Health benefits
The US FDA recommends moderate consumption of fish as part of a healthy and balanced diet. There is broad scientific consensus that docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) found in seafood are beneficial to neurodevelopment and cognition, especially at young ages.[64][65] The United Nations Food and Agriculture Organization has described fish as "nature's super food."[66] Seafood consumption is associated with improved neurologic development during pregnancy[67][68] and early childhood[69] and is more tenuously linked to reduced mortality from coronary heart disease.[70]
Fish consumption has been associated with a decreased risk of dementia, lung cancer and stroke.[71][72][73] A 2020 umbrella review concluded that fish consumption reduces all-cause mortality, cancer, cardiovascular disease, stroke and other outcomes. The review suggested that two to four servings per week is generally safe.[74] However, two other recent umbrella reviews have found no statistically significant associations between fish consumption and cancer risks and have cautioned researchers when it comes to interpreting reported associations between fish consumption and cancer risks because the quality of evidence is very low.[75][76]
The parts of fish containing essential fats and micronutrients, often cited as primary health benefits of eating seafood, are frequently discarded in the developed world.[77] Micronutrients including calcium, potassium, selenium, zinc, and iodine are found in their highest concentrations in the head, intestines, bones, and scales.[78]
Government recommendations promote moderate consumption of fish. The US Food and Drug Administration recommends moderate (4 oz for children and 8–12 oz for adults, weekly) consumption of fish as part of a healthy and balanced diet.[79] The UK National Health Service gives similar advice, recommending at least 2 portions (about 10 oz) of fish weekly.[80] The Chinese National Health Commission recommends slightly more, advising 10–20 oz of fish weekly.[81]
Health hazards
Barracuda found in Florida are avoided due to a high risk of ciguatera. The same fish found in Belize presents a lesser risk due to the lower prevalence of ciguatera-causing dinoflagellates in the Caribbean. Thus, knowing a fish's origin and life history is essential to determining its health hazards. 
Organic and inorganic compounds including methylmercury, microplastics, and polychlorinated biphenyls (PCBs) can bioaccumulate to dangerous levels in apex predators like swordfish and marlin. There are numerous factors to consider when evaluating health hazards in seafood. These concerns include marine toxins, microbes, foodborne illness, radionuclide contamination, and man-made pollutants.[77] Shellfish are among the more common food allergens.[82] Most of these dangers can be mitigated or avoided with accurate knowledge of when and where seafood is caught. However, consumers have limited access to relevant and actionable information in this regard and the seafood industry's systemic problems with mislabelling make decisions about what is safe even more fraught.[83]
Ciguatera fish poisoning (CFP) is an illness resulting from consuming toxins produced by dinoflagellates which bioaccumulate in the liver, roe, head, and intestines of reef fish.[84] It is the most common disease associated with seafood consumption and poses the greatest risk to consumers.[77] The population of plankton that produces these toxins varies significantly over time and location, as seen in red tides. Evaluating the risk of ciguatera in any given fish requires specific knowledge of its origin and life history, information that is often inaccurate or unavailable.[85] While ciguatera is relatively widespread compared to other seafood-related health hazards (up to 50,000 people suffer from ciguatera every year), mortality is very low.[86]
Scombroid food poisoning, is also a seafood illness. It is typically caused by eating fish high in histamine from being stored or processed improperly.[citation needed]
Fish and shellfish have a natural tendency to concentrate inorganic and organic toxins and pollutants in their bodies, including methylmercury, a highly toxic organic compound of mercury, polychlorinated biphenyls (PCBs), and microplastics. Species of fish that are high on the food chain, such as shark, swordfish, king mackerel, albacore tuna, and tilefish contain higher concentrations of these bioaccumulates. This is because bioaccumulates are stored in the muscle tissues of fish, and when a predatory fish eats another fish, it assumes the entire body burden of bioaccumulates in the consumed fish. Thus species that are high on the food chain amass body burdens of bioaccumulates that can be ten times higher than the species they consume. This process is called biomagnification.[87]
Man-made disasters can cause localized hazards in seafood which may spread widely via piscine food chains. The first occurrence of widespread mercury poisoning in humans occurred this way in the 1950s in Minamata, Japan. Wastewater from a nearby chemical factory released methylmercury that accumulated in fish which were consumed by humans. Severe mercury poisoning is now known as Minamata disease.[88][77] The 2011 Fukushima Daiichi Nuclear Power Plant disaster and 1947 - 1991 Marshall Islands nuclear bomb testing led to dangerous radionuclide contamination of local sea life which, in the latter case, remained as of 2008.[89][77]
A widely cited study in JAMA which synthesized government and MEDLINE reports, and meta-analyses to evaluate risks from methylmercury, dioxins, and polychlorinated biphenyls to cardiovascular health and links between fish consumption and neurologic outcomes concluded that:
"The benefits of modest fish consumption (1-2 servings/wk) outweigh the risks among adults and, excepting a few selected fish species, among women of childbearing age. Avoidance of modest fish consumption due to confusion regarding risks and benefits could result in thousands of excess CHD [congenital heart disease] deaths annually and suboptimal neurodevelopment in children."[70]
Mislabelling
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Escolar is sometimes difficult to distinguish from tuna when cooked. Unlike tuna, escolar is associated with keriorrhea and severe cramping following consumption.[90] In many restaurants, most fish labeled as tuna, white tuna, or albacore are mislabeled escolar.[91][92] Due to the wide array of options in the seafood marketplace, seafood is far more susceptible to mislabeling than terrestrial food.[77] There are more than 1,700 species of seafood in the United States' consumer marketplace, 80 - 90% of which are imported and less than 1% of which are tested for fraud.[91] However, more recent research into seafood imports and consumption patterns among consumers in the United States suggests that 35%-38% of seafood products are of domestic origin.[93] consumption suggests Estimates of mislabelled seafood in the United States range from 33% in general up to 86% for particular species.[91]
Byzantine supply chains, frequent bycatch, brand naming, species substitution, and inaccurate ecolabels all contribute to confusion for the consumer.[94] A 2013 study by Oceana found that one third of seafood sampled from the United States was incorrectly labeled.[91] Snapper and tuna were particularly susceptible to mislabelling, and seafood substitution was the most common type of fraud. Another type of mislabelling is short-weighting, where practices such as overglasing or soaking can misleadingly increase the apparent weight of the fish.[95] For supermarket shoppers, many seafood products are unrecognisable fillets. Without sophisticated DNA testing, there is no foolproof method to identify a fish species without their head, skin, and fins. This creates easy opportunities to substitute cheap products for expensive ones, a form of economic fraud.[96]
Beyond financial concerns, significant health risks arise from hidden pollutants and marine toxins in an already fraught marketplace. Seafood fraud has led to widespread keriorrhea due to mislabeled escolar, mercury poisoning from products marketed as safe for pregnant women, and hospitalisation and neurological damage due to mislabeled pufferfish.[92] For example, a 2014 study published in PLOS One found that 15% of MSC certified Patagonian toothfish originated from uncertified and mercury polluted fisheries. These fishery-stock substitutions had 100% more mercury than their genuine counterparts, "vastly exceeding" limits in Canada, New Zealand, and Australia.[97]
Sustainability
Research into population trends of various species of seafood is pointing to a global collapse of seafood species by 2048. Such a collapse would occur due to pollution and overfishing, threatening oceanic ecosystems, according to some researchers.[98]
A major international scientific study released in November 2006 in the journal Science found that about one-third of all fishing stocks worldwide have collapsed (with a collapse being defined as a decline to less than 10% of their maximum observed abundance), and that if current trends continue all fish stocks worldwide will collapse within fifty years.[99] In July 2009, Boris Worm of Dalhousie University, the author of the November 2006 study in Science, co-authored an update on the state of the world's fisheries with one of the original study's critics, Ray Hilborn of the University of Washington at Seattle. The new study found that through good fisheries management techniques even depleted fish stocks can be revived and made commercially viable again.[100] An analysis published in August 2020 indicates that seafood could theoretically increase sustainably by 36–74% by 2050 compared to current yields and that whether or not these production potentials are realised sustainably depends on several factors "such as policy reforms, technological innovation, and the extent of future shifts in demand".[101][102]
The FAO State of World Fisheries and Aquaculture 2004 report estimates that in 2003, of the main fish stocks or groups of resources for which assessment information is available, "approximately one-quarter were overexploited, depleted or recovering from depletion (16%, 7% and 1% respectively) and needed rebuilding."[103]
The National Fisheries Institute, a trade advocacy group representing the United States seafood industry, disagree. They claim that currently observed declines in fish populations are due to natural fluctuations and that enhanced technologies will eventually alleviate whatever impact humanity is having on oceanic life.[104]
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