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AIP Fish Cakes with Beetroot & Horseradish



This recipe started with a tin of tuna and some leftover cooked beetroot. It wasn’t meant to be specifically AIP (autoimmune protocol) but it just turned out that way. It’s another complete paleo meal filled with nutritious foods – fish, kale, dill, beetroot, lemon, red onion, and leafy greens. All the good stuff is right here!

What is AIP? For those unfamiliar with the term, AIP stands for Autoimmune Protocol, which is a modified paleo diet (it’s much stricter) that excludes eggs, nightshades, nuts and seeds (including seed derived spices). It’s an healing and anti-inflammatory approach recommended for people with autoimmune disease/conditions. You can learn more about AIP here, so for now let’s get back to the recipe.

12 Mistakes To Avoid When Starting The Paleo Autoimmune Protocol 

Cook’s notes: I used pole caught tinned tuna but you can use any other type of fish. I recommend oily fish such as salmon, trout, sardines or mackerel. If you don’t have dill, feel free to use other fresh herb of choice, and kale can be replaced with spinach. For the relish, I used pre-cooked beetroot but you grate some raw beetroot or boil a few bulbs ahead of time. Horseradish is optional but very nice, you can use a little wasabi for a kick as well.

Make ahead tip: You can prepare a larger batch of relish and store it in an air-tight jar in the refrigerator for up to 5 days. It will go well with beef burgers or grilled chicken, or as a little topping on sliced avocado.



AIP Fish Cakes with Beetroot & Horseradish

  • Author: Irena Macri
  • Prep Time: 10 mins
  • Cook Time: 10 mins
  • Total Time: 20 mins
  • Yield: 2 1x
  • Category: Dinner



For the fish cakes

  • 100 g kale, leaves removed from the stem
  • 250 g tinned tuna or other fish
  • handful of fresh dill
  • 2 spring onions/scallions
  • 1 small clove of garlic
  • zest of ½ lemon
  • 2 tablespoons lemon juice
  • ¼ cup tapioca flour or cassava flour
  • pinch of salt
  • coconut oil for cooking

For the relish

  • 23 medium cooked beetroots
  • 1/3 small red/Spanish onion, roughly diced
  • 1 1/2 tablespoons apple cider vinegar
  • 3 tablespoons olive oil
  • generous pinch of salt
  • 1 teaspoon grated horseradish or wasabi


  1. Make the fish cakes. Bring a small pot of water to boil and add the kale leaves. Cook for 1 minutes, until slightly wilted, then rinse under cold water and strain. Squeeze excess liquid and add the kale leaves to a food processor fitter with an S-blade. Add the rest of the fish cake ingredients, except for the tapioca flour and coconut oil. Whiz the mixture for 10-20 seconds, until it starts to come away from the sides. Then add the tapioca and whiz a couple of times to incorporate. Transfer the mixture to a bowl.
  2. Heat a teaspoon of coconut oil in a large skillet over medium-high heat. Using your hands, mould the fish mixture into small patties and flatten slightly. Add the hot pan and cook for 2-3 minutes each side, or until golden brown. Remove to a plate.
  3. Prepare the relish. In the meantime, wash the food processor and put it back together with an S-blade in. Add the relish ingredients and blitz a few times, until ground up into a salsa like consistency. Transfer to a small ramekin.
  4. Wash and prepare a side salad or some green veggies.
  5. Serve the fish cakes with the relish and a side salad.



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