How Often Is Too Often to Eat Sushi or Other Raw Fish?
Please don't take our spicy tuna rolls away.
As one of our takeout go-tos, we'll be the first to admit that sushi may have become its own food group in our diets. With so many options (sashimi, nigiri, and maki rolls, oh my!), it's hard to refrain from picking up one of those conveniently pre-packaged little meals from the refrigerated section of the grocery store or lunch joint near the office.
Our love of raw fish doesn’t stop there, though. When dining out, our eyes light up at menu items like fresh ceviche or tuna tartare. And don't even get us started on poke bowls—chunks of colorful, raw fish topping off a salad or rice bowl with avocado and crunchy veggies just says “lunch” to us.
But we've started to wonder if we eat sushi a little too often. Is a weekly (or even daily) sushi habit healthy? We asked experts to weigh in on how often you should really be eating raw fish.
Raw fish is packed with important nutrients
These ocean-dwellers are chock-full of omega-3 fatty acids. "The omega-3 fatty acids found in fatty fish like salmon have been linked to a laundry list of benefits, from fighting heart disease to supporting brain health and staving off type 2 diabetes,” says Health's contributing nutrition editor Cynthia Sass, MPH, RD. Because it’s loaded with protein, she explains, fish is also an ideal post-workout meal to help support healing and recovery.
Eating fish raw could be one of the better ways to reap the benefits of omega-3 fatty acids, Sass adds. Some forms of cooking fish, such as frying and microwaving, may reduce the levels of these healthy fats, according to 2009 study of skipjack tuna.
It's important to remember, though, that a piece of salmon sashimi isn't nutritionally equivalent to a spicy tuna roll doused in soy sauce. Sass notes that many new-age sushi varieties contain high-calorie ingredients like creamy sauces, mayonnaise, and fried tempura, and could set you back 500 calories or more per roll—that's as much as a quarter-pound burger. "There's a health halo around sushi that doesn't [always] quite fit," she says.
Eating it could come with risks
Not to kill your sushi vibe, but there are some gross things that could potentially happen if you consume raw fish—being exposed to bacteria and parasites like tapeworms, for instance. Diphyllobothrium latem and related species are the largest tapeworms that can infect humans (they can grow up to 30 feet long!) who consume raw fish. According to the Centers for Disease Control and Prevention (CDC), infections are most common in Europe, North America, and Asia.
How worried should you actually be about bacteria in your salmon roll? "If you're in a high-risk group, don't chance it," Sass says (more on that later). But if you're not, she recommends making sure you have "a lot of trust" in the establishment where you're eating. "Look for restaurants with 'A' health inspection ratings, read reviews, and don't be afraid to ask questions—a restaurant should be able to describe to you exactly how they have prepared your fish in order to kill parasites and keep it safe."
When cooking fish at home, make sure to cook it to an internal temperature of at least 145° Fahrenheit.
Some individuals should not consume raw seafood at all
High-risk groups, such as people with compromised immune systems, babies, young children, and older adults should not eat raw or undercooked fish at all. Pregnant women are also discouraged from consuming raw fish, since in addition to a weakened immune system, they could risk potentially acquiring bacteria or parasites that might be harmful to baby.
Orlando-based ob-gyn Christine Greves, MD, a fellow of the American Association of Obstetrics and Gynecology, tells us that pregnant and breastfeeding women should steer clear of raw seafood completely due to another culprit: mercury. This naturally-occurring mineral can be toxic in high levels, and babies exposed to mercury in the womb can experience brain damage and hearing and vision problems, she explains. Should you choose to consume fish during pregnancy, Dr. Greves recommends choosing low-mercury fish such as salmon, tilapia, and shrimp, and cooking them completely. Avoid tuna, swordfish, king mackerel, and shark, since they have higher concentrations of mercury.
Pregnant and craving sushi? Dr. Greves ordered cooked sushi rolls during her own pregnancy. "Ask them to use a clean knife to avoid potential contact with the bacteria," she says, noting that it’s not uncommon for the same knife to be used on different types of rolls, and a clean knife eliminates cross-contamination.
How much is too much?
While there isn’t a one-size-fits-all recommendation of how much raw fish you should eat, the American Heart Association recommends capping seafood intake at 12 ounces (two average meals) per week for low-mercury varieties, and less if you’re including types of fish with higher mercury levels.
As much as we may will it, though, our bodies can't function solely on takeout sushi. In addition to eating a combination of cooked and high-quality, low-mercury fish, Sass stresses the importance of maintaining a varied diet. She suggests mixing in plenty of vegetables, fresh fruit, healthful fats (like avocado, extra virgin olive oil, and nuts for alternate sources of omega-3 fatty acids), whole grains, healthy carbs (like sweet potato and squash), lean proteins, and antioxidant-rich herbs and spices.