Pescetarian Diet: Pros and Cons

The pescetarian diet, sometimes spelled "pescetarian," combines the principles of vegetarianism with the inclusion of fish and seafood. The term "pescetarian" blends the Italian word “pesce,” meaning fish, with “vegetarian,” and was introduced in the early 1990s. This dietary approach offers a middle ground for individuals seeking the health and ethical benefits of vegetarianism while still incorporating animal protein. There are different types and levels of vegetarianism and veganism. For example, semi-vegetarianism - also known as being flexitarian - involves following a mostly vegetarian diet that's occasionally supplemented with any type of meat. The pescatarian diet is neither fully nor semi vegetarian.

What is a Pescetarian Diet?

The pescatarian diet is primarily a plant-based dietary pattern. A vegetarian avoids eating all animal meats: Red meat - meat from livestock animals such as cows, pigs, and lambs. Poultry, or white meat - from birds such as chickens, turkeys, and ducks. Seafood - from aquatic life such as all fish, crustaceans (such as, lobster and crab), and molluscs (such as scallops and mussels). Pescatarians don't eat any meat or poultry. As a pescatarian, exactly how much fish you eat is completely down to you - there is no limitation. A pescatarian eats a vegetarian diet with the addition of fish and other seafood but no other types of meat. This includes fish such as salmon, tuna and cod, and seafood such as prawns, scallops, crab, lobster and squid. Some pescatarians also eat non-meat animal products - such as eggs and dairy products - while others choose not to. For a balanced diet, you should also eat a range of vegetarian foods, including: Fruit and vegetables, whole grains and cereals - such as rice, bulgur wheat, and oats, legumes - such as all types of beans and peas, nuts and seeds - such as flaxseeds and chia seeds, eggs and dairy, if lacto-ovo-vegetarian - such as eggs, cheese, and milk.

Motivations for Choosing a Pescetarian Diet

There are many possible reasons for becoming a pescatarian. Here are some of the most common:

• Ethical motivations: Some people are against killing animals for food. While fish are also living creatures, transitioning from an omnivore (meat and plant-based) diet to a pescatarian diet is more manageable for some meat lovers and still limits animal consumption. Also, the conditions in which many land animals (livestock) are raised for slaughter are often seen as poor and inhumane.
• Environmental concerns: Raising livestock also comes with an environmental cost. The UN estimates it is responsible for 15% of all man-made carbon emissions making a sizeable contribution to the global warming crisis. Following a pescatarian diet is thought to cause fewer greenhouse gas emissions than those who eat meat every day. In general, choosing fish over meat or poultry is better for the environment, as it generates fewer greenhouse gas emissions getting to your table.
• Health benefits: Limiting your meat intake is associated with a lower risk of several health issues, including obesity, type 2 diabetes, and heart disease. Adding fish to a vegetarian diet can also help fill in any nutrition gaps, says Dr. Hu. And by switching from omnivore to pescatarian, you'll likely eat more fiber- and nutrient-rich plant-based foods - healthier for you and the planet, Hu adds.

Potential Health Benefits

A pescatarian diet offers numerous potential health benefits, primarily due to the combination of a plant-based approach with the inclusion of fish and seafood.

• Heart Health: Fish, especially fatty fish like salmon, herring, and trout, are concentrated in omega-3 fatty acids. Omega-3s are fats that are essential to health and are involved in critical processes including regulating inflammation in the body. According to Clare Thornton-Wood, registered dietitian and British Dietetic Association (BDA) member, a balanced pescatarian diet has many health benefits:"A pescatarian diet typically includes lots of lean protein in the form of white fish, and plenty of omega-3 fatty acids from oily fish such as salmon, mackerel, fresh tuna, and sardines." She says the key benefits are: Omega-3 fatty acids - 'healthy fats' that help keep your heart, blood vessels, lungs, and immune system healthy. Protein - a nutrient needed for many important functions, including the growth and repair of cells, muscle health, bone health, hormone regulation, and digestive health. Coupled with whole-grain cereals, nuts, fruit, vegetables and small amounts of dairy, this forms the basis of the Mediterranean diet which is widely recognised as one of the healthiest lifestyle diets. Following the pescatarian diet as part of wider healthy eating may help to prevent several health problems, including: Coronary heart disease, heart attacks, high blood pressure, stroke, type 2 diabetes and colorectal cancer. Apart from fish, the pescatarian diet consists mainly of plant foods. According to one 2017 analysis, people who consume a diet high in vegetables and other plant foods have a reduced risk of coronary heart disease. The study authors say that the heart health benefits of a plant-based diet include improved blood lipids and lower blood pressure. The same research concludes that a vegetarian diet could reverse atherosclerotic plaques when combined with exercise and stress management. Atherosclerosis occurs when plaque builds up in the arteries. This causes the arteries to harden, narrow, and restrict the blood flow. Reducing or eliminating red meat from your diet may improve your heart health. In fact, according to one study, pescatarians live longer than people who consume red meat and poultry.
• Cancer Prevention: A 2022 study found that people who follow a pescatarian diet had a lower risk of cancer than meat eaters. Following a pescatarian diet also had a specific reduction in risk for colorectal cancers - those affecting the colon and rectum. This is likely due to a lack of red meat, which is linked to cancer, and to a higher intake of fruits and veggies, which contain nutrients and phytochemicals that help fight changes in the cells that can lead to cancer.
• Diabetes and Inflammation: Studies show that following a plant-based diet may help reduce the risk of type 2 diabetes and metabolic syndrome. Metabolic syndrome is a cluster of conditions, including insulin resistance, high blood pressure, and obesity. The omega-3 fats found in fish have powerful anti-inflammatory effects and may benefit health in many ways when consumed in large doses.
• Improved Gut Health: High-fiber foods, which are typically a major component of a pescatarian diet, are great for your gut. The fiber in plant foods helps prevent constipation and feeds your gut microbiome, which is home to bacteria, fungi and yeast that live in your small and large intestines. Your microbiome plays a key role in your immune system, digestion and metabolism. A healthy microbiome can also boost your mental health.
• A More Stable Appetite: Many foods in the pescatarian diet, like legumes, nuts and seeds, can help curb afternoon cravings. These foods are naturally high in fiber and protein, which take longer to digest than simple carbs like chips and ultra-processed foods. The result is that you may eat fewer calories throughout the day and feel less hungry.
• Provides a Variety of Nutrients: Plant-based foods such as fruits, veggies, beans, whole grains, lentils, nuts, and seeds supply many vitamins, phytochemicals, and minerals, and seafood provides protein and omega-3 fatty acids. Seafood is an excellent source of lean, complete protein. For example, a 5 ounce can of tuna in water contains 30 grams of protein and only 1 gram of saturated fat. Plus, about 90% of a can of tuna calories come from protein. Most Americans don’t eat enough seafood, which features high levels of omega-3 fatty acids. For example, salmon and tuna contain the two main types of omega-3s-eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).

Potential Disadvantages and Considerations

While the pescatarian diet offers many advantages, there are potential drawbacks and considerations to keep in mind:

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• Mercury Exposure: Mercury is present in the atmosphere and bodies of water, so most fish may be a source of mercury. Heavy metal and pollutants in marine fish is a global issue. With the majority of fish consumed by humans being marine fish, mostly from coastal fisheries, there is a risk of contamination. Food and Drug Administration (FDA) explains that the mercury in fish is not a risk for most people. However, they advise women considering becoming pregnant, women who are pregnant, nursing mothers, and young children not to eat specific fish. Fish to avoid include: shark, sword fish, king mackerel and tilefish. Fish low in mercury include: canned light tuna, salmon, pollock, shrimp and catfish. The NHS advises that if you are pregnant, breastfeeding, or planning to conceive you should eat no more than two portions of oily fish per week as too much could be harmful to the developing or new-born baby. Sea bream, bass, turbot, halibut, and rock salmon also need to be limited as they are higher in mercury than white fish. Shark, swordfish, and marlin contain much higher quantities and should be completely avoided by this group, while the rest of the population should limit intake to one portion per week.
• Nutrient Deficiencies: Although it’s possible for a person following a vegetarian diet to consume all of the nutrients they need through the foods they eat, any diet that restricts a large number of foods could lead to suboptimal intake of one or more nutrients. Eliminating red meat from your diet may raise your risk of iron deficiency anemia, a condition in which your body doesn’t produce enough oxygen-bearing red blood cells. As with all diets, it's all about making sure you're getting enough of the nutrients and minerals you need. For example, red meat is high in iron, so as this is omitted from the pescatarian diet, Thornton-Wood recommends alternative sources of iron such as: Eggs, green leafy vegetables, molasses - add to smoothies and fortified breakfast cereals. If you also exclude eggs and dairy, then getting adequate amounts of calcium, zinc, vitamin B12, and iodine can also sometimes be difficult. Good food choices include fortified plant milks.
• Dietary Planning: It is possible for you to absorb all the nutrients you need on a vegetarian or pescatarian diet. However, restricting certain foods can lead to deficiencies in one or more nutrients. For example, as we discussed above, removing red meat from your diet can result in a deficiency in iron (which you can make up by eating other foods). Or, removing dairy products could result in a calcium deficiency (which you can make up with certain vegetables, beans, nuts, and seeds).
• Sustainability: Also a concern: nearly all fish contain at least traces of methylmercury, a contaminant that can harm the brain and nervous system. You can avoid both these issues, says Hu, by thinking small. "Small fish like anchovies and sardines - and shellfish like scallops, oysters, and mussels - have much less of an environmental impact" than big fish, he explains. When you buy fish, look for those produced sustainably - and choose stores that are transparent about where their fish comes from.
• Cost: Your grocery bill may be higher.
• Dining Out: It’s tricker to dine out. You won’t find fish on every menu.
• Food Preparation: Depending on your current diet, going pescatarian may represent a shift from how you’re used to eating. And if you’re unsure how to cook fish, you may find the transition tough. Luckily, fish and shellfish are relatively simple to prepare. People have an impression that cooking fish is difficult and elaborate, but in fact, it’s easier than chicken. 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 cooking techniques - such as baking a fillet in a pan with veggies for a one-pan meal, or drizzling fish with 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. The right preparation for fish is key if you want to reap the health benefits, in particular those that affect your ticker. In fact, a review of 24 studies revealed that nonfried fish could reduce the likelihood of cardiovascular disease events. In comparison, the consumption of fried fish was linked with an increased risk of cardiovascular events.
• Processed Foods: Pescatarians can still eat unhealthy foods like pizza, French fries and packaged snacks. Processed foods tend to be higher in calories, unhealthy fats and sugar. They’re also low in vitamins and minerals.

Tips for Becoming a Pescetarian

Thornton-Wood's starter tips:

• Start gradually if you find this easier, replacing one meat meal at a time with a fish or plant-based one.
• Consider other plant-based sources of protein - such as lentils and pulses - and don't wholly rely on fish for protein. Where possible, aim for a couple of different sources each day.
• Eat a variety of fish and seafood and aim to get these from sustainable sources.
• Try to keep your intake of processed foods to a minimum.
• If you’re new to fish but curious about a pescatarian diet, the key is to start slowly and simply until you figure out which types of fish you like best.

Pescetarian Meal Ideas

Listed below are some suggestions for sources of fish that a person on a pescatarian diet can eat:

• canned sardines
• canned salmon
• canned tuna
• fish sticks
• frozen salmon, trout, and herring
• frozen shrimp
• fresh fish, such as cod, salmon, pollock, catfish, and sardines
• fresh shellfish, such as shrimp, clams, and scallops

Other foods to include are:

• fruit
• vegetables
• cereals and whole grains, including oats, bulgar wheat, amaranth, corn, and rice
• pseudo grains, such as quinoa and buckwheat, which are gluten-free
• legumes, including kidney beans, pinto beans, and peas
• legume products, including tofu and hummus
• nuts and nut butters
• seeds, such as flaxseeds, hemp seeds, and chia
• eggs and dairy, if lacto-ovo-vegetarian

Here are some meal ideas you can incorporate into your pescetarian diet:

• Tuna Veggie Grain Bowl: Combine cooked quinoa, tuna, sautéed cauliflower, zucchini, and asparagus. Top with cherry tomatoes, dill, and spicy mayonnaise.
• Salmon Southwest Salad: Combine drained salmon with mixed greens, black beans, corn, cherry tomatoes, avocado, red onion, and cilantro, then serve with lime wedges for a zesty finish.
• Mediterranean Tuna Salad: Combine drained tuna with halved cherry tomatoes, sliced Kalamata olives, chopped cucumber, and feta. Dress with lemon juice, olive oil, and oregano.

Pescatarian vs. Mediterranean Diet

Both the pescatarian diet and the Mediterranean diet have health benefits, but they differ in some key aspects. The pescatarian diet is vegetarian with the addition of fish and seafood, while the Mediterranean diet is plant-based and includes olive oil as a primary fat source. The key difference between these two popular dietary approaches is that the Mediterranean diet allows people to eat moderate amounts of poultry and lean red meat. The pescatarian diet restricts all meat and poultry, making seafood its main source of animal protein. Both eating patterns are plant-forward, emphasizing seafood, and are known for their heart-health benefits. They emphasize vegetables, fruits, legumes, whole grains, and healthy fats.

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