BACKGROUND: Despite general agreement about the toxicity of methylmercury (MeHg), fish consumption advice remains controversial. Concerns have been raised that negative messages will steer people away from fish and omega-3 fatty acid (FA) benefits. One approach is to provide advice for individual species that highlights beneficial fish while cautioning against riskier fish. OBJECTIVES: Our goal in this study was to develop a method to quantitatively analyze the net risk/benefit of individual fish species based on their MeHg and omega-3 FA content. METHODS: We identified dose-response relationships for MeHg and omega-3 FA effects on coronary heart disease (CHD) and neurodevelopment. We used the MeHg and omega-3 FA content of 16 commonly consumed species to calculate the net risk/benefit for each species. RESULTS: Estimated omega-3 FA benefits outweigh MeHg risks for some species (e.g., farmed salmon, herring, trout); however, the opposite was true for others (swordfish, shark). Other species were associated with a small net benefit (e.g., flounder, canned light tuna) or a small net risk (e.g., canned white tuna, halibut). These results were used to place fish into one of four meal frequency categories, with the advice tentative because of limitations in the underlying dose-response information. Separate advice appears warranted for the neurodevelopmental risk group versus the cardiovascular risk group because we found a greater net benefit from fish consumption for the cardiovascular risk group. CONCLUSIONS: This research illustrates a framework for risk/benefit analysis that can be used to develop categories of consumption advice ranging from "do not eat" to "unlimited," with the caveat that unlimited may need to be tempered for certain fish (e.g., farm-raised salmon) because of other contaminants and end points (e.g., cancer risk). Uncertainties exist in the underlying dose-response relationships, pointing in particular to the need for more research on the adverse effects of MeHg on cardiovascular end points.

BACKGROUND: Health recommendations advocating increased fish consumption need to be placed in the context of the potential collapse of global marine capture fisheries. METHODS: Literature overview. RESULTS: In economically developed countries, official healthy eating advice is to eat more fish, particularly that rich in omega-3 oils. In many less economically developed countries, fish is a key human health asset, contributing >20% of animal protein intake for 2.6 billion people. Marine ecologists predict on current trends that fish stocks are set to collapse in 40 years, and propose increased restrictions on fishing, including no-take zones, in order to restore marine ecosystem health. Production of fishmeal for aquaculture and other non-food uses (22 MT in 2003) appears to be unsustainable. Differences in fish consumption probably contribute to within-country and international health inequalities. Such inequalities are likely to increase if fish stocks continue to decline, while increasing demand for fish will accelerate declines in fish stocks and the health of marine ecosystems. CONCLUSIONS: Urgent national and international action is necessary to address the tensions arising from increasing human demand for fish and seafood, and rapidly declining marine ecosystem health.

Fish and other seafood may contain organic mercury but also beneficial nutrients such as n-3 polyunsaturated fatty acids. We endeavored to study whether maternal fish consumption during pregnancy harms or benefits fetal brain development. We examined associations of maternal fish intake during pregnancy and maternal hair mercury at delivery with infant cognition among 135 mother-infant pairs in Project Viva, a prospective U.S. pregnancy and child cohort study. We assessed infant cognition by the percent novelty preference on visual recognition memory (VRM) testing at 6 months of age. Mothers consumed an average of 1.2 fish servings per week during the second trimester. Mean maternal hair mercury was 0.55 ppm, with 10% of samples > 1.2 ppm. Mean VRM score was 59.8 (range, 10.9-92.5). After adjusting for participant characteristics using linear regression, higher fish intake was associated with higher infant cognition. This association strengthened after adjustment for hair mercury level: For each additional weekly fish serving, offspring VRM score was 4.0 points higher [95% confidence interval (CI), 1.3 to 6.7]. However, an increase of 1 ppm in mercury was associated with a decrement in VRM score of 7.5 (95% CI,-13.7 to -1.2) points. VRM scores were highest among infants of women who consumed > 2 weekly fish servings but had mercury levels </= 1.2 ppm. Higher fish consumption in pregnancy was associated with better infant cognition, but higher mercury levels were associated with lower cognition. Women should continue to eat fish during pregnancy but choose varieties with lower mercury contamination.

Diet composition may be a modifiable predictor of risk for abnormal glucose tolerance during pregnancy. Prior studies suggest that diets high in total fat, saturated fat, red and processed meats, and with high glycaemic load increase the risk of developing gestational diabetes mellitus (GDM), while polyunsaturated fats, carbohydrates and fibre are protective. The aim of this study was to investigate associations of these and other nutrients and foods, including n-3 fatty acids, trans fats, whole grains and dietary patterns, with risk of GDM. We studied 1733 women with singleton pregnancies enrolled in Project Viva, a prospective pregnancy and birth cohort study in eastern MA. Using multinomial logistic regression, we examined associations of first trimester diet, assessed by validated food frequency questionnaire, with results of glucose tolerance testing at 26-28 weeks of gestation. A total of 91 women developed GDM and 206 women had impaired glucose tolerance (IGT). Pre-pregnancy body mass index (BMI) was a strong predictor for GDM risk (OR 3.44 [95% CI 1.88, 6.31] for pre-pregnancy BMI >/=30 vs.<25 kg/m(2)). After adjustment for confounders, the OR [95% CI] for risk of GDM for total dietary fat was 1.00 [0.96, 1.05], for saturated fat 0.98 [0.88, 1.08], for polyunsaturated fat 1.09 [0.94, 1.26], for trans fat 0.87 [0.51, 1.49], and for carbohydrates 1.00 [0.96, 1.03] per each 1% of total energy. The adjusted OR [95% CI] for risk of GDM for a one standard deviation increase in energy-adjusted glycaemic load (32 units, about two soft drinks) was 0.96 [0.76, 1.22] and for each daily serving of whole grains was 0.90 [0.73, 1.13]. Dietary patterns and intake of red and processed meats were not predictive of glucose tolerance outcome. Estimates for IGT were similar to those for GDM. Intake of n-3 fatty acids was associated with increased GDM risk (OR 1.11 [95% CI 1.02, 1.22] per each 300 mg/day), but not with IGT risk. Except for this finding, perhaps due to chance, these data do not show that nutrient or food intake in early pregnancy is linked to risk of GDM. Nutritional status entering pregnancy, as reflected by pre-pregnancy BMI, is probably more important than pregnancy diet in development of GDM.

BACKGROUND: Gestational weight gain is important to assess for epidemiological and public health purposes: it is correlated with infant growth and may be related to maternal outcomes such as reproductive health and chronic disease risk. Methods commonly used to assess weight gain incorporate assumptions that are usually not borne out, such as a linear weight gain, or do not account for differential length of gestation. METHODS: We introduce a novel method to assess gestational weight gain, the area under the weight gain curve. This is easily interpretable as the additional pound-days carried due to pregnancy and avoids many flaws in alternative assessments. We compare the performance of the simple difference, weekly gain, Institute of Medicine categories and the area under the weight gain curve in predicting birthweight and maternal weight retention at 6, 12, 24 and 36 months postpartum. The analytic sample comprises 2016 participants in Project Viva, an observational prospective cohort study of pregnant women in Massachusetts. RESULTS: For birthweight outcomes, none of the weight gain measures is a meaningfully superior predictor. For 6-month postpartum weight retention the simple difference is superior, while for 12-, 24- and 36-month weight retention the area under the weight gain curve is superior. CONCLUSIONS: These findings are plausible biologically: the same amount of weight gained early vs later in the pregnancy may reflect increased maternal fat stores. The timing of weight gain is reflected best in the area under the weight gain curve. Different methods of measuring gestational weight gain may be appropriate depending on the context.

OBJECTIVE:: To estimate changes over time in birth weight for gestational age and in gestational length among term singleton neonates born from 1990 to 2005. METHODS:: We used data from the U.S. National Center for Health Statistics for 36,827,828 singleton neonates born at 37-41 weeks of gestation, 1990-2005. We examined trends in birth weight, birth weight for gestational age, large and small for gestational age, and gestational length in the overall population and in a low-risk subgroup defined by maternal age, race or ethnicity, education, marital status, smoking, gestational weight gain, delivery route, and obstetric care characteristics. RESULTS:: In 2005, compared with 1990, we observed decreases in birth weight (-52 g in the overall population,-79 g in a homogenous low-risk subgroup) and large for gestational age birth (-1.4% overall,-2.2% in the homogenous subgroup) that were steeper after 1999 and persisted in regression analyses adjusted for maternal and neonate characteristics, gestational length, cesarean delivery, and induction of labor. Decreases in mean gestational length (-0.34 weeks overall) were similar regardless of route of delivery or induction of labor. CONCLUSION:: Recent decreases in fetal growth among U.S., term, singleton neonates were not explained by trends in maternal and neonatal characteristics, changes in obstetric practices, or concurrent decreases in gestational length. LEVEL OF EVIDENCE:: III.

Lead has been phased out of gasoline in India since 2001. However, elevated blood lead levels continue to be reported, and little is known about the predictors of lead exposure. The purpose of this study was to examine the lead burden and identify possible predictors of blood lead among children in Chennai, India after the phase-out of leaded gasoline. Subjects were children from twelve schools in Chennai. Venous blood was collected and analyzed for lead. Demographic, environmental, and nutritional information was collected using questionnaires administered to the primary caregiver. Generalized estimating equations were used to assess predictors of blood lead. We found that lead exposure remains elevated among children four or more years after the phase-out of lead from gasoline. Industrial activity, water storage vessels, and lower socio-economic status are predictors of elevated blood lead in this population, but additional work is required to better define preventable risk factors.

BACKGROUND: Accumulating evidence has shown an increased risk of type 2 diabetes in general populations exposed to arsenic, but little is known about exposures during pregnancy and the association with gestational diabetes (GD). OBJECTIVES: We studied 532 women living proximate to the Tar Creek Superfund Site to investigate whether arsenic exposure is associated with impaired glucose tolerance during pregnancy. METHODS: Blood glucose was measured between 24 and 28 weeks gestation after a 1-hr oral glucose tolerance test (GTT) as part of routine prenatal care. Blood and hair were collected at delivery and analyzed for arsenic using inductively coupled plasma mass spectrometry with dynamic reaction cell. RESULTS: Arsenic concentrations ranged from 0.2 to 24.1 microg/L (ppb)(mean +/- SD, 1.7 +/-1.5) and 1.1 to 724.4 ng/g (ppb)(mean +/- SD, 27.4 +/- 61.6) in blood and hair, respectively. One-hour glucose levels ranged from 40 to 284 mg/dL (mean +/- SD, 108.7 +/- 29.5); impaired glucose tolerance was observed in 11.9% of women when using standard screening criterion (> 140 mg/dL). Adjusting for age, Native-American race, prepregnancy body mass index, Medicaid use, and marital status, women in the highest quartile of blood arsenic exposure had 2.8 higher odds of impaired GTT than women in the lowest quartile of exposure (95% confidence interval, 1.1-6.9)(p-trend = 0.008). CONCLUSIONS: Among this population of pregnant women, arsenic exposure was associated with increased risk of impaired GTT at 24-28 weeks gestation and therefore may be associated with increased risk of GD.

BACKGROUND: Maternal diet may influence outcomes of pregnancy and childhood, but data on correlates of food and nutrient intake during pregnancy are scarce. OBJECTIVE: To examine relationships between maternal characteristics and diet quality during the first trimester of pregnancy. Secondarily we examined associations of diet quality with pregnancy outcomes. METHODS: As part of the ongoing US prospective cohort study Project Viva, we studied 1,777 women who completed a food frequency questionnaire during the first trimester of pregnancy. We used linear regression models to examine the relationships of maternal age, prepregnancy body mass index, parity, education, and race/ethnicity with dietary intake during pregnancy. We used the Alternate Healthy Eating Index, slightly modified for pregnancy (AHEI-P), to measure diet quality on a 90-point scale with each of the following nine components contributing 10 possible points: vegetables, fruit, ratio of white to red meat, fiber, trans fat, ratio of polyunsaturated to saturated fatty acids, and folate, calcium, and iron from foods. RESULTS: Mean AHEI-P score was 61+/-10 (minimum 33, maximum 89). After adjusting for all characteristics simultaneously, participants who were older (1.3 points per 5 years, 95% confidence interval [CI][0.7 to 1.8]) had better AHEI-P scores. Participants who had higher body mass index (-0.9 points per 5 kg/m(2), 95% CI [-1.3 to -0.4]), were less educated (-5.2 points for high school or less vs college graduate, 95% CI [-7.0 to -3.5]), and had more children (-1.5 points per child, 95% CI [-2.2 to -0.8]) had worse AHEI-P scores, but African-American and white participants had similar AHEI-P scores (1.3 points for African American vs white, 95% CI [-0.2 to 2.8]). Using multivariate adjusted models, each five points of first trimester AHEI-P was associated lower screening blood glucose level (beta -.64 [95% CI -0.02 to -1.25]). In addition, each five points of second trimester AHEI-P was associated with a slightly lower risk of developing preeclampsia (odds ratio 0.87 [95% CI 0.76 to 1.00]), but we did not observe this association with first trimester AHEI-P (odds ratio 0.96 [95% CI 0.84 to 1.10]). CONCLUSIONS: Pregnant women who were younger, less educated, had more children, and who had higher prepregnancy body mass index had poorer-quality diets. These results could be used to tailor nutrition education messages to pregnant women to avoid long-term sequelae from suboptimal maternal nutrition.

The authors investigated the rate of gestational weight gain associated with the lowest combined risk of 5 short- and longer-term maternal and child health outcomes for 2,012 mother-child pairs recruited in 1999-2002 into Project Viva, a prebirth cohort study in Massachusetts. Within each maternal prepregnancy body mass index (BMI, kg/m(2)) stratum, they performed a logistic regression analysis predicting all 5 outcomes, from which they determined the rate of gain at which average predicted prevalence of the adverse outcomes was the lowest. The mean rate of total gestational weight gain was 0.39 kg/week (standard deviation, 0.14). The prevalence of small for gestational age was 6%, large for gestational age was 14%, preterm delivery was 7%, substantial postpartum weight retention was 16%, and child obesity was 10%. The lowest predicted outcome prevalence occurred with a 0.28-kg/week gain for women whose BMI was 18.5-24.9, a 0.03-kg/week loss for a BMI of 25.0-29.9, and a 0.19-kg/week loss for a BMI of >/=30.0 kg/m(2)-the lowest observed weight changes in overweight and obese women. For normal-weight and overweight women, lowest-risk gains varied modestly with adjustment for maternal characteristics and with different outcome weightings. For obese women, the lowest-risk weight change was weight loss in all models. Recommendations for gestational weight gain for obese women should be revised.

OBJECTIVE: The purpose of this study was to examine associations of weight gain from prepregnancy to glycemic screening with glucose tolerance status. STUDY DESIGN: Main outcomes were failed glycemic screening (1-hour glucose result >/= 140 mg/dL) with either 1 high value on 3-hour oral glucose tolerance testing (impaired glucose tolerance in pregnancy) or >/= 2 high values on 3-hour oral glucose tolerance testing (gestational diabetes mellitus). We performed multinomial logistic regression to determine the odds of these glucose intolerance outcomes by quartile of gestational weight gain among 1960 women in Project Viva. RESULTS: Mean gestational weight gain was 10.2 +/- 4.3 (SD) kg. Compared with the lowest quartile of weight gain, participants in the highest quartile had an increased odds of impaired glucose tolerance in pregnancy (adjusted odds ratio, 2.54; 95% confidence interval, 1.25-5.15), but not gestational diabetes mellitus (odds ratio, 0.93; 95% confidence interval, 0.50-1.70). CONCLUSION: Higher weight gain predicted impaired glucose tolerance in pregnancy, but not gestational diabetes mellitus.

OBJECTIVE. The goal was to examine the associations of weight-for-length at birth and at 6 months with obesity at 3 years of age. METHODS. We studied 559 children in Project Viva, an ongoing, prospective, cohort study of pregnant women and their children. We measured length and weight at birth, 6 months, and 3 years. Our main exposures were weight-for-length z score at birth adjusted for gestational age and weight-for-length z score at 6 months adjusted for weight-for-length z score at birth. We used multivariate regression analyses to predict the independent effects of birth weight-for-length z score and, separately, 6-month weight-for-length z score on BMI z score, the sum of subscapular and triceps skinfold thicknesses, and obesity (BMI for age and gender of >/=95th percentile) at age 3. RESULTS. Mean weights at birth, 6 months, and 3 years were 3.55, 8.15, and 15.67 kg, respectively. Corresponding lengths were 49.9, 66.9, and 97.4 cm. At 3 years, 48 children (9%) were obese. After adjustment for confounding variables and birth weight-for-length z score, each increment in 6-month weight-for-length z score was associated with higher BMI z scores, higher sums of subscapular and triceps skinfold thicknesses, and increased odds of obesity at age 3. The predicted obesity prevalence among children in the highest quartiles of both birth and 6-month weight-for-length z scores was 40%, compared with 1% for children in the lowest quartiles of both. Whereas birth weight-for-length z scores were associated with higher BMI z scores, the magnitude of effect was smaller than that of weight-for-length z scores at 6 months. CONCLUSIONS. More-rapid increases in weight for length in the first 6 months of life were associated with sharply increased risk of obesity at 3 years of age. Changes in weight status in infancy may influence risk of later obesity more than weight status at birth.

BACKGROUND: It has been suggested that even mild exposure to alcohol, caffeine, smoking, and poor diet may have adverse long-term neurodevelopmental effects. In addition, there is evidence that timing of high exposures (e.g. binge drinking) can have particularly negative effects. This paper describes the design and implementation of The Lifestyle During Pregnancy Study addressing major methodological challenges for studies in this field. The study examines the effects of lifestyle during pregnancy on offspring neurodevelopment. METHODS: In 2003, we initiated a prospective follow-up of 1750 mother-child pairs, sampled on the basis of maternal alcohol drinking patterns from The Danish National Birth Cohort (DNBC), a study of 101,042 pregnancies enrolled 1997-2003. Data collection in the DNBC involved four prenatal and postnatal maternal interviews, providing detailed information on maternal alcohol drinking patterns before and during pregnancy, caffeine intake, smoking, diet, and other lifestyle, medical, and sociodemographic factors. RESULTS: At the age of 5 years, the children and their mothers participated in a comprehensive assessment of neurobehavioural development focusing on global cognition, specific cognitive functions, and behaviour. Two new tests assessing attention and speed of information processing among children were developed, and data on important potential confounders such as maternal intelligence quotient, vision, and hearing abilities were collected. Efforts were made to standardise procedures and obtain high inter-rater reliability. CONCLUSIONS: We expect that the study will illuminate the significance or lack of significance of maternal lifestyle during pregnancy and contribute to better understanding the effects of alcohol drinking during pregnancy at low to moderate consumption levels.

The main source of human exposure to mercury is the consumption of fish contaminated with methylmercury, which may adversely affect early neurodevelopment. This study assessed mercury levels in hair of preschoolers in Spain, where fish consumption is elevated, with the aim of investigating the influence of their fish intake and other factors on mercury exposure, and evaluating their association with cognitive development. A population-based birth cohort from Granada (Spain) was studied at the age of 4yr. Total mercury (T-Hg) levels were determined in children's hair, and daily fish intake was assessed by a food frequency questionnaire. The McCarthy Scales of Children's Abilities (MSCA) were used to assess children's motor and cognitive abilities. Complete data were gathered on 72 children, and multivariate analyses were performed to evaluate the influence of mercury exposure and fish intake on MSCA outcomes. Mean concentration of T-Hg in hair was 0.96mug/g (95% confidence interval=0.76; 1.20mug/g). T-Hg levels were associated with higher frequency of oily fish consumption, place of residence, maternal age, and passive smoking. After adjustment for fish intake, T-Hg levels >/=1mug/g were associated with decrements in the general cognitive (-6.6 points), memory (-8.4 points), and verbal (-7.5 points) MSCA scores. Higher mercury exposure in children from this Mediterranean area was associated with cognitive development delay. Studies on the putative benefits of fish intake during early development should consider mercury exposure from different fish species.

Meconium is a matrix that can be obtained easily and noninvasively and is useful for detecting antenatal fetal exposure to environmental toxins. Taiwan is an island with high fish consumption, and many pregnant women would like to enjoy the benefits of fish without jeopardizing their health or that of their child. The aim of this study is to assess the mercury concentration in meconium in relation to the health risk of mercury exposure. A total of 198 mother-infant pairs residing in the city of HsinChu were recruited for the study between January 2007 and June 2007. The average mean concentration of mercury in meconium was 79.2+/-7.3ngg(-1) dry wt We use the Monte Carlo technique to assess the uncertainty in risk assessment and the impact of these uncertainties on the estimation of expected risk of mercury intake from fish in mothers. Based on the FAO/WHO's tolerable daily intake of methylmercury (0.23mugkg(-1)d(-1)), we found that 17.3% and 14.0% of the daily mercury exposure estimated exceeded the reference dose for foreign-born and Taiwan-born mothers, respectively. We found that the mercury concentration in meconium was much higher than in other studies, except for one study done in Tagum in the Philippines where mercury is used in gold mining. This may be because Asia is the largest emitter of anthropogenic mercury, accounting for 53% of worldwide emissions. Sensitivity analysis suggests that mercury concentration in fish and the rate of ingesting fish may be the key parameters for governments offering risk management guidance to protect the health of mothers and unborn babies.

The purposes of this study were to assess the hair mercury concentration of women of childbearing age in Taiwan, and to calculate a hazard quotient (HQ) to evaluate the risk of fish consumption for these women. We also examined perceptions of risk associated with fish consumption and whether women in our study changed their habits in response to such risks. The average concentration of mercury was 1.73+/-2.12mugg(-1)(range: 0.02-16.34mugg(-1)), exceeding the US EPA reference dose of 1mugg(-1) in 52.9% of study subjects. The WHO tolerance limit of 10mugg(-1) was exceeded in 1.5% of study subjects. Hair mercury concentration in groups who consumed fish was significantly higher than in groups who never consumed fish (p<0.05). The hazard quotient (exposure estimate/oral reference dose) exceeded 1.0 for 29% of subjects, based on the US EPA's reference dose (0.1mugkg(-1)d(-1)), and the average HQ equaled 1.26. When told that some fish contain high levels of mercury that may be harmful for unborn babies, 67.6% of women still indicated that they would not change their amount of fish intake. The high hair mercury concentrations among women of childbearing age in Taiwan are a cause for concern, due to the effect on babies' brain development. The government should provide specific information about risks and benefits of fish consumption for women to make risk-balancing decisions.

Overexposure to glucocorticoids may link prenatal adversity with detrimental outcomes in later life. Glycyrrhiza, a natural constituent of licorice, inhibits placental 11-beta-hydroxysteroid dehydrogenase type 2, the feto-placental "barrier" to higher maternal levels of cortisol. The authors studied whether prenatal exposure to glycyrrhiza in licorice exerts detrimental effects on cognitive performance (subtests of the Wechsler Intelligence Scale for Children III as well as the Children's Developmental Neuropsychological Assessment and the Beery Developmental Test of Visual-Motor Integration) and psychiatric symptoms (Child Behavior Checklist) in 321 Finnish children 8.1 years of age born in 1998 as healthy singletons at 35-42 weeks of gestation. In comparison to the group with zero-low glycyrrhiza exposure (0-249 mg/week), those with high exposure (>/=500 mg/week) had significant decrements in verbal and visuospatial abilities and in narrative memory (range of mean differences in standard deviation units,-0.31 to -0.41; P < 0.05) and significant increases in externalizing symptoms and in attention, rule-breaking, and aggression problems (range of odds ratios, 2.15 to 3.43; P < 0.05). The effects on cognitive performance appeared dose related. Data are compatible with adverse fetal "programming" by overexposure to glucocorticoids and caution against excessive intake of licorice-containing foodstuffs during pregnancy.

Contemporary reproductive aged women and their offspring are facing an unprecedented onslaught of toxicant exposures from myriad sources in their day-to-day life. Public health recommendations regarding optimal diet and nutrition in pregnancy must incorporate several considerations including safety of available foodstuffs, cultural practices and lifestyle issues. Gestational consumption of contaminated seafood remains a potential source of toxicant exposure, including mercury, for the developing child. Health care professionals responsible for the care of women and their developing children need to become apprised of: a) risks associated with toxicant bioaccumulation in pregnancy; b) ongoing information emerging in the important field of reproductive toxicology; and c) strategies within the clinical setting to facilitate nutritional sufficiency and precautionary avoidance of adverse exposure among young women.

OBJECTIVE: Few biomarkers for dietary intake of various food groups have been established. The aim of the present study was to explore whether selenium (Se), iodine, mercury (Hg) or arsenic may serve as a biomarker for total fish and seafood intake in addition to the traditionally used n-3 fatty acids EPA and DHA. DESIGN: Intake of fish and seafood estimated by an FFQ was compared with intake assessed by a 4 d weighed food diary and with biomarkers in blood and urine. SETTING: Validation study in the Norwegian Mother and Child Cohort Study (MoBa). SUBJECTS: One hundred and nineteen women. RESULTS: Total fish/seafood intake (median 39 g/d) calculated with the MoBa FFQ was comparable to intake calculated by the food diary (median 30 g/d, rS = 0.37, P < 0.001). Erythrocyte DHA and blood Hg, Se and arsenic concentrations were positively correlated with intake of fish and seafood, but the association for DHA was weakened by the widespread use of supplements. The main finding was the consistent positive association between the intake of fish/seafood and blood arsenic concentration. In multivariate analyses, blood arsenic was associated with blood Hg and fish and seafood intake. In these models, arsenic turned out to be the best indicator of intake of fish and seafood, both totally and in subgroups of fish/seafood intake. CONCLUSIONS: While DHA reflected the intake of fatty fish and n-3 PUFA supplements, blood arsenic concentration also reflected the intake of lean fish and seafood. Blood arsenic appears to be a useful biomarker for total fish and seafood intake.

BACKGROUND: Fish is an important source of nutrition worldwide. Fish contain both the neurotoxin methyl mercury (MeHg) and nutrients important for brain development. The developing brain appears to be most sensitive to MeHg toxicity and mothers who consume fish during pregnancy expose their fetus prenatally. Although brain development is most dramatic during fetal life, it continues for years postnatally and additional exposure can occur when a mother breast feeds or the child consumes fish. This raises the possibility that MeHg might influence brain development after birth and thus adversely affect children's developmental outcomes. We reviewed postnatal MeHg exposure and the associations that have been published to determine the issues associated with it and then carried out a series of analyses involving alternative metrics of postnatal MeHg exposure in the Seychelles Child Development Study (SCDS) Main Cohort. METHODS: The SCDS is a prospective longitudinal evaluation of prenatal MeHg exposure from fish consumption. The Main Cohort includes 779 subjects on whom recent postnatal exposure data were collected at the 6-, 19-, 29-, 66-, and 107-month evaluations. We examined the association of recent postnatal MeHg exposure with multiple 66- and 107-month outcomes and then used three types of alternative postnatal exposure metrics to examine their association with the children's intelligence quotient (IQ) at 107 months of age. RESULTS: Recent postnatal exposure at 107 months of age was adversely associated with four endpoints, three in females only. One alternative postnatal metric was beneficially associated with 9-year IQ in males only. CONCLUSIONS: We found several associations between postnatal MeHg biomarkers and children's developmental endpoints. However, as has been the case with prenatal MeHg exposure in the SCDS Main Cohort study, no consistent pattern of associations emerged to support a causal relationship.

BACKGROUND: Depression during pregnancy has adverse consequences for both mother and child. Although common in western countries, depression appears to be virtually absent in countries with high seafood intake. We test the hypothesis that low seafood intake during pregnancy is associated with increased prevalence of depressive symptoms. METHODS: This study used data prospectively collected from women participating in the Avon Longitudinal Study of Parents and Children in the period 1991-1992. At 32 weeks' gestation, the mother completed a questionnaire that included symptoms of depression and a food frequency questionnaire from which the amount of omega-3 fatty acids from fish was calculated. Statistical analysis took social and lifestyle factors into account. RESULTS: Unadjusted and adjusted analyses showed lower maternal intake of omega-3 from seafood was associated with high levels of depressive symptoms. Compared with women consuming more than 1.5 g omega-3 from seafood per week, those consuming none were more likely to have high levels of depressive symptoms at 32 weeks' gestation (adjusted odds ratios = 1.54; 95% confidence interval = 1.25-1.89). CONCLUSIONS: These observational data support an association between low omega-3 intake from seafood and increased risk of high levels of depressive symptoms during pregnancy. Eating seafood during pregnancy may have beneficial effects on mental well-being.