Is Sushi 'Healthy'? Here's Everything You Need to Know

Lebanese people eat sushi in venues as varied as high-end restaurants and prepared foods sections of grocery stores - and many believe it's a nutritious choice. But is sushi healthy?

"Sushi has this halo of being healthy <http://time.com/3921573/sushi-fish-sashimi/>," says Katherine Zeratsky, a registered dietitian nutritionist and associate professor of nutrition at Mayo Clinic. After all, traditional sushi has all the makings of a health food: it's stuffed with fresh fish, wrapped in thin sheets of seaweed and presented in neat little rolls. But experts warn not to expect your weekly spicy tuna order to slim your waistline.

One of the biggest problems with sushi is portion control. While it may look compact, sushi can have a lot of calories: a single sushi roll cut into six to nine pieces can contain as many as 500 calories, says Isabel Maples, a registered dietitian and spokesperson for the Academy of Nutrition and Dietetics. (A spicy shrimp roll with condiments has about 550 calories, according to the USDA <https://ndb.nal.usda.gov/ndb/foods/show/234945?man=&lfacet=&count=&max=25&qlookup=shrimp+tempura+roll&offset=&sort=default&format=Full&reportfmt=other&rptfrm=&ndbno=&nutrient1=&nutrient2=&nutrient3=&subset=&totCount=&measureby=&Q257919=8.0&Qv=1&Q257919=9.0&Qv=1>.) "Our eyes will tell us something, and it may or may not match with what's happening nutritionally," adds Zeratsky - and that's before factoring in additional rolls, appetizers or a cup of sake. "It can add up."

Most of those calories come from the sticky white rice that holds your roll together. Sushi rice is typically made by adding in vinegar and sugar, and the sugar gives it more calories than steamed rice, Zeratsky says. This sweetened sticky sushi rice also gets patted and packed down considerably during the cooking and assembly process, so you could be consuming half a cup to an entire cup of white rice in just one roll, says Nancy Farrell, a registered dietitian nutritionist based in Fredericksburg, Va. "It's really easy to pop them in your mouth" without realizing just how much rice you've eaten.

How to make your sushi order healthier

Still, sushi can absolutely be "part of healthy diet," notes Zeratsky - as long as you're careful about how and what you order. "It just depends on how you do it," she says. Here's what to look out for.

Choose the right roll

The ingredients tucked inside (and piled on top of) your roll are the biggest deciding factors in whether or not your sushi is healthy. Fish is usually low in calories, high in protein and packed with powerful nutrients like omega-3s <http://time.com/4825829/fish-diet-rheumatoid-arthritis/>. Include steamed and fresh vegetables, which are rich in fiber <http://time.com/3936636/diet-gut-bacteria/>, and avocados, a heart-healthy fat, says Farrell, a spokesperson for the Academy of Nutrition and Dietetics. Keep it simple, and your sushi roll will usually be healthier for you. But avoid mayonnaise-based sauces (a main ingredient in most rolls with "spicy" fillings) or battered and fried vegetables (labeled "crunchy" or "tempura").

Cut down on dips and soy sauce

Dips and sauces can quickly escalate the sodium and fat levels in your sushi dinner. Spicy mayo, for example, is a "very concentrated source" of fat and calories, says Zeratsky. She recommends adding "just a touch to your tongue" to enjoy the flavor, rather than dunking your dinner generously. As for soy sauce, even a tablespoon of a reduced-sodium variety can contain 575 mg of sodium <https://ndb.nal.usda.gov/ndb/foods/show/191494?fgcd=&manu=&lfacet=&format=&count=&max=25&offset=&sort=default&order=asc&qlookup=low+sodium+soy+sauce&ds=&qt=&qp=&qa=&qn=&q=&ing=>: about 25% of the recommended daily upper limit. If you can't part with your soy sauce, Maples suggests simply sprinkling a bit over your sushi or dipping delicately to err on the healthy side. Some condiments, on the other hand, are packed full of flavor and nutrients. Ginger, popular in its pickled form to accompany sushi rolls, has anti-inflammatory benefits, notes Maples, while Farrell points to daikon radish as "an amazing source of vitamin C."

Get quality raw fish

Even if you're not concerned about sushi's effect on your waistline, experts say sushi lovers should still be cautious when it comes to eating raw fish. When "eating anything that's raw, there is some inherent risk" of getting sick from bacteria and parasites, says Zeratsky, so people should make sure their fish is from a reputable restaurant and has been refrigerated properly. (A strong fishy smell is a big red flag that it may not be fresh enough to eat, she says.) Your safest bets are rolls with vegetables or cooked seafood in them, says Maples. And be aware of how long takeout or delivery sushi is left out before you consume it. Raw fish shouldn't be left out for more than two hours, or longer than one hour if it is 90 degrees or warmer, according to the U.S. Food and Drug Administration <https://www.fda.gov/food/resourcesforyou/consumers/ucm077331.htm>. In a story that made headlines in early 2018, a man said he contracted a 5-foot long tapeworm after eating raw salmon nearly every day <http://time.com/5110153/sushi-lover-five-foot-tapeworm/>; parasites can survive in raw fish when its internal temperature rises too high or when the fish is improperly frozen.

Another health concern when it comes to eating sushi is mercury, a metal that occurs naturally in our environment but is heightened by pollution and then absorbed by most seafood and shellfish. Consuming trace amounts of mercury via seafood is safe for most people, but it can stunt early development, so pregnant women and young children are advised to avoid raw seafood and even certain types of cooked fish that have high mercury levels <http://time.com/4259955/government-warnings-about-mercury-in-fish-inadequate-report/>, like ahi tuna, king mackerel and swordfish, Maples says. Most people who eat sushi occasionally need not worry, but if you eat sushi multiple times a week, "one of easiest ways to minimize your risk is to mix up types of sushi you get," Maples advises, "so that you don't have same ones over and over." Another protective measure is to choose seafood "high in omega fatty acids but low in mercury, like salmon <http://time.com/3984098/salmon-omega/> or shrimp."

Upgrade your sushi order

There are plenty of ways to make a sushi dinner a healthy one. Maples chooses brown rice; it's higher in fiber and fills you up more than starchy white rice, which digests fairly quickly and could leave you hungry just a few hours after a sushi feast. Getting sushi wrapped in cucumber or ordering sashimi, thinly sliced fresh fish served without rice, are other ways to make your sushi order healthier, Zeratsky says. Going for rolls or to sushi restaurants where the proportion of fish to rice is higher is an additional way to get more healthy, filling protein and less of these starchy carbs.

If you just can't part with your white sushi rice, simply eat less of it. A good way to do so is to pair your sushi with something that has more protein or fiber, such as edamame or a side of vegetables, or to start your meal with a miso soup or salad. And whenever you're eating out, don't be afraid to ask your server questions about how a roll is prepared or what's in it, so you "know what you're getting and make a better choice," Zeratsky says