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This article presents the nutritional value of shrimp on the strength of its nutrient composition and daily value (DV%). With its relatively lower lipid content (~ 1%), the DV (%) of 100 g shrimp for an adult human is 75%, 70% and 35% for eicosapentanoic acid + docosahexanoic acid, essential amino acids (methionine, tryptophan and lysine) and protein respectively. The lower atherogenic (0.36) and thrombogenic (0.29) indices of shrimp show its cardio-protective nature. The controversy relating to shrimp cholesterol and the overall health benefits of eating shrimp are discussed to indicate that shrimp should be a regular item in the diet of normolipidemic peoples.
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GENERAL ARTICLES
CURRENT SCIENCE, VOL. 104, NO. 11, 10 JUNE 2013 1487
The authors are in the Central Institute of Brackishwater Aquaculture,
N
o. 75, Santhome High Road, R.A. Puram, Chennai 600 028, India.
*For correspondence. (e-mail: syamdayal@ciba.res.in)
Shrimps – a nutritional perspective
J. Syama Dayal*, A. G. Ponniah, H. Imran Khan, E. P. Madhu Babu, K. Ambasankar and
K. P. Kumarguru Vasagam
This article presents the nutritional value of shrimp on the strength of its nutrient composition
and daily value (DV%). With its relatively lower lipid content (~ 1%), the DV (%) of 100 g shrimp
for an adult human is 75%, 70% and 35% for eicosapentanoic acid + docosahexanoic acid, essen-
tial amino acids (methionine, tryptophan and lysine) and protein respectively. The lower athero-
genic (0.36) and thrombogenic (0.29) indices of shrimp show its cardio-protective nature. The
controversy relating to shrimp cholesterol and the overall health benefits of eating shrimp are dis-
cussed to indicate that shrimp should be a regular item in the diet of normolipidemic peoples.
Keywords: Daily value, dietary cholesterol, nutritional composition, shrimp.
FOOD helps human beings maintain good health by pro-
viding all essential nutrients. Consuming a variety of
foods in balanced proportions will prevent deficiency
diseases and chronic diet-related disorders. Shrimp is one
of the most delicious seafoods and is part of almost every
nation’s traditional meal. Its popularity has created a
demand for its produce around the world. Considering the
limit in the supply from wild catch, farming of shrimp
was started in many countries to meet the demand, and is
growing rapidly. One can gauge its growth from the past
production figures which rose from 1 million tonnes (mt)
in 2001 to 4.02 mt in 2010, including the Indian contribu-
tion of about 0.1 mt (ref. 1). The potential for growth of
Indian shrimp is exhibited by increase in its exports by
24% in quantity and 42% by value in 2012 compared to
2011 (ref. 2). Shrimp production is expected to grow
more than 50% globally during 2010–2030, indicating its
vibrant production potential3.
Fresh and clean shrimps can be served either cooked or
uncooked with sauce. From a nutritional standpoint,
shrimps are high in protein, low in saturated fat4 and
calories, and have a neutral flavour. Due to these charac-
teristics, shrimps form a natural additive in salads, pastas,
curry, soups and stir-fried dishes. Shrimps have also been
identified as a rich source of vitamin B12, selenium,
ω
-3
highly unsaturated fatty acids (HUFA) and astaxanthin, a
potent natural antioxidant5. Despite the several nutritional
parameters of shrimp based on which it can be considered
as a healthy food, there is reluctance among dieticians
and health professionals as well as consumers because
of its relatively higher cholesterol6–8. A clinical study
showed that moderate shrimp consumption in normolipi-
demic subjects will not adversely affect the overall lipo-
protein profile and can be included in ‘heart healthy’
nutritional guidelines9. Lack of scientific studies directly
linking shrimp consumption to cardiovascular disease
(CVD) has left the dieticians and doctors in a predica-
ment. Egg from poultry has been identified as a high-
cholesterol food item for human and its consumption has
been a matter of debate for cardiovascular health. Unlike
shrimps, many studies have been carried out on the effect
of egg consumption on serum lipid profile in relevance to
CVD and other metabolic disorders in humans. However,
the argument on cholesterol-rich egg consumption and
its relation on CVD risk has not yet been conclusively
settled. A review by a medical doctor and co-workers
criticized the indiscriminate consumption of eggs by
adults10. Another recent review argues that dietary cho-
lesterol does not increase the risk of heart disease in
healthy populations, and therefore suggests the with-
drawal of recommended dietary intake (RDI) of less than
300 mg/day (in USA)11. Several studies agree that choles-
terol in egg does not contribute much to blood choles-
terol, and support the idea of eating an egg each day.
An attempt has been made in this article to evaluate the
nutritional value of shrimp in man’s platter, mainly
focusing on its nutritional composition, daily value of
major nutrients and dietary cholesterol. This may put to
rest the negative perceptions and controversies on shrimp
cholesterol and might pave the way for accepting it as a
nutritional food for healthy human beings6,7,9,12. The
shrimps (Penaeus monodon and Fenneropenaeus indicus)
used for analysis in our laboratory were in the size range
10–25 g collected from both wild caught and cultured.
Protein and other vital nutrients of human
importance in shrimp
Similar to any animal meat, shrimp is an excellent source
of dietary protein. The analysed nutrients in the eatable
GENERAL ARTICLES
CURRENT SCIENCE, VOL. 104, NO. 11, 10 JUNE 2013
1488
muscle of shrimp are presented in Table 1. Three-fourths
of the edible portion of shrimp are water. Nearly 80% of
the remaining portion (dry matter) comprises of protein.
The average protein content of fresh shrimp is 19.4 g/
100 g and it contributes 87% of the total energy. Our
body cannot synthesize certain amino acids and they must
be obtained through diet; these are called essential amino
acids. The protein digestibility corrected amino acid score
(PDCAAS) is based on the amino acid content of food
protein, true digestibility, and its ability to supply the es-
sential amino acids according to requirement. The
PDCAAS of shrimp is 1, indicating its superior protein
Table 1. Average analysed nutrient profile of 100 g edible shrimp meat*
Nutrient
Protein (g) 19.4 ± 0.56
Lipid (g) 1.15 ± 0.19
Water (g) 76.3 ± 0.57
Energy (kcal) 89.0 ± 1.12
Essential amino acids (mg)
Isoleucine 930.7 ± 8.10
Leucine 1463.9 ± 22.30
Lysine 1480.1 ± 27.57
Methionine + cysteine 668.1 ± 16.57
Phenylalanine + tyrosine 1389.2 ± 19.27
Threonine 756.0 ± 8.89
Tryptophan 223.3 ± 2.90
Valine 935.7 ± 5.89
Lipid composition
SFA (mg) 257.5 ± 3.71
MUFA (mg) 163.5 ± 7.90
PUFA (mg) 321.0 ± 5.23
Eicosapentaenoic (mg) 112.0 ± 3.02
Docosahexaenoic (mg) 75.5 ± 1.43
n – 3 PUFA (mg) 204.5 ± 2.23
n – 6 PUFA (mg) 106.0 ± 2.31
n – 6/n – 3 PUFA 0.5 ± 0.01
PUFA/SFA 1.3 ± 0.05
Cholesterol (mg) 173 ± 6.93
Macro minerals (mg)
Calcium 107.3 ± 1.96
Magnesium 58.5 ± 1.38
Phosphorus 303.4 ± 3.22
Potassium 259.6 ± 3.25
Sodium 176.1 ± 3.04
Micro minerals (μg)
Copper 918 ± 4.62
Iron 2196.5 ± 16.61
Manganese 50.5 ± 1.64
Selenium 44 ± 1.06
Zinc 1403.5 ± 5.43
*These are the average values (n = 60) with SEM of nutrients from the
data obtained for tiger shrimp (Penaeus monodon) and Indian white
shrimp (Fenneropenaeus indicus) from both wild caught (10–20 g) and
cultured (20–25 g). The average proximate composition (%) of feeds
used is 9.55, 38.32, 6.30, 3.93, 12.51 and 29.39 for moisture, crude pro-
tein, ether extract, crude fibre, total ash and nitrogen-free extract
respectively.
quality. The fullness factor is 3.3 on a 0–5 scale, indicat-
ing that it provides more essential nutrients per calorie
and can be considered a healthy food choice like fish13.
Another advantage of eating shrimp is its significant
lower lipid content. Analysed lipid levels in shrimp were
around 1.15 g/100 g. No other meaty food can claim such
a low lipid level as fresh shrimp. The lipid class composi-
tion of shrimp comprises of 65–70% phospholipids, 15–
20% cholesterol and 10–20% total acyl glycerols. The pre-
dominance of phospholipids in shrimp lipid indicates its
rich nutritional quality, which is an integral part of cell
membrane and transport lipoproteins. Furthermore, 32%
of shrimp lipid is composed of poly unsaturated fatty ac-
ids (PUFA), a term usually associated with high-quality
seafood. Within this, about 64% is contributed by
ω
-3
PUFA and the remaining 33% by
ω
-6 PUFA, making a
ω
-6/
ω
-3 PUFA ratio around 1.9, indicating high health
benefits. The
ω
-6/
ω
-3 PUFA ratio is a critical
dietary factor due to its decisive role in balancing the
eicosanoid synthesis14. A healthy diet should have a
PUFA/SFA ratio of at least 0.54 and above15. The
shrimps assessed in our study had higher values (> 1.9)
than the recommend ratio and are definitely a valuable
source of PUFA. Shrimp is also beneficial due to its mild
anti-inflammatory nature because of its high selenium,
docosahexanoic acid and low saturated fatty acids13.
Epidemiological studies revealed that consumption of
seafood, including shrimp rich in ω-3 PUFA is associated
with a reduced risk of coronary heart diseases16,17 and
cancer18. The US Dietary Guidelines recommend that
individuals at both higher and average CVD risk consume
an average of at least 250 mg/day EPA + DHA (1750 mg/
week)19. Eating 100 g edible portion of shrimp in a day
will provide > 180 mg of EPA + DHA. In order to meas-
ure the propensity of shrimp-eating in reducing the risks
of coronary heart disease, the atherogenic and throm-
bogenic indices were calculated20. Shrimp exhibited val-
ues of 0.36 and 0.29 for atherogenic and thrombogenic
indices respectively, which are lower than other non-
vegetarian foods, indicating its cardio-protective nature.
Shrimps were also found to be a rich source of astaxan-
thin, a lipid soluble carotenoid formed from ingested
β
-carotene or zeaxanthin through oxidative transforma-
tion5,21. Astaxanthin has been found to be a potent natural
antioxidant, exceeding ten times the antioxidant activity
of
β
-carotene and 500 times that of
α
-tocopherol5. The
astaxanthin level of wild shrimps has been reported to
vary between 740 and 1400 μg/100 g in edible meat por-
tions21, which again supports the argument for including
them as part of the daily diet.
Human diet requires minerals such as calcium, phospho-
rus, magnesium, potassium and sodium in large amounts
and hence these are referred to as macro minerals. A 100 g
serving of shrimp provides > 100 mg of calcium, > 300 mg
of phosphorus and > 40 μg of selenium. Among their nu-
merous functions, minerals help regulate the fluid balance,
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CURRENT SCIENCE, VOL. 104, NO. 11, 10 JUNE 2013 1489
Figure 1. Daily value (DV%)* of one serving (100 g) of shrimp for important nutrients.
enzyme production and bone health. Eating shrimp
(100 g/day) would provide approximately ten vitamins
and ten minerals. Shrimp contains important vitamins like
vitamin A (180 IU), vitamin D (2 IU) and vitamin E
(1.32 μg), vitamin B12 (1.11 μg) and vitamin B3
(1.77 mg)22. All these nutrients are known to exhibit consi-
derable level of variation in relation to molting stage of
shrimp23. Hence the shrimps used for analysis in our
laboratory were in post-molt stage. Within the marketable
size range, much variation is not observed in macro and
micro nutrients. The cultured tiger shrimps were sampled
from commercial ponds with standard management
culture practices without any disease outbreaks and natu-
ral calamities.
Shrimp consumption in relation to RDA of
nutrients
The recommended daily allowance (RDA) projects the
quantitative recommendation of nutrients for people in
general to stay healthy. This may be different for differ-
ent categories like children, adult males and females. The
Indian Council for Medical Research (ICMR) favours the
FAO/WHO/UNU guidelines for framing the RDA guide-
lines, with slight modifications. The RDA for a nutrient
will be in a standard unit which helps the common man to
easily calculate his own requirements based on the body
weight and/or basal metabolic rate. The RDA can be used
to calculate the daily value of foods (DV%). Hundred
grams of shrimp has been taken to calculate the DV%
that was recommended as serving size of meat24. For
example, the RDA of protein is measured as intake/kg body
weight, as 0.8 g/kg of individual body weight25. It means
that an individual weighing 70 kg would need to take
56 g (0.8 × 70) of protein daily. Considering this RDA,
consumption of 100 g shrimp containing 19.4 g protein
by an individual weighing 70 kg would fulfil 35% of the
daily protein requirement. This is the DV% of 100 g
shrimp with respect to protein. Similarly, one can com-
pute the DV% for the nutrients considering the require-
ment and content of a particular nutrient in the selected
food item. Figure 1 shows the calculated DV% for impor-
tant nutrients in 100 g shrimp for a 70 kg adult man.
Using this chart one can obtain a quick assessment for
selecting shrimp for his/her meal in a day. When shrimps
are scored in the DV% chart of nutrients, the following is
observed: DV% > 70 is rated outstanding selenium,
methionine, tryptophan, threonine, EPA + DHA and lysine;
DV% 50–70 (excellent) – copper, isoleucine, cystine, his-
tidine, leucine, valine and phosphorus; DV% 25–50 (very
good) – protein and phenylalanine; DV% 10–25 (good) –
calcium, magnesium, iron and zinc; DV% < 10 (poor)
sodium, potassium, energy, lipid and manganese.
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1490
Table 2. Comparison of shrimp, egg and meat* on their cholesterol, saturated fatty acids and
atherogenic index
Non-vegetarian food SFA@ (g/100 g) Cholesterol# (mg/100 g) Atherogenic index$
Shrimp 0.25 173 0.36
Egg 4.0 400 0.40
Chicken 6.0 100 0.50
Mutton 7.0 65 1.00
Beef 8.0 70 0.70
Pork 13.0 90 0.67
Health significance Lowest in shrimp; Moderate in shrimp; Lowest in shrimp;
good for health but not harmful good for health
due to low SFA
*Dietary guidelines24,25,30. @Higher saturated fatty acids consumption increases blood cholesterol.
#Cholesterol consumption should not be more than 300 mg (USA) per day. $Lower atherogenic index is good
for a healthy heart.
Dietary cholesterol controversies and shrimp
consumption
Cholesterol is an important sterol that plays a prominent
role in membrane structure and is also a precursor for the
synthesis of steroid hormones and bile acids in man. A
relatively constant level of cholesterol in the blood (150–
200 mg/dl) is maintained primarily by controlling the
level of de novo synthesis. The synthesis and utilization
of cholesterol must be tightly regulated in order to pre-
vent CVD. Reduction in circulating cholesterol levels can
have a profound positive impact on CVD. It is long been
presumed that control of dietary intake is one of the easi-
est means to reduce cholesterol. The cholesterol, SFA
and atherogenic indices of shrimp, egg and other non-
vegetarian meats are given in Table 2 in relation to the
ICMR dietary guidelines25. Though shrimps are adequate
in many essential nutrients, their higher cholesterol level
and with the consumers’ perception of the link between
dietary cholesterol and CVD, medical practitioners and
dieticians have placed shrimp in avoidable food item
ignoring its overall lipid and fatty acid profiles6,7. More-
over, there is no sound scientific evidence to support this
assumption, in particular, the relation between shrimp
cholesterol level and occurrence of CVD. A clinical trial
comparing the serum lipid profile of volunteers who ate
shrimp and eggs, concluded that shrimp consumption in
normolipidemic people would not adversely affect the
overall lipoprotein profile and shrimp can be included in
‘heart healthy’ nutritional guidelines9. A recent review
based on epidemiological and clinical studies from the
past 20 years, claims that dietary cholesterol does not
increase the risk for heart disease in healthy popula-
tions11. Studies in support of a direct relationship between
dietary cholesterol and increased risk for heart disease are
limited, and they mostly demonstrate that diabetic individu-
als are at risk. Citing this as evidence, withdrawal of RDI
of less than 300 mg/day (in USA) of dietary cholesterol
was suggested, since this is restricting the consumption of
eggs, otherwise a good source of quality protein, carote-
noids and choline. Further evidence was provided by a
challenge trial in which adults were allowed to consume
640 mg of daily cholesterol for four weeks. This study
identified that in 75% of individuals there was limited or
no increase in plasma cholesterol level. However, in 25%
of the individuals, there was blood cholesterol elevation
consequent to high cholesterol intake. Surprisingly, the
increase was observed for both LDL and HDL cholesterol
with no changes in the LDL/HDL cholesterol ratio, a key
marker of CVD risk11. Consumption of a high-cholesterol
diet with high saturated fat results in the increase of LDL
level rather than diets with high PUFA26. This indicates
the necessity to look at the overall dietary lipid influence
on serum lipids rather than cholesterol alone. In another
clinical study with type-2 diabetic patients, low-cholesterol
beef was replaced with cholesterol-rich poultry meat;
18% reduction in serum total cholesterol was observed.
This study also concluded that significant reduction in
cholesterol may be due to the higher PUFA and lower
SFA proportions in poultry meat compared to beef27. This
supports the notion that the type of dietary fatty acid,
rather than the level of dietary cholesterol, is the most po-
tent regulator of serum cholesterol levels28. Another rea-
son to encourage shrimp consumption is the potential
association between hypotriglyceridemic
ω
-3 PUFA and
CVD17, shrimp being an excellent source of EPA + DHA
(DV > 70%). It was concluded in a human clinical trial
that shrimp when consumed in moderation can play a role
in a heart-healthy diet, because it does not markedly
affect the ratio of ‘good’ HDL to ‘bad’ LDL cholesterol9.
Therefore, consuming 100 g of shrimp even on a daily
basis would only supply less than the RDA (< 300 mg/day)
of cholesterol. Furthermore, an experiment with hyper-
cholesterolemic rat models documented the cholesterol-
lowering effect of the extract of salted and fermented
shrimp12. Another study with a rat model reported the
serum lipid-lowering effects of Antarctic krill oil on
dietary intake29. Antarctic krill is a small swimming crus-
tacean, which is considered to be the ancestor of shrimp
and prawn.
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CURRENT SCIENCE, VOL. 104, NO. 11, 10 JUNE 2013 1491
Shrimps have low fat, less cholesterol and high PUFA
content compared to eggs, and the current understanding
on dietary cholesterol linked with egg consumption
clearly confirms the nutritional value of shrimps. Based
on the above-mentioned evidences on health-related out-
comes, the nutrient profiles analysed in this study and a
detailed appraisal of the RDA of national and interna-
tional agencies, it can be concluded that shrimp can be
considered as healthy food for humans. The health bene-
fits of eating shrimp go beyond
ω
-3 fatty acids and other
individual nutrients; it is the effect of the combined nutri-
ents present in shrimp, including proteins, trace minerals
and carotenoids. Therefore, to benefit from vital nutrients
like
ω
-3 HUFA, astaxanthin, protein, essential amino
acids, vitamins and minerals, a moderate quantity of
shrimp should be consumed by people. Only those who
are at a clear risk of CVD and diabetics may avoid this,
until the dietary cholesterol controversy is settled.
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ACKNOWLEDGEMENTS. We thank Dr S. Ayyappan, Director
General, Indian Council of Agricultural Research (ICAR), New Delhi
for his encouragement under ‘ICAR Outreach Activity on Nutrient Pro-
filing and Evaluation of Fish as a Dietary Component’. The support
from Dr B. P. Mohanty, Coordinator and Dr T. V. Sankar, Co-
coordinator of this network program is acknowledged. We also thank
Dr G. Gopikrishna for valuable suggestions that helped us improve the
manuscript.
Received 27 August 2012; revised accepted 1 April 2013
... Marine-derived long-chain omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) help to reduce the risk of heart disease and contribute to brain and vision development in infants. Shrimp farming and wild catching is of the important fishing activities [2]. As shrimp be consumed for their taste and for the benefit of vital like nutrients like omega-3-High Unsaturated Fatty acids, astaxanthin, essential amino acids, vitamins and minerals [2]. ...
... Shrimp farming and wild catching is of the important fishing activities [2]. As shrimp be consumed for their taste and for the benefit of vital like nutrients like omega-3-High Unsaturated Fatty acids, astaxanthin, essential amino acids, vitamins and minerals [2]. Mendil, [3] states that minerals plays an important role in maintaining body functions by maintain acid-base balance, haemoglobin, bones formation and teeth structure, and catalyze many metabolic reactions. ...
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... It has a significant role in the aquatic ecosystem with respect to biodiversity and its place in the food pyramid in the environment (Jassim, 2013). Shrimps are low in calories with a balance of healthy proteins and fats (Dayal et al., 2013). They also contain vitamins and mineral treasure trove. ...
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... Shrimp is one of the most popular seafood worldwide, which is rich in omega-3 fatty acids (Smith & Guentzel, 2010) and essential amino acids such as methionine, tryptophan, and lysine (Dayal et al., 2013). Globally, shrimp production reached 5 million tons in 2020, and it is forecast to grow to 5.5 million tons in 2021, highlighting its annual increase of 5% (Anderson, Valderrama, & Jory, 2019). ...
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Considered Mother Nature’s medicine cabinet in many areas of the world, marine organisms have been known from time immemorial to possess curative powers. But until recently, their bioactive compounds, nutraceutical properties, and commercial potential remained undiscovered. Bringing together widely scattered literature, Marine Products for Healthcare: Functional and Bioactive Nutraceutical Compounds from the Ocean discusses the importance of marine products as a source of nutraceuticals, food additives, and other useful ingredients in health protection and product formulation The book begins with a discussion of the general characteristics of functional foods and an overview of the functionality of marine fishery products. It includes detailed discussions on nutraceutical and other functional properties of their seafood components including proteins, bioactive peptides, polyunsaturated fatty acids, polysaccharides, chondroitin, carotenoids, minerals, and shell waste products. Other chapters examine the role of seaweeds as food supplements, additives, and bioactive compounds; microalgae and corals rich in nutrients, pigments, and therapeutic agents; and secondary metabolites of corals, particularly sponges, that have potential as lifesaving drugs. The book also explores recent developments in food fortification, packaging, and drug delivery systems with particular reference with marine ingredients and concludes with a delineation of the safety hazards posed by some marine products. The science of discovering health promoting compounds from marine sources and techniques for extracting and purifying these chemicals is advancing. More than just a review of the science and market base available for the development of marine nutraceutical/functional food, this book provides a greater understanding of how consumer attitude and legal concerns will impact the kind of products that can be made.
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JAC, 58 (2011) 2047-2067. doi:10.1016/j.jacc.2011.06.063
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We have determined the fatty acid content and composition of retail samples of meat and assessed them with respect to UK dietary recommendations. Fifty beef sirloin steaks, pork chops and lamb chops were purchased from four supermarkets on separate occasions. The percentage of muscle (boneless basis) in the samples was 84.4 ± 4.3, 69.8 ± 7.7 and 78.9 ± 7.1 for beef, lamb and pork, respectively, with fatty acid contents of 3.84 ± 1.3, 4.73 ± 1.66 and 2.26 ± 0.7 g per 100 g muscle, respectively. Adipose tissue fatty acid contents were 70.0 ± 8.2, 70.6 ± 8.6 and 65.3 ± 9.4 g per 100 g tissue. A range of C20 and C22 polyunsaturated fatty acids (PUFA) was present in the muscle of all three species and pork adipose tissue but their concentrations in lamb and beef adipose tissue were too low to measure. The mean P:S ratios for beef, lamb and pork muscle were (adipose tissue values in parentheses): 0.11 (0.05); 0.15 (0.09) and 0.58 (0.61), and the n-6:n-3 ratios were 2.1 (2.3), 1.3 (1.4) and 7.2 (7.6). We conclude that the muscles of red meat species are a valuable source of PUFA, particularly the C20 and C22 n-3 fatty acids, in the human diet and that, considered as part of a varied diet, the low P:S ratio of the ruminant muscle, the high n-6:n-3 ratio of pork and the total fatty acid contents do not detract significantly from the nutritional value of lean meat.
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The perceived notion that dietary cholesterol is associated with increased risk for coronary heart disease (CHD) has led to dietary recommendations of no more than 300  mg/day for healthy populations in the USA. This study will review the recent evidence that challenges the current dietary restrictions regarding cholesterol while it presents some beneficial effects of eggs (an icon for dietary cholesterol) in healthy individuals. The European countries, Australia, Canada, New Zealand, Korea and India among others do not have an upper limit for cholesterol intake in their dietary guidelines. Further, existing epidemiological data have clearly demonstrated that dietary cholesterol is not correlated with increased risk for CHD. Although numerous clinical studies have shown that dietary cholesterol challenges may increase plasma LDL cholesterol in certain individuals, who are more sensitive to dietary cholesterol (about one-quarter of the population), HDL cholesterol also rises resulting in the maintenance of the LDL/HDL cholesterol ratio, a key marker of CHD risk. The lines of evidence coming from current epidemiological studies and from clinical interventions utilizing different types of cholesterol challenges support the notion that the recommendations limiting dietary cholesterol should be reconsidered.
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A widespread misconception has been developing among the Canadian public and among physicians. It is increasingly believed that consumption of dietary cholesterol and egg yolks is harmless. There are good reasons for long- standing recommendations that dietary cholesterol should be limited to less than 200 mg/day; a single large egg yolk contains approximately 275 mg of cholesterol (more than a day's worth of cholesterol). Although some studies showed no harm from consumption of eggs in healthy people, this outcome may have been due to lack of power to detect clinically relevant increases in a low-risk population. Moreover, the same studies showed that among participants who became diabetic during observation, consumption of one egg a day doubled their risk compared with less than one egg a week. Diet is not just about fasting cholesterol; it is mainly about the postprandial effects of cholesterol, saturated fats, oxidative stress and inflammation. A misplaced focus on fasting lipids obscures three key issues. Dietary cholesterol increases the susceptibility of low-density lipoprotein to oxidation, increases postprandial lipemia and potentiates the adverse effects of dietary saturated fat. Dietary cholesterol, including egg yolks, is harmful to the arteries. Patients at risk of cardiovascular disease should limit their intake of cholesterol. Stopping the consumption of egg yolks after a stroke or myocardial infarction would be like quitting smoking after a diagnosis of lung cancer: a necessary action, but late. The evidence presented in the current review suggests that the widespread perception among the public and health care professionals that dietary cholesterol is benign is misplaced, and that improved education is needed to correct this misconception.