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® Plant Sterols ActiFolate™ PharmaSoy ® UltraMeal Plus with Beta-Sitosterol and Other Plant Sterols Nutritional Support for Healthy Cholesterol Levels The National Cholesterol Education Program of the National Institutes of Health (NIH) recommends the consumption of 2 grams of plant sterols daily to promote healthy cholesterol levels. And the American Heart Association recognizes the possible cholesterol-lowering effects of soy protein and adds it to the limited number of foods it recommends individuals eat daily to reduce heart disease risk. UltraMeal Plus provides both plant sterols and soy protein—along with body-ready folates for UltraMeal® Plus healthy homocysteine metabolism—in a delicious, heart-healthy meal replacement beverage. Patient Benefits: • Specifically formulated to provide: Healthy Heart Support ❤ 15 grams of soy protein per serving from PharmaSoy® ❤ 2 grams of plant sterols per serving—including 1 gram of beta-sitosterol per serving ❤ 4-5 grams of fiber per serving (varies by flavor) ❤ ActiFolate™—a proprietary blend of body-ready folates including L-5-methyl tetrahydrofolate ❤ A low-glycemic-index meal option of only 160 calories ❤ A full complement of vitamins and minerals, including dairy-free calcium and chromium • Available in 2 delicious, dairy-free flavors for a convenient and healthy meal • Comes with easy-to-follow program instructions and dietary recommendations A scientifically based formula with a unique combination of natural ingredients for comprehensive cardiovascular health support. The superior nutrition of UltraMeal combined with plant sterols— including beta-sitosterol—for maintaining healthy cholesterol levels. Scientifically Formulated for a Natural Approach Beta-sitosterol is the most prevalent plant sterol (of over 40), It is estimated that over 102 million American adults have accounting for approximately 50% of dietary plant sterols blood cholesterol levels above a desirable range, and over from fruit and vegetable sources. Since over half of American 22 million have elevated cardiovascular health concerns— adults do not meet the minimum recommended consumption both of which are scientifically linked to unhealthy body of five servings of fruits and vegetables per day, adding composition (excess body fat). plant sterols with UltraMeal Plus may be an appropriate recommendation for those patients wishing to promote 26-Year Incidence of Coronary Heart Disease <50 years cardiovascular health. 50+ years Incidence of CHD per 1,000 800 PharmaSoy®—Even More Support for CV Health 700 600 PharmaSoy is a technologically advanced blend that includes 440 superior soy protein and isoflavones. Just two servings of 500 366 UltraMeal Plus provide 30 grams of high quality soy 400 333 292 300 268 200 100 223 177 M <25 W <25 179 119 76 0 include 25 grams of soy protein a day may reduce the risk 350 255 protein. Diets low in saturated fat and cholesterol that of heart disease. Soy protein has also been shown to have cholesterol-lowering effects. M 25-29 W 25-29 M 30+ W 30+ BMI Levels Adapted from Hubert HB et al. Circulation 1983;67:968-77. ActiFolate™—CV Support in a Body-Ready Form UltraMeal Plus provides a proprietary blend of body-ready UltraMeal Plus is a research-based meal replacement folates—ActiFolate—to promote healthy methylation and featuring the great taste, convenience, and nutrition of the homocysteine levels.2-4 Homocysteine levels within a family of UltraMeal formulas that promote healthy body normal range support healthy cholesterol metabolism composition—combined with the NIH-recommended and overall cardiovascular health.5-8 nutrition of plant sterols—to promote healthy cholesterol. Dietary Fiber—For CV Health and More Plant Sterols—A “Plus” for CV Health Two servings of UltraMeal Plus provide almost half the Plant sterols (which include beta-sitosterol) have been minimum daily fiber recommendation to support not only recommended by the NIH to promote cardiovascular health cardiovascular health but also gastrointestinal health, in combination with healthy lifestyle changes, such as a insulin management, and a healthy body composition.9-12 diet low in saturated fat and cholesterol, regular exercise, and maintaining a healthy body composition (lean muscle1 Excellent Source of Calcium to-fat ratio). Foods containing at least 0.65 grams per UltraMeal Plus also provides 600 mg of dairy-free calcium serving of plant sterol esters, eaten twice a day with (60% RDI) from PharmaSoy. Calcium, along with regular meals for a daily total intake of at least 1.3 grams, as part exercise and a healthy diet, can play a significant role in of a diet low in saturated fat and cholesterol, may reduce reducing the rate of bone loss or bone thinning and in the risk of heart disease. A serving of UltraMeal Plus protecting bone strength. supplies 2 grams of plant sterols. A Healthy Lifestyle Approach Other Features of UltraMeal Plus Cardiovascular health can be impacted by hereditary influences, excess body fat, or a diet high in saturated Low Glycemic Index fat and cholesterol or low in fiber. The NIH recommends UltraMeal Plus has a low glycemic index, making it an healthy lifestyle changes to reduce the risk of coronary appropriate source of nutrition for patients with blood sugar heart disease and help lower LDL cholesterol levels. A concerns. UltraMeal Plus is sweetened naturally with fructose— healthy diet and regular exercise program are an integral which is found in fruits and is the preferred sugar source to part of the UltraMeal Body Composition Program. promote healthy blood sugar management.13 1 UltraMeal Plus may also be used as a complement to a lifestyle changes program to promote cardiovascular Taste and Variety Available in delicious Natural Vanilla and Natural Dutch Chocolate—the most popular flavors in the UltraMeal line. and overall health. Convenience Compliance is Key Mixes easily with water and travels well to make a healthy meal Achieving and maintaining optimal clinical outcomes anywhere—at home, at work, or on the go. requires patient compliance—which is why UltraMeal Plus was developed in the tradition of UltraMeal products to Value meet the taste and busy lifestyle demands of your patients. For a little more than $2.50 per serving at the suggested retail price, UltraMeal Plus is an inexpensive, high quality meal option for your patients. LDL Cholesterol Goals and Lifestyle Change Recommendations for Different Risk Categories1 Risk Category LDL Goal LDL Level at which to Initiate Lifestyle Changes Coronary Heart Disease or High CHD Risk <100 mg/dL ≥100 mg/dL Moderate Risk <130 mg/dL ≥130 mg/dL Low Risk <160 mg/dL ≥160 mg/dL Quality and Purity You Can Trust UltraMeal Plus is researched, developed, and manufactured by Metagenics, Inc. and features only natural ingredients and non-genetically engineered, identity-preserved soy protein. To complement restricted diets, UltraMeal Plus is free of gluten, wheat, yeast, egg, dairy, as well as artificial colors, Major risk factors for CHD include cigarette smoking, hypertension, low HDL cholesterol, family history of premature CHD, and age (M 45+, W 55+). Healthcare practitioners worldwide have recommended the UltraMeal Program and UltraMeal products for their patients—who continually remark on the delicious taste, convenience, and the enhanced energy and well-being they experience while promoting their health with the sweeteners, and flavors. UltraMeal is manufactured according stringent standards with the health of your patients in mind. In addition, the Functional Medicine Research Center—the research arm of Metagenics—has conducted on-site human clinical trials with UltraMeal Plus. UltraMeal Program. For over 13 years the UltraMeal family of products has been in clinical use worldwide. UltraMeal Plus represents the latest innovation in promoting patient health with lifestyle-friendly nutrition. ® UltraMeal Plus with Beta-Sitosterol and other plant sterols to promote healthy cholesterol levels UltraMeal Plus ® with Beta-Sitosterol and other plant sterols to promote healthy cholesterol levels Nutrient Profile of UltraMeal Plus: References: Caloric Distribution Percent of Total Energy Protein . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38% of calories Carbohydrate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51% of calories Fat . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11% of calories 1. Third Report on the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). National Heart, Lung and Blood Institute of the NIH.2002. Nutritional Information per Serving (all flavors) Serving size . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 scoops (50 g) Servings per container . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 Calories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 160 Fat . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 g Cholesterol* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 mg Sodium† . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 170-180 mg Potassium† . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 510-660 mg Total Carbohydrate. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 g Simple. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 g Complex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 g Dietary Fiber† . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-5 g Protein. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 g Soy Isoflavones . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 mg Each Serving Contains: Vitamin A (as retinyl palmitate) . . . . . . . . . . . . . . . . . . 1,750 Vitamin D (as cholecalciferol) . . . . . . . . . . . . . . . . . . . . . . 200 Vitamin C (as ascorbic acid) . . . . . . . . . . . . . . . . . . . . . . . . . 60 Vitamin E (as d-alpha tocopheryl acetate). . . . . . . . . . 11 Thiamin (as thiamin hydrochloride) . . . . . . . . . . . . . . . . 750 Riboflavin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 850 Niacin (as niacinamide) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Pantothenic Acid (as D-calcium pantothenate) . . . . . . . 5 Vitamin B6 (as pyridoxine hydrochloride) . . . . . . . . . . . . 25 Vitamin B12 (as methylcobalamin & cyanocobalamin) . 30 Biotin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 150 Folate†† (as folic acid, L-5-methyl. . . . . . . . . . . . . . . . . . . 500 tetrahydrofolate†††, and 5-formyl tetrahydrofolate) Vitamin K . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40 Calcium (as calcium phosphate) . . . . . . . . . . . . . . . . . . . 600 Iron (as ferrous fumarate) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Phosphorus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 460 Iodine (as potassium iodide) . . . . . . . . . . . . . . . . . . . . . . . . 75 Magnesium (as magnesium citrate)† . . . . . . . . . . 180-190 Zinc (as zinc citrate) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Copper (as copper gluconate) . . . . . . . . . . . . . . . . . . . . . . . . . 1 Manganese (as manganese gluconate) . . . . . . . . . . . . . . . 1 Molybdenum (as molybdenum amino acid chelate) 75 Chromium (as chromium polynicotinate) . . . . . . . . . . 100 Selenium (as selenomethionine) . . . . . . . . . . . . . . . . . . . . 35 % U.S. RDI IU . . . . . . . . . . . . . . . . . . . . 35 IU . . . . . . . . . . . . . . . . . . . . 50 mg. . . . . . . . . . . . . . . . . . 100 IU . . . . . . . . . . . . . . . . . . . . 35 mcg . . . . . . . . . . . . . . . . . . 50 mcg . . . . . . . . . . . . . . . . . . 50 mg . . . . . . . . . . . . . . . . . . . 50 mg . . . . . . . . . . . . . . . . . . . 50 mg . . . . . . . . . . . . . . . . 1250 mcg. . . . . . . . . . . . . . . . . 500 mcg . . . . . . . . . . . . . . . . . . 50 mcg. . . . . . . . . . . . . . . . . 125 mcg . . . . . . . . . . . . . . . . . . 50 mg . . . . . . . . . . . . . . . . . . . 60 mg . . . . . . . . . . . . . . . . . . . 17 mg . . . . . . . . . . . . . . . . . . . 46 mcg . . . . . . . . . . . . . . . . . . 50 mg . . . . . . . . . . . . . . . . . . . 45 mg . . . . . . . . . . . . . . . . . . . 60 mg . . . . . . . . . . . . . . . . . . . 50 mg . . . . . . . . . . . . . . . . . . . 50 mcg. . . . . . . . . . . . . . . . . 100 mcg . . . . . . . . . . . . . . . . . . 83 mcg . . . . . . . . . . . . . . . . . . 50 Other Ingredients (Vanilla): Soy protein isolate (PharmaSoy®), fructose, maltodextrin, soy fiber, phytosterols, corn bran, natural flavors, lecithin, olive oil, xanthan, carrageenan, and cellulose gum. Directions: Blend, shake, or briskly stir two level scoops into eight ounces of chilled water. Form: 25 oz. (700 g) Powder Container * Information on cholesterol content is provided for individuals who, on the advice of a physician, are modifying their dietary intake of cholesterol. † Content varies according to flavor. †† Featuring ActiFolate™—a proprietary blend of active folates. ††† As Metafolin® U.S. Patent Nos. 5,997,915; 6,254,904. 2. Bailey LB, Gregory JF. Polymorphisms of methylenetetrahydrofolate reductase and other enzymes: metabolic significance, risks and impact on folate requirement. J Nutr 1999;129(5):919-22. 3. Deloughery TG, Evans A, Sadeghi A, et al. Common mutation in methylenetetrahydrofolate reductase. Correlation with homocysteine metabolism and late-onset vascular disease. Circulation 1996;94(12):3074-78. 4. Donnelly JG. Folic acid. Crit Rev Clin Lab Sci 2001;38(3):183-223. 5. Venn BJ, Green TJ, Moser R, et al. Comparison of the effect of low-dose supplementation with L-5-methyltetrahydrofolate or folic acid on plasma homocysteine: a randomized, placebo-controlled study. Am J Clin Nutr 2003;77(3):658-62. 6. Litynski P, Loehrer F, Linder L, et al. Effect of low doses of 5-methyltetrahydrofolate and folic acid on plasma homocysteine in healthy subjects with or without the 677C➙T polymorphism of methylenetetrahydrofolate. Eur J Clin Invest 2002;32(9):662-68. 7. Fohr IP, Prinz-Langenohl R, Brönstrup A, et al. 5, 10-Methylenetetrahydrofolate reductase genotype determines the plasma homocysteine-lowering effect of supplementation with 5-methyltetrahydrofolate or folic acid in healthy young women. Am J Clin Nutr 2002;75:275-82. 8. Nygard O, Vollset SE, Refsum H, et al. Total plasma homocysteine and cardiovascular risk profile. The Hordaland Homocysteine Study. JAMA 1995;274(19):1526-33. 9. Anderson JW, Gustafson NJ, Brayant CA, et al. Dietary fiber and diabetes: A comprehensive review and practical application. J Am Diet Assoc 1987;87(9):1189-97. 10. Anderson JW, Tietyen-Clark J. Dietary fiber: Hyperlipidemia, hypertension, and coronary heart disease. Am J Gastroenterology 1986;81(10):907-19. 11. Howarth NC, Saltzman E, Roberts SB. Dietary fiber and weight regulation. Nutr Rev 2001;59(5):129-39. 12. Marlett JA, McBurney MI, Slavin JL. Position of the American Dietetic Association: health implication of dietary fiber. J Am Diet Assoc 2002;102(7):993-1000. 13. Uusitupa, MIJ. Fructose in the diabetic diet. Am J Clin Nutr 1994;59(3 Suppl):S753-S57. MET874 Rev5/04 www.metagenics.com