Healthy fish consumption and reduced mercury exposure: counseling women in their reproductive years.

OBJECTIVE: To provide family physicians with a practical, evidence-based approach to counseling women about healthy fish eating. SOURCES OF INFORMATION: MEDLINE was searched for articles published between 1999 and 2008. Most studies described in this article provide level II or III evidence. MAIN MESSAGE: Fish is an important component of a healthy diet for women in their reproductive years owing to the beneficial effects of omega-3 fatty acids on the neurologic development of the fetus. However, some fish species contain considerable methylmercury, which crosses the placenta and has harmful effects on neurobehavioural development. As many jurisdictions have issued fish consumption advisories, which can be confusing, women would benefit from individualized assistance from a trusted source, their family physicians, to clarify the risks and benefits of eating fish. CONCLUSION: We recommend that family physicians counsel women in their reproductive years about healthy choices regarding fish in their diet, and provide appropriate resources.