Everyone seems to be buzzing about the latest round in the "fish wars". So I'll wade into the fray with my own perspective on this issue. I've spent a lot of time looking at the data on both the benefits and the risks of fish consumption, and I get questions on this all the time from my patients, and even from moms on the street.

In my view, this issue is pretty straightforward, so I'm often amazed at all the flap. The bottom line is that research convincingly shows that omega-3 fatty acids are good for the development of the baby's brain. Research also convincingly shows that mercury is bad for the development of the baby's brain. Nobody has yet conclusively demonstrated the 'perfect balance' between the risks of mercury and the benefits of omega-3s, and the opinions vary. Hence the announcement today that disagrees with the FDA and EPA guidelines.

But let's step back for a moment and use a little common sense. Any intelligent mother-to-be is perfectly capable of picking and choosing what she eats, and with very little effort she can get plenty of omega-3s and very little mercury. So why argue?

For example, there are fish like salmon and sardines that are chock full of omega-3s, and have almost no mercury. Moms - dig in!  Also, for mothers that don't like fish, can't find good local fish, or are worried about mercury, the fish oil supplements have been tested and found to be virtually mercury free and also seem to be low in other worrisome pollutants. I sometimes recommend fish oil supplements to new moms.

Vegetarians don't need to worry. Omega-3 fatty acids are found in flax seeds, flax oil, canola oil, walnuts, beans, dark green leafy vegetables and fortified foods such as eggs (if you eat them), bread, and juice. It's harder to get enough Omega-3s if you're a vegetarian, but that just means you need to pay a bit more attention. It's not really a problem.

So do I agree or disagree with the announcement today saying that women should eat more fish? Yes on both counts - I both agree and disagree. There's no controversy about the need for Omega-3 fatty acids. But the devil's in how you get 'em. Telling women to just eat any old fish does a dis-service to those people who don't understand the risks from mercury. It also insults women's intelligence. By all means, make sure you're getting enough Omega-3s, but do it your way, not theirs. Pick among the menu of alternatives, but pick sparingly from the high-mercury end of that menu.

This debate is really similar to lots of other "controversies" in environmental health. People debate endlessly about the benefits of fruits and vegetables versus the risks from pesticide residues; or about the benefits of breastfeeding versus the risks of chemical contaminants in breast milk. In each of these situations, the goals are clear: first, pursue the established benefits (eat the omega 3s, fruits and vegetables, and breastfeed); second, avoid the risks when you can (steer clear of high-mercury fish, buy organic fruits and vegetables, and avoid chemicals that can get into breastmilk when you can); third, let's stop wasting our time debating these pseudo-controversies, and instead let's work for public policy changes that will reduce pollution in our environment, so we don't have to worry about nasty stuff in our food.

For some resources on which fish are low in mercury, check here. A nice overview of the Omega-3 issue for pregnant women is here. For those interested in the scientific issues, the best in-depth article (in my opinion) is here. Check it out and make up your own mind!