Common Sense Health: Tiny fish offer great nutrition

By Diana Gifford-Jones on March 6, 2026.

This week, I write from Tokyo, where small fish are eaten with remarkable regularity. A traditional Japanese breakfast includes such fish – salted, dried, grilled and served cold – consumed head-to-tail, bones, eyeballs and all. Small sardines are tucked into lunch boxes. Convenience stores sell little fish for snacking. It’s common to add sardines or mackerel to spaghetti sauce. Eating little fish is a way of life.

What is it about little fish? A large Japanese cohort study following more than 80,000 adults for roughly nine years found that people who regularly consumed small fish had significantly lower risks of death from all causes and from cancer, particularly among women. Even modest intake of just a few times per month was associated with measurable reductions in mortality.

Nutrition science offers an explanation. Small oily fish, such as sardines and anchovies, are rich in omega-3 fatty acids, along with minerals and high-quality protein that support cardiovascular, brain, and bone health. Emerging evidence suggests regular sardine consumption may also improve insulin response and reduce the risk of type 2 diabetes.

Eating the head, bones, and organs means the Japanese are consuming concentrated micronutrients such as calcium and vitamin A that are largely lost when fish are filleted. Westerners throw that nutrition away.

A reader recently reminded me of the Japanese word kuchisabishii, translated literally as “lonely mouth”. It describes eating out of boredom, not hunger. But if mindless snacking is the need, then little dried and crunchy fish are a great choice.

A modelling study published in BMJ Global Health estimated that replacing some red-meat consumption with forage fish – species such as sardines, anchovies, and herring – could prevent up to 750,000 premature deaths annually by 2050. These fish are exceptionally nutrient-dense, and in comparison to any other animal protein, have among the lowest environmental footprints, if one can say that of fish.

In North America, seafood choices tend to centre on large predatory fish such as salmon and tuna. These species are popular and nutritious, but they are also more expensive, accumulate more contaminants over long lifespans, and require greater ecological resources. Meanwhile, vast quantities of small forage fish are processed into animal feed.

There is a practical challenge, however. Achieving the levels of omega-3 fatty acids associated with cardiovascular benefit – particularly EPA and DHA – requires consistent intake. For many North Americans, eating small oily fish several times a week is a stretch, whether because of taste preferences, access, cost, or habit.

For that reason, supplementation can be a sensible adjunct. A high-quality fish oil provides concentrated, purified omega-3s without requiring major dietary overhaul. Readers can find the fish oil recommended by W. Gifford-Jones, MD, Certified Naturals Omega3X, in natural health food stores. It has earned the recommendation because it delivers high levels of EPA and DHA in a purified form that is tested for contaminants and formulated to enhance absorption.

None of this calls for dramatic change. It may simply mean replacing meaty meals with modest, more frequent servings of small fish. Imagine a tin of sardines on whole-grain toast, anchovies folded into pasta, or herring added to a salad. Frequency is better than occasional large portions.

Tokyo’s markets do not advertise their bountiful fish sections with signs proclaiming “Eat fish. Lower the risk of death.” But would it be a crime to encourage people to think about their mortality when grocery shopping? Fresh or tinned, little whole fish are affordable, accessible, and ordinary. Perhaps that is the lesson. Healthful patterns tend to endure when they are woven quietly into daily life, rather than announced as resolutions.

This column offers opinions on health and wellness, not personal medical advice. Visit http://www.docgiff.com to learn more. For comments, diana@docgiff.com. Follow on Instagram @diana_gifford_jones

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