Pescatarian Diet 101: Food List, Meal Plan, Benefits, Risks, and More
- November 28, 2021
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Fish contain heart-healthy fats that can help stave off heart disease. Getty Images
Some of the healthiest diets in the world feature fish as the main event. If you’re interested in this diet, which is nongimmicky and flexible enough to fit your preferences, here’s what you need to know.
What Exactly Is a Pescatarian Diet?
In the simplest terms, pesce means fish. “A pescatarian diet is one that prioritizes fish and seafood as the primary protein source,” says the Kansas City–based registered dietitian Cara Harbstreet, RD, the author of The Pescatarian Cookbook: The Essential Kitchen Companion. If you’re following this diet, you may also choose to include eggs and dairy in your meals and snacks.
This is not an all-fish diet. Harbstreet says those eating pescatarian typically have two or more seafood meals per week. The remainder of the meals and snacks are plant-based and are similar to a Mediterranean-style of eating.
Why You May Consider Becoming a Pescatarian
Most people consider a pescatarian diet because of its health benefits, says Nicole Hallissey, RDN, a registered dietitian nutritionist in New York City and the author of The Truly Healthy Pescatarian Cookbook: 75 Fresh & Delicious Recipes to Maintain a Healthy Weight. The American Heart Association (AHA) recommends eating at least two fish meals a week in order to consume ample omega-3 fatty acids, which promote cardiovascular health. (1) “Omega-3s are anti-inflammatory, and chronic inflammation is linked to diseases like heart disease, type 2 diabetes, arthritis, and cancer,” says Hallissey.
Other people may opt for a pescatarian diet out of ethical concerns and a desire to avoid eating meat, particularly from livestock or poultry.
Then, there are potential environmental benefits. While seafood does have a smaller carbon footprint than livestock or poultry, there are still concerns regarding overfishing and the fuel efficiency of fishing boats, according to the ocean advocacy organization Oceana. (2) Making smart choices when buying fish is key. More on that below.
The pescatarian diet is not a rigid diet but one that allows for flexibility, says Harbstreet. For instance, while pescatarians generally avoid meat, they may occasionally eat a chicken breast, say, when sharing a family meal. That said, the following are the typical foods that someone may choose to eat and avoid on this diet.
What to Eat
- Eggs (optional)
- Yogurt (optional)
- Cheese (optional)
- Milk (optional)
- Beans and legumes
- Nuts and seeds
- Whole grains (whole-grain pasta, bread, and brown rice count)
What to Avoid
- Deli meat
Are Some Fish Better Than Others in a Pescatarian Diet?
The AHA suggests opting for fatty fish, which include salmon, tuna, sardines, and mackerel. (1) But there’s room for other species in your diet, too. “The best choice is the one that you enjoy. It’s one that fits your taste and texture preferences, is within your budget, and that you’ll cook and eat without it going to waste,” says Harbstreet. Fattier fish are “oilier” fish, and they tend to have a more fish-forward taste. White fish like tilapia and cod are far milder in taste, but also contain fewer omega-3s. Shrimp and scallops also tend to have an easy-to-like flavor, she says.
It’s important to choose sustainably sourced fish whenever possible. As a resource, Hallissey recommends the Monterey Bay Aquarium Seafood Watch, which features state-by-state downloadable and printable buying guides. Find them here. If you’re going for canned fish, she recommends the Wild Planet line, which sources fish sustainably and carries tuna, salmon, sardines, mackerel, and more.
Diabetes Meal Plan: Salmon Cakes
First, you’re eating more fish. A study published in December 2014 in the journal Nutrients found that even seafood eaters don’t get the recommended amount on average. (3) There are a lot of reasons to meet that mark. A May 2018 advisory from the AHA published in the journal Circulation recommended two or more seafood meals per week in order to reduce the risk of heart disease, stroke, sudden cardiac death, and congestive heart failure. (4)
What’s more, in a study of more than 400,000 people (the largest analysis to date), men and women who ate the most fish had a 9 and 8 percent lower risk, respectively, of mortality from any cause versus groups who ate the least, per October 2018 research in the Journal of Internal Medicine. (5) The researchers say it’s likely the anti-inflammatory omega-3s that provide the life-lengthening benefits.
Because this is also a plant-based diet, you’ll reap all the advantages of eating ample vegetables, fruits, legumes and beans, and nuts and seeds of all kinds. For people with type 2 diabetes, a review in October 2018 in BMJ Open Diabetes Research & Care found that plant-based eating is associated with better blood sugar control, cholesterol management, as well as emotional and psychological health compared with other diets recommended to those with the disease. (6)
Depending on your current diet, it may be quite a shift from how you’re used to eating. And if you’re unsure about how to cook fish, you may also find the transition tough. Luckily, fish and shellfish are actually relatively simple to prepare.
“People have an impression that cooking fish is difficult and elaborate, but in fact, it’s easier than chicken,” says Hallissey. One fear is undercooking, and it’s common to swing in the other direction and totally overcook the fish, leaving it dry and unpalatable — and leaving you wondering why you’re even trying this in the first place.
Hallissey suggests learning a few easy techniques for cooking — like baking a fillet on a pan with veggies for a one-pan meal, or drizzling fish in olive oil, salt, and pepper and sautéing in a pan (don’t forget to flip). Canned fish, like sardines, light tuna, and salmon are great options, as they’re inexpensive and already cooked, requiring no prep.
Also, be mindful of how you’re preparing your fish. Broiling, grilling, baking, poaching, steaming, and sautéing are preferable to frying. As many as 36 percent of people consume fried foods daily. (7) Among those who eat one serving a week of fried fish or shellfish, their risk of dying from cardiovascular disease increases by 13 percent compared with those who have none, according to research published January 2019 in BMJ.
The current recommendation from the AHA is at least two servings of fish per week. If you’re within these parameters, it’s unlikely you’re consuming much mercury, says Harbstreet. The benefits of eating quality, unfried fish outweigh mercury risk. Instead, misplaced fears about mercury may dissuade you from consuming fish at all, and that’s unfortunate. If you are concerned, consume lower-mercury fish.
But if you’re pregnant, you want to pay particular attention to your choices. Pregnant women are falling short on fish, with about 50 percent eating fewer than 2 ounces per week on average, according to the U.S. Food and Drug Administration (FDA). (8) The nutrients in fish support healthy fetal growth, and so experts recommend consuming two to three servings of lower-mercury fish per week. Ideally, these should come from their “best choices” list, which includes catfish, shrimp, tilapia, salmon, sardines, and cod. (9) Children who eat fish should stick to those recommendations as well.
A pescatarian diet is a well-rounded diet that focuses heavily on plant foods and includes the recommended amount of weekly seafood intake. “The wide variety of foods on this diet typically supplies adequate nutrition,” says Harbstreet. If you have any concerns or have eliminated entire food groups while on this diet, speak with a registered dietitian or your doctor to see if you may need to be examined for any nutrient deficiencies.
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These are the top five of-the-moment bestsellers (they’re updated hourly, so they’re always changing) in the category of Fish and Seafood Cooking. They might surprise you.
- Mediterranean Diet Instant Pot Cookbook, $10.81, Amazon
- Air Fryer Cookbook, $9.11, Amazon
- The Whole Fish Cookbook: New Ways to Cook, Eat, and Think, $40, Amazon
- Aloha Kitchen: Recipes from Hawai’i, $19.49, Amazon
- Thug Kitchen: Eat Like You Give a F*ck, $14.20, Amazon
Absolutely. If you enjoy seafood and want to commit to getting more fish, shellfish, and plant-based foods into your diet, then the pescatarian diet may be a great option for you. “Keep an open mind,” says Harbstreet. “Many people have a misconception that a pescatarian diet can be expensive. In reality, it can be just as convenient and affordable as other proteins. You can get dinner on the table faster than with poultry, beef, or pork,” she adds. That’s a win all around.
Editorial Sources and Fact-Checking
- Fish and Omega-3 Fatty Acids. American Heart Association. March 23, 2017.
- McDermott A. Eating Seafood Can Reduce Your Carbon Footprint, but Some Fish Are Better Than Others. Oceana. February 1, 2018.
- Jahns L, Raatz SK, Johnson LK, et al. Intake of Seafood in the U.S. Varies by Age, Income, and Education Level but Not by Race-Ethnicity. Nutrients. December 2014.
- Rimm EB, Appel LJ, Chiuve SE, et al. Seafood Long-Chain n-3 Polyunsaturated Fatty Acids and Cardiovascular Disease: A Science Advisory From the American Heart Association. Circulation. July 3, 2018.
- Zhang Y, Zhuang P, He W, et al. Association of Fish and Long-Chain Omega-3 Fatty Acids Intakes With Total and Cause-Specific Mortality: Prospective Analysis of 421 309 Individuals. Journal of Internal Medicine. 2018.
- Toumpanakis A, Turnbull T, Alba-Barba I. Effectiveness of Plant-Based Diets in Promoting Well-Being in the Management of Type 2 Diabetes: A Systematic Review. BMJ Open Diabetes Research & Care. October 30, 2018.
- FDA and EPA Issue Final Fish Consumption Advice. U.S. Food and Drug Administration (FDA). January 18, 2017.
- Eating Fish: What Pregnant Women and Parents Should Know. FDA. March 27, 2019.