Frequently Asked Health Questions

What is FirstLine Therapy?

It's a comprehensive therapeutic lifestyle changes (TLC) program that provides patients with the necessary knowledge to make healthy lifestyle choices to manage or reverse chronic illness and improve health. TLC is the first, and arguably the most important, therapy health care providers can use to treat many chronic health problems.

How long do I need to remain on this program?

That really depends on your health goals. Staying on the program for a minimum of 4 weeks is suggested before making any further decisions. Working together, you and your health care practitioner at CCWM may decide to continue the program as is, or in some modified version for a longer period of time.

Will I be hungry on this program?

Depending on what weight goals you and your health care provider at CCWM decide upon, some caloric restriction may be part of your program. There are two different calorie programs in the booklet: a 1300- and a 1600-calorie program. Your health provider may also decide to place you on the program without any calorie restrictions. The dietary program generally takes some adjustment, and you may experience some hunger during this time. However, most individuals adapt to the diet within a week. Even on the lower-calorie program, many people experience no increase in hunger, possibly because the nutritional support helps in balancing insulin and glucose response. If you continue to experience extreme hunger, discuss possible adjustments in your program with your health care provider at CCWM.

What is the "glycemic index"? How is it different from the "glycemic load"?

The glycemic index (GI) is a ranking of foods on a scale from 0 to 100 according to the extent to which they raise blood sugar levels after eating. Glucose is given a relative number of 100 to provide a baseline to which all others can be compared. For example, an apple has a GI of 38 which is less than half that of glucose, but higher than soybeans (which have a GI of 18). Foods with a GI of 55 or less are considered to be low—glycemic—index foods.

The GI considers the quality of a carbohydrate. The glycemic load (GL) carries that a step further and considers the quantity of carbohydrate—namely its fiber content and/or portion size. Fiber is a "good" component of carbohydrates (as opposed to sugar). The higher fiber content a food has, the lower its GL. Carrots are a high GI food. But when served as a handful of raw carrots, it has a low GL. Carrot juice, which has a lower fiber content, has a high GL. Likewise, 3/4 cup of watermelon (also a high GI food) has a low GL, while half a watermelon has a high GL. Research suggests that glycemic load is an important consideration in the treatment and prevention of chronic diseases.

Why can't I get everything I need from my diet?

There are several reasons for this. First, remember that as a society, our dietary habits have changed over the past couple of generations. A healthy diet consists of plenty of fruits and vegetables and whole grains. Fruits and vegetables should be preferably fresh. Fresh frozen is still good, but not as good as "off the farm" fresh! Recent studies indicate that the majority of meals in the U.S. are eaten in restaurants rather than in the home. Restaurant food tends to be too high in fat and sugar. Additionally, convenience foods now make up a much higher percentage of the average diet than they did in the past. In some people well over 60% of their food is from so-called "empty" calorie foods (candy, sweets, chips, or other highly processed foods that contain very little real nutritional value other than calories). Remember that the more highly processed a food is, the more likely it is to have a low nutritional value.

Another factor is the high stress found in today's fast-paced and busy life. The greater the external stresses, the higher the nutritional demands on the body. Eating a poor-quality diet robs you of the nutritional factors necessary to help you stay healthy.

Lastly, many people are simply unaware of how to shop for healthy foods. Convenience and taste become the major criteria for food selection, while nutritional value is given little attention, if any at all.

Many nutritional researchers point to the rising problems of obesity, diabetes, heart disease and other diseases of modern society as evidence of the deteriorating quality of the diet most people consume. If you have questions about your diet, it is important that you discuss them with your healthcare provider on your next visit to Comprehensive Center for Women's Medicine.

Most complex meals (protein, carbohydrates, and fats) have a moderate GL because proteins and healthy fats (which have a low GI) help balance out carbohydrates that may have a higher GI. Its important to include whole fruits and vegetables in your regular eating pattern to help achieve a balanced, low-GL diet. Research suggests that glycemic load is an important consideration in the treatment and prevention of chronic diseases.

What are medical foods?

Medical foods are formulated with macro- and micronutrients that are recognized by scientific principles to support the dietary management of a disease or condition, and are to be administered under the supervision of a
physician or licensed healthcare practitioner. Medical foods contain nutrients in therapeutic amounts that typically cannot be acquired through a typical diet. Metagenics is one of the few professional nutraceutical companies that formulates, manufactures, and tests medical foods.

What are nutraceuticals?

Definitions for this term vary slightly in the industry, but agree on a key point-they are recommended for a specific health purpose, which would indicate a recommendation in a clinical setting. We refer to our nutritional supplements as nutraceuticals because they are solely recommended and supervised by health care practitioners to help patients improve health and support healthy physiological function.

Where do vitamins come from?

Vitamins are substances found in food that are required by your body to convert the food into energy. Since our bodies cannot manufacture these substances (or in the amount we may need), we have to get them from our diet. Unfortunately, the foods that many of us choose to eat have had most of the vitamins processed out. As many as 30 - 40 vitamins and minerals may be taken out of our food; "enriched" foods may have a dozen added back. Generally the richest source of vitamins and minerals comes from fresh fruits, vegetables, and grains. Nutritional supplements may contain vitamins that are natural (food derived) or synthetic (manufactured).

What do vitamins do in the body?

In order to accomplish all of the thousands of day-to-day functions of your body, the food you eat every day must be converted into energy and raw materials (building blocks for muscles, bones, ligaments enzymes, hormones, and so on). To do all this, vitamins are required. Since humans lack the ability to manufacture these critical nutrients in our bodies, we have to get them in our diet.
Generally, vitamins perform 3 major functions:

• They are "cofactors" and catalysts for enzymes, which means they are required for the enzymes to do their jobs. The B-complex vitamins B1 and B2, for example are required for every function in the body that requires production of energy-which means every function!

• They act as antioxidants, which means they prevent highly reactive molecules called free radicals from damaging delicate cell membrane structure. Vitamins C and E are powerful antioxidants, protecting cell membranes from free radicals.

• They act as "pre-hormones." For example, vitamin D functions as a hormone to facilitate calcium uptake and utilization.

What do minerals do in the body?

Minerals have very many important functions-life could not exist without them. Iron is required for the manufacture of the chemical hemoglobin, which carries oxygen in the blood to all the cells of the body. Calcium is necessary for strong bones, and for transmission of messages within cells and from cell to cell. Magnesium is required for production of energy from the food you eat, and a selenium-containing molecule protects the body from damage by free radicals.

What are some of the benefits of UltraMeal products?

UltraMeal has been clinically tested as part of a balanced dietary and regular exercise program and shown to reduce body fat while preserving lean muscle mass. The typical over-the-counter product is an extremely sweet drink or bar with generally small amounts of poor quality proteins. UltraMeal has 15 or more grams of protein per serving. Lower protein products may result in loss of lean muscle mass in body composition programs. Also, the main ingredient in many over-the-counter products is plain table sugar or sucrose. There is no added sucrose in UltraMeal products. UltraMeal contains the low-glycemic index carbohydrate fructose (fruit sugar) as part of the macronutrient blend. Fructose does not cause the rise in blood sugar that sucrose can. Third, unlike many over-the-counter products, UltraMeal varieties are fortified with a complete vitamin and mineral core supplying valuable sources of all these important nutrients. It is a particularly rich source of non-dairy calcium for improving bone health. Fourth, unlike many other products, UltraMeal shake formulas are formulated to exclude yeast, eggs, hydrogenated oils, sucrose, or gluten. The UltraMeal Bar contains a very similar ratio of vitamins, minerals, proteins, carbohydrates, and fat to the UltraMeal soy powdered drink mix.

Can I follow this dietary plan if I am diabetic or hypoglycemic?

UltraMeal has been tested for its glycemic index (GI). The GI of a food is an important tool to provide dietary guidance to individuals with blood sugar dysregulation. The GI allows for the classification of carbohydrate foods according to their glycemic response; the higher the GI of a food, the higher its potential for raising blood sugar. UltraMeal has been tested as a low GI food. Therefore, it should be very well tolerated by individuals with these conditions. The complete dietary plan, including the UltraMeal products, should also be well tolerated. You should discuss with your health care practitioner the integration of the program into your prescribed dietary plan.

Can I use this dietary program if I'm gluten or dairy sensitive?

Yes. Except for UltraMeal WHEY, all of the UltraMeal products are formulated without gluten or dairy. UltraMeal WHEY is suitable for lactose-intolerant individuals. Additionally, using the exchange option lists, you can make food choices within the program that are gluten- and dairy-free as well.

Can I take supplements during this program?

Yes, although the UltraMeal Program is designed to provide at least 100% of the RDI for all vitamins. Follow your practitioner's recommendations.

Should I discontinue prescription medications while on this program?

No. Medication should be carefully monitored by your health care practitioner. Only in conjunction with him or her should you make a decision to change prescriptive medication.

Why is it important to support my body's ability to excrete or remove estrogen?

The ebb and flow of a woman's sex hormones have a natural rhythm, and a woman may experience as many as 500 menstrual cycles from puberty to menopause. A woman's menstrual rhythm may be influenced by factors that include her lifestyle, genetics, chemical exposures, current and past health, history of pregnancy and childbirth, and even her mother's health in pregnancy. The phases of a woman's menstrual cycle depend on certain hormones (such as estrogen and progesterone) triggering one another as their levels naturally rise and fall in a carefully orchestrated fashion. However, in modern times of high stress, pollution, and unbalanced diets, many women's menstrual cycles lose their delicate hormonal balance.

Does estrogen balance affect how I feel?

For premenopausal women (generally under the age of 45), problems with estrogen balance may manifest as premenstrual syndrome, irregular menstrual cycles, fibrocystic breast disease, endometriosis, dysmenorrhea (menstrual cramping), and/or menorrhagia (heavy menstrual bleeding). During perimenopause (generally between the ages of 45 and 55) women can also experience problems with estrogen balance, but at this time it may manifest as hot flashes, night sweats, anxiety attacks, and/or heart palpitations.

How important is my diet and regular exercise?

Estrogen balance is crucial in the cycle. Lifestyle and other previously mentioned factors can influence estrogens in various ways. Estrogens normally circulate through the body and influence various activities at a cellular level. After a time, they are broken down (detoxified) and excreted. The body can detoxify estrogens in various ways, which may increase or decrease their hormonal strength. A woman's diet, physical activity, stress level, and chemical exposures influence the way her body detoxifies estrogens. Therefore, our lifestyle choices can influence our hormone cycles! A key example of a lifestyle choice is the consumption of foods or beverages that contain saturated fats, alcohol, pesticide residues, or hormones. These can overload our organs responsible for detoxification and excretion or increase our exposure to "foreign" sources of estrogen. However, we can eat in a way that helps us detoxify and excrete estrogens safely. For some women, supporting natural hormone balance through diet, nutrition, and lifestyle modification may provide many health benefits. That's what the Estrium Program is all about.

Should I exercise while on this plan?

Yes. Exercise is an appetite suppressant, and it also accelerates the burning of calories. Besides acting as an aid in weight stabilization, aerobic exercise will improve cardiovascular and pulmonary fitness. Your exercise program can be as simple as 30 minutes of walking 3 times a week. (This level of exercise led to improved muscle mass in our UltraMeal research studies.)

Can I use this diet if I am pregnant or nursing?

No. UltraMeal products have not been tested in these situations; therefore, it is not recommended for use at these times.

What if I need additional fiber?

On a nutritional program that involves liquid supplementation, some patients may experience a change in bowel habits. Clinical experience has shown that, for some people, an additional fiber supplement may reduce symptoms of diarrhea o constipation. While the UltraMeal products contain 4-5 grams of fiber per serving, your health care practitioner may recommend an additional fiber supplement, such as Herbulk® or MetaFiber®.

Is it true that consumption of soy protein has beneficial effects on heart disease?

Yes. The FDA has determined 25 grams of soy protein a day, when included in a diet low in saturated fat and cholesterol, may reduce the risk of cardiovascular disease. Soy protein has also been shown to have cholesterol lowering effects. Every soy-based UltraMeal product contains approximately 17 grams of soy protein per serving.

What are plant sterols?

Plant sterols (also known as phytosterols) are found naturally in a range of plant sources such as vegetable oils, nuts, grains, and seeds. A typical American daily intake ranges from 200-400 mg per day, far below the NIH recommendations of 2 grams daily.


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Comprehensive Center for Women's Medicine services the following areas for FirstLine Therapy and women's health issues; Chicago, Northbrook, Elmhurst,
Lombard, Wheaton, Joliet, Plainfield, Addison, Hoffman Estates, Barrington, Oak Lawn, Tinley Park, Frankfort as well as other Chicago areas.