Q&A: mercury and tuna; fatty liver disease; the DASH diet & how much alcohol is okay

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In this week’s reader-submitted Q&A, we’re tackling these questions:

• Should I worry about mercury in tuna?

• What is MASLD, or fatty liver disease, and when should I worry about it?

• What do you think about the DASH diet?

• How much alcohol is okay these days?

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Disclaimer: The views expressed here are entirely my own. They are not a substitute for advice from your personal physician.

Photo by Sean Robertson on Unsplash

The following subscriber questions have been lightly edited for length and clarity.

QUESTION #1: MERCURY AND TUNA

Dear Dr. McBride, I am trying to eat more lean protein like fish… but now I am worried about mercury in tuna. Do you think that is something I need to consider?

- Rachel P.

Dear Rachel,

Protein is so important for health. I wrote about protein requirements here. So, I love that you are getting lots of fish in your diet. Tuna is a great source of protein, minerals and vitamins. It has a lot of selenium which is important for metabolism and thyroid function and helps protect your body from damage caused by oxidative stress.

The amount of mercury in tuna depends on the species of tuna that you eat. The smallest tuna, like snapjack, have very little mercury, while albacore and yellowfin have 3 times as much. Bigeye and Bluefin have much more. 

Why does mercury matter? Mercury is especially dangerous for pregnant women and children, so there are FDA guidelines on how much they should consume. The recommendation for pregnant women is no more than 3 servings of canned tuna per week and no more than 1 serving of albacore or yellowfin tuna. For children under 12, it’s even less and a lot of experts recommend that pregnant women and children don’t eat tuna at all. 

Mercury tends to leave the body after a few months. Even in rare cases of mercury poisoning due to fish consumption, most people recover once they switch their diet. 

Long story short: If you eat tuna occasionally, you really don’t need to worry. I hope that helps! 

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QUESTION #2: FATTY LIVER DISEASE

My doctor used to tell me I have “NASH” or “non-alcoholic steatohepatitis” - which always seemed to be a nice way for him to tell me I needed to lose weight. He said it was due to fat deposits in my liver. What is this new liver thing called MASLD? My new doctor says I have this. Is it the same thing as NASH? Is it more or less serious? Can I drink a glass of wine with it? I can’t get a straight answer!

-JP

Hi JP,