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Is Sushi Healthy? 7 Reasons Why It’s Not (Plus Better Options)

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Updated: October 23, 2017

Is sushi healthy? - Dr. Axe

Once considered a “fancy” food available to only a certain demographic, sushi today is ubiquitous in America — from high-end restaurants to stands at the local mall, you can find sushi everywhere. Most people also consider it a health food: you’ll often see people choosing sushi when they want a “lighter” meal, a healthy work lunch or are watching their eating habits. But with so many different types of sushi, rice and fish involved, is sushi healthy?

The answer? It’s complicated. Most sushi you’re probably eating, unfortunately, is pretty far from healthy. But there’s no need to dump the chopsticks just yet; there are better-for-you sushi options out there, if you know how to choose them.

So what’s the deal with sushi? Why does this popular food land so low on my healthy eats list? Is it because it often contains fish you shouldn’t eat? And, if you’re a big fan, how can you make the meal better for you?


What Is Sushi? A Short History

Let’s start with what sushi is and isn’t. Here in the States, we often think of sushi as rolls of raw fish and a few other ingredients wrapped around white rice. Sushi, however, is actually any food with vinegared rice. Its origins date back to about 4th century China, where salted fish was first placed in cooked rice, which caused the fish to undergo a fermentation process. Fermenting the fish allowed it to last much longer than fresh, and so the idea of using vinegared, fermented rice as a preservative caught on. (1, 2)

It spread to Japan in the 9th century, where fish is a diet staple, and was embraced. In fact, it’s the Japanese that are credited with actually eating the fish and rice together. Sushi remained much the same until the 1800s, when sushi makers figured out a way to reduce the fermentation process to just a few hours.

Then, in the 1820s, a savvy entrepreneur by the name of Hanaya Yohei, based in Edo, sped up the fermentation process completely. He discovered that by adding rice vinegar and salt to just-cooked rice and letting it sit for a few minutes, then adding a thin slice of raw, fresh fish, the entire fermentation process could be eliminated; the fish was so fresh that it didn’t need it. Today, we call this type of sushi nigiri sushi.

With Yohei’s speedy new way of preparation, sushi really took off in what’s now known as Tokyo. Later, when refrigeration became more advanced, sushi was able to take off not just in other Japanese cities, but worldwide. The first city to embrace sushi in the U.S. was Los Angeles; here, the first American sushi restaurant opened in Little Tokyo. From there, it spread to Hollywood and then to other major cities. And the rest, as they say, is (sus)history!


Your Sushi Questions

Sushi’s background is the perfect segue to discuss that vital question, is sushi healthy? The sushi we’re getting today is a far cry from the sushi that Yohei pioneered on Tokyo’s streets. Let’s dig in to the most popular sushi questions and figure out if sushi is good for you:

How many calories are in a sushi roll? It’s hard to say exactly how many calories are in a sushi roll. That’s because sushi rolls can be fairly simple, with just rice and veggies, or loaded with several types of fish, calorie-laden sauces like mayonnaise and cream cheese, fried foods (hello, tempura) and sauces. And bear in mind that each sushi roll, usually made up of six pieces, contains about a cup of white rice, or about 200 calories — before any fillings or toppings.

How many calories are in a spicy tuna roll? Spicy tuna rolls weigh in at about 300 calories, which doesn’t seem like too much. However, most of those calories come from the rice and the spicy sauce, which is usually a mixture of mayonnaise and chili sauce. If the chef has a heavy hand, the calories could come in much higher.

How much sugar is there in sushi? While the levels of sugar vary, sushi is definitely not a sugar-free food, even though it’s one you probably don’t associate with sweeteners.

Sushi rice itself is prepared with sugar and rice vinegar; each cup of sushi rice requires about a tablespoon of sugar. Short-grained rice, the type used for sushi, is also known to spike blood sugar levels. If you’re pre-diabetic, having elevated blood sugar levels often can push you into full-blown diabetes. And even if you’re not, too much sugar has been linked to weight gain, increased bad cholesterol, heart disease, liver problems, hypertension and more.

Would you like a side of sugar with that sugar? The sauces used in sushi are loaded with sugar as well. In fact, many of them, like sweet chili sauce, are essentially just empty sugar calories.


Is Sushi Healthy? 7 Huge Reasons Why Most Sushi Is Bad for You

If you’re wondering what it is about those sushi rolls that make it a poor meal option, here are six.

1. Your sushi rolls are full of unhealthy, unsustainable fish — if you’re even getting what you are ordering.

Wild-caught fish like tuna and salmon are great for you. They’re full of omega-3 fatty acids that help protect our hearts and brains, and they’re packed with protein. Unfortunately, that’s probably not the fish you’re getting. More likely you’re being fed farmed fish, which are dangerous to your health and full of antibiotics, pesticides and dangerous chemicals.

These fish farms produce an enormous amount of excrement, which in turn harms other sea life and provides a breeding ground for bacteria. Feeding the fish in fish farms also leads to overfishing of smaller fish species like wild sardines and herring and decreases biodiversity.

If you’ve ever wondered how sushi restaurants can afford to sell sushi so cheaply, this is why; they’re paying peanuts for farmed fish. Of course, that’s if you’re even getting what you believe you’re ordering. A study out of UCLA examined the fish ordered at 26 different L.A.-area restaurants over four years. (3)

They found that 47 percent of the fish used in sushi was mislabeled. While tuna and salmon were usually what they said (salmon was mislabeled 1 out of 10 times, which is still depressing), halibut and red snapper orders were almost always ended up being a different type of fish. An honest mistake? One of the study’s authors doesn’t think so.

“Fish fraud could be accidental, but I suspect that in some cases the mislabeling is very much intentional, though it’s hard to know where in the supply chain it begins,” said Paul Barber, a UCLA professor of ecology and evolutionary biology and senior author of the study. “I suspected we would find some mislabeling, but I didn’t think it would be as high as we found in some species.” (4)

At times, the real fish found in the sushi was from endangered species. Mislabeling is also problematic because certain groups of people, like pregnant women and children, should avoid certain types of fish altogether. Though the study focused on L.A., previous studies suggest this is rampant throughout the country.

Do you really know what kind of fish you’re eating?

2. There’s a ton of bacteria in sushi.

If you’re getting your sushi from places like the grocery store, you might be getting more than you bargained. A study out of Norway detected the bacteria mesophilic Aeromonas spp in 71 percent of the 58 samples they examined. (5) This bacteria is known to cause gastrointestinal issues, skin and soft tissue infections and other unpleasant things. (6)

The researchers found that it was likely the poor temperature control during the transportation between the factory and store that leads to the growth in bacteria. They also found that some of the bacteria can be introduced through both raw veggies and fish. If you’re not consuming high-quality ingredients that have been transported in the proper temperature, the safety of your sushi is likely compromised.

But if you’re thinking that you’ll be safe if you stick to only restaurant sushi, I’m going to burst that bubble, too. Yet another study found that salmonella and listeria was higher in restaurants with fresh sushi than in frozen, industrially processed sushi from supermarkets. (7) As the study’s authors put it, “The quality of freshly prepared sushi strongly depends on the skills and habits of the preparation cooks, which may vary.”

3. It contains too much mercury.

Eating sushi weekly has been linked to higher-than-safe mercury levels. (8) Mercury in fish is connected to serious health issues, particularly in children and pregnant women, ranging from developmental disabilities to shortened attention spans and learning disabilities.

And if you’re eating fish that’s got a high level of mercury (usually tuna, swordfish, shark and mackerel) because of the healthy benefits that fish have, you’re out of luck. It turns out that too much mercury actually cancels out the positive benefits of omega-3s and increases your risk of cardiovascular disease. (9)

Plus, large tuna like Atlantic Bluefin and Bigeye, which are prized for sushi, not only have the highest mercury levels, but they’re also in jeopardy. These fish are overfished to satisfy the needs of sushi eaters.

4. The staple ingredients aren’t very good for you.

Everyone dips their sushi pieces into soy sauce. Unfortunately, soy sauce tops my list as one of the worst condiments. Soy is loaded with sodium, which contributes to high blood pressure and increases your risk of a heart attack or stroke. Plus, nearly all soy in the U.S. is made from GMO seeds. I’ll pass, thanks.

And how about all of that white rice? Refined carbohydrates like white rice are more empty calories. They enter directly into your bloodstream, causing a sugar spike then crash. They’ve been linked to diseases of the heart, liver, kidneys and pancreas, along with Celiac disease, gluten intolerance and allergies. Because each roll contains about a cup of rice, you’re getting a fair amount of this nutrient-barren food. Is sushi healthy? Not when it’s wrapped in rice.

5. Crispy and spicy rolls are killing your health.

If you’re a fan of crunchy and spicy rolls, you’re likely getting an extra serving of calories and chemicals. Those crunchy veggies or fish are coated in a batter and then deep fried, most likely in canola oil, which is terrible for your health.

It’s a refined, genetically modified oil that can cause kidney, liver and heart problems; hypertension and strokes; and adds trans fat to your diet.

And as mentioned earlier, those spicy sauces drizzled all over your sushi are made from mayonnaise or mayo-like substances and often full of sugar and other nasties.

6. That wasabi? It’s not real.

You might be skipping the sauces to load up on the spicy wasabi instead. After all, wasabi is believed to have strong anti-inflammatory and antimicrobial properties. (10) Surprise! Most of the wasabi — we’re talking 99 percent — served in American restaurants isn’t wasabi at all. (11)

Instead, it’s a mix of horseradish and green food coloring. Even in Japan, where the real wasabi plant originates from, real wasabi is far from common, as it’s a very expensive plant to grow.

I don’t have a problem with horseradish, but I am concerned about food dyes. Yellow dye no. 5, one of the dyes found in “wasabi,” is a known carcinogen. Why voluntarily consume something that’s been linked to cancer?

7. Your raw fish may contain parasites.

A new study published in the journal BMJ Case Reports found that infections from the parasite anisakidosis — also called herring worm disease — are on the rise as sushi grows in popularity. Anisakidosis infections come from eating raw/undercooked fish or seafood infected with anisakis worms. Symptoms of an infection include severe abdominal pain, nausea and vomiting and diarrhea.

Properly trained sushi chefs should be able to detect anisakis worms because they can be seen in the fish, but the Center for Disease Control warns that the only way to avoid parasites is to eat well-cooked fish. (12)


Sushi You Can Eat … and 5 Great Substitutes

Hopefully you’re not still wondering if sushi is good for you. But if you’ve been a sushi fan, eliminating it can be difficult. Luckily there are substitutes you can make so that your sushi is healthier.

1. Eat sashimi. Though sashimi is technically not sushi, this is the best way to enjoy a dinner out at a sushi restaurant. Sashimi is way healthier; it’s literally just the fish without any of the extra sauces or rice accompanying it. Of course, you still run the risk of not getting the right type of fish but if you’re willing to take the risk of eating sushi, this is the type to go for.

2. Use coconut aminos instead of soy sauce. Get rid of the GMO soy and use coconut aminos instead. This alternative is soy-free, but tastes just like soy sauce. It’s perfect for dipping rolls into without the fear of soy side effects.

3. Pile on the veggies and ginger. Perhaps skip the fish altogether and load up on veggie rolls. More places are getting creative with their vegetable fillings, letting you enjoy a sushi-like experience without the fear of eating bad fish.

You can also swap out wasabi for fresh ginger. Did you know that ginger is actually the most widely used condiment in the world? It’s a staple in Asian diets, which have long recognized its anti-inflammatory and healing properties. Instead of adding food dyes to your plate, try sneaking in some ginger.

4. Ask for brown rice instead of white. Unlike its white counterpart, brown rice is actually good for you (in small doses, of course!). It’s high in fiber and nutrients, making it a much healthier option than the refined carbs that are white rice.

5. Make your own sushi! You knew this was coming — make your own! It’s actually really easy to prepare your own sushi at home. When you do this, you have full control of what’s going in and what you’re consuming. You can enjoy your meal instead of worrying about what you may or may not be eating.

I have two recipes I recommend. My Vegan Sushi is suitable for all diets, including grain-free: the “rice” is made from cauliflower!

If rolling isn’t your thing, this Smoked Salmon Sushi Bowl has all the sushi flavors you love in an easy-to-inhale bowl.


Final Thoughts

  • Sushi as we know it hit the U.S. in the 1960s.
  • Most sushi is unhealthy and full of sugar and empty calories.
  • The fish most used in sushi is farmed and unhealthy. Many times, fish is mislabeled, which means you could be eating one that’s dangerous to your health or that’s endangered.
  • Sushi is also loaded with bacteria, whether you buy it from a grocery store or a restaurant.
  • Sushi has been linked to high mercury levels in people, which can have dangerous side effects.
  • Ingredients like soy sauce, white rice and spicy sauces are all detrimental to your health and have no benefits.
  • While you can make swaps so your sushi is a bit healthier, the best way to enjoy sushi is homemade.

Read Next: The Truth About Swai Fish


Josh Axe

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