Chin J Integr Med 2013 Sep;19(9):643-649 • 643 •

FEATURE ARTICLE
Edible Bird's Nest: Food or Medicine?
Rebecca S.Y. Wong

ABSTRACT Edible bird's nest (EBN) is derived from the saliva of certain types of
swiflets. It is consumed in many parts of the world for its nutritional and medicinal
values. Although many claims have been made on the therapeutic and health-
promoting effects of EBN, scientific documentations regarding these effects are very
limited in published literature. It is not until recently that the biological effects of EBN
are being investigated and evidence-based studies are being conducted. Several
studies have found that EBN may enhance cell proliferation and differentiation and
various beneficial effects have been reported in vitro as well as in vivo . While these
studies point towards the potential use of EBN in the treatment or even prevention
of several diseases, the mechanisms of action of EBN remain largely unknown and
more explorations are needed. This review is one of the very few scientific reviews on
EBN which focuses on recent evidence-based discoveries.
KEYWORDS edible bird's nest, nutritional values, composition, potential health-promoting effects

Edible bird's nest (EBN) is a renowned Chinese
delicacy which may have been around since the ancient
Chinese dynasties. Although the use of bird's nest
can be dated back to many centuries ago in Chinese
literature, there is a scarcity in scientific documentations
in published literature. While some consume it mainly
as a food, traditionally EBN has been consumed for its
medicinal values. Its use is believed to enhance one's
complexion, alleviate asthma and strengthen the immune
system(1) and its beauty-rejuvenating applications have
long existed, especially among the Chinese. Recently,
several studies have investigated the biological effects
of EBN.(2-4) Some studies have also documented the use
of EBN as a type of alternative medicine in athletes(5)
and cancer patients.(6,7) The popular use of EBN both as
a food and a medicine has led to extensive harvesting
of bird's nest(8) and has made the product expensive,
creating a huge market worldwide. However, despite its
popularity, evidence on the therapeutic values of EBN is
very limited with very few studies to prove the biological
effects of EBN scientifically. Besides, the mechanism
of action of EBN is also poorly understood. This article
gives a overview of EBN from its nutritional components
to its potential health-promoting effects, with an
emphasis on recent evidenced-based discoveries.
The Swiftlets that Produce EBN
EBN is generally regarded as the saliva produced
by certain types of swiftlets, which belong to a family of
birds called Apodidae and are under the tribe Collocaliini .
They are small birds that feed on insects, mainly found
from the Indian Ocean to the South Pacific in the
Australasian region.(9) There are three main genera of
swiftlets, namely Collocalia (non-echolating swiftlets),
Aerodramus (echolating swiftlets) and Hydrochous (giant
swiftlets).(10) However, only the first two genera are of
much commercial values because they produce edible
nests which are expensive and popular in many parts
of the word. The Collocalia species are smaller birds
with an average weight of 6.5 grams in comparison with
the Hydrochous species, which are larger in size, with
an average weight of 37 grams.(10) As early as 1885,
Green(11) reported the existence of EBN by Collocalia ,
which was brought into England through the Health
Exhibition at South Kensington around the same time.
However, the use of bird's nest has been documented
in Chinese literature and may have existed long
before any scientific documentation. On the other
hand, several species of the Aerodramus genus
also produce EBN. (1,12) For example, the swiftlets
that produce EBN in Malaysia belong to the genus
Aerodramus fuciphagus . These swiftlets make their
nests from saliva derived from salivary glands found
©The Chinese Journal of Integrated Traditional and Western
Medicine Press and Springer-Verlag Berlin Heidelberg 2013
Faculty of Medicine, SEGi University, Selangor, Malaysia
Correspondence to: Dr. Rebecca S.Y. Wong, Tel: 603-6145
2777 (ext 3064), Fax: 603-6145 2649, E-mail: rebeccawongsy@
gmail.com; rebecca@segi.edu.my
DOI: 10.1007/s11655-013-1563-y
• 644 • Chin J Integr Med 2013 Sep;19(9):643-649

under their tongue and have three main breeding
seasons: (1) from December to March; (2) April to
July; and (3) August to November.(1)
EBN as A Food
EBN is an expensive and popular delicacy
especially among the Chinese. While some consume
EBN for health-promoting purposes, others merely
consider it a delicious and nutritious food. An
understanding of the composition of EBN is important
as it helps in the understanding of EBN as a food in the
context of its nutritional values. Table 1 gives a summary
of the composition of EBN from various sources.
One of the earliest documentations of the
composition of EBN was probably by Guppy in 1886, in
which he described the nests obtained "were of inferior
quality, and were for the most part composed of fibrous
materials derived from the vegetable drift (the husks of
pandanus seeds especially)".(13) Several decades later,
Wang reported the composition of Chinese EBN with an
emphasis on the nature of the proteins found in these
nests.(14) In the study, it was concluded that Chinese
bird's nests were mainly made up of glycoprotein which
had a percentage composition very similar to salivary
mucin. Further experiments demonstrated that Chinese
bird's nests were digested by pepsin and trypsin, but
the rate of digestion was slower than that of boiled
eggs. Wang(14) further commented that the nest protein
studied was of inferior quality.
More recently several studies investigated
the composition of bird's nest.(1,12,15-17) In one study,
Yu, et al(15) studied the five monoses (D-mannitose,
D-galactose, N-acetyl-D-galactosamine, N-acetyl-D-
glucosamine, and N-acetyl neuraminate) constituting to
the oligosaccharide chain and developed a technique
to distinguish between fake and genuine EBN. In
another study, several glyconutrients were identified
in EBN such as N-acetylgalactosamine (glcNAc),

Table 1. Composition of EBN

Source
Oima Atoll, Solomon Islands
Chinese EBN
EBN
EBN by Aerodramus swiftlets:
Comparing red "blood" nest and
white nest
EBN from Collacalia swiftlets
EBN by Aerodramus fuciphagus
in three zones of Malaysia (18
unprocessed and 4 processed
samples)
Composition/remarks Author/reference
The nests were of inferior quality, and were for the most part Guppy, 1886(13)
composed of fibrous materials derived from the vegetable drift.
Chinese bird's nests were mainly made up of glycoprotein. Wang, 1921(14)
Its percentage composition was very similar to salivary mucin.
Chinese bird's nests were digested by pepsin and trypsin, but the
rate of digestion was slower than that of boiled eggs.
Nest protein studied was of inferior quality
EBN consisted of several glyconutrients: Dhawan, et al, 2002(16)
glcNAc 7.2%
glcNAc 5.3%
Galactose 16.9%
Fucose 0.7%
Lipid: 0.14%–1.28% Marcone, et al, 2005(12)
Ash: 2.1%
Carbohydrate: 25.6%–27.26%
Protein: 62%–63%
Three major adulterants were karaya gum, red seaweed and
Tremella fungus (2%–10%)
Both types of nest were identical in composition
Both types of nests contain a common 77kDa protein with
properties close to those of the ovotransferrin protein found in
eggs, which may be responsible for severe allergic reactions in
children who cannot tolerate edible bird's nests.
Occurrence of a proteoglycan, which was rich in nonsulfated Nakagawa, et al, 2007(17)
chondroitin glycosaminoglycans (GAGS).
Proteoglycan found to contain 83% of carbohydrates, with 79%
being GalNAc and GlcUA (D-glucuronic acid).
Main nutrients include: Norhayati, et al, 2010(1)
Crude protein
Various types of minerals (calcium, sodium, magnesium,
potassium phosphorus, iron, zinc, copper)
Sialic acid
Processed samples had higher levels of minerals when compared
to those of the unprocessed samples
Low percentage of sialic acid (0.7%–1.5%) was reported
Chin J Integr Med 2013 Sep;19(9):643-649
N-acetylglucosamine (glcNAc), galactose and fucose.(16)
On the other hand, Marcone studied the composition of
two types of EBN build by Aerodramus swiftlets, namely,
the more expensive red "blood" nest and the white
nest and demonstrated that both types of nest were
identical in their chemical composition. The percentages
of lipid, carbohydrate and protein were 0.14%–1.28%,
2.1%, 25.62%–27.26% and 62%–63%, respectively.
In addition, both types of nest contain a common
77kDa protein with properties close to those of the
ovotransferrin protein found in eggs. It was postulated
that this protein may be the culprit of severe allergic
reactions observed in children who cannot tolerate
EBN. The study also identified three major adulterants
in commercially available EBN, namely karaya gum,
red seaweed and Tremella fungus, and the percentage
composition ranges from 2% to 10%.(12)
In 2007, Nakagawa, et al (17) reported the
occurrence of a proteoglycan from the EBN of Collocalia
swiftlets, which was rich in nonsulfated chondroitin
glycosaminoglycans (GAGS). The proteoglycan was
also found to contain 83% of carbohydrates, with 79%
being GalNAc and GlcUA (D-glucuronic acid). In a more
recent study investigating the nutritional content of EBN
collected from three different zones of Malaysia, the
composition of 18 unprocessed and 4 processed EBN
samples was analyzed.(1) It was reported that the main
nutrients were crude protein (ranging from 56.2±0.7 to
61.5±0.6 g/100 g), various types of minerals (calcium,
sodium, magnesium, potassium phosphorus, iron,
zinc, copper) in varying concentrations, and sialic acid.
It was also reported that the processed samples had
higher levels of minerals when compared to those of
the unprocessed samples. While minerals are important
to health, the overconsumption of minerals may bring
about adverse effects. Another worrying fact was the
low percentage of sialic acid reported (0.7% to 1.5%),
which was contradictory to previously published data
(9%) by Kathan and Weeks.(18)
In addition, it is worth mentioning that although
EBN is generally considered a safe, delicious and
nutritious food for many, it is not uncommon that
one develops food allergies against them. In a study
carried out to investigate food allergy among adults
that attended a clinical immunology/allergy centre
in Singapore, 9.5% of patients (7 out of 74) who
took part in the study were reported to be allergic to
EBN.(19) This finding coincided with that of an earlier
• 645 •
study carried out to investigate dietary restriction and
supplementation in children with atopic eczema in
Hong Kong, which reported that patients with ectopic
eczema were more likely to have taken EBN soup. In
this study, 9 patients (19%, P =0.046) with mild atopic
eczema and 48 patients (36%, P =0.046) with more
severe disease had consumed EBN.(20)
EBN as A Medicine
Although many believe and claim that EBN has
various health-promoting effects and medicinal values,
a search on published literature regarding the scientific
proves for the therapeutic effects of EBN returns only
a few results. One of the earliest modern scientific
documentations of the biological effects of EBN can be
traced back to 1986 during which a glycoprotein in the
extract of EBN from Collocalia species was reported
to potentiate mitogenic response of human peripheral
blood monocytes in the presence of Concanavalin or
phytohemagglutinin A and that the potentiating effect
of EBN was stable to limited digestion with trypsin,
alkaline pH and extraction with ether. (21) One year
later, an epidermal growth factor (EGF)-like activity
was discovered and partially purified from the EBN
of Collocalia swiftlets. This EGF-like activity was
characterized using various biochemical methods
such as molecular weight, competitive binding assays
and gel electrophoresis and was found to share many
similarities in terms of its physical properties with EGF
isolated from mouse or shrew. This was one of the
earliest pieces of scientific evidence of the probable
presence of EGF in EBN.(2) Being an important growth
factor of the EGF family of proteins, EGF plays a
pivotal role in the proliferation, differentiation and
survival of its target cells. (22) The discovery of this
EGF-like activity in EBN, therefore, had laid down a
foundation for later studies on their potential effects in
cell proliferation and differentiation.
In one study, it was demonstrated that EBN in a
formulation containing pearl powder, was effective in
increasing DNA synthesis in T lymphocytes as well as
serum immunoglobulin M level in mice. This finding
suggested that EBN may have enhancing effects on
immunity. The study further reported that the formulation
reduced malondialdehyde (a product of lipid peroxides)
in mice brain tissues and increased superoxide
dismutase in the erythrocytes of rats.(3) This suggested
that EBN may offer protection against oxidative stress.
In another study, the immune enhancing effects were
• 646 •
studied by investigating the antiviral efficacy of EBN.
It was shown that EBN extract was capable of binding
to influenza viruses; to inhibit haemagglutination
of influenza viruses to red blood cells as well as
to neutralise influenza virus-infected madin-darby
canine kidney epithelial cells (MDCK) cells. The study
concluded that EBN may be useful in the prevention
of influenza viral infection.(4)
More recently, Aswir and Wan Nazaimoon (23)
investigated the effects of EBN on cell proliferation
using the human colonic adenocarcinoma cell line
(Caco-2 cells) and the effects of EBN on tumour
necrosis factor-alpha (TNF-α) release using a
mouse leukaemic monocyte macrophage cell line,
RAW 264.7. In this study, two types of commercially
available and four types of unprocessed EBN from
four different regions of Malaysia were studied.
When the Caco-2 cells were treated with EBN, all six
types of EBN showed a significant increase in the
percentage of cell proliferation when compared to the
negative control, ranging from 135.48%±10.50% to
215.07%±4.74% (P <0.05). On the other, when RAW
264.7 cells were treated with EBN, a reduction in the
percentage of TNF-α release was demonstrated
when the two commercially available and two
unprocessed EBN samples were used. The remaining
two unprocessed EBN samples, however, gave an
increase in the percentage of TNF-α release. It was
therefore concluded that EBN was able to influence
cell proliferation in Caco-2 cells and TNF-α release in
RAW 267.2 cells, and the extent of the effects varied
with the source of EBN and whether it was processed
or unprocessed.
In addition, the effects of EBN on the proliferation
of corneal keratocytes had also been investigated.
Zainal Abidin, et al(24) demonstrated that EBN enhanced
cell proliferation of corneal keratocytes derived from
New Zealand white rabbits in vitro , and that such
enhancement was more marked for keratocytes cultured
in serum-containing medium. The study also confirmed
that the addition of EBN did not change the phenotypes
of corneal keratocytes as evidenced by phase contrast
microscopy and gene expression analysis of aldehyde
dehydrogenase, collagen type 1 and lumican via reverse
transcription polymerase chain reaction (RT-PCR).
Other than its in vitro effects, the in vivo effects
of EBN have also been studied. Matsukara, et al (25)
Chin J Integr Med 2013 Sep;19(9):643-649
demonstrated that oral administration of EBN in
ovariectomised rats improved femur bone strength and
calcium concentration. It was shown that ovariectomised
rats fed with edible bird's nest extract (EBNE) had a
significantly higher final body weight and higher femur
calcium, phosphorus and hydroxyproline concentrations
when compared to that of the control (P <0.05) and that
those rats fed with high-EBNE showed better results
than those fed with low-EBNE. Dermal thickness was
also shown to be thickened in rats fed with EBNE
whereas the serum estradiol levels did not increase. The
study therefore concluded that EBN supplementation
may enhance bone strength and improve skin aging.
Although the above studies have investigated
various biological effects of EBN, the mechanisms
by which EBN acts in vivo and in vitro remain largely
unknown. Very little is available in published literature
except one study which looked into the mechanisms of
EBNE-induced proliferation of human adipose-derived
stem cells (hADSCs).(26) Several Chinese medicines
have been reported to exert effects on adult stem cells
and might play a role in tissue regeneration.(27) EBN
is one among them showing effects on hADSCs. The
enhanced proliferation of hADSCs was found to be
mediated via EBNE-induced production of interleukin
(IL)-6 and vascular endothelial growth factor (VEGF),
which was in turn due to activation of activator protein
(AP)-1 and nuclear factor (NF)-κB. Furthermore, the
EBNE induced production of IL-6 and VEGF, as well as
the EBNE-induced proliferation of hADSCs, were found
to be inhibited by PD98059 (a p44/42 MAPK inhibitor),
SB203580 (a p38 MAPK inhibitor), and PDTC (a NF-
κB inhibitor), but not SP600125 (a Jun N-terminal
kinase inhibitor). Table 2 summarizes the biological
effects of EBN.
Authenticity and Quality of EBN
Although the number of scientific studies carried
out on the biological and health-promoting effects of
EBN has increased greatly, it is worth mentioning that
issues regarding the authenticity and quality of EBN
need urgent attention and solution. Fake EBN, EBN
with adulterants and contaminated EBN, either with
bird droppings or other contaminants may be harmful
to those who consume it. Some reported examples of
imitation substitutes found in EBN include edible plant-
exude, gum karaya or sterculia.(28) Other substances
which have been found to reduce the purity of EBN
include red seaweed and tremella fungus.(12)
Chin J Integr Med 2013 Sep;19(9):643-649 • 647 •

Table 2. The Biological Effects of EBN

Biological effect
Pro-mitogenic effects
EGF-like activity
Pro-proliferative & immune
enhancing effects
Antioxidative effects
Antiviral effects
Pro-proliferative and anti-
inflammatory effects
Pro-proliferative effects
Bone-strengthening and skin
enhancing effects
Pro-proliferative effects
Remarks Author/reference
A glycoprotein in the extract of EBN from Collocalia species Ng MH, et al, 1986(21)
was reported to potentiate mitogenic response of human
peripheral blood monocytes in the presence of Concanavalin
or phytohemagglutinin A
An EGF-like activity was discovered and partially purified Kong, et al, 1987(2)
from the edible nest of Collocalia swiftlets and was found
to share many similarities in terms of its physical properties
with EGF isolated from mouse or shrew
EBN in a formulation containing pearl powder was reported Zhang, et al, 1994(3)
to be effective in increasing DNA synthesis in T lymphocytes
as well as serum immunoglobulin M level in mice
EBN formulation reduced malondialdehyde (a product of lipid Zhang, et al, 1994(3)
peroxides) in mice brain tissues and increased superoxide
dismutase in the erythrocytes of rats
EBNE was capable of binding to influenza viruses; to inhibit Guo, et al, 2006(4)
haemagglutination of influenza viruses to red blood cells as
well as to neutralise influenza virus-infected MDCK cells
EBN was able to influence cell proliferation in Caco-2 cells Aswir, et al, 2011(23)
and TNF- α release in RAW 267.2 cells
EBN enhanced cell proliferation of corneal keratocytes Zainal Abidin, et al, 2011(24)
derived from New Zealand white rabbits in vitro
Ovariectomized rats fed with EBNE had a significantly higher Matsukawa, et al, 2011(25)
final body weight and higher femur calcium, phosphorus and
hydroxyproline concentrations when compared to that of
the control. This was accompanied by an increased dermal
thickness
EBNE-induced proliferation of human adipose-derived Roh, et al, 2012(26)
stem cells was found to be mediated via EBNE-induced
production of IL-6 and VEGF and was inhibited by PD98059,
SB203580, and PDTC, but not SP600125

Several techniques, including electronic
microscopy, energy disperse X-ray microanalysis
and spectroscopy, were used in comparing imitation
substances in EBN with substances of plant origins.(27)
In one study, spectrophotometry has also been applied
in the identification of EBN, which can differentiate
EBN from saliva, pig's skin and Tremella fucifomis .(29) In
addition, stereoscopy has also been used to differentiate
white EBN pieces, red EBN, white fungus pieces and
EBN painted with colloid. Authentic EBN pieces were
found to be different from white fungus pieces under
the stereoscope. The former was semitransparent with
fine cracks as compared to the latter, which appeared
to be opaque and without cracks. On the other hand,
EBN painted with colloid had unclear surface lines and
plastered feathers on the surface.(30) Other methods
that have been applied to authenticate EBN include
DNA-based polymerase chain reactions, protein-based
two dimensional gel electrophoresis (31) and genetic
identification based on mitochondrial DNA.(32)
Other than the authenticity issues mentioned,
the presence of harmful substances in EBN has also
caught much attention recently. For example nitrite and
staphylococcus aureus were detected in imported EBN
in China lately.(33) Another potentially harmful substance
that has been found in EBN is semicarbazide. In one
study, semicarbazide was detected in instant bottled
EBN samples and the source of the semicarbazide was
believed to have originated from the bleaching process
used in EBN preparation.(34)
The presence of nitrate or nitrite in food and
drinking water has long been a potential health problem
and there are legal limits to their concentrations.(35)
Nitrates, nitrites and nitrosamines in food may play
a role in neural tube defects, chronic diseases and
cancer.(36) Therefore, the concentrations of nitrite in
EBN must be closely monitored. It is believed that
the droppings of the swiftlets are a source of nitrite
contamination and some believe that it may be difficult
to produce EBN that is completely free of nitrite.
Red EBN in general is more costly and thought
to be of higher health benefits in comparison to white
EBN. Interestingly, nitrite in the bird's droppings has
• 648 •
Table 3. Grading of Raw Unclean EBN
Grade Shape Size Feathers
Ⅰ 180° >4cm <10 spots
Ⅱ 180° >4cm Heavy, >10 spots
135° >4cm Heavy, >10 spots
Ⅲ 90° – Heavy, >10 spots
been reported to turn white EBN red. In one study, it
was reported that vapours from 'bird soil' containing
guano droppings from swiftlet houses were capable of
turning white EBN red under hot and humid conditions.
The study concluded that the red coloration found in
EBN may be due to environmental factors in the cave
or swiftlet house where the EBN is produced.(37)
To ensure high quality EBN, both good animal
husbandry practice and proper EBN handling are
crucial steps to be taken. It is important that swiftlet
ranches comply strictly with the specified requirements
laid down by the authorities and adequate cleaning is
applied to raw unclean EBN. In one study carried out
on the prevalence of nitrite and nitrate in EBN, it was
reported that cleaning could substantially reduce but
not completely remove the nitrite in EBN.(38) Besides,
EBN should also be sorted and graded accordingly.
One example of a grading system is provided by the
Food and Safety Division of the Ministry of Health,
Malaysia in 2012, as one of the steps in the standard
operating procedure (SOP) on the control of nitrite
level in EBN.(39) In this grading system, unclean EBN
is divided into Grades Ⅰ, Ⅱ and Ⅲ whereby Grade Ⅰ
EBN is the purest with the absence of bird droppings
and Grades Ⅱ and Ⅲ EBN have bird droppings found
in them. Other criteria used in the grading of raw
unclean EBN include its shape, size, colour and the
number of feather spots present (Table 3). In addition,
other points of control found in the SOP include the
bird house, transport vehicle, processing, softening
and cleaning of EBN.(39)
EBN is consumed in many parts of the world for
its nutritional and medicinal values and an increasing
demand for EBN worldwide has created a huge
market for EBN. Although there is a lack of scientific
documentations of the biological and health-promoting
effects of EBN in the past, researchers have started to
report such effects in scientific publications lately. While
several studies have documented the potential immune
system-enhancing, antiviral, bone-strengthening, cell-
proliferation enhancing and anti-skin aging effects
Chin J Integr Med 2013 Sep;19(9):643-649
Colour Droppings
White Absent
White/slightly yellow Present
White/slightly yellow Present
White/slightly yellow Present
of EBN, more explorations are necessary before
conclusions can be made on the health-promoting
effects of EBN. Of particular importance is the
elucidation of the underlying mechanisms by which EBN
exerts these effects, both in vitro and in vivo . It would
also be good if the use of EBN in human subjects is
followed up in a clinical setting to investigate the health-
promoting effects or therapeutic values of EBN. Also, it
is not uncommon that EBN from different sources result
in variations in the effects studied. Therefore, it would be
beneficial if EBN formulations can be standardised so
that a more predictable outcome can be achieved for the
use of EBN in various conditions.
It is also important to ensure that EBN is
produced and processed under the strictest conditions
so that EBN that reaches the consumers is authentic
and safe for consumption in order to achieve its
health-promoting effects.
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(Received December 24, 2012)
Edited by GUO Yan