The Best Seafood for People With Diabetes


Seafood is high in protein and big on taste. Find out how to make fish and shellfish part of your diabetes diet.

Most people think of type 2 diabetes as a blood sugar issue, but it’s so much more than that. Insulin resistance — the hallmark of type 2 diabetes — can create problems for your cardiovascular health. In fact, people with type 2 diabetes are twice as likely to have heart disease or a stroke as their peers without diabetes, according to the Centers for Disease Control and Prevention (CDC).

“That’s why I recommend dietary approaches that benefit overall health and cardiovascular health,” says Jill Weisenberger, RD, a certified diabetes care and education specialist in Newport News, Virginia, and author of The Beginner’s Guide to What to Eat with Type 2 Diabetes.

And fish is a worthy consideration in your heart-healthy diet and lifestyle plan. Not only is fish a great source of protein and healthy fat, it contains plenty of important vitamins and minerals, notes the Washington State Department of Health.

How Often Should You Eat Fish Per Week?
The American Heart Association (AHA) recommends eating 2 servings of fish per week, where 1 serving equals 3.5 ounces (oz) of cooked fish, or about ¾ cup of flaked fish. The AHA emphasizes eating fatty fish like salmon, mackerel, trout, and sardines, because these choices are especially high in omega-3 fatty acids (more on these shortly). Limit fish like shark, swordfish, and tilefish, as these have a higher risk of mercury contamination.

The American Diabetes Association (ADA) echoes these recommendations for people with diabetes. The ADA also notes that it’s best to grill, broil, or bake fish, as breaded and fried fish packs extra carbs and calories.

The best part about fish? You don’t have to do a lot to seafood to make it taste good.

So get to know your local seafood purveyor and make seafood part of your type 2 diabetes diet.

Salmon for Heart-Healthy Omega-3s
Salmon is a great choice of fish for type 2 diabetes because it’s high in omega-3 fatty acids, the “healthy” fats that can help reduce your risk of common diabetes-related complications like heart disease, heart failure, and stroke, according to the AHA. In fact, an analysis of four international studies published March 2021 in JAMA Internal Medicine found that eating at least 2 servings of fish per week is associated with a lower risk of heart attack, stroke, and death among people with heart disease.

As with most fish, you have a number of options for healthy cooking with diabetes, including baking, broiling, stewing, and roasting, per the AHA. Weisenberger suggests coating cooked salmon with this heart-healthy dressing: 1 tablespoon (tbsp) olive oil, 1 ½ tbsp lemon juice, 2 crushed garlic cloves, and a handful of fresh chopped basil. “Every single ingredient is heart-healthy and perfect for people with type 2 diabetes,” Weisenberger says. Add a salad, roasted vegetables like broccoli or asparagus, and a whole-grain like brown rice for a balanced meal, she adds.

Tilapia for Tons of Protein and Little Fat
Tilapia is a low-calorie, high-protein fish that has a very mild flavor, Weisenberger says. One small fillet that’s been steamed or poached contains 137 calories and 28.5 grams (g) of protein, according to estimates from the U.S. Department of Agriculture (USDA). Tilapia is also fairly easy to find as both a fresh and frozen fillet, and it’s even easier to prepare. Tilapia fillets are often thin, so they cook quickly (be careful not to overcook them, however, because they’ll start to fall apart).

Try this diabetes-friendly tilapia dish from Weisenberger: Sauté onions, peppers, or whatever vegetables you have on hand. Then add canned tomatoes, tomato sauce (look for low-sodium options), and Italian seasonings. Raise the heat to a low boil and place the tilapia on top. Cover and cook for a few minutes, or until the fish is cooked through. “I’d serve it with brown rice, barley, or quinoa,” Weisenberger says.

Cod for a Versatile, Low-Calorie Meal
Like tilapia, cod is a low-calorie, high-protein white fish (148 calories and 32.6 g protein per small steamed or poached fillet, as the USDA notes). “[Cod] has very little saturated fat and a nice amount of omega-3s,” Weisenberger says. But unlike tilapia, cod makes a slightly firmer fillet that can withstand more aggressive cooking methods such as grilling, as well as bolder seasoning. Weisenberger loves using cod for fish tacos or even seafood gumbo (tilapia is too thin for this).

Another great way to prepare cod is to cut it in chunks, add your favorite veggies, herbs, spices, and a drizzle of olive oil. Wrap each portion in aluminum foil and bake. “This is a great way to give each family member their own personalized meal,” Weisenberger says. “I might choose onions and broccoli, and you might choose mushrooms and asparagus.

Trout for Heart-Healthy Fatty Acids
If you know someone who fishes, hope that you get treated to a fresh trout or bass. “Fattier fish like trout contain higher amounts of omega-3 fatty acids,” says Baltimore-based Julie Stefanski, RD, CDCES, national spokesperson for the Academy of Nutrition and Dietetics. The AHA backs that up, noting trout is one of many types of fish that offer these heart-healthy omega-3s.

Try baking or broiling trout with sodium-free seasoning or a little citrus juice. The challenge for people who are just learning to cook seafood is to not oversalt, especially because you want to aim for less than the AHA-approved 2,300 milligrams (mg) of salt a day, or 1,500 mg for most adults. Every fish variety has unique flavors, so it should be easy to make meals salt-free with just a touch of flavorful herbs.

Shrimp for Calorie Control and a Hearty Helping of Protein
Shrimp is very low in calories and high in protein, Weisenberger says. A 4-oz serving contains 120 calories and 23 g of protein, according to the USDA. It does contain relatively high amounts of cholesterol (170 mg) compared with other kinds of seafood, so people with diabetes who are also trying to avoid high cholesterol might want to skip it. While more research is needed, a review and meta-analysis published in August 2015 in the American Journal of Clinical Nutrition noted that dietary cholesterol significantly increased both total and LDL cholesterol, which can increase the risk for heart disease.

Other Shellfish for Portion Control
The challenge of having to work to get the meat out of succulent shellfish such as crab and lobster shells makes it hard to overindulge on shellfish in your diabetes diet. Plus, crab and lobster are “naturally low in fat and calories,” Stefanski says. One cup of steamed crab packs only 97 calories and nearly 1 g of fat, per estimates from the USDA. Meanwhile, 1 cup of steamed lobster provides 128 calories and 1.2 g of fat. But if you add melted butter, both fat and calories can skyrocket. “Instead, try incorporating shellfish into plant-based meals such as salads and stir-fries with tons of colorful veggies,” Stefanski says. Try a bay leaf seasoning in the cooking water for extra zest rather than salting the cooking liquid, and don’t let diabetes keep you from getting creative — use cooked seafood in recipes from cold salads to pasta, rice dishes, and soups.

Canned Tuna and Salmon for Your Budget
Fresh or frozen seafood is a delicious addition to a diabetes diet, but it can be pricey for some people. Frozen salmon can cost $8.99 or more per 10-oz fillet. Meanwhile, canned tuna and canned salmon are more affordable ($1.69 per 5-oz can of pink salmon) shelf-stable staples you can keep in your pantry. And they do count as part of your fish-eating goal for the week. “Most people don’t include enough fish in their diets, but with this easy option they may reach the goal of 2 to 3 servings of fish per week,” Stefanski says. Pick fish canned in water rather than packed in oil to reduce calories and fat. For an easy, filling meal, mix one packet of tuna with a bit of avocado, a touch of mayo if desired, and lemon pepper seasoning, Stefanski says. Then, spread the mixture over whole-wheat toast.

Sardines for Flavor and Nutrients
“Sardines really do deserve an ‘A’ on their nutritional report card,” Stefanski says. Not only are sardines high in omega-3s, but they contain some calcium and vitamin D, she says. Per the USDA, 1 oz of canned sardines in oil offers 108 mg of calcium and 1.36 mcg of vitamin D. Those attributes make them an excellent food to include as part of your diabetes diet and your bone health program, as long as you read labels to find brands low in salt. Canned sardines are relatively affordable ($2.49 per 3.75-oz can) and they are flavorful on their own — with available varieties including mustard-dill and hot pepper — or added to other dishes. If you’re adventurous, try grilling fresh sardines.


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