Questions on Mercury in Fish, Constipation and Water

Patient Expert

I keep hearing that women who are pregnant should avoid fish that are high in mercury. Are there specific types of fish that pregnant women should avoid?

There has been a lot of press lately on the risks associated with high mercury intake, particularly to pregnant women. If a woman is exposed to high levels of mercury while she is pregnant, both she and the baby can be at risk. A high level of mercury during pregnancy has been linked to developmental delays and nervous system damage to the baby.

The Environmental Protection Agency and the Food and Drug Administration recommend that pregnant women, those who may become pregnant and women who are nursing avoid consuming fish that are high in mercury. Their recommendations include:

  • Do not eat shark, swordfish, king mackerel or tilefish because they contain high levels of mercury.

  • Eat up to 12 ounces per week of fish and shellfish that are low in mercury.

  • Be careful when purchasing tuna. Light tuna has less mercury than albacore, but up to 6 ounces of albacore tuna per week is safe.

  • Check local advisories about the safety of fish caught by family and friends in your local lakes, rivers and coastal areas. If no advice is available, eat up to 6 ounces per week of fish you catch from local waters, but don't consume any other fish during that week.

Remember that fish and shellfish are an important part of a healthy diet because they have high-quality protein and other essential nutrients. They are also low in saturated fat and high in heart healthy omega-3 fatty acids. A well-balanced diet includes a variety of fish and shellfish even for those who should monitor their mercury intake.

I suffer from constipation, what can I do about it?

Constipation is a common problem for many people, particularly the elderly. Many factors can contribute to constipation such as inactivity, dehydration and poor nutrition. However, just because you do not have a bowel movement everyday, it does not mean that you suffer from constipation. It is a common misconception that you must have a bowel movement daily, typically people only have three or more per week.

In determining how to treat constipation, it is helpful to determine the cause. Common causes of constipation include:

  • Sedentary lifestyle

  • Low-fiber diet

  • Dehydration

  • Depression

  • Aging

  • Systemic disease (multiple sclerosis, Parkinson's disease, stroke, spinal cord injury, diabetes mellitus and thyroid disease)

  • Use of pain medications

  • Bowel obstruction

If you do suffer from constipation there are some simple measures you can take to help promote elimination. Increase your fluid intake to at least 64 ounces of water-based beverages per day. You can also try prune juice or apple juice, which have a laxative effect. Increasing physical activity can also stimulate your bowels to move. When our bodies are inactive our bowels tend to follow suit - so start moving.

Nutrition therapy is also helpful in alleviating constipation. A high-fiber diet can promote bowel movement. The American Dietetic Association recommends that adults consume 25 - 30 grams of fiber every day. To increase your fiber intake start consuming more whole grains, fruits, vegetables, bran cereals and whole wheat bread. However, sudden increases in fiber intake can lead to bloating, gas and abdominal pain so start adding fiber into your diet slowly.

I know that I'm supposed to drink 64 ounces of water per day, but I don't really like water. Is there something else I can drink to meet those requirements?

The average adult loses about 2 ½ liters of water daily through urine, stool, sweat, breathing and other body functions. While water in foods replaces about 20 percent of this fluid, it is important to replace the remainder of those loses with water-based fluids.

It's not always easy to meet your fluid needs, especially if you are not partial to water. However, water isn't the only option when it comes to replenishing fluids. In fact, any water-based, caffeine-free beverage can be used to meet fluid requirements. This includes low-fat milk, decaffeinated coffee and tea and sports drinks. Water-based foods like fruits, vegetables and soups can also help you meet your daily fluid needs.

It is important to remember that these water alternatives add calories that plain old H2O doesn't have. There are also many calorie free options that you can add to water to enhance the taste. Consider adding slices of lemon, lime, orange or cucumber or a sprig of mint to add flavor without adding calories. Using a caffeine-free, calorie free drink mix is another way to add flavor while keeping water calorie free.