Not All Fish Are Equal: How to Choose the Best for Heart Health

Eating fish regularly can boost heart health, but not all types offer the same benefits. Some varieties are rich in omega-3 fatty acids, while others may contain high levels of mercury or cholesterol. Experts recommend choosing the right fish—and watching portion sizes—to protect the heart and avoid risks. The American Heart Association advises eating at least two servings of fish each week. Fatty fish, such as salmon, mackerel, herring, trout, anchovies, and sardines, are among the best choices. These contain high levels of omega-3 fatty acids, which help lower cholesterol, manage blood pressure, and reduce inflammation.

Omega-3s also cut oxidative stress, lowering the risk of cardiovascular disease. Lean fish like cod, sole, haddock, and halibut provide protein with little fat, making them heart-healthy too. However, some lean options, including tilapia and catfish, have an unbalanced omega-6 to omega-3 ratio, which could harm heart health if eaten too often. Shellfish, such as oysters, mussels, and shrimp, offer omega-3s but may also be high in cholesterol. Tuna, though not as fatty as salmon, still contains useful omega-3s—though certain types, like albacore, can carry more mercury. The Dietary Guidelines for Americans suggest picking low-mercury fish, such as salmon, sardines, or canned light tuna. Pregnant or nursing women should limit fish intake to two or three servings a week. Too much mercury, found in some tuna and other large fish, can raise the risk of heart disease and other health problems.

Choosing the right fish can improve heart health by providing essential omega-3s and lean protein. But balancing types and portions is key, especially for those at risk from mercury or cholesterol. Following expert guidelines helps ensure the benefits outweigh the risks.