There are a couple of concerns about fish that are holding some people back from moving closer to the recommendations made for Americans in the Dietary Guidelines (see our post Singing ‘Get Off Your SoFAS’). Getting 8 ounces a week is a formidable goal, especially if you haven’t been eating fish. In addition to not being in the habit of eating fish, there are two concerns that I’ve heard: 1) Some people are really apprehensive about potential harm from mercury in fish; 2) The price of fish is perceived to push up the food budget.

1. Mercury Fear

Exposure to mercury from fish consumption has been linked in past studies to a potential increase risk of heart attack and stroke, but the evidence from those studies is not holding up.  New research has been published in The New England Journal of Medicine on March 24, 2011 that has really clarified this issue.

In order to resolve the question of whether the heart/stroke health benefits of eating fish outweigh the risks of mercury in fish a study was conducted. This study had a very interesting method. The researchers drew from over 173,000 subjects. The Harvard researchers had the stored toenail clippings of the subjects. Are you as surprised as I was to think that there’d ever be a use for toenail clippings? As it turns out, toenails are a more accurate measure of long-term exposure to mercury than blood testing. The researchers found no link between the highest levels of mercury intake and increased risk of heart disease or stroke. What they did find was a slight association between eating fish and decreased risk for heart disease and stroke. Their conclusion is that the nutritional benefits of fish, even those varieties higher in mercury such as shark and swordfish, outweighed the risks.

Mercury is toxic to our nerves; but the amount that we’re getting in fish appears not to be enough for the general public to be concerned about. Pregnant women and children, on the other hand, should continue to be careful with any fish high in mercury. Unborn children exposed to mercury are often born with deficits in memory, attention, language and cognitive thinking, as well as both fine motor and visual spatial skills. The fish that pregnant women and young children should avoid include: King mackerel, tilefish, shark and swordfish (these are all large fish). Pregnant women and children can eat shellfish, canned fish, ocean and farm-raised fish. Some of the varieties that are consistently low in mercury include shrimp, salmon, catfish, Pollock and canned light tuna. There’s a terrific list of fish and the amounts of mercury at the FDA’s website.

2. Food cost of fish

I use two methods in managing the food budget as related to fish: 1) Buying frozen fish; 2) Using canned fish varieties.

Frozen fish – I use quite a bit of fish, often frozen. My trick is that I put the frozen fish in a non-stick skillet with a little olive oil; sprinkle it with seasoning (often rotisserie spice, lemon pepper, or dill weed and a little salt or pepper.) I turn the burner to a low heat; this helps the center of the fish cook before the outside burns. I cover the skillet, but leave a quarter to third inch opening so that the fish won’t steam and fall apart. This is one of our ‘fast and easy dinners. I serve it with vegetables and brown rice or microwaved yam with lime. Frozen fish is generally less pricy than fresh fish; take advantage of the price break.

Canned fish – I remember it in my post World War II childhood home. In those days, salmon patties and tuna casseroles were staples. If you or your children are not used to fish, opening cans is good place to start – mixing canned fish into other ingredients. Also, you will want to pay attention to the mild-flavored fish. And note, if fish smells ‘fishy’ before it’s cooked, it is not fresh; so don’t even buy it.

Besides cardiovascular health, fish consumption seems to be linked with a reduced risk of Age-Related Macular Degeneration (AMD). AMD is the leading cause of blindness in older Americans. In another Harvard study, published in Archives of Ophthalmology, researchers found that those eating fish at least once a week were 42% less likely to develop AMD than women eating fish less than once a month. The protective association seemed to be linked primarily to the consumption of canned tuna and dark-meat fish, to reap the benefits you don’t need to break the family food budget.

Below I have posted a recipe that I’ve developed to make a healthy meal of my all-time favorite comfort food – Tuna Noodle Casserole. Compared with traditional recipes, you’ll notice whole grain; increased vegetables; no salty, fatty canned soups; extra virgin olive oil; non-fat milk and only a little cheese for flavor. If you enjoy Tuna Noodle Casserole as a comfort food, maybe this recipe will help you feel comforted, well nourished, and safe from excessive salt, bad fats, and additives at the same time.

Tuna Noodle Comfort Casserole

This recipe makes a large casserole – enough to feed 6 to 8 people easily.  The recipe is just as good if you cut the ingredients in half or third; but remember, you may not have any leftovers if you cut it down. Having leftovers is a favorite laborsaving device. Preparation takes time.  Divide it by two meals or more and the amount of work per meal is greatly reduced.

Ingredients:

Vegetable spray

13.25 ounces whole wheat Rotini, cooked and drained

2 cups onion, chopped

1 cup celery, finely chopped

2 cups, red bell peppers, seeded and chopped

8 ounces mushrooms, chopped

1 teaspoon garlic, minced

6 tablespoons extra virgin olive oil, divided

½ cups whole-wheat flour

3 cups non-fat milk

Salt and pepper to taste

30 ounces canned tuna or salmon, drained and flaked (*see note below)

2 cups frozen peas and carrots, defrosted

3/4 cup whole-wheat breadcrumbs (**see note below)

½ cup parsley, finely chopped

½ cup Parmesan cheese, grated

Directions:

Preheat oven to 375 degrees F.  Spray a 2-quart baking dish with vegetable spray. Cook the noodles to al dente, and drain, following directions on the noodle package (about 10 – 12 minutes).

Stir the onion, celery, red pepper, mushrooms, and garlic in 2 tablespoons of olive oil. Sauté for about 10 - 15 minutes, until tender and most of the liquid has evaporated. Meanwhile, put 3 tablespoons of olive oil in a saucepan and heat. Whisk in the flour until smooth. Gradually whisk in the milk, cook until the sauce is smooth and slightly thickened, about 5 minutes. Add salt and pepper to taste.

Stir the tuna, peas and carrots, mushroom mixture, and noodles together.  Transfer to the baking dish.

Mix the parsley, Parmesan cheese, breadcrumbs and one-tablespoon olive oil, and a little salt and pepper, if desired. Sprinkle the crumb mixture over the casserole.

Bake 25 minutes, until lightly browned and bubbly. Serve hot. If you made enough, it is still very good for 2^nd and 3^rd easy to warm-up meals. Good health can be yummy and convenient and cost-effective to prepare.

*Note: Use water packed tuna. If you use oil packed tuna, some of the omega-3 fatty acids (good fats) are lost in the oil and go down the drain.

**Note: I toasted two heels of my whole-wheat loaf; then tore into quarters and processed in the blender until I had fine crumbs. If you don’t want to make fresh whole-wheat breadcrumbs, use the pre-made seasoned dried bread crumbs – about 3 - 4 tablespoons.