Environmental public health and recommendations for fish oil and seafood intake

We commend Greene et al. for discussing declining global fisheries in their analysis of current evidence regarding fish oil supplementation and treatment of coronary heart disease (CHD).1 As the authors stated, it is important to reassess dietary and supplement recommendations not only because of conflicting evidence and new treatments for CHD but also because current recommendations are at odds with the earth’s capacity to provide fish oil and seafood.1–3 Additionally, information on critical issues such as food safety and the public health effects of aquaculture should be included in cross-discipline assessments of seafood and health. Aquaculture, or farmed seafood, has expanded in recent decades to meet a growing demand and now accounts for one half of all seafood destined for human consumption.4 Importantly, aquaculture includes a vast array of production methods and species ranging from shellfish (which filter surrounding water and require no feed) to carnivorous finfish (which rely on formulated feed made with wild fish). As the authors briefly state, certain types of aquaculture are closely linked to wild fish supplies. In 2010, 16.6% of wild-caught fish (15 million metric tons) were processed into fishmeal and fish oil, and the majority of both products were used in aquaculture feed.5 The reliance of aquaculture on fish meal and fish oil as feed is problematic when wild fish stocks continue to decline.4 In addition to relying on wild fish as feed, some production methods have significant impacts on marine ecology and public health. Large-scale offshore finfish aquaculture uses open nets or pens and can result in pollution from concentrated waste, chemicals, metals, uneaten feed, and veterinary drugs including antibiotics.6 Use of certain chemicals impacts occupational health and food safety and may contaminate nearby fish populations in which commercial or recreational fishing may occur.7–10 This is a critical and timely public health issue in the United States because federal agencies are poised to permit large-scale offshore aquaculture in the Gulf of Mexico. Evidence from other countries demonstrates a need for strict environmental regulation and active monitoring,6,9,11 but it is unclear how these aquaculture sites will be regulated in the United States.12 Seafood is often overlooked within the sustainable and healthy food systems movement. The discussion by Greene et al. is a good start to rectifying this pervasive omission. The United States is investing significant funds into expanding domestic aquaculture, and health professionals’ engagement with these issues would complement the work of marine scientists to encourage responsible development. More evidence on the links between aquaculture and public health could direct public funds toward researching and evaluating aquaculture methods that limit the use of chemicals and that contain or recycle waste products. Some of these methods include recirculating aquaculture, aquaponics, biofloc shrimp production, and integrated multitrophic aquaculture.13 The scope of public health considerations regarding terrestrial food animals has expanded to include resource use, climate change, pollution, community health impacts, and overuse of antibiotics.14–17 Similarly, future recommendations regarding seafood and fish oil consumption should take into account declining fisheries and the myriad of externalities of certain types of aquaculture.