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Part III Health applications of seafood Handbook of Seafood Q uality, Safety and Health Applications Edited by Cesarettin Alasalvar, Fereidoon Shahidi, Kazuo Miyashita and Udaya Wanasundara © 2011 Blackwell Publishing Ltd. ISBN: 978-1-405-18070-2

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Page 1: Handbook of Seafood Quality, Safety and Health Applications (Alasalvar/Handbook of Seafood Quality, Safety and Health Applications) || Health Benefits Associated with Seafood Consumption

P1: SFK/UKS P2: SFKc29 BLBK298-Alasalvar August 5, 2010 18:7 Trim: 244mm×172mm

Part III

Health applications ofseafood

Handbook of Seafood Q uality, Safety and Health Applications

Edited by Cesarettin Alasalvar, Fereidoon Shahidi, Kazuo Miyashita and Udaya Wanasundara

© 2011 Blackwell Publishing Ltd. ISBN: 978-1-405-18070-2

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29 Health benefits associated withseafood consumption

Maria Leonor Nunes, Narcisa Maria Bandarra,and Irineu Batista

29.1 Introduction

The use of fish and shellfish in human nutrition is well documented since ancient times inarchaeological settlements as well as in ancient civilizations. However, fish processing andinternational trade gained enormous importance only in the 20th century [1].

The consumption of fish and fish-derived products has increased over recent decades inmany countries, especially between 1980 and 2001, as a result of higher living standards andthe good image of seafood among consumers. The world average use of fish products reached16.6 kg per capita in 2005 [2], but it is unevenly distributed around the globe, with markedcontinental, regional and national differences as well as income-related variations. Per capitaapparent annual fish consumption can vary from less than 1 kg to more than 100 kg.

Seafood encompasses a wide range of wild and farmed animals and seaweeds, in whichfish, crustaceans, and molluscs are the most important groups, both due to the high diversityof species and its use as food. The traditional view of seafood as a source of high-qualityanimal protein to fulfil the basic food requirements has shifted, and a significant part ofthe actual demand is related to its peculiar structure and physical, chemical, and sensoryattributes. In fact, these characteristics associated with a high number of available species,has led seafood to play a particular role in a balanced diet as well as in modern gastronomy.On the other hand, the relevance of seafood in the diet to diminish the increased incidencesof cardiovascular, cancer, and inflammatory diseases and to improve consumer’s well-beinghas been successfully supported by the results of a high number of epidemiological studiesand meta-analyses. This chapter presents relevant information on nutritional value and somebenefits associated with the consumption of seafood.

29.2 Nutritional value

The chemical composition of fish products varies greatly among species and from oneindividual fish to another, depending on age, sex, environment, and season. Proteins andlipids are the major components, whereas carbohydrates are usually detected at very lowlevels (�0.5%) [3]. Vitamin content is comparable to that of mammals, except for vitamins

Handbook of Seafood Q uality, Safety and Health Applications

Edited by Cesarettin Alasalvar, Fereidoon Shahidi, Kazuo Miyashita and Udaya Wanasundara

© 2011 Blackwell Publishing Ltd. ISBN: 978-1-405-18070-2

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370 Seafood Quality, Safety and Health Applications

A and D, which are found in large amounts in the meat of fatty species and in the liver oflean fish, such as cod and halibut. Fish meat is a particularly valuable source of minerals,namely calcium and phosphorus as well as iron, copper, and selenium. In addition, saltwaterfish is an excellent source of iodine.

29.2.1 Protein

Proteins are important for the growth and development of the human body, maintenanceand repairing of damaged tissues, and for production of enzymes and hormones requiredfor many body processes. For most seafood species, protein content ranges between 10 and25%, with an average of 17 to 100 g, which accounts for 80 to 90% of the energy providedper 100 g of lean species [4]. The protein found in seafood is of good quality due to its highdigestibility, and the specific amounts and relative proportions and availability of essentialamino acids. The amount of connective tissue in fish and shellfish muscle is quite low andit softens and dissolves more readily when heated compared to the connective tissue of landanimals, making seafood meat easy to chew. Almost all species are well balanced with respectto their essential amino acids. The predominant amino acids are usually lysine and leucineand, within the nonessential, aspartic and glutamic acids are the most abundant. Very oftenthe amount of essential amino acids is greater than that in the standard protein (32–100 gprotein) and values regularly referred to in the literature for the chemical score, biologicalvalue, and protein efficiency ratio. Protein digestibility and corrected amino acid score arealso good indicators of the quality of fish proteins [5,6].

29.2.2 Lipids

Lipids perform several important biological functions for living organisms, namely storageand transport of energy, formation of cell membranes, maintenance of their structural in-tegrity, and prostaglandins synthesis and transport of fat-soluble vitamins. Fish lipid contentvaries, depending on the species as well as on the season but, in general, fish have less fatthan red meats. Fat content ranges widely from 0.2% to almost 30%. Contrary to terrestrialanimals, in which most lipids are generally deposited in adipose tissue, fish have lipids inthe liver, muscle, and perivisceral and subcutaneous tissues. According to the fat content,fish products are generally classified into three categories. For instance, Atlantic salmon,European sardine, herring, mackerel, and eel have more than 10% muscle fat and are con-sidered fatty, whereas lean species, such as hake and cod, have less than 1% of muscle fat.Other species, such as trout, sea bass, or sea bream, are classified as intermediate becausetheir muscle lipid content accounts for 5 to 10% of their wet weight. Regarding farmedfish, lipid content can vary widely depending on the farming conditions and compositionof the feed. Fish lipids are composed of saturated fatty acids (SFA), monounsaturated fattyacids (MUFA), and polyunsaturated fatty acids (PUFA), whose proportions and amountsvary considerably from one species to another (Table 29.1) [4]. As a rule, the fattest speciescontain more long-chain omega-3 (n-3 or �-3) PUFA than the leaner species; the amount ofSFA, in percentage, is almost constant in most species. In the majority of species, PUFA arethe dominant group; however, there are some exceptions, for instance meagre and silver- andblack-scabbard fish, where the content of MUFA is higher than that of PUFA. In general,palmitic acid (16:0) is the most relevant within the SFA group, oleic acid (18:1 n-9) is thedominant in MUFA, and eicosapentaenoic acid (EPA, 20:5 n-3) and docosahexaenoic acid(DHA, 22:6 n-3) present the highest amounts in PUFA [7].

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Health benefits associated with seafood 371

Tab

le29.1

Typi

caln

utrit

iona

ldat

aof

mol

lusc

s,cr

usta

cean

s,an

dfis

hpr

oduc

ts.A

dapt

edfr

omN

unes

etal

.[4]

,with

perm

issi

onof

Weg

enin

gen

Aca

dem

icPu

blis

hers

Com

mon

oct

op

us

Atl

an

tic

salm

on

Euro

pea

nh

ak

eSa

rdin

eN

utr

itio

na

ld

ata

(per

100

gof

ed

ible

pa

rt)

Gro

ove

dca

rpet

shell

Ra

wR

aw

Boiled

Norw

ay

lob

ster

Ra

wR

aw

Boiled

Gri

lled

Ra

wB

oiled

Frie

dR

aw

Gri

lled

Ca

nn

ed

Ener

getic

valu

e(k

cal)

58.1

77.4

116.

593

.826

6.7

278.

731

5.4

73.9

118.

916

3.7

187.

119

7.7

210.

7Pr

otei

n(g

)11

.715

.623

.720

.916

.220

.723

.817

.020

.121

.717

.924

.124

.0To

talf

at(g

)0.

91.

21.

30.

521

.921

.123

.70.

73.

77.

110

.99.

212

.716

:0(m

g)13

8.4

177.

418

9.7

60.1

2687

.724

50.1

2753

.589

.754

9.4

507.

716

95.3

1487

.619

94.7

Tota

lSFA

(mg)

223.

526

5.9

282.

989

.042

91.3

4049

.444

87.6

142.

885

6.6

778.

127

45.9

2396

.330

01.4

18:1

(mg)

25.2

40.8

43.6

66.9

3809

.724

50.1

2821

.655

.133

1.9

1658

.697

9.8

742.

143

75.7

Tota

lMU

FA(m

g)11

9.7

90.1

96.6

87.7

1003

7.3

7824

.587

47.4

110.

365

0.0

1790

.425

57.5

2069

.455

81.9

18:2

n-6

(mg)

5.0

4.8

0.9

3.9

691.

260

3.9

695.

07.

340

.634

45.4

104.

585

.842

3.8

20:5

n-3

(mg)

58.6

196.

521

1.0

57.1

1172

.116

29.9

1800

.066

.037

1.4

91.9

1671

.812

87.9

791.

722

:6n-

3(m

g)54

.922

5.3

239.

276

.817

72.6

2326

.325

93.8

155.

398

0.1

258.

611

69.4

1334

.212

55.7

Tota

lPU

FA(m

g)25

5.7

560.

059

1.3

155.

151

48.2

6590

.673

59.0

273.

416

44.8

3860

.840

71.0

3493

.828

06.0

Tota

lPU

FAn-

3(m

g)19

0.0

496.

952

5.6

139.

443

26.4

5622

.662

55.4

246.

914

91.7

388.

437

53.3

3245

.923

07.7

Tota

lPU

FAn-

6(m

g)65

.763

.165

.715

.776

5.6

968.

011

03.6

26.6

153.

234

72.4

317.

724

7.9

498.

3C

hole

ster

ol(m

g)44

6410

568

40na

na19

2825

2838

naC

alci

um(m

g)51

1326

72.0

1261

6815

2954

7067

445

Phos

phor

us(m

g)17

816

518

521

620

921

632

221

923

030

329

630

763

7M

agne

sium

(mg)

103

4349

40.5

2326

4026

3243

2935

42Ir

on(m

g)8.

50.

70.

50.

40.

50.

30.

40.

50.

50.

71.

71.

93.

0So

dium

(mg)

244

259

178

444

3814

878

369

169

1344

6539

018

7Po

tass

ium

(mg)

7823

616

441

330

123

440

840

837

359

540

449

636

9M

anga

nese

(mg)

0.65

�0.

020.

040.

10�

0.02

0.02

0.04

�0.

02�

0.02

0.03

�0.

02�

0.02

0.21

Cop

per

(mg)

0.18

0.21

0.50

2.50

0.06

0.06

0.04

�0.

030.

03�

0.03

�0.

030.

110.

15Zi

nc(m

g)2.

11.

32.

44.

50.

50.

80.

90.

70.

80.

81.

71.

22.

5C

hlor

ide

(mg)

347

438

258

na46

225

1125

8519

515

9215

274

032

7Vi

tam

inA

(�g)

na2.

76.

78.

333

6570

2.8

5.3

4.3

129.

09.

0Vi

tam

inE

(mg)

na0.

732.

12.

24.

05.

34.

30.

240.

45na

0.02

50.

71.

5Vi

tam

inD

(�g)

na0

0na

1111

9.2

5.6

5.2

7.0

1711

8.8

Vita

min

B 1(m

g)na

0.02

2�

0.01

8na

0.18

0.17

0.19

0.01

90.

018

0.03

60.

018

0.04

9�

0.02

Vita

min

B 2(m

g)na

0.04

20.

044

na0.

041

0.08

10.

120.

044

0.03

50.

065

0.14

0.19

0.04

Vita

min

B 6(m

g)na

0.06

70.

046

0.1

0.45

0.34

0.21

nana

na0.

410.

300.

1Vi

tam

inB 1

2(�

g)na

1.3

1.7

1.4

nana

na0.

630.

360.

8310

9.3

naFo

late

(�g)

na12

1313

.510

8.4

1027

2328

2431

21N

iaci

ne(m

g)na

1.3

2.5

2.2

na3.

04.

41.

21.

01.

86.

28.

46.

0

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372 Seafood Quality, Safety and Health Applications

Cholesterol is an important lipid component in cell membranes, and the body uses it inbuilding a number of hormones and vitamin D. This compound has been the subject ofseveral studies for its role in clogging arteries and thus contributing to heart disease andstroke. Cholesterol in many marine species is the main sterol, accounting for more than90% of all sterols, while in some shellfish species it might be present at percentages thatcan be as low as 25% [8]. Cholesterol levels are not significant in most seafood productsand those found in fish and a large number of shellfish species are between 24 and 85mg/100 g (Table 29.1). In bivalve molluscs, phytosterols are also present, coming frommicroalgae and sediments [9–11]. However, cephalopods usually contain higher levels, forexample, European squid has approximately values near 140 mg cholesterol/100 g tissue[4]. Nevertheless, according to some authors [12], the presence of high amounts of taurinein these species helps to reduce cholesterol absorption. This hypocholesterolemic effect oftaurine is due to the enhancement of cholesterol degradation and the excretion of bile acid,as referred to by Yokogoshi et al. [13]. As a rule, cholesterol contents in wild and farmedfish species are not significantly different.

29.2.3 Minerals and vitamins

Minerals help the body’s cellular activity, particularly in enzyme action, muscle contraction,nerve reaction, and blood clotting. For most fish species the order of prevalence is potassium→ chloride or phosphorus → sodium → magnesium → calcium → iron → zinc →copper → manganese (Table 29.1). Canned fish products, such as sardines, smelts, andsalmon are especially valuable sources of calcium due to the presence of soft bones. Oystersand crustaceans are usually good sources of zinc; oysters, bluefish, and shrimp are rich iniron; oysters, crabs, and lobster contain relevant levels of copper. In general, all seafoodsare important sources of selenium and iodine, particularly relevant in wild species. Freshseafood is low in sodium, but in some processed products such as when smoked, cured, andsurimi, the content of this mineral could be slightly higher.

Among their many functions, vitamins enable the assimilation of carbohydrates, proteins,and fats. They are also critical in the formation of blood cells, hormones, and neurotrans-mitters. Fish products usually are not a predominant source of vitamins; however, levels ofvitamin B, particularly niacin, B12 and B6, are comparable to those of other foods with highprotein content, and some fatty species supply reasonable amounts of vitamins A and D.These vitamins are found especially in fish liver oils. However vitamins are also present inflesh, such as �-tocopherol, which could attain 4 mg/100 g in salmon.

29.3 Effect of cooking on nutritional value

The type of cooking method may affect some nutritional components (Table 29.1). Moisturecontent usually decreases during the cooking process and the size/shape, thickness, and thefish species also influence such a decrease. Consequently, the proportion of solids increasesand the amounts of certain nutrients could be higher in cooked products. Usually, fryingleads to a higher water loss associated to the absorption of oil, resulting in an increased fatcontent. Nevertheless, oil absorption seems to be higher when the fat content of the productis lower. As expected, the fatty acid profile in fried products is influenced by the compositionof the vegetable oil used. Relative to minerals and vitamins, there is not a common trend.Usually, sodium content increases due to the salt added before cooking and some vitamins

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Health benefits associated with seafood 373

are destroyed while the content of others is not significantly changed. In general, boiling andgrilling are quite satisfactory in terms of nutrient keeping.

29.4 Health benefits of seafood

The health benefits of fish products have been claimed for many years and they seem tobe strongly correlated to the quality of proteins and the presence of high amounts of n-3PUFA. Such benefits have been described in several papers, reviews, and reports, thoseassociated with the role of these fatty acids in the prevention of several diseases being themost thoroughly documented.

29.4.1 Essential n-3 fatty acids

The long chain n-3 PUFA, such as EPA and DHA, are very important from a nutritional pointof view and can be mainly found in marine fish products. However, it is important to take intoaccount that both fatty acids are not produced by fish, but by unicellular marine microalgaethat are consumed by other marine species [14] and accumulated through the trophic chain.

Alpha-linolenic acid (ALA, 18:3 n-3) is the essential fatty acid precursor of the n-3 seriessynthesized in plant organisms using � 12- and � 15-desaturases [14,15]. However, ALAcannot be synthesized by animals due to the lack of these desaturase enzymes [16] and itsessential importance for mammalian was recognized [17]. The conversion of ALA into EPAand EPA into DHA occurs in healthy human adults at a limited rate that can attain 5% in thecase of EPA production and only 0.05% for DHA [18,19]. Such rates confirm the importanceof the inclusion of these n-3 PUFA in the diet.

29.4.2 Cardioprotector effect/coronary heart disease (CHD)

The association of long chain n-3 PUFA and cardiovascular disease (CVD) was establishedfrom the prior observations of low CHD mortality in Eskimos from Greenland, despitetheir high fat intake [20,21]. Pioneer research studies from the 1970s on the GreenlandInuit indicated that the intake of n-3 PUFA (fish, seal, and whale meat) reduced the risk ofmyocardial infarct, and researchers proposed that the mechanism associated with this effectwas the reduction of thrombosis risk [22].

These findings led to a high number of research works trying to establish a relationshipbetween n-3 PUFA intake and CVD. A few of these studies were not conclusive but the vastmajority pointed out to a positive role of n-3 PUFA in the prevention of CVD [23].

A part of the effects of dietary n-3 PUFA on CVD is explained by the traditional lipoproteinrisk factors associated to the blood levels of total cholesterol, low-density lipoprotein (LDL)cholesterol, high-density lipoprotein (HDL) cholesterol and triacylglycerols (TAGs), as wellas by other mechanisms relating to haemostasis, lipid peroxidation and oxidative stress, andinflammatory processes, with endothelial function also being involved [24].

Many systematic reviews on observational studies, randomized controlled trials, and clin-ical, animal, and in vitro studies suggest that the regular intake of n-3 PUFA protects againstcoronary artery and sudden death [25]. Moreover, a meta-analysis based on primary andsecondary CHD prevention showed a significant decrease of all-cause mortality risk [18,26].Another study carried out over two years confirmed that men with a previous myocardialinfarction receiving daily fish oil capsules (900 mg EPA+DHA) or 200 to 400 g of fatty fish

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374 Seafood Quality, Safety and Health Applications

per week containing 500 to 800 mg n-3 PUFA per day, presented a reduction of 29% in globalmortality and 33% in cardiac mortality [27]. GISSI study [28] based on a high number ofmyocardial infarcts survivors, supplemented with a daily dose of 850 mg of EPA and DHAshowed a reduction of 21% in global death and 45% in sudden death. Moreover, dietaryn-3 PUFA seems to stabilize the myocardium electrically, resulting in reduced susceptibilityto ventricular arrhythmias, thereby reducing the risk of sudden death. The intake of n-3PUFA was also positively related with the prevention of cardiac arrhythmias in animal modelstudies, due to the development of a non-fatal ventricular fibrillation as well as ventriculartachycardia and ventricular premature beats [23].

From a meta-analysis across 11 cohort studies [29], it was concluded that fish consumptionis inversely associated with fatal CHD, and mortality from CHD may be reduced by eatingfish once per week or more. Further studies [30–32] also confirmed the positive effects offish n-3 PUFA consumption.

Controversial results relating n-3 PUFA intake and stroke incidence were presented in areview by Sidhu [23]. Later, Psota et al. [32] pointed out a beneficial association betweenthe ingestion of these fatty acids and stroke reduction in humans.

The protein component of fish also influences the concentration of lipid plasma con-stituents. Thus, several papers were published with studies on animals. The studies in rabbits[33,34] conclude that dietary proteins act synergistically with dietary lipids to regulatecholesterol metabolism and cod proteins induced a decrease of the very low-density lipopro-tein (VLDL) cholesterol level in plasma. It was also concluded that cod proteins increasedHDL cholesterol and reduced TAG concentration in plasma, which was accompanied by anincrease in lipoprotein lipase (LPL) activity and reduction in VLDL cholesterol levels. Thestudies in rats concluded that cod protein decreased plasma TAG and cholesterol concentra-tion [35]. The increase of LPL activity in the adipose tissue of rats fed with cod proteinswas observed [36]. Demonty et al. [37] showed that both cod protein and menhaden oil exertindependent and beneficial effects on lipid metabolism in rats. They also demonstrated thatthe combination of cod protein and fish oil resulted in 50% lower plasma TAG comparedwith the casein-beef tallow mixture.

The results obtained in human studies showed that the consumption of lean white fishby postmenopausal women induced higher concentrations of total and HDL cholesterol,LDL apolipoprotein B (Apo B), and sex hormone-binding globulin than other animal proteinsources [38]. In another work with humans, the consumption of fish protein from lean whitefish induced lower plasma VLDL TAG and higher concentrations of LDL TAG and LDL ApoB in premenopausal women [39]. The results of the study by Lacaille et al. [40] suggested thatfish proteins may be partly associated with the variations in plasma sex hormones status andplasma lipoprotein lipase activity in normolipidemic men. The effects of the incorporation oflean beef, poultry, and lean fish into a diet with a high PUFA:SFA ratio and high fibre contenton lipoprotein profiles in hypercholestorolemic men were studied by Beauchesne-Rondeauet al. [41]. The lean fish diet had the added benefit of improving HDL2 cholesterol level andsignificantly increased the ratio of HDL2 to HDL3 cholesterol more than the lean beef andpoultry diets.

29.4.3 Hypertension

A meta-analysis across 31 studies with fish oil supplementation, based on a dose responseeffect of n-3 PUFA on blood pressure, was referred to by Morris et al. [42], showing adecrease of 0.66 mm Hg in systolic and 0.35 mm Hg in diastolic pressure per gram of n-3

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Health benefits associated with seafood 375

PUFA. Nevertheless, the hypotensive effect of these fatty acids was more evident in subjectswith clinical atherosclerosis or hypercholesterolemia. Subsequent works pointed out a moreactive role in blood pressure reduction of DHA compared with EPA [43], inhibiting therenin–angiotensin system.

29.4.4 Diabetes

The lower incidence of non-insulin-dependent diabetes mellitus (NIDDM) in populationsconsuming large amounts of fish was reported by Kromann and Green [44]. The consumptionof n-3 PUFA has been associated with a low incidence of diabetes, improving the insulinsensitivity [23]. A recent work in n-3 PUFA consumption during an energy restrictionstudy pointed out the importance of n-3 PUFA consumption for the improvement of insulinsensitivity and possibly for the prevention of type-2 diabetes, with a positive effect on insulinresistance in young overweight individuals, independent from changes in body weight, TAG,erythrocyte membrane, or adiponectin [45].

Some epidemiological studies [46] on a population of lean fish eaters suggested that afish constituent other than n-3 PUFA protected against the development of impaired glucosetolerance and NIDDM. In this respect, some studies with rats [47–49] evaluated the roleof dietary cod proteins in the regulation of insulin sensitivity. They demonstrated that codproteins improved glucose tolerance and appeared to involve, at least in part, a direct actionof amino acids on insulin-stimulated glucose transport in skeletal muscle cells. It was alsoconcluded that these proteins normalized the activation status of the phosphatidylinositol(PI) 3-kinase/Akt pathway, which was associated with increased translocation of glucosetransporter type 4 (GLUT4) to the T-tubules. The metabolic effect of dietary proteins oninsulin and glucose responses in healthy women was investigated by von Post-Skagegard etal. [50], who concluded that a cod protein meal, compared with milk or soy protein meal,lowered insulin levels and reduced the insulin to C-peptide and insulin to glucose ratios.Ouellet et al. [51] demonstrated that cod protein improved insulin sensitivity compared withother animal proteins in insulin-resistant men and women. According to these authors, thisbeneficial effect could be attributed to the specific amino acid composition of these proteins,with lower branched-chain amino acids (valine, leucine, and isoleucine) and the higherarginine content of the cod protein diet compared with other animal protein diets. It is alsomentioned that taurine, whose content is about three to four times greater in white fish thanin beef or pork, also improved insulin sensitivity. The influence of dietary intake of proteinsfrom different sources on the occurrence of microalbuminuria in type-1 diabetic patients wasstudied by Mollsten et al. [52]. The major findings of this control study indicated that a dietincluding a high amount of fish protein (∼9.3 g of fish protein per day) lowered the risk ofmicroalbuminuria in young type-1 diabetic patients.

29.4.5 Cancer

In a systematic review about the effect of n-3 PUFA on cancer risks by McLean et al. [53], adelay in the onset of some cancer types (breast, colorectal, lung, and prostate) and the intakeof these fatty acids was found. In the case of aero-digestive, bladder, lymphoma, ovarian,pancreatic, and stomach cancer, no association between n-3 PUFA intake and cancer inci-dence was established. Chapkin et al. [54] showed that n-3 PUFA suppressed the mediatinginflammatory Th 1 cells that are linked to the occurrence of colon cancer. In a study by Istfan

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et al. [55], it was hypothesized that n-3 PUFA and vitamin D had the potential to delay theprogression of prostate cancer cells.

29.4.6 Other effects

The consumption of n-3 PUFA seems to reduce the risk of depression, postpartum depression,bipolar disorder, schizophrenia, and humour fluctuations [56]. The positive effect of EPAin schizophrenia treatment was demonstrated when it was added to usual antipsychoticagent [57]. Other studies showed a positive role of n-3 PUFA in the control of rheumatoidarthritis, prevention of osteoporosis [58], development of the nervous system, improvementof photoreception, and reproductive system [23], as well as in weight loss [59].

29.5 Conclusions

Seafood is an important source of nutrients, which are fundamental for a balanced diet.Moreover, the recognized beneficial health effects of fish lipids and proteins make fish a fooditem especially recommended for human health and well-being. Daily recommendations forn-3 PUFA intake were established based on data related with the prevention and the treatmentof CVD. The consumption of two fish meals a week or at least a mean level of 500 mg ofEPA+DHA per day are actually strongly recommended by several health authorities [60,61].In the case of secondary prevention, a double dose of 1 g per day is advised [62].

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