In 2004, The UK government advice stated that consumers should increase fish consumption to two portions a week, one of which should be oil-rich fish. However, survey data show that this advice has not been acted upon by most members of the public. In addition, limited data on consumer attitudes highlight barriers to increased fish consumption, such as concerns about buying and cooking fish, perceptions that fish is expensive, and worries that fish meals may not be eaten by all family members. The ‘two-a-week’ message is underpinned by strong scientific evidence for heart health, while weaker emerging evidence associates certain nutrients found in fish with a lower risk of immune dysfunction, normal brain development in infants, insulin sensitivity and maintenance of cognitive function in later life. Clearly, further refinement of the two-a-week message is needed to ensure that greater numbers of people respond. Ideas include determining appropriate portion sizes for babies and children, increasing awareness of the broad range of fish and shellfish species, highlighting sustainable sources of fish, and reassuring consumers that frozen and prepared fish products count towards the two-a-week target. Further work is also needed to address barriers to consumption, particularly among teenagers and younger adults, who have the lowest intakes.