Should Pescatarians Be Especially Concerned About Mercury Poisoning?
An RD weighs in on whether pescatarians need to be extra careful.
Kim Kardashian West recently tweeted that her daughter, North is a pescatarian, which should really tell you all you need to know about the seafood-friendly diet. But even ignoring the fact that North can do no wrong, pescetarianism has plenty going for it. You get the benefits linked to other meatless diets, without as much of an obstacle to consuming enough B12, protein, and iron. Plus, seafood is loaded with omega-3s, a source of healthy anti-inflammatory fats that many people don't get enough of in their diet. (See: What Is a Pescatarian Diet and Is It Healthy?)
No diet is without its drawbacks though, and eating seafood carries a potential risk of mercury poisoning. Janelle Monáe, for one, ended up with mercury poisoning while following a pescatarian diet and is now recovering, according to her recent interview with The Cut. "I started feeling my mortality," she said about the experience.
Monáe probably isn't exaggerating—mercury poisoning is no joke. Eating seafood is the most common cause of methylmercury (a type of mercury) exposure in the U.S., according to the Environmental Protection Agency (EPA). Symptoms of methylmercury poisoning can include muscle weakness, loss of peripheral vision, and impaired speech, hearing, and walking, per the EPA.
At this point, if you're aware that mercury can accumulate in your body over time, you might be questioning whether the pescatarian diet is such a good idea. (Related: Can You Eat Sushi While Pregnant?)
Should Pescatarians Be Worried About Mercury Poisoning?
The good news: There's no need to steer clear of the pescatarian diet—or seafood in general—for fear of mercury poisoning, says Randy Evans, M.S., R.D., consultant to meal delivery service Fresh n' Lean. "[Pescetarianism] is generally considered a very healthy diet, and you can always ask your doctor to check your mercury levels," he explains.
FYI: People who switch to a pescatarian diet do tend to show slightly elevated mercury levels during lab tests, but results will depend on a lot of variables, says Evans. The types of seafood you're eating, how often you eat seafood, where the seafood was caught or farmed, and other aspects of your diet can all factor in, he explains. (Related: How to Cook Fish When You're Reluctant, According to Obama's Former Chef)
That said, the EPA recommends prioritizing certain types of seafood that are known to be lower in mercury and limiting seafood that's higher in mercury. In general, smaller types of fish are your best bet. This chart from the Food and Drug Administration (FDA) lays out the "best choices", "good choices", and the choices that are best avoided, particularly for women who are pregnant or breastfeeding.
To make matters even more complicated, some fish, especially wild-caught varieties, are high in selenium, which can potentially mitigate the toxic effects of mercury, says Evans. "We have research that indicates it may not be as simple as measuring the mercury in salmon and defining it as 'good' or 'bad,'" he explains. "New science shows many types of fish contain elevated levels of selenium which can help limit the damage mercury can cause."
Do the Benefits of the Pescatarian Diet Outweigh the Risks?
The pescatarian diet is very open-ended, so how it affects your mercury levels and other aspects of your health will depend on your approach, says Evans.
"As with any diet, we look for an emphasis on real whole foods to provide essential nutrients, vitamins, minerals, phytonutrients, and fiber," he explains. "On a pescatarian diet, having a lot of variety would include plenty of plant foods along with different types and amounts of fish along with healthy dairy and eggs."
Main takeaway: Even as a pescatarian, avoiding dangerously high mercury levels is completely doable.