Diabetes experts recommend eating fish for cardiovascular health, but if your only experience with fish so far has been fish sticks or fried fish, you might be wondering how and why to include fish in your strategy for eating well with diabetes. “It’s a great lean protein choice, low in fat, and it contains important vitamins and minerals,” says Cassandra Rico, MPH, RD, associate director of medical affairs and health outcomes for the American Diabetes Association. And the best part of all is that “you don’t have to do a whole lot to seafood to make it taste good,” she says. “You can add just a few herbs and bake it in the oven. It’s a lot easier to prepare than I think people perceive.” So get to know your local seafood purveyor and make seafood part of your type 2 diabetes diet.

 Salmon for Omega-3s

Salmon is often at the top of the recommended list because it’s high in omega-3 fatty acids, the “healthy” fats that can boost your heart, skin, brain, and more. As with most fish, you have a number of options for healthy cooking with diabetes, including poaching, broiling, and baking it in the oven at 350 to 400 degrees, Rico advises. “I like to just lightly saute it if the cut is not too thick or else grill it — salmon is just delicious grilled.” It is a firm fish, so it holds up well on the grate. She suggests dill as an herb that goes well with salmon, as does fresh lemon juice.

Tilapia for Protein

Tilapia is a low-fat, high-protein fish that is fairly easy to find in both fresh and frozen fillets and even easier to prepare. “I like to saute tilapia in a pan,” Rico says. Tilapia fillets are often thin, so they cook easily this way (be careful not to overcook them, however, because they’ll start to fall apart). A healthy prep method when you have diabetes is to use a good nonstick pan with just a little cooking spray and maybe a touch of white wine or stock. “Serve fillets with a few healthy sides like steamed or roasted veggies and brown rice or a whole-wheat roll,” suggests Rico, who also likes a fresh mango or black-bean-and-corn salsa with her fish.

Cod for Grilling

Like tilapia, cod is a white fish, but it makes a slightly firmer fillet that can withstand more aggressive cooking methods, such as grilling, and bolder seasoning. It’s important to pay attention to cooking time, Rico says. “The thinner the fillet, the faster it will cook,” she notes. “Usually with thicker fillets, you may want to flip them over halfway through cooking.” Consider marinating cod before cooking, giving it time to absorb flavors. However, pay attention to the ingredients in any store-bought marinades and skip those high in salt or sugar.

 Trout for Fatty Acids

If you know someone who fishes, hope that you get treated to a fresh trout or bass. “Rainbow trout is one of those high in omega-3 fatty acids,” Rico says. Try baking or broiling trout with nonsalt 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 American Heart Association-approved 2,300 milligrams (mg) of salt a day, or 1,500 mg if you have high blood pressure. 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

Because shrimp contains relatively high amounts of cholesterol compared with other kinds of seafood, many people with diabetes who are also trying to avoid high cholesterol might skip it. But eating a healthy serving of shrimp once a week or once every two weeks won’t hurt your heart or diabetes diet, Rico says, especially if your overall diet is low in fat. “A 3- to 4-ounce serving of shrimp has about as much cholesterol as one egg,” she adds.

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 on your diabetes diet. Plus, shellfish is simple and healthful to prepare. 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. Canned tuna and canned salmon are both shelf-stable staples you can keep in your pantry. And they do count as part of your fish-eating goal for the week. “Pick fish canned in water rather than packed in oil for half the calories and almost no fat,” Rico suggests. Mixed with a little plain yogurt or mustard, and these canned options can become tasty sandwich fillings or salad toppings.

Sardines for Flavor

Canned sardines are a healthy choice when you have diabetes. They are cheap and flavorful on their own — with available varieties including mustard-dill and hot pepper — or added to other dishes. Sardines are very high in calcium and vitamin D as well as omega-3 fatty acids. This makes 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. They have so much flavor that you can use them sparingly as a flavoring in other dishes like soups and stews, Rico says. If you’re adventurous, try grilling fresh sardines.

How Often?

Many experts recommend eating seafood about twice a week, but new research suggests that in the case of seafood and diabetes, more isn’t always better. While the jury is still out, a 2009 study published in the American Journal of Clinical Nutritionuncovered a slight increase in the risk of type 2 diabetes in women who eat a lot of fish — particularly in those who eat a few servings per week and in those who eat fish more than once a day. However, a 2011 study on the same topic found that fish consumption decreases diabetes risk in men and does not affect risk in women. Because it’s not known what this research may mean for people who have already been diagnosed with diabetes, it seems prudent to keep it to twice a week. Talk to your doctor if your blood sugar seems to be more difficult to manage after you eat seafood.

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