The Mediterranean Diet

No. 5 - Fish

More fish, less meat. Simple.

Now a lot of people say that they don’t like fish. However, as with vegetables, if you make a list of fish that you like, there may be more kinds that you’ll eat than you thought. I have had many people using eatTHISdiet who began trying recipes with fish that they thought they hated only to have them become favorites.

There’s a lot of reasons that eating fish is better for you than other sources of animal protein. One is that fish is generally lower in fat, but more importantly, the type of fats in seafood is the “good fats.” The most important of these are the Omega 3 fats.

Here’s a list of the content of Omega 3 fats in different fish.

There has been some consideration lately about contamination in fish. This is an issue but not one that should keep you from making seafood a major part of your diet. Here’s more information.

More about Fish and Shellfish:

In Your Pantry: Shellfish, Part One
In Your Pantry: Shellfish, Part Two
In Your Pantry: Fish
Bay Scallops
Clams
Crab
Freshness of Shrimp
Halibut
Mussels
Salmon
Salmon, Wild vs. Farmed
Sea Scallops
Shrimp
Types of Shrimp

Recipes containing seafood:

Halibut

Halibut with Basil Pea Puree
Halibut with Curry Butter and Snap Peas
Halibut with Dill Pesto Orzo
Halibut with Rosemary Maple Glaze
Halibut with Seven Spices

Grouper

Filet of Grouper with Four Onion Marmalade
Grouper with Caramelized Shallot Horseradish Sauce
Grouper with Horseradish Glaze
Pistachio Crusted Grouper Braised in Curry

Salmon

Orange Dill Salmon
Roasted Salmon with Corn Relish
Salmon Salad
Saffron Salmon Risotto
Salmon in Parchment with Mangoes
Salmon with Caper Mayonnaise
Salmon with Parmesan Crust
Salmon with Red Thai Curry Sauce
Udon Noodle Salad with Salmon

Trout

Baked Cumin Trout with Squash and Pumpkin Seeds
Pumpkin-Crusted Trout

Tuna

Braised Tuna with Ginger and Plum Sauce
Sweet Red Pepper Barbecue Tuna
Seared Tuna with Saki-Wasabi Sauce
Tuna with Ancho Fig Sauce
Tuna with Wasabi Pea Crust

Other Fish

Blackened Redfish
Fish Enchiladas
Grilled Red Snapper with Garlic Tartar Sauce
Oven Fried Fish
Rockfish with Lemon Caper Butter
Sole in Parchment with Vegetables and Mushroom Sauce
Sea Bass with White Beans and Tomato Vinaigrette

Soups

Clam Chowder
Fish and Root Vegetable Stew
Shrimp Gazpacho

Clams / Mussels

Mussels with Red Pepper Mayonnaise
Mussels with White Wine Herbed Butter
Paella
Steamed Clams with Spicy Tomato Corn Broth and Fettucine

Crab

Crab Cakes

Scallops

Bay Scallops with Mushroom Bisque and Tomatoes
Bay Scallops with White Wine and Herbed Butter
Curried Sea Scallops
Mushroom Scallops
Pizza with Scallops and Thai Peanut Sauce
Soy Mustard Scallops

Shrimp

Barbecue Shrimp
Fettucine with Dill Pesto and Shrimp
Indian Shrimp Curry
Jerk Shrimp
Lemon Mint Shrimp
Linguine with Shrimp in Tomato Vodka Cream Sauce
Paella
Shrimp Cocktail
Shrimp Etouffee
Shrimp Fettuccine Salad
Shrimp Fra Diavolo
Shrimp Primavera with Angel Hair Pasta
Shrimp Risotto with Peas
Shrimp Scampi
Shrimp Quesadillas
Thai Coconut Shrimp
Whole Wheat Linguine with Shrimp and Leeks

Salads

Barbecue Shrimp Salad
Caesar Salad with Grilled Salmon
Chipotle Seviche
Crab and Corn Salad
Crab Louis
Crab Salad with Dill and Mango
Leek and Salmon Fettuccine Salad
Napa Cabbage Salad with Seared Tuna and Peanut Dressing
Salade Nicoise
Salmon Salad
Seviche
Shrimp and Roasted Fennel Salad
Shrimp Fettuccine Salad
Shrimp Salad
Shrimp Scampi Orzo Pasta Salad
Udon Noodle Salad with Salmon

Research Articles - Seafood in The Mediterranean Diet

You can read more about the science of why eating seafood is so good for you in these articles:

Fish Really Is Brain Food!
I'm sure you've heard the old saw, too: 'Fish is brain food!' While research has shown that eating fish and omega-3 fatty acids have been associated with lower risk of Alzheimer disease and stroke, a study in the Archives of Neurology this month seems to show that eating fish helps reduce the cognitive decline associated with aging.

A Mediterranean Diet Won't Make You Fat
You've probably heard that a "Mediterranean Diet" will help you live longer. What is a "Mediterranean Diet"? Essentially, a diet like that of the Greek and Mediterranean regions--a diet low in meat and dairy products, but high in vegetables, legumes, fruits and nuts, cereals, fish, and olive oil, with a moderate alcohol intake.

Yes, You Can Eat Red Meat (Just Not Every Day)
My patients are always saying that they can't eat healthy because they like to eat red meat. Well, I like eating a good steak as much as the next person and I do. I don't eat red meat that often ' probably about 5 times a month or so. I do eat leaner cuts and Dr. Gourmet recipes reflect these healthier choices.

Eating fish slows the progression of heart disease!
We have known for a long time that eating fish is good for you. Eating fatty fish like tuna and salmon has been shown to reduce the risk of sudden death. There has not been research, however, to show what effect eating fish might have on the progression of the narrowing of arteries that feed blood to the heart. It is the reduction in size of these blood vessels (the coronary arteries) with plaque that doctors call atherosclerosis.

Why Well-Designed Research is So Important
Arranging and completing large scale, long term research trials to study people's lifestyle is a complex task. There are so many considerations to adjust for including variables such as age, gender, race, family history of health problems, smoking, income, and on and on. Also, finding an accurate cross sample of the population is key to any research. Even after all of this is accomplished there is always the question of whether the participants actually made a significant modification in their lifestyle during the study.

Dietary Fat and the Risk of Alzheimer's Disease
It has become clearer and clearer that diets high in saturated fat and trans fats are associated with health problems. I have written about many different research studies that link diets high in these types of fats with heart disease and stroke. Recently, however, a very well designed study shows a clear connection between Alzheimer's Disease and an increased intake of saturated and trans fat.

Good Fats Appear to Protect You From Pneumonia
Much has been written in my columns and in the press about good fats. A great deal of research has gone into this in the last few years, and while our knowledge is still evolving, it appears that eating foods rich in Omega 3 fats and Omega 6 fats is beneficial to your health. There are likely a number of reasons for this, but one is that these fats appear have an anti-inflammatory effect on the body.

Portion Size
Portion size is the single most important key to eating healthy.

What I (Un)Learned in Medical School
It was about 15 years ago, but as amazing as it may seem, I actually had a professor say, "I don't care about my diet, I'll just take Zocor or another cholesterol lowering medication and keep eating my thick, juicy steaks." This was in response to a Grand Rounds lecturer speaking about the importance of diet in preventing heart disease.

Shrimp Are Fine!
At least once a week I'll be talking with a patient about their high cholesterol and it seems like every third person will say, "But Doc, I don't eat any shrimp!" Almost every time they're shocked when I say tell them that shrimp is OK. The best part is that this gets their attention and I love talking about the things you can eat. (I get a similar reaction when I talk about eating red meat or eggs.)

Not just any fish for omega-3 fatty acids
Previous studies on the relationship between fish consumption and the blood levels of omega-3 fatty acids have been focused mainly on those populations who eat fish frequently. Further, the fish these groups eat tended to be saltwater fish almost exclusively.

Are you eating the right kind of fish? I've written extensively about the omega-3 fatty acids in fish and their impact on heart health. Similarly, certain plant sterols (unsaturated fatty acids found in plants) can also have a positive impact on your risk of cardiovascular disease. Is there a combination of the right types of plant sterols and types of fish that will yield the most protective results?

Eating healthy important for kids' weight, too
It's clear that what's known as a "Western" diet, comprised of high-fat foods, refined grains, and lots of sugar, is one of the primary causes of the rise in obesity levels throughout the Western world. Most studies of dietary patterns, however, are focused on adults and their diets while in adulthood.

Omega-3 fatty acids not just good for your heart: By now you know that polyunsaturated fatty acids, such as omega-3 fatty acids, can help reduce your risk of heart disease. A lesser known type of polyunsaturated fatty acids are the omega-6 fatty acids. Emerging research suggests that it's not just the amount of omega-3s in your diet, but also the ratio of omega-3s to omega-6s that is important.

Omega-3 fatty acids and your bones
Just last week I wrote about bone mineral density and omega-3 and omega-6 fatty acids. Recently researchers in Sweden published a study (Am J Clin Nutr 2007;85:803-7) in which they recruited 73 healthy young men to participate in a long-term study of bone mineral density and blood levels of omega-3 fatty acids.

Eat Fish, Eat Well, Think Better
I have written many times about the benefits of eating fish at least a couple of times a week. Most of the studies so far have been "retrospective" where researchers look back at information and work to draw conclusions. There have been such studies about the association of fish consumption and Alzheimer's Disease, but a group of researchers report on a prospective study in this month's American Journal of Clinical Nutrition (2007;85:1142-1147).

Getting the balance right
We've seen in previous studies that eating red meat has been linked to breast cancer in women as well as colon or rectal cancer. Researchers at the University of North Carolina noted these results as well as those studies that link eating more fruits and vegetables with a reduced risk of these cancers. Similarly, some dietary patterns, such as the Mediterranean Diet, appear to protect against colon and rectal cancers.

A healthy diet helps you avoid skin cancer
Cancer is caused by a multitude of factors, but one that we're sure of is cellular damage through oxidation. High levels of sun exposure causes this oxidative damage to skin cells, which can lead to skin cancer. On the other hand, we also know that anti-oxidants in the diet, like vitamins C and E, can help reduce this damage.

Good fats protect your arteries
It used to be that all fat was bad but we now know that this is not the case. Research has shown that eating foods higher in polyunsaturated and monounsaturated fats like those in safflower oil, olive oil and fatty fish is protective. On the other hand we know that eating a diet that high in saturated fats can lead to heart disease.

Clinically proven!
More and more such claims as "clinically proven" are being found on food products. This is due to a wave of "functional foods" that are hitting the market. In some cases these can be great products with cholesterol lowering properties. In other cases the claims made are dubious.

Eat fish now. Eat fish later
We know that fish high in omega-3 and omega-6 fatty acids are good for you, but recent studies have not consistently shown that eating these fish will help reduce the risk of specific cancers. Alicja Wolk and her colleagues at the National Institute of Environmental Medicine in Stockholm, Sweden, noted that those previous studies had not differentiated between consumption of fatty fish, lean fish, and other seafood....

Omega 3 Fat Supplements and Alzheimer's Disease
We know that there are tremendous benefits to eating fresh, healthy foods. Numerous studies show that eating more fish, eating foods that are high in Vitamin C and other antioxidants as well as whole grains can prevent many conditions, including heart disease, diabetes, stroke, cancers and Alzheimer's disease.

Fish oil and public policy
The research on supplements has been very disappointing so far. We know for instance, that eating foods rich in Vitamin C will prevent disease but taking Vitamin C supplements doesn't have the same effect. A recent study showed similar findings with both antioxidant supplements and Vitamin B.