Attitudes and Beliefs About Eating Fish:

A National Opinion Survey Conducted for The Center for Food, Nutrition and Agriculture Policy

An Executive Summary

Fish is part of a healthy diet. There is a growing body of research linking the omega-3 fatty acids found in fish with optimal brain function and cognition and improved eye and skin health. Moreover, studies show that these omega-3 fatty acids are protective against certain cancers and may have a therapeutic effect on depression and specific autoimmune diseases including lupus, psoriasis and arthritis. Because of these significant health benefits, the 2005 Dietary Guidelines for Americans issued by the Department of Health and Human Services (HHS) and the U.S. Department of Agriculture (USDA) and guidelines from the American Heart Association and the American Dietetic Association recommend consuming two eight-ounce servings of fish a week for optimal health.

But while the health benefits of fish are well known, almost all ocean fish and seafood naturally contain minute amounts of methylmercury, an organic form of mercury that can be toxic to humans at very high exposure levels. Of key concern is that methylmercury may harm an unborn baby’s or young child’s developing nervous system if pregnant and nursing women consume large amounts of fish containing high levels of methylmercury. To safeguard the public, the two federal agencies responsible for regulating mercury levels in fish -- the U.S. Food and Drug Administration (FDA) and the Environmental Protection Agency (EPA) -- have put in place very stringent restrictions, including issuing a joint seafood advisory for pregnant and nursing women, women who may become pregnant and young children about the best ways to add fish to their diets.

According to the joint FDA/EPA advisory, these individuals can safely consume up to 12 ounces a week of fish that are low in mercury, such as shrimp, salmon, pollock, catfish and canned light tuna. The advisory also tells these special groups that they can safely eat up to 6 ounces a week of canned albacore tuna. In general, there are 2 ounces of albacore in a typical serving. However, FDA and EPA have also identified those types of fish that have higher levels of methylmercury and should be avoided by pregnant and nursing women, women who might become pregnant and young children. These fish are shark, swordfish, tilefish and king mackerel.

But while FDA, EPA and the public health community are working to disseminate this seafood consumption advice, the public is also hearing negative messages about mercury levels in fish. Communicated through the mass media, these messages largely come from environmental groups that are pressing for stronger mercury emission standards and allege that many women of childbearing age may have unsafe levels of mercury in their blood, putting their unborn babies and young children are at risk for neurological impairment. Reinforcing these media accounts, the public has also been exposed to political advertising that suggests the government has failed to regulate adequately mercury emissions in the environment.

With so much conflicting information about the health benefits and mercury levels in seafood, an important question for the public health community is how are consumers responding to this information? Has fish consumption in the United States been affected? Moreover, are the messages designed for vulnerable populations -- pregnant and nursing women, women who may become pregnant and young children -- reaching these groups effectively or are there major gaps in awareness and understanding?

To answer these questions, the Center for Food, Nutrition and Agriculture Policy at the University of Maryland commissioned a new opinion poll of 1,040 adult Americans aged 18 and over. Conducted in June 2005 by Opinion Research Corporation, the survey finds extensive public confusion about mercury levels in fish and a growing knowledge gap about which species of fish are low or high in mercury. What follows is a summary of these research findings:

1. Few Americans eat the amount of fish and shellfish recommended for optimal health.

While almost nine in ten adult Americans (89 percent) report eating fish and shellfish at least occasionally, a little over one-third (36 percent) say they eat fish/shellfish once a week or more. This is in direct contrast with the recommendations contained in the dietary guidelines of consuming two servings of fish a week.
In contrast, over half of the public (53 percent) eats fish/shellfish a couple times a month or less. This includes 24 percent who eat fish/shellfish a couple of times a month, 12 percent who consume fish about once a month, and 17 percent who eat fish less than once a month.
According to the survey findings, virtually no one reported eating fish every day.
The most frequent consumers of fish and shellfish are Americans age 65 and older, with 52 percent saying they eat fish and shellfish once a week or more.

2. Although more than half have not changed their seafood eating habits, some Americans are eating seafood less often.

Although more than half of Americans say they are eating the same amount of seafood versus a year ago (61 percent), more than one in ten adults (12 percent) say they are consuming less.
Moreover, about one third of Americans responsible for the meals of young children say the amount of seafood they are feeding them has changed from one year ago, with 11 percent feeding young children less seafood. According to the survey, half of Americans (47 percent) say they are giving their young children the same amount of seafood versus one year ago while another 23 percent of children under the age of four do not eat seafood.

3. Many Americans recall hearing about the health effects of eating fish.

Two thirds of Americans (66 percent) say they heard something about the health effects of eating fish in the past year. Individuals age 55-64 are most aware of hearing something about the health effects of eating fish (77 percent) while younger adults aged 18-24 are least aware (59 percent).
While 60 percent recall hearing information about the health benefits of eating fish, four out of ten Americans -- 43 percent -- said they remember hearing negative news, especially about the presence of mercury and other contaminants (35 percent).
Another 5 percent recalled information that fish is bad for your health, in general, or that you one could get sick or get “poisoned” from eating fish. (Note: Respondents were allowed more than one response for this question; therefore, percentages may add to more than 100 percent).

4. Concern about mercury levels in fish and seafood may be affecting seafood consumption patterns.

Today, almost one-third of the public (31 percent) reports being concerned about the amount of mercury in fish and shellfish, indicating a growing trend. Of these consumers, four in ten (30 percent) say they are very concerned while another 55 percent report being somewhat concerned.
Based on this growing concern, the survey finds that many consumers are changing the types of seafood they eat. Specifically, 55 percent say they have changed the types of fish and shellfish that they eat.
At the same time, many consumers report cutting back on the amount of fish and shellfish they now eat. Forty-three percent report say they are eating seafood less often while another 35 percent say that have cut back on the portion size.

5. Most Americans do not understand the government’s advice on eating seafood.

Although the joint FDA/EPA seafood advisory is intended only for pregnant and nursing women, women who might become pregnant and young children, the public does not understand this distinction. This has led many consumers to disregard important health messages about the many health benefits of eating more fish.
When asked to whom the FDA/EPA seafood advisory applies, a large number of individuals identified the elderly (45 percent), pre-teens and teenagers (35 percent), and men (29 percent), while nearly one third (30 percent) believe this information applies to all Americans. This confusion represents a major barrier to the public’s adoption of public health guidelines recommending 2-3 fish meals a week.
At the same time, the survey finds that the public is very confused about the amount of mercury that commonly consumed types of fish and shellfish contain. When asked to name those fish and shellfish that contain higher levels of mercury, two thirds of Americans (68 percent) said they didn’t know.
Even more troubling, consumers mistakenly believe that many commonly consumed fish and shellfish are high in mercury. According to the survey, about a third (32 percent) of the public incorrectly said tuna, salmon and shrimp contained higher levels of mercury, while only 4 percent correctly identified swordfish. Even less than1 percent named king mackerel and shark as fish containing higher mercury levels.

The new survey was based on telephone interviews with 1,040 adult Americans (522 men, 518 women) using a national probability sample of individuals 18 years of age and older, living in private households in the continental United States. Interviewing was completed during the period June 23-26, 2005. To ensure a reliable and accurate representation of the total national adult population, complete interviews were weighted to known proportions for age, gender, geographic region, and race. The margin of error for the total sample is plus or minus 3.1 percent.

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