As any of you who have had the surgery know I often recommend fish as "good" food. What that means is that it is a good source of protein (always important in the Bariatric population) and it has "good" fat. Many
fish have Omega-3 fatty acids (good fat) and a recent government report
came to the conclusion that eating fish may reduce your risk of heart
disease. I wanted to address some of the concerns that patients may have about fish.
What about Mercury?
Only
woman who are or may become pregnant, mothers who are nursing and young
children are advised to avoid the following fish: shark, tilefish,
swordfish, and king mackerel because of high mercury levels. In
2004 the Environmental Protection Agency (EPA) advised these same high
risk groups to also limit canned albacore (white) tuna and tuna steak
to no more than 6 ounces per week.
What about PCB's? PCB's are banned industrial chemicals that persist in the environment. PCB's are most likely to show up in fish from lakes and local rivers, but they can be in the ocean as well. Farmed salmon tends to have higher levels than wild. Farmed
salmon tends to get PCB's from their feed; wild salmon eat a more
varied diet and have much lower levels. Salmon is also generally low in
mercury. Farmed salmon from South American sources (
Chile in particular) tend to have the lowest amounts of PCB's. To reduce PCB's in fish remove skin and fat with a sharp knife before cooking (or ask the seller to do it). Broil, bake, or grill the fish on a rack instead of sautéing or frying. The
rack allows the fat (where the chemicals concentrate) to drain off but
retains the healthy Omega-3s. Do not use batter or breading which will
trap the fat drippings.
Is it farmed or wild? A new law requires supermarkets to label fish with its country of origin and whether it is farmed or wild. Most salmon is farmed including "Atlantic" salmon and most smoked salmon. Alaskan salmon is wild and almost all canned salmon is wild. Price can also be a good indicator; wild salmon is generally more expensive.
The following is a list of fish that are generally low in contaminants and mercury and high in the Omega-3s:
Anchovies
Herring
Mackerel
Sablefish (also called black cod)
Salmon (wild, most canned salmon)
Sardines
Striped Bass (farmed)
Tilapia (farmed in the
U.S.)
A more immediate threat to your health than mercury, PCB's, or other contaminants is parasites and micro-organisms. For this reason be sure to always cook all fish. Cooked fish should flake easily when tested with a fork. Shellfish cooks in about 5 minutes, steam mussels and clams to the point where the shell opens. It
is not advisable to eat seafood raw or undercooked, this is especially
important if you are pregnant, in poor health, or have a compromised
immune system.
In Good Health,
Michael Bilof
drbilof@gsbwc.com
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