How can more women of childbearing age be encouraged to follow fish consumption recommendations?

Preferences for seafood consumption advice in pregnant American women

Many women of childbearing age, and pregnant and nursing women in particular, do not consume enough seafood to derive optimal health benefits for themselves and their children. We sought to identify how seafood consumption advice could be designed to encourage pregnant women to eat recommended amounts of seafood. In three focus groups with pregnant or recently pregnant American women, we examined reactions to three aspects of seafood consumption advice. First, we found focus group participants preferred gain-framed statements emphasizing benefits of taking action vs. loss-framed statements emphasizing costs of failing to take action. Many participants indicated the gain-framed statements would encourage them to eat seafood and increase their consumption. Second, we compared responses to a recommendation to eat seafood and a recommendation to eat lower mercury seafood because fear of mercury is a known barrier to seafood consumption by pregnant women. We found no clear preference in our focus groups for either message, suggesting potential value of both messages in communication. Lastly, we examined preferences for systems of categorizing seafood into different consumption categories where the number of categories and the number of species listed in each category varied. We found shorter, dichotomous lists of species to eat and avoid were preferred by some participants for their clarity and ease of use. Longer, more comprehensive lists with additional species and consumption categories (e.g., eat once a week), however, were preferred by many participants because they provided more options and were more likely to be used as a reference. These findings suggest using a layered approach to communication might be helpful by providing short, dichotomous lists of best seafood to eat and seafood to be avoided followed by a link to a longer, more complete list of recommended seafood to be eaten and seafood that should be avoided.

Fish consumption and advisory awareness in the Great Lakes basin

BACKGROUND

Fish is a dietary staple in the United States. Risk of exposure to persistent contaminants through fish consumption is a significant health concern. Great Lakes basin states, along with the US Environmental Protection Agency and the Great Lakes Consortium for Fish Consumption Advisories, have developed and continuously updated fish consumption advisories specifically for the Great Lakes basin residents.

OBJECTIVES

To characterize Great Lakes basin residents' fish consumption and advisory awareness, we conducted a point-in-time survey to describe fish consumption habits and awareness of state and EPA/FDA fish advisories.

METHODS

We used a randomized, address-based sampling approach to recruit respondents from the eight Great Lakes basin states. Weighted survey analysis procedures were used to estimate population prevalence of fish consumption habits, state and EPA/FDA advisory awareness, and demographic and background characteristics. Logistic regression models were used to assess the associations between demographic and background factors and fish consumption and awareness of advisories, respectively.

RESULTS

About 92% of respondents, representing an estimated 61 million adults, reported eating fish in the last 12 months. About 64% of respondents only consumed commercial fish, and an estimated 5 million fish consumers exceeded the EPA/FDA recommended limit for fish meals. Minorities were more likely to exceed the EPA/FDA recommended limit. About half of the respondents were aware of state or EPA/FDA advisories; however, minorities and women were less aware of the EPA/FDA advisory. After adjusting for demographic characteristics, sportfish consumption was significantly associated with state advisory awareness; commercial fish consumption was significantly associated with EPA/FDA awareness.

DISCUSSION

Most respondents only consumed commercial fish, but an estimated 18.6 million adults consumed sportfish. While half of the fish consumers were aware of state or EPA/FDA advisories, minorities and women continue to be less aware of fish advisories. Improved outreach strategies are needed to inform them about safe fish-consumption guidelines.

Promoting Fish Consumption Messages: Perspectives of Hmong Women of Childbearing Age

Objectives: Through focus groups, we aimed to understand ways to promote safe and healthy fish consumption among Hmong women in Minnesota. Methods: English-speaking Hmong women aged 18-40 were eligible to participate in 90-minute focus groups. Through our questions, we sought to gain understanding of the women's health-seeking behaviors and to obtain feedback on current messaging. We recorded the focus groups and transcribed and double-coded the data using sequential directed content analysis. Results: Thirteen Hmong women participated across 3 focus groups. The final coding tree included 6 primary themes related to health messaging, with adequate inter-coder reliability for each. Women identified the Internet as the primary source of health information with website preferences driven in-part by preferences of elders. Discrepancies between health beliefs of elder and younger generations were noted, with some evidence that personal fish consumption preferences outweighed cultural norms. Messages clearly targeting the Hmong population were preferred, with discrepancy in risk-versus benefit-framed messages. Conclusions: Findings highlight the need for culturally informed messages that are clear and carefully tailored. Our findings will inform future development of safe and healthy fish consumption messaging to better support the Hmong community in Minnesota.

A systematic review of the determinants of seafood consumption

Although seafood is considered to be an important part of a balanced diet, many national food consumption surveys suggest that seafood is not consumed in sufficient amounts. As consumers are moving to diversify their diet from animal-based protein, it is important to understand the factors influencing consumption of marine foods. This review aims to assess the characteristics of seafood consumers as well as the influences on seafood consumption in Europe, USA, Canada, Australia and New Zealand. Systematic search strategies were used to identify relevant journal articles from three electronic databases (PubMed, Web of Science and Embase). Three searches were carried out and identified 4405 unique publications from which 121 met the criteria for the review process. The reviewed studies revealed that seafood consumers were more likely to be older, more affluent and more physically active and were less likely to smoke compared with non-seafood consumers. Sex and BMI did not appear to have a directional association with seafood consumption. The most commonly reported barriers to seafood consumption were cost, followed by sensory or physical barriers, health and nutritional beliefs, habits, availability and cooking skills. The most commonly reported influences were beliefs about the contribution of seafood to health, environmental influences and personal preferences. Based on the findings of this review, future intervention strategies to increase seafood consumption may need to consider affordability and education in terms of health, nutrition and cooking skills. More research is needed to explore the effectiveness of specific interventions at increasing the consumption of seafood.

Fish consumption among women anglers of childbearing age in the Great Lakes region

Fish consumption advisories are issued by the federal government for women of childbearing age (WCBA). These advisories make recommendations about the amount and types of fish that should be consumed to provide the greatest health benefits to women and their children while avoiding risks from chemical contaminants. We used diary methods to study fish consumption patterns of 1395 WCBA in the Great Lakes coastal region who purchased fishing licenses, a group which has significant opportunity to eat larger quantities of fish. Very few members of this group reported exceeding the federal recommendations for total fish consumption (between 3% and 5% depending on assumptions about portion sizes), consumption of canned "white" tuna (0%), or consumption of "do not eat" species (4%). They did report eating more fish on average than recent national study estimates, but they did not report consuming as much fish as is recommended to obtain the greatest health benefits of fish consumption. Only 10-12% of study participants reported eating within the recommended range of 8-12oz. of fish per week, with 84-87% eating less than the recommended amount. Additional efforts are likely needed to encourage WCBA to eat more low-risk fish, even among this group of higher-than-average fish consumers.