Discover How to Enjoy Sushi on a Low-Carb Diet Without Guilt!

For fans of seafood and Japanese cuisine, sushi is a must-consume on any diet regime. It’s not only delicious, but dietitians say that sushi can be a key part of a healthy diet. But navigating the world of sushi can be challenging, especially when you're trying to maintain a low-carb diet. Many traditional sushi preparations are high in carbohydrates due to the inclusion of rice, sugar, and other ingredients. However, with the right knowledge and choices, you can absolutely enjoy sushi while staying true to your low-carb goals.

Understanding Sushi and Carbohydrates

The carbohydrate content in sushi will depend on which variety you opt for. The types of sushi that have the highest number of carbs include nigiri, maki, uramaki, and temaki, all of which include rice in their recipes. Sushi rice is the variety used for sushi dishes. Unlike plain white rice, sushi rice is seasoned with sugar and rice vinegar. The carbohydrate content of a sushi roll will depend on its ingredients and fillings. For example, a tuna roll containing rice and raw tuna will have about 4.59 grams of total carbs. Similar to a sushi roll, the carb content in a single piece of sushi will depend on its ingredients. One piece of sushi with tuna and rice, for example, will contain 4.59 grams of carbs.

Traditional sushi is made of small pieces of raw fish wrapped in rice and dried seaweed called nori. Pickled ginger, wasabi, and soy sauce are common garnishes. The rice, which is the main ingredient, is prepared with vinegar, salt, and often added sugar. That’s why sushi can be such a challenge for people with diabetes. Rice is a food with a lot of carbs and can cause glucose levels to spike, or create a roller coaster with unpredictable swings in your glucose levels. Because of this, diaTribe recommends you reduce these “spiky” carbs with the goal of eliminating them.

Sushi Varieties and Their Carb Content

If you’re new to sushi, use the list below to learn about how the different types are made. These different types of sushi vary primarily in how the fish and rice are put together.

Sashimi: Thinly sliced raw fish served by itself without vinegared rice or nori.
Chirashi: Vinegared rice in a bowl, topped with raw fish and nori slices.
Nigiri: A hand-pressed mound of vinegared rice, topped with a slice of raw fish.
Temaki: Fish, vinegared rice, and vegetables, hand-rolled in nori and shaped into a cone.
Maki: Fish, vinegared rice, and vegetables, rolled in nori and sliced into rounds.
Uramaki: Sometimes called inside-out roll because the vinegared rice is on the outside, and the nori is hidden inside.

Low-Carb Sushi Options

Sashimi: The Ultimate Low-Carb Choice

Sashimi is sushi without the rice. Sashimi is a fantastic food to eat in general, and even more so when you’re trying to stay low carb at a Japanese restaurant. Sashimi is simply raw fish, a meat, which means it’s mostly protein, a good amount of healthy fats and only a trace amount of carbs. One piece of sashimi (approx. 30g or 1 oz) has between 5-8g of protein and less than 1g of carbs. Salmon and tuna are the most common choices, but we recommend trying different fish like kingfish or snapper. Straight up raw fish not your deal?

Read also: Enjoy Sushi on Keto

The main difference between sashimi and sushi is the former is not served with rice. Instead, they’re plain raw fish, such as mackerel, tuna, and salmon, cut into bite-sized pieces.

Rice-Free Rolls

Craving some big, fat rolls? No worries, there are low carb work arounds that almost all sushi joints will accomodate. You can get rolls wrapped in cucumber or soy paper. I actually prefer the cucumber because it provides a bit of ‘crunch’, as the fillings tends to be pretty soft. Fillings will usually include crab, avocado, and fish (salmon/tuna/yellowtail/etc).

Naruto rolls contain no rice. Naruto sushi, which are sushi rolls wrapped with shavings of cucumber rather than rice and nori.

Rice-Free Sushi Bowl

Sushi bowls, also called poke bowls or chirashi bowls, are the salad versions of your favorite sushi rolls.

Konjac Ramen

This is a personal favourite of mine and it’s not always easy to find, but if you can, then definitely try it out! Konjac ramen uses special konjac noodles (also known as shirataki noodle) made from the root of the elephant yam and are super low carb (around 2-3g / 100g).

Read also: Healthy Keto Sushi Bowl Recipe

Ingredients to Watch Out For

First, you need to know what foods to avoid. Most Japanese dishes use ingredients that are not suitable for the keto diet, including rice, breading, soy, sugar, and starch.

Contain rice, whether sushi, white, or brown rice. Regardless of the variety, rice is very high in carbohydrates.
Are coated with tempura breading. Some sushi rolls are coated, garnished, or fried with tempura breading. But this adds extra carbs to your sushi.
Have too much soy. Most soy sauces contain few net carbs, but nutritionists say they’re okay to consume on keto in moderation.
Contain added sugar and starch. Sugar and starch are among the main types of carbohydrates. You’ll find them in Japanese food like tamago and imitation crab meat. They’ll also be in common side dishes like pickled ginger and wasabi.

WARNING: Krab (fake crab) is VERY high carb, with a 1/2 cup having up to 12g of carbs. This is because sugar and other high carbohydrate binding agents are used in making this product. Always ask for real crab to be substituted in to your roll if the roll comes with krab. Also be careful about sweet sauces on the rolls, which contain a lot of sugar.

Low-Carb Condiments and Sides

Of course, no sushi meal is complete without sides.

Edamame: Despite being made of legume, edamame can be a keto-friendly side dish as long as you consume it in moderation. As delicious as these are, one serving (around 1/2 cup) of edamame (soy beans) has around 9g of carbs. They’re a popular entree option and are served warm and lightly salted. This won’t be a deal breaker and if you’re good with everything else then go for it, but if you’re trying to be super strict then avoid edamame!
Miso soup: Miso soup is a staple in any Japanese meal. Often served in a small bowl as a starter before the main dish, miso soup is generally quite low carb with only 5-6g of carbs per serve. Miso soup is made from a stock called dashi, miso paste and often has wakame (seaweed) and occasionally tofu. Despite its small size, miso soup can help fill you up so you don’t overeat on other dishes.
Seaweed salad: Seaweed salad is a simple dish that only contains seaweed flavored with vinegar and seasoning. From our research into The 50 Lowest Carb Vegetables, seaweed is actually really low in carbs and a rich source of protein! HOWEVER, traditional Japanese seaweed salad (also known as ‘Wakame Sarada’) is not just seaweed and is usually marinated in soy sauce, sugar, ginger juice, sesame seeds as well as a few other things. As delicious as it is, this does bump up the carbs to around 10g per serve which makes it not-so-low carb.
Chicken skewers: If you need more protein, you can order a side of plain chicken skewers. Most Japanese restaurants also have this in shrimp, fish, or steak.

Tips for Ordering Low-Carb Sushi at Restaurants

When dining at a Japanese restaurant, remember to skip the rice and tempura breading.

Don’t be afraid to ask for modifications to existing rolls if nothing there meets exact criteria! If you are a regular and order it enough, you might end up with a roll named after you.

Read also: Refreshing Keto Sushi

If you don’t find anything that fits into your keto macros, request the chef to customize your meal.

The Health Benefits of Sushi

Sushi can be healthy - many of the ingredients used to make sushi come with nutritional benefits. Fish and shellfish contain high-quality protein, heart-healthy omega-3 fatty acids, and other essential nutrients that are an important part of a healthful diet. “Eating fish regularly has been associated with lower risks of chronic diseases like heart disease," said Mary Ellen Phipps, a Houston, Texas-based registered dietitian and nutritionist. The American Diabetes Association (ADA) recommends people with diabetes eat 4 ounces of fish at least two times per week. Many sushi varieties are also rolled and garnished with vegetables. There’s evidence that eating a variety of vegetables is associated with a reduced risk for heart disease, including heart attack and stroke. Vegetables are an important source of many nutrients, including potassium, fiber, folate, vitamin A, and vitamin C.“And the seaweed wraps used to hold sushi together (nori) offer iron, calcium, and vitamin A, as well as some anti-inflammatory properties,” said Phipps.Traditional sushi is low in fat, saturated fat, and cholesterol.

Sushi Nutrition Facts

Traditional sushi is low in fat, saturated fat, and cholesterol, for example:

Tuna roll: Vinegared rice, raw tuna, and nori. One roll: 194 calories, 0.8g fat, 0.3g saturated fat, 33mg cholesterol, 67mg sodium, 21g carb, 24g protein.
Shrimp roll: Vinegared rice, raw shrimp, and nori. One roll: 155 calories, 1g fat, 0.3g saturated fat, 107mg cholesterol, 482mg sodium, 22g carb, 13g protein.
Vegetable roll: Vinegared rice, asparagus, avocado, cucumber, green onion, and nori. One roll: 206 calories, 8.2g fat, 1.2g saturated fat, 0mg cholesterol, 153mg sodium, 30g carb, 6.6g protein.

In contrast, “Americanized” decadent sushi is often made with less healthy ingredients high in fat, saturated fat, cholesterol, sodium, and carbohydrate. Maki and Uramaki rolls have been more Americanized than any other type of sushi. Exercise caution when eating these types of rolls, which may contain deep-fried ingredients, mayonnaise, or cream cheese, for example:

Shrimp tempura rolls: Vinegared rice, nori, battered and deep-fried shrimp, and may also have a crunchy, deep-fried coating. One roll: 400 calories, 11g fat, 2g saturated fat, 25mg cholesterol, 1160mg sodium, 61g carb, 11g protein.
Spicy tuna rolls: Vinegared rice, nori, tuna mixed with spicy mayonnaise, and maybe topped with spicy mayonnaise. One roll: 379 calories, 19g fat, 3.1g saturated fat, 43mg cholesterol, 463mg sodium, 26g carb, 23g protein.
Philadelphia rolls: Vinegared rice, nori, smoked salmon, and cream cheese. One roll: 391 calories, 14g fat, 6.3g saturated fat, 35mg cholesterol, 1115mg sodium, 55g carb, 11g protein.

Garnishes and sauces can also add more sodium and carbohydrate to sushi.

1 tbsp teriyaki sauce, 690mg sodium, 2.8g carb
1 tbsp wasabi, 678mg sodium, 9.2g carb
1 tbsp pickled ginger, 99mg sodium, 3g carb
½ ounce masago (roe), 380mg sodium, 3g carb
1 tbsp unagi (eel) sauce, 33 mg sodium, 6.8g carb
1 tbsp soy sauce, 879mg sodium, 0.8g carb

Keep in mind the ADA recommends people with diabetes have no more than 2300mg sodium daily. So, just one roll with soy sauce, wasabi, and pickled ginger would knock your sodium intake out of the ballpark. Then of course there’s the abundance of carbs. To stay in range, diaTribe recommends you have 100-150g carbs total per day with only 30g carbs per meal or snack. Certain types of sushi with a lower carb count, such as maki (as opposed to uramaki) can help you stay in range.

Editor’s note: The nutrition information provided was retrieved from the Nutritionix database. However, it should be noted that nutrition information varies from one source to another based on portion size, brand, and ingredients added. Therefore, you should consider the information as a point of reference only.

Is Sushi Safe?

Raw fish may carry parasites, bacteria, and viruses that cause foodborne illness. Food and Drug Administration recommends sushi fish be flash-frozen at sub-zero temperatures.” Complete freezing will kill any parasites.Raw fish is also highly perishable. So, whether you are eating at a sushi bar or a Japanese restaurant, choose a busy place that serves a lot of sushi. The high turnover gives you a better chance of getting fresh fish.Additionally, the FDA recommends pregnant women, children, older adults, and persons with weakened immune systems avoid raw fish. The good news is most sushi menus offer vegetarian sushi and sushi made with cooked fish that may be a good option for these groups.

Making Sushi Diabetes-Friendly

Here are a few steps you can take to make your sushi more diabetes-friendly:

Count carbs Counting carbs is the only way to know how many carbs you’re eating. This is important because carbs have the biggest effect on glucose, and it's easier to manage your glucose if you eat fewer carbs at each meal. "I find that eating one or two pieces of rice-filled sushi is generally pretty easy to manage and correct later if needed, whereas an entire plate is much harder to gauge and bolus for," said Larkin Fegurgur Clark, a San Francisco based journalist, filmmaker, and photographer who has has type 1 diabetes for 28 years.
Opt for maki sushi instead of uramaki or nigiri There tends to be more rice on the uramaki and nigiri sushi, which contributes to a higher carbohydrate content. For example, a California roll - a type of uramaki roll with rice on the outside, has 38g carbs compared to the 27g carbs in a maki tuna roll. Although uramaki has more carbs in general, Clark finds the structure of uramaki and nigiri beneficial, in that the fish is placed over a mound of rice. "If my blood sugars are running high or I simply decide mid-meal, I don't want to have to put in the legwork of remembering to pre-bolus for the rice, such as when I'm out with a group. I can easily separate the rice and eat the lower-carb portion of the serving," Clark said. Chirashi sushi with the rice in a bowl will also make it easier to separate the rice.
Pair sushi rolls with other foods If carbs are combined with protein, fiber, or fats, it can slow down the release of glucose into the blood. So, start your meal with miso soup, a salad, or a side of edamame or vegetables.Phipps, who has been living with type 1 diabetes for 30 years, finds this strategy helpful. "I've found that if I enjoy a non-starchy veggie or salad before eating the sushi roll and do a pre-bolus time of 20-25 minutes, my blood sugars typically do just fine," she said.Clark also finds that sushi rolls with added fat can blunt the effect of the rice carbs. "I gravitate toward Rainbow or California rolls, both because I like the flavor and because the protein and added fat from the avocado seem to help delay the impact of the rice carbs a bit," Clark said.
Order brown rice instead of white Due to consumer demand, some restaurants now offer sushi made with brown rice. Brown rice has fiber that can slow the uptake of glucose. The fiber in brown rice also helps to fill you up more than white rice. Whether you’re eating sushi made with white or brown rice, portion control is a must.
Choose sashimi over sushi rolls Sashimi is only fish and has zero carbohydrates.“Sashimi is a go-to if my blood sugars are on the high side and there’s not enough time to bring them down before the sushi arrives,” said Clark. “I might also order sashimi with a side of rice, making it easier to bolus for the rice in a more familiar presentation, versus it being wrapped in a roll.”
Watch out for sauces Sauces such as teriyaki or unagi can contain a considerable amount of sodium and added sugar. Be sure to request the sauce on the side so you can control the amount you consume. Some restaurants will provide low-sodium soy sauce as an option.
Ask the server questions Sushi rolls - especially specialty rolls, can vary in size and ingredients. Ask the server about how many pieces are in the roll and what’s inside each piece. For example, Maki rolls range from small (Hosomaki) with one filling to large (Futomaki) with 2-3 fillings. The larger the roll, the more rice, and carbohydrates. "Larger rolls that have more rice will obviously require a larger pre-bolus, as will any sushi with a sweeter marinade or sauce incorporated into it," said Clark."I always ask the server ahead of time if there are any sweet marinades or sauces I should be aware of, as that's not always clear on the menu," she added.

Keto Sushi Recipe

Yes, you read it right! Keto sushi is here and it truly is amazing. I used to be a big eater of sushi and have missed it greatly. I put off trying keto sushi for a long time because I thought it would be a huge time sink and a massive headache to be able to make it properly. Well, I tried it, I liked it, and I’ve made it numerous times since. It’s really not as hard as I thought it’d be, and it’s SO good! I definitely recommend this to anyone that loves sushi - you won’t regret it.

It is totally possible to make keto California rolls using my keto sushi rice recipe! Traditional sushi made with sushi rice may be a challenge to eat if you are following a low carb, ketogenic diet or if you are watching your blood sugar. However, this recipe uses cauliflower instead of rice so it does not elicit the same glucose response. Yay for all you sushi lovers, I’ve got just the recipe for you. I created this recipe for Levels Health. Let me tell you, creating sushi that elicits a level glucose response was a fun challenge. I’ve created loads of other recipes for Levels Health including this Lower Carb Cowboy Caviar, Romesco Sauce or this decadent Salted Pistachio Chocolate Torte. This recipe for Keto California rolls will elicit a level glucose response so you can enjoy eating sushi again. It’s simple to make and is easily customizable to your favorite sushi ingredients.

Ingredients

16 oz. Cauliflower
6 oz. Cream Cheese softened
1-2 tbsp. Rice Vinegar unseasoned
1 tbsp. Soy Sauce or coconut aminos
5 sheets Nori
1 6 inch Cucumber
½ medium Avocado

Instructions

Using a food processor, rice the cauliflower into rice-sized pieces by pulsing.
Slice the cucumber on each end, then place the cucumber upright and slice off each side. Discard the middle and slice about 2 side pieces into small strips. Set aside in the fridge.
In a very hot pan, add cauliflower rice and cook. Season with soy sauce as the cooking process happens, about 1 tbsp.
Once the cauliflower is finished up and dried out some, add to a bowl with cream cheese and rice vinegar. Mix together well and set in the fridge until cool.
Once the rice mixture is cooled, slice 1/2 an avocado into small strips and scoop out of the shell.
Put a nori sheet down on a bamboo roller covered with saran wrap (this helps with sticking).
Spread some of the cauliflower rice mixture over the nori sheet, leaving about 3/4 inches of space at the top.
Roll sushi tightly using bamboo.
Serve and enjoy! This makes a total of 3 servings of Keto Sushi.

A big tip I have is to not rice the cauliflower too far. You have to make sure you don’t over-process it otherwise you will have more of a paste, rather than have some sort of texture to the “rice” once you mix the cream cheese in. When cooking the cauliflower, make sure to have a very hot pan. I would also recommend grabbing a bamboo roller for this as it really helps keep the sushi tight and keep the roll whole.

Instructions Make your sushi "rice"Steam your bag of cauliflower rice according to the package directions- mine took 4 minutesPour the bag of cauliflower rice into a colander and allow it to drain. Do not squeeze the water out, simply allow it to drainPour the drained cauliflower rice into a medium bowlSprinkle your cauliflower with rice vinegar, psyllium, powdered sugar and sea salt. Mix well until all the ingredients are combined. Pop the “rice” into the refrigerator while you prepare your California roll ingredients. “Rice” can also be made a day or two ahead of timePrep your California Roll ingredientsCut cucumber into matchsticks, slice the avocadoDrain your crab meat and mix with mayoAssemble your California RollCover a bamboo sushi rolling mat with plastic wrap and place one sheet of nori on top with the rough side facing upSpoon about 4 heaping tablespoons of “rice” onto the nori and spread evenly to the edges using your fingers. Sprinkle with sesame seeds, then flip the whole sheet over so that the “rice” is facing down (it will be on the outside of the roll)Leave a gap of about one inch at the top of your sheet of nori and then arrange your filling in rows on the nori: crab, avocado, cucumber and tobiko (if using)Roll both the nori and the mat and squeeze as you go so that the roll is tightOn a cutting board, cut the roll using a very sharp knife- it may help to rub the knife with a damp paper towel between cuts.

Additional Tips for Low-Carb Sushi

DIY with a sushi kit Making sushi rolls at home with a sushi kit is easier than you think, and it doesn’t even require culinary skills. Sushi-making kits are readily available in stores and online. A basic sushi-making kit includes a rolling mat, rice paddle, and rice spreader. Other kits provide all the ingredients needed for sushi rice, plus seasonings, a rolling mat, and recipes. Making sushi at home has many advantages. “You can more accurately measure the amount of carbs per serving and better control other variables, like added sugars and pre-bolus timing,” said Clark.However, per the FDA recommendations, be sure to store raw fish properly to avoid foodborne illness, especially for pregnant women, children, and older adults.
Keep a diary Clark and Phipps both agree that it can take trial and error to keep your glucose levels stable while eating sushi when you have diabetes.“If I really love a certain sushi type and it adversely impacts my blood sugars the first time I eat it, I’ll try eating it again with a minor adjustment to insulin dosing and/or timing. The more data I have on that food’s impact on my blood sugars, the more likely I’m able to stay in range when eating it in the future,” Clark said.

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