Medifast Diet Products: July 2008: Healthy, delicious, nutritionally complete Medifast meal replacement foods such as high protein, low carb, vitamin enriched shakes, bars, entres, drinks, and snacks. can help you loose up to 5 pounds a week!

Medifast belongs to the category of controlled portions and a very low calorie diet (VLCD). Medifast controls portions by using supplements of an exact size and calorie content in the program. Using Medifast products on a schedule will also help maintain your weight.

Weight loss, in the context of medicine or health or physical fitness, is a reduction of the total body weight, due to a mean loss of fluid, body fat or adipose tissue and/or lean mass, namely bones mineral deposits, muscle, tendon and other connective tissue.

Unintentional weight loss
A significant loss of total body weight is a serious, chronic illness. Substantial, unintentional weight loss is a symptom of acute or chronic illness, especially if other evidence is present.
Weight loss, for example, accompanied by early satiety, bilious vomiting of partially undigested food, postprandial epigastric pain and eructation may indicate Superior Mesenteric Artery Syndrome. Weight loss accompanied by insatiable thirst and hunger and fatigue may indicate diabetes mellitus, a chronic disease characterized by an abnormal accumulation of carbohydrates in the bloodstream due to insufficient production of insulin, a hormone produced in the pancreas that, when secreted into the bloodstream, permits cellular metabolism and utilization of glucose.
Poor management of type 1 diabetes mellitus, also known as insulin-dependent diabetes mellitus (IDDM), leads to an excessive amount of glucose and an insufficient amount of insulin in the bloodstream. This triggers the release of triglycerides from adipose (fat) tissue and catabolism (breakdown) of amino acids in muscle tissue. This results in a loss of both fat and lean mass, leading to a significant reduction in total body weight. Note that untreated type 1 diabetes mellitus will usually not produce weight loss, as these patients get acutely ill before they would have had time to lose weight.
Myriad of additional scientific considerations are applicable to weight loss, including but not limited to: physiological and exercise sciences, nutrition science, behavioral sciences, and other sciences.
One area involves the science of bioenergetics including biochemical and physiological energy production and utilization systems, that are frequently evidence of diabetes, and ketone bodies, acetone particles occurring in body fluids and tissues involved in acidosis, also known as ketosis, somewhat common in severe diabetes.
In addition to weight loss due to a reduction in fat and lean mass, illnesses such as diabetes, certain medications, lack of fluid intake and other factors can trigger fluid loss. And fluid loss in addition to a reduction in fat and lean mass exacerbates the risk for cachexia.
Infections such as HIV may alter metabolism, leading to weight loss.
Hormonal disruptions, such as an overactive thyroid (hyperthyroidism), may also exhibit as weight loss. Intentional weight loss
Weight loss may refer to the loss of total body mass in an effort to improve fitness, health, and/or appearance.
Therapeutic weight loss, in individuals who are overweight, can decrease the likelihood of developing diseases such as diabetes. Overweight and obese individuals face a greater risk of health conditions such as type 2 diabetes, heart disease, high blood pressure, stroke, osteoarthritis and certain types of cancer. For healthy weight loss, a physician should be consulted to develop a weight loss plan that is tailored to the individual.
Weight loss occurs when an individual is in a state of negative energy balance. When the human body is spending more energy in work and heat than it is gaining from food or other nutritional supplements, it will catabolize stored reserves of fat or muscle.
Although weight loss may involve loss of fat, muscle or fluid, weight loss for the purposes of maintaining health should aim to lose fat while conserving muscle and fluid.
It is not uncommon for people who are already at a medically healthy weight to intentionally lose weight. In some cases it is with the goal of improving athletic performance or to meet weight classifications in a sport. In other cases, the goal is to attain a more attractively shaped body. Being underweight is associated with health risks. Health problems can include difficulty fighting off infection, osteoporosis, decreased muscle strength, trouble regulating body temperature and even increased risk of death.
Therapeutic weight loss techniques

The least intrusive weight loss methods and those most often recommended by physicians, are adjustments to eating patterns and increased physical exercise. Usually, health professionals will recommend that their overweight patients combine a reduction of the caloric content of the diet with an increase in physical activity. In addition, a much proposed method to hold oneself to a decreased calorie-diet is to increase the amount of water you drink. This method has been proposed by nutritionists as BCM and other organizations involved in weight loss.
Other methods of losing weight include use of drugs and supplements that decrease appetite, block fat absorption, or reduce stomach volume. Surgery is another method. Bariatric surgery artificially reduces the size of the stomach, limiting the intake of food energy. Some of these treatments may have serious side-effects.

"Crash Dieting"
A crash diet is where a person willfully restricts themselves of all nourishment (except water) for more than 12 hours. The desired result is to have the body burn fat for energy with the goal of losing a significant amount of weight in a short time. Crash dieting is not the same as flexible intermittent fasting, where dieters fast for 2 days each week and calories are cycled. Generally the weight lost in a crash diet returns when normal eating resumes.
Weight loss industry
In the developed world, there is a substantial market for products which promise to make weight loss easier, quicker, cheaper, more reliable, or less painful. These include books, CDs, crèmes, lotions, pills, rings and earrings, body wraps, body belts and other materials, fitness centers, personal coaches, weight loss groups and food products and supplements. US residents in 1992 spent an estimated $30 billion a year on all types of diet programs and products, including diet foods and drinks.
Between $33 billion and $55 billion is spent annually on weight loss products and services, including medical procedures and pharmaceuticals, with weight loss centers garnering between six percent and 12 percent of total annual expenditure. About 70 percent of American's dieting attempts are of a self-help nature. Although often short-lived, these diet fads are a positive trend for this sector as Americans ultimately turn to professionals to help them meet their weight loss goals.

Medifast National Convention 2008 delivered on its promise to be the best and biggest to date! Over 700 attendees took their businesses to the next level this past week with unforgettable workshops, networking opportunities, general sessions, trainings, and more.

We would like to thank everyone who came together to make Medifast National Convention 2008 truly something to remember for years to come!

Couldn't make it to Orlando? Or to a particular workshop? You can now check out the workshop materials and PowerPoint slideshows in your Documents on Demand! To find them:

Log into your Back Office
Click on Documents on Demand in the left navigation panel
Open the "NC 2008 Workshop Materials" folder

Open the particular Workshop folder you wish to view

Medifast products contain essential nutrients as well as all the daily vitamins that you require. Medifast can help you lose weight while giving you these valuable supplements in your diet. Medifast helps you lose while you win.

An essential nutrient is a nutrient required for normal body functioning that cannot be synthesized by the body and must be obtained from a dietary source. Some categories of essential nutrient include vitamins, dietary minerals, essential fatty acids, and essential amino acids.

Different species have very different essential nutrients. Most essential nutrients are substances that are metabolically necessary but cannot be synthesized by the organism. Dietary minerals, for example, cannot be synthesized in biological systems, so (for example) a human must obtain the iron they need to build hemoglobin from their diet. Of course, this iron is recycled, but some is inevitably lost, for example during menstruation.

Many essential nutrients are toxic in large doses (see hypervitaminosis or the nutrient pages themselves below). Some can be taken in amounts larger than required in a typical diet, with no apparent ill effects. Linus Pauling said of vitamin B3, (either niacin or niacinamide), "What astonished me was the very low toxicity of a substance that has such very great physiological power. A little pinch, 5 mg, every day, is enough to keep a person from dying of pellagra, but it is so lacking in toxicity that ten thousand times as much can [sometimes] be taken without harm." A similar statement can be made about vitamin C and some other vitamins.

List of essential nutrients

* Essential substances often not considered to be nutrients:
o Oxygen
o Water
o Sunlight
* Essential fatty acids:
o Linolenic acid (the shortest chain omega-3 fatty acid)
o Linoleic acid (the shortest chain omega-6 fatty acid)
* Essential amino acids necessary for all humans:
o Histidine
o Isoleucine
o Lysine
o Leucine
o Methionine
o Phenylalanine
o Threonine
o Tryptophan
o Valine
* Essential amino acids necessary for human children and not adults:
o Arginine
* Vitamins:
o Biotin (vitamin B7, vitamin H)
o Choline (vitamin Bp)
o Folate (folic acid, vitamin B9, vitamin M)
o Niacin (vitamin B3, vitamin P, vitamin PP)
o Pantothenic acid (vitamin B5)
o Riboflavin (vitamin B2, vitamin G)
o Thiamine (vitamin B1)
o Vitamin A (retinol)
o Vitamin B6 (pyridoxine, pyridoxamine, or pyridoxal)
o Vitamin B12 (cobalamin)
o Vitamin C (ascorbic acid)
o Vitamin E (tocopherol)
o Vitamin K (naphthoquinoids)
Dietary minerals: Biochemical studies reported in 2006 indicate that the following elements (aside from constituent elements of other essential nutrients) are required for human health:
o Calcium (Ca)
o Chloride (Cl-)
o Copper (Cu)
o Iodine (I)
o Iron (Fe)
o Magnesium (Mg)
o Manganese (Mn)
o Molybdenum (Mo)
o Nickel (Ni)[5]
o Phosphorus (P) (as phosphate)
o Potassium (K)
o Selenium (Se)
o Sodium (Na)
o Sulfur (S)
o Zinc (Zn)

The body's requirements vary widely. At one extreme a 70 kg human contains 1.0 kg of calcium but only 3 mg of cobalt.

Elements with speculated role in human health

Many elements have been implicated at various times to have a role in human health. For none of these elements has a specific protein or complex been identified:

* Boron (B)
* Chromium (Cr)
* Fluorine (F) (necessity unknown in humans)
* Silicon (Si) (also present in rice husk).

The Medifast diet is designed to help you lose weight, but sometime during the diet you will want to begin exercising. The Medifast diet does not contain large amounts of calories so you must begin exercising slowly.

Exercise and Health

Let's talk about exercise and why it is essential for good health and weight loss. Most people who exercise regularly will tell you that it is the key, the most important single thing they do to stay healthy and fit. Many of those people won't be reading this newsletter or going to our diet site because they don't have any weight they need to lose. This newsletter is really intended for those of us who do have weight to lose, be it ten pounds or a hundred pounds.

Exercise is an essential component of any weight loss plan. Without it, you will have to diet much more strenuously to achieve your goal. Now I'm not talking about running five miles and then hitting the gym for two hours of weight lifting every day. The kind of exercise needed in a successful weight loss plan is basic and easy. Walking for one half hour daily is a very good start. Kenneth Cooper showed the world through very well done scientific studies over several years, that walking is a safe and effective way to get the benefits of exercise. Swimming is also great. Riding the stationary bike works too. The key is to start slowly and slowly progress. Many people make the mistake of overdoing their new exercise program in the beginning and after two days they are so tired and sore, they just quit. That won't do you any good at all. That is not the way to do it.

Begin any new exercise program slowly. Let's use walking as an example of how to do it right. Figure out a time that you can walk each day. Begin with just thirty minutes of moderate speed (normal) walking. After two weeks, increase the time by fifteen minutes. Now do this forty five minute walk for one month and then increase by another fifteen minutes. Now you are walking for one hour daily. Do this one hour walk for another month before any increase in duration or intensity. Now you may be ready to start jogging instead of just walking. Maybe you don't really want to jog. No problem, you don't have to. You can stay with your walk forever if you like; just pick up the speed a little. The formula described above works exactly the same for swimming or riding a bike.

Now let's talk about why exercise is important to losing weight and keeping it off permanently. Daily aerobic exercise (walking, swimming, biking) raises your basic metabolic rate (BMR). It resets your metabolic thermostat to a higher setting. Your BMR goes up during exercise and stays at a higher level than normal throughout the day. You burn more calories and you lose weight. Simple really, but many people fail to include this essential ingredient in their weight loss plan. Exercise also increases blood flow in you brain, and makes your heart and lungs stronger and more efficient. You will think better, feel better, and even sleep better. All good things.

Let's finish by talking a little about lifting weights. Weight lifting is basically an anaerobic form of exercise; not at all like the aerobic types that we talked about before. When you lift weights you stress an individual muscle or muscle group and strengthen it through a process of muscle breakdown and repair. Building lean muscle is a good idea, and it will help you stay trim, but it should only be added to your weight loss plan after you have lost approximately twenty percent of the weight you want to lose. At that point, it is a very good thing to do. Again, start slowly. You can, and should, eventually combine aerobic exercise with some weight lifting in you routine to achieve optimal health. I personally do aerobic exercise every day and lift twice a week.

That is all for this month. Please visit out website at medifasttucson.com. You will find all the products you need for losing weight and also many informative articles on health. My next newsletter in August will focus on diabetes and weight loss. As always, "the key to good dieting is good nutrition."

Dr. Brad Manny
Owner/Director Medifast Tucson

Wednesday Evenings:

Stay in Shape! Medifast Maintenance Call - 8:00 p.m. Eastern (5:00 p.m. Pacific). Dial 1-512-225-9427 followed by pin code: 77421#. For the fun, interactive Stay in Shape! Maintenance Call, Lori Andersen, RN, coordinates discussions with various Masters of Weight Loss who have lost 60+ lbs. and kept the weight off for at least 4 years. Each week, Lori and her guest(s) share helpful hints and tips for everyone on the Maintenance Program. Be sure to listen and participate in this exciting, informative call.

This call is now recorded live each week! To hear the recorded playback, dial 1- 512-505-6863. The recording is posted the day following the call (Thursday morning).

Medifast Doctor's Support Call - 8:30 p.m. Eastern (5:30 p.m. Pacific). Dial 1-646-519-5860 followed by the pin code: 0971#. Listen and participate in this call, where Dr. Wayne Andersen, Medical Director and Co-Founder of Take Shape For Life, or one of his colleagues discusses current topics regarding creating a healthy weight and a physically optimal life.

This call is now recorded live each week! To hear the recorded playback, dial 1-212-461-8671. The recording is posted the day following the call (Thursday morning).

Monday Evenings:


Medifast Nurse's Support Call - 8:30 p.m. Eastern (5:30 p.m. Pacific). Dial 1-646-519-5860 followed by the pin code: 0971#. Join Lori Andersen, RN, for the weekly Nurse's Support Call. Every week, Lori provides our callers with supportive information to maximize success with their weight-loss and health goals! Be sure to listen in and participate in this inspirational call. Anyone and everyone is encouraged to participate in this call.

This call is now recorded live each week. To hear the recorded playback, dial 1-212-461-8672. The recording is posted the day following the call (Tuesday morning).


Take Shape For Life Field Leadership Call - 9:00 p.m. Eastern (6:00 p.m. Pacific). Dial 1-512-305-4638 followed by the pin code: 99662#. Led by Dr. Wayne Andersen and our Field Leaders, anyone interested in building a successful business and staying current with all that is happening with Take Shape For Life needs to listen in and participate in this incredible call!


This call is now recorded live each week. To hear the recorded playback, dial 1-512-505-6854. The recording is posted the day following the call (Tuesday morning).

Medifast products have a very complete line of minerals and vitamins in each suppement. Medifast has created these products so you do not have to worry about taking extra vitamins each day. Medifast works.

Dietary minerals are the chemical elements required by living organisms, other than the four elements carbon, hydrogen, nitrogen, and oxygen which are present in common organic molecules. The term "mineral" is archaic, since the intent of the definition is to describe ions, not chemical compounds or actual minerals. Furthermore, once dissolved, so-called minerals do not exist as such, sodium chloride breaks down into sodium ions and chloride ions in aqueous solution. Some dietitians recommend that these heavier elements should be supplied by ingesting specific foods (that are enriched in the element(s) of interest), compounds, and sometimes including even minerals, such as calcium carbonate. Sometimes these "minerals" come from natural sources such as ground oyster shells. Sometimes minerals are added to the diet separately from food, such as mineral supplements, the most famous being iodine in "iodized salt." Dirt eating, called pica or geophagy is hypothesized to be a means of supplementing the diet with elements, but this has not been verified. The chemical composition of soils will vary depending on the location.

Vitamins, which are not considered minerals, are organic compounds, some of which contain heavy elements such as iodine and cobalt. The dietary focus on "minerals" derives from an interest in supporting the biosynthetic apparatus with the required elemental components. Appropriate intake levels of certain chemical elements is thus required to maintain optimal health. Commonly, the requirements are met with a conventional diet. Excessive intake of any element (again, usually as an ion) will lead to poisoning. For example, large doses of selenium are lethal. On the other hand, large doses of zinc are less dangerous but can lead to a harmful copper deficiency (unless compensated for, as in the Age-Related Eye Disease Study).

Dietary minerals classified as "macromineral" are required in relatively large amounts. Conversely "microminerals" or "trace minerals" are required relatively in minute amounts. There is no universally accepted definition of the difference between "large" and "small" amounts.

Essential minerals

At least seven minerals are required to support biochemical processes, many playing a role as electrolytes or in cell structure and function. In human nutrition, the dietary bulk "mineral elements" (RDA > 200 mg/day) are in alphabetical order (parenthetical comments on folk medicine perspective):

* Calcium (for muscle, heart and digestive system health, builds bone, neutralizes acidity, supports synthesis and function of blood cells)
* Chloride (for production of hydrochloric acid in the stomach and in cellular pump functions)
* Magnesium is required for processing ATP and related reactions (health builds bone, increases alkalinity)
* Phosphorus is a component of bones (see apatite) and energy processing and many other functions (bone mineralization)
* Potassium is a systemic electrolyte and is essential in coregulating ATP with sodium
* Sodium is a systemic electrolyte and is essential in coregulating ATP with potassium

Trace minerals

Numerous minerals are required in trace amounts and are usually cofactors for enzymes. Some trace mineral elements (RDA < 200 mg/day) are (alphabetical order):

* Cobalt is required for biosynthesis of vitamin B12 family of coenzymes
* Copper is required component of many redox enzymes, including cytochrome c oxidase
* Fluorine participates in formation of tooth enamel which contains fluoroapatite (see Water fluoridation)
* Iodine is required for the biosynthesis of thyroxine
* Iron is required for many proteins and enzymes, notably hemoglobin
* Manganese is a cofactor in function of antioxidant enzymes such as superoxide dismutase
* Molybdenum is required for xanthine oxidase and related oxidases
* Nickel is present in urease
* Selenium is required for peroxidase (antioxidant proteins)
* Sulfur is an essential component of cysteine and methionine amino acids and participates as an enzyme cofactor
* Zinc is pervasive and required for several enzymes such as carboxypeptidase, liver alcohol dehydrogenase, carbonic anhydrase

Other trace minerals

Many elements have been suggested as required in human nutrition, but such claims have usually not been scientifically proven. One problem with identifying efficacy is because many elements are innocuous at low concentrations, so proof of efficacy is lacking. Definitive evidence for efficacy comes from characterization of a biomolecule with an identifiable and testable function. Of the many trace elements still lacking solid proof, chromium is often cited. Chromium(III) is implicated in sugar metabolism in humans, leading to a market for chromium picolinate.

* Vanadium (There is no established RDA for vanadium. No specific biochemical function has been identified for it in humans, although vanadium is found in other organisms)


Food sources

* Dairy products, calcium-fortified foods, canned fish with bones (salmon, sardines), and green leafy vegetables for calcium
* Nuts, soy beans, and cocoa for magnesium
* Table salt (sodium chloride, the main source), sea vegetables, olives, milk, and spinach for sodium
* Legumes, potato skin, tomatoes, and bananas for potassium
* Table salt is the main dietary source for chlorine
* Meat, eggs, and legumes for sulfur
* Red meat, leafy green vegetables, fish (tuna, salmon), eggs, dried fruits, beans, whole grains, and enriched grains for iron.

Medifast products contain all the essential vitamins and minerals. When following the Medifast plan and taking the required number of supplements, you will get all the vitamins your need on a daily basis. Medifast is good for you.

Vitamins are classified as either water-soluble, meaning that they dissolve easily in water, or fat-soluble vitamins, which are absorbed through the intestinal tract with the help of lipids (fats). In general, water-soluble vitamins are readily excreted from the body. Each vitamin is typically used in multiple reactions and, therefore, most have multiple functions.

In humans there are 13 vitamins: 4 fat-soluble (A, D, E and K) and 9 water-soluble (8 B vitamins and vitamin C).
Vitamin generic descriptor name ↓ Vitamer chemical name(s) ↓ Solubility ↓ Recommended dietary allowances
(male, age 19–70) Deficiency disease Upper Intake Level
(UL/day) Overdose disease
Vitamin A Retinoids
(retinol, retinoids
and carotenoids) Fat 900 µg Night-blindness and
Keratomalacia 3,000 µg Hypervitaminosis A
Vitamin B1 Thiamine Water 1.2 mg Beriberi N/D ?
Vitamin B2 Riboflavin Water 1.3 mg Ariboflavinosis N/D ?
Vitamin B3 Niacin, niacinamide Water 16.0 mg Pellagra 35.0 mg Liver damage (doses > 2g/day) and other problems
Vitamin B5 Pantothenic acid Water 5.0 mg Paresthesia N/D ?
Vitamin B6 Pyridoxine, pyridoxamine, pyridoxal Water 1.3-1.7 mg Anaemia 100 mg Impairment of proprioception, nerve damage (doses > 100 mg/day)
Vitamin B7 Biotin Water 30.0 µg Dermatitis, enteritis N/D ?
Vitamin B9 Folic acid, folinic acid Water 400 µg Deficiency during pregnancy is associated with birth defects, such as neural tube defects 1,000 µg
Vitamin B12 Cyanocobalamin, hydroxycobalamin, methylcobalamin Water 2.4 µg Megaloblastic anaemia
Vitamin C Ascorbic acid Water 90.0 mg Scurvy 2,000 mg Refer to Vitamin C megadosage
Vitamin D Ergocalciferol, cholecalciferol Fat 5.0 µg-10 µg Rickets and Osteomalacia 50 µg Hypervitaminosis D
Vitamin E Tocopherols, tocotrienols Fat 15.0 mg Deficiency is very rare; mild hemolytic anemia in newborn infants. 1,000 mg Possible heart problems
Vitamin K phylloquinone, menaquinones Fat 120 µg Bleeding diathesis N/D Increases coagulation in patients taking warfarin.

In nutrition and diseases
Riboflavin (Vitamin B2)
Riboflavin (Vitamin B2)

Vitamins are essential for the normal growth and development of a multicellular organism. Using the genetic blueprint inherited from its parents, a fetus begins to develop, at the moment of conception, from the nutrients it absorbs. It requires certain vitamins and minerals to be present at certain times. These nutrients facilitate the chemical reactions that produce among other things, skin, bone, and muscle. If there is serious deficiency in one or more of these nutrients, a child may develop a deficiency disease. Even minor deficiencies may cause permanent damage.

For the most part, vitamins are obtained with food, but a few are obtained by other means. For example, microorganisms in the intestine—commonly known as "gut flora"—produce vitamin K and biotin, while one form of vitamin D is synthesized in the skin with the help of natural ultraviolet in sunlight. Humans can produce some vitamins from precursors they consume. Examples include vitamin A, produced from beta carotene, and niacin, from the amino acid tryptophan.

Once growth and development are completed, vitamins remain essential nutrients for the healthy maintenance of the cells, tissues, and organs that make up a multicellular organism; they also enable a multicellular life form to efficiently use chemical energy provided by food it eats, and to help process the proteins, carbohydrates, and fats required for respiration.

Deficiencies

Deficiencies of vitamins are classified as either primary or secondary. A primary deficiency occurs when an organism does not get enough of the vitamin in its food. A secondary deficiency may be due to an underlying disorder that prevents or limits the absorption or use of the vitamin, due to a “lifestyle factor”, such as smoking, excessive alcohol consumption, or the use of medications that interfere with the absorption or use of the vitamin. People who eat a varied diet are unlikely to develop a severe primary vitamin deficiency. In contrast, restrictive diets have the potential to cause prolonged vitamin deficits, which may result in often painful and potentially deadly diseases.

Because human bodies do not store most vitamins, humans must consume them regularly to avoid deficiency. Human bodily stores for different vitamins vary widely; vitamins A, D, and B12 are stored in significant amounts in the human body, mainly in the liver, and an adult human's diet may be deficient in vitamins A and B12 for many months before developing a deficiency condition. Vitamin B3 is not stored in the human body in significant amounts, so stores may only last a couple of weeks.

Well-known human vitamin deficiencies involve thiamine (beriberi), niacin (pellagra), vitamin C (scurvy) and vitamin D (rickets). In much of the developed world, such deficiencies are rare; this is due to (1) an adequate supply of food; and (2) the addition of vitamins and minerals to common foods, often called fortification.

Some evidence also suggests that there is a link between vitamin deficiency and mental disorders.
Remember to always take all your Medifast meal replacements each day. Medifast works!

Medifast has an ongoing fight against obesity in American. Medifast products and the Medifast diet will help combat obesity across the country. Medifast utilizes a VLCD approach and controlled portions to help you lose weight. Medifast works.

Obesity in the United States has been increasingly cited as a major health issue in recent decades. While many industrialized countries have experienced similar increases, American obesity rates are the highest in the world with 64% of adults being overweight or obese, and almost a quarter being obese. Estimates of the number of obese American adults have been rising steadily, from 19.4% in 1997, 24.5% in 2004 to 26.6% in 2007.

The economic cost attributable to obesity in the United States has been estimated to be as high as $99.2 billion in 1995, with $51.64 billion attributable to direct medical costs. Researchers for the Centers for Disease Control and Prevention and RTI International estimate that in 2003, obesity-attributable medical expenditures reached $75 billion.



In the military

An estimated 16% of active duty U.S. military personnel were obese in 2004, with the cost of remedial bariatric surgery for the military reaching $15 million in 2002. Obesity is currently the largest single cause for the discharge of soldiers.

Incidence by state

The following figures were averaged from 2004-2006 adult data compiled by the CDC BRFSS program and 2003 child data from the National Survey of Children's Health.


State ↓ Overweight adults (%) Obese adults (%) Overweight children (%) Rank
Alabama 64.7 29.4 16.7 3
Alaska 63.7 25.8 11.1 16
Arizona 57.3 21.7 12.2 43
Arkansas 63.7 27.0 16.4 8
California 59.9 22.7 13.2 36
Colorado 54.2 17.6 9.9 51
Connecticut 57.7 20.1 12.3 47
Delaware 62.2 23.6 14.8 29
D.C. 55.0 22.2 22.8 40
Florida 60.0 22.9 14.4 34
Georgia 61.4 26.1 16.4 14
Hawaii 54.5 20.1 13.3 47
Idaho 59.8 23.2 10.1 31
Illinois 60.7 24.4 15.8 25
Indiana 62.5 26.8 15.6 9
Iowa 62.1 24.9 12.5 20
Kansas 61.3 24.3 14.0 27
Kentucky 64.9 27.5 20.6 7
Louisiana 63.4 28.2 17.2 4
Maine 60.1 23.0 12.7 33
Maryland 60.1 24.4 13.3 25
Massachusetts 55.3 19.8 13.6 50
Michigan 62.7 26.8 14.5 9
Minnesota 61.3 23.7 10.1 28
Mississippi 66.5 30.6 17.8 1
Missouri 62.8 26.3 15.6 12
Montana 58.0 20.7 11.1 45
Nebraska 63.0 25.4 11.9 18
Nevada 60.8 22.5 12.4 37
New Hampshire 59.5 22.4 12.9 38
New Jersey 59.6 22.2 13.7 40
New Mexico 59.3 22.0 16.8 42
New York 58.6 22.4 15.3 38
North Carolina 62.3 25.6 19.3 17
North Dakota 63.8 25.1 12.1 19
Ohio 62.5 26.0 14.2 15
Oklahoma 62.9 26.8 15.4 9
Oregon 59.8 23.3 14.1 30
Pennsylvania 61.4 24.5 13.3 23
Rhode Island 58.8 20.5 11.9 46
South Carolina 63.7 27.8 18.9 5
South Dakota 62.9 24.9 12.1 20
Tennessee 63.9 27.8 20.0 5
Texas 63.1 26.3 19.1 12
Utah 55.8 21.1 8.5 44
Vermont 55.4 20.0 11.3 49
Virginia 61.0 24.5 13.8 23
Washington 59.5 23.2 10.8 31
West Virginia 65.5 29.8 20.9 2
Wisconsin 61.8 24.8 13.5 22
Wyoming 60.2 22.8 8.7 35

Anti-obesity efforts

Due to pressure from parents and anti-obesity advocates, many school districts have removed sodas, junk foods, and candy from snack and vending machines and cafeterias. State legislators in California, for example, passed laws banning the sale of machine-dispensed snacks and drinks in elementary schools in 2003, despite objections by the California-Nevada Soft Drink Association. The state followed more recently with legislation to prohibit their soda sales in high schools by 2009, with the shortfall in school revenue to be compensated by an increase in funding for school lunch programs. In mid-2006, the American Beverage Association (including Cadbury Schweppes, Coca Cola and PepsiCo) agreed to a voluntary ban on the sale of all high-calorie drinks and all beverages in containers larger than 8, 10 and 12 ounces in elementary, middle and high schools, respectively.

Avitaminosis is any disease caused by chronic or long-term vitamin deficiency or caused by a defect in metabolic conversion, such as tryptophan to niacin. They are designated by the same letter as the vitamin.

Conversely hypervitaminosis is the syndrome of symptoms caused by over-retention of fat-soluble vitamins in the body.

Types

Avitaminoses include

* vitamin A deficiency causes xerophthalmia or night blindness
* thiamine deficiency causes beriberi
* niacin deficiency causes pellagra
* vitamin B12 deficiency leads to megaloblastic anemia
* vitamin C deficiency leads to scurvy
* vitamin D deficiency causes rickets
* vitamin K deficiency causes impaired coagulation.

Medifast products are loaded with vitamins to help you stay healthy. There is really no need to take extra vitamins while on Medifast. Medifast works.

Dietary supplements, often containing vitamins, are used to ensure that adequate amounts of nutrients are obtained on a daily basis, if optimal amounts of the nutrients cannot be obtained through a varied diet. Scientific evidence supporting the benefits of some dietary supplements is well established for certain health conditions, but others need further study. A meta-analysis in 2006 suggested that Vitamin A and E supplements not only provide no tangible health benefits for generally healthy individuals, but may actually increase mortality, although two large studies included in the analysis involved smokers, for which it was already known that beta-carotene supplements can be harmful.

In the United States, advertising for dietary supplements is required to include a disclaimer that the product is not intended to treat, diagnose, mitigate, prevent, or cure disease, and that any health claims have not been evaluated by the Food and Drug Administration. In some cases, dietary supplements may have unwanted effects, especially if taken before surgery, with other dietary supplements or medicines, or if the person taking them has certain health conditions. Vitamin supplements may also contain levels of vitamins many times higher, and in different forms, than one may ingest through food.

Intake of excessive quantities can cause vitamin poisoning, often due to overdose of Vitamin A and Vitamin D (The most common poisoning with multinutrient supplement pills does not involve a vitamin, but is rather due to the mineral iron). Due to toxicity, most common vitamins have recommended upper daily intake amounts.

Since 2005, suppliers have distinguished their products as either Medical Grade or Pharmaceutical Grade products. Both of these classifications indicate products that are manufactured to be easily absorbed by the body. Normal vitamin manufacturing is not regulated in the United States to the same standards as are medicinal pharmaceuticals, although U.S. vitamins which are manufactured for food consumption by humans or animals must be manufactured to Food Chemicals Codex (FCC), grade, commonly called "food grade".

Governmental regulation of vitamin supplements

Most countries place dietary supplements in a special category under the general umbrella of foods, not drugs. This necessitates that the manufacturer, and not the government, be responsible for ensuring that its dietary supplement products are safe before they are marketed. Unlike drug products, that must explicitly be proven safe and effective for their intended use before marketing, there are often no provisions to "approve" dietary supplements for safety or effectiveness before they reach the consumer. Also unlike drug products, manufacturers and distributors of dietary supplements are not generally required to report any claims of injuries or illnesses that may be related to the use of their products.

Names in current and previous nomenclatures

The reason the set of vitamins seems to skip directly from E to K is that the vitamins corresponding to "letters" F-J were either reclassified over time, discarded as false leads, or renamed because of their relationship to "vitamin B", which became a "complex" of vitamins. The German-speaking scientists who isolated and described vitamin K (in addition to naming it as such) did so because the vitamin is intimately involved in the Koagulation of blood following wounding. At the time, most (but not all) of the letters from F through J were already designated, so the use of the letter K was considered quite reasonable.

The following table lists chemicals that had previously been classified as vitamins, as well as the earlier names of vitamins that later became part of the B-complex:
Previous name Chemical name Reason for name change
Vitamin B4 Adenine DNA metabolite
Vitamin B8 Adenylic acid DNA metabolite
Vitamin F Essential fatty acids Needed in large quantities (does
not fit the definition of a vitamin).
Vitamin G Riboflavin Reclassified as Vitamin B2
Vitamin H Biotin Reclassified as Vitamin B7
Vitamin J Catechol, Flavin Protein metabolite
Vitamin L1 Anthranilic acid Protein metabolite
Vitamin L2 Adenylthiomethylpentose RNA metabolite
Vitamin M Folic acid Reclassified as Vitamin B9
Vitamin O Carnitine Protein metabolite
Vitamin P Flavonoids No longer classified as a vitamin
Vitamin PP Niacin Reclassified as Vitamin B3
Vitamin U S-Methylmethionine Protein metabolite

We are so excited to see everyone at the luxurious Omni Orlando Resort this week for National Convention 2008! This will definitely be the largest National Convention ever, with over 730 attendees registered and ready to take their business to the next level. Get ready to be exposed to all of the fun, excitement, learning, and business-building opportunities National Convention has to offer!


What To Wear:

We know some of you have questions about what the different attires mean for each event found in the "Schedule of Events" area of the National Convention website. Please use the below descriptions as guidelines when packing for this week!

Casual is relaxed attire. This could be jeans, khakis, or whatever you wear to dress comfortably.

Casual/Active is your more comfortable clothing that you can move freely in. This could incorporate athletic shoes, lighter-weight clothing, etc.

Business Casual is a more formal casual dress. This could be slacks and a nice polo for men or slacks and a nice top for women.

Dinner Dress is a comfortable attire but more formal than Business Casual. This could be a nice dress shirt and slacks for men or a sundress for women.

Business or Formal is a formal dinner attire. For men, this could be a tux or nice suit. For ladies, this could be an evening dress or nice pant suit.

Swimwear is whatever you feel comfortable swimming in.


Workshops:

Get ready!Medifast National Convention has a wide variety of informative workshops that range from basic presentation skills to advanced business development. Whether you're a new Health Coach, a seasoned Business Coach, or even an experienced Business Leader, you and your business will benefit from these enlightening and highly specialized workshops presented by our top Business Leaders!

To check out a complete list of workshops before Medifast National Convention:

Go to www.tsflnationalconvention2008.com
Click on the "Workshop Schedule" link on the left panel.

For more information, please visit the Medifast National Convention web site. We can't wait to see you all in sunny Orlando later this week for what is sure to be the best Medifast National Convention to date!

Medifast has been around for a long time. About twenty years, actually. It is one of the few diets to be FDA inspected and has undergone rigorous studies. Medifast works and Medifast is safe.

The Weight-Loss Industry

Looking for a quick and easy way to lose weight? You're not alone. An estimated 50 million Americans will go on diets this year. And while some will succeed in taking the weight off, very few--perhaps 5 percent--will manage to keep all of it off in the long run.

One reason for the low success rate is that many people look for quick and easy solutions to their weight problems. They find it hard to believe in this age of scientific innovations and medical miracles that an effortless weight-loss method doesn't exist.

So they succumb to quick-fix claims like "Eat All You Want and Still Lose Weight!" or "Melt Fat Away While You Sleep!" And they invest their hopes (and their money) in all manner of pills, potions, gadgets, and programs that hold the promise of a slimmer, happier future.

The weight-loss business is a booming industry. Americans spend an estimated $30 billion a year on all types of diet programs and products, including diet foods and drinks. Trying to sort out all of the competing claims--often misleading, unproven, or just plain false--can be confusing and costly.

This brochure is designed to give you the facts behind the claims, to help you avoid the outright scams, and to encourage you to consider thoroughly the costs and consequences of the dieting decisions you make.

The Facts about Weight Loss

Being obese can have serious health consequences. These include an increased risk of heart disease, stroke, high blood pressure, diabetes, gallstones, and some forms of cancer. Losing weight can help reduce these risks. Here are some general points to keep in mind:

* Any claims that you can lose weight effortlessly are false. The only proven way to lose weight is either to reduce the number of calories you eat or to increase the number of calories you burn off through exercise. Most experts recommend a combination of both.

* Very low-calorie diets are not without risk and should be pursued only under medical supervision. Unsupervised very low-calorie diets can deprive you of important nutrients and are potentially dangerous.

* Fad diets rarely have any permanent effect. Sudden and radical changes in your eating patterns are difficult to sustain over time. In addition, so-called "crash" diets often send dieters into a cycle of quick weight loss, followed by a "rebound" weight gain once normal eating resumes, and even more difficulty reducing when the next diet is attempted.

* To lose weight safely and keep it off requires long-term changes in daily eating and exercise habits. Many experts recommend a goal of losing about a pound a week. A modest reduction of 500 calories per day will achieve this goal, since a total reduction of 3,500 calories is required to lose a pound of fat. An important way to lower your calorie intake is to learn and practice healthy eating habits.

In Search of the "Magic Bullet"

Some dieters peg their hopes on pills and capsules that promise to "burn," "block," "flush," or otherwise eliminate fat from the system. But science has yet to come up with a low-risk "magic bullet" for weight loss. Some pills may help control the appetite, but they can have serious side effects. (Amphetamines, for instance, are highly addictive and can have an adverse impact on the heart and central nervous system.) Other pills are utterly worthless.

The Federal Trade Commission (FTC) and a number of state Attorney General have successfully brought cases against marketers of pills claiming to absorb or burn fat. The Food and Drug Administration (FDA) has banned 111 ingredients once found in over-the-counter diet products. None of these substances, which include alcohol, caffeine, dextrose, and guar gum, have proved effective in weight-loss or appetite suppression.

Beware of the following products that are touted as weight-loss wonders:

* Diet patches, which are worn on the skin, have not been proven to be safe or effective. The FDA has seized millions of these products from manufacturers and promoters.

* "Fat blockers" purport to physically absorb fat and mechanically interfere with the fat a person eats.

* "Starch blockers" promise to block or impede starch digestion. Not only is the claim unproven, but users have complained of nausea, vomiting, diarrhea, and stomach pains.

* "Magnet" diet pills allegedly "flush fat out of the body." The FTC has brought legal action against several marketers of these pills.

* Glucomannan is advertised as the "Weight Loss Secret That's Been in the Orient for Over 500 Years." There is little evidence supporting this plant root's effectiveness as a weight-loss product.

* Some bulk producers or fillers, such as fiber-based products, may absorb liquid and swell in the stomach, thereby reducing hunger. Some fillers, such as guar gum, can even prove harmful, causing obstructions in the intestines, stomach, or esophagus. The FDA has taken legal action against several promoters containing guar gum.

* Spirulina, a species of blue-green algae, has not been proven effective for losing weight.

Phony Devices and Gadgets

Phony weight-loss devices range from those that are simply ineffective to those that are truly dangerous to your health. At minimum, they are a waste of your hard-earned money. Some of the fraudulent gadgets that have been marketed to hopeful dieters over the years include:

* Electrical muscle stimulators have legitimate use in physical therapy treatment. But the FDA has taken a number of them off the market because they were promoted for weight loss and body toning. When used incorrectly, muscle stimulators can be dangerous, causing electrical shocks and burns.

* "Appetite suppressing eyeglasses" are common eyeglasses with colored lenses that claim to project an image to the retina which dampens the desire to eat. There is no evidence these work.

* "Magic weight-loss earrings" and devices custom-fitted to the purchaser's ear that purport to stimulate acupuncture points controlling hunger have not been proven effective.

Diet Programs

Approximately 8 million Americans a year enroll in some kind of structured weight-loss program involving liquid diets, special diet regimens, or medical or other supervision. In 1991, about 8,500 commercial diet centers were in operation across the country, many of them owned by half-dozen or so well-known national companies.

Before you join such a program, you should know that according to published studies relatively few participants succeed in keeping off weight long-term. Recently, the FTC brought action against several companies challenging weight-loss and weight-maintenance claims. Unfortunately, some other companies continue to make overblown claims.

The FTC stopped one company from claiming its diet program caused rapid weight loss through the use of tablets that would "burn fat" and a protein drink mix that would adjust metabolism. The FTC also took action against three major programs using doctor-supervised, very low-calorie liquid diets, and they agreed to stop making claims unless they could back them up with hard data.

Before you sign up with a diet program, you might ask these questions:

* What are the health risks?

* What data can you show me that proves your program actually works?

* Do customers keep off the weight after they leave the diet program?

* What are the costs for membership, weekly fees, food, supplements, maintenance, and counseling? What's the payment schedule? Are any costs covered under health insurance? Do you give refunds if I drop out?

* Do you have a maintenance program? Is it part of the package or does it cost extra?

* What kind of professional supervision is provided? What are the credentials of these professionals?

* What are the program's requirements? Are there special menus or foods, counseling visits, or exercise plans?

Clues to Fraud

It is important for consumers to be wary of claims that sound too good to be true. When it comes to weight-loss schemes, consumers should be particularly skeptical of claims containing words and phrases like:

* easy
* effortless
* guaranteed
* miraculous
* magical
* breakthrough
* new discovery
* mysterious
* exotic
* secret
* exclusive
* ancient

Sensible Weight Maintenance Tips
These are also used in the Medifast plan.

Losing weight may not be effortless, but it doesn't have to be complicated. To achieve long-term results, it's best to avoid quick-fix schemes and complex regimens. Focus instead on making modest changes to your life's daily routine. A balanced, healthy diet and sensible, regular exercise are the keys to maintaining your ideal weight. Although nutrition science is constantly evolving, here are some generally-accepted guidelines for losing weight:

* Consult with your doctor, a dietician, or other qualified health professional to determine your ideal healthy body weight.

* Eat smaller portions and choose from a variety of foods.

* Load up on foods naturally high in fiber: Fruits, vegetables, legumes, and whole grains.

* Limit portions of foods high in fat: dairy products like cheese, butter, and whole milk; red meat; cakes and pastries.

* Exercise at least three times weekly.

Medifast strives to keep you abreast of changes to the Medifast field support schedule changes.
Please note that due to Medifast National Convention next week,Medifast Field Support will operate under a modified schedule, starting Monday, July 21.

Field Support will be be available to serve you next week, July 21 through July 25, from 9 a.m. to 6 p.m.

*The Medifast Client Contact Center will still operate using its usual schedule.

We appreciate your cooperation and understanding as members of Field Support join others from the Take Shape For Life Home Office and over 700 Health Coaches in sunny Orlando, FL to make National Convention 2008 the best yet!

Medifast can help you control your Adult onset diabetes. Medifast has an entire line of Diabetic products to help you.

The citric acid cycle, also known as the Krebs cycle, is a series of enzyme-catalyzed chemical reactions of central importance in all living cells that use oxygen as part of cellular respiration. In eukaryotes, the citric acid cycle occurs in the matrix of the mitochondrion. The components and reactions of the citric acid cycle were established by seminal work from both Albert Szent-Györgyi and Hans Krebs.
In aerobic organisms, the citric acid cycle is part of a metabolic pathway involved in the chemical conversion of carbohydrates, fats and proteins into carbon dioxide and water to generate a form of usable energy. Other relevant reactions in the pathway include those in glycolysis and pyruvate oxidation before the citric acid cycle and oxidative phosphorylation after it. In addition, it provides precursors for many compounds including some amino acids and is therefore functional even in cells performing fermentation.
Overview
Two carbons are oxidized to CO2, and the energy from these reactions is transferred to other metabolic processes by GTP (or ATP), and as electrons in NADH and QH2. The NADH generated in the TCA cycle may later donate its electrons in oxidative phosphorylation to drive ATP synthesis; FADH2 is covalently attached to succinate dehydrogenase, an enzyme functioning both in the TCA cycle and the mitochondrial electron transport chain in oxidative phosphorylation. FADH2 thereby facilitates transfer of electrons to coenzyme Q, which is the final electron acceptor of the reaction catalyzed by the Succinate: ubiquinone oxidoreductase complex, also acting as an intermediate in the electron transport chain.
The citric acid cycle is continuously supplied new carbons in the form of acetyl-CoA, entering at step 1 below.
Substrates Products Enzyme Reaction type Comment
1 Oxaloacetate +
Acetyl CoA +
H2O Citrate +
CoA-SH Citrate synthase Aldol condensation rate limiting stage,
extends the 4C oxaloacetate to a 6C molecule
2 Citrate cis-Aconitate +
H2O Aconitase Dehydration reversible isomerisation
3 cis-Aconitate +
H2O Isocitrate Hydration
4 Isocitrate +
NAD+ Oxalosuccinate +
NADH + H + Isocitrate dehydrogenase Oxidation generates NADH (equivalent of 2.5 ATP)
5 Oxalosuccinate α-Ketoglutarate +
CO2 Decarboxylation irreversible stage,
generates a 5C molecule
6 α-Ketoglutarate +
NAD+ +
CoA-SH Succinyl-CoA +
NADH + H+ +
CO2 α-Ketoglutarate dehydrogenase Oxidative
decarboxylation generates NADH (equivalent of 2.5 ATP),
regenerates the 4C chain (CoA excluded)
7 Succinyl-CoA +
GDP + Pi Succinate +
CoA-SH +
GTP Succinyl-CoA synthetase substrate level phosphorylation or ADP->ATP,
generates 1 ATP or equivalent
8 Succinate +
ubiquinone (Q) Fumarate +
ubiquinol (QH2) Succinate dehydrogenase Oxidation uses FAD as a prosthetic group (FAD->FADH2 in the first step of the reaction) in the enzyme,
generates the equivalent of 1.5 ATP
9 Fumarate +
H2O L-Malate Fumarase H2O addition
(hydration)
10 L-Malate+
NAD+ Oxaloacetate +
NADH + H+ Malate dehydrogenase Oxidation generates NADH (equivalent of 2.5 ATP)
Mitochondria in animals including humans possess two succinyl-CoA synthetases, one that produces GTP from GDP, and another that produces ATP from ADP. Plants have the type that produces ATP (ADP-forming succinyl-CoA synthetase).
The GTP that is formed by GDP-forming succinyl-CoA synthetase may be utilized by nucleoside-diphosphate kinase to form ATP (the catalyzed reaction is GTP + ADP -> GDP + ATP).
A simplified view of the process
• The citric acid cycle begins with acetyl-CoA transferring its two-carbon acetyl group to the four-carbon acceptor compound (oxaloacetate) to form a six-carbon compound (citrate).
• The citrate then goes through a series of chemical transformations, losing first one, then a second carboxyl group as CO2. The carbons lost as CO2 originate from what was oxaloacetate, not directly from acetyl-CoA. The carbons donated by acetyl-CoA become part of the oxaloacetate carbon backbone after the first turn of the citric acid cycle. Loss of the acetyl-CoA-donated carbons as CO2 requires several turns of the citric acid cycle. However, because of the role of the citric acid cycle in anabolism, they may not be lost since many TCA cycle intermediates are also used as precursors for the biosynthesis of other molecules.
• Most of the energy made available by the oxidative steps of the cycle is transferred as energy-rich electrons to NAD+, forming NADH. For each acetyl group that enters the citric acid cycle, three molecules of NADH are produced.
• Electrons are also transferred to the electron acceptor Q, forming QH2.
• At the end of each cycle, the four-carbon oxaloacetate has been regenerated, and the cycle continues.
Products
Products of the first turn of the cycle are: one GTP (or ATP), three NADH, one QH2, and two CO2.
Because two acetyl-CoA molecules are produced from each glucose molecule, two cycles are required per glucose molecule. Therefore, at the end of all cycles, the products are: two GTP, six NADH, two QH2, and four CO2
Description Reactants Products
The sum of all reactions in the citric acid cycle is: Acetyl-CoA + 3 NAD+ + Q + GDP + Pi + 2 H2O → CoA-SH + 3 NADH + 3 H+ + QH2 + GTP + 2 CO2
Combining the reactions occurring during the pyruvate oxidation with those occurring during the citric acid cycle, the following overall pyruvate oxidation reaction is obtained: Pyruvic acid + 4 NAD+ + Q + GDP + Pi + 2 H2O → 4 NADH + 4 H+ + QH2 + GTP + 3 CO2
Combining the above reaction with the ones occurring in the course of glycolysis, the following overall glucose oxidation reaction (excluding reactions in the respiratory chain) is obtained: Glucose + 10 NAD+ + 2 Q + 2 ADP + 2 GDP + 4 Pi + 2 H2O → 10 NADH + 10 H+ + 2 QH2 + 2 ATP + 2 GTP + 6 CO2
(the above reactions are equilibrated if Pi represents the H2PO4- ion, ADP and GDP the ADP2- and GDP2- ions, respectively, and ATP and GTP the ATP3- and GTP3- ions, respectively).
Estimates for the total number of ATP obtained after complete oxidation of one glucose in glycolysis, citric acid cycle, and oxidative phosphorylation given in the literature range from 30-38 molecules of ATP. A recent assessment of the total ATP yield obtained in these distinct reaction cycles, taking into account updated proton-to-ATP ratios, has arrived at an estimate of 29.85 ATP per glucose molecule.
Regulation
Although pyruvate dehydrogenase is not technically a part of the citric acid cycle, its regulation is included here.
The regulation of the TCA cycle is largely determined by substrate availability and product inhibition. NADH, a product of all dehydrogenases in the TCA cycle with the exception of succinate dehydrogenase, inhibits pyruvate dehydrogenase, isocitrate dehydrogenase and α-ketoglutarate dehydrogenase, and also citrate synthase. Acetyl-CoA inhibits pyruvate dehydrogenase, while succinyl-CoA inhibits succinyl-CoA synthase and citrate synthase. When tested in vitro with TCA enzymes, ATP inhibits citrate synthase and α-ketoglutarate dehydrogenase; however, ATP levels do not change more than 10% in vivo between rest and vigorous exercise. There is no known allosteric mechanism that can account for large changes in reaction rate from an allosteric effector whose concentration changes less than 10%.
Calcium is used as a regulator. It activates pyruvate dehydrogenase, isocitrate dehydrogenase and α-ketoglutarate dehydrogenase. This increases the reaction rate of many of the steps in the cycle, and therefore increases flux throughout the pathway.
Citrate is used for feedback inhibition, as it inhibits phosphofructokinase, an enzyme involved in glycolysis that catalyses formation of fructose 1,6-bisphosphate, a precursor of pyruvate. This prevents a constant high rate of flux when there is an accumulation of citrate and a decrease in substrate for the enzyme.
Recent work has demonstrated an important link between intermediates of the citric acid cycle and the regulation of hypoxia inducible factors (HIF). HIF plays a role in the regulation of oxygen homeostasis, and is a transcription factor which targets angiogenesis, vascular remodeling, glucose unitization, iron transport and apoptosis. HIF is synthesized constitutively and hydroxylation of at least one of two critical proline residues mediates their interaction with the von Hippel Lindau E3 ubiquitin ligase complex which targets them for rapid degradation. This reaction is catalyzed by prolyl 4-hydroxylases. Fumarate and succinate have been identified as potent inhibitors of prolyl hydroxylases thus leading to the stabilization of HIF.
Major metabolic pathways converging on the TCA cycle
Several catabolic pathways converge on the TCA cycle. Reactions that form intermediates of the TCA cycle in order to replenish them (especially during the scarcity of the intermediates) are called anaplerotic reactions.
The citric acid cycle is the third step in carbohydrate catabolism (the breakdown of sugars). Glycolysis breaks glucose (a six-carbon-molecule) down into pyruvate (a three-carbon molecule). In eukaryotes, pyruvate moves into the mitochondria. It is converted into acetyl-CoA by decarboxylation and enters the citric acid cycle.
In protein catabolism, proteins are broken down by protease enzymes into their constituent amino acids. The carbon backbone of these amino acids can become a source of energy by being converted to Acetyl-CoA and entering into the citric acid cycle.
In fat catabolism, triglycerides are hydrolyzed to break them into fatty acids and glycerol. In the liver the glycerol can be converted into glucose via dihydroxyacetone phosphate and glyceraldehyde-3-phosphate by way of gluconeogenesis. In many tissues, especially heart tissue, fatty acids are broken down through a process known as beta oxidation which results in acetyl-CoA which can be used in the citric acid cycle. Beta oxidation of odd chain fatty acids can yield propionyl CoA which can result in further glucose production by gluconeogenesis in the liver.
The citric acid cycle is always followed by oxidative phosphorylation. This process extracts the energy (as electrons) from NADH and QH2, oxidizing them to NAD+ and Q, respectively, so that the cycle can continue. Whereas the citric acid cycle does not use oxygen, oxidative phosphorylation does.
The total energy gained from the complete breakdown of one molecule of glucose by glycolysis, the citric acid cycle and oxidative phosphorylation equals about 30 ATP molecules, in eukaryotes. The citric acid cycle is called an amphibolic pathway because it participates in both catabolism and anabolism.

Medifast can be used successfully with Adult onset or Type II diabetes. It is not recommended for Type I Juvenile onset diabetes. Medifast has an entire line of low glycemic Diabetic products to help you lose weight. The use of these Medifast products will also help you control your blood sugar.

The term diabetes, without qualification, usually refers to diabetes mellitus, which is associated with excessive sweet urine (known as "glycosuria") but there are several rarer conditions also named diabetes. The most common of these is diabetes insipidus in which the urine is not sweet (insipidus meaning "without taste" in Latin); it can be caused by either kidney (nephrogenic DI) or pituitary gland (central DI) damage.

The principal two idiopathic forms of diabetes mellitus are known as types 1 and 2. The term "type 1 diabetes" has universally replaced several former terms, including childhood-onset diabetes, juvenile diabetes, and insulin-dependent diabetes (IDDM). Likewise, the term "type 2 diabetes" has replaced several former terms, including adult-onset diabetes, obesity-related diabetes, and non-insulin-dependent diabetes (NIDDM). Beyond these two types, there is no agreed-upon standard nomenclature. Various sources have defined "type 3 diabetes" as, among others, gestational diabetes, insulin-resistant type 1 diabetes (or "double diabetes"), type 2 diabetes which has progressed to require injected insulin, and latent autoimmune diabetes of adults (or LADA or "type 1.5" diabetes. There is also maturity onset diabetes of the young (MODY) which is a group of several single gene disorders with strong family histories that present as type 2 diabetes before 30 years of age.

Type 1 diabetes mellitus


Type 1 diabetes mellitus is characterized by loss of the insulin-producing beta cells of the islets of Langerhans in the pancreas, leading to a deficiency of insulin. The main cause of this beta cell loss is a T-cell mediated autoimmune attack. There is no known preventive measure which can be taken against type 1 diabetes; it is about 10% of diabetes mellitus cases in North America and Europe (though this varies by geographical location), and is a higher percentage in some other areas. Most affected people are otherwise healthy and of a healthy weight when onset occurs. Sensitivity and responsiveness to insulin are usually normal, especially in the early stages. Type 1 diabetes can affect children or adults but was traditionally termed "juvenile diabetes" because it represents a majority of the diabetes cases in children.

The principal treatment of type 1 diabetes, even from its earliest stages, is replacement of insulin combined with careful monitoring of blood glucose levels using blood testing monitors. Without insulin, diabetic ketoacidosis often develops which may result in coma or death. Treatment emphasis is now also placed on lifestyle adjustments (diet and exercise) though these cannot reverse the progress of the disease. Apart from the common subcutaneous injections, it is also possible to deliver insulin by a pump, which allows continuous infusion of insulin 24 hours a day at preset levels, and the ability to program doses (a bolus) of insulin as needed at meal times.

Type 1 treatment must be continued indefinitely in essentially all cases. Treatment need not significantly impair normal activities, if sufficient patient training, awareness, appropriate care, discipline in testing and dosing of insulin is taken. However, treatment is burdensome for patients, insulin is replaced in a non-physiological manner, and this approach is therefore far from ideal. The average glucose level for the type 1 patient should be as close to normal (80–120 mg/dl, 4–6 mmol/l) as is safely possible. Some physicians suggest up to 140–150 mg/dl (7-7.5 mmol/l) for those having trouble with lower values, such as frequent hypoglycemic events. Values above 200 mg/dl (10 mmol/l) are sometimes accompanied by discomfort and frequent urination leading to dehydration. Values above 300 mg/dl (15 mmol/l) usually require medical treatment and may lead to ketoacidosis, although they are not immediately life-threatening. However, low levels of blood glucose, called hypoglycemia, may lead to seizures or episodes of unconsciousness and absolutely must be treated immediately.

Type 2 diabetes mellitus


Type 2 diabetes mellitus is characterized differently due to insulin resistance or reduced insulin sensitivity, combined with reduced insulin secretion. The defective responsiveness of body tissues to insulin almost certainly involves the insulin receptor in cell membranes. In the early stage the predominant abnormality is reduced insulin sensitivity, characterized by elevated levels of insulin in the blood. At this stage hyperglycemia can be reversed by a variety of measures and medications that improve insulin sensitivity or reduce glucose production by the liver. As the disease progresses the impairment of insulin secretion worsens, and therapeutic replacement of insulin often becomes necessary.

There are numerous theories as to the exact cause and mechanism in type 2 diabetes. Central obesity (fat concentrated around the waist in relation to abdominal organs, but not subcutaneous fat) is known to predispose individuals for insulin resistance. Abdominal fat is especially active hormonally, secreting a group of hormones called adipokines that may possibly impair glucose tolerance. Obesity is found in approximately 55% of patients diagnosed with type 2 diabetes. Other factors include aging (about 20% of elderly patients in North America have diabetes) and family history (type 2 is much more common in those with close relatives who have had it). In the last decade, type 2 diabetes has increasingly begun to affect children and adolescents, likely in connection with the increased prevalence of childhood obesity seen in recent decades in some places.

Type 2 diabetes may go unnoticed for years because visible symptoms are typically mild, non-existent or sporadic, and usually there are no ketoacidotic episodes. However, severe long-term complications can result from unnoticed type 2 diabetes, including renal failure due to diabetic nephropathy, vascular disease (including coronary artery disease), vision damage due to diabetic retinopathy, loss of sensation or pain due to diabetic neuropathy, and liver damage from non-alcoholic steatohepatitis.

Type 2 diabetes is usually first treated by increasing physical activity, decreasing carbohydrate intake, and losing weight. These can restore insulin sensitivity even when the weight loss is modest, for example around 5 kg (10 to 15 lb), most especially when it is in abdominal fat deposits. It is sometimes possible to achieve long-term, satisfactory glucose control with these measures alone. However, the underlying tendency to insulin resistance is not lost, and so attention to diet, exercise, and weight loss must continue. The usual next step, if necessary, is treatment with oral antidiabetic drugs. Insulin production is initially only moderately impaired in type 2 diabetes, so oral medication (often used in various combinations) can be used to improve insulin production (e.g., sulfonylureas), to regulate inappropriate release of glucose by the liver and attenuate insulin resistance to some extent (e.g., metformin), and to substantially attenuate insulin resistance (e.g., thiazolidinediones). According to one study, overweight patients treated with metformin compared with diet alone, had relative risk reductions of 32% for any diabetes endpoint, 42% for diabetes related death and 36% for all cause mortality and stroke. Oral medication may eventually fail due to further impairment of beta cell insulin secretion. At this point, insulin therapy is necessary to maintain normal or near normal glucose levels.

Gestational diabetes


Gestational diabetes mellitus (GDM) resembles type 2 diabetes in several respects, involving a combination of relatively inadequate insulin secretion and responsiveness. It occurs in about 2%–5% of all pregnancies and may improve or disappear after delivery. Gestational diabetes is fully treatable but requires careful medical supervision throughout the pregnancy. About 20%–50% of affected women develop type 2 diabetes later in life.

Even though it may be transient, untreated gestational diabetes can damage the health of the fetus or mother. Risks to the baby include macrosomia (high birth weight), congenital cardiac and central nervous system anomalies, and skeletal muscle malformations. Increased fetal insulin may inhibit fetal surfactant production and cause respiratory distress syndrome. Hyperbilirubinemia may result from red blood cell destruction. In severe cases, perinatal death may occur, most commonly as a result of poor placental profusion due to vascular impairment. Induction may be indicated with decreased placental function. A cesarean section may be performed if there is marked fetal distress or an increased risk of injury associated with macrosomia, such as shoulder dystocia.

A 2008 study completed in the U.S. found that more American women are entering pregnancy with preexisting diabetes. In fact the rate of diabetes in expectant mothers has more than doubled in the past 6 years. This is particularly problematic as diabetes raises the risk of complications during pregnancy, as well as increasing the potential that the children of diabetic mothers will also become diabetic in the future.

Other types

There are several rare causes of diabetes mellitus that do not fit into type 1, type 2, or gestational diabetes; attempts to classify them remain controversial. Some cases of diabetes are caused by the body's tissue receptors not responding to insulin (even when insulin levels are normal, which is what separates it from type 2 diabetes); this form is very uncommon. Genetic mutations (autosomal or mitochondrial) can lead to defects in beta cell function. Abnormal insulin action may also have been genetically determined in some cases. Any disease that causes extensive damage to the pancreas may lead to diabetes (for example, chronic pancreatitis and cystic fibrosis). Diseases associated with excessive secretion of insulin-antagonistic hormones can cause diabetes (which is typically resolved once the hormone excess is removed). Many drugs impair insulin secretion and some toxins damage pancreatic beta cells. The ICD-10 (1992) diagnostic entity, malnutrition-related diabetes mellitus (MRDM or MMDM, ICD-10 code E12), was deprecated by the World Health Organization when the current taxonomy was introduced in 1999.

Wednesday Evenings:

Stay in Shape!Medifast Maintenance Call - 8:00 p.m. Eastern (5:00 p.m. Pacific). Dial 1-512-225-9427 followed by pin code: 77421#. For the fun, interactive Stay in Shape! Maintenance Call, Lori Andersen, RN, coordinates discussions with various Masters of Weight Loss who have lost 60+ lbs. and kept the weight off for at least 4 years. Each week, Lori and her guest(s) share helpful hints and tips for everyone on the Maintenance Program. Be sure to listen and participate in this exciting, informative call.

This call is now recorded live each week! To hear the recorded playback, dial 1- 512-505-6863. The recording is posted the day following the call (Thursday morning).

Medifast Doctor's Support Call - 8:30 p.m. Eastern (5:30 p.m. Pacific). Dial 1-646-519-5860 followed by the pin code: 0971#. Listen and participate in this call, where Dr. Wayne Andersen, Medical Director and Co-Founder of Take Shape For Life, or one of his colleagues discusses current topics regarding creating a healthy weight and a physically optimal life.

This call is now recorded live each week! To hear the recorded playback, dial 1-212-461-8671. The recording is posted the day following the call (Thursday morning).

Monday Evenings:

Medifast Nurse's Support Call - 8:30 p.m. Eastern (5:30 p.m. Pacific). Dial 1-646-519-5860 followed by the pin code: 0971#. Join Lori Andersen, RN, for the weekly Medifast Nurse's Support Call. Every week, Lori provides our callers with supportive information to maximize success with their weight-loss and health goals! Be sure to listen in and participate in this inspirational call. Anyone and everyone is encouraged to participate in this call.

This call is now recorded live each week. To hear the recorded playback, dial 1-212-461-8672. The recording is posted the day following the call (Tuesday morning).

Take Shape For Life Field Leadership Call - 9:00 p.m. Eastern (6:00 p.m. Pacific). Dial 1-512-305-4638 followed by the pin code: 99662#. Led by Dr. Wayne Andersen and our Field Leaders, anyone interested in building a successful business and staying current with all that is happening with Take Shape For Life needs to listen in and participate in this incredible call!

This call is now recorded live each week. To hear the recorded playback, dial 1-512-505-6854. The recording is posted the day following the call (Tuesday morning).

The Medifast diet induces a state of ketosis by limiting calories and utilizing a moderately high protein intake. Medifast allows you to lose from three to five pounds weekly using this very low calorie approach. The state of ketosis induced by the Medifast diet is mild.

Ketosis is a state in metabolism occurring when the liver excessively converts fat into fatty acids and ketone bodies which can be used by the body for energy.
Adipose tissue consists of highly specialized cells which store energy in the form of a triglyceride and release it upon hydrolysis in a process known as lipolysis, yielding three fatty acids and one glycerol molecule. These ketone bodies are a by-product of the lipid metabolic pathway after the fat is converted to energy. Ketoacidosis, by contrast, is the accumulation of excessive keto acids in the blood stream (specifically acetoacetate and beta-hydroxy butyrate).
Metabolic pathways
Most medical resources regard ketosis as a physiological state associated with chronic starvation. Glucose is regarded as the preferred energy source for all cells in the body with ketosis being regarded as a crisis reaction of the body to a lack of carbohydrates in the diet. In recent years this viewpoint, both the body's preference for glucose and the dangers associated with ketosis, has been challenged by some doctors.
Ketone bodies, from the breakdown of fatty acids to acetyl groups, are also produced during this state, and are burned throughout the body. Excess ketone bodies will slowly decarboxylate into acetone. That molecule is excreted in the breath and urine. When glycogen stores are not available in the cells (glycogen is primarily created when carbohydrates such as starch and sugar are consumed in the diet), fat (triacylglycerol) is cleaved to give 3 fatty acid chains and 1 glycerol molecule in a process called lipolysis. Most of the body is able to utilize fatty acids as an alternative source of energy in a process where fatty acid chains are cleaved to form acetyl-CoA, which can then be fed into the Krebs cycle. During this process a high concentration of glucagon is present in the serum and this inactivates hexokinase and phosphofructokinase-1 (regulators of glycolysis) indirectly, causing most cells in the body to use fatty acids as their primary energy source. At the same time, glucose is synthesized in the liver from lactic acid, glucogenic amino acids, and glycerol, in a process called gluconeogenesis. This glucose is used exclusively for energy by cells such as neurons and red blood cells.
Similar conditions
Ketosis should not be confused with ketoacidosis (diabetic ketoacidosis or the less common alcoholic ketoacidosis), which is severe ketosis causing the pH of the blood to drop below 7.2. Ketoacidosis is a medical condition usually caused by diabetes and accompanied by dehydration, hyperglycemia, ketonuria and increased levels of glucagon. The high glucagon, low insulin serum levels signals the body to produce more glucose via gluconeogenesis and glycogenolysis, and ketone bodies via ketogenesis. High levels of glucose causes the failure of tubular reabsorption in the kidneys, causing water to leak into the tubules in a process called osmotic diuresis, causing dehydration and further exacerbating the acidosis.
Diet
If the diet is changed from a highly glycemic diet to a diet that does not substantially contribute to blood glucose, the body goes through a set of stages to enter ketosis. During the initial stages of this process the adult brain does not burn ketones, however the brain makes immediate use of this important substrate for lipid synthesis in the brain. After about 48 hours of this process, the brain starts burning ketones in order to more directly utilize the energy from the fat stores that are being depended upon, and to reserve the glucose only for its absolute needs, thus avoiding the depletion of the body's protein store in the muscles.
Whether ketosis takes place can be checked by using special urine test strips such as Ketostix.
Deliberately induced ketosis through a low-carbohydrate diet has been used to treat medical conditions although most such treatments remain controversial.

Remember, Medifast works!

It's not too late to register for the Medifast National convention!
If you're serious about your Take Shape For Life business, RIGHT NOW! is the time to secure your attendance for what is guaranteed to be our most successful, unforgettable Medifast National Convention ever! You will be exposed to all of the fun, excitement, learning, and business-building opportunities Medifast National Convention has to offer.

Taking place at the luxurious Omni Orlando Resort,Medifast National Convention 2008 will feature:

Countless educational opportunities
Excellent workshops taught by elite Field Leaders
Unforgettable team building and networking with other Health Coaches
Exciting recognition activities
and so much more!
To sign up to attend or to learn more, visit the National Convention Web site or call the Client Contact Center at 1-800-572-4417!

Correction:
The dress for Wednesday's Advanced Regional Leadership Training has changed from "Ready for Executive Director Experience" to Casual. Attendees of this event will have plenty of time to return to their rooms and change into their "Dinner Dress" before the Executive Director Experience.

We encourage all attendees of this event to make a note and prepare their attire accordingly! Please visit the Schedule of Events for information (including attire) for each National Convention event!

We can't wait to see you all next week at the breathtaking Omni Orlando Resort!

New Number for Recorded Playback of Medifast Nurse's Support Call



Note: The number for the Monday Medifast Nurse's Support Call Recorded Playback has been changed to 212-461-8672.

Join Lori Andersen, RN, for the recorded playback of the weekly Medifast Nurse's Support Call. Every week, Lori provides our callers with supportive information to maximize success with their weight-loss and health goals!

See the Support Call Schedule at the bottom of this email for more information on the Nurse's Support Call and other beneficial weekly calls!

Medifast helps you to obtain the essential fatty acids while losing weight! Medifast supplies all the necessary protein on a daily basis. All Medifast products are also loaded with vitamins for your health.

Essential Fatty Acids, or EFAs, are fatty acids that cannot be constructed within an organism from other components (generally all references are to humans) by any known chemical pathways; and therefore must be obtained from the diet. The term refers to those involved in biological processes, and not fatty acids which may just play a role as fuel. As many of the compounds created from essential fatty acids can be taken directly in the diet, it is possible that the amounts required in the diet (if any) are overestimated. It is also possible they can be underestimated as organisms can still survive in less than ideal, malnourished conditions.
There are two families of EFAs: ω-3 (or omega-3 or n-3) and ω-6 (omega-6, n-6.) Fats from each of these families are essential, as the body can convert one omega-3 to another omega-3, for example, but cannot create an omega-3 from scratch. They were originally designated as Vitamin F when they were discovered as essential nutrients in 1923. In 1930, work by Burr, Burr and Miller showed that they are better classified with the fats than with the vitamins.
Functions
In the body, essential fatty acids serve multiple functions. In each of these, the balance between dietary ω-3 and ω-6 strongly affects function.
• They are modified to make
o the classic eicosanoids (affecting inflammation and many other cellular functions)
o the endocannabinoids (affecting mood, behavior and inflammation)
o the lipoxins from ω-6 EFAs and resolvins from ω-3 (in the presence of aspirin, down regulating inflammation.)
o the isofurans, neurofurans, isoprostanes, hepoxilins, epoxyeicosatrienoin acids (EETs) and Neuroprotectin D
• They form lipid rafts (affecting cellular signaling)
• They act on DNA (activating or inhibiting transcription factors such as NFκB, which is linked to pro-inflammatory cytokine production)
Nomenclature and terminology
Fatty acids are straight chain hydrocarbons possessing a carboxyl (COOH) group at one end. The carbon next to the carboxylate is known as α, the next carbon β, and so forth. Since biological fatty acids can be of different lengths, the last position is labeled ω, the last letter in the Greek alphabet. Since the physiological properties of unsaturated fatty acids largely depend on the position of the first unsaturation relative to the end position and not the carboxylate, the position is signified by (ω minus n). For example, the term ω-3 signifies that the first double bond exists as the third carbon-carbon bond from the terminal CH3 end (ω) of the carbon chain. The number of carbons and the number of double bonds is also listed. ω-3 18:4 (stearidonic acid) or 18:4 ω-3 or 18:4 n-3 indicates an 18-carbon chain with 4 double bonds, and with the first double bond in the third position from the CH3 end. Double bonds are cis and separated by a single methylene (CH2) group unless otherwise noted. So in free fatty acid form, the chemical structure of stearidonic acid is:

The essential fatty acids start with the short chain polyunsaturated fatty acids (SC-PUFA):
• ω-3 fatty acids:
o α-Linolenic acid or ALA (18:3)
• ω-6 fatty acids:
o Linoleic acid or LA (18:2)
These two fatty acids cannot be synthesized by humans, as humans lack the desaturase enzymes required for their production.
They form the starting point for the creation of longer and more desaturated fatty acids, which are also referred to as long-chain polyunsaturated fatty acids (LC-PUFA):
• ω-3 fatty acids:
o eicosapentaenoic acid or EPA (20:5)
o docosahexaenoic acid or DHA (22:6)
• ω-6 fatty acids:
o gamma-linolenic acid or GLA (18:3)
o dihomo-gamma-linolenic acid or DGLA (20:3)
o arachidonic acid or AA (20:4)
ω-9 fatty acids are not essential in humans, because humans generally possess all the enzymes required for their synthesis. Exceptions do occur in older people or people with a liver problem that do not completely produce a sufficient amount, and hence many supplement companies market Omega 3-6-9 blends.
Essentiality
Between 1930 and 1950, arachidonic acid and linolenic acid were termed 'essential' because each was more or less able to meet the growth requirements of rats given fat-free diets. Further research has shown that human metabolism requires both ω-3 and ω-6 fatty acids. To some extent, any ω-3 and any ω-6 can relieve the worst symptoms of fatty acid deficiency. Particular fatty acids are still needed at critical life stages (e.g. lactation) and in some disease states. In nonscientific writing, common usage is that the term essential fatty acid comprises all the ω-3 or -6 fatty acids. Authoritative sources include the whole families, without qualification. The human body can make some long-chain PUFA (arachidonic acid, EPA and DHA) from lineolate or lineolinate.
Traditionally speaking the LC-PUFA are not essential. See (Cunnane 2003) for a discussion of the current status of the term 'essential'. Because the LC-PUFA are sometimes required, they may be considered "conditionally essential", or not essential to healthy adults.
Mary G. Enig has pointed out numerous studies showing the need for omega-3 and omega-6 essential fatty acids in mammalians A 2005 study has shown evidence that gamma-linolenic acid, GLA, a product of omega-6, has been shown to inhibit the breast cancer promoting gene of Her2/neu.
Biologist Ray Peat has pointed out flaws in the studies purportedly showing the need for n-3 and n-6 fats. He notes that so-called EFA deficiencies have sometimes been reversed by adding B vitamins or a fat-free liver extract to the diet. In his view, 'the optional dietary level of the "essential fatty acids" might be close to zero, if other dietary factors were also optimized.'
Essential fatty acids should not be confused with essential oils, which are "essential" in the sense of being a concentrated essence.
Food sources
Almost all the polyunsaturated fat in the human diet is from EFA. Some of the food sources of ω-3 and ω-6 fatty acids are fish and shellfish, flaxseed (linseed), hemp oil, soy oil, canola (rapeseed) oil, chia seeds, pumpkin seeds, sunflower seeds, leafy vegetables, and walnuts.
Essential fatty acids play a part in many metabolic processes, and there is evidence to suggest that low levels of essential fatty acids, or the wrong balance of types among the essential fatty acids, may be a factor in a number of illnesses, including osteoporosis.
Plant sources of ω-3 contain neither eicosapentaenoic acid (EPA) nor docosahexaenoic acid (DHA). The human body can (and in case of a purely vegetarian diet often must, unless certain algae or supplements derived from them are consumed) convert α-linolenic acid (ALA) to EPA and subsequently DHA. This however requires more metabolic work, which is thought to be the reason that the absorption of essential fatty acids is much greater from animal rather than plant sources (see Fish and plants as a source of Omega-3 for more).
The IUPAC Lipid Handbook provides a very large and detailed listing of fat contents of animal and vegetable fats, including ω-3 and -6 oils. The National Institutes of Health's EFA Education group publishes 'Essential Fats in Food Oils.' This lists 40 common oils, more tightly focused on EFAs and sorted by n-6:3 ratio. Stuchlik and Zak, 'Vegetable Lipids as Components of Functional Food list notable vegetable sources of EFAs as well as commentary and an overview of the biosynthetic pathways involved. Users can interactively search at Nutrition Data for the richest food sources of particular EFAs or other nutrients. Careful readers will note that these sources are not in excellent agreement. EFA content of vegetable sources varies with cultivation conditions. Animal sources vary widely, both with the animal's feed and that the EFA makeup varies markedly with fats from different body parts.
Human health
Almost all the polyunsaturated fats in the human diet are EFAs. Essential fatty acids play an important role in the life and death of cardiac cells.

Remember, Medifast works!

The use of the Medifast Diabetic line in a weight loss program can help you lose weight quickly and prevent and possibly cure Adult Onset Diabetes that is caused by excess weight. These Medifast products are low glycemic and help you control your blood sugar.

Diabetes mellitus is currently a chronic disease, without a cure, and medical emphasis must necessarily be on managing/avoiding possible short-term as well as long-term diabetes-related problems. There is an exceptionally important role for patient education, dietetic support, sensible exercise, self glucose monitoring, with the goal of keeping both short-term blood glucose levels, and long term levels as well, within acceptable bounds. Careful control is needed to reduce the risk of long term complications. This is theoretically achievable with combinations of diet, exercise and weight loss (type 2), various oral diabetic drugs (type 2 only), and insulin use (type 1 and increasingly for type 2 not responding to oral medications). In addition, given the associated higher risks of cardiovascular disease, lifestyle modifications should be undertaken to control blood pressure and cholesterol by exercising more, smoking cessation, consuming an appropriate diet, wearing diabetic socks, and if necessary, taking any of several drugs to reduce pressure. Many Type 1 treatments include the combination use of regular or NPH insulin, and/or synthetic insulin analogs such as Humalog, Novolog or Apidra; the combination of Lantus/Levemir and Humalog, Novolog or Apidra. Another Type 1 treatment option is the use of the insulin pump with some of the most popular pump brands being: Cozmo, Animas, Medtronic Minimed, and Omnipod.

In countries using a general practitioner system, such as the United Kingdom, care may take place mainly outside hospitals, with hospital-based specialist care used only in case of complications, difficult blood sugar control, or research projects. In other circumstances, general practitioners and specialists share care of a patient in a team approach. Optometrists, podiatrists/chiropodists, dietitians, physiotherapists, clinical nurse specialists (eg, Certified Diabetes Educators and DSNs (Diabetic Specialist Nurse)), or nurse practitioners may jointly provide multidisciplinary expertise. In countries where patients must provide their own health care (i.e., the United States in the developed world), the impact of out-of-pocket costs of diabetic care can be high. In addition to the medications and supplies needed, patients are often advised to receive regular consultation from a physician (e.g., at least every three to six months).

Cures for different types of diabetes

Cures for type 1 diabetes


There is no practical cure now for type 1 diabetes. The fact that type 1 diabetes is due to the failure of one of the cell types of a single organ with a relatively simple function (i.e. the failure of the islets of Langerhans) has led to the study of several possible schemes to cure this form of diabetes mostly by replacing the pancreas or just the beta cells. Only those type 1 diabetics who have received either a pancreas or a kidney-pancreas transplant (often when they have developed diabetic kidney disease (i.e., nephropathy) and become insulin-independent may now be considered "cured" from their diabetes. A simultaneous pancreas-kidney transplant is a promising solution, showing similar or improved survival rates over a kidney transplant alone. Still, they generally remain on long-term immunosuppressive drugs and there is a possibility that the immune system will mount a host versus graft response against the transplanted organ.

Transplants of exogenous beta cells have been performed experimentally in both mice and humans, but this measure is not yet practical in regular clinical practice partly due to the limited number of beta cell donors. Thus far, like any such transplant, it has provoked an immune reaction and long-term immunosuppressive drugs have been needed to protect the transplanted tissue. An alternative technique has been proposed to place transplanted beta cells in a semi-permeable container, isolating and protecting them from the immune system. Stem cell research has also been suggested as a potential avenue for a cure since it may permit regrowth of Islet cells which are genetically part of the treated individual, thus perhaps eliminating the need for immuno-suppressants. This has been done in mice, and a 2007 trial of 15 newly diagnosed patients with type 1 diabetes treated with stem cells raised from their own bone marrow after immune suppression showed that the majority did not require any insulin treatment for prolonged periods of time.

Microscopic or nanotechnological approaches are under investigation as well, in one proposed case with implanted stores of insulin metered out by a rapid response valve sensitive to blood glucose levels. At least two approaches have been demonstrated in vitro. These are, in some sense, closed-loop insulin pumps.

Cures for type 2 diabetes

Type 2 has had no cure. But, very recently, it has been shown that a type of gastric bypass surgery can normalize blood glucose levels in 80-100% of severely obese patients. The effect is not due to weight loss because it usually occurs within days of surgery, which is before significant weight loss happens. The pattern of secretion of gastrointestinal hormones is changed by the bypass and removal of the duodenum and proximal jejunum, which together form the upper (proximal) part of the small intestine. The precise causal mechanisms are being intensively researched. This approach may become a standard treatment for some people with type 2 diabetes in the near future. One hypothesis is that the proximal small intestine is dysfunctional in type 2 diabetes; its removal eliminates the source of an unknown hormone that contributes to insulin resistance. This surgery has been widely performed on morbidly obese patients and has had the additional the benefit of reducing the death rate from all causes by up to 40%. A small number of normal to moderately obese patients with type 2 diabetes have successfully undergone similar operations.

Prognosis

Patient education, understanding, and participation is vital since the complications of diabetes are far less common and less severe in people who have well-controlled blood sugar levels. Wider health problems accelerate the deleterious effects of diabetes. These include smoking, elevated cholesterol levels, obesity, high blood pressure, and lack of regular exercise. According to a study, women with high blood pressure have a threefold risk of developing diabetes.

Anecdotal evidence suggests that some of those with type 2 diabetes who exercise regularly, lose weight, and eat healthy diets may be able to keep some of the disease or some of the effects of the disease in 'remission.' Certainly these tips can help prevent people predisposed to type 2 diabetes and those at pre-diabetic stages from actually developing the disorder as it helps restore insulin sensitivity. However patients should talk to their doctors about this for real expectations before undertaking it (esp. to avoid hypoglycemia or other complications); few people actually seem to go into total 'remission,' but some may find they need less of their insulin medications since the body tends to have lower insulin requirements during and shortly following exercise. Regardless of whether it works that way or not for an individual, there are certainly other benefits to this healthy lifestyle for both diabetics and nondiabetics.

The way diabetes is managed changes with age. Insulin production decreases because of age-related impairment of pancreatic beta cells. Additionally, insulin resistance increases because of the loss of lean tissue and the accumulation of fat, particularly intra-abdominal fat, and the decreased tissue sensitivity to insulin. Glucose tolerance progressively declines with age, leading to a high prevalence of type 2 diabetes and post challenge hyperglycemia in the older population. Age-related glucose intolerance in humans is often accompanied by insulin resistance, but circulating insulin levels are similar to those of younger people. Treatment goals for older patients with diabetes vary with the individual, and take into account health status, as well as life expectancy, level of dependence, and willingness to adhere to a treatment regimen.

The diagnosis of type 1 diabetes and many cases of type 2, is usually prompted by recent-onset symptoms of excessive urination (polyuria) and excessive thirst (polydipsia), and often accompanied by weight loss. These symptoms typically worsen over days to weeks; about a quarter of people with new type 1 diabetes have developed some degree of diabetic ketoacidosis by the time the diabetes is recognized. The diagnosis of other types of diabetes is usually made in other ways. These include ordinary health screening; detection of hyperglycemia during other medical investigations; and secondary symptoms such as vision changes or unexplainable fatigue. Diabetes is often detected when a person suffers a problem that is frequently caused by diabetes, such as a heart attack, stroke, neuropathy, poor wound healing or a foot ulcer, certain eye problems, certain fungal infections, or delivering a baby with macrosomia or hypoglycemia.

Diabetes mellitus is characterized by recurrent or persistent hyperglycemia, and is diagnosed by demonstrating any one of the following:

* Fasting plasma glucose level at or above 126 mg/dL (7.0 mmol/l).
* Plasma glucose at or above 200 mg/dL (11.1 mmol/l) two hours after a 75 g oral glucose load as in a glucose tolerance test.
* Random plasma glucose at or above 200 mg/dL (11.1 mmol/l).

A positive result, in the absence of clinical symptoms of diabetes, should be confirmed by another of the above-listed methods on a different day. Most physicians prefer to measure a fasting glucose level because of the ease of measurement and the considerable time commitment of formal glucose tolerance testing, which takes two hours to complete. According to the current definition, two fasting glucose measurements above 126 mg/dL (7.0 mmol/l) is considered diagnostic for diabetes mellitus.

Patients with fasting glucose levels between 110 and 125 mg/dL (6.1 and 7.0 mmol/l) are considered to have impaired fasting glycemia. Patients with plasma glucose at or above 140 mg/dL or 7.8 mmol/l two hours after a 75 g oral glucose load are considered to have impaired glucose tolerance. Of these two pre-diabetic states, the latter in particular is a major risk factor for progression to full-blown diabetes mellitus as well as cardiovascular disease.

While not used for diagnosis, an elevated level of glucose irreversibly bound to hemoglobin (termed glycosylated hemoglobin or HbA1c) of 6.0% or higher (the 2003 revised U.S. standard) is considered abnormal by most labs; HbA1c is primarily used as a treatment-tracking test reflecting average blood glucose levels over the preceding 90 days (approximately). However, some physicians may order this test at the time of diagnosis to track changes over time. The current recommended goal for HbA1c in patients with diabetes is <7.0%, which is considered good glycemic control, although some guidelines are stricter (<6.5%). People with diabetes who have HbA1c levels within this range have a significantly lower incidence of complications from diabetes, including retinopathy and diabetic nephropathy.

Screening

Diabetes screening is recommended for many people at various stages of life, and for those with any of several risk factors. The screening test varies according to circumstances and local policy, and may be a random blood glucose test, a fasting blood glucose test, a blood glucose test two hours after 75 g of glucose, or an even more formal glucose tolerance test. Many healthcare providers recommend universal screening for adults at age 40 or 50, and often periodically thereafter. Earlier screening is typically recommended for those with risk factors such as obesity, family history of diabetes, high-risk ethnicity (Hispanic, Native American, Afro-Caribbean, Pacific Island, and South Asian ancestry).

Many medical conditions are associated with diabetes and warrant screening. A partial list includes: high blood pressure, elevated cholesterol levels, coronary artery disease, past gestational diabetes, polycystic ovary syndrome, chronic pancreatitis, fatty liver, hemochromatosis, cystic fibrosis, several mitochondrial neuropathies and myopathies, myotonic dystrophy, Friedreich's ataxia, some of the inherited forms of neonatal hyperinsulinism. The risk of diabetes is higher with chronic use of several medications, including high-dose glucocorticoids, some chemotherapy agents (especially L-asparaginase), as well as some of the antipsychotics and mood stabilizers (especially phenothiazines and some atypical antipsychotics).

People with a confirmed diagnosis of diabetes are screened routinely for complications. This includes yearly urine testing for microalbuminuria and examination of the retina (retinal photography) for retinopathy. In the UK, screening for diabetic retinopathy has helped reduce the incidence of legal blindness since its implementation.[citation needed]

Prevention

Type 1 diabetes risk is known to depend upon a genetic predisposition based on HLA types (particularly types DR3 and DR4), an unknown environmental trigger (suspected to be an infection, although none has proven definitive in all cases), and an uncontrolled autoimmune response that attacks the insulin producing beta cells. Some research has suggested that breastfeeding decreased the risk in later life; various other nutritional risk factors are being studied, but no firm evidence has been found. Giving children 2000 IU of Vitamin D during their first year of life is associated with reduced risk of type 1 diabetes, though the causal relationship is obscure.

Children with antibodies to beta cell proteins (i.e., at early stages of an immune reaction to them) but no overt diabetes, and treated with vitamin B-3 (niacin), had less than half the diabetes onset incidence in a 7-year time span as did the general population, and an even lower incidence relative to those with antibodies as above, but who received no vitamin B3.

Type 2 diabetes risk can be reduced in many cases by making changes in diet and increasing physical activity. The American Diabetes Association (ADA) recommends maintaining a healthy weight, getting at least 2½ hours of exercise per week (several brisk sustained walks appears sufficient), having a modest fat intake, and eating a good amount of fiber and whole grains. The ADA does not recommend alcohol consumption as