LETTERS
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
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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 largescale 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,
Published online ahead of print July 18, 2013 | American Journal of Public Health
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. j
Jillian P. Fry, PhD, MPH
David C. Love, PhD, MSPH
About the Authors
Jillian P. Fry and David C. Love are with the Public Health
and Sustainable Aquaculture Project, Johns Hopkins Center
for a Livable Future, Environmental Health Sciences
Department, Johns Hopkins Bloomberg School of Public
Health, Baltimore, MD.
Correspondence should be sent to Jillian Fry, 615 N. Wolfe
Street, W7010, Baltimore, MD 21205 (e-mail: jfry@jhsph.
edu). Reprints can be ordered at http://www.ajph.org by
clicking the “Reprints” link.
This letter was accepted May 2, 2013.
doi:10.2105/AJPH.2013.301434
Contributors
J. P. Fry and D. C. Love both conceptualized the letter.
J. P. Fry drafted the letter and D. C. Love revised the text.
References
1. Greene J, Ashburn SM, Razzouk L, Smith DA. Fish
oils, coronary heart disease, and the environment. Am
J Public Health. 2013;103(9):jjj---jjj.
2. Jenkins DJ, Sievenpiper JL, Pauly D, et al. Are dietary
recommendations for the use of fish oils sustainable?
CMAJ. 2009;180(6):633---637.
3. Brunner EJ, Jones PJS, Friel S, Bartley M. Fish,
human health and marine ecosystem health: policies in
collision. Int J Epidemiol. 2009;38(1):93---100.
4. Naylor RL, Hardy RW, Bureau DP, et al. Feeding
aquaculture in an era of finite resources. Proc Natl Acad
Sci U S A. 2009;106(36):15103---15110.
5. Food and Agriculture Organization of the United
Nations. The state of world fisheries and aquaculture.
2012. Available at: http://www.fao.org/docrep/016/
i2727e/i2727e.pdf. Accessed April 30, 2013.
6. Goldburg RJ, Elliott MS, Naylor RL. Marine aquaculture in the United States. Pew Oceans Commission. 2001.
Available at: http://www.pewtrusts.org/uploadedFiles/
wwwpewtrustsorg/Reports/Protecting_ocean_life/env_
pew_oceans_aquaculture.pdf. Accessed April 30,
2013.
7. Sapkota A, Sapkota AR, Kucharski M, et al. Aquaculture practices and potential human health risks:
Current knowledge and future priorities. Environ Int.
2008;34(8):1215---1226.
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LETTERS
8. Cole DW, Cole R, Gaydos SJ, et al. Aquaculture:
environmental, toxicological, and health issues. Int J Hyg
Environ Health. 2009;212(4):369---377.
9. Holmer M. Environmental issues of fish farming in
offshore waters: perspectives, concerns and research
needs. Aquaculture Environment Interactions. 2010;1
(1):57---70.
10. Trotter B. Cooke Aquaculture to pay $490,000
after illegal pesticides kill lobsters in Canada. Bangor
Daily News. April 27, 2013. Available at: http://
bangordailynews.com/2013/04/27/business/cookeaquaculture-to-pay-490k-after-illegal-pesticides-killlobsters-in-canada. Accessed April 30, 2013.
11. Sarà G, Lo Martire M, Sanfilippo M, et al. Impacts of
marine aquaculture at large spatial scales: Evidences
from N and P catchment loading and phytoplankton
biomass. Mar Environ Res. 2011;71(5):317---324.
12. Harvard Law School Emmett Environmental Law &
Policy Clinic, Environmental Law Institute, The Ocean
Foundation. Offshore aquaculture regulation under the
Clean Water Act. 2012. Available at: http://eli-ocean.
org/fish/files/CWA-aquaculture.pdf. Accessed April 30,
2013.
13. Klinger D, Naylor R. Searching for solutions in
aquaculture: charting a sustainable course. Annu Rev
Environ Resour. 2012;37(1):247---276.
14. Wing S, Horton RA, Rose KM. Air pollution from
industrial swine operations and blood pressure of neighboring residents. Environ Health Perspect. 2013;121
(1):92---96.
15. West BM, Liggit P, Clemans DL, Francoeur SN.
Antibiotic resistance, gene transfer, and water quality
patterns observed in waterways near CAFO farms and
wastewater treatment facilities. Water Air Soil Pollut.
2010;217(1-4):473---489.
16. Godfray HCJ, Beddington JR, Crute IR, et al. Food
security: the challenge of feeding 9 billion people. Science.
2010;327(5967):812---818.
17. McMichael AJ, Powles JW, Butler CD, Uauy R. Food,
livestock production, energy, climate change, and health.
Lancet. 2007;370(9594):1253---1263.
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American Journal of Public Health | Published online ahead of print July 18, 2013