#619: How Much Fish Should a Healthy Diet Contain?

Yeah, so across most Western countries, the recommendations are largely similar.

So for example, in the UK, the Scientific Advisory Committee on Nutrition, or SACN, recommends eating at least two portions of fish per week.

And a portion serving size is generally something between 120 to 140 grams.

And then there's also a specific recommendation that one of those portions or servings per week be an oily fish.

So are like salmon, sardines, mackerel, etc.

European Food Standards Agency recommendations are generally similar to that.

In America, we also have a broadly similar recommendation.

The Academy of Nutrition and Dietetics recommends about two 120 gram servings of seafood per week.

Again, it also recommends focusing on choices that are rich in omega-3 fatty acids, EPA and DHA.

It also then makes specific recommendations for keeping mercury levels low or eating fish that are not high in mercury.

So those would be fish, for example, like bluefin tuna or swordfish.

Australia similarly two to three servings of fish and seafood per week.

In Australia the recommended serving size is slightly higher it's 150 grams per serving but again it's pretty consistent across the board.

Japan which is one of the countries in the world with the highest fish consumption has some interesting recommendations.

It doesn't necessarily make specific portion serving size recommendations per week for the general population, likely because there's just high seafood generally.

It does make more nuanced recommendations, which is specific to historical public health issues in Japan, which is specifically high sodium intake.

So there's a sodium cap and official Japanese public health guidelines warn to limit very, very heavy salted or salting of fish or pickling of fish.

And then they also, because of the prevalence of high mercury fish and the prevalence of fish consumption generally, for pregnancy, they make very specific recommendations for pregnant women to have different stratifications.

So they make a category of fish where there's no limit required, and that's salmon, sardines, horse mackerel.

Then there's fish with moderate restriction recommended, which is less than 160 grams a week, and that would be albacore tuna and bream, for example.

And then there's a strict restriction of 80 grams or less, all of which is due to mercury levels, which would be, again, like I said, bluefin tuna or swordfish.

So broadly speaking, those guidelines are very reflective of specific population-based requirements in Japan.

For the wider kind of Western countries that we have mentioned in terms of the UK, Europe, North America or Australia, the recommendations broadly fall at this kind of dose recommendation of about two servings per week and generally recommend that at least one of those servings be oily omega-3 fatty acid rich fish.

As you mentioned, we have this kind of general convergence around these guidelines with this one to two servings per week, typically with at least one of those being from oily fish, those serving sizes in that range of 120 to 150 grams per serving, more or less.

and so given that level of convergence i think this is one of the reasons why people would tend to take well this is a very clear quote evidence-based recommendation that is very solid and so when maybe now we can think about where this comes from because there's maybe two ways to think about general recommendations is this a on one hand strictly evidence-based recommendation based on data around those actual doses Or is it more of a sensible, plausible, heuristic for overall dietary patterns based on some of the epidemiology we may have, or maybe somewhere in between? So to start working through that, there's maybe two layers of where these come from.