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Enzymotec Ltd. is a nutritional ingredients and medical foods company. The Company"s technologies, research expertise and clinical validation process enables it to develop solutions across a range of products. The Company operates in two segments: Nutrition segment and VAYA Pharma segment. Both of the Company"s segments offer a range of products that leverage its lipid-related offerings. Its product suite addresses the entire human life-cycle, from infancy to old age, and comprises ingredients in products ranging from infant formula to nutritional supplements, as well as branded medical foods, sold only under a doctor"s supervision. It markets its product portfolio to established global consumer companies and physicians and target large and growing consumer health and wellness markets. The Company"s clinically-validated products include bio-functional lipid-based compounds designed to address dietary needs, medical disorders and common diseases.

All participants were familiar with the commercial weight loss products and supplements commonly sold in the pharmacy. Almost all of them would recommend these products to their clients, as they believed that the weight loss products and supplements could help their clients to achieve weight loss. Nevertheless, some participants raised potential issues surrounding the sales of these products, including the weight loss that could be of short-term due to loss of water instead of fats, as well as habit-forming potential associated with some commercial products containing laxatives. Other related problems such as overclaims of product effectiveness were also cited.

Participants were unanimous of the opinion that the provision of education and advice was a vital part of their role in weight management. Apart from clients who requested WMS themselves, participants also reported routinely addressing weight issues among clients with non-communicable diseases, especially those with cardiovascular disease, diabetes, hypertension, and osteoarthritis. While all participants would like to engage in modifying the physical activity and dietary behaviors of their overweight or obese clients, some would also create awareness among their clients regarding the health risks associated with overweight or obesity as well as the importance and benefits of losing weight. Almost all participants believed they play a part in promoting weight loss products or supplements to complement their weight management advices.

Participants also described the need for training in weight management. More than half of the participants had completed some previous training on how to manage overweight or obese clients. All participants who had previous training on weight management agreed that this sort of training was effective, and improved their confidence in the management of overweight or obese clients. They opined that the weight management training not only refreshed their previously acquired knowledge and skills, but also provided some new insights on weight management, for instance, on the efficacy of drug therapy for weight loss and the latest commercial weight loss products and supplements in the market. Participants who had never attended any training on weight management also considered such training to be beneficial in expanding knowledge on this topic.

In terms of training needs and preferences, participants desired to have a multi-day training program to adequately cover related aspects on weight management. They would like the training session to be conducted more than once a year to share how well they have integrated the knowledge and skills learnt during previous sessions into their daily practices. Training topics deemed necessary by the participants included cognitive behavioral therapy, exercise, and dietary counseling, particularly calorie counting, as well as communication skills to initiate potentially sensitive weight topics with clients, convince overweight or obese clients to lose weight, and build rapport with clients. Most participants would like to have experience sharing sessions or case studies as part of the weight management training, especially those that involved actual clients. In addition, some participants would like the involvement of other health care professionals in weight management training, either as participants during group discussions, or as providers of the training. A few participants would like more exposure on commercial weight loss products or supplements.

Community pharmacists in our study would carefully screen for the suitability for the initiation of drug therapy, in which they would reserve for clients who have failed other weight management interventions, and thus was in accordance with drug manufacturers" recommendations. Nevertheless, it is noteworthy to observe that almost all community pharmacists in our study engaged in the sales of weight loss products or supplements. To date, evidence to support the efficacy and most importantly, the safety of over-the-counter weight loss products and supplements is still limited (17, 18). Moreover, within the literature, community pharmacists have been subjected to close scrutiny, where criticism from consumers emerged in the social media with regards to the perceived conflicts of interest of community pharmacists selling weight loss products to increase their net revenue (5, 19). Consumers opined that community pharmacists" advice on weight management may be biased in order to profit from selling a product (19, 20). While it is understandable that community pharmacists need to maintain a viable business, and therefore stand to gain from the sales of weight loss products or supplements, this role conflict must be addressed, and a balance achieved so that pharmacists do not allow business objectives to undermine their positive public professional image.

In general, community pharmacists in this study believed that they can positively contribute to the area of weight management. They cited multiple roles that they could play in weight management interventions and services, including provision of education and advice, selection of weight loss products and supplements, monitoring, and providing referrals to other healthcare professionals. However, practical barriers such as the lack of space, time, and reimbursement, were acknowledged. These barriers would need to be addressed to strengthen and improve community pharmacists" roles and contributions in WMS. This may include reviewing current training programs in weight management for pharmacists, and appropriate remuneration models for community pharmacy-based WMS.

17. Pittler MH, Ernst E. Dietary supplements for body-weight reduction: a systematic review. Am J Clin Nutr. (2004) 79:529–36. doi: 10.1093/ajcn/79.4.529

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Epinephelus fuscoguttatus; amino acid transporters; antioxidant activity; aquaculture; catalase; dietary supplements; fish meal; growth performance; hybrids; hydrolysis; intestinal microorganisms; intestines; liver; muscles; peptides; species diversity; swine; villi; weight gain

Aeromonas hydrophila; Ctenopharyngodon idella; alginates; antioxidant activity; antioxidants; apoptosis; aquaculture; aquaculture industry; carboxylic ester hydrolases; catalase; dietary supplements; dose response; fatty acid metabolism; fish; gene expression regulation; glutathione peroxidase; growth performance; histopathology; kidneys; liver; malondialdehyde; oligosaccharides; protective effect; superoxide dismutase; transcriptomics; triacylglycerols

Pangasianodon hypophthalmus; amino acids; ammonia; dietary supplements; erythrocytes; feed conversion; fish culture; food intake; growth performance; hematocrit; hemoglobin; leukocyte count; metabolism; nitrates; nitrites; pepsin; probiotics; specific growth rate; water quality; weight gain

Morus (Moraceae); Trachinotus ovatus; Vibrio harveyi; animal growth; aspartate transaminase; blood proteins; body weight; carboxylic ester hydrolases; digestion; disease resistance; feed additives; feed supplements; fish; fish feeding; fish feeds; growth performance; hepatopancreas; high density lipoprotein; immune response; intestines; juveniles; leaves; lipid content; lipid metabolism; mulberries; multienzyme complexes; muscles; protein content; stomach; survival rate; triacylglycerols; trypsin

antibiotics; arable soils; bioactive compounds; curcumin; dietary supplements; disease control; farmed fish; fish feeds; fish nutrition; fish production; fucoidan; growth performance; infectious diseases; livestock; macroalgae; nanoparticles; therapeutics; virulent strains

... Extreme climatic events affect all living organisms, including fish. This study evaluated growth, hematological, immune-antioxidant, and molecular stress responses to understand the acclimatization ability of European seabass, Dicentrarchus labrax fed on four different dietary supplements with subsequent exposure to an extreme ambient warm (32 ᵒC) event. Fish were fed on diets supplemented with vi ...

Aeromonas sobria; Oreochromis niloticus; animal growth; aquaculture; blood serum; body weight; chitosan; dietary supplements; feed intake; fish; growth performance; immune response; interleukin-10; lipid peroxidation; liver; lysozyme; nanocomposites; nitric oxide; somatotropin; specific growth rate; vitamin E; weight gain

Litopenaeus vannamei; antioxidants; aquaculture; biofloc technology; catalase; chitosan; dietary supplements; food intake; glutathione; glutathione transferase; growth performance; hemocytes; hepatopancreas; juveniles; lipid peroxidation; protective effect; salinity; salt stress; shrimp; stress tolerance

Bacillus subtilis; Bifidobacterium; Cynoglossus semilaevis; Lactobacillus; amylases; analysis of variance; antioxidant activity; aquaculture industry; blood serum; carboxylic ester hydrolases; catalase; dietary supplements; digestive enzymes; enzyme activity; feed additives; feed conversion; fish; foregut; genes; glutathione peroxidase; growth performance; high-throughput nucleotide sequencing; immunity; immunostimulants; intestinal microorganisms; intestines; kidneys; liver; lysozyme; malondialdehyde; microbial communities; midgut; probiotics; proteinases; ribosomal RNA; specific growth rate; spleen; superoxide dismutase; synergism; weight gain

Oreochromis niloticus; ammonia; amylases; antioxidant activity; body weight; carboxylic ester hydrolases; catalase; cortisol; dietary supplements; digestive enzymes; enzyme activity; essential oils; feed conversion; fish; genes; glucose; glutathione peroxidase; growth performance; immunity; interleukin-1beta; interleukin-8; lysozyme; malondialdehyde; menthol; messenger RNA; regression analysis; superoxide dismutase; tumor necrosis factor-alpha; weight gain

Aeromonas; Pangasianodon hypophthalmus; albumins; aquaculture; arsenic; bioaccumulation; blood glucose; catalase; climate change; dietary supplements; feed conversion; fish; glucose; glutathione peroxidase; glutathione transferase; growth performance; histopathology; immunity; immunoglobulins; liver; myeloperoxidase; pollution; protective effect; protein content; protein efficiency ratio; respiratory burst; riboflavin; specific growth rate; superoxide dismutase; temperature; weight gain

Oreochromis niloticus; absorption; amylases; aquaculture; aquaculture industry; blood serum; body weight; carboxylic ester hydrolases; digestive enzymes; feed conversion; feed intake; feed supplements; fish; ghrelin; growth performance; health status; intestines; liver; proteinases; satiety; sodium butyrate; specific growth rate; stomach; weight gain

B-lymphocytes; Micropterus salmoides; adverse effects; antioxidant activity; apolipoprotein B; apoptosis; chenodeoxycholic acid; cholesterol; dietary fat; dietary supplements; digestion; fish; gene expression; genes; glutathione peroxidase; growth performance; high fat diet; intestinal absorption; intestines; juveniles; lipid content; lipid metabolism; liver; malondialdehyde; messenger RNA; muscles; protein content; superoxide dismutase; triacylglycerols; weight gain

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Oreochromis niloticus; aquaculture; carnitine; catalase; dietary supplements; enzyme activity; fish; growth performance; hematology; histology; lipid content; liver; muscles; satiety; specific growth rate; triacylglycerols; weight gain

Acanthopagrus schlegelii schlegelii; Lactobacillus plantarum; antioxidant activity; aquaculture; blood proteins; blood serum; complement; dietary supplements; feed conversion; fish feeds; glutathione peroxidase; growth performance; intestines; liver; lysozyme; probiotics; protein content; superoxide dismutase

B-lymphocytes; Litopenaeus vannamei; Sargassum; Vibrio; alanine transaminase; albumins; alkaline phosphatase; aspartate transaminase; biomass; cholesterol; feed supplements; growth performance; hematologic tests; hemocytes; hepatopancreas; histology; intestinal microorganisms; intestines; phosphorus; polyethylene; protein content; shrimp; tanks; triacylglycerols

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Lithobates catesbeianus; betaine; bullfrogs; dietary supplements; energy metabolism; euthanasia; experimental diets; glycolysis; growth performance; homocysteine; meat quality; messenger RNA; methionine; methyltransferases; muscles; pH; protein deposition; slaughter; soybeans; weight gain

Ctenopharyngodon idella; aquaculture; aspartic acid; collagen; dietary supplements; docosahexaenoic acid; eicosapentaenoic acid; feed additives; fish; flavor; glutamic acid; growth performance; health services; meat quality; muscles; nutritive value; pH; polyphenols; regression analysis; tea; water holding capacity; weight gain

Gracilaria; Photobacterium damselae subsp. piscicida; Sparus aurata; algae; antibiotics; antioxidants; aquaculture; aquaculture feeds; dietary supplements; disease outbreaks; drug therapy; erythrocytes; fish; growth performance; health status; immunostimulants; industry; intestines; lysozyme; pathogens; protective effect; rearing

Oreochromis niloticus; Streptococcus agalactiae; biofloc technology; blood serum; dietary supplements; disease resistance; feed conversion; fish culture; growth performance; immune response; immunostimulants; mucus; specific growth rate

Litopenaeus vannamei; alanine transaminase; alkaline phosphatase; analysis of covariance; aquaculture; bacterial communities; biofilters; biofloc technology; cholesterol; data collection; dietary supplements; gamma-glutamyltransferase; growth performance; hemocytes; immune system; polypropylenes; shrimp; weight gain

Acidovorax; Aeromonas; Lactobacillus helveticus; Misgurnus anguillicaudatus; Shewanella; antioxidant activity; aquaculture; dietary supplements; digestive enzymes; disease resistance; enzyme activity; growth performance; innate immunity; intestinal microorganisms; intestines; species richness

Cyprinus carpio; Elaeagnus angustifolia; alanine transaminase; animal growth; antioxidants; aquaculture; aspartate transaminase; carp; catalase; dietary supplements; feed formulation; globulins; growth performance; hematocrit; hemoglobin; hepatotoxicity; immunostimulants; leaf extracts; leukocyte count; lysozyme; malondialdehyde; monocytes; neutrophils; oxidative stress; protein content; serum albumin; superoxide dismutase; survival rate

Bacteroidetes; Firmicutes; Portunus trituberculatus; Saccharomonospora; Thermobifida; Vibrio alginolyticus; antibiotics; antioxidant activity; aquaculture; community structure; crabs; dietary supplements; growth performance; hepatopancreas; innate immunity; intestinal microorganisms; intestines; specific growth rate; survival rate; weight gain

Cyprinus carpio; antioxidant activity; antioxidant enzymes; aquaculture; blood glucose; blood serum; carp; catalase; cholesterol; condition factor; crude protein; dose response; enzyme activity; feed supplements; fillets; fish production; food conversion; glucose; glutathione peroxidase; grape seeds; growth performance; liver; proanthocyanidins; proximate composition; regression analysis; specific growth rate; superoxide dismutase; triacylglycerols; weight gain