How do I know that Metagenics marine oil is high quality?
Metagenics unconditionally guarantees the quality and purity of our concentrated EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) formulas made with marine oil. Each formula contains only the highest quality, purity-certified omega-3 fatty acids that meet or exceed label claim (milligram, not just area percent). These formulas are also enhanced with antioxidants to aid product stability.
The exceptional manufacturing and purification technology for our marine oils produces a product that exceeds the highest quality standards available for fish oil. It also exceeds the quality criteria for the Council for Responsible Nutrition's Omega-3 Monograph (the industry's current voluntary standard for purity). Our dedication to every detail and exhaustive testing includes:

• In-house and third-party (independent) testing of raw materials (marine oil) for heavy metals and other harmful contaminants
• In-house and third-party testing of EPA/DHA content of final product
• In-house testing for yeasts, molds, and harmful bacteria
• In-house testing for disintegration time and shelf stability

How do I order Metagenics nutritional products?
Metagenics formulas are only available through licensed healthcare practitioners. Patients may find a practitioner.

How do I find a Metagenics practitioner near me?
Simply click here to locate a health care practitioner near you who offers Metagenics nutraceuticals and medical foods or to find a certified FirstLine Therapy practitioner who offers therapeutic lifestyle changes programs.

Do you conduct third-party (independent) testing for verifying marine oil purity?
EVERY batch of our marine oil concentrates is assayed by one of the top independent testing labs in the world and currently the world market leader in testing for dioxins. Testing every batch of concentrated oil prior to bottling or encapsulation is highly unusual and Metagenics may be the only professional nutraceutical company to practice this added safety measure. Checks for numerous contaminants are conducted including:

• 220 pesticides
• 6 heavy metals
• 7 markers of PCBs
• 15 dioxins & furans
• 12 dioxin-like PCBs

How do I contact Metagenics?
If you have questions about a specific Metagenics product or how to use it, please consult your health care practitioner. For other questions or comments, please Contact us Online.

What quality measures do you take for your softgels?
The gelatin used in our softgels is obtained from countries known to be free of bovine spongiform encephalopathy (BSE) and have programs in place to prevent its occurrence. And for enteric-coated formulas, we utilize enteric coating compliant with the United States Pharmacopeia (USP) to avoid premature dissolution in the stomach. According to USP guidelines, enteric coating must delay gastric disintegration by a minimum of one hour.

What makes Metagenics different from most nutritional supplement companies?
A lot of things make us stand above other companies—a focus on patient health, quality manufacturing, ingredient testing, safety reviews, clinical testing, scientific research, unique formulas, and more. For specifics, check out the Quality Difference section.

Does Metagenics fish oil contain mercury or other contaminants?
We use fish oil from fresh, clean, deep-sea, wild-caught, cold-water fish with lower risk of contamination. In addition, our purity-certified fish oils undergo a proprietary refinement process to remove heavy metals and other environmental pollutants. An advanced molecular distillation process of every batch ensures the highest purity and batch consistency. And every batch is thoroughly tested for impurities at every step, from raw material to packaging. Our dedication to exhaustive third-party and in-house testing enable us to make the following guarantees:

• Mercury—less than 5 ppb (below detection limit)
• Lead—less than 20 ppb (below detection limit)
• Dioxins and Furans TEQ—less than 0.5 ppt
• PCBs TEQ—less than 1 ppt
• Also tested for yeasts, molds, and bacteria

What are the advantages of choosing EPA-DHA oil formulas from Metagenics?
Not all EPA-DHA oil formulas are the same. The advantages of our premium, purity-certified EPA-DHA oil formulas include:

• Third-party, purity-certified
• Natural lemon flavor
• Concentrated levels of specific omega-3s
• Custom made in Norway
• Low cost per concentrated dose

Is the Metagenics marine oil pharmaceutical grade, ultra pure, and/or ultra refined?
There is no unified definition for these terms. To date, the only internationally recognized, minimal quality standards are based on the EU CRN monograph. "Pharmaceutical grade" is a marketing term often used to imply a higher standard of purity. While there are pharmaceutical grades established for some chemicals, there is no such grade for marine oils. However, our fish oils are produced in Norway and the manufacturing plant is licensed for pharmaceuticals by the Norwegian Medicines Agency, Norway's equivalent to the Food and Drug Administration. (There are only 3 pharmaceutical licensed omega-3 manufacturing facilities in the world.) Under the accepted market definitions, Metagenics offers "ultra pure" and "ultra refined" marine oil formulas that meet a higher standard of quality.

Is the Metagenics fish oil collected from Norwegian fish?
The fish oil in Metagenics formulas is processed in Norway, but the fish may also come from elsewhere. Fish oil resellers may imply that their product is made exclusively from fish from Norwegian waters. In truth, the majority of wild-caught fish for supplements comes from off the coast of South America (Peru and Chile), with smaller amounts coming from Europe, Africa, and the United States. What is the key takeaway point? Don't be misled by slick marketing tactics. The finest raw material sources start with fresh, clean, deep-sea, wild-caught, cold-water fish (from Norway or elsewhere); the oils from these fish should then be further purified through advanced processes to remove any concern of harmful levels of potential contaminants.

Is Metagenics Omega-3 oil clinically tested?
Thousands of studies have been conducted on the potential health benefits of fish or essential fatty acids from fish oil (particularly EPA and DHA) in human health. As a research-based company dedicated to patient health, Metagenics focuses on maintaining a variety of purity-certified, highly concentrated formulas to best suit individual health needs. These advanced formulas have been successfully utilized in documented case studies at the FMRC[link] and are recommended by health care professionals worldwide.

Why can't I just take flaxseed oil?
Flaxseed oil has been shown to benefit health in several areas, and is an important source of alpha-linolenic acid (ALA), another omega-3 essential fatty acid that is the "parent" for EPA and DHA. While ALA can be converted in the body to EPA and DHA, this process is relatively slow and unreliable in humans—and typically yields only minimal amounts of either EPA or DHA. To achieve similar amounts of EPA and DHA as found in supplements from marine sources (that have already converted ALA to EPA and DHA), an exponentially larger amount of plant-derived ALA would have to be consumed. ALA, EPA, and DHA have each demonstrated unique health support applications. Therefore, substituting flaxseed oil where concentrated EPA or DHA is recommended may not produce expected clinical outcomes.

Which is better—ethyl ester or triglyceride form?
Both forms provide excellent health support, and clinical experience has shown no difference. While dietary fats, such as those in fish, are naturally found in a triglyceride form, it's not the form our body absorbs. Triglyceride marine oil must first be digested by the body. Similarly, the molecular distillation process for manufacturing and purifying marine oils "digests" the oils and converts them into the ethyl ester form. All purified and concentrated marine oils are converted to ethyl ester forms during processing. If desired, an additional processing step can reassemble the oils back into the triglyceride form. The primary benefit of this step is for stability of the oil in lieu of a capsule, such as in liquids where the oil is more vulnerable to oxidation. This reconverted triglyceride form must still be broken down (digested) prior to absorption. Processed triglyceride form marine oil does not mean a more "natural" oil. Furthermore, unprocessed oils in triglyceride form may contain impurities that "predigested" ethyl ester forms of fish oil do not. A majority of marine oil studies have been conducted using the ethyl ester form, so this extra processing step to assure safety does not appear to detract from its health support potential.

How does a TOTOX level predict rancidity? And does Metagenics test for it?
Rancidity is immediately noticeable by smell or taste-no sophisticated test required. Nevertheless, TOTOX levels are often quoted as an indicator of marine oil freshness, which is partially true. But oxidative values are only one set of parameters in determining the quality or rancidity of marine oil. Oxidative measures include peroxide, anisidine, and/or TOTOX ("total oxidation"—a calculated expression of anisidine value + 2x peroxide value).

Marine oils with high oxidative values will likely have strong odor and poor taste, but so can marine oils with low values (due to degraded components during oil decomposition that are undetectable in oxidative tests). Metagenics marine oils are tested for peroxide and anisidine levels (which may be used to calculate TOTOX) after manufacture of the oil—prior to adding flavor and/or encapsulation—and safeguarded at every step thereafter. For added insurance, Metagenics also repeats peroxide assays after final processing (capsulation, bottling), as these tests detect the first compounds of oxidation (i.e., hydroperoxides) and validate that no oxidation occurred during final processing to degrade the purity of the oils.

Also note that natural antioxidants (e.g., mixed tocopherols, rosemary) are added to each formula to maintain stability over the product's shelf life. In addition, we provide proper storage guidelines on the product labels for all marine oil supplements to maintain product quality.

Why add lemon flavor?
Even the cleanest marine oil carries a slightly detectable "fishy" taste that might prevent product use and clinical outcomes. No flavor, however, could mask the taste or smell of rancidity.

What are the amounts of whey and rice protein used in UltraBalance Protein?
There is a total of 15 grams of protein per serving in UltraBalance Protein. Whey protein makes up 9 grams and rice protein makes up 6 grams of the total.

I have dairy sensitivity. Can I still take UltraBalance Protein?
The general answer to this question follows, but please remember to ask your health care practitioner this question on your next visit, as each case is individual.

Dairy sensitivities may have several causes. Some people have difficulty digesting milk sugar (lactose intolerance) because they lack the enzymes necessary to break down lactose. Since UltraBalance Protein is formulated without milk sugar, it should be suitable or those who are lactose intolerant.

Other people have a sensitivity to the proteins in milk. Milk is made up of several different types of protein, with casein being a common allergen. Another milk protein known to be much less sensitizing is beta lactalbumin, which is the protein source in UltraBalance Protein. Since intact protein in general is more sensitizing than partially hydrolyzed (digested) protein, the beta lactalbumin in UltraBalance Protein is hydrolyzed, making it even less likely to cause symptoms for you.

A good rule of thumb is that if you can consume a few tablespoons of whole milk without developing any problems, the dairy protein in UltraBalance Protein will likely NOT be a problem for you.

Is there caffeine in the chocolate UltraMeal products?
Yes, there is ~20 mg of caffeine per serving. To put that in perspective, a cup of brewed coffee generally contains 150 mg of caffeine, so the amount of caffeine in UltraMeal products are probably too low to significantly affect most people.

Can I use salt while on this program?
We suggest you use salt sparingly or not at all. If you have been advised to restrict your salt intake, look for salt-free products whenever canned or processed foods are used in the diet. There are many good salt-free seasonings available at your local health food store.

What additional spices or flavorings can I use?
Seasonings can enhance the natural flavors of food without added butter, margarine, or salt. There is an abundant array of other herbs and spices that can add flavor and variety to foods. They have practically no calories and can be used in endless combinations. Ask your health care provider for suggestions or experiment yourself with the list of herbs and spices we have provided on the shopping list.

Can I drink coffee and tea?
This is a decision best left up to you and your health care practitioner. We generally recommend consuming water-processed decaffeinated coffee or decaffeinated tea. Many herbal teas are naturally decaffeinated and can add variety and flavor as well.

Can I drink diet drinks?
While diet sodas contain no calories, they often leave people desiring other sweet snacks because of their sweet taste. Additionally, there is some research that suggests the artificial sweetener aspartame may be associated with some health problems. We therefore do not recommend diet drinks, although that decision is best left to your health care practitioner. We do recommend you consume 6-8 glasses of water a day. Low-sodium seltzer or mineral water may also be used.

Can I use canned vegetables instead of fresh vegetables with this program?
Fresh and frozen vegetables retain more of their vitamins and generally have little added salt. If these are unavailable, try to purchase canned vegetables that don't have added salt or fat.

Can I swap menus from one day to the next?
Yes, by all means. The menus are meant as a guide for the kinds of dishes you may be consuming. Keep in mind that some of the menu plans are designed for the 1400-calorie dietary program and some for the 1000-calorie dietary program. Choose from the appropriate menu for the program you and your health care practitioner have decided upon.

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.)

Is the Program an appropriate for children?
No. UltraMeal products should not be the sole source of nutrition for infants or children under age 12. UltraMeal's nutritional content is based on the adult RDIs, and no testing in children has been done at this time. Under the supervision of a health care practitioner, however, the program may be appropriate for older children or adolescents, although it may be advisable to start the program at the second week when they would use UltraMeal twice daily. Your health care practitioner must help you decide if and how the product may be used with your child.

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.

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.

How much UltraMeal will I need in order to complete 4 weeks of the program?
For 4 weeks on the UltraMeal Program, you will need to purchase 5 canisters of powder or 7 boxes of the bars. After that, 1 canister or box will last 1 to 2 weeks depending on whether you use the product once or twice daily.

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.

Do I have to mix the UltraMeal powder with water?
UltraMeal is delicious mixed alone with cold water. It can also be mixed with various fruits and other ingredients. Refer to the section in the Patient Guide on mixing instructions. Remember, however, added ingredients will add calories.

I have heard that liquid diets are unsafe. How does UltraMeal compare?
The UltraMeal Program is not a liquid diet. Even the 1000-calorie dietary program includes vegetables, fruits, grains, and proteins. This calorie intake is well above the very low liquid calorie diets of 800 calories per day that may raise safety concerns. UltraMeal has been designed to contain a high quality source of complete protein, along with vitamins and trace minerals essential for maintaining health and protecting lean body mass.

Does UltraMeal contain caffeine or other stimulants?
No stimulants are added, but cocoa naturally contains caffeine and theobromine. The natural chocolate from cocoa in UltraMeal Dutch Chocolate, UltraMeal Plus Dutch Chocolate, UltraMeal WHEY Dutch Chocolate, UltraMeal Mocha, and UltraMeal Plus Mocha has approximately 20 mg of caffeine and less than 150 mg of theobromine per serving. UltraMeal Bar Chocolate Raspberry, Chocolate Banana, and Chocolate Fudge contain approximately 10 mg caffeine and 60 mg theobromine per bar. The natural chocolate in UltraMeal RICE has approximately 8 mg of caffeine and less than 150 mg of theobromine per serving. These small amounts are about 1/5 or less the amount found in a cup of brewed coffee.

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®.

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.

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 may decide to continue the program as is, or in some modified version for a longer period of time.

What should I eat when I've completed the program?
The dietary portion of the program is a well-balanced, nutrient-dense diet and is suggested as a dietary program for long-term use. You may continue to use 1 serving per day of UltraMeal as a nutritious, delicious, and convenient quick meal option. In consultation with your health care practitioner, you may also decide to increase total calories in a maintenance program.

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.

What determines the cost of UltraMeal?
UltraMeal products are made from the highest quality ingredients, backed by published research, manufactured with exacting standards, and they are guaranteed for freshness and potency. As the developer and manufacturer of UltraMeal, Metagenics has an uncompromising commitment to manufacturing a product of unmatched quality and integrity. All-natural ingredients are used with no artificial colors, flavors, or preservatives. To complement restricted diets, all UltraMeal shake formulas are formulated to exclude what and dairy (with the exception of UltraMeal WHEY, which is suitable for lactose-intolerant individuals). Because UltraMeal can be used as a meal option, many people find their grocery bills decrease substantially.

Do UltraMeal powders come in flavors?
Yes, and all UltraMeal products are naturally flavored.

UltraMeal medical food is available in Vanilla, Dutch Chocolate, Raspberry, Country Peach, Mocha, Strawberry Supreme, and Banana Blast. Also available in variety pack of single serving packets.

UltraMeal Plus medical food is available in Vanilla, Dutch Chocolate, Mocha, and Strawberry Supreme. Also available in variety pack of single serving packets.

UltraMeal Plus 360 medical food is available in Vanilla, Dutch Chocolate, Mocha, and Strawberry Supreme.

UltraMeal RICE 360 medical food is available in Vanilla and Dutch Chocolate.

UltraMeal RICE is available in Chocolate and Vanilla flavors.

UltraMeal WHEY is available in Vanilla and Dutch Chocolate.

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.

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.

If I am allergic to dairy products, will UltraMeal supply enough calcium in my diet?
UltraMeal, UltraMeal Plus, UltraMeal RICE, and UltraMeal Bar are all excellent sources of non-dairy calcium. Each serving of UltraMeal contains 600 mg of calcium. The recommended daily allowance for calcium is dependent upon your age and sex, but generally you'll need somewhere between 1000 to 1500 mg per day. You can see that 1 or 2 servings a day of UltraMeal can be a healthy start to maintaining healthy bones. UltraMeal WHEY is suitable for lactose-intolerant individuals and provides non-dairy calcium.

Why is folate a featured ingredient in UltraMeal?
Folate is an important B vitamin often in short supply in the typical diet, but has been shown to nutritionally support the management of cardiovascular conditions and hormone imbalance. UltraMeal provides ActiFolate® — a proprietary blend of 3 folates to assure your body gets the folate it needs in a body-ready form.

What is unique about soy-based UltraMeal vs. other soy powdered beverages?
Not all powdered soy blends are the same. They can vary widely in soy quality, nutrition, and additives-as well as manufacturing quality and purity. And they may not be suitable for those with blood sugar concerns. Some powders may focus solely on protein or reduced calories, but UltraMeal is formulated for total nutrition with targeted ingredients that have been clinically shown to promote healthy body composition. UltraMeal provides quality soy from PharmaSoy®, a technologically advanced nutritional blend of superior soy protein, isoflavones, and dairy-free calcium. Naturally sweetened UltraMeal is fortified with essential vitamins and minerals for optimal nutrition, which makes it an ideal meal option. And soy-based UltraMeal is formulated without artificial ingredients, additives, dairy, gluten, wheat, egg, or yeast. UltraMeal also considers your whole dietary plan, with recommendations for foods and meals that can help you meet daily nutritional guidelines at a variety of calorie levels.

Can I use UltraMeal if I am sensitive to soy?
UltraMeal RICE and UltraMeal RICE Plus 360 medical food werespecifically formulated using quality rice protein for those individuals with a sensitivity to soy. UltraMeal RICE, UltraMeal WHEY, or UltraMeal RICE Plus 360° medical food may be used as an alternative within the body composition program wherever an UltraMeal serving is indicated or as directed by your health care practitioner.

What is different about UltraMeal Plus?
The "plus" in UltraMeal Plus medical food is a proprietary blend of soy protein and plant sterols to nutritionally support conditions associated with cardiovascular disease, such as hyperlipidemia, hypercholesterolemia, metabolic syndrome, and altered body composition. The NIH recommends consumption of 2 grams of plant sterols daily-along with a healthy dietary program, fiber, and regular exercise-to promote cardiovascular health. Plus, the FDA states that foods containing at least 0.65 grams per serving of plant sterol esters, eaten twice a day with meals for a daily total intake of at least 1.3 grams, as part of a diet low in saturated fat and cholesterol, may reduce the risk of heart disease. UltraMeal Plus contains 2 grams of plant sterols per serving. Your health care practitioner may recommend an alternative clinically tested dietary plan for UltraMeal Plus depending on your health concerns.

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.

What is detoxification?
Detoxification is the elimination of toxins from the body that we are exposed to externally from environmental sources, and internally from products generated by ongoing, normal daily cellular processes. Your liver is the principal player in detoxification, and the UltraClear, UltraClear PLUS, and UltraClear Plus pH (as well as UltraClear MACRO and UltraMeal RICE functional foods) are designed to give this organ, as well as other tissues, nutritional support for the detoxification process.

Why do I need a detoxification program?
Today, we are all exposed to toxins in the foods we eat, the air we breathe, and the water we drink. In addition, we produce toxins within our bodies in the processes of digestion and elimination, combating disease and infection, and dealing with stress.

What is unique about UltraClear medical foods?
UltraClear and UltraClear PLUS are patented medical foods specifically designed for the nutritional support of detoxification. No other medical food product on the market has been patented for this use. These products are powdered beverage drink mixes that contain specific amounts and types of protein, carbohydrates, and fats that are easily absorbed and utilized. A specific core of nutrients and phytonutrients are added to help nutritionally support important detoxification activities. UltraClear Plus pH also has a patent pending.

What is the difference between UltraClear and UltraClear PLUS?
UltraClear was developed initially and is used more in individuals with problems associated with Phase I (cytochrome P450) detoxification issues. UltraClear PLUS was developed to give additional nutritional support for individuals with Phase II (conjugation) detoxification problems. Both are supported by published research. Your health care practitioner will determine which of these two medical foods is best for you, or if you should take UltraClear MACRO, UltraMeal RICE, and/or a nutraceutical instead.

What is the difference between UltraClear PLUS and UltraClear Plus pH?
UltraClear PLUS medical food is designed for those with imbalanced detoxification capacity, or low Phase II activity, who exhibit a urinary pH above 6.6. Such a condition may lead to a build-up of stored toxins and subsequent increase in symptoms and/or tissue damage. UltraClear Plus pH offers the same macro- and micronutrient profile as UltraClear PLUS, with added nutrients to promote an alkaline urinary pH status and enhance Phase II activity for those with a urinary pH below 6.6. An altered urinary pH level may negatively impact the individual's ability to excrete toxins out of the body.

Would the program be helpful for a person who has recently undergone repeated antibiotic therapy?
Yes. Medications like antibiotics may place an added burden on your body's detoxification systems. Your health care practitioner may recommend starting with UltraClear SUSTAIN® and/or introducing a source of acidophilus or bifidobacteria culture to support healthy intestinal flora and digestion following the use of antibiotics.

Is this an appropriate program for children?
No. This program should not be used for infants or children under the age of 12. The product's nutritional content is based on adult RDIs, and no testing in children has been performed. However, under the supervision of a health care practitioner, the beverages may be appropriate as a meal supplement for children over 12. Your practitioner must help you decide if and how the product may be used with your child.

Can I follow this program if I am diabetic or hypoglycemic?
Probably, but you should make this decision with the guidance of your health care practitioner. Discussing integration of the detoxification program into your prescribed dietary program is necessary to avoid upsetting your glucose/insulin balance.

Can I go on this program if I am pregnant or nursing?
No. UltraClear products have not been tested in these conditions; therefore, this program is not recommended for use at these times.

How many canisters of the beverage product will be needed for a 28-day program?
If you are following the program servings exactly, you will need 3 canisters of UltraClear or UltraClear PLUS (21 servings/canister). You will need 5 canisters of UltraClear MACRO or UltraMeal RICE (14 servings/canister). If taking AdvaClear® as part of the program, you will need 1 large size bottle (126 capsules) of this product.

These products seem expensive. Why is this?
UltraClear products are made from the highest quality ingredients and manufactured with exacting standards. They are also guaranteed for freshness and potency. Although they may seem expensive, because the beverages can be used as a meal replacement, many people actually find their grocery bills decrease substantially while on the program.

How long do I need to remain on this program?
That really depends on your health goals. Clinical experience suggests that patients usually experience benefit within four weeks of following the program. Together, you and your health care practitioner can decide to continue the program as is, or to implement a modified version of the program for a longer period of time.

Should I discontinue prescription medications while on this program?
No. Your health care practitioner should carefully monitor your medications. The decision to change a prescription medication in any way can only be made in conjunction with your health care practitioner.

Can I take supplements while on this program?
These products contain therapeutic levels of carefully selected nutrients. Since some other supplements may contain ingredients that could interfere with the program, we suggest following the recommendations of your health care practitioner.

Can I exercise while I'm on this program?
Yes. However, strenuous or prolonged exercise may be reduced during this program if you are restricting calories. You can gain benefit from an exercise program as simple as 30 minutes of walking 3 times a week. You should follow the advice of your health care practitioner. Adequate rest and stress reduction are also important to the success of this program.

Can I substitute other products on this program?
No. While other "copycat" formulations exist, UltraClear, UltraClear PLUS, and UltraClear Plus pH (as well as UltraClear MACRO and UltraMeal RICE functional foods) are made from an exclusive rice protein concentrate. The ingredients are carefully selected and the formulas scientifically designed to ensure the highest quality products possible. Because the products are unique and supported by years of clinical and research experience, recommendations in the Patient Guide apply only to these products.

How are the UltraClear medical foods different from the other Metagenics medical food products?
UltraClear, UltraClear PLUS, and UltraClear Plus pH are medical foods specifically designed for the nutritional management of chronic fatigue syndrome (CFS). These formulas are designed to address certain imbalances in the body that create the symptoms associated with CFS. Your health care practitioner chose the medical food he or she recommended to you based on your individual, underlying problems.

Can I use these products at the same time as other Metagenics medical foods?
Possibly. Your health care practitioner will determine which products and programs are best suited to your individual needs.

Do I have to mix UltraClear, UltraClear PLUS, UltraClear Plus pH, UltraClear MACRO, or UltraMeal RICE with water?
UltraClear, UltraClear PLUS, UltraClear Plus pH, UltraClear MACRO, and UltraMeal RICE are designed to be mixed with water. However, your health care practitioner may suggest other mixing instructions such as the recipes in the Patient Guide.

What is the "grit" in the bottom of the glass of mixed product?
These products are well blended during manufacturing, but a small amount of mineral remains insoluble in the final powder. It is harmless and well absorbed by the body. As you finish drinking it, stir your beverage briskly to get the insoluble minerals into suspension.

What can I use as a sweetener?
We have listed some accepted natural sweeteners on the Basic Dietary Guidelines chart. One of those options is stevia. Stevia is a dietary supplement often used as a natural, herbal sweetener that appears to have no negative effects on detoxification. It is many times sweeter than table sugar. Stevia is found in most health food stores and is available as a white powder or liquid and can be used in cooking or added directly to foods. However, if you normally crave sweet foods, you should avoid all sweeteners including stevia in order to give your taste buds a chance to appreciate naturally sweet foods such as fruits, carrots, tomatoes, etc.

Is it possible to lose weight on this program?
Yes, especially if you mix your powdered beverage in water and eat the minimum amounts of the other listed foods, while making sure to drink lots of water. Incidentally, edema (water retention) can be a sign that the body needs detoxification. Some individuals may lose 2 to 5 pounds of fluid weight during their first few days on the program. Since these products are not intended to be used as part of a weight loss or weight management program, you should discuss your calorie needs and weight goals with your health care practitioner.

Will I be hungry on this program?
Depending on what weight goals you and your health care practitioner decide upon, some caloric restriction may be part of your program. Your health care practitioner may also decide to place you on the program without any calorie restrictions. Even on the lower calorie program, many people experience no increase in hunger. If you experience extreme hunger, discuss possible adjustments in your program with your practitioner.

Can I use canned vegetables instead of fresh vegetables with this diet?
Fresh and frozen vegetables retain more of their vitamins and generally have less added salt. If they are unavailable, purchase canned vegetables without added salt or fat. Canned beans and legumes are generally acceptable.

What is the best way to wash fruits and vegetables to eliminate toxins?
Washing produce in a dilute solution of dish soap, and rinsing thoroughly, works well for some fruits and vegetables.

I notice there are legumes in this dietary program. My digestive system doesn't handle legumes very well. What can I do?
Legumes are desirable because they are high in protein and fiber but low in fat. Here are a few suggestions that may increase your tolerance:

• Increase your intake slowly over the course of 2-3 weeks.
• Try soaking the beans for half an hour before cooking them and discard the water.
• Experiment-you may find that certain legumes work better for you than others (lentils, for example, are often easy for many people to tolerate).
• Try an enzymatic aid that's taken with the meal. Your health care practitioner can recommend an appropriate formula. These aids can be quite helpful; however, some people have found that a larger dose than the one suggested on the package is required.

Can I use salt while I am on this diet?
Generally we over-salt our food. We suggest that you use salt sparingly, or not at all. If you have been advised to restrict your salt intake, look for salt-free products whenever you use canned or processed foods in the diet. There are many good salt-free seasonings on the market. Your local health food store offers a variety of these products.

What additional spices or flavorings can I use?
Seasonings can enhance the natural flavors of food without added butter, margarine, or salt. There is an abundant array of herbs and spices that can add flavor and variety to foods. They have practically no calories and can be used in endless combinations. Ask your health care practitioner for suggestions or experiment yourself with the list of herbs and spices we have provided on the Foods to Include list in the Patient Guide.

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 or constipation. An oligoantigenic (low-allergy potential) fiber supplement, such as MetaFiber®, may be useful in these situations. MetaFiber is a blend of insoluble and soluble fibers. Each serving provides 7 grams of fiber. The National Cancer Institute recommends 20-35 grams of fiber per day.

Can I drink coffee and tea?
Caffeine has been eliminated from the dietary program as it can have a significant negative affect on detoxification. Decaffeinated coffee still has a small amount of caffeine, so consuming this is a decision best left up to you and your health care practitioner. Many herbal teas are naturally decaffeinated and can add variety and flavor to your program.

Do any of these products contain caffeine or other stimulants?
UltraMeal RICE Chocolate flavor has ~20 mg of caffeine per serving. To put that in perspective, a cup of brewed coffee generally contains 150 mg of caffeine, so the amount of caffeine in UltraMeal products are probably too low to significantly affect most people. UltraMeal RICE Vanilla flavor has no caffeine.

Could I be allergic or intolerant to any UltraClear medical food product?
Any drug, nutritional supplement, additive, medical food, or food product has the potential to cause an allergic reaction. If you know you are allergic to any of the ingredients contained in any of these products, you should not consume it.

Can I take these products if I have a sensitivity to rice?
Possibly. The rice protein concentrate in the products has undergone a process to enhance its nutritional properties and remove the most common allergy-causing components. The result is a highly nutritious rice protein that many rice-sensitive individuals can tolerate. However, everyone's level of sensitivity is different. Discuss possible rice sensitivity with your health care practitioner before use, and be alert to any symptoms that may arise from this sensitivity.

Can I use this program if I am gluten and dairy-sensitive?
Yes. All the products in this program are formulated without wheat, gluten or dairy products.

UltraClear, UltraClear PLUS, UltraClear Plus pH, UltraClear MACRO, or UltraMeal RICE is my primary source of protein. Could I become sensitized to it?
These products should not result in food intolerance. Due to the very low allergy potential of rice protein concentrate relative to other grain proteins, these products have been well tolerated by individuals who have previously had sensitivity to grain-based proteins.

What should I eat when I've completed the program?
Once you have reached your health goals, you and your health care practitioner should reassess your program and progress. Together you should determine the next step, whether that be taking other supplements or medical foods, making other dietary changes, or continuing to use these products. A long-term maintenance plan that may include the dietary program recommended in this booklet can help you maintain the health improvements that you've made. The dietary portion of the program is well-balanced and nutrient-dense, and therefore acceptable for long-term use.

How often may I use the products and programs?
You may go on the 28-day program as often as every few months, if recommended by your health care practitioner.