Abstract:
Guidance on foods to limit or avoid in pregnancy is provided on the NHS website for England. Advice on fish consumption is related to exposure to mercury, dioxins and polychlorinated biphenyls, which may have adverse effects on fetal neurodevelopment. Our aim was to provide evidence on the effectiveness of the guidance in minimising exposure to toxins while maximising nutrient intake in a mixed-methods study. An online questionnaire on fish consumption before/during pregnancy was completed by postpartum women (≤12 months) in England (n = 598). A subsample of participants was invited to take part in an interview (n = 14). Women who ate fish before pregnancy reduced their intakes of both oily and white fish during pregnancy, with some avoiding it altogether. Women did not exceed the limit on tinned tuna, but there was evidence of mis-recall on the suggested limit. Overall intakes of fish were below that recommended during pregnancy (36% compliance for pre-pregnancy consumers). Barriers to fish consumption included risk aversion, confusion over specific details of the guidance, cost, availability, family preferences and smell/taste. Clarity and simplicity of the NHS guidance, with an overall message on the number of portions of fish a week advised prominently shown, would help pregnant women to benefit from the nutrients in fish while minimising exposure to toxins. The guidance on the number of cans of tuna advised per week is poorly recalled and needs to be disseminated accurately. The guidance on shark/marlin/swordfish could receive less prominence as it is rarely eaten by pregnant women in England.
摘要:
英国NHS网站上提供了限制或避免怀孕的食物指南。关于鱼类消费的建议与汞接触有关,二恶英和多氯联苯,这可能会对胎儿神经发育产生不利影响。我们的目的是在混合方法研究中,提供有关指南在最大程度地减少毒素暴露,同时最大程度地增加营养摄入量方面的有效性的证据。在英格兰(n=598),产后妇女(≤12个月)完成了关于怀孕前/怀孕期间鱼类消费的在线问卷调查。参与者的子样本被邀请参加面试(n=14)。怀孕前吃鱼的妇女在怀孕期间减少了油性和白色鱼的摄入量,有些人完全避免。妇女没有超过罐装金枪鱼的限制,但是有证据表明在建议的限度内召回错误。鱼的总体摄入量低于怀孕期间的建议(怀孕前消费者的依从性为36%)。鱼类消费的障碍包括风险厌恶,对指导的具体细节感到困惑,成本,可用性,家庭偏好和气味/味道。NHS指南的清晰度和简洁性,突出显示了关于每周鱼类份数的总体信息,这将有助于孕妇从鱼类中的营养中受益,同时最大限度地减少接触毒素。关于每周建议的金枪鱼罐头数量的指南没有得到很好的召回,需要准确地传播。关于鲨鱼/马林鱼/箭鱼的指导可能会不那么突出,因为它很少被英格兰的孕妇食用。