What Is a Pescatarian Diet and Is It Healthy?

Here's what you need to know before you sign on to pescetarianism.

What Is a Pescatarian Diet and Is It Healthy?

Maybe you've heard the hype about plant-based eating but just can't commit to cutting so many foods out of your life. Or maybe you want to be a vegetarian or vegan, but you just reallllly love sushi. Either way, a pescatarian lifestyle might suit your preferences.

The pescatarian (also spelled pescetarian, with an e) diet may not get the same buzz as keto, paleo, or other trendy diet plans, but don't discount this eating style just because it's not as flashy or new. Here's what you need to know about the pescatarian diet and why it may or may not be for you.

What's a pescatarian diet?

A hint: It involves fish. At its core, a pescatarian diet is a plant-focused diet with the addition of fish and seafood.

There are two variations to note: Some pescatarians eat dairy and eggs, while others limit animal products to fish and seafood only. "Each person's pescatarian preferences can vary," says Josh Axe, D.N.M., C.N.S., D.C., founder of Ancient Nutrition. Technically, if you eat dairy and eggs, you're on a "lacto-ovo-pescatarian" diet. Meats like beef, chicken, pork, and turkey are always a no-go on a pescatarian diet.

What are the benefits a pescatarian diet?

Pescatarianism marries the benefits of plants and seafood. "Although meatless diets can vary widely, many people who base the bulk of their food intake around plant foods are very healthy," says Axe. "While some plant-based eaters might exclude all animal products (like vegans), there are a lot of benefits to keeping fish and seafood in your diet, since this can help with several common nutrient deficiencies seen in vegetarians," he explains.

These usually include a shortage of vitamin B12 (which is found only in animal products), a lack of protein or certain amino acids (the building blocks of protein), an imbalanced ratio of essential fatty acids (omega-6s to omega-3s), or deficiency in iron (which can lead to anemia).

Protein and vitamin B12 are critical for the body's metabolic processes and nerve function as well as for building strong bones and muscle. However, not all protein is created equal: "Because of the way amino acids work in the body, there are two important things to consider when it comes to protein in your diet: how much you should aim to eat daily and what types of protein you eat," says Axe.

There are complete proteins (usually animal products) that supply all of the necessary essential amino acids your body needs. And there are incomplete proteins (most plants) that are lacking in one or more of the essential amino acids. "This can make it risky to cut all animal foods from your diet," he says, because you risk lacking some amino acids.

Yet, vegans and vegetarians aren't doomed if they choose to go meatless: You can combine plant-based proteins to get all the amino acids you need. For example, beans and rice alone are incomplete, but they combine to form a complete protein. (It just takes a bit more planning than simply chowing down on a piece of chicken breast.)

So, one perk of choosing a pescatarian diet over a vegan or vegetarian diet is that you can still score these complete proteins and vitamin B12 from seafood. Not to mention, fish itself is pretty good for you.

"One of the primary reasons that fish is so good for us is because of its high levels of omega-3 fats," says Axe. Your body needs to have a balance of both omega-3 and omega-6 fats, but most people consume far too many omega-6s from seed/vegetable oils, plant foods, and farm-raised animal products, he says. "Omega-3 fatty acids are considered anti-inflammatory, while omega-6s are pro-inflammatory. We need both types, but many people are lacking in omega-3s," he says.

By eating fish and seafood like salmon, shrimp, and tuna as part of a pescatarian diet, you're getting a great dose of healthy omega-3 fats to lower inflammation and counterbalance the omega-6 fats that you may be getting from other foods in your diet.

"The combination of nutrients found in seafood also helps regulate your heartbeat, reduce blood pressure and cholesterol levels, decrease blood clot formation, lower triglycerides, and prevent a heart attack or stroke," says Axe.

Yes, there are omega-3s in plant-based foods. But they're not as easily absorbed by the body, which can be a disadvantage for non-meat-eaters. "Alpha-linolenic acid (ALA) is the type of omega-3 found in plant foods (like walnuts and flaxseed), while eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are the most important omega-3 fats found in seafood and some animal products like eggs or beef," he says.

"ALA, EPA, and DHA must come from our diets, yet vegetarians often think that they can cover their bases by eating lots of nuts, taking flax oil, or loading up on seeds. This is actually a misconception: It's true that the body can convert some ALA to EPA and DHA, but this process isn't very efficient and we are much better off eating EPA and DHA directly to get the most benefits," he explains. This is another key advantage that pescatarianism has over going totally plant-based.

What are the downsides of a pescatarian diet?

As a pescatarian, it can be challenging to get enough iron, says Lauren Manaker M.S., R.D.N., a dietitian in Charleston, SC. Load up on leafy greens, beans, and legumes to get adequate amounts, or supplement if necessary.

If you're going strict pescatarian and avoiding dairy and eggs too, a lack of calcium and choline could be a concern, she adds. "The two best sources of choline are egg yolks and liver. Choline supplementation is often necessary for anyone following a pescatarian diet," she says. Note: If you're pregnant, trying to get pregnant, or lactating, you need even more choline than the average person.

"It's possible to start feeling mentally deprived when following a pescatarian diet because meat and most animal products become 'off limits,'" says Axe. (See: Why Restrictive Dieting Usually Backfires) "It's also possible to become bored with eating fish (or eggs and dairy) over and over again each day in order to obtain enough protein." This may lead you to increase your carbohydrate intake, which could cause weight gain, protein deficiency, fatigue, and other health problems, he says.

A fix? Mix things up by trying new flavors or recipes. If you're sticking to a pescatarian diet, experiment with different sauces, seasonings, cooking techniques, and ingredients, like a strange fruit or vegetable you've never tried before.

No matter the diet plan you choose, you'll need to focus on whole foods, produce, and protein, rather than filling up on junk, says Axe.

Is mercury a concern on the pescatarian diet?

"Mercury is, in fact, toxic, but its toxic effects are somewhat mitigated by the mineral selenium, which is present in nearly all wild-caught seafood," says Axe. "However, considering the level of toxins found in today's oceans, mercury toxicity is a real concern, so it's best to also focus on eating smaller fish."

Basically, the smaller a fish is, the less mercury it stores in its tissues. "That's because mercury in fish builds up as you move up the food chain, meaning bigger fish (like swordfish or tuna) tend to have more than smaller fish (sardines, anchovies, herring, and salmon)," he says.

The best types of fish to eat on a pescatarian diet include naturally fatty fish, like salmon, sardines, mackerel, anchovies, and herring. Wild-caught fish are definitely preferable to farm-raised fish, as they are lower in toxins and chemicals that are often used in many fish-farming facilities, he explains.

And just as grass-fed animal products are higher in nutrients, the same goes for wild fish. "Farmed fish are generally lower in EPA and DHA when compared to freshwater fish and contribute to heavy metal toxicity, so avoid seafood products like farmed salmon," he says.

If you're ready to give pescatarianism a whirl, plan to eat fish at least two or three times a week. (Here are healthy fish and seafood recipes to get you started.)

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