Affordability influences nutritional quality of seafood consumption among income and race/ethnicity groups in the United States

Background The 2020 US Dietary Guidelines for Americans recommend that the US population consume more seafood. Most analyses of seafood consumption ignore heterogeneity in consumption patterns by species, nutritional content, production methods, and price, which have implications for applying recommendations. Objectives We assessed seafood intake among adults by socioeconomic and demographic groups, as well as the cost of seafood at retail to identify affordable and nutritious options. Methods NHANES 2011–2018 dietary data (n = 17,559 total, n = 3285 eating seafood) were used to assess adult (≥20 y) intake of seafood in relation to income and race/ethnicity. Multivariable linear regression assessed the association between seafood consumption and income, adjusted for age, sex, and race/ethnicity, and the association between nutrients and seafood price, using Nielsen 2017–2019 retail sales data, adjusted for sales volume. Results Low-income groups consume slightly less seafood than high-income groups [low income: mean 120.2 (95% CI: 103.5, 137.2) g/wk; high income: 141.8 (119.1, 164.1) g/wk] but substantially less seafood that is high in long-chain n–3 (ω-3) PUFAs [lower income: 21.3 (17.3, 25.5) g/wk; higher income: 46.8 (35.4, 57.8) g/wk]. Intake rates, species, and production method choices varied by race/ethnicity groups and within race/ethnicity groups by income. Retail seafood as a whole costs more than other protein foods (e.g., meat, poultry, eggs, beans), and fresh seafood high in n–3 PUFAs costs more (P < 0.002) than fresh seafood low in n–3 PUFAs. Retail seafood is available in a wide range of price points and product forms, and some lower-cost fish and shellfish were high in n–3 PUFAs, calcium, iron, selenium, and vitamins B-12 and D. Conclusions New insights into the relation between seafood affordability and consumption patterns among income and ethnicity groups suggest that specific policies and interventions may be needed to enhance the consumption of seafood by different groups.publishedVersio

Identifying Opportunities for Aligning Production and Consumption in the U.S. Fisheries by Considering Seasonality

Seasonality is a natural feature of wild caught fisheries that introduces variation in food supply, and which often is amplified by fisheries management systems. Seasonal timing of landings patterns and linkages to consumption patterns can have a potentially strong impact on income for coastal communities as well as import patterns. This study characterizes the relationship between seasonality in seafood production and consumption in the United States by analyzing monthly domestic fisheries landings and imports and retail sales of farmed and wild seafood from 2017 to 2019. Analyses were conducted for total seafood sales, by product form, by species group, and by region of the United States. The data reveal strong seasonal increases in consumption around December and March. Seasonal increases in consumption in Spring and Summer occurred in parallel with domestic fishing production. Domestic landings vary by region, but most regions have peak fishing seasons between May and October. Alaska has the largest commercial fishery in the United States and seasonal peaks in Alaska (July/August, February/March) strongly influence seasonality in national landings. Misalignment between domestic production and consumption in some seasons and species groups creates opportunities for imports to supplement demand and lost opportunities for domestic producers.publishedVersio

Risks Shift Along Seafood Supply Chains

Seafood is a highly traded commodity and 71% of the United States (U.S.) supply is imported. This study addresses questions about imported seafood safety and compares risks of outbreaks and recalls across countries of origin, species, and stages of the supply chain. We found that where seafood comes from does not play a major role in risk. Risk is a function of the activities happening at each stage of the supply chain, inherent riskiness of some products or processes, and “pass through” risks introduced at upstream and midstream stages of the supply chain. Dominant farmed species (shrimp, tilapia, catfish) became less risky as they move along the supply chain toward consumers. We recommend investments in agencies overseeing food safety and health, enhanced traceability within supply chains, and more open government datasets that support systems-level analyses.publishedVersio

Food Sources and Expenditures for Seafood in the United States

The aim of this study was to explore United States (U.S.) seafood consumption patterns, food sourcing, expenditures, and geography of consumption. We analyzed seafood intake and food sourcing using the National Health and Nutrition Examination Survey (NHANES) cycles 2007–2008 to 2015–2016 for US adults ≥19 years old (n = 26,743 total respondents; n = 4957 respondents consumed seafood in the past 24 h). Seafood expenditures were extrapolated by combining NHANES with three other public datasets. U.S. adults consumed 63% of seafood (by weight) at home. The top sources of seafood (by weight) were food retail (56%), restaurants (31%), and caught by the respondent or someone they know (5%). Sixty-five percent of consumer expenditures for seafood were at restaurants and other “away from home” sources while 35% were at retail and other “at home” sources. Slightly less than half of overall U.S. food expenditures are “away from home,” which is much lower than for seafood, suggesting that consumers have very different spending habits for seafood than for an aggregate of all foods.publishedVersio

Risks Shift Along Seafood Supply Chains

Seafood is a highly traded commodity and 71% of the United States (U.S.) supply is imported. This study addresses questions about imported seafood safety and compares risks of outbreaks and recalls across countries of origin, species, and stages of the supply chain. We found that where seafood comes from does not play a major role in risk. Risk is a function of the activities happening at each stage of the supply chain, inherent riskiness of some products or processes, and “pass through” risks introduced at upstream and midstream stages of the supply chain. Dominant farmed species (shrimp, tilapia, catfish) became less risky as they move along the supply chain toward consumers. We recommend investments in agencies overseeing food safety and health, enhanced traceability within supply chains, and more open government datasets that support systems-level analyses

Data_Sheet_1_Application of the food-energy-water nexus to six seafood supply chains: hearing from wild and farmed seafood supply chain actors in the United States, Norway, and Vietnam.DOCX

IntroductionThe food-energy-water (FEW) nexus highlights the interdependencies between the systems that people rely on for these essential resources. For example, globally, over two thirds of freshwater withdrawals are used to produce food, and another 10% is used during energy generation. In addition, the food system uses one eighth of global net energy. Seafood is a nutritionally important food, and it is critical to use freshwater and energy resources efficiently throughout seafood supply chains to safeguard future supplies and to reduce environmental impacts. Diverse seafood production methods result in highly variable resource use across supply chains, which may contribute to siloed efforts within supply chains to improve efficiency, instead of larger efforts that involve multiple seafood supply chains. Additionally, efforts to develop and implement efficiency strategies must be informed by fishers, aquaculturists, processors, and other seafood supply chain actors to avoid investing time and resources into strategies that will have low uptake. A significant proportion of seafood is imported into the U.S., so engaging with industry and stakeholders in the U.S. and abroad is critical for understanding and improving the FEW nexus associated with seafood consumed by Americans.MethodsTo understand how resources are being used, current and potential strategies to improve resource use, and relevant motivations and barriers, we conducted 47 semi-structured interviews from 2019 to 2021 with seafood supply chain actors, including producers and processors. Seafood supply chains included were farmed catfish produced in the U.S., farmed pangasius and shrimp produced in Vietnam, farmed Atlantic salmon produced in Norway, and wild-caught sockeye and pink salmon caught in the U.S.ResultsWe provide detailed descriptions of stages within each supply chain regarding resource use and efficiency strategies, and report higher-level findings that apply across supply chains. There was variation across settings regarding how resources are used and opportunities and barriers for improving efficiencies, but we also found commonalities in settings, indicating that resource-saving strategies or innovations could lead to increased efficiency across multiple supply chains. Interviewees shared that cost savings drove past adoption of, and high interest in, energy conservation practices. Generally, direct costs did not motivate reduced use of freshwater, but associated costs like energy to run pumps and supplies to treat contaminated surface water drove interest in reducing water use.DiscussionEfforts to improve resource use in the U.S. seafood supply should focus on identifying and scaling-up strategies that (i) involve improved efficiency of more than one resource and/or (ii) apply across multiple settings. This work should involve partnerships between industry, government agencies, and academic researchers, and should be informed by supply chain actors’ experiences and insights. The qualitative insights from this study encompass rich descriptions of FEW-relevant factors at the level of specific supply chain stages as well as findings across six major seafood supply chains in three countries. The study provides an essential complement to existing quantitative characterizations of resource use, and enables nuanced and informed responses to challenges.</p

Expert Performance in Visual Differentiation of Bacterial and Fungal Keratitis

This study quantifies the performance of an international cohort of cornea specialists in image-based differentiation of bacterial and fungal keratitis, identifying significant regional variation and establishing a reference standard for comparison against machine learning models

Effect of general anaesthesia on functional outcome in patients with anterior circulation ischaemic stroke having endovascular thrombectomy versus standard care: a meta-analysis of individual patient data

Background: General anaesthesia (GA) during endovascular thrombectomy has been associated with worse patient outcomes in observational studies compared with patients treated without GA. We assessed functional outcome in ischaemic stroke patients with large vessel anterior circulation occlusion undergoing endovascular thrombectomy under GA, versus thrombectomy not under GA (with or without sedation) versus standard care (ie, no thrombectomy), stratified by the use of GA versus standard care. Methods: For this meta-analysis, patient-level data were pooled from all patients included in randomised trials in PuMed published between Jan 1, 2010, and May 31, 2017, that compared endovascular thrombectomy predominantly done with stent retrievers with standard care in anterior circulation ischaemic stroke patients (HERMES Collaboration). The primary outcome was functional outcome assessed by ordinal analysis of the modified Rankin scale (mRS) at 90 days in the GA and non-GA subgroups of patients treated with endovascular therapy versus those patients treated with standard care, adjusted for baseline prognostic variables. To account for between-trial variance we used mixed-effects modelling with a random effect for trials incorporated in all models. Bias was assessed using the Cochrane method. The meta-analysis was prospectively designed, but not registered. Findings: Seven trials were identified by our search; of 1764 patients included in these trials, 871 were allocated to endovascular thrombectomy and 893 were assigned standard care. After exclusion of 74 patients (72 did not undergo the procedure and two had missing data on anaesthetic strategy), 236 (30%) of 797 patients who had endovascular procedures were treated under GA. At baseline, patients receiving GA were younger and had a shorter delay between stroke onset and randomisation but they had similar pre-treatment clinical severity compared with patients who did not have GA. Endovascular thrombectomy improved functional outcome at 3 months both in patients who had GA (adjusted common odds ratio (cOR) 1·52, 95% CI 1·09–2·11, p=0·014) and in those who did not have GA (adjusted cOR 2·33, 95% CI 1·75–3·10, p&lt;0·0001) versus standard care. However, outcomes were significantly better for patients who did not receive GA versus those who received GA (covariate-adjusted cOR 1·53, 95% CI 1·14–2·04, p=0·0044). The risk of bias and variability between studies was assessed to be low. Interpretation: Worse outcomes after endovascular thrombectomy were associated with GA, after adjustment for baseline prognostic variables. These data support avoidance of GA whenever possible. The procedure did, however, remain effective versus standard care in patients treated under GA, indicating that treatment should not be withheld in those who require anaesthesia for medical reasons