Fish
What is Fish?
Fish contains a variety of beneficial nutrients including omega-3s, protein, and various vitamins and minerals. Children with ASD often have a decreased intake of fish, which may increase the risk of ADHD or cause omega-3 deficiency. Fish can be a staple protein in a balanced diet.
Fish is one of the top 8 food allergens, which makes it more likely that someone will react to them in some way [1].
Close to 40% of people with fish allergies do not experience their first reaction until adulthood [4].
Just because you are allergic to fish, does not mean you are allergic to shellfish [4].
Mercury content depends on the type of fish (see Mercury levels below)
Children with ASD often have decreased intake of fish, which may increase risk of ADHD [4,14]
There are extremely varying results on whether mercury intake during pregnancy, high or low fish consumption during pregnancy, and consumption of Omega-3’s have an effect on risk for ASD [5-10].
Nutrient Breakdown
Fish contains a variety of beneficial nutrients including:
Canned fish contains higher amounts of calcium because it usually contains the bones!
Mercury
Mercury content in fish depends on the type of fish. Fish such as shark, swordfish, and mackerel have the highest amounts of mercury and should not be consumed. Fish like salmon, tilapia, light tuna, and catfish have lower levels of mercury. [2]
In order to get full health benefits of fish, the FDA says kids should eat fish 2-3 times a week (smaller portion sizes than adults). Portion sizes include:
Children younger than 6: About 3-5 ounces per week
Children ages 6-8: About 4-6 ounces per week
Children ages 9 and up: Portions increase as calorie needs increase, up to 8-12 ounces per week (the amount recommended for adults)
Foods Containing Fish
Worcestershire sauce
Barbecue sauce containing Worcestershire sauce
Surimi (imitation fish)
Caesar salad and dressing
Fish sauce
Gelatin
Fish Alternatives
Food Reactions
Close to 40 percent of people with fish allergy do not experience their first allergic reaction to fish until they are adults [4]. An allergic reaction to fish is when proteins in the fish bind to IgE antibodies made by the immune system. The next time you eat fish the immune system will trigger leading to reaction symptoms. These symptoms can be very severe and could result in anaphylaxis.
An important thing to remember is that fish and shellfish are not the same. Someone could be allergic to one and not the other, or they could be allergic to both. An important thing to be aware about is cross-contamination risk between fish and shellfish. [4]
The body can respond to foods in many different ways including food allergies, food sensitivities, or food intolerances. If you suspect a food reaction, you can either choose to avoid the food or seek food reaction testing. Click here more information on the difference in types of food reactions and testing options.
DISCLAIMER: Always consult with your pediatrician and/or your Registered Dietitian to help you test for a food reaction or to aid you in making individualized dietary changes.
Fish & Autism in the Research
Mercury in Fish
Exposure to methylmercury by eating fish during pregnancy was not found to be associated with risk of ASD. [5-7]
Mean levels of mercury, lead and aluminum were higher in the hair of individuals with ASD than those without. Sources included fish intake, living by a gasoline station and using aluminum pans.[9]
Some studies have shown high blood mercury levels as a risk factor for the development of ASD, while others show no comparison. [10]
Fish Intake + ASD & ADHD
Individuals with autism are often found to have low intakes of fish, shellfish, seaweed and vegetables. [14]
Low adherence to a diet rich in fruit, vegetables, pasta, and rice and low consumption of fatty fish was associated with ADHD diagnosis [4]
Fish Intake During Pregnancy
Low fish consumption of the mother is a concern for poor social cognition with children with ASD. [11]
High fish intake during the second half of pregnancy have been linked to increased child autism traits. Large fish and shellfish were found especially to increase, while salmon was found to decrease. [13]
Some research states that consumption of large fatty fish during pregnancy helps to improve cognitive function and protect against ASD traits.[15]
Omega-3 Fatty Acid Intake
See the Omega-3 Note for more research on omega-3s
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[1] What You Need to Know about Food Allergies. U.S. Food and Drug Administration.https://www.fda.gov/food/buy-store-serve-safe-food/what-you-need-know-about-food-allergies. Published 2020. Accessed August 18, 2020.
[2] 1. Mercury Levels in Fish | American Pregnancy Association. American Pregnancy Association. https://americanpregnancy.org/is-it-safe/mercury-levels-in-fish-1088#:~:text=In%20high%20quantities%2C%20methylmercury%20can%20be%20toxic%20to,Gulf%20of%20Mexico%2C%20swordfish%2C%20shark%2C%20and%20king%20mackerel. Published 2020. Accessed August 25, 2020.
[3] 2020. [online] Available at: <https://fdc.nal.usda.gov/fdc-app.html#/food-details/781089/nutrients> [Accessed 10 August 2020].
[4]1. Fish. Food Allergy Research & Education. https://www.foodallergy.org/living-food-allergies/food-allergy-essentials/common-allergens/fish. Published 2020. Accessed August 26, 2020.
[5] Rossignol DA, Genuis SJ, Frye RE. Environmental toxicants and autism spectrum disorders: a systematic review. Transl Psychiatry. 2014;4:e360.
[6] Van wijngaarden E, Davidson PW, Smith TH, et al. Autism spectrum disorder phenotypes and prenatal exposure to methylmercury. Epidemiology. 2013;24(5):651-9.
[7] Mckean SJ, Bartell SM, Hansen RL, Barfod GH, Green PG, Hertz-picciotto I. Prenatal mercury exposure, autism, and developmental delay, using pharmacokinetic combination of newborn blood concentrations and questionnaire data: a case control study. Environ Health. 2015;14:62.
[9] Mohamed Fel B, Zaky EA, El-sayed AB, et al. Assessment of Hair Aluminum, Lead, and Mercury in a Sample of Autistic Egyptian Children: Environmental Risk Factors of Heavy Metals in Autism. Behav Neurol. 2015;2015:545674.
[10] Rahbar MH, Samms-vaughan M, Loveland KA, et al. Seafood consumption and blood mercury concentrations in Jamaican children with and without autism spectrum disorders. Neurotox Res. 2013;23(1):22-38.
[11] Golding J, Rai D, Gregory S, et al. Prenatal mercury exposure and features of autism: a prospective population study. Mol Autism. 2018;9:30.
[13] Vecchione R, Vigna C, Whitman C, et al. The Association Between Maternal Prenatal Fish Intake and Child Autism-Related Traits in the EARLI and HOME Studies. J Autism Dev Disord. 2020;
[14] Nakamura M, Nagahata T, Miura A, Okada E, Shibata Y, Ojima T. Association between Dietary Intake and Autistic Traits in Japanese Working Adults: Findings from the Eating Habit and Well-Being Study. Nutrients. 2019;11(12)
[15] Julvez J, Méndez M, Fernandez-barres S, et al. Maternal Consumption of Seafood in Pregnancy and Child Neuropsychological Development: A Longitudinal Study Based on a Population With High Consumption Levels. Am J Epidemiol. 2016;183(3):169-82.
[16] Field SS. Interaction of genes and nutritional factors in the etiology of autism and attention deficit/hyperactivity disorders: a case control study. Med Hypotheses. 2014;82(6):654-61.
[17] Newberry SJ, Chung M, Booth M, et al. Omega-3 Fatty Acids and Maternal and Child Health: An Updated Systematic Review. Evid Rep Technol Assess (Full Rep). 2016;(224):1-826.
[18] Saugstad LF. Infantile autism: a chronic psychosis since infancy due to synaptic pruning of the supplementary motor area. Nutr Health. 2011;20(3-4):171-82.
[19] Steenweg-de graaff J, Tiemeier H, Ghassabian A, et al. Maternal Fatty Acid Status During Pregnancy and Child Autistic Traits: The Generation R Study. Am J Epidemiol. 2016;183(9):792-9.
[20] De felice C, Cortelazzo A, Signorini C, et al. Effects of ω-3 polyunsaturated fatty acids on plasma proteome in Rett syndrome. Mediators Inflamm. 2013;2013:723269.
[22] Ríos-Hernández A, Alda JA, Farran-Codina A, Ferreira-García E, Izquierdo-Pulido M. The Mediterranean Diet and ADHD in Children and Adolescents. Pediatrics. 2017;139(2):e20162027. doi:10.1542/peds.2016-2027
