Tilapia's worse than bacon? Oh, please.

David Katz, MD, PREVENTION

A report by researchers at Wake Forest University in the Journal of the American Dietetic Association reverberated through headlines far and wide yesterday: farm raised tilapia, a popular fish, may be harmful, not beneficial, to eat.

There's just one problem with those headlines: the study had nothing to do with health outcomes associated with eating tilapia, or any other fish for that matter.

This was a study of the flesh of fish--period. The researchers analyzed the nutrient content of various fish, and did the customary compare and contrast. It will come as no surprise that salmon, widely known as a rich source of healthful, generally under-consumed omega-3 fatty acids, got a very favorable review.

But the real news was that tilapia, among the more popular fish choices, is richer in omega-6 than omega-3 fats. Both of these are in the polyunsaturated fat class, but they have somewhat opposing effects in our metabolism. Whereas omega-3s have anti-inflammatory effects, omega-6s, also found in dairy, and most vegetable oils from corn to soybean to sunflower, tend to have pro-inflammatory effects. This, in theory, could contribute to increased risk of chronic disease, including heart disease, over time.

Did the study show that eating tilapia actually does increase inflammation? No.

Did the study show that eating tilapia actually increases the risk of heart disease? No. Of any disease? No.

Did the study show in any way that tilapia may be 'less good' for us than bacon, as I saw at least one news segment proclaim? No.

And chew on this: while you doubtless got the punch line and heard that tilapia contains more omega-6 than omega-3, did you hear at any point how much TOTAL fat tilapia contains? No.

The answer to that question is: not much. In 100 grams of baked tilapia, representing about 130 calories, there is only about 2.5 grams of total fat. So while there may be more omega-6 than omega-3, there is not a whole lot of either. And here's the reality check that belies the headlines and sound bites: in 100 grams of cooked pork bacon, there is roughly 42 grams of fat! TWENTY times as much, give or take.

To so much as hint that the findings in this new study indicate bacon is more healthful than tilapia is serious overfishing of the medical news.

The overall quantities of omega-6 and omega-3 fats in the diet, and possibly the ratio of one to the other, do matter. You can increase your intake of omega-3 by eating more fatty fish (e.g., salmon) and seafood, flaxseeds, walnuts, and canola oil, and/or by taking a supplement. You can reduce your intake of omega-6s by limiting consumption of dairy fat, corn oil, and soybean oil; and by using olive and canola oils preferentially in cooking.

The studies of actual outcomes in actual people show consistently that eating fish regularly is associated with better health. To go from the analysis of fish flesh to projections about human health outcomes is a whale of a tale not remotely deserving of all the attention it received.

I plan to keep eating tilapia on a regular basis. Feel free to do the same. It is a nutritious food, and very unlikely, given its low fat content, to be the reason the balance of omega- 3 and omega-6 fats in your diet is not everything it should be. Do not rely on tilapia as your source of omega-3, of course; it's not a good one, and this is not news. For reliable intake of omega-3, eat salmon, or take a supplement as I do.

Bottom line: the media were telling fishy stories yesterday. And you know how reliable those are.

Cook an easy, delicious fish recipe:

Mediterranean Tilapia and Spinach in Spicy Tomato Sauce

Penne with Salmon and Roasted Vegetables

Baked Cod with Lemon and Olive Oil