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Creamy Tomato Baked Fish (PCOS-Friendly)

One thing there isn’t a lot of in my free 30-Day PCOS Diet Challenge is seafood recipes, so I’d like to share this one with you that you’re welcome to use to replace any of the dinners in the meal plan!

This fairly simple one-pan dish takes a Mediterranean style but includes the richness of coconut milk to boost the fat content while also adding a creamy mouthfeel.

If you have access to halibut, this fish is a great choice for this PCOS-friendly recipe.

PCOS Dinner Recipe Baked Fish

Here’s everything you’ll need to make this PCOS-Friendly Baked Fish recipe:

  • Fish fillet
  • Canned crushed tomatoes
  • Canned coconut milk
  • Dried oregano
  • Dried basil
  • Red pepper flakes
  • Salt
  • Pepper
  • Garlic
  • Cauliflower
  • Tomatoes
  • Butternut squash
  • Fresh basil

While this meal is complete on its own, the carb count is relatively low since butternut squash is the only ingredient that’s somewhat starchy. This makes it not only great for the pescatarians amongst us, but it’s also a great dish for women with insulin resistance. If you’re sharing with others or wanted more carbs, a bit of quinoa on the side would go really well with this.

xo Kym

P.S. If you are struggling to make the switch to a PCOS diet, I run a free 30-Day PCOS Diet Challenge which is the perfect way to really kickstart your health transformation. This event includes weekly meal plans, recipes, shopping lists, and video lessons, all within a supportive community environment. However, if this recipe has inspired you and you want to get started right away, then I recommend downloading my free 3-Day PCOS Diet Meal Plan as well. It’s a 15-page PDF ebook that contains some of my most popular PCOS recipes, a shopping list ready to go, and some additional information about how to use food to heal your PCOS.

This one-pan meal checks all the boxes for a healthy PCOS dinner recipe!

PCOS Dinner Recipe Baked Fish

Creamy Tomato Baked Fish (PCOS-Friendly)

Prep Time: 25 minutes
Cook Time: 20 minutes
Total Time: 45 minutes

This fairly simple one-pan dish takes a Mediterranean style but includes the richness of coconut milk to boost the fat content while also adding a creamy mouthfeel.



  • 28 oz Fish fillet


  • 28 oz Canned crushed tomatoes
  • 3/4 cup Canned coconut milk
  • 1 tsp Dried oregano
  • 1 tsp Dried basil
  • 1/2 tsp Red pepper flakes
  • 1 tsp Salt
  • 1/2 tsp Black pepper


  • 1 tsp Garlic (minced)
  • 5 cup Cauliflower (riced)
  • 2 Tomatoes (sliced 1/4" thick)
  • 2 cup Butternut squash (diced into 1/2" cubes)
  • 1/2 cup Fresh basil


  1. Preheat the oven to 425°F (220°C).
  2. In a large bowl, combine the crushed tomatoes, coconut milk, garlic, oregano, dried basil, red pepper flakes, salt, and pepper. Mix well.
  3. Either in a microwave or on a stove top, pre-cook the riced cauliflower for 5 minutes.
  4. Add the cooked riced cauliflower to a cheesecloth or nut milk bag, and squeeze out as much liquid as possible.
  5. Add the cauliflower rice to a large baking dish, then layer the fresh tomatoes on top. Add half of the tomato cream sauce, then layer the squash on top of the sauce. Add the fish fillets then pour the remaining sauce over the dish.
  6. Bake for 20 minutes, until the fish is cooked and the squash is tender.
  7. Garnish with fresh basil and serve.

Nutrition Information:



Serving Size:


Amount Per Serving: Calories: 456Total Fat: 12gSaturated Fat: 9gTrans Fat: 0gUnsaturated Fat: 2gCholesterol: 186mgSodium: 1211mgCarbohydrates: 36gFiber: 12gSugar: 16gProtein: 56g

Please note that the nutrition information above isn’t always 100% accurate.

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