75 Seafood allergens misidentifications of, 173 risks associated with, 172–174 Seafood consumption, 30–42, 688. See also Fish advice from outside the US, 24–26 contaminants of concern in, 55–59 and coronary heart disease, 92–96 current intake by population subgroups, 37–42 current intake by the general population, 34–37 current safety hazards, controls, and risks, 156–157 daily totals, 36–37 EPA and DHA, 45–55 estimates by EPA/DHA content classification, 50 in fast-food restaurants, 36, 224 future seafood supplies, 42–45 general trends and predictions for supply and sources of popular fish, 44 health risks associated with, 121–194 with high versus low EPA/DHA content, 49–54 individualizing messages about for different groups, 10

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Seafood Choices: Balancing Benefits and Risks major types of seafood, 31–34 nutrient profiles of seafood compared to other foods in the diet, 45–55 recommendations on, 18–21 regional differences in, 33 research recommendations on, 13–14, 60, 108 selecting a variety of, 22, 138 staying within applicable advisories, 7, 107 trends over time, 30–31 in the US, 3–4 Seafood meal analysis, example of decision pathways for, 255 Seafood portions EPA/DHA in, estimating, 261–264, 267–268 methylmercury in, estimating, 262–264, 267–268 number needed to consume 100 mg EPA/DHA in animal protein foods, 202 Seafoodborne illnesses estimating frequency of, 154–155 reducing risk of, 155, 159–168 traced to molluscan shellfish, 158 Second World War, 31 Secondary prevention studies with cardiovascular outcomes, 494–559 case-control studies, 550–557 Cochrane reviews, 496–497 cohort studies, 522–549 ecological studies, 558–559 meta-analysis, 494–495, 498–499, 516–519 randomized controlled trials, 500–515 review studies, 498–499, 520–521 Selenide, 153, 293 Selenium, 45, 152, 202, 290–294 deprivation of, 59, 292 essentiality of, 292–293 food sources of, 293–294 methylation of, 294 plants accumulating, 294 and seafood contaminants, health risks associated with, 152–153 toxicity of, 294 Selenoproteins, 58 and biological functions, 293–294 Selenosis, 294 Self-rating questionnaire, 72 Serotonin, 89 Serving size. See also Seafood portions recommendations on, 42, 240 Seychelles Child Development Study (SCDS), epidemiological study on methylmercury, 125–126, 128, 136–138, 153 Shellfish, 17, 288. See also Mollusks Shellfish toxins, 170–171 Silver, risks associated with seafood consumption, 152 Sleep patterns, and development in infants and children, 83 Slogans, role of, 248 Sources of EPA and DHA, 48–49 of protein, 198 Soy oil, 21, 150 Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), 19, 269 Spillover effects, for non-targeted population segments, recommendations for testing consumer messages to identify, 12, 232, 241 Sport and subsistence fishers, current seafood intake by, 41–42 State advisories about seafood consumption, 22, 24, 269 about Vibrio vulnificus, 159 impact of, 234 Stereoacuity, 79 Stroke, 96–98 hemorrhagic, 97 ischemic, incidence of, 96 research recommendations on, 14, 108 Stroke studies, 560–583 case-control studies, 578–579 Cochrane reviews, 560–561 cohort studies, 562–577 ecological studies, 580–581 meta-analysis, 560–561 review studies, 580–581 Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Axis I Disorders–Clinical Version (SCID-CV), 72 Studies on adult chronic diseases, data tables, 494–677 on women, infants, and children, data tables, 298–493

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Seafood Choices: Balancing Benefits and Risks Subsistence fishers, 10, 219 current seafood intake by, 41–42 Substitution analysis, 207, 253 with graphical presentation of information, 257 impact on selected contaminants of changes in consumption patterns, 202–203 impact on selected nutrients of changes in consumption patterns, 201–202 with tabular presentation of information, 256 Succinic dehydrogenase, 294 Sulfiting agents, exposure to, 173 Supplementary information on nutrients of special interest in seafood, 289–295 omega-3 fatty acids, 289–290 selenium, 290–294 Supplements. See Dietary supplements; Fish-oil supplementation Surveillance studies, of targeted subpopulations, research recommendations on systematic, 13, 60 Sustainability, of seafood, 689–690 Sweden, 133, 139, 147 Symptoms of seafoodborne illness, early onset of, 154 of selenium deficiency, 292 Synergism, 143 T Tabular presentation of information, substitute question approach with, 256 TACs. See Teller Acuity Cards Taiwan, PCB poisoning in, 144 Target populations, 10–11, 238, 250, 266 expert identification of, 251–252 Taste, 219 TCDD. See 2,3,7,8-Tetrachlorodibenzo-p-dioxin TDI. See Tolerable Daily Intake Technical jargon, used by experts, 252 TEFs. See Toxicity Equivalency Factors Teller Acuity Cards (TACs), 79, 85 TEQ. See Toxicity Equivalency Test of Oral Language Development, 127 2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD), 58, 140–141, 145–146 Texas, a “core state” for management plan to reduce Vibrio vulnificus illness, 159, 162 TG. See Triglycerides Theoretical models describing health behavior, food choice, and behavior change, 684 Health Belief Model, 684 Life Course Perspective, 684 Optimistic Bias, 684 PEN-3, 684 Transtheoretical Model, 684 Thermal abuse, 169–170, 289 Third National Report on Human Exposure to Environmental Chemicals, 124 Thresholds, 143 Toddlers’ research recommendations, 13–14, 67, 265 Tolerable Daily Intake (TDI), 146, 206 Tools for consumers, to be developed by federal agencies, recommendations for improving, 11–12, 240 Total Diet Study, 146 analyses of dioxin-like compounds in seafood, 59 Total seafood, percentage of persons using food, and quantities consumed in a day, 36–37 Toxic Substance Control Act (TSCA), 142 Toxicity, 289 DLC exposure limits in foods, 146 DLC exposures from seafood, 146–147 neurological, of methylmercury, 124–133 and recommended intake limits for dioxins, DLCs, and PCBs, 145–147 of selenium, 294 Toxicity Equivalency Factors (TEFs), 140, 145, 289 values from WHO, 145 Toxicity Equivalency (TEQ), 145 Toxins, 289. See also Neurotoxins naturally occurring, 168–171 in shellfish, 170–171 Trade-offs, 197, 231, 238 Traditional foods, 40–41, 231 Transfers, of maternal DNA to the fetus or breastfeeding infant, associated with prenatal omega-3 fatty acid intake, 73

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Seafood Choices: Balancing Benefits and Risks Transplacental gradient, 78 Transtheoretical Model, describing health behavior, food choice, and behavior change, 684 Trends in future seafood supplies, 43–45 in seafood consumption, 30–31 Triacylglycerol concentrations, 94 Triglycerides (TG), 98, 289 TSCA. See Toxic Substance Control Act Tumor promoters, 141 Tuna, light vs. white, 34–35, 203, 266 24-hour recalls of dietary intake, 33, 280 U Uncertainty factor (UF), 211, 213, 289 in substitution analysis, and changes in consumption patterns, 203, 207 UNEP. See United Nations Environmental Programme United Nations Environmental Programme (UNEP), 122, 139 US Environmental Protection Agency (USEPA), 7, 21–23, 122, 135–137, 140–141, 144, 146, 178, 199 national fishing advisories from, 22–23, 232–233 USDA. See Department of Agriculture USEPA. See US Environmental Protection Agency V Value trade-offs, 10, 289 Variety of seafood, selecting for consumption, 22, 138 Vegetarians, 21 VEP. See Visual evoked potential Vibrio parahaemolyticus, 155, 162 Vibrio vulnificus, 154–155, 289 cases of illness involving commercial oyster products, 160 reducing risk of seafoodborne illness from, 155, 159–162 state reports for, 159 Vibrio vulnificus Management Plan, table of compliance for core states, 161 Viruses, reducing risk of seafoodborne illness from, 165 Visual acuity, 79 and benefits to infants from postnatal supplementation through formula, 85 and sensory-motor development, 78–79 Visual evoked potential (VEP) acuity procedure, 85 Visual information, superiority over text or numbers, 258 Visual recognition memory (VRM), 82 W Walnut oil, 21, 45–46, 53, 150 Warnings. See Advisories and warnings about seafood consumption Waters, known to contain contaminants, 37 Web-based health information, 22, 30, 225–229, 249, 253 and the current information environment influencing seafood choices, 225–229 interactive health communication, 225 online seafood information and advocacy, 225, 228 Wechsler Intelligence Scale for Children, 126–127 Whites, in the MEC Study, 38–39 WHO. See World Health Organization WIC. See Special Supplemental Nutrition Program for Women, Infants, and Children Wild-caught fish, 149, 213 Women of childbearing age, 22 Inuit, 41 postpartum depression, 312–321 preeclampsia, 298–311 who are or may become pregnant or who are breast-feeding, specific guidance for healthy consumption, 8, 207, 209, 265 who increase seafood and/or omega-3 fatty acid intake, 298–321 Women’s studies, 298–493 on allergy effects in infants and children of mothers who increase seafood and/or omega-3 fatty acid intake, 378–387

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Seafood Choices: Balancing Benefits and Risks on development effects in infants of mothers who increase seafood and/or omega-3 fatty acid intake, 338–377 on gestation and birth weight effects in infants of mothers who increase seafood and/or omega-3 fatty acid intake, 322–337 on postpartum depression effects in women who increase seafood and/or omega-3 fatty acid intake, 312–321 on preeclampsia effects in women who increase seafood and/or omega-3 fatty acid intake, 298–311 Woodcock-Johnson Tests of Achievement, 126 Workshop presentations, 27 agendas of, 687–690 World Health Organization (WHO), 125, 140, 145–146 advice on seafood consumption, 21, 26, 128, 150 World War II, 31 Z Zero tolerance policy, 164, 171–172