I hardly ever eat fish. What can I eat instead?

If you hardly ever eat fish, start by bringing it back in small, easy forms, such as canned sardines, fish in rice porridge, a clear fish soup or steamed fish. Thailand's 2:1:1 healthy plate lists fish among the low-fat protein foods for one quarter of the plate, together with skinless chicken, eggs, soybeans and tofu, so on days without fish, have one of these at your meals. As a weekly guide, the NHS advises at least 2 portions of fish a week, 1 of them oily.

How often is it recommended to eat fish?

Health agencies in the UK and US give similar amounts, roughly twice a week, and Thailand's 2:1:1 healthy plate includes fish among the protein choices for each meal.

What Thailand's 2:1:1 plate says

Ramathibodi Hospital explains the 2:1:1 healthy plate recommended by the Thai Health Promotion Foundation (ThaiHealth): divide a plate into 4 equal parts, with 2 parts vegetables, 1 part rice or other starch and 1 part meat. For the meat part it suggests low-fat choices such as skinless chicken, fish or eggs, soybeans and tofu, and avoiding processed meats such as Chinese sausage, sausages, ham and bacon. With one plate per meal, fish can be part of everyday meals, not an occasional treat.

For covering the food groups with the 2:1:1 plate, see Living alone with patchy meals: how can I cover food groups?

What counts as oily fish

The NHS lists salmon, sardines, mackerel, trout, herring, pilchards and sprats as oily fish, and cod, haddock and pollock as white fish. It notes that fresh and canned tuna do not count as oily fish. Shellfish such as prawns, mussels, scallops and squid count as seafood too.

If I don't eat fish, what can I have instead at meals?

Thailand's 2:1:1 plate lists fish together with other low-fat protein foods. If you do not eat fish, or eat it only now and then, make sure one of these appears at your meals every day, together with vegetables, fruit and rice.

Other low-fat choices

About omega-3

People who stop eating fish often wonder about omega-3. NIH ODS, part of the US National Institutes of Health, explains that the kinds found in fish and other seafood are EPA and DHA, while plant oils such as flaxseed, soybean and canola oil, and nuts and seeds such as flaxseed, chia seeds and walnuts, contain another kind called ALA. Fish and plants contain different kinds of omega-3.

Which fish are easy to find in Thailand, and how can I cook them?

Fish is part of everyday Thai food, from fresh markets to rice-and-curry stalls. You do not need expensive imported fish.

Fish you can buy easily

• Short mackerel (pla tu), often sold steamed in small baskets
• Tilapia (pla nin), snakehead fish and catfish from the market
• Saba mackerel and salmon from supermarkets and Japanese restaurants
• Canned sardines in tomato sauce
• Shrimp and squid

Cook it without much oil

The NHS says fish that is steamed, baked or grilled is a healthier choice than fried fish, because frying can increase the fat content. Thai dishes that fit well include:

• Steamed fish with lime and chilli
• Tom yum or a clear soup with fish
• Sour curry (kaeng som) with fish
• Rice porridge with fish
• Grilled saba or grilled pla tu with chilli dip and fresh vegetables

Ramathibodi Hospital's 2:1:1 tips also suggest steaming, baking, blanching, boiling or stewing, and cutting down on dishes made with coconut milk or oil. Deep-fried fish and fish in a coconut-milk curry such as chu chee are fine now and then, but they add more fat than steamed or soup dishes.

I don't like fish. How can I start eating it?

Many people avoid fish because of the bones, the smell or not knowing how to cook it. Start with forms that get around those problems.

Get around the bones and smell

• Choose fillets, or fish such as salmon and saba that have few small bones.
• Canned sardines are soft enough to eat with the bones, and need no cooking.
• Strong flavours such as lime, lemongrass, ginger and chilli in steamed fish or tom yum make the smell less noticeable.

Start small

• Add a few pieces of fish to rice porridge or noodle soup instead of pork.
• Mix flaked fish into an omelette or fried rice made with little oil.
• When you eat out, choose one fish dish a week to start with, such as steamed fish at a seafood restaurant or grilled saba at a Japanese restaurant, then work up to twice a week.

Seafood counts too

The NHS includes shellfish such as prawns and squid in its advice on fish and shellfish, and the US guidance is about seafood, not only fish. A shrimp tom yum or a squid salad also counts towards your weekly amount.

Who should take care with which fish?

Most people can eat a variety of fish, but some groups are advised to choose carefully.

Pregnant or breastfeeding women and children

The US FDA advises people who are pregnant or breastfeeding to eat 8 to 12 ounces, about 225 to 340 grams, of a variety of seafood a week from choices lower in mercury, with 1 serving being 4 ounces, about 113 grams, and children to eat 2 servings a week from its "Best Choices" list. That list includes salmon, sardines, Pacific chub mackerel, tilapia, catfish, shrimp, squid and canned light tuna. The FDA lists 7 fish as the highest in mercury: king mackerel, marlin, orange roughy, shark, swordfish, tilefish from the Gulf of Mexico and bigeye tuna.

The NHS advises girls, women planning a pregnancy and women who are pregnant or breastfeeding to have no more than 2 portions of oily fish a week. Other people can eat more.

Salted, dried and fermented fish

Salted fish, dried fish and fermented fish sauce or pla ra are part of Thai cooking, but they are high in salt. Use them as a seasoning rather than as your main way of eating fish.

If you react to fish or seafood

If you get itching, a rash, swelling or trouble breathing after eating fish or shellfish, stop eating it and see a doctor. Get urgent help if you have trouble breathing. If you take regular medicines or have a health condition that you see a doctor about regularly, ask a doctor or pharmacist about large changes to your diet.