Doctor's Note

What was that about smaller brains? See my last video, Fish Intake Associated With Brain Shrinkage. More on the effect on teens in my video Nerves of Mercury.

More on PCBs in:

The “package deal” concept is a recurring one (see, for example, New Mineral Absorption Enhancers Found). Yes, dairy products are the #1 source of calcium in the U.S., but they’re also the #1 source of saturated fat. Thankfully there’s a way to get calcium without all this baggage and the same with DHA (and iron, and protein, and…).

It is a rare circumstance where I recommend supplements, but there is at least one (vitamin B12) that is critical for those eating plant-based diets. My latest summary of recommendations can be found here.

For more context check out my blog: Top 10 Most Popular Videos from 2013

If you haven't yet, you can subscribe to my videos for free by clicking here.

  • Leslie

    Does the science really show clearly and conclusively that vegans need to take a DHA supplement?

    • Ji Kang

      Or is ALA good enough from flax, while also limiting omega-6 from diet?

      • George
        • Dikaiosyne

          The article you cite doesn’t support your unqualified “Yes!”.

          • nc54

            There is evidence, not sure what you are looking for. Here is some more:

            “A UK research group, led by Dr Ailsa Welch at the University of East Anglia, estimated dietary intakes and blood levels of ALA, EPA and DHA among 4,902 fish-eaters and non-fish-eating meat-eaters, vegetarians or vegans. Surprisingly, despite the significantly lower intakes of EPA and DHA among non-fish-eaters, their blood levels ofEPA and DHA were much more similar to those of regular fish eaters. The researchers estimated the conversion of ALA into EPA and DHA by calculating the ratio of long-chain omega-3 fatty acids to plant-derived dietary ALA. This ratio was significantly greater in all the non-fish-eating groups than in the fish eaters, suggesting that in non-fish-eaters the body may compensate for the lack of EPA and DHA by boosting its conversion of ALA from plant foods.”

          • DH

            If this is the study I am thinking of – EPIC-Norfolk – the data are based on very few vegans, a questionnaire that defined veganism on the basis of one week of food intake, and there was a huge range in numbers. Jack Norris actually critiques this paper in detail here: http://veganhealth.org/articles/omega3#n3intake

            “The general trend is that lacto-ovo vegetarians and vegans have lower levels of EPA and DHA in their blood. One exception is the 5 vegan women in the 2010 UK study who had, on average, higher DHA levels than even the fish-eaters. This is probably an anomaly for a few reasons. First, “vegan” was simply defined as someone who did not list eating animal products in their 7-day diet diaries. These vegans might have only been vegan for one week. Second, there were only 5 vegan women in the study making the finding unlikely to be statistically significant. Third, the standard deviation for the DHA levels of the vegan women was very high at 211 µmol/l. That means that one or two of the vegan women had very high levels of DHA but some had very low levels.

    • guest

      That is a fabulous question and one I have been deliberating on and researching many months. I think the best answer is “we don’t know”. Any other answer, ultimately, is dishonest and it comes down to a matter of balancing values and preferences for each individual.
      Vegans make DHA in very small amounts, far less than what regular marine fish consumers get from their diets. And there is a lot of evidence correlating DHA intake, and achieved DHA levels, with various positive health outcomes. However, none of it is randomized, and none of it is in vegans.
      Evolutionarily, there is some evidence that our early hominid ancestors had broad access to DHA-rich food sources in the Rift valley; and in brain structures, the majority of EFA is DHA. Some scientists have made the argument that access to DHA is what caused our divergence from other, non-human primates in terms of frontal cortex size. But this remains an argument. They weren’t actually there at the time to study this phenomenon.
      The question I struggle with personally is: “Can all the benefits of eating oily marine fish be distilled to a single molecule – DHA”? I think the answer is likely to be no, but if some of the benefits (without the risk of contaminants) do translate to consumption of just DHA in ‘vegan’ supplements, then it would be worthwhile to consume DHA. But we really don’t know. Fish contain millions of molecules, not just DHA (and EPA).
      While blood levels of DHA in observational studies remain a health predictor based partly on confounding by healthy lifestyle habits in fish consumers (viz. Mozaffarian’s studies), I am not going to take chances with my neural health and potentially cause dementia by shooting my DHA levels down to undetectable levels.
      On the other hand, taking DHA as an isolated micronutrient could conceivably cause harm, as the SU.FOL.OM3 study suggested in women consuming a combined DHA/EPA supplement (increased cancer risk, but in a subgroup analysis).
      So I respect people who have either opinion on this issue – for or against – and I believe there is no definitive answer to whether DHA is truly a ‘vitamin’ (essential for bodily function). It is up the individual’s values and preferences in weighing all of this, at times contradictory, evidence.

      • Darryl

        When in doubt, do a meta-analysis (31 trials, 100,000 patients). The effect of EPA+DHA supplementation on risk of cardiovascular events is strong (36% reduction), while the effect on overall mortality is modest (5% reduction, and non-significant). Most interesting, there was no further benefit after the first 200 mg EPA+DHA.

        • guest

          This is truly a moving target though. There’s been a number of negative trials published since that meta-analysis was published, and it appears to conflate observational with randomized studies (I admit that I only read the abstract). A much more recent meta-analysis by Mozaffarian et al in The Lancet found that randomized trials in aggregate found no benefit in terms of cardiovascular risk – and this meta-analysis did not even include the latest neutral trial, the Risk and Prevention Study.

          http://www.sciencedirect.com/science/article/pii/S0140673613612994

          “When the analysis was restricted to RCTs, the effect was 0·95 (95% CI 0·87–1·05) per 100 mg/day EPA+DHA.”

        • Leslie

          It seems like none of the studies look at the merits of a vegan diet rich in omega 3 greens, nuts, and seeds, and if an abundance of these foods on a daily basis would provide the same reduction rates as the EPA + DHA supplementation. Do you know if there are studies that have looked at this?

          • VegAtHeart

            These are good thoughts. It is possible that the observed positive effects of DHA/EPA supplementation may arise from improvements to the large number of sufferers of chronic inflammation, especially those who follow a pro-inflammatory diet. It would be useful to learn more about how these supplements affect those on an anti-inflammatory diet.

          • Darryl

            To date, the important vegan diet intervention trials like those of Ornish and Esselstyn looked at disease markers rather than outcomes or mortality, so they’re not quite comparable. Adventist 2 is perhaps the first prospective study large enough to compare vegan with other diets with respect to disease outcomes (mortality), and do note the Adventist omnivores that serve as the reference are among the world’s healthiest.

            As for ω-3 from plants, there is a 2012 meta-analysis of ALA studies, all of which have used prospective cohorts rather than RCTs. Among the 15 studies measuring ALA intake using dietary questionaires, there was a significant 10% reduction in CVD events, and significant 20% reduction in CVD mortality. However, the ones that use biomarkers for ALA intake found a non-significant 20% risk reduction trend, but no effect on mortality. It seems likely there’s an positive effect, but both effect size and strength of evidence are smaller than with EPA+DHA.

          • http://www.DonForresterMD.com/ Don Forrester MD

            Esselstyn’s about ready to publish a long term follow up with some remarkable results. Caution needs to be used when viewing meta-analytic studies. They are becoming popular because they are relatively inexpensive. You have to be careful and see what criteria were used to exclude studies and remember that any statistical flaws in the studies used are brought along with them when the studies are rolled together. At this point I would avoid fish and fish oil and for my patients that I think might benefit from algae based sources.

  • Alessio

    Dr. Greger,
    what is your position on DHA supplements in elderly?
    For example, in your opinion, can a vegan over 65 years of age, obtain all the DHA and EPA he/she needs from flax seeds and greens only, or is a DHA supplement needed? Obviously I’m referring to vegan people who can’t be tested for blood DHA and EPA levels. Unfortunately, in many countries, these expensive tests are not available.

    • http://nutritionfacts.org/ Michael Greger M.D.

      That’s my current recommendation. I am working on updating my omega-3 recommendations, though, as they were made back in 2011 and there have been about 4,000 studies published since…

      • Alessio

        Thank you so much! ;)

      • Synergy

        I currently supplement with an EPA-DHA algal oil combination by Deva. However, there is a much cheaper variety of another brand at a local store that is only DHA. I understand that DHA supplies brain benefits, and can be converted to EPA for heart benefits, but is there a significant difference in effectiveness?

        (I do consume hemp protein, ground flax, soy and occasionally chia mixed with water or fruit juice, as well)

        Also, with regard to related heart health, I just got blood work done with the following cholesterol readings:

        LDL = 52
        HDL = 65
        TG = 43

        Now, I know you said in the past that there is no such thing as too low, but that number really stunned me. Even if its super cardio-protective, could it be an indication of some other health issue? (like how cancer lowers cholesterol, though my HDL is pretty good so I don’t think that could be a possibility?) Could it be the algal oil?

        My background: I’m a 24 year old male caucasian lacto-ovo vegetarian (vegan on most days depending on what’s available). I am slightly underweight at 135 and 6’0″ and largely sedentary with a loaded schedule of college, work and very little sleep. I do drink alcohol, as well. 1-2 beers a day — craft beer only for health and taste interests (typically never more than 3-4). Vitamin D3, B12, calcium and iron tested good. Folate kind of high (23.5 ng/mL) I do eat candy or protein bars 2-4 times a week when I’m too busy for a meal and pizza 1-2 a week (nearly a full large sorrento in one night). So, I am confused with the results. My family has “normal” to high cholesterol almost across the board, but are all omnivores.

        • Darryl

          EPA is an intermediate in algal DHA synthesis, and the major supplier of refined algal oil produces a product with a EPA:DHA ratio that appears to range from 1.6 to 2. The EPA might not be mentioned on the label, and the DHA amount might also be considerably higher than listed (the label indicating a minimum amount).

        • guest

          “I understand that DHA supplies brain benefits, and can be converted to EPA for heart benefits, but is there a significant difference in effectiveness?”

          You can make EPA from ALA but you can only make trivial amounts of DHA from ALA.

          “Even if its super cardio-protective, could it be an indication of some other health issue?”

          Unlikely in a 24 year old male

          “Could it be the algal oil?”

          If anything one would expect to see rising levels of LDL with long-chain fatty acid supplementation, rather than a hypocholesterolemic effect.

      • guest

        All vegan DHA supplements contain added vitamin E, and you have a video alerting people not to take vitamin E, and other popular vegan doctors have done the same…..yet you are taking a vegan DHA supplement that contains added vitamin E (unless you have found one without E. Last I checked, there aren’t any on the market without E.)

        Please explain this contradiction as it is confusing a lot of vegans out there.

  • Darryl

    Due to “adverse climatic conditions”, there’s a current fish oil / meal supply crisis as fish oil supplies fell 27% and fish meal by 34% in 2012. This likely further reduces the EPA+DHA content of farmed salmon, which has already fallen by two-thirds from 2000 to 2012.

  • LenS

    You can get DHA & EFA without resorting to marine sources. Supplements Like YES EFA take mercury out of the equation and let your body make the DHA it needs.

  • Ronald Chavin

    In addition to the 23 scientific studies indicating that a baby’s BRAIN HEALTH will not be harmed by a mother who eats plenty of fish, which I posted under Dr. Greger’s previous video, here are 13 more scientific studies which indicate that if a mother eats plenty of fish, her baby’s OVERALL HEALTH will be substantially better compared to a mother who didn’t eat any fish:
    http://www.ncbi.nlm.nih.gov/pubmed/24265794
    http://www.ncbi.nlm.nih.gov/pubmed/24094480
    http://www.ncbi.nlm.nih.gov/pubmed/22449171
    http://www.ncbi.nlm.nih.gov/pubmed/23963690
    http://www.ncbi.nlm.nih.gov/pubmed/21199856
    http://www.ncbi.nlm.nih.gov/pubmed/22006485
    http://www.ncbi.nlm.nih.gov/pubmed/21535434
    http://www.ncbi.nlm.nih.gov/pubmed/11395920
    http://www.ncbi.nlm.nih.gov/pubmed/21534748
    http://www.ncbi.nlm.nih.gov/pubmed/18400711
    http://www.ncbi.nlm.nih.gov/pubmed/18403927
    http://www.ncbi.nlm.nih.gov/pubmed/15716794
    http://www.ncbi.nlm.nih.gov/pubmed/12509593

    • b00mer

      Fyi, I can’t see your comment on the previous video

      In the list here, I see three possibly meaningful studies regarding infantile wheeze, weight, and asthma.

      The rest don’t really convince me that eating fish per se is beneficial, rather that having good n-3 levels is beneficial:

      studies showing n-3 supplementation is better than n-6 supplementation (4 studies); n-3 supplementation is better than a placebo (1 study); two reviews looking at why n-3s are important overall and one looking at n-3 vs n-6; one study showing higher n-3 levels are better than higher n-6 levels; and confusingly, one study showing meat intake related to higher rates of rhinoconjunctivitis.

      The benefits of good n-3 levels are clear and not in dispute. But personally, there’s still no way I would introduce the carcinogens, endocrine disruptors, heavy metals, etc to my already ala-rich/low n-6 diet (avg about 300-400% rda, with ~2:1 n6:n3 ratio), *especially* with a developing fetus involved. When pregnant and breastfeeding, I would choose algae-derived n-3. Effects from carcinogens may not be visible for decades following exposure, and several bioaccumulated environmental toxins have been shown to have trans-generational epigenetic effects. Why anyone who’s been educated on the risks would advocate for fish over algae is baffling to me.

    • Marcella

      to add, those studies you posted were on omega 3 supplementation, not on pregnant women who ate fish.

  • punky

    I recently became a vegetarian I have a question for you does Marshmallow have any pork or fish in them at all ? this is every important to me thank you so much for your help .

    • Daniel Wagle

      It has gelatin, which is an animal slaughter by product.

    • b00mer

      Animal-derived gelatin is made from skin, bones, and connective tissue. You can purchase vegan marshmallows online (amazon has them), or you can also make your own – I saw this recipe just recently and people seem to give it good reviews:

      http://www.veggieboards.com/t/12910/marshmallow-fluff-in-the-jar

      Scroll to about halfway down the page to see it. Keep in mind, these are vegan but NOT healthy!

      • Marcella

        I want to add, you can make a very unhealthy Vegan diet, in otherwords as the saying goes ‘don’t throw out the baby with the wash’. A good Vegan plant-based diet would focus more on whole foods and less on processed foods, stay on the outside isle at the grocery store, avoid the middle ones :) . Although I have to say, it took alot of the ‘transition’ foods to help me move away from an almost 100% meat diet 25 yrs ago. My total cholesterol was over 400 at 30 yrs old, now its 141, but there was a time I was considered a ‘Fat Vegan’, it is so easy to do, there are lots of fat and unhealthy Vegan foods waiting for your buying dollar, so word to the wise, if you ‘need’ to dip into the processed bad foods for a while to help you ‘pass over’, do it, but do it over a short time. Find vegan whole foods that you enjoy, learn how to spice food to where it tastes so good you look back at the flesh-eating years and wonder what was clogged in your brains cells for so long!!! hehe

    • Thea

      punky: Congrats on becoming a vegetarian.

      Daniel and b00mers replies were both great. Here’s the third piece to know – how to get vegan commercial marshmallows for those times when you have an urgent marshmallow need and don’t want to make your own.

      I recently got to try the brand Dandies. I LOVED them. The Dandies were just like I remember marshmallow’s tasting. Below is a link if you are interested. Of course, as b00mer points out, they aren’t healthy. But at least they are ethical and no-worse health-wise than a standard marshmallow. And as an occasional treat, they are just fine.

      http://www.amazon.com/Dandies-Original-Vanilla-Marshmallows-10/dp/B003L7DFQA/ref=sr_1_1?ie=UTF8&qid=1385658913&sr=8-1&keywords=dandies+marshmallows

      • punky

        thank you for your help .

  • DH

    Each day for breakfast I eat a ton of raw veggies and on the side I make a smoothie mixed with following items:
    -1/4 cup frozen blueberries
    -1/2 cup unsweetened almond milk
    -4-5 heaping tablespoons of nuts & seeds (mix of almonds, walnuts, hazelnuts, pecans, sunflower seeds, pumpkin seeds)
    -2 brazil nuts (selenium!)
    -2 tbsp. of wheat bran
    -1 tbsp. of wheat germ
    -1 tbsp. of hempseed
    -2 tbsp. of flaxseed (whole)
    -1 tbsp. of raw cacao nibs

    Does anyone think this contains too much fat? If so, what substitute would you recommend for all the nuts and seeds?

    (A small modification I am going to make is to change from raw nibs to cacao powder, but this won’t drop the fat all that much – perhaps by 1-1.5 g only)

    THANKS FOR ALL YOUR HELP!

    • Marcella

      Simply have your doctor run a Lipid profile (cholesterol) and see how you are doing, I would go ahead and ask him to check your Omega 3 too as it will have the EPA and DHA breakdown. Having lab run is very easy and will help support your good choices. If you haven’t gained weight I would also assume your dietary intake of whole plant food fats has not exceeded your body’s needs. Remember, we do need fats, and the best way is to get them in whole foods as you are doing. Remember there are always those out in there wanting to knock down healthy plant-based eating over their own S.A.D. choices.

      • DH

        Marcella, thanks for your comments. I agree we need fats. I just am not sure that a lot of nuts and seeds qualifies as whole plant food fats, if taken to excess. I like your comments.

  • Kevin

    I know some are very contaminated, but are there some fish oil based DHA supplements that are not too contaminated to take? I have not found the algae based DHA and the fish oil based supplements are quite inexpensive at Costco. Similarly, can we find safe organic Triphala that does not contain pesticides or heavy metals?

    • b00mer

      From Dr. Gregers video: “Is Distilled Fish Oil Toxin- Free?” http://nutritionfacts.org/video/is-distilled-fish-oil-toxin-free/

      “[researchers] found the same PCBs and insecticides, even in the supposedly “PBC-free” fish oil. And the exact same levels of other industrial pollutants. The bottom-line: ‘This suggests that the commercial molecular distillation treatment used for removal of toxic contaminants is only effective for some of the contaminants.’ So, they conclude, that you have to balance the trade-off between risks and benefits, especially given how ineffective current fish oil treatments are at removing some of these contaminants.”

      As you said, the algae-based DHA are pricey, and I also have concerns about stability and shelf life when it comes to any n-3 supplements. For the time being, I feel comfortable with my wfpb diet with leafy greens, chia, and flax. I will revisit this of course in the future when I am considering pregnancy. Darryl has mentioned prices of algae-based supplements possibly decreasing in the (near?) future due to expiring patent issues and more competition.

      • DH

        You make a good point about stability and shelf life. This is one reason that DHA vegan tabs are loaded with antioxidants like rosemary extract and the like. I don’t refrigerate mine but probably should. From my reading of every vegan DHA status paper I could get my hands on, as well as talking to Jack Norris about this issue repeatedly, I’ve come to believe that without supplementation it is impossible to achieve normal DHA status on a plant-based diet, no matter how much ALA one consumes. However, the question is whether DHA status is important or is it just a marker of a healthy lifestyle (as seen in people who tend to eat fish – they are typically healthier in other respects, so confounding by healthy user bias). I don’t know the answer but in my own case, after an interregnum, I decided to resume DHA as a “just in case” measure. The biological plausibility that DHA is important for adult nervous system health is pretty compelling.

    • b00mer

      Oh, and regarding triphala/amla: I have purchased both triphala and amla from Banyan Botanicals. They have a page specifically about quality control in regards to heavy metal testing, microbial testing, and identification. I got a half pound of organic powdered amla and triphala each for $9.99. I like to add just a pinch to my oatmeal. They also require sustainable farming practices from their sources and do not sell several Ayurvedic botanicals that are endangered.

      http://www.banyanbotanicals.com/quality-control.html

  • Alon Goldreich

    Question:
    I have taken your advise on giving up fish in favor of vegan DHA.
    Now, on one hand i’m told the best source of DHA is fresh, cold pressed, refrigerated oil (e.g.flaxseed oil). On the other hand, i’m told recent study shows ALL oils are bad (for cardiovascular reasons). So my question is; should I still use the “higher quality” liquid oil, or go for the DHA powder capsules???

    Thanks for the GREAT content. This is real public service!

    • DH

      “So my question is; should I still use the “higher quality” liquid oil, or go for the DHA powder capsules???”

      Alon, I have never seen vegan DHA in any form other than either a container of liquid (like an elixir) or in a liquid gel-cap (I myself take the latter). That is because at room temperature DHA has the properties of an oil and is fluid. If you have found DHA in powderized form, it is likely significantly denatured.

      And you cannot make sufficient quantities of DHA from high-quality flaxseed oil, unless you have bought a mix (like Udo’s oil) that contains both flaxseed oil (which is ALA) and DHA. While vegans do have more ability to convert ALA to EPA than non-vegans, all of the data that I have ever seen suggests that transformation to DHA is extremely limited (at best 15%, and probably lower), and thus vegans who do not consume DHA (either from diet or supplements) end up with very low levels of DHA.

      • Alon Goldreich

        I re-watched the video. I assumed all those containers shown contained powder (minute 3:15), but the visible ones are indeed gel capsules. Thanks for the correction.

        So since it is liquid oil in capsules. How do you weigh the benefit from it versus the damage from consuming oils in general?

        • DH

          Hmm. Good question. Not all oils are bad. Good oils are omega-3 (ALA, EPA, DHA). Bad oils include omega-6′s in large quantities (found in many vegetable seed oils), and saturated fats and trans fats. A relatively benign oil is monounsaturated fat – but all oils are high in calories. The nice thing about the omega-3′s like DHA is that you really do not need a lot of it to have benefit. We are talking about fractions of a gram here (less than the weight of a paper clip). It is micronutrient dosing, typically in milligrams rather than gram quantities. I would not blanket avoid an oil unless I knew what it was. So yes, coconut oil is bad for you, as is lard, sewet and butter. On the other hand, DHA, EPA and ALA are not bad for you – they are quite healthy.

          • Alon Goldreich

            Caldwell Esselstyn (who seems to have great reputation) got me paranoid about oils:
            please tell me what u think after watching this…

            https://www.youtube.com/watch?v=b_o4YBQPKtQ

          • DH

            Alon, if you go back to the original Rudell studies that Ess is talking about, the monkeys assigned to the polyunsaturated fat diets did best, whereas those on the MUFA and SFA diets did the worst. In addition, I believe Ess has long recommended omega-3 fatty acid supplements to his patients. Again we are not talking about fats in macronutritient amounts, but rather in micronutritient amounts, and we are referring only to the ‘good fats’ like omega-3′s, which are also labelled as “Essential Fatty Acids”, solely because they cannot be manufactured by the human body. The Essential Fatty Acids include omega-6 linoleic acid (in small amounts), omega-3 alpha-linonlenic acid (ALA – a plant-derived fat), omega-3 eicosapentaenoic acid (EPA) and omega-3 docosahaexanoic acid (DHA). When Ess refers to ‘oil’ in his video, he is largely talked about cooking oils, especially olive oil, which is a source of empty calories and contains substantial amounts of the MUFA that accelerated atherosclerosis in the 5-year Rudell studies.

            When you take any speech out of context in a 4-minute snapshot like that, you are going to miss the broader picture.

          • Alon Goldreich

            Thanks for clarifying this.

          • Alessio

            DHA and EPA are not essential.

  • rana

    interesting as usual :-) .. I wonder though, what do you think about this article that claim that what because the Selanium:MeHg ratio is more important then the MeHg alone: http://www.ncbi.nlm.nih.gov/pubmed/20561558
    I know that the fish industry and compenies like starkist quoting this guy and claiming that their tuna is with good ratio…

    • Marcella

      Why risk it?

  • TimelessRainDrops
  • Brian

    What about BMAA from cyanobacteria in Algae?

  • Sebastian Tristan

    Question #1: Are vegan DHA supplements safe? Aren’t they also contaminated with pollutants or other toxic elements? Question #2: If we consume seaweeds like Nulse, Arame, Nori, Laver, do we get DHA/EPA?

    • Thea

      Sebastian: Concerning your question #1: I could be wrong, but it is my understanding that vegan DHA supplements are based off of algae that is grown in special sanitary vats under controlled conditions. In other words, they are not harvesting the algae from the sea. So, unless the company is using dirty water, the vegan DHA supplements would be very clean/safe.

      I can’t swear to that, but I remember reading it a couple places when I did research some time ago. You could always ask a specific company if you were interested in a particular brand.

      I don’t know the answer to #2.

      • Sebastian Tristan

        Thanks.

  • Michel Voss
  • Mainely Vegan

    What is your opinion on Wild Alaskan Salmon (mostly Sockeye) and Pacific Sardines, both of which are on Monterey’s safest seafood list? These are my only exceptions to a vegan diet. What about for my baby granddaughter?

    • Thea

      Mainely Vegan: Regardless of where fish spend their formative years, their flesh still has a lot of saturated fat (at least 15% I believe), and their flesh is still animal protein. If you are interested, you might want to check out the series on IGF-1 on this site which shows how cancer growth is linked to animal protein consumption. Also, it’s my understanding that even the most remotely raised fish are showing signs of contamination. So, while some seafood may be safer compared to other seafood (ie, on someone’s “safest” list), that doesn’t mean it is actually a good idea to eat it…

      For me: I can’t think of any reason for anyone to eat fish – but most especially for a baby/young person. Why give them a taste for something that is not only bad for them long term, but is contributing to destroying the ocean – something a child will care about greatly in the decades to come?

      Having said that, I would think that if salmon were a very small part of a person’s diet (1 percent of calories??), it wouldn’t hurt an adult health-wise at this point in time.

      I’m not an expert. I’m just sharing my 2 cents. Good luck to you and your granddaughter.