Pescatarian Diet by Sue Kira

by sue

Pescatarian Diet

by Sue Kira, Naturopath & Clinical Nutritionist

Introduction to a Pescatarian diet

Benefits of a Pescatarian diet

Fish and seafood choices for a Pescatarian diet

Disadvantages of a Pescatarian diet

Case study: The Pescatarian way helps cardiovascular markers

Introduction to a Pescatarian diet

The term Pescatarian was derived from ‘pesce’, the Italian word for fish and is associated with people who add aquatic animals to a vegetarian diet.

You could say that a Pescatarian is a vegetarian who also enjoys fish and seafood.

Pescatarians, sometimes called pesco-vegetarians (not pesky-vegetarians) do not eat any land animals or birds, such as beef, pork, chicken, or turkey, but do eat fish and other seafood, such as shrimp/prawns, squid/calamari, oysters and clams.

Vegetarian foods, such as fruits, vegetables, beans, grains, and nuts, are also enjoyed on a Pescatarian diet. As some seafood can be high in mercury, there are warnings on how much seafood should be consumed in this diet, especially during pregnancy and for children.

Pescatarian-based diets have been around for thousands of years, not just in Italy, but also Greece and Japan. Other Asian and Mediterranean countries have relied heavily on fish for protein and nutrient intake for generations.

Fish and seafood are some of the healthiest sources of dietary protein and fats.

Salmon and sardines are two popular nutrient-dense foods packed with high levels of omega-3 fatty acids, amino acids (protein), vitamin D and vitamin A. Other types of fish and seafood provide similar benefits along with B vitamins and minerals such as potassium, phosphorus, calcium, magnesium and selenium.

How healthy are pescatarian diets?

The common denominator of vegetarian and vegan-type diets is that the bulk of their food intake is based around healthy plant foods. While some plant-based eaters exclude all animal products (vegans), others choose to include fish and seafood (pescatarians).

There are many benefits to include fish and seafood in your diet, as this can help with some of the common problems seen in vegetarian and vegan diets, including:

  • Nutrient deficiencies such as iron, vitamin B12 and zinc
  • Potential for protein imbalance due to lack of certain amino acids
  • Imbalanced ratio of essential fatty acids (omega-6s to omega-3s)

Fish are an excellent source of protein, because not only do they supply all essential amino acids (called a complete protein), but they also have a lower potential for immune responses (allergies) – however there are many people who cannot eat fish due to allergies. Fish and other seafood, included with a mostly plant-based diet, is a great combination.

Benefits of a Pescatarian Diet

Provides plenty of Omega-3 fatty acids
One of the main reasons that fish is so good for us is because of its high levels of omega-3 fats. We live in a world where most people consume far too many omega-6 fats from seed and vegetable oils, plant foods, and farm-raised animal products, so eating more omega-3 foods is a great way to balance this.

Omega-6 fats can heighten levels of inflammation, whereas the Omega-3 fatty acids are considered anti-inflammatory. We need both types, but many people lack omega-3 fats or have too many Omega 6’s.

Consuming higher levels of omega-3 fats has been linked with better mental health, lower triglyceride levels, improved cardiovascular health, better hormone control, increased reproductive health and fertility, and lower risk for diabetes.

Alpha-linolenic acid (ALA) is the type of omega-3 found in plant foods (like walnuts and flaxseeds), while eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are the most important long-chain omega-3 fats found in fish and seafood.

ALA, EPA and DHA must come from our diets, as our bodies cannot make these fats, which is why they are called ‘essential fats’ because it is essential that we eat them.

Helps to lower inflammation
Inflammation is the root of most diseases; lowering inflammation prevents the likelihood of developing diseases.

Omega-3 fats from fish and seafood are valuable to fight inflammation and are great to control inflammatory conditions that lead to numerous diseases, including cancer.

Both Omega 3 and Omega 6 fatty acids are important for our hormones, cell membranes and immune responses. But omega-3 and omega-6 fatty acids have opposite effects when it comes to inflammation. In general, too much omega-6 and too little omega-3 can cause inflammation.

Improves heart health
Consumption of EPA and DHA (from fish/seafood/oils) has been shown to help reduce the risk of heart disease or death from heart disease. The combination of the beneficial nutrients found in fish and seafood helps to: regulate heartbeats; prevent a heart attack or stroke; reduce blood pressure, cholesterol and triglyceride levels; and decrease blood clot formation.

Lower cancer risk
Inflammation dictates the rate of tumour progression. Including anti-inflammatory Omega 3 rich foods in your diet is important for cancer prevention and treatment. Omega-3s can help people with cancer slow down the growth of tumours.

A Pescatarian diet high in omega-3s can also support people undergoing chemotherapy or other cancer treatments, because the diet helps to preserve muscle mass and regulate inflammatory responses, which are compromised in cancer and cancer treatments.

Helps reduce cognitive decline
Omega-3s like DHA are essential for the health of the brain and preservation of cognitive function as we age. Many studies found that low omega-3 levels are associated with multiple markers of impaired brain function like dementia or Alzheimer’s disease.

Lower levels of omega-3s during pregnancy are associated with children having low memory test scores, learning difficulties, and increased risk of ADHD and ADD.

Improves Mood and Depression
Omega-3s from fish and seafood are associated with better cognitive health, decreased depression, anxiety and ADHD, and lower risk for dementia, because they fight oxidative stress in the body. Following a Pescatarian diet can be a natural support for anxiety, ADHD, and depression.

Helps with weight loss and weight maintenance
Low intakes of omega-3s are now being tied to obesity and weight gain. Studies show that people (including vegetarians) who eat more plant foods tend to have lower BMIs and better weight control, because they generally eat lower amounts of saturated fats and calories overall. Pescatarian or not, your diet should contain plenty of whole plant foods to maintain good weight and health. 

Fish and seafood choices for a Pescatarian diet

Wild-caught fish are definitely a better option over farm-raised fish because they are lower in toxins and chemicals that are commonly used in fish-farm practices. Just as grass-fed/pasture raised animals are higher in good fats and nutrients, it’s the same for wild caught fish.

Farmed fish are generally lower in the good fats EPA and DHA compared to wild caught fish and they contribute to heavy metal toxicity, so it’s best to avoid inferior seafood products if possible, such as farmed salmon and prawns/shrimp.

Fish and seafood recommended as the highest in EPA and DHA include:

  • Sardines
  • Trout
  • Herring
  • Salmon
  • Anchovies
  • Blue-fin tuna (the lowest mercury content tuna – most others are high)
  • Whitefish

How much fish to eat

Eating fish 3-5 times a week is great, with 3 serves per week of the fatty types to get enough of the anti-inflammatory omega-3 fats EPA and DHA that you need. If this feels too much for you, start with a couple of serves a week added to your favourite vegetarian dishes.

Disadvantages of a Pescatarian Diet

It is possible to get bored from eating fish to obtain enough protein, potentially leading one to eat more carbs instead, which can produce weight gain, protein deficiency, fatigue, and other health problems. A good balance between fish meals and vegetarian meals can help.

Many people who are considering eating lots of fish and seafood are apprehensive about mercury toxicity. Considering the level of toxins found in today’s oceans, mercury toxicity is a genuine concern.

Generally, the bigger fish have the most mercury so it’s best to focus on eating smaller fish where possible. The mercury in fish/seafood can be bound by the mineral selenium, which is present in nearly all wild-caught seafood (but not farmed fish).

You can also add selenium to your diet by including Brazil nuts (3-6 per day) which can help to bind mercury, making it less toxic and easier for the body to clear.

Having said that, for anyone who is pregnant, breastfeeding, or for children eating fish/seafood, to be on the safe side it is best to eat smaller fish and get levels tested once a year. Hair analysis is a great way to check your metal and mineral levels. Any health practitioner can help you with this.

Seafood like prawns, shrimp, mussels and clams are ‘bottom feeders’ and more likely to contain toxins from the bottom of the ocean or fish farm dams. To avoid this or to reduce exposure, chose wild caught ‘bottom feeders’ and only eat them once per week or less, compared to eating wild caught ocean fish 3-5 times per week. Other yummy seafoods to enjoy with less toxicity include squid (calamari) and octopus.


Before you commence your diet, see your medical or health care professional for qualified guidance about what foods and supplements are best for your body. While on the diet do not stop any medications or supplements previously prescribed unless advised otherwise by your medical or health care professional.

During the early stages of a new diet, you may experience symptoms such as fatigue, headaches, or body aches, which may occur because your body is detoxifying. However, if you are unsure about a symptom at any time, check immediately with your medical or health care professional.

Case study: The Pescatarian way helps cardiovascular markers

Client name and identifying information changed

When Emma first visited me, she was worried about her cardiovascular risk markers because her doctor told her that her bad (LDL) cholesterol was elevated, her good (HDL) cholesterol was low, and she showed inflammation in her blood.

Her doctor wanted to medicate her because she had a significant family history of cardiovascular disease, but many from her family suffered terrible side effects from the drugs. She asked her doctor to give her time to first work on balancing things naturally. He gave her a three-month deadline.

Emma told me she didn’t want supplements and desired something that was sustainable and affordable, so we talked about her diet and lifestyle.

At that point, her diet was ‘reasonable’, except she ate a lot of bread for convenience, and a lot of red meat because her husband liked it. I asked if she would miss red meat if she didn’t eat it for a while and she said it made her feel a bit sick at times as she felt that she didn’t digest it well.

I asked her if she liked fish and seafood and fortunately this was her favourite food. Her husband liked seafood but loved his red meat more.

To keep things simple, I suggested a Pescatarian diet which could help to support her cardio markers. We discussed how it’s better if the family eats the same meal together, but she could always cook a piece of fish for herself and at the same time, a steak for her hubby to keep him happy.

Also, if she did miss red meat, to eat it very occasionally but mainly stay with the Pescatarian diet to help her cardiovascular system. She was happy to do this.

It turned out that when she cooked her delicious seafood and fish meals that hubby wanted to eat them more often than not, which made life easier for Emma.

Emma stuck to her Pescatarian diet (which was also gluten and dairy free and low sugar) for three months without any bread or red meat. She had her markers tested again and found that her good fats were excellent, her bad fats low, and there was no inflammation in her blood. The doctor was pleased and happy for Emma to continue with what she was doing and he would re-check her blood in another three months to be sure that all was still good.

For the next three months Emma predominantly ate gluten free and dairy free Pescatarian food. She occasionally had a steak with her husband and some chicken.

Although she wasn’t ‘officially Pescatarian’ anymore, Emma had a sustainable diet that suited her and her husband, while still keeping her cardio markers healthy.


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