Good fish/bad fish: A composite benefit-risk by dose curve
Good fish/bad fish: A composite benefit-risk by dose curve
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DOI：
10.1016/j.neuro.2004.12.010
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发表时间：
2005-08-01
期刊：
影响因子：
3.4
通讯作者：
Burger, J
中科院分区：
文献类型：
--
作者：
Gochfeld, M;Burger, J
平衡鱼类消费的风险和益处现在是一个备受关注的公共卫生话题。许多研究确定了吃鱼的健康益处，包括产前发育和成人心血管疾病，部分归因于omega-3（n-3）多不饱和脂肪酸（PUFA）。许多报告对甲基汞和多氯联苯对发育中的胎儿大脑的影响表示关切（尽管成年人也会表现出甲基汞的影响）。大多数报告和论文集中在娱乐或生计鱼类，但绝大多数人获得大部分或所有的鱼从商业来源。我们对新泽西市场上九种最常见的鱼类进行了分析，得出加权平均甲基汞浓度为0.23 ug/g（ppm湿重）。在不同的鱼类品种中，多不饱和脂肪酸和污染物的数量和分布存在很大差异。认识到利益和伤害都必须与剂量有关，我们提出了一个复合剂量反应曲线，目前基于有限的数据，以确定一个区域的利益，高于利益阈值和低于伤害阈值。在母体鱼摄入量约为8-15克/天的效益阈值下，怀孕期和出生体重会得到改善。荟萃分析显示，成人心血管获益约为7.5-22.5 g/天（假设典型膳食为8盎司/227 g），中点也为15 g/天，但这是摄入分层的人为因素。获益渐近线较难提取，但高于45 g/天，在某些研究中超过100 g/天。使用EPA参考剂量0。鱼类摄入量的危害阈值转换为27克/天（对于选择平均甲基汞含量为0.23 ppm的普通商业鱼类），对于选择甲基汞含量低的鱼类的人（0.23 ppm），则为65克/天。1 ppm）。然而，这些是最差情况阈值，因为RfD包括不确定性因素。有些人每天吃超过65克。剂量-获益和剂量-损害曲线的形状需要更好的数据来估计阈值和渐近线，这将影响复合曲线。我们建议这种方法澄清了改善“我应该吃什么”的风险沟通所需的数据类型。食用鱼类的益处受到社会经济阶层和/或避免食用鱼类替代的更有害食物的混淆，这可能是与PUFA含量一样重要的益处机制。需要更好的剂量重建的额外研究，并且需要大规模的干预研究。(c)2005年爱思唯尔公司All rights reserved.
Balancing risks and benefits of fish consumption is now a high visibility public health topic. Many studies identify health benefits of eating fish, both for prenatal development and adult cardiovascular conditions, partly attributed to omega-3 (n-3) polyunsaturated fatty acids or PUFAs). Many reports raise concerns about methylmercury and polychlorinated biphenyl effects on the developing fetal brain (although adults, too, can manifest methylmercury effects). Most reports and advisories focus on recreational or subsistence fish, but the vast majority of people obtain most or all of their fish from commercial sources. Our analysis of the nine most common fish in New Jersey markets, yielded a weighted average methylmercury concentration of 0.23 ug/g (ppm wet weight). There are great disparities in the amount and distribution of both PUFAs and contaminants) in different fish species. Recognizing that both benefits and harm must be related to dose, we propose a compound dose-response curve, currently based on limited data, to identify a zone of benefit, above the benefit threshold and below the harm threshold. The duration of pregnancy and birth weight improve at a benefit threshold of about 8-15 g/day maternal fish intake. Meta-analyses reveal adult cardiovascular benefits around 7.5-22.5 g/day bracket (assuming an 8 ounce/227 g typical meal), yielding a midpoint also at 15 g/day, but this is an artifact of the intake stratification. Benefit asymptotes are harder to extract, but are above 45 g/day, and in some studies exceed 100 g/day. Using the EPA Reference Dose of 0. 1 ug/kg day as a methylmercury threshold, The fish intake threshold for harm converts to 27 g/day (for a selection of common commercial fish averaging 0.23 ppm MeHg) to 65 g/day for someone choosing fish low in MeHg (0. 1 ppm). However, these are worst case thresholds since the RfD includes uncertainty factors. Some people eat much more than 65 g/day. The shape of the dose-benefit and dose-harm curves require better data for estimating thresholds and asymptotes, which will impact the composite curve. We propose this approach clarifies the kinds of data needed to improve risk communication on "what should I eat". Benefits from fish consumption are confounded by socioeconomic class and/or by the avoidance of more harmful foods that fish replaces, which may be as important a benefit mechanism as the PUFA content. Additional studies with better dose- reconstruction are needed and large scale intervention studies are desirable. (c) 2005 Elsevier Inc. All rights reserved.