After a 2011 study by the Minnesota Department of Health showed that 10 percent of newborns tested along the North Shore had concerning levels of mercury in their blood, public health officials faced a conundrum.
Too much mercury can cause lasting problems with understanding and learning.
So how could they reduce the levels of mercury in women of child-bearing age, without sacrificing the health benefits of eating fish — especially in communities in northeast Minnesota with a deep cultural connection to fishing?
The answer was a partnership between the Minnesota Department of Health and health clinics in Cook County and on the Grand Portage reservation dubbed FISH — Fish are Important to Superior Health.
Nearly 500 women had their blood sampled for mercury and healthy fatty acids. They answered questions about how much fish they ate. And health care providers talked to them about what types of fish they could safely eat, and how often.
Six months later, women came back for a return visit, and had blood samples taken again. The results, officials say, were encouraging.
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"We found that women did not stop eating fish. That was good," said Pat McCann, a research scientist who led the project for the Minnesota Department of Health.
Research has shown that when women receive information about mercury in fish, they often stop eating fish, McCann said — either because they find it too complicated to decide what kinds of fish, or how much fish they can safely eat, or because they feel it's just too scary to risk being exposed to mercury.
But McCann said the information provided to participants along the North Shore seemed to assuage those fears.
"Their fatty acid levels didn't change, so that indicates they're still getting the beneficial aspects of eating fish," she said. "But their mercury levels were lower at the follow-up visit."
Moreover, many women reported during their follow-up visits that they actually ate more fish. But they switched to eating more species low in mercury, like Lake Superior herring or whitefish.
"Fish and fishing is our history and a strong part of the culture of the communities along the North Shore," said Rita Plourde, CEO of Sawtooth Mountain Clinic, which took part in the project.
Clinics are now including screening for high mercury levels in future prenatal visits. They're also including information about safe fish consumption in other patient visits.
The Department of Health has also teamed up with Health Partners to launch a statewide campaign to highlight the health benefits of eating fish, and the importance of choosing the right fish to reduce mercury exposure.
"We want women and children to eat fish," said McCann. "The benefits outweigh risks if they choose fish low in mercury and other contaminants."