THE CLINICAL AND NUTRITIONAL BENEFITS OF KRILL OIL A Scientific Summary Written by Research & Development unit BioActive Ingredients Division, Enzymotec Ltd. March 2011 OVERVIEW The Antarctic krill Euphausia superba is found in the cold Antarctic waters of the Southern Ocean and makes up an estimated biomass of over 500,000,000 tons, a figure that is about twice that of humans. Krill oil is comprised from Antarctic krill extraction, which is sourced from vessels and facilities managed by CCAMLR members who monitor the conservation of Antarctic marine life. Krill oil is comprised of three major components: omega-3 fatty acids (FAs) attached to phospholipids, omega-3 FAs attached to triglycerides, astaxanthin and other antioxidants1. Each of the krill oil components were tested for safety and efficacy by a battery of clinical and pre-clinical trials that proved its safety and beneficial contributions to human health. These studies revealed that krill oil is safe and effective for multiple indications, from chronic inflammation to hyperlipidemia, cognitive function, fatty liver disease, joint health and more. Furthermore, clinical and pre-clinical studies that tested krill oil vs. fish oil, suggested that krill oil may be more effective than fish oil for some indications. In krill oil, most of the omega-3 FAs are attached to phospholipids, making these important components bio-available to the body and thus, allowing omega-3 to be absorbed by the target organs such as the heart, brain and liver, where they exert their beneficial effects. Enzymotec’s Krill Oil+™ was found to be Generally Recognized As Safe (GRAS) by the American Food and Drug Administration (FDA), and obtained a Novel Food status from the European Union. 2 The Clinical and Nutritional Benefits of Krill Oil KRILL OIL COMPOSITION AND CHARACTERISTICS Figure 1a. Triglycerid Choline Krill oil is comprised of three major components: omega-3 fatty acids (FAs) [primarily eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)] attached to phospholipids, omega-3 FAs attached to triglycerides, as well as antioxidants, mainly astaxanthin1. Each of the krill oil components has clinically proven health benefits, and so the krill oil offers unique combined benefits. Phospholipids are distinct from triglycerides in both their structure and their role in the living organism. Phospholipids are considered the building blocks of the cell membrane while triglycerides are used by the human body as storage molecules. Both triglycerides and phospholipids are comprised of FAs attached to glycerol backbone which is a short chain of 3 carbon atoms (Figure1). However, the triglyceride molecule has three FAs attached to the glycerol back bone (Figure1a), while a phospholipid molecule has the glycerol back bone attached to only two FAs and to a polar head group (Figure 1b). The polar head group is comprised of a phosphate and an organic molecule, linked to each other. The organic molecule in krill oil phospholipids is chiefly choline and therefore phosphatidylcholine (PC) is the most abundant phospholipid in krill oil (Figure 1b). The phospholipids in krill oil are mainly attached to the FAs EPA and DHA both of which have long been recognized as beneficial to human health7. Phospholipids are considered bipolar molecules since they have FAs on one side and a polar head group on the other. This unique structure allows them to construct the bi-layer of the biological membrane. The third important component of krill oil is the antioxidant astaxanthin, which is a natural occurring carotenoid. Antioxidants act as protectors of the human cell, protecting it from damages that could lead to numerous illnesses. They are found in the cell membrane protecting it from oxidation, acting as scavengers that absorb free radicals and inhibit oxidation of bio-molecules such as fatty acids. In addition to astaxanthin, krill oil contains other antioxidants such as vitamin A and vitamin E. Figure 1b. Phosphhatidylcholine Figure 1. The structure of triglycerides and phospholipids. Triglycerides are comprised of a glycerol backbone attached to 3 fatty acids (Figure 1a), and phospholipids are comprised of a glycerol backbone attached to 2 fatty acids and a polar head group (Figure 1b). The Clinical and Nutritional Benefits of Krill Oil 3 KRILL OIL – MECHANISM OF ACTION The mechanism in which krill oil exerts its beneficial effects on human health can be explained through the effect of each of its components: EPA/DHA, PC and antioxidants, on one hand, and through the combined effect of the whole krill oil, on the other. THE EFFECTS OF EACH COMPONENT 4 EPA / DHA PHOSPHATIDYLCHOLIN The omega-3 FAs, EPA and DHA are an important component in krill oil. Numerous studies showed that omega-3 FAs particularly EPA and DHA, enhance quality of life, lower the risk of premature death, and have a significant positive influence on human health for a wide range of indications, such as cardiovascular disease prevention, anti-inflammation, brain development, behavior, mood, and more 8, 9. Recently, researchers reported on an omega-3 receptor which was found in cells of the immune system 10. The study showed that omega-3 FAs such as DHA and EPA mediate potent anti-inflammatory effects when they bind to this receptor. Omega-3 seems to have cognitive benefits and to be vital throughout all human life, from embryo development through childhood, adolescence, adulthood and the senior years. During the third trimester of pregnancy and the first two years of childhood, the brain rapidly grows and consumes high amounts of DHA. DHA and EPA are important to the development of the embryo’s visual and other sensory functions 9. The administration of EPA and DHA has been associated with cognitive improvement in a broad spectrum of psychiatric disorders as shown in many human and animal studies 11-14. While deficiency of omega-3 FAs is associated with a wide range of neurological disorders, such as attention-deficit hyperactivity disorder (ADHD) 15-18, dyslexia 19, depression and aggression 20, and autism 21-24. The importance of DHA and EPA continue throughout adult life, DHA and EPA supplementation improves several mood parameters in young, healthy adults 25, and improves age-associated memory impairment 26. Aside from triglycerides, krill oil contains a notable amount of phospholipids, primarily PC, attached to omega-3. Phospholipids were studied extensively and their beneficial effects on cognitive, mental functions9, 27 and on chronic liver diseases 28, 29 are well established. Phospholipids, such as PC that exist in human breast milk, are often added to infant formulae. It is suggested that they are important to the development of the newborn 30, 31. The phospholipids in the krill oil have an additional contribution since they are also the carriers for omega-3 and are responsible for delivering both EPA and DHA to the target organs. Studies suggest that phospholipids are better omega-3 carriers when compared to triglycerides and therefore omega-3 FAs attached to phospholipids are considered to have higher bioavailability 2. ANTIOXIDANTS Antioxidants are molecules capable of inhibiting the oxidation of other molecules. FAs are susceptible to peroxidation, which is a process whereby free radicals "steal" electrons from the lipids in cell membranes. Since FAs are the main component in the cell membranes, this process leads to a chain reaction that damages the membrane leading to eventual cell death. Antioxidants exert their activity by scavenging free radicals and inhibiting the oxidation chain reaction. Through this activity, antioxidants protect the cell from oxidative damages and thereby protect the human body from a variety of illnesses. The Clinical and Nutritional Benefits of Krill Oil KRILL OIL COMBINED EFFECTS Each of the different components of krill oil can exert its activity on different systems and could benefit human health. The following schematic drawing shows how krill oil affects two major systems in the human body: 1. The cell membrane (physical properties and function) 2. Chronic inflammation KRILL OIL PC OMEGA-3 AO Chronic Inflammation Cell Membrane Heart Fatty Liver Brain Atherosclerosis Figure 2. Schematic presentation of the combined mechanisms of action of krill oil components. All components of krill oil: PC, omega-3 and antioxidants (AO) affect membrane structure and chronic inflammation. The membrane structure may affect cognitive function and chronic inflammation. Chronic inflammation may lead to atherosclerosis, cardiovascular disease and liver disease progression. Atherosclerosis can also lead to vascular dementia and to cognitive impairment. The Clinical and Nutritional Benefits of Krill Oil 5 EFFECTS ON STRUCTURE AND FUNCTION OF THE CELL MEMBRANE Phospholipids are the main component in the cell membranes of the human body (Figure 3). The cell membrane is one of the most important cellular structures, acting as a physical barrier that separates the interior of the cell from the outside environment, allowing selective movement of substances in and out of the cell. The structure of the membrane is highly affected by its components, the polar groups as well as the fatty acids attached to the phospholipids. Studies showed that high level of omega-3 FAs changes the membrane fluidity and affects both the structure and the function of proteins embedded in the membrane, including enzymes, receptors, and ion channels, leading to changes in cellular function 32. High concentrations of omega-3 FAs are observed in the membranes of heart cells 33 and in the membranes of blood vessels cells (vascular endothelial cells) 34, where it influences the function of the cardiovascular system. DHA is one of the major fatty acids found in the brain, where it plays a crucial role in the maintenance of membrane fluidity and functionality 35. Krill oil components are carried into the cell membranes of different organs in the human body, including the immune system. When krill oil components are delivered to the immune cells, they modulate the action of the immune system where they have shown to prevent chronic inflammation. EFFECTS ON CHRONIC INFLAMMATION Inflammation is an immunological self-defense mechanism utilized by the body against injury, pathogens and diseases. However, when inflammation becomes chronic rather than transitory, it imposes serious malfunctioning conditions and illnesses. Today, scientists believe that chronic inflammation is one of the main contributing factors to chronic degenerative diseases and may be the engine that drives many illnesses of middle and old age. Such influences can lead to the development of cardiovascular disease (CVD) by destabilizing cholesterol deposits in the coronary arteries, leading 6 PHOSPHOLIPIDS FATTY ACIDS ANTIOXIDANTS Figure 3. The cell membrane structure. The cell membrane is a selective permeable lipid bi-layer which comprises the outer layer of a cell. Phospholipids with their attached fatty acids are the molecular building blocks of the membrane. The composition of both the polar heads of the phospholipids as well as the fatty acids attached is crucial and has a pivotal effect on the membrane's physical characteristics and functionality. Aside from phospholipids and fatty acids, antioxidants are also embedded in the cell membrane. to heart attacks and potentially to stroke. Also, it can lead to the degeneration of nerve cells in the brain, and consequent cognitive dysfunction, and even encourage the transformation of cells into cancer cells. The effect of EPA and DHA on chronic inflammation was studied in a large number of clinical trials consisting of participants with chronic inflammatory conditions as well as healthy subjects. While EPA and DHA do not interfere with the proper functioning of healthy immune systems, they may potentially inhibit incorrect inflammatory responses in patients with chronic inflammatory conditions 36. Krill oil contains EPA and DHA attached to phospholipids. Since phospholipids are found to be efficient carriers, krill oil has improved antiinflammatory potency. The Clinical and Nutritional Benefits of Krill Oil KRILL OIL BENEFITS - SCIENTIFIC EVIDENCE KRILL OIL MAY HAVE BENEFICIAL EFFECTS ON: • The negative action of chronic inflammation - C-Reactive Protein (CRP) level - Joint health • Blood lipids - Blood cholesterol, triglyceride and glucose levels • Woman Premenstrual Syndrome (PMS) symptoms - Emotional swings related to the menstrual cycle - Physical discomfort during menstruation KRILL OIL BIOAVAILABILITY Krill Oil bioavailability is the degree and rate at which omega-3 FAs are absorbed into the living system and are made available at the site of physiological activity. Studies showed that the bioavailability of FAs attached to phospholipids is better than FAs attached to triglycerides. Therefore, the absorbance of FAs by target tissues such as the heart, brain and the liver of the tested animals is greater when attached to phospholipids than to triglycerides 2 . In krill oil, the majority of the omega-3 FAs are attached to phospholipids and the rest are attached to triglycerides while in fish oil the omega-3 FA are attached only to triglycerides. Researchers tested krill oil bioavailability in humans, showing that the plasma level of both EPA and DHA was significantly elevated after krill oil administration, leading to the conclusion that krill oil is highly bioavailable 3, 4. These findings are further supported by pre-clinical trials that showed high bioavailability of EPA and DHA in mice liver and brain after krill consumption 5, 6. • Behavioral function - Stress and mood • Fatty liver conditions The Clinical and Nutritional Benefits of Krill Oil 7 KRILL OIL IS A POTENT ANTI-INFLAMMATORY AGENT Krill oil contains two potent anti-inflammatory constituents, omega-3 phospholipids (PC-EPA\DHA) and the carotenoid astaxanthin. The vital lipids found in krill oil can be considered as a “next-generation” omega-3 dietary supplement, one with benefits that overreach those of fish oil 9, 37. marker – C Reactive Protein (CRP) by 30% following 14 and 30 days of administration to humans (Figure 5), in addition to reducing infiltration of inflammatory cells into the joint 38, 39. Furthermore, a human clinical trial showed that krill oil significantly reduces the physiological and emotional symptoms related to premenstrual syndrome (PMS) and provides pain relief better than fish oil 40. This is further supported by two pre clinical trials which showed that krill oil inhibits the inflammatory response to stimulus in obese rats 41, and suppresses the development of the autoimmune disease lupus, in mice model 6. Human clinical trials and pre-clinical trials showed that krill oil inhibits the inflammatory symptoms in chronic inflammatory patients and animal models. Krill oil supplementation significantly reduces Rheumatoid Arthritis parameters (Figure 4), which are mostly related to immune system malfunction. Krill oil has also shown to significantly lower the inflammatory MEAN CHANGE FROM BASELINE Placebo 0.2 0 ** * Krill 300mg/d * -0.2 -0.4 -0.6 -0.8 -1 -1.2 -1.4 CRP PERCENT OF CHANGE FROM BASELINE Pain Stiffness 8 Placebo 40 30 * ** Functional Impairment Krill 300mg/d ** 20 10 0 -10 -20 -30 -40 7 14 30 Days The Clinical and Nutritional Benefits of Krill Oil Figure 4: Krill oil significantly reduces Rheumatoid Arthritis parameters in patients. The effect of krill oil supplementation on the three Osteoarthritis Index parameters was examined: pain, stiffness and functional impairment. The patients were supplemented with krill oil (300 mg per day), or placebo for 30 days. The results represent the change in mean score between baseline and end point, of 45 patients per group. The differences between the groups (krill oil to placebo) over time were assessed by one-way ANOVA ;*p<0.05, **p<0.005 38. Figure 5: Krill oil significantly reduces CRP level in patients with chronic inflammation. The effect of krill oil supplementation on CRP levels in patients with chronic inflammation was examined. Patients with elevated levels of the inflammatory marker – C Reactive Protein (CRP) (CRP>1mg/dl) were supplemented with krill oil (300 mg per day), or placebo for 30 days. The results represent the percent of change in mean CRP levels of 45 patients per group. The differences between the groups (krill oil to placebo) were assessed with one-way ANOVA ;*p<0.05, **p<0.008 38. KRILL OIL DECREASES THE LEVELS OF TRIGLYCERIDES AND LDL-CHOLESTEROL WHILE ELEVATING HDL- CHOLESTEROL PERCENT OF CHANGE FROM BASELINE Several risk factors have been identified to increase the risk of coronary heart disease and heart attack. Among the risk factors are elevated blood lipids, a condition known as hyperlipidemia. Hyperlipidemia may be an elevation in either cholesterol level, triglyceride level or both. The beneficial effect of EPA and DHA on triglyceridelowering and on reducing the risk of cardiovascular disease has been extensively studied and researched over the years 42. Based on the existing scientific evidence the American Heart Association (AHA) has recommended the use of omega-3 FAs for secondary prevention of cardiovascular events in people with documented coronary artery disease. In addition the FDA has approved a prescription drug based on omega-3 fatty acid ethyl ester formulation, for the treatment of very high triglyceride levels. Despite the fact that the benefits of EPA and DHA are Placebo 45 35 25 15 5 -5 -15 -25 -35 ** * ** -45 Total Cholestorol LDL (bad) Cholestorol BAD CHOLESTEROL AND GOOD CHOLESTEROL Krill 2gr/d ** 55 well established, fish oil consumption was shown to adversely increase the level of LDL- Cholesterol (bad cholesterol) 42. A human clinical trial found that krill oil positively manages blood lipids in hyperlipidemic patients by significantly reducing triglycerides, total cholesterol and LDL-Cholesterol. It also increases HDL-Cholesterol and reduces glucose blood level 43 (Figure 6). While fish oil may adversely elevate LDL-C level 42, krill oil was shown to significantly reduce LDL-C in hyperlipidemic patients 43. The data described above is further supported by a series of pre-clinical trials conducted in hyperlipidemic and obese rats showing similar results in modulating blood lipids as well as hepatic and heart triglycerides reduction 41, 44, 45. HDL (good) Cholestorol Triglycerides Figure 6: Krill oil maintains blood lipids and cholesterol in hyperlipidemic patients. The effect of krill oil supplementation on total cholesterol, LDL-Cholesterol, HDL-Cholesterol and triglycerides in hyperlipidemic patients was examined. Hyperlipidemic patients were supplemented with krill oil (2 g per day), or placebo for 12 weeks (90 days). The results represent the percent of change in mean values of 30 patients per group. The differences over time within each group (baseline to day 90) were assessed by paired Student’s t-test; *P < 0.05, **P < 0.0001 43. Lipids like cholesterol or triglycerides do not move freely in the blood stream, but rather are transported via lipoproteins. Cholesterol can be mainly transported in two forms of lipoproteins, either as a Low Density Lipoprotein (LDL) or a High Density Lipoprotein (HDL). High levels of LDL particles were shown to promote cardiovascular disease and therefore are referred to as the bad cholesterol particles, as opposed to HDL particles which are frequently referred to as good cholesterol or healthy cholesterol particles. When too much LDL (bad) cholesterol circulates in the blood, it can slowly build up in the inner walls of the arteries that feed the heart and brain. Together with other substances, it can form plaque, a thick, hard deposit that can narrow the arteries and make them less flexible. A clot which is formed and blocks a narrowed artery, can lead to a heart attack or to a stroke. On the other hand, high levels of HDL seem to protect against heart attack. The Clinical and Nutritional Benefits of Krill Oil 9 KRILL OIL REDUCES PREMENSTRUAL SYNDROME (PMS) SYMPTOMS inhibition in attention deficit hyperactivity disorder (ADHD) diagnosed in young adults46. Nearly all women of reproductive age experience a variety of physical discomforts and emotional problems during menstruation. These difficulties adversely impact their quality of life. A human clinical trial examined 70 women diagnosed with premenstrual syndrome (PMS), and showed that krill oil reduces the symptoms of PMS and dysmenorea, which is defined as a condition characterized by severe uterine pain during menstruation, pain that usually limits normal activity or requires medication. The authors concluded that krill oil significantly reduces dysmenorrhea, improves the emotional symptoms of PMS and provides greater pain relief even when compared to fish oil 40. KRILL OIL BENEFITS FATTY LIVER DISEASES KRILL OIL IMPROVES COGNITIVE AND MENTAL HEALTH Cognitive function in general and memory function in particular are vulnerable to aging and to a variety of pathologic processes such as neurodegenerative diseases and stroke. The term "cognition" holds a vast array of brain functions such as memory, associations, concept formation, language, attention, mood and more. Extensive scientific research verifies the crucial beneficial role phospholipids and DHA\EPA have in cognitive and mental functions. Phospholipids were shown to positively affect mood and stress management, and to improve memory and learning damage caused by age or disease 9, 27. DHA and EPA have been associated with cognitive improvement in a broad spectrum of psychiatric disorders, as well as several mood parameters, and age-associated memory impairments 25, 26. Krill oil is comprised of a substantial amount of phospholipids attached to DHA and EPA, and is therefore expected to exert a positive effect on cognitive functions. A human clinical trial that examined women diagnosed with PMS concluded that krill oil significantly reduces the emotional symptoms of PMS 40. Another pilot open-label clinical trial, shows that krill oil significantly improves the scores of executive function, self control and behavioral 10 Fatty liver disease (FLD) is a condition caused by triglyceride fat accumulation in liver cells due to an abnormal retention of lipids within a cell. One of the major risks of FLD is liver dysfunction. Accumulation of fat may also be accompanied by a progressive inflammation of the liver (hepatitis). A human clinical trial that was conducted on patients with chronic liver disease demonstrated that the administration of PC-omega-3 is beneficial in the treatment of chronic liver diseases 29. These results are supported by series of pre-clinical trials done by Lieber et. al. in chronically alcohol-fed baboons. The trials revealed that PC attached to polyunsaturated fatty acids (PC-PUFA) is effective in preventing alcohol-induced hepatic fibrosis and cirrhosis, and that the polyunsaturated phospholipids themselves might be responsible for the protective effect, rather than the choline that failed to protect the liver 4749 . Fatty liver disease is treated in several European countries with a high grade phospholipids drug called Essentiale. Krill oil contains about 40% of phospholipids, mostly PC-PUFA, and therefore, has high potential to protect the liver in fatty liver conditions. Pre-clinical study proves that krill oil significantly reduces liver weight and total liver fat in mice fed a high-fat diet, and suggests that krill oil may be of therapeutic value in patients with metabolic syndrome and/or nonalcoholic fatty liver disease (Figure 7) 44. The Clinical and Nutritional Benefits of Krill Oil Figure 7: Krill oil significantly reduces liver fat in high fat liver mice model. 27 * TOTAL LIVER FAT 24 21 18 15 * 12 9 6 3 0 Normal Diet High Fat Diet High Fat Diet + Krill Oil The effect of krill oil supplementation on total liver fat, in high-fat-fed mice was examined. Mice were fed either normal or high fat diets or high fat diets and krill oil for 8 weeks. The results represent the mean of the total liver fat (g/100g) of 6-10 mice per group. Difference between normal and high fat diet was examined by Student’s t-test. Differences between high fat diet and high fat diet with different krill oil dosage (only one dosage is presented here) were examined by ANOVA followed by Tukey’s test; *P < 0.01 44. KRILL OIL, QUALITY, SAFETY AND METHODOLOGY KRILL OIL QUALITY The main quality standard indices for krill oil are microbiology, environmental contaminant levels (e.g. PCBs) and peroxide value (PV). In addition to the standard quality parameters, there are additional quality indicators, commonly used to test fishery products, which should be used to indicate the freshness and quality of the product. TMA, TVN AND TMAO Trimethylamine oxide (TMAO) is a natural and nontoxic substance found in marine products. Tri Methyl Amine (TMA) is a product of choline and TMAO degradation, and is responsible for the characteristic ‘fishy’ odor of rotting fish. TMA has been extensively discussed as a spoilage index for commercial fish 50. An additional index for spoilage is the total volatile basic nitrogen (TVN) which includes TMA, ammonia and other basic nitrogenous compounds. Thus, the most common chemical parameters for assessing the freshness of marine products are TVN and TMA levels. In addition to the standard parameters, Enzymotec Ltd. adopted the TMA and TVN quality indices in the manufacture of its products and as a standard parameter in its Certificate Of Analysis. Enzymotec’s Ltd. Krill Oil+™ specifications were approved by third party laboratories and by Consumer Labs random examination and were found to be in full compliance with the label claims. KRILL OIL SAFETY Krill oil has been available on the market in different countries and consumed for many years without any known adverse effects. In addition, numerous clinical trials have shown that krill oil is safe and well tolerated, with no indication of adverse effects on safety parameters 3, 4, 38, 40, 43. Pre-clinical trials support these conclusions and have shown no toxicity in animals that consumed krill oil 51. Furthermore, Krill Oil+™ was found to be "Generally Recognized as Safe" (GRAS) by the FDA and has obtained Novel Food status from the European Union. The Clinical and Nutritional Benefits of Krill Oil 11 KRILL OIL ECO-HARVESTING ENZYMOTEC LTD. KRILL OIL+™ Enzymotec Ltd. supports sustainable management of krill populations and an eco-friendly supply chain aimed to maintain the conservation of marine life resources. Its krill biomass is supplied only from vessels and facilities monitored by members of the Convention on the Conservation of Antarctic Marine Living Resources (CCAMLR). Enzymotec Ltd. manufactures according to GMP guidelines and follows the standard quality indices accepted in the industry. The raw material to be extracted, krill biomass, is composed of lipids, sugars and proteins. By using a solvent extraction process, the lipids are separated and further purified, while the proteins and free sugars are removed. Various solvents may be used for the extraction process, all of which are of food-grade quality and are used and removed from the product in accordance with good manufacturing practices. CCAMLR is an international treaty between 25 nations that seeks to manage Antarctic fisheries with the goal of preserving species diversity and stability of the entire Antarctic marine ecosystem. The CCAMLR was established in 1982, in response to concerns that increasing krill fishing activities could have a deleterious impact on the Southern Ocean ecosystem. Krill for direct human consumption is insignificant segment out of the precautionary catch limit set by CCAMLR. Enzymotec Ltd. offers an extensive portfolio of krill oil solutions. There are 3 major Krill Oil+™ grades: 1. Pure Krill Oil+™ characterized by its freshness, high stability and flowability. 2. High Potency Krill Oil+™ contains the highest available levels of Phospholipids, Omega-3 and Astaxanthin. 3. Custom made Krill Oil+™ suitable for customer needs (e.g. cost effective grades). 12 The Clinical and Nutritional Benefits of Krill Oil ABOUT ENZYMOTEC Infant Nutrition Enzymotec is a dynamic biotechnology company and a leading global supplier of lipid-based products and solutions. We develop, manufacture and market innovative biofunctional ingredients and final products based on sophisticated proprietary technologies. Enzymotec offers high quality lipid-based products as original solutions for body and mind. We employ state of the art processing tools, lipid technology expertise and the highest manufacturing standards. Our research and development team are introducing new products clinically tested under the supervision of top scientists in leading medical centers. Our goal is to provide our customers with the safest, most effective and highest quality products. With 150 employees worldwide, we are currently active in more than 40 countries. Enzymotec strategic partners are leading pharmaceutical companies and nutrition firms. Our dietary supplement products can be found in leading health and drug stores worldwide. Enzymotec's headquarters, research and development center and GMP-compliant manufacturing facility are located in Israel. Our US office is located in New Jersey. We have a joint venture with AAK in Sweden and a manufacturing facility for raw-materials in India. Providing lipid compositions that mimic the fat in human milk for the wellbeing of infants. BioActive Ingredients Providing premium innovative bioactive ingredients tailored to suit unique needs of pharmaceuticals and nutrition industries. ABOUT THE BIOACTIVE INGREDIENTS DIVISION Enzymotec’s BioActive ingredients Division is a leading supplier of lipid-based products providing high quality solutions for body and mind. We develop, manufacture and market BioActive ingredients for the pharmaceutical and nutrition markets. BUSINESS DIVISIONS Our solutions are based on advanced and novel technologies and produced in highly modern manufacturing facilities that enable us to keep the highest standards and quality control and make us leaders among the international manufactures. Enzymotec's products treat conditions in the largest therapeutic markets and deliver innovative solutions in three business segments: The company is committed to R&D innovation and invests in clinical trials, regulatory approvals and patent protection on a global scale. VAYA Pharma is a research-based, specialty pharmaceutical division, dedicated to the discovery, development, manufacture and marketing of innovative, clinically tested, effective and safe lipids based medicines. The Clinical and Nutritional Benefits of Krill Oil 13 REFERENCES 1. Tou, J.C., Jaczynski, J. & Chen, Y.C. Krill for human consumption: nutritional value and potential health benefits. Nutr Rev 65, 63-77 (2007). 2. Wijendran, V. et al. 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