Collaborative ECHO research led by Emily Oken, MD, MPH of Harvard Medical School and the Harvard Pilgrim Health Care Institute, and Kristen Lyall, ScD of Drexel University, investigates fish consumption and the use of omega-3 supplements among pregnant women.
This research, titled “Demographic and health characteristics associated with fish and n-3 fatty acid supplement intake during pregnancy: results from pregnancy cohorts in the ECHO program,” is published in Public Health Nutrition.
Omega-3 fatty acids, also known as n-3 fatty acids, are essential nutrients during pregnancy for supporting child health and neurodevelopment and may also improve other pregnancy outcomes. Fish intake is the primary source of these nutrients in the diet. Prior research on who eats fish and uses supplements during pregnancy has been limited, involving fewer participants and older data that may not represent current consumption.
This study included 10,800 pregnant participants enrolled by 23 ECHO Cohort study sites that collected information on fish consumption, and 12,646 participants at 35 sites that collected information on omega-3 supplement use. While the ECHO Program began 2016, some study sites had been collecting participant data for many years before. In this study, information on fish consumption and omega-3 supplement use was collected from pregnant participants from 1999 to 2020.
After collecting this information, the researchers sorted participant data based on how often they ate fish: never or less than once per month, once per month to less than once per week, one to two times per week, or more than twice per week. They then compared participant fish consumption and supplement use across various demographic and lifestyle factors, including age, race, ethnicity, education, weight, and smoking status.
The research team observed that about 25% of pregnant participants did not eat any fish or ate fish less than once per month, but older participants were more likely to eat fish. Participants who were non-Hispanic Black, non-Hispanic Asian, or Hispanic ate less fish on average than those who identified as non-Hispanic White. Participants categorized as overweight were also less likely to eat fish.
Omega-3 supplement use was also rare—with only 1 in 6 study participants reporting taking omega-3 supplements. Supplement use was more common in participants who were older and had more education, a lower body mass index (BMI), and a diet that included fish.
“This study observed that one-quarter of participants in this large nationwide dataset rarely or never consumed fish during pregnancy, and omega-3 supplement use was uncommon, even among those who did not consume fish,” Dr. Oken said.
Experts recommend that people need additional omega-3 fatty acids during pregnancy. Ongoing effective public health advice and resources to support clinicians are needed to encourage consumption of low-mercury fish during pregnancy and intake of omega-3 supplements among those who do not consume fish.