Sushi is a healthy, convenient, and popular food item with many options (sashimi, nigiri, and maki rolls). Then there’s fresh ceviche, tuna tartare, and poke bowls—chunks of colorful, raw fish topping off a salad or rice bowl with avocado and crunchy veggies.
But is it possible to eat sushi too often? Is a weekly (or even daily) sushi habit healthy? We asked experts to weigh in on how often you should be eating raw fish.
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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,” said Health‘s contributing nutrition editor Cynthia Sass, MPH, RD. Because it’s loaded with protein, explained Sass, 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, said Sass. Some forms of cooking fish may reduce the levels of these healthy fats. A 2022 study published in Marine Drugs notes that several studies have highlighted that heat, including cooking, has been reported to reduce the levels of fish lipids and also leads to the formation of unwanted by-products such as free radicals, peroxides, aldehydes, and other unhealthy products.
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 pointed out 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,” said Sass.
There are some risks to eating raw fish, such as being exposed to bacteria and parasites like tapeworms. According to the Centers for Disease Control and Prevention (CDC), 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, especially freshwater fish. Infections are most common in Europe, North America, and Asia.
How worried should you be about bacteria in your salmon roll? “If you’re in a high-risk group, don’t chance it,” said Sass. But if you’re not, Sass recommended 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, advises the CDC.
High-risk groups, such as people with compromised immune systems, babies, young children, and adults 65 and older, should not eat raw or undercooked fish, advises the Food and Drug Administration (FDA). Pregnant people 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 the baby, says the FDA.
Orlando-based ob-gyn Christine Greves, MD, a fellow of the American Association of Obstetrics and Gynecology, said that pregnant and breastfeeding people should steer clear of raw seafood due to mercury. This naturally-occurring mineral can be toxic at high levels, and babies exposed to mercury in the womb can experience brain damage and hearing and vision problems, according to the Environmental Protection Agency (EPA). Should you consume fish during pregnancy, Dr. Greves recommended choosing low-mercury fish such as salmon, tilapia, and shrimp and cooking them thoroughly. Avoid tuna, swordfish, king mackerel, and shark since they have higher mercury concentrations.
Pregnant and craving sushi? Dr. Greves ordered cooked sushi rolls while pregnant. “Ask them to use a clean knife to avoid potential contact with the bacteria,” said Dr. Greves, 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.
While there isn’t a one-size-fits-all recommendation of how much raw fish you should eat, the American Heart Association recommends two servings of fish per week (a serving is 3 ounces cooked).
In addition to eating a combination of cooked and high-quality, low-mercury fish, Sass stressed the importance of maintaining a varied diet. Sass suggested mixing in plenty of vegetables, fresh fruit, healthful fats (like avocado, extra virgin olive oil, and nuts for alternate omega-3 fatty acids), whole grains, healthy carbs (like sweet potato and squash), lean proteins, and antioxidant-rich herbs and spices.
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