Cardiovascular Health Blood Sugar Body Composition Program Guide

Easy-to-Follow Program This scientifically designed program includes targeted nutrition, a healthy eating plan, simple exercise, and basic recommendations for stress management. If that sounds easy, that s because it is. After just a few weeks, most people notice improved energy as they work toward better health. Targeted Nutrition Your healthcare provider will recommend a Metagenics medical food designed to support your specific health conditions, along with other nutritional supplements. Eating Plan Professional Supervision A modified Mediterranean diet with a low glycemic load may look like a mouthful, but it s actually very simple. Just follow the recommendations. If you have a condition related to cardiovascular health, blood sugar, and body composition, you re at a critical crossroads where you can take control of your health. By taking action now, you may start to feel better and enjoy more years of active living to do the things you enjoy most. Moderate Exercise Just 30 minutes of brisk walking 5 days a week is a great start. Add resistance training to build muscle. And stretching helps improve flexibility and aid muscle recovery. Stress Management Practicing stress management techniques helps curb unhealthy habits that contribute to illness. Schedule time for at least 1 stress relief activity each day. Your success can improve dramatically when you follow the guidance of your healthcare provider. Program adjustments may be made to better suit your individual health needs.

Targeted Nutrition Daily Program Tracking This program includes a medical food from the UltraMeal or GlycemX family of products. Along with a specially designed diet, the medical foods outlined below are scientifically designed to provide advanced nutritional support. The chart below provides an easy way to track your food servings, exercise, and stress management activities each day. Simply make a copy (or create your own chart) at the beginning of the week. Follow the recommendations as closely as possible. Nutritional Support for the Management of Conditions Associated with: (2 servings) Day 1 Day 2 Day 3 Day 4 Day 5 Day 6 Day 7 Metabolic Syndrome UltraMeal UltraMeal Bar Legumes (1-2 servings*) Metabolic Syndrome & Cardiovascular Disease Hypercholesterolemia UltraMeal PLUS UltraMeal PLUS 360 UltraMeal PLUS 360 RICE Category 1 (3-4 minimum; unlimited) Type 2 Diabetes UltraGlycemX GlycemX 360 Category 2 (1-2 servings*) Your healthcare provider may also recommend targeted nutritional supplements based on your individual health needs. Eating Plan This food plan was based on healthier versions of diets found in countries bordering the Mediterranean Sea. People in this region with healthy lifestyle habits who eat a diet rich in fruits, vegetables, whole grains, healthy fats (like olive oil), and fish are among the healthiest people in the world. Concentrated Protein (2-3 servings*) Oils/Fats (4-6 servings*) Nuts & Seeds (1-2 servings*) Fruits (2-3 servings*) Dairy/Dairy Alt. (0-1 serving*) Whole Grains (1 serving) Refer to the Food Choices for specific food recommendations and serving sizes. This generous list includes foods high in taste with a lower glycemic index (GI) or glycemic load (GL). These foods produce a lower glucose and insulin response to stabilize blood sugar, which also helps curb hunger and cravings. It s unlikely that these foods (in the serving sizes suggested) will be a trigger to overeating. And most patients say it s much more food than they re normally used to eating. Exercise (5 days/week) Stress Management (1+ activities daily) *Ask your healthcare provider if an additional serving of these food categories is appropriate for you. Minimum servings represent approximately 1300 calories per day. Maximum servings represent approximately 1600-2000 calories per day. = 1300+ calorie/day plan = 1600+ calorie/day plan = 1800+ calorie/day plan = 2000 calorie/day plan

Food Choices For best results, select foods from this approved list paying careful attention to the allowed serving sizes. Your healthcare provider may make additional dietary suggestions or limitations. Legumes (vegetable protein) Beans: black, cannellini, garbanzo/chickpea, fat-free refried, kidney, lima, mung, navy, pinto (½ cup) Beans: green soy/edamame (¹ ³ cup) Hummus (¼ cup) Lentils: red & green (½ cup) Peas: sweet green (¾ cup) or yellow & green split or snow (½ cup) Soups: bean, pea (¾ cup) Category 1 Serving Size = ½-1 cup Fresh or canned juices made from these vegetables are also allowed Asparagus Artichokes Bamboo shoots Bean sprouts Broccoli, broccoflower Brussels sprouts Cabbage Cauliflower Celery Chives, onion, leeks, scallions Cucumber/Dill pickles Cabbage (all types) Eggplant Garlic Green beans Greens: bok choy, escarole, Swiss chard, kale, collard greens, spinach, dandelion, mustard greens, beet greens Lettuce/Mixed greens: romaine, red & green leaf, endive, spinach, arugula, radicchio, watercress, chicory Mushrooms Okra Peppers Radishes Tomatoes Water chestnuts (5 whole) Squash: zucchini, yellow, summer, spaghetti squash Salsa (sugar-free) Sea vegetables (kelp, etc.) Category 2 Serving size = ½ cup, or as indicated Beets Winter squash: acorn, butternut Sweet potatoes or yams, (½ medium baked) Carrots (½ cup cooked or 2 med. raw or 12 baby carrots) Potato: new potatoes, such as red or Yukon Gold (½ med.) Rutabaga, parsnips, turnips Concentrated Protein Beef: lean, organic, free-range (e.g., flank steak) (3 oz.) Cheese, cottage: lowfat or nonfat (¾ cup) Cheese, mozzarella: part skim or nonfat (2 oz. or ½ cup shredded) Cheese, Parmesan: fresh grated (6 Tbsp.) Cheese, ricotta: part skim or nonfat (½ cup) Eggs (2 whole or 3 whites + 1 whole) Fish & shellfish: all varieties (3 oz.) Game meats: venison, elk, buffalo, etc. (3 oz.) Lamb: lean leg Poultry, all types: white meat only, dark meat turkey okay (3 oz.) Soy or veggie burger (4 oz.) Tempeh (3 oz. or ½ cup) Tofu, unsweetened: fresh (8 oz. or 1 cup) or baked (3.5 oz.) Oils/Fats Avocado (¹ 8 ) Coconut milk: light (3 Tbsp.) or regular (1.5 Tbsp.) Oils (all cold-pressed): canola, coconut, flaxseed oil (refrigerate), grapeseed, extra virgin olive (1 tsp.) Mayonnaise made with above oils, no sugars added (1 tsp.) Olives (8-10 med.) Vegetable oil spread: organic (1.5 tsp.) Nuts & Seeds Almonds or hazelnuts, (10-12 whole nuts) Coconut, unsweetened grated (3 Tbsp.) Walnut or pecan halves, (7-8) Peanuts (18 nuts or 2 Tbsp.) Pine nuts or pistachios (2 Tbsp.) Sunflower, pumpkin, or sesame seeds, (2 Tbsp.) Nut butter (1 Tbsp. made from above nuts) Fruits Apple (1 med.) Applesauce, unsweetened (¾ cup) Apricot (3 med.) Berries: blackberries, blueberries (1 cup); raspberries, strawberries (1.5 cups) Cantaloupe (¼) Cherries (15) Figs: fresh (2) Grapes (15) Grapefruit (1 whole) Honeydew melon (¼ small) Kiwi (2) Mango (½ med.) Nectarine (2 small) Orange (1 large) Peach (2 small, 1 med.) Persimmon (½) Pear (1 med.) Plum (2 small) Tangerine (2 small) Watermelon (2 cups) Dairy & Dairy Alternatives Serving size = 6 oz. or ¾ cup Buttermilk: 1%, 2%, or nonfat Cheese, feta: nonfat Milk: 1% or nonfat Milk alternatives, unsweetened: soy, almond, hazelnut, or hemp Sour cream: nonfat (6 Tbsp.) Yogurt, plain unsweetened: lowfat, fat-free, regular, goat milk, or Greek Yogurt, soy: plain unsweetened (4 oz.) Whole Grains Breads: 100% whole grain or 100% rye (1 slice) Buckwheat, sorghum, teff, barley, or quinoa Bulgur (or cracked wheat) (² 3 cup cooked) Crackers: whole grain rye, lite rye, sesame rye, rye crispbread, or sesame wheat (3 crackers) Millet (¹ ³ cup cooked) Oatmeal: unsweetened (¾ cup cooked) Oats: steel cut or whole (¹ ³ cup uncooked) Pasta: whole wheat, spelt, farro, or kamut Pita: whole wheat (½) Rice: brown or wild Tortilla: whole wheat (½) or low carbohydrate (1 large or 2 small) Beverages Coffee: decaffeinated Tea: decaffeinated or herbal Vegetable juices: unsweetened Water: seltzer, plain, flavored Seasonings & Sweeteners Serving size = unlimited, or as indicated Carob Cinnamon Flavored extracts: almond, coconut, vanilla, etc. Lemon Lime Mustard: dry or liquid with no sugar/honey Onions Peppers Tamari soy sauce Vinegar All other herbs/spices Agave syrup (1 tsp. daily) Stevia

Sample Menu & Recipes This delicious menu and sample recipes was designed for multiple (or family) servings of about 1600 calories for the day. Recipes that are vegetarian (V) or free of gluten (GF) and/or dairy (DF) have been designated as such. Breakfast 1 medium peach or large orange 1 Hardboiled Egg Hard-Boiled Egg (serving: ½ protein) (serves 1) (GF, DF) Lay egg in saucepan and cover with cold water. Bring water to a boil. Reduce heat and simmer for approximately 10 minutes. Place egg into cold water and leave until completely cooled. Basic Recipe Basic Recipe (serving: 1 medical food) (GF, DF) 8-10 oz. purified water Add ice if desired (and reduce water accordingly). Shake or blend the product until mixed. Drink immediately. Do not store. Lunch 1 serving Turkey Chili Spinach salad: 1-2 cups chopped spinach; 1 hardboiled egg, sliced; ¼ cup each: bean sprouts, chopped red pepper, and cherry tomatoes; 1 grated carrot; 2 Tbsp. chopped walnuts or pumpkin seeds; 1 Tbsp. vinaigrette dressing Turkey Chili (servings: 1 protein, 1 legume, 1 oil, 1 cat. 1 veg.) (serves 8) (GF, DF) 2 lb. ground raw turkey 2 (16-oz.) cans tomatoes (undrained), diced 2 (15-oz.) cans red kidney beans, drained 8-oz. can tomato sauce 1 medium onion, chopped ¼ cup dry red wine (optional) 1 tsp. dried parsley flakes ¾ tsp. dried basil, crushed ¾ tsp. dried oregano, crushed ½ tsp. black pepper ½ tsp. ground cinnamon 1 clove garlic, minced ¼-½ tsp. ground red pepper 1-2 Tbsp. chili powder 1 bay leaf In a 4-quart Dutch oven, cook the turkey until it is no longer pink. Drain off fat. Stir in remaining ingredients. Simmer uncovered for 45 minutes, stirring occasionally. Remove bay leaf before serving. Peach Melba (serving: 1 fruit, 1 medical food) (serves 1) (GF, DF) Peach Melba recipe 2 scoops vanilla- or originalflavored medical food 8-10 oz. water ½ fresh peach ½ cup fresh or frozen raspberries 2-4 ice cubes (omit if using frozen fruit) Dinner ¾ cup Creamy Cold Tomato Soup 3 oz. sautéed halibut 1 serving brown rice or barley with vegetables: 1 cup steamed broccoli; ¼ cup each: red or yellow peppers, mushrooms, and onions; stir-fried in 1 tsp. coconut or olive oil; season to taste Creamy Cold Tomato Soup (servings: ¼ dairy, 2 cat. 1 veg.) (serves 5) (V, GF) 1 cucumber, chopped 1 scallion, chopped 1 clove garlic 4 cups tomato juice 1 green pepper, chopped ½ tsp. dill weed 1 cup plain yogurt, nonfat or lowfat Sliced mushrooms OR tomato chunks for garnish Pepper to taste Combine all ingredients (except yogurt) in small amounts in blender and blend until smooth. Add pepper to taste. Whisk in yogurt. Chill several hours before serving and garnish as desired with mushrooms or tomatoes. Snack ¼ cup Hummus with 2 whole carrots, raw celery, and cucumber sticks Hummus (servings: 1 legume, ½ nuts & seeds, ¾ oil ) (serves 8) (V, GF, DF) 16-oz. can garbanzo beans (chickpeas) or 2 cups home-cooked ½ cup lemon juice 2 Tbsp. olive oil or flaxseed oil 2 cloves of garlic, crushed Paprika, sea salt, and fresh parsley to taste 1 tsp. cumin ¼ cup tahini (sesame butter) Drain beans and reserve liquid. Blend beans with remaining ingredients. If mixture seems dry, add some of the reserved liquid slowly to the blender to make a smooth paste. Garnish with a sprinkle of paprika and parsley.

Moderate Exercise Tips & Helpful Information Before beginning an exercise program, it is important to have a physical exam and get your healthcare provider s approval. If you have been relatively inactive, consider starting with 30 minutes of brisk walking 5 days a week. It is best to begin your walking program on level pathways. When you feel ready, try to walk up some hills to help your body burn calories faster. Over time, increase your pace and distance, but only if you feel comfortable doing so. To increase muscle mass and tone your body, consider incorporating a monitored strength-training program. Don t forget to gently stretch before and after any exercise activity to improve flexibility and aid muscle recovery. Stress Management You don t have to make big changes in your life to reduce your stress just lessen the impact that stressful occurrences can have on you. These quick and simple tips make it easy for you to change your response to stress and help you live a healthier life. Take the time for at least one of these activities each day. Breathe from your belly Take a short walk Burst into exercise Listen to music Dance or sing Take a mental break Have a good laugh Write in your journal Take a power nap Eating & Snacking Don t skip meals. It increases hunger and you may eat too much later. And it deprives your body of nutrients that ensure program success. Break the fast. Skipping breakfast signals a fasting mode to store fat and burn muscle for energy. Eating breakfast reduces risk to obesity and metabolic syndrome by 35% to 50%. But breakfasts of high-gi foods (donuts, bagels, sugary cereals) increase risk to heart disease and type 2 diabetes. Choose low-gi foods instead. Eat slowly. It takes 20 minutes for your stomach to send the full message to your brain. Eating is a pleasant experience, so savor it! Dining Out Snack first. Consume the medical food beverage (or bar) before you go out, as you may be too full later. Consuming a medical food or snack beforehand also helps prevent overeating. Control portions. Order menu items that closely resemble the meal plan, and ask for a doggie bag before you eat. Leave an adequate portion to enjoy immediately and take the rest home. Shopping Go organic. Look for foods (fresh, canned, frozen) and seasonings that are USDAcertified organic. Roam wild & free. Select wild caught salmon over farm-raised (artificial colors/ chemicals). Choose free-range and hormone-free chicken, turkey, and beef. Menu Planning Plan ahead. Prepare a week s menu and buy all the foods you ll need. Short cuts. When you get home, rinse and cut up raw vegetables for quick salads and snacks. Travel & Work Get packing. Choose portable, healthy snacks for work or short travel. Premeasure servings of the medical food powder into plastic sandwich bags. Shake it up. Buy a small battery-operated mixer or shaker cup with lid for times when a blender isn t available. Check the bar. Ask if a medical food in bar form is available for a convenient travel option.