Pescatarian Diet: Food List, Mercury Groups and Research

A pescatarian diet is a vegetarian-style eating pattern that adds fish and other seafood, and most pescatarians also eat eggs and dairy. Its two main nutrition questions are which seafood to choose for lower mercury, where FDA and EPA sort fish into three groups, and how to cover iron and iodine without red meat. Large cohort studies link pescatarian eating to somewhat lower rates of heart disease than meat-based diets, but they show association, not proof. Below: what a pescatarian eats, the mercury groups, USDA seafood numbers, nutrients to watch and what the research measured.

Peptide Labs does not sell fish, seafood or fish oil. This article is general nutrition information, not medical advice.

What is a pescatarian?

The word blends the Italian pesce (fish) with vegetarian. There is no official definition, but in research a pescatarian, sometimes called a pesco-vegetarian or fish eater, eats fish and seafood and no meat or poultry. Eggs and dairy are usually included, so in practice the pattern looks like a lacto-ovo vegetarian diet with seafood added. Some people choose it for health reasons, some for environmental or animal-welfare reasons, and some as a step toward eating less meat.

Pescatarian vs vegetarian comes down to one food group. Seafood adds a ready source of protein, vitamin B12, iodine and the long-chain fats EPA and DHA, which plant foods do not supply. That is why the nutrient gaps a vegetarian needs to plan around are smaller for a pescatarian, though iron still deserves attention.

Pescatarian food list

• Seafood: fish such as salmon, sardines, trout, cod, tilapia and canned tuna, plus shellfish such as shrimp, clams, oysters and crab.
• Legumes and soy: beans, lentils, chickpeas, tofu, tempeh and edamame.
• Whole grains: oats, brown rice, quinoa, barley and whole-wheat bread or pasta.
• Vegetables and fruit: any kind, fresh, frozen or canned without added sugar.
• Nuts and seeds: walnuts, almonds, chia, flaxseed and pumpkin seeds.
• Eggs and dairy (optional): eggs, milk, yogurt and cheese, or fortified plant milks.
• Fats: olive, canola and other vegetable oils.

The pattern overlaps heavily with the Mediterranean eating pattern, which also centers on plant foods and fish while keeping red meat low.

Pescatarian diet and mercury: the FDA and EPA fish groups

Fish differ in how much methylmercury they contain, which is why the agencies group them. The FDA and EPA joint advice, last revised in October 2021, is written for people who might become or are pregnant or breastfeeding and for children ages 1 to 11, but the same chart is a handy reference for anyone who eats a lot of fish. It sorts commonly eaten fish into three groups:

• Lowest-mercury group: includes anchovy, Atlantic mackerel, catfish, clam, cod, crab, flounder, haddock, oyster, salmon, sardine, shrimp, tilapia, freshwater trout and canned light tuna.
• “Good Choices”: includes bluefish, carp, Chilean sea bass, grouper, halibut, mahi mahi, rockfish, snapper, Spanish mackerel, ocean striped bass, albacore (white) tuna and yellowfin tuna.
• “Choices to Avoid” (highest mercury): king mackerel, marlin, orange roughy, shark, swordfish, tilefish from the Gulf of Mexico and bigeye tuna.

The official chart also gives weekly serving counts for each group by age, which we do not repeat here; check the current FDA chart or ask your clinician. For fish caught by family and friends, the agencies say to check local fish and shellfish advisories first, and to limit that catch if no advisory exists. Note that Atlantic mackerel sits in the lowest-mercury group while king mackerel is on the avoid list, and canned light tuna ranks lower in mercury than albacore.

Seafood nutrition: USDA numbers per serving

The table uses USDA FoodData Central SR Legacy entries, converted to a 3-ounce (85-gram) cooked serving. EPA plus DHA are the long-chain fats most studied in seafood. The percent Daily Value (%DV) uses the FDA Daily Values printed on Nutrition Facts labels. The FDA group column refers to the mercury chart above.

Three patterns stand out. Oily fish such as salmon, mackerel, sardines and trout carry several times more EPA and DHA than lean fish like cod or shellfish like shrimp. Many low-mercury fish are also rich in vitamin B12, with clams far above the Daily Value. And swordfish shows that a fish can be nutritious and still land on the avoid list because of mercury. For more on these fats, see our omega-3 guide and our comparison of krill oil and fish oil.

Nutrients to watch on a pescatarian diet

Iron

Most seafood is modest in iron apart from clams, oysters and sardines, and plant foods supply nonheme iron, which the body absorbs less well. The NIH Office of Dietary Supplements (ODS) estimates iron bioavailability at about 14% to 18% from mixed diets and 5% to 12% from vegetarian diets, and notes that vitamin C taken with a meal enhances nonheme iron absorption. Our guide to iron in foods lists the top sources; if you suspect low iron, ask your clinician for a blood test rather than starting pills on your own.

Iodine

ODS lists seafood, eggs, milk and milk products among the top food sources of iodine, so a pescatarian who eats them regularly usually has good sources. People who eat little seafood or dairy can fall short, partly because most salt in US processed foods is not iodized. Our iodine article covers iodized salt and supplements.

B12 and zinc

B12 comes only from animal foods and fortified products, so seafood, eggs and dairy usually cover it. Zinc is abundant in oysters and present in other seafood. Pescatarians who eat fish only occasionally should read our guide to B12 sources and zinc foods guide.

Is a pescatarian diet healthy? What the research shows

There are no long randomized trials of pescatarian diets. The evidence comes from large prospective cohorts that follow people who already eat this way:

• Adventist Health Study 2 (Orlich and colleagues, JAMA Internal Medicine, 2013): 73,308 Seventh-day Adventists in North America followed for about 5.8 years. Compared with nonvegetarians, pesco-vegetarians had a 19% lower rate of death from any cause after adjustment (hazard ratio 0.81). Associations were larger in men. Adventists also tend to avoid smoking and alcohol, so results may not apply to everyone.
• EPIC-Oxford (Tong and colleagues, BMJ, 2019): 48,188 UK adults followed for 18 years. Fish eaters had a 13% lower rate of ischemic heart disease than meat eaters, and vegetarians a 22% lower rate. Vegetarians, but not fish eaters, had a 20% higher rate of total stroke, mostly hemorrhagic stroke.

Observational studies cannot rule out other differences between groups, such as exercise, income or smoking, even after statistical adjustment. Diet was also measured by questionnaires. A fair summary is that pescatarian eating is linked with favorable heart outcomes in these cohorts, and that the overall quality of the diet, not the label, is what researchers can measure. A pescatarian diet built on fried fish and refined grains is a different diet from one built on vegetables, legumes and oily fish.

Practical cautions

• Allergies: fish and crustacean shellfish are major food allergens under FDA rules. People with these allergies need a different protein plan.
• Pregnancy and young children: follow the FDA and EPA chart and your clinician’s advice on which fish to choose.
• Supplements: fish oil is not the same as eating fish, and ODS notes it might prolong clotting times in people taking warfarin; ask your clinician before starting one.
• Plant-forward balance: our flexitarian diet guide covers a related pattern that includes occasional meat.

Frequently Asked Questions

Questions about a label? Contact us or read our Buyer’s Guide. Food comes first; ask a healthcare provider or registered dietitian before a major diet change or a new supplement, especially if you are pregnant, take medicines or have a food allergy. These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

Last reviewed October 2026.

Related guides: Flexitarian Diet: Food List, Key Nutrients and Research, Omega-3: Benefits, Foods, Side Effects and Heart Research, Mediterranean Diet: What It Is, Food List and What the Research Shows.