Aquatic foods provide essential nutrients but can also contain hazardous heavy metals like mercury, cadmium, lead, and arsenic, posing health risks. This study analysed over 138,000 records from the World Health Organization to assess heavy metal levels in aquatic foods, quantify associated risks, and develop mitigation strategies. Most aquatic foods exhibited low heavy metal concentrations, with 98.5% meeting safety standards. However, mercury in fish, cadmium, lead and arsenic in molluscs, and cadmium in cephalopods were notably higher than in other categories. Biological traits influenced accumulation patterns through biomagnification for mercury and bioaccumulation for other metals. Aquatic foods are categorised into low, medium, and high-risk groups with recommended maximum intake guidelines. Adopting a 'Best Choices' strategy by consuming only low-risk aquatic foods could significantly reduce risks. This study provides a global comprehensive evidence base to inform targeted interventions, policies, industry practices, and consumer choices for mitigating risks while promoting sustainable aquatic food consumption as a vital nutritional resource.

seafood; food safety; sustainable consumption; biological trait; health risk