ASK AMY: Is Tilapia okay for PCOS? - PCOS Diva
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ASK AMY: Is Tilapia okay for PCOS?

Ask Amy:  I see that in your meal plans when your recipes call for a white flaky fish, you use haddock or cod.  What about tilapia?  Is this an okay fish to use? – Erin R.

Amy says:  Before I explain why tilapia is not a good food choice for women with PCOS, I need to explain a bit about essential fatty acids (EFA’s). We don’t make EFA’s on our own, we get them from the food we eat. As women with PCOS, we need lots of omega 3 type  EFA’s.  Omega 3’s help calm the inflammation in our bodies help with insulin sensitivity, reduce cholesterol and more.  Omega 6 EFA’s are  very inflammatory yet we need both types of  EFA’s. Researchers agree that the optimal ratio of omega-6 to omega-3 is somewhere between 2:1 and 4:1. However, the standard American diet of processed food, corn-fed beef and lots of omega 6 oils like corn oil, safflower and soybean oil  results in the typical ratio for Americans to be anywhere from  10:1 and 30:1.

Fish is a wonderful source of Omega 3 fatty acids. But not all fish are created equal. Omega 3 levels in fish vary by species, and by what the fish eats. Normally herbivore fish eat algae, which contain medium-chain omega 3 fats that they convert to the very beneficial long chain omega 3s including EPA and DHA.

Most tilapia found in grocery stores are  farm-raised on a diet of corn and soy.  but it has very low levels of beneficial omega-3 fatty acids and very high levels of omega-6 fatty acids, certainly not the ratio we are looking for .  Because the corn and soy are short-chain omega 6 fats, they convert to an inflammation-promoting long-chain omega 6 known as Arachidonic Acid (AA). Tilapia  has some of the highest levels of AA of any food source. This type of Omega 6  actually alters our gene expression and induces whole body inflammation.  This is particularly dangerous for women with PCOS who already have an exaggerated inflammatory response. (1)

And just when it couldn’t get much worse, tilapia also has higher saturated and monounsaturated fat to polyunsaturated fatty acid (PUFA) ratios than other farmed or wild fish.

So don’t be fooled by this so-called healthy fish.  Be sure to ask for the type of fish used in fish tacos and white fish dishes at restaurants and opt for a sustainably caught wild fish like Alaskan salmon, cod, haddock or sole.

Also, consider supplementing your PCOS diet with a carefully sourced fish oil supplement.  Ideally, choose one that includes both DHA and EPA Omega 3 fatty acids.  Above all, be sure that your fish oil comes from a respected nutraceutical company that is GMP certified.  PCOS Diva Ultra DHA Omega 3 Fish Oil Supplement is a terrific choice.

(1) Wake Forest University Baptist Medical Center (2008, July 10). Popular Fish, Tilapia, Contains Potentially Dangerous Fatty Acid Combination


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  1. Great point, I didn’t think to ask in restaurants which type of fish. Question though, do you still think wild caught fish is just as good for us with the pollution from Japan making its way to the California coast? I often have this discussion with my husband if it’s better to still buy wild caught vs farm raised. Thanks!

  2. Yes, I do think wild is still better than farmed. I recently took a course about this and the expert agreed as well.