The researchers posit that adopting a diet rich in marine forage fish could prove particularly advantageous for low and middle-income countries, where these fish are abundant and economically accessible. This dietary shift could be instrumental in mitigating the significant burden of heart disease prevalent in such regions. They highlight mounting evidence associating the consumption of red and processed meats with heightened risks of non-communicable diseases (NCDs), which accounted for approximately 70% of global deaths in 2019. Among these NCDs, coronary heart disease, stroke, diabetes, and bowel cancer constituted nearly half of the toll, with coronary artery disease being the predominant contributor.
Marine forage fish emerge as a promising dietary alternative due to their rich content of omega-3 long-chain polyunsaturated fatty acids (DHA and EPA), calcium, and vitamin B12. These nutrients are crucial for cardiovascular health, potentially aiding in the prevention of coronary heart disease. Moreover, forage fish boasts the lowest carbon footprint among animal food sources, underscoring their environmental sustainability. However, despite their nutritional and ecological benefits, a substantial portion of the forage fish catch, primarily from regions grappling with food insecurity and malnutrition, is diverted towards fishmeal and fish oil production for fish farming, catering predominantly to affluent consumers.
Recognising the potential of forage fish to alleviate the global burden of disease, the researchers embarked on a comprehensive analysis. They devised four distinct scenarios, each reflecting a different approach to forage fish allocation globally. These scenarios aimed to evaluate the efficacy of substituting red meat with forage fish, considering projected red meat consumption trends and historical forage fish catch data. The scenarios ranged from prioritising domestic supply to equitably distributing forage fish to regions with suboptimal fish intake levels.
Their analysis yielded promising results, suggesting that widespread adoption of forage fish consumption could yield substantial public health benefits by mitigating the incidence of coronary heart disease and other diet-related illnesses. By preventing between half a million and 750,000 deaths from dietary-related diseases by 2050, particularly coronary heart disease-related fatalities, and averting 8–15 million disability-adjusted life years (DALYs), predominantly in low—and middle-income countries, this approach demonstrates considerable potential.
However, the researchers acknowledge the limitations posed by the finite supply of forage fish, emphasising that it cannot entirely replace red meat consumption. Nevertheless, by augmenting daily per capita fish intake towards recommended levels and reducing deaths from coronary heart disease, stroke, diabetes, and bowel cancer by an estimated 2% by 2050, forage fish integration into diets presents a viable strategy for improving public health outcomes.
Among the four scenarios explored, prioritising the allocation of forage fish to regions with lower fish consumption levels emerged as the most effective approach for reducing the global burden of disease. This strategy underscores the importance of targeting interventions towards populations with the greatest need, predominantly situated in low and middle-income countries. Furthermore, for landlocked nations devoid of direct access to seafood, such as Mongolia and several African countries, expanding global marketing and trade in forage fish becomes imperative to facilitate access to this nutritious food source.
Despite the theoretical promise of forage fish, the researchers acknowledge various barriers hindering their widespread adoption. Challenges such as fishmeal and oil processing, overfishing, climate change impacts, and cultural acceptance necessitate a multi-sectoral policy approach to overcome. Suggestions include prioritising access to affordable fish, promoting nutrient-rich microalgae as fish feed, and implementing culturally tailored interventions to foster healthy dietary habits and awareness.
Moreover, advocating for consumer education initiatives, such as climate change impact labels on food items and highlighting the nutritional value of forage fish, could facilitate the transition away from red meat consumption. By combining policy interventions, community engagement, and educational campaigns, stakeholders can synergistically work towards realising the health and environmental benefits of integrating forage fish into dietary patterns, thereby contributing to improved public health outcomes globally.
More information: Shujuan Xia et al, Unlocking the potential of forage fish to reduce the global burden of disease, BMJ Global Health. DOI: 10.1136/bmjgh-2023-013511
Journal information: BMJ Global Health Provided by The BMJ
