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Snetselaar L, Bailey R, Sabaté J, et al. Seafood Consumption during Childhood and Adolescence and Neurocognitive Development: A Systematic Review [Internet]. Alexandria (VA): USDA Nutrition Evidence Systematic Review; 2020 Jul.

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Seafood Consumption during Childhood and Adolescence and Neurocognitive Development: A Systematic Review [Internet].

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METHODOLOGY

The NESR team used its rigorous, protocol-driven methodology to support the 2020 Dietary Guidelines Advisory Committee in conducting this systematic review.

NESR’s systematic review methodology involves:

  • Developing a protocol,
  • Searching for and selecting studies,
  • Extracting data from and assessing the risk of bias of each included study,
  • Synthesizing the evidence,
  • Developing conclusion statements,
  • Grading the evidence underlying the conclusion statements, and
  • Recommending future research.

A detailed description of the methodology used in conducting this systematic review is available on the NESR website: https://nesr.usda.gov/2020-dietary-guidelines-advisory-committee-systematic-reviews, and can be found in the 2020 Dietary Guidelines Advisory Committee Report, Part C: Methodology.x This systematic review was peer reviewed by Federal scientists, and information about the peer review process can also be found in the Committee’s Report, Part C. Methodology. Additional information about this systematic review, including a description of and rationale for any modifications made to the protocol can be found in the 2020 Dietary Guidelines Advisory Committee Report, Chapter 9. Dietary Fats and Seafood.

Below are details of the final protocol for the systematic review described herein, including the:

  • Analytic framework
  • Literature search and screening plan
  • Literature search and screening results

ANALYTIC FRAMEWORK

The analytic framework (Figure 1) illustrates the overall scope of the systematic review, including the population, the interventions and/or exposures, comparators, and outcomes of interest. It also includes definitions of key terms and identifies key confounders considered in the systematic review. The inclusion and exclusion criteria that follow provide additional information about how parts of the analytic framework were defined and operationalized for the review.

An analytic framework visually represents the overall scope of the systematic review question, and depicts the contributing elements that were examined and evaluated, including the target population, exposure, comparison, outcomes, and key confounders. This is the analytic framework for the systematic review question on seafood consumption during childhood and adolescence (up to 18 years of age) and neurocognitive development. For this systematic review, the target population considered was infants and toddlers (birth to 24 months) and children and adolescents (ages 2-18 years) for the intervention/exposure and children and adolescents (ages 2-18 years), adults (ages 19-64 years) and older adults (ages 65 years and older) for the outcome. The interventions or exposures considered were seafood consumption (type, source, amount/frequency and/or timing of exposure) and their comparators were different types, sources, and/or amounts of seafood consumed; different frequency of and/or timing of seafood consumption. The outcomes considered were developmental domains, examined via milestone achievement and/or scales/indices, including cognitive, language/communication, movement/physical, social-emotional, and academic performance; attention deficit disorder (ADD) or attention-deficit/hyperactivity disorder (ADHD); anxiety; depression; autism spectrum disorder (ASD) for children and adolescents ages 2-18 years. The outcomes considered for 19 years and older were neurocognitive health outcomes including cognitive decline, mild cognitive impairment, dementia including Alzheimer’s Disease, anxiety and depression. The key confounders were Child sex, Child age, Race/ethnicity, Socioeconomic status, Infant feeding mode, Non-fish dietary exposure to n-3 PUFAs, Smoking, Parental education, and family history of neurocognitive disorder (only ADD, ADHD, Anxiety, ASD, Depression, Alzheimer’s). Other factors to be considered were Key nutrients in seafood (e.g., n-3 PUFAs, iron, iodine, selenium, fish protein, vitamin D); Environmental chemicals (e.g., mercury, persistent organic pollutants, and polychlorinated biphenyls); Blood biomarkers of seafood intake (e.g., n-3 PUFAs, and environmental pollutants).

Figure 1

Analytic framework.

LITERATURE SEARCH AND SCREENING PLAN

Inclusion and exclusion criteria

This table (Table 6) provides the inclusion and exclusion criteria for the systematic review. The inclusion and exclusion criteria are a set of characteristics used to determine which articles identified in the literature search were included in or excluded from the systematic review.

Table 6. Inclusion and exclusion criteria.

Table 6

Inclusion and exclusion criteria.

Electronic databases and search terms

Listed below are the databases and search terms searched to identify all potentially relevant articles that have been published to address this systematic review question and a second systematic review question on seafood intake during pregnancy and lactation and neurocognitive development in the child.

PubMed

  • Provider: U.S. National Library of Medicine
  • Date(s) Searched: October 23, 2019
  • Date range searched: January 1, 2000 - October 23, 2019
  • Search Terms:
    • #1 - “Pregnancy”[Mesh] OR pregnancy OR “Pregnant Women”[Mesh] OR “pregnant women” OR pregnant OR “Lactation”[Mesh] OR lactation OR “Breast Feeding”[Mesh] OR “breast feeding” OR “Maternal Health”[Mesh] OR “maternal health” OR “Prenatal Exposure Delayed Effects”[Mesh] OR “Maternal Exposure”[Mesh] OR pregnan*[tiab] OR pre-pregnancy[tiab] OR prenatal[tiab] OR maternal OR mother* OR postpartum OR perinatal OR peri-natal OR pre-conception OR preconception OR peri-conception OR periconceptional OR “Peripartum Period”[Mesh] OR peripartum[tiab] OR peri-partum[tiab] OR gestation* OR natal OR puerperium[tiab] OR “Maternal Nutritional Physiological Phenomena”[Mesh] OR “Infant”[Mesh] OR infant OR “Infant, Newborn”[Mesh] OR newborn OR baby OR babies OR “Fetus”[Mesh] OR fetus OR “Child”[Mesh] OR toddler* OR child OR children OR childhood OR “Child, Preschool”[Mesh] OR preschool OR teen* OR “Adolescent”[Mesh] OR adolescent* OR “Pediatrics”[Mesh] OR pediatric*
    • #2 - Seafood OR “Seafood”[Mesh] OR seafoods OR sea-food OR “sea food” OR sea-foods OR fish OR “fish consumption” OR “Fishes”[Mesh] OR fishes OR “Fish Proteins”[Mesh] OR “fish proteins” OR “fish products” OR “fish flour” OR “fatty fish” OR shellfish OR “shellfish proteins” OR “mercury poisoning” OR “Mercury Poisoning”[Mesh] OR methylmercury OR “Sharks”[Mesh] OR sharks OR swordfish OR “Tuna”[Mesh] OR tuna OR “Salmon”[Mesh] OR salmon OR sardines OR “Gadiformes”[Mesh] OR pollock OR “Flounder”[Mesh] OR flounder OR cod OR “Tilapia”[Mesh] OR tilapia OR shrimp OR “Ostreidae”[Mesh] OR oysters OR “Mya”[Mesh] OR “Bivalvia”[Mesh] OR clams OR “Pectinidae”[Mesh] OR scallops OR “Brachyura”[Mesh] OR crab OR “Perciformes”[Mesh] OR mackerel OR “Catfishes”[Mesh] OR catfishes OR “Trout”[Mesh] OR trout OR lobster OR “Decapodiformes”[Mesh] OR squid OR halibut OR “mahi mahi” OR crawfish OR anchov* OR herring OR rockfish OR marine product* OR “Fatty Acids, Omega-3”[Mesh]
    • #3 - “Mental Disorders”[Mesh] OR mental disorder*[tiab] OR “Cognition”[Mesh] OR cognition[tiab] OR cognitive[tiab] OR metacognition[tiab] OR neurocognitive[tiab] OR neurodevelop*[tiab] OR neurological[tiab] OR “Depression”[Mesh] OR depression[tiab] OR Alzheimer*[tiab] OR senility[tiab] OR senile[tiab] OR presenile[tiab] OR “Dementia”[Mesh] OR dementia[tiab] OR anxiety[tiab] OR “Psychomotor Performance”[Mesh] OR motor skill*[tiab] OR “Executive Function”[Mesh] OR executive function* OR attention deficit disorder*[tiab] OR ADHD[tiab] OR “Child Behavior Disorders”[Mesh] OR developmental disorder*[tiab] OR “Autism Spectrum Disorder”[Mesh] OR Autism[tiab] OR Asperger[tiab] OR language processing[tiab] OR language delay* OR “Child Development”[Mesh] OR child develop*[tiab] OR developmental delay[tiab] OR developmental disabilit*[tiab] OR motor skill*[tiab] OR “Problem Solving”[Mesh] OR developmental domain* OR academic performance[tiab] Or academic achievement[tiab] OR academic failure[tiab] OR academic success*[tiab] OR “Mental Health”[Mesh] OR mental health[tiab] OR “Mental Processes”[Mesh:NoExp]
    • #4 - (#1 AND #2 AND #3)
    • #5 - (#1 AND #2 AND #3) NOT (“Animals”[Mesh] NOT (“Animals”[Mesh] AND “Humans”[Mesh])) NOT (editorial[ptyp] OR comment[ptyp] OR news[ptyp] OR letter[ptyp] OR review[ptyp] OR systematic review[ptyp] OR systematic review[ti] OR meta-analysis[ptyp] OR meta-analysis[ti] OR meta-analyses[ti] OR retracted publication[ptyp] OR retraction of publication[ptyp] OR retraction of publication[tiab] OR retraction notice[ti]) Filters: Publication date from 2000/01/01 to 2019/10/23; English

Cochrane Central Register of Controlled Trials (CENTRAL)

  • Provider: John Wiley & Sons
  • Date(s) Searched: October 23, 2019
  • Date range searched: January 1, 2000 - October 23, 2019
  • Search Terms:
    • #1 - [mh “Pregnancy”] OR [mh “Pregnant Women”] OR [mh “Lactation”] OR [mh “Breast Feeding”] OR [mh “Maternal Health”] OR [mh “Prenatal Exposure Delayed Effects”] OR [mh “Maternal Exposure”] OR [mh “Peripartum Period”] OR [mh “Maternal Nutritional Physiological Phenomena”] OR [mh Infant] OR [mh “Infant, Newborn”] OR [mh Fetus] OR [mh Child] OR [mh “Child, Preschool”] OR [mh “Adolescent”] OR [mh “Pediatrics”]
    • #2 - (pregnan* OR lactation OR “breast feeding” OR “maternal health” OR pre-pregnancy OR prenatal OR maternal OR mother* OR postpartum OR perinatal OR peri-natal OR pre-conception OR preconception OR peri-conception OR periconceptional OR peripartum OR peri-partum OR gestation* OR natal OR puerperium OR infant OR newborn OR baby OR babies OR fetus OR toddler* OR child OR children OR childhood OR preschool OR teen* OR adolescent* OR pediatric*):ti,ab,kw
    • #3 - #1 OR #2
    • #4 - [mh “Seafood”] OR [mh “Fishes”] OR [mh “Fish Proteins”] OR [mh “Mercury Poisoning”] OR [mh “Sharks”] OR [mh “Tuna”] OR [mh “Salmon”] OR [mh “Gadiformes”] OR [mh “Flounder”] OR [mh “Tilapia”] OR [mh “Ostreidae”] OR [mh “Mya”] OR [mh “Bivalvia”] OR [mh “Pectinidae”] OR [mh “Brachyura”] OR [mh “Perciformes”] OR [mh “Catfishes”] OR [mh “Trout”] OR [mh “Decapodiformes”] OR [mh “Fatty Acids, Omega-3”]
    • #5 - (seafood OR seafoods OR sea-food OR “sea food” OR sea-foods OR fish OR “fish consumption” OR fishes OR “fish proteins” OR “fish products” OR “fish flour” OR “fatty fish” OR shellfish OR “shellfish proteins” OR methylmercury OR “mercury poisoning” OR sharks OR swordfish OR tuna OR salmon OR sardines OR pollock OR flounder OR cod OR tilapia OR shrimp OR oysters OR clams OR scallops OR crab OR mackerel OR catfishes OR trout OR lobster OR squid OR halibut OR “mahi mahi” OR crawfish OR anchov* OR herring OR rockfish OR marine product*):ti,ab,kw
    • #6 - #4 OR #5
    • #7 - [mh “Mental Disorders”] OR [mh “Cognition”] OR [mh “Depression”] OR [mh “Dementia”] OR [mh “Psychomotor Performance”] OR [mh “Executive Function”] OR [mh “Child Behavior Disorders”] OR [mh “Autism Spectrum Disorder”] OR [mh “Child Development”] OR [mh “Problem Solving”] OR [mh “Mental Health”] OR [mh ^“Mental Processes”]
    • #8 - (“mental disorder*” OR cognition OR cognitive OR metacognition OR neurocognitive OR neurodevelop* OR neurological OR depression OR Alzheimer* OR senility OR senile OR presenile OR dementia OR anxiety OR motor skill* OR “attention deficit disorder*” OR ADHD OR “developmental disorder*” OR Autism OR Asperger OR “language processing” OR “language delay*” OR “child develop*” OR “developmental delay” OR “developmental disabilit*” OR “motor skill*” OR “developmental domain*” OR “academic performance” OR “academic achievement” OR “academic failure” OR “academic success*” OR “mental health”):ti,ab,kw
    • #9 - #7 OR #8
    • #10 - #3 AND #6 AND #9” with Publication Year from 2000 to 2019, in Trials (Word variations have been searched)

Embase

  • Provider: Elsevier
  • Date(s) Searched: October 23, 2019
  • Date range searched: January 1, 2000 - October 23, 2019
  • Search Terms:
    • #1 - ‘pregnancy’/exp OR ‘pregnant woman’/exp OR ‘lactation’/exp OR ‘breast feeding’/exp OR ‘maternal welfare’/exp OR ‘prenatal exposure’/exp OR ‘mother’/exp OR ‘perinatal period’/exp OR ‘maternal nutrition’/exp OR ‘infant’/exp OR ‘newborn’/exp OR ‘baby’/exp OR ‘fetus’/exp OR ‘child’/exp OR ‘childhood’/exp OR ‘preschool’/exp OR ‘adolescent’/exp OR ‘pediatrics’/exp
    • #2 - pregnan*:ab,ti OR lactation:ab,ti OR ‘breast feeding’:ab,ti OR ‘prenatal exposure’:ab,ti OR ‘pre pregnancy’:ab,ti OR prenatal:ab,ti OR maternal:ab,ti OR mother*:ab,ti OR postpartum:ab,ti OR perinatal:ab,ti OR ‘peri natal’:ab,ti OR ‘pre conception’:ab,ti OR preconception:ab,ti OR ‘peri conception’:ab,ti OR periconceptional:ab,ti OR peripartum:ab,ti OR gestation*:ab,ti OR natal:ab,ti OR puerperium:ab,ti OR infant:ab,ti OR newborn*:ab,ti OR childhood:ab,ti OR baby:ab,ti OR babies:ab,ti OR fetus:ab,ti OR child:ab,ti OR preschool:ab,ti OR adolescent:ab,ti OR teen*:ab,ti OR pediatric*:ab,ti
    • #3 - #1 OR #2
    • #4 - ‘sea food’/exp OR ‘fish’/exp OR ‘fish consumption’/exp OR ‘fish protein’/exp OR ‘fish product’/exp OR ‘fish meal’/exp OR ‘fatty fish’/exp OR ‘shellfish’/exp OR ‘shellfish protein’/exp OR ‘mercurialism’/exp OR ‘methylmercury’/exp OR ‘shark’/exp OR ‘swordfish’/exp OR ‘tuna’/exp OR ‘salmonine’/exp OR ‘sardine’/exp OR ‘gadiformes’/exp OR ‘flounder’/exp OR ‘atlantic cod’/exp OR ‘tilapia’/exp OR ‘shrimp’/exp OR ‘oyster’/exp OR ‘mya’/exp OR ‘bivalve’/exp OR ‘clam’/exp OR ‘scallop’/exp OR ‘brachyura’/exp OR ‘crab’/exp OR ‘perciformes’/exp OR ‘mackerel’/exp OR ‘catfish’/exp OR ‘lobster’/exp OR ‘decapodiformes’/exp OR ‘squid’/exp OR ‘halibut’/exp OR ‘crayfish’/exp OR ‘anchovy’/exp OR ‘herring’/exp OR ‘rockfish’/exp OR ‘omega 3 fatty acid’/exp
    • #5 - seafood*:ab,ti OR fish:ab,ti OR ‘fish consumption’:ab,ti OR ‘fish protein*’:ab,ti OR ‘fish product*’:ab,ti OR ‘fish meal*’:ab,ti OR ‘fatty fish’:ab,ti OR ‘shellfish protein*’:ab,ti OR mercurialism:ab,ti OR methylmercury:ab,ti OR shark:ab,ti OR swordfish:ab,ti OR tuna:ab,ti OR salmonine:ab,ti OR salmon:ab,ti OR sardine*:ab,ti OR gadiformes:ab,ti OR pollock:ab,ti OR flounder:ab,ti OR cod:ab,ti OR tilapia:ab,ti OR shrimp:ab,ti OR oyster*:ab,ti OR bivalve:ab,ti OR mya:ab,ti OR clam:ab,ti OR clams:ab,ti OR scallop*:ab,ti OR crab:ab,ti OR perciformes:ab,ti OR mackerel:ab,ti OR catfish:ab,ti OR trout:ab,ti OR lobster:ab,ti OR squid:ab,ti OR decapodiformes:ab,ti OR halibut:ab,ti OR ‘mahi mahi’:ab,ti OR crayfish:ab,ti OR crawfish:ab,ti OR achov*:ab,ti OR herring:ab,ti OR rockfish:ab,ti OR ‘marine product*’:ab,ti OR ‘omega 3 fatty acid*’:ab,ti
    • #6 - #4 OR #5
    • #7 - ‘mental disease’/exp OR ‘cognition’/exp OR ‘depression’/exp OR ‘dementia’/exp OR ‘anxiety’/exp OR ‘psychomotor performance’/exp OR ‘executive function’/exp OR ‘child development’/exp OR ‘developmental disorder’/exp OR ‘psychomotor disorder’/exp OR ‘problem solving’/exp OR ‘mental health’/exp OR ‘mental function’/de
    • #8 - ‘mental disorder*’:ab,ti OR cognition:ab,ti OR cognitive:ab,ti OR metacognition:ab,ti OR neurocognitive:ab,ti OR neurodevelop*:ab,ti OR neurological:ab,ti OR depression:ab,ti OR alzheimer*:ab,ti OR senility:ab,ti OR senile:ab,ti OR presenile:ab,ti OR dementia:ab,ti OR anxiety:ab,ti OR ‘motor skill*’:ab,ti OR ‘executive function’:ab,ti OR ‘attention deficit disorder’:ab,ti OR adhd:ab,ti OR ‘developmental disorder’:ab,ti OR ‘language processing’:ab,ti OR ‘language delay*’:ab,ti OR ‘child develop*’:ab,ti OR autism:ab,ti OR asperger:ab,ti OR ‘developmental delay’:ab,ti OR ‘developmental disabilit*or developmental domain*’:ab,ti OR ‘academic performance’:ab,ti OR ‘academic achievement’:ab,ti OR ‘academic failure’:ab,ti OR ‘academic success*’:ab,ti OR ‘mental health’:ab,ti
    • #9 - #7 OR #8
    • #10 - #3 AND #6 AND #9
    • #11 - #3 AND #6 AND #9 AND ([article]/lim OR [article in press]/lim) AND [humans]/lim AND [english]/lim AND [2000-2019]/py NOT ([conference abstract]/lim OR [conference review]/lim OR [conference paper]/lim OR [editorial]/lim OR [erratum]/lim OR [letter]/lim OR [note]/lim OR [review]/lim OR [systematic review]/lim OR [meta analysis]/lim)

Cumulative Index of Nursing and Allied Health Literature (CINAHL Plus)

  • Provider: EBSCOhost
  • Date(s) Searched: October 23, 2019
  • Date range searched: January 1, 2000 - October 23, 2019
  • Search Terms:
    • #S1 - (MH “Pregnancy”) OR pregnancy OR (MH “Expectant Mothers”) OR “expected mothers” OR pregnant OR (MH “Lactation”) OR lactation OR (MH “Breast Feeding”) OR breastfeeding OR (MH “Maternal-Child Health”) OR “maternal child health” OR (MH “Prenatal Exposure Delayed Effects”) OR (MH “Maternal Exposure”) OR pregnan* OR pre-pregnancy OR prenatal OR maternal OR mother OR postpartum OR perinatal OR perinatal OR pre-conception OR preconception OR peri-conception OR periconceptional OR “peripartum period” OR peripartum OR peri-partum OR gestation* OR natal OR (MH “Puerperium”) OR Puerperium OR (MH “Maternal Nutritional Physiology”) OR (MH “Infant”) OR infant OR (MH “Infant, Newborn”) OR newborn OR baby OR babies OR (MH “Fetus”) OR fetus OR (MH “Child”) OR child OR (MH “Child, Preschool”) OR toddler OR (MH “Adolescence”) OR teen* OR adolescent OR (MH “Pediatrics”) OR pediatrics
    • #S2 - seafood OR (MH “Seafood”) OR seafood* OR sea-food OR “sea food” OR (MH “Fish”) OR fish OR “fish consumption” OR fishes OR “fish protein*” OR “fish product*” OR “fish flour” OR “fatty fish” OR (MH “Shellfish”) OR shellfish OR “shellfish proteins” OR “mercury poisoning” OR (MH “Mercury Poisoning”) OR methylmercury OR shark* OR swordfish OR tuna OR salmon OR sardine* OR Pollock OR flounder OR cod OR tilapia OR shrimp OR oyster* OR clams OR scallops OR crab OR mackerel OR catfish* OR trout OR lobster* OR squid OR halibut OR “mahi mahi” OR crawfish OR achov* OR herring OR rockfish OR marine product* OR (MH “Fatty Acids, Omega-3”)
    • #S3 - (MH “Mental Disorders”) OR mental disorder* OR (MH “Cognition”) OR cognition OR cognitive OR metacognition OR neurocognitive OR neurodevelop* OR neurological OR “cognitive dysfunction” OR “depressive disorders OR (MH “Depression”) OR depression OR (MH “Alzheimer’s Disease”) OR “Alzheimer’s disease” OR (MH “Dementia, Senile”) OR senile OR senility OR presenile OR (MH “Dementia”) OR (MH “Anxiety”) OR anxiety OR (MH “Psychomotor Performance”) OR motor skill* OR (MH “Executive Function”) OR executive function* OR (MH “Attention Deficit Hyperactivity Disorder”) OR attention deficit disorder* OR ADHD OR (MH “Child Behavior Disorders”) OR developmental disorder* OR (MH “Autistic Disorder”) OR autism OR Asperger OR “language processing” OR language delay* OR (MH “Child Development”) OR child develop* OR (MH “Developmental Disabilities”) OR developmental delay* OR developmental disabilit* OR (MH “Motor Skills Disorders”) OR motor skill* OR (MH “Problem Solving”) OR developmental domain* OR “academic performance” OR “academic achievement” OR “academic failure” OR academic success* OR (MH “Mental Health”) OR “mental health” OR (MH “Mental Processes”)
    • #S4 - S1 AND S2 AND S3
    • #S5 - S1 AND S2 AND S3 NOT (MH “Literature Review” OR MH “Meta Analysis” OR MH “Systematic Review” OR MH “News” OR MH “Retracted Publication” OR MH “Retraction of Publication”) Limiters - Publication Year: 2000-2019; Peer Reviewed; English Language; Human

LITERATURE SEARCH AND SCREENING RESULTS

The flow chart (Figure 2) below illustrates the literature search and screening results for articles examining this systematic review question and a second question on seafood consumption during pregnancy and lactation and neurocognitive development in the child. The results of the electronic database searches, after removal of duplicates, were screened independently by two NESR analysts using a step-wise process by reviewing titles, abstracts, and full-texts to determine which articles met the inclusion criteria. Refer to Table 7 for a list of excluded articles for the rationale for exclusion for each excluded full-text article. A manual search was conducted to find articles that were not identified when searching the electronic databases; all manually identified articles are also screened to determine whether they meet criteria for inclusion.

This flow chart illustrates the literature search and screening results for articles examining the relationship between seafood intake during pregnancy and lactation and neurocognitive development of the infant and the relationship between seafood consumption during childhood and adolescence (up to 18 years of age) and neurocognitive development. The literature search yielded 8,020 articles (5,485 after duplicates removed). During title screening, 4,168 articles were screened out. During abstract screening, 1,182 articles were screened out. During full-text screening, 100 articles were screened out. During the hand search, 2 additional articles were identified to include. A total of 37 articles (26 for the systematic review examining the relationship between seafood consumption during pregnancy and lactation and neurocognitive development in the child; 13 for the systematic review examining the relationship between seafood consumption during childhood and adolescence (up to 18 years of age) and neurocognitive development) were included at the end of the search and screening process.

Figure 2

Flow chart of literature search and screening results.

Excluded articles

The table below (Table 7) lists the articles excluded after full-text screening for this systematic review question and a second question on seafood consumption during pregnancy and lactation and neurocognitive development in the child, and includes columns for the categories of inclusion and exclusion criteria (see Table 6) that studies were excluded based on. At least one reason for exclusion is provided for each article, as indicated by an “X” in one of the columns, though this may not reflect all possible reasons for exclusion. Information about articles excluded after title and abstract screening is available upon request.

Table 7. Articles excluded after full-text screening with rationale for exclusion.

Table 7

Articles excluded after full-text screening with rationale for exclusion.

Footnotes

x

Dietary Guidelines Advisory Committee. 2020. Scientific Report of the 2020 Dietary Guidelines Advisory Committee: Advisory Report to the Secretary of Agriculture and the Secretary of Health and Human Services. U.S. Department of Agriculture, Agricultural Research Service, Washington, DC.

xii

Two articles were included in both the review for pregnancy and lactation and the review for childhood and adolescence

Copyright Notice

The contents of this document may be used and reprinted without permission. Endorsements by NESR, NGAD, CNPP, FNS, or USDA of derivative products developed from this work may not be stated or implied.

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