Can sushi be unhealthy? Hidden risks and healthier choices

October 22, 2025 •

4 min read

Despite its reputation as a healthy meal, some sushi varieties contain hidden calories, unhealthy fats, and excessive sodium that can undermine its nutritional value. A significant study found that weekly consumption of certain fish, including tuna in sushi, led to higher blood mercury levels. So, can sushi be unhealthy? The answer is nuanced and depends largely on what you order and where it's sourced from.

Quick Summary

Certain sushi variations can be unhealthy due to high sodium from soy sauce, excess refined carbs from rice, added fats from sauces and toppings, and potential risks from raw fish like parasites, bacteria, and mercury.

Key Points

High-Sodium Content: The combination of salty rice and liberal use of soy sauce can lead to high sodium intake, potentially affecting blood pressure.
Refined Carbs: Most sushi is made with high-glycemic white rice, which can cause blood sugar spikes and lead to overeating.
Hidden Fats and Calories: Many 'Americanized' sushi rolls include high-fat ingredients like cream cheese, spicy mayo, and fried tempura, significantly increasing calorie count.
Foodborne Illness Risk: Sushi with raw fish can harbor bacteria and parasites like Salmonella or Anisakis, especially if not handled and prepared properly.
Mercury Contamination: Larger predatory fish like certain tuna varieties used in sushi can contain high levels of mercury, a neurotoxin.
Smart Choices Matter: To make sushi healthier, opt for sashimi, nigiri, or simple veggie rolls with brown rice and limit your soy sauce and portion size.

The Double-Edged Nature of Sushi

Sushi has earned a global reputation as a healthy, low-calorie meal, packed with lean protein and omega-3 fatty acids from fresh fish. However, this perception only tells part of the story. The healthiness of a sushi meal is heavily dependent on the specific ingredients and preparation methods. Modern American-style sushi, in particular, often deviates significantly from traditional Japanese preparation, introducing elements that can make it far less nutritious. From hidden calorie bombs to food safety concerns, understanding the potential downsides is key to making informed choices.

The Perils of Refined Carbs and Sodium

One of the most significant health drawbacks of many popular sushi rolls is the high concentration of refined white rice. The rice is often seasoned with a sugary, salty vinegar mixture, which increases its caloric load. As a refined carbohydrate, white rice is digested quickly, leading to a spike in blood sugar levels followed by a subsequent crash. This can cause renewed hunger shortly after eating, potentially leading to overconsumption and weight gain. In contrast, nutrient-dense brown rice offers more fiber and a lower glycemic impact, but it is not always available or used in equal amounts.

Another primary culprit is the high sodium content. While many focus on the sodium in soy sauce, the rice itself is often prepared with salt. This, combined with pickled vegetables and liberal dipping in soy sauce, can contribute a significant amount of sodium to a meal. A single teaspoon of regular soy sauce can account for 10–15% of the recommended daily salt intake. Excessive sodium consumption is linked to high blood pressure and other cardiovascular issues.

High-Calorie Ingredients and Overeating

Many popular sushi rolls are laden with ingredients that dramatically increase their calorie and fat content. These are a far cry from the simple, fresh ingredients of traditional sushi.

Tempura and other fried items: Shrimp tempura, spider rolls, and other fried additions add unhealthy fats and hundreds of extra calories.
Creamy sauces and cheeses: Spicy mayonnaise, cream cheese (as seen in Philadelphia rolls), and other creamy sauces are high in fat and calories and are not traditional sushi ingredients.
Large, 'specialty' rolls: Overstuffed with extra rice, multiple fillings, and rich sauces, these large rolls can quickly accumulate calories, turning a light meal into a heavy one.
All-you-can-eat buffets: The 'all-you-can-eat' model encourages overeating, which can lead to excessive consumption of high-calorie, high-sodium rolls.

The Risks of Raw Fish: Bacteria, Parasites, and Mercury

Consuming sushi with raw fish carries inherent food safety risks that can't be ignored. Raw seafood can harbor harmful bacteria, parasites, and viruses. Reputable restaurants minimize this risk by sourcing 'sushi-grade' fish, which has been flash-frozen to kill parasites. However, this term is not strictly regulated by the FDA, and improper handling can still lead to contamination. Common foodborne illnesses associated with sushi include Anisakiasis (parasitic worms), Salmonella, Listeria, and Vibrio.

Another significant concern is mercury contamination, especially in certain types of fish. Larger predatory fish higher up the food chain, such as tuna (especially bluefin and bigeye) and swordfish, tend to accumulate higher levels of methylmercury. High exposure to mercury is a neurotoxin that can be dangerous, particularly for pregnant women and young children, who are often advised to limit or avoid certain types of raw fish.

Making Healthier Sushi Choices

To enjoy sushi without the unhealthy downsides, you can take a proactive approach to what you order. It's about moderation and mindful ingredient selection.


Feature	Healthier Choice	Unhealthier Choice
Rice Type	Brown Rice	White Rice
Preparation	Sashimi, Nigiri	Tempura, Fried Rolls
Sauces	Light soy sauce, Wasabi, Ginger	Spicy Mayo, Cream Cheese Sauce
Fillings	Fresh vegetables, Lean fish	Imitation crab, High-fat sauces
Sodium	Low-sodium soy sauce	Standard soy sauce, Salty rice
Quantity	8-10 pieces, Sashimi	All-you-can-eat, Large specialty rolls

How to Order Healthier Sushi

Choose Sashimi or Nigiri: These options prioritize fresh fish with minimal rice, reducing carbohydrate and calorie intake. Sashimi, in particular, is an excellent choice for a low-carb, high-protein meal.
Opt for Brown Rice: If available, substitute white rice for brown rice to increase fiber and nutrient content and reduce the glycemic spike.
Request Simpler Rolls: Stick to rolls with fresh, simple ingredients like cucumber, avocado, and lean fish. Avoid overly complex rolls with multiple sauces and high-fat fillings.
Manage Soy Sauce Intake: Use low-sodium soy sauce and dip your sushi lightly. Better yet, try just a small dab of wasabi and ginger, which offer flavor without the added sodium.
Add Nutrient-Dense Sides: Complement your sushi with miso soup (be mindful of sodium) or a seaweed salad. Edamame is another great side that adds protein and fiber.
Vary Your Fish Choices: To reduce mercury exposure, avoid excessive consumption of large predatory fish like certain types of tuna. Opt for lower-mercury alternatives like salmon, eel, or shrimp.

Conclusion: Mindful Enjoyment is Key

So, can sushi be unhealthy? The short answer is yes, but it doesn't have to be. The nutritional value and potential risks vary widely depending on how it's prepared and served. While traditional sushi with fresh fish, minimal rice, and a few vegetables is a balanced and nutrient-rich meal, many modern variations pile on high-calorie, high-fat, and high-sodium ingredients. Food safety is another concern, particularly with raw fish, but this can be mitigated by choosing reputable restaurants that follow proper handling protocols. By being a mindful eater and making smart choices, you can navigate the sushi menu to enjoy the delicious flavors without compromising your health. For more detailed information on making healthier sushi choices, consult reputable nutritional resources like this article from Healthline.

Frequently Asked Questions

For most healthy adults, consuming low-mercury fish in moderation is safe. However, frequent consumption of high-mercury predatory fish like bigeye tuna, swordfish, and some mackerel can lead to mercury buildup over time. Varying your fish choices is key to minimizing this risk.

You can significantly reduce sodium by using low-sodium soy sauce or using it sparingly. Also, be aware that the rice and pickled ginger contain salt, so balancing your meal with other dishes can help. Some chefs can also use less salt in the rice preparation if you ask.

Not always. Raw fish carries a risk of parasites, bacteria, and viruses. Reputable restaurants mitigate this risk by using 'sushi-grade' fish that has been frozen to kill parasites, but improper handling can still pose a risk. People with compromised immune systems, the elderly, pregnant women, and young children should avoid raw fish entirely.

The unhealthiest rolls are typically those with deep-fried ingredients (tempura), creamy sauces (spicy mayo), cream cheese, and excessive amounts of rice. Examples include shrimp tempura rolls and Philadelphia rolls.

White sushi rice is a refined carbohydrate often seasoned with sugar and salt. It can cause blood sugar spikes and offers less fiber and nutrients compared to brown rice. While okay in moderation, opting for brown rice is a healthier alternative.

Eat at reputable restaurants with a high turnover of customers. Fresh sushi should not have a strong, fishy smell. The fish should appear translucent and firm. Ask questions about their food handling practices if you have concerns.

The healthiest options include sashimi (pure fish without rice), nigiri (small ball of rice with fish), vegetable rolls, and hand rolls with less rice. These choices maximize protein and healthy fats while minimizing refined carbs and sauces.