What Is the Pesco Mediterranean Diet? We Asked a Nutritionist

When you hear the word “diet,” calorie-counting and food restrictions may come to mind. But that’s not the case with the Mediterranean diet, a meal plan that focuses on whole grains, fresh produce, lean meats and healthy fats. Now, it’s time you’ve met its second iteration, the pesco Mediterranean diet, which is essentially the same as the O.G., only it prioritizes fish as a main source of protein. We asked Dr. Felicia Stoler, DCN, a registered dietician, nutritionist and exercise physiologist, for all the deets on the flexible diet plan. (Spoiler: It’s easier to stick to than you may think.)

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pesco mediterranean diet woman buying fish
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What Is The Pesco Mediterranean Diet?

The Basics

  • It’s like the Mediterranean diet, but fish is the main source of protein
  • Also like the Mediterranean diet, olive oil is the main form of fat in the pesco Mediterranean diet. (In other words, you’ll be cooking your meals in EVOO, not butter.)
  • In terms of dairy, low-fat, protein-rich foods—like yogurt—are prioritized over foods high in fat and sodium, like cheese (although lean Mediterranean options, like feta, are still on the table).
  • Whole grains, fresh produce, healthy fats, plant-based protein and fish are the main components, while refined sugars, saturated fats and processed foods should be eaten sparingly.

The Details

“As the name suggests, the pesco Mediterranean diet focuses on proteins from fish…in addition to nuts, seeds, legumes and other plants,” explains Stoler. Those on the pesco Mediterranean diet plan can also eat dairy (read: mostly low-fat dairy, rather than hard cheeses and butter, which are high in saturated fat and sodium) and eggs, just like those on the standard Mediterranean diet. Like its predecessor, healthy fats, fresh fruits and veggies, whole grains and protein-rich plant-based foods are the bulk of what you’ll eat on the pesco Mediterranean diet. It’s a departure from the typical American diet, which relies heavily on processed foods. In fact, U.S consumption of ultra-processed foods (like frozen pizza, soda and baked goods) has increased steadily over the last 20 years, a trend that’s commonly associated with obesity and heart disease.

To pull it off without getting bored, diversifying the seafood you eat is crucial. “We always think salmon, salmon, salmon, sometimes tuna; but there’s plenty in between, and different types of water creatures have varying nutrient levels,” explains Stoler. “In Europe, the diets around the Mediterranean include seafood and fish like sardines, anchovies, canned fish, salted fish.”

In other words, if you’re going to get sick of eating salmon and shrimp on the daily and you have no interest in casting a wider net (pun intended), the pesco Mediterranean diet may get old fast, and you likely won’t stick to it.

How Is It Different From The Regular Mediterranean Diet?

The pesco Mediterranean diet stars fish as the main source of protein, versus chicken, beef and pork. It’s great for people who already like fish, shellfish and seafood in general. If you don’t, cutting yourself off from other animal proteins would likely make sticking to the diet more difficult (and you might have a hard time staying full if you aren’t diligent about consuming other protein-rich, plant-based foods).

If fish isn’t your thing, the regular Mediterranean diet is likely a better choice for you (although they’re essentially identical, minus the pesco iteration having a preferred source of animal protein). It focuses on foods that are found in the Mediterranean (as you might have guessed), so you’ll be able to eat a lot of produce, grains, nuts and other ingredients that are popular in Greece, Italy, Israel and the Middle East. We’re talking Greek yogurt, chickpeas, quinoa, walnuts, feta cheese, a whole lot of olive oil—you get the picture. Red meat isn’t totally off the table, but it’s meant to be eaten sparingly; the same goes for refined sugars, saturated fats and processed foods. You should also be mindful of the carbs you’re consuming, taking care to choose complex carbohydrates (like barley, quinoa and brown rice) instead of pasta, white bread, baked goods and the like, says David Becker, a board-certified cardiologist at Chestnut Hill Temple Cardiology.

In the end, one diet isn’t necessarily better than the other. “There are many people, myself included, who feel that encouraging high consumption of fish [and] seafood—while great for your health—is not sustainable, especially knowing that we’ve been overfishing the oceans and seas,” explains Stoler. “There are pollutants and contaminants in these waters, and the delicate balance of the aquaculture is at risk, [as well as] the overall health of the planet.” (On that note, keep in mind that buying farm-raised fish is a more sustainable choice than wild-caught.)

So, before you pigeonhole yourself into eating seven salmon fillets a week, consider the environment and additional sources of plant-based protein, like nuts, beans and tofu.

pesco mediterranean diet woman cooking fish
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What Are The Benefits Of The Pesco Mediterranean Diet?

Hellooo, omega-3 fatty acids, aka essential fats that can reduce your risk of heart disease and stroke, lower your blood pressure and triglycerides and assist in reducing inflammation. Omega-3s are also rich in vitamin D and selenium, protect the heart from erratic cardiac issues, improve blood vessel function and can even aid in prenatal and postnatal neurological development.

Since our bodies don’t produce omega-3s autonomously, it’s imperative that we consume them through food or supplements—and fish are packed with them. One to two 3-ounce servings of fatty fish a week can reduce your risk of fatal heart disease by 36 percent, says the American Heart Association (AHA). Then again, fish are far from the only source of omega-3s out there. “Omega-3 fatty acids can be found in chia, walnuts, hemp, algal oil and more,” says Stoler.

Fish has also been scientifically proven to work wonders for your brain. Research shows that eating baked or broiled fish at least once a week can significantly lower your risk of Alzheimer’s disease, according to the Fisher Center for Alzheimer’s Research Foundation. Fish is also known to reduce the risk of many chronic illnesses, lower triglycerides, reduce blood clotting, lower your stroke risk and aid with irregular heartbeats, says the Mayo Clinic. Due to all these perks, it’s recommended by the AHA that we have two servings of fatty fish a week (either 3½ ounces cooked or a ¾ cup of flaked fish). On the pesco Mediterranean diet, you’re likely going to consume even more.

If you still need convincing, the Mediterranean diet can even possibly boost your mood, meaning its fish-filled cousin can, too. In a 2017 study by BMC Medicine, researchers monitored a group of people with depression for 12 weeks as they tried the meal plan. By the end of the study, most participants reported a major improvement in their symptoms. Scientists have also noted a connection between fish and anxiety reduction. While a definite explanation hasn’t been discovered, researchers believe omega-3s can travel to the brain easily and positively communicate with mood-regulating molecules and neurotransmitters, says JAMA Network.

Fish and other popular Mediterranean diet foods have also been found to improve headaches and migraines. If you suffer from chronic headaches, they may be triggered by nutritional deficiencies, according to Maria Marlow, integrative nutrition health coach and author of The Real Food Grocery Guide. More magnesium (which is found in leafy greens, beans, nuts and seeds), riboflavin (which is found in broccoli, eggs and almonds) and omega-3s can counteract those deficiencies.

And of course, a major benefit of this diet plan is that there’s no calorie counting required and no food groups are totally off limits (although refined sugars are largely avoided, which is inherently good for your health). The pesco Mediterranean or regular Mediterranean diets could be easy ways for you to eat more nutritiously (or even possibly lose weight) without feeling like you’re depriving yourself.

Does The Pesco Mediterranean Diet Have Risks?

“There are no risks,” Stoler says, “but the underlying assumption is that an individual likes fish and seafood. I also look at sustainability, availability, price and budget—the [pesco Mediterranean diet] can be more expensive and out of reach for people.”

The TL;DR? If you’re all about fish and seafood and can afford buying the proper groceries, the pesco Mediterranean diet could be a solid fit for you. In the end, it’s all about finding a meal plan that works for your lifestyle—that’s crucial for actually committing to this new way of eating for the long haul and changing your habits for the better.

“I still hold firm in suggesting that people develop eating behaviors that they can stick to with a priority on eating more plant-based [foods] and less processed [foods],” concludes Stoler. She also recommends minding your portion sizes, eating foods closer to the way they’re found in nature and trying to reduce food waste, no matter what diet you’re on.

taryn pire

Food Editor

Taryn Pire is PureWow’s food editor and has been writing about all things delicious since 2016. She’s developed recipes, reviewed restaurants and investigated food trends at...