Ask Dr. Gourmet

What can I substitute for fish and shellfish, if I am allergic to them?

I am interested in the Mediterranean Diet and your diet books, but I am allergic to fish and shellfish. What can I substitute for the fish/shellfish? I don't often eat meat.

Dr. Gourmet Says...

Certainly there's good research to support including fish in one's diet, and this is a basic finding in Mediterranean diet studies: generally speaking, you should aim to consume 6 days of seafood meals in a 2 week cycle. That said, there are a lot of folks who are allergic or simply don't like seafood.

It's a Mediterranean-STYLE Diet

There are a lot of choices for you in creating balance and still following the other Mediterranean diet principles. First and foremost, remember that the goal is to follow more of the 9 basic principles but that doesn't mean you have to be perfect and follow all of them exactly. Moderate alcohol intake is one of the principles, for example, but I don't tell patients to begin drinking if it is not something they are interested in doing.

A good plan would be to replace one or two of the three fish meals each week with a vegetarian option. The other meals could be substituted with lean meat or poultry.

Finding Substitute Recipes

If you are using one of the pre-planned menus in my books, like The Dr. Gourmet Diet for Coumadin Users (PDF) or my Low Sodium Diet (PDF) or Diet for People with GERD/Acid Reflux (PDF), there's an easy way to find a non-fish or -shellfish recipe to use: look at our lists of meals by number of servings.

Click below for the number of servings you need to make (usually 2 but you might be multiplying recipes), then scroll down for the list of recipes under the amount of time you have to cook (tip: check the recipe you're substituting for and use the same cooking time). Choose a vegetarian, chicken, or other land animal protein recipe, head to the grocery store, and you're good to go! (Note that you will need to adjust the pre-planned shopping list accordingly.)

Recipes by Number of Servings

Serves 2
Serves 3
Serves 4-5
Serves 6
Serves 8+

Important in Fish: Omega-3 Fatty Acids

The essential fatty acids that are abundant in fish can be a bit more of a challenge to include in your diet. Here are some good non-fish-or-shellfish sources and making them a part of your meals is important if you are not going to have fish:

Green leafy vegetables like spinach
Soybeans and soybean oil
Walnuts, Brazil nuts, hazelnuts, pecans
Canola oil
Flaxseed oil
Eggs
Sesame butter (tahini)
Tofu
Soy milk

There's good evidence that you can eat healthy (and lose weight) without eating fish. Substituting more meatless meals is a good option, but making sure that you get an adequate amount of the good fats in your diet is key.

Thanks for writing,

Timothy S. Harlan, MD, FACP, CCMS
Dr. Gourmet