How To Shop For & Order Fish In Restaurants: A Doctor Explains

Dr. B.J. Hardick DR. B.J. HARDICK

Once upon a time, fish was one of nature’s perfect foods. After all, salmon and other fish come loaded with protein, nutrients, antioxidants, and anti-inflammatory omega 3 fatty acids.

Then someone realized if you raise and breed fish in pens (like cattle, but in water), they grow bigger more quickly, you control their feeding regime, they weren’t exposed to mercury and other toxins, and you didn’t have to pay those burly fisherman to round up wild fish.

Like most things, if it sounds too good to be true, it probably is.

Wild Caught Or Farmed?

Most fish these days is farm-raised. Unlike wild-caught fish that swim in their natural environment, farmed fish are typically confined in pens that harm the environment and disrupt nearby ecosystems as harmful chemicals, waste, bacteria, and viruses leak out into and contaminate nearby wild populations.

In some cases, these parasites and viruses have made wild Atlantic salmon populations nearly extinct.

Whereas wild-caught fish dine on their natural diet like algae, farmed fish eat soy, corn, grain, and vegetable oils. Not exactly what fish should dine on, right?

Farmed Fish Contain Inflammatory Omega Fatty Acids

Altogether, this disastrous unnatural diet creates an inferior fat profile: Most farm-raised fish contain far more inflammatory omega 6 fatty acids.

Increased intake of these omega 6 fatty acids especially prevalent in farm-raised fish plays a role in nearly every disease including heart disease, Type 2 diabetes, dementia, and cancer.

Even if you do consume adequate amounts of omega 3s, over-consuming inflammatory omega 6s can override those anti-inflammatory benefits and adversely impact your health.

All fish have omega 3s, but because they eat their natural diet, wild fish deliver more omega 3s. More omega 3s mean that omega 6s don’t build up, reducing inflammation in the bargain.

Fish Toxicity

Sadly, even wild-caught fish isn’t perfect these days. Many come contaminated with mercury, pollutants, and toxins like polychlorinated biphenyls (PBCs). One upside: Fish contain selenium, a mineral that binds some mercury.

With these and other problems, no “perfect” fish exists today, yet overall wild-caught have a superior nutritional content and lower toxicity. They live in their natural environment, and that matters.

Steps To Ensure The Healthiest Fish Selection

I always recommend my patients go wild. That isn’t always possible if you’re, say, in a restaurant. Whenever wild isn’t on the menu, these 5 strategies can help you make the best fish decisions.

  1. Beware of buzzwords like “organic”. While better than conventionally raised farmed fish, organic fish still feed on grain and other decidedly non-fish foods. They still live in overcrowded net pens or “feedlots.”

  2. Eat more plant foods. Besides helping your budget (wild-caught salmon isn’t cheap), colorful fruits and vegetables provide nutrients like selenium and sulfur that prevent mercury buildup.

  3. Go smaller. If you’re concerned about mercury (you should be), bigger fish like shark, swordfish, and tuna often contain more pollutants because they eat smaller fish. Be an informed consumer. You can learn about fish with the least and most mercury content here.

  4. Skip the dirty ones. Popular farmed fish include tilapia, catfish, salmon, and trout. Researchers in one study found high amounts of bacterial pathogens and other problems in tilapia, arguing eating this fish “might pose therapeutic problems as well as health risk to consumers.” Yuck. If you see these on your restaurant menu and they aren’t marked “wild,” order another entrée.  

  5. Supplement smartly. If you’d rather pass altogether on fish, a quality supplement delivers those same omega 3 fatty acids. Fish oil provides many benefits including cognitive and heart health while reducing our inflammatory-heavy diet. Look for a quality fish oil third-party tested against mercury and other toxins. Ideally, each softgel should carry about 500 mg combined eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).  There are also vegan supplement options.

Additional Articles

Two additional articles related to this topic are:

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