Junk is junk: seafood at chain restaurants

Part of our mission is to help people to add more seafood to their diet. Seafood in general is a point in the Mediterranean diet and a great source of omega-3 fats, which we know are important for cardiovascular health. Mediterranean diet guidelines suggest eating fish twice a week, on average.

But what about the fish offerings from fast food or chain restaurants? At least some of my patients believe that if they choose a Filet-O-Fish® from McDonald's or another fish option from their favorite chain restaurant that they're making a healthier choice. But is fast food fish really a healthy choice?

A team of researchers from Johns Hopkins, George Washington University, and other schools across the world, from Boston to Norway, surveyed published nutrition information on seafood served at 159 chain restaurants - with a total of 100,948 locations - throughout the United States (Am J Clin Nutr 2021; 113:1546-1555).

In 2018, the FDA required that chain restaurants with 20 or more locations were to disclose nutrition information for their standard menu items. Thus between March and July of 2019 the authors were able to access that information online for nearly 90% of those chains, with the rest added by acquiring the nutrition information by visiting a physical location.

The authors analyzed the over 2,300 seafood menu items offered by chain restaurants during that period, noting calories, fat and saturated fat, sodium, cholesterol, sugar, and protein, as well as the common name of the item (i.e., Atlantic salmon, shrimp, Pacific cod, etc.). Then the items' nutrition information was standardized to 100-gram amounts for easier comparison across seafood types and varying presentations (soup, appetizer, entree, etc.).

The news isn't very good. The authors state, "the average saturated fat content of seafood meals would provide 49-61% of the daily limit of saturated fat intake for adult women and 37-49% of the daily limit of saturated fat intake for adult men."

Worse yet, 19% of the seafood items contained more than 2,300 milligrams of sodium per serving, which is the high end of the USDA's daily recommendation.

Casual dining chains such as Applebee's, Olive Garden, or Red Lobster tended to have more calories as well as more saturated fat, cholesterol, and sugar compared to other chain types - in fact, "Consumers would be more likely to meet their daily nutritional requirements with a single meal at a casual dining chain compared with other chains" (emphasis added).

What this means for you

Don't be fooled into thinking that something is good for you just because it comes from a freshwater or saltwater source. The amount of fat and salt sometimes added to a seafood dish can actually make it far worse for you than a filet mignon. As with other animal proteins, when you choose seafood at a restaurant, look for items that have been grilled, steamed, or broiled and are not loaded with creamy or buttery sauces.