THE CLINICAL AND NUTRITIONAL BENEFITS OF KRILL OIL A Scientific Summary

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. Efficacy of dietary arachidonic acid provided as triglyceride or phospholipid as substrates for brain
arachidonic acid accretion in baboon neonates. Pediatr Res 51, 265-72 (2002).
3. Ulven, S.M. et al. Metabolic Effects of Krill Oil are Essentially Similar to Those of Fish Oil but at Lower Dose of EPA and DHA, in
Healthy Volunteers. LIPIDS (2010).
4. Maki, K.C. et al. Krill oil supplementation increases plasma concentrations of eicosapentaenoic and docosahexaenoic acid in
overweight and obese men and wemen. Nutrition Reaserch 29, 609-615 (2009).
5. Bridges, K.M., Gigliotti, J.C., Altman, S., Jaczynski, J. & Tou, J.C. Determination of digestibility, tissue deposition, and metabolism
of the omega-3 fatty acid content of krill protein concentrate in growing rats. J Agric Food Chem 58, 2830-7 (2010).
6. Venkatraman, J.T., Chandrasekar, B., Kim, J.D. & Fernandes, G. Effects of n-3 and n-6 fatty acids on the activities and expression
of hepatic antioxidant enzymes in autoimmune-prone NZBxNZW F1 mice. LIPIDS 29, 561-8 (1994).
7. Harris WS et al. Towards establishing dietary reference intakes for eicosapentaenoic and docosahexaenoic acids. The Journal
of Nutrition 139, 804s-819s (2009).
8. Manerba, A., Vizzardi, E., Metra, M. & Dei Cas, L. n-3 PUFAs and cardiovascular disease prevention. Future Cardiol 6, 343-50
(2010).
9. Kidd, P.M. Omega-3 DHA and EPA for cognition, behavior, and mood: clinical findings and structural-functional synergies with
cell membrane phospholipids. Altern Med Rev 12, 207-27 (2007).
10. Oh da, Y. et al. GPR120 is an omega-3 fatty acid receptor mediating potent anti-inflammatory and insulin-sensitizing effects.
Cell 142, 687-98 (2010).
11. Hallahan, B., hibbeln, J.R., Davis, J.M. & Garland, M.R. Omega-3 fatty acid supplementation in patients with recurrent self harm.
190, 118-122 (2007).
12. Stoll, A.L., Severus, W.E. & Freeman, M.P. Omega 3 Fatty Acids in biopolar disorder. 56, 407-412 (1999).
13. Su, K.P., Huang, S.Y., Chiu, C.C. & Shen, W.W. Omega-3 fatty acids in major depressive disorder. A preliminary double-blind,
placebo-controlled trial. Eur Neuropsychopharmacol 13, 267-71 (2003).
14. Zanarini, M.C. & Frankenburg, F.R. omega-3 Fatty acid treatment of women with borderline personality disorder: a double-blind,
placebo-controlled pilot study. Am J Psychiatry 160, 167-9 (2003).
15. Mitchell, E.A., Aman, M.G., Turbott, S.H. & Manku, M. Clinical characteristics and serum essential fatty acid levels in hyperactive
children. Clin Pediatr (Phila) 26, 406-11 (1987).
16. Stevens, L.J. et al. Essential fatty acid metabolism in boys with attention-deficit hyperactivity disorder. Am J Clin Nutr 62, 761-8
(1995).
17. Chen, J.R., Hsu, S.F., Hsu, C.D., Hwang, L.H. & Yang, S.C. Dietary patterns and blood fatty acid composition in children with
attention-deficit hyperactivity disorder in Taiwan. J Nutr Biochem 15, 467-72 (2004).
18. Young, G.S., Maharaj, N.J. & Conquer, J.A. Blood phospholipid fatty acid analysis of adults with and without attention deficit/
hyperactivity disorder. Lipids 39, 117-23 (2004).
19. Richardson, A.J. Long-chain polyunsaturated fatty acids in childhood developmental and psychiatric disorders. Lipids 39, 121522 (2004).
20. Hibbeln, J.R., Ferguson, T.A. & Blasbalg, T.L. Omega-3 fatty acid deficiencies in neurodevelopment, aggression and autonomic
dysregulation: opportunities for intervention. Int Rev Psychiatry 18, 107-18 (2006).
21. Vancassel, S. et al. Plasma fatty acid levels in autistic children. Prostaglandins Leukot Essent Fatty Acids 65, 1-7 (2001).
22. Morley, J.E. & Banks, W.A. Lipids and cognition. J Alzheimers Dis 20, 737-47 (2010).
23. McCann, J.C. & Ames, B.N. Is docosahexaenoic acid, an n-3 long-chain polyunsaturated fatty acid, required for development of
normal brain function? An overview of evidence from cognitive and behavioral tests in humans and animals. Am J Clin Nutr 82,
281-295 (2005).
24. Vaisman, N. et al. Correlation between changes in blood fatty acid composition and visual sustained attention performance in
children with inattention: effect of dietary n-3 fatty acids containing phospholipids. Am J Clin Nutr 87, 1170-80 (2008).
25. Fontani, G. et al. Cognitive and physiological effects of Omega-3 polyunsaturated fatty acid supplementation in healthy subjects.
Eur J Clin Invest 35, 691-9 (2005).
26. Maggioni, M. et al. Effects of phosphatidylserine therapy in geriatric patients with depressive disorders. Acta Psychiatr Scand
81, 265-70 (1990).
27. Vakhapova, V., Cohen, T., Richter, R., Herzog, H. & Korczyn, A. Phosphatidylserine Containing –3 Fatty Acids May Improve
Memory Abilities in Non-Demented Elderly with Memory Complaints: A Double-Blind Placebo-Controlled Trial. Dement Geriatr
Cogn Disord 29, 467–474 (2010).
28. Grimstad, T. et al. Salmon diet in patients with active ulcerative colitis reduced the simple clinical colitis activity index and
increased the anti-inflammatory fatty acid index - a pilot study. Scand J Clin Lab Invest (2010).
29. Hayashi, H. et al. Beneficial effect of salmon roe phosphatidylcholine in chronic liver disease. Curr Med Res Opin 15, 177-84
(1999).
14
The Clinical and Nutritional Benefits of Krill Oil
30. Harzer, G., Haug, M., Dieterich, I. & Gentner, P.R. Changing patterns of human milk lipids in the course of the lactation and
during the day. Am J Clin Nutr 37, 612-21 (1983).
31. Koletzko, B. et al. Global standard for the composition of infant formula: recommendations of an ESPGHAN coordinated
international expert group. J Pediatr Gastroenterol Nutr 41, 584-99 (2005).
32. Parker, G. et al. Omega-3 fatty acids and mood disorders. Am J Psychiatry 163, 969-78 (2006).
33. Leifert, W.R., McMurchie, E.J. & Saint, D.A. Inhibition of cardiac sodium currents in adult rat myocytes by n-3 polyunsaturated
fatty acids. J Physiol 520 Pt 3, 671-9 (1999).
34. Hashimoto, M., Hossain, S., Yamasaki, H., Yazawa, K. & Masumura, S. Effects of eicosapentaenoic acid and docosahexaenoic
acid on plasma membrane fluidity of aortic endothelial cells. LIPIDS 34, 1297-304 (1999).
35. Philbrick, D.J., Mahadevappa, V.G., Ackman, R.G. & Holub, B.J. Ingestion of fish oil or a derived n-3 fatty acid concentrate
containing eicosapentaenoic acid (EPA) affects fatty acid compositions of individual phospholipids of rat brain, sciatic nerve
and retina. J Nutr 117, 1663-70 (1987).
36. Sijben, J. & Calder, P. Differential immunomodulation with long-chain n-3 PUFA in health and chronic disease. Proceedings of
the Nutrition Society 66, 237-259 (2007).
37. Kidd, P.M. Integrated brain restoration after ischemic stroke--medical management, risk factors, nutrients, and other
interventions for managing inflammation and enhancing brain plasticity. Altern Med Rev 14, 14-35 (2009).
38. Deutsch, L. Evaluation of the effect of Neptune Krill Oil on chronic inflammation and arthritic symptoms. J Am Coll Nutr 26,
39-48 (2007).
39. Ierna, M., Kerr, A., Scales, H., Berge, K. & Griinari, M. Supplementation of diet with krill oil protects against experimental
rheumatoid arthritis. BMC Musculoskelet Disord 11, 136 (2010).
40. Sampalis, F. et al. Evaluation of the effects of Neptune Krill Oil on the management of premenstrual syndrome and dysmenorrhea.
Altern Med Rev 8, 171-9 (2003).
41. Batetta, B. et al. Endocannabinoids may mediate the ability of (n-3) fatty acids to reduce ectopic fat and inflammatory mediators
in obese Zucker rats. J Nutr 139, 1495-501 (2009).
42. Lee, J.H., O'Keefe, J.H., Lavie, C.J., Marchioli, R. & Harris, W.S. Omega3 fatty acids for cardioprotection. Mayo Clin Proc 83,
324-32 (2008).
43. Bunea, R., El Farrah, K. & Deutsch, L. Evaluation of the effects of Neptune Krill Oil on the clinical course of hyperlipidemia.
Altern Med Rev 9, 420-8 (2004).
44. Tandy, S. et al. Dietary krill oil supplementation reduces hepatic steatosis, glycemia, and hypercholesterolemia in high-fat-fed
mice. J Agric Food Chem 57, 9339-45 (2009).
45. Zhu, J.J., Shi, J.H., Qian, W.B., Cai, Z.Z. & Li, D. Effects of krill oil on serum lipids of hyperlipidemic rats and human SW480 cells.
Lipids Health Dis 7, 30 (2008).
46. Massrieh, W. Health Benefits of Omega-3 Fatty Acids from Neptune Krill Oil. Lipid Technology 20 (2008).
47. Lieber, C.S., Leo, M.A., Mak, K.M., DeCarli, L.M. & Sato, S. Choline fails to prevent liver fibrosis in ethanol-fed baboons but
causes toxicity. Hepatology 5, 561-72 (1985).
48. Lieber, C.S., DeCarli, L.M., Mak, K.M., Kim, C.I. & Leo, M.A. Attenuation of alcohol-induced hepatic fibrosis by polyunsaturated
lecithin. Hepatology 12, 1390-8 (1990).
49. Lieber, C.S. et al. Phosphatidylcholine protects against fibrosis and cirrhosis in the baboon. Gastroenterology 106, 152-9
(1994).
50. Baixas-Nogueras, S., Bover-Cid, S., Vidal-Carou, M.C., Veciana-Nogues, M.T. & Marine-Font, A. Trimethylamine and total volatile
basic nitrogen determination by flow injection/gas diffusion in Mediterranean hake (Merluccius merluccius). J Agric Food
Chem 49, 1681-6 (2001).
51. Ruggiero-Lopez, D. et al. Comparative effects of dietary corn, fish and Krill oils on intestinal glycosylation. Biochem Mol Biol Int
33, 1001-10 (1994).
The Clinical and Nutritional Benefits of Krill Oil 15
Headquarter
Enzymotec USA , Inc.
Sagi 2000 Industrial Park
P.O. Box 6
Migdal HaEmeq 23106
ISRAEL
Tel: + 972 74 717 7177
Fax: + 972 74 717 7001
info@enzymotec.com
A subsidiary of Enzymotec Ltd.
55 Madison Avenue, Suite 400
Morristown ,NJ 07960
Tel: + 973 912 9400
Fax: + 973 912 9500
USA@enzymotec.com
Websites
www.enzymotec.com
www.enzybioactive.com