Evaluating the Risks and the Benefits

SINCE THE PUBLICATION OF PIOneering studies demonstrating low rates of death from coronary heart disease (CHD) among Greenland Eskimos, fish (used herein to refer to finfish or shellfish) has been considered a healthy food. During ensuing years, evidence from several researchparadigms—includinganimal-experimental, observational, and clinical studies—further supported this hypothesis and identified 2 longchain n-3 polyunsaturated fatty acids (n-3 PUFAs), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), as the likely active constituents. DHA also appears important for neurodevelopmentduringgestationand infancy. Conversely, concern has arisen over potential harm from mercury, dioxins, and polychlorinated biphenyls (PCBs) present in some fish species. The public is faced with seemingly conflicting reports on the risks and benefits of fish intake, resulting in controversy and confusion over the role of fish consumption in a healthy diet. To elucidate the relative risks and benefits, we reviewed the scientific evidence for adverse and beneficial health effects of fish consumption.