According to the CDC (Centers for Disease Control) overweight and obesity are defined as abnormal or excessive fat accumulation that may impair health.

Assessment of weight and health risk involves using three key measures:  

1. Body mass index (BMI)
2. Waist circumference
3. Risk factors for diseases and conditions associated with obesity

BMI is a useful measure of overweight and obesity. It is calculated from your height and weight. BMI is an estimate of body fat and a good gauge of your risk for diseases that can occur with more body fat. The higher your BMI, the higher your risk for certain diseases such as heart disease, high blood pressure, type 2 diabetes, gallstones, breathing problems, and certain cancers.  Although BMI can be used for most men and women, it does have some limits:

• It may overestimate body fat in athletes and others who have a muscular build
• It may underestimate body fat in older persons and others who have lost muscle

Here are some examples of BMI scores:

Waist Circumference: If your fat is around your waist rather than at your hips, you’re at a higher risk for heart disease and type 2 diabetes.  This risk goes up with a waist size that is greater than 35 inches for women and greater than 40 inches for men.  To correctly measure your waist, stand and place a tape measure around your middle, just above your hip bones. Measure your waist just after you breathe out.

Risk Factors for Health Topics Associated with Obesity: Conditions that will put you at a greater risk for heart disease and other health conditions:

• High blood pressure (hypertension)
• High LDL cholesterol (bad cholesterol)
• Low HDL cholesterol (good cholesterol)
• High triglycerides
• High blood glucose (sugar)
• Family history of premature heart disease
• Physical inactivity
• Cigarette smoking

Metabolic syndrome is becoming more and more common in the United States. Researchers are not sure whether the syndrome is due to one single cause, but all of the risks for the syndrome are related to obesity.

The two most important risk factors for metabolic syndrome are:

• Extra weight around the middle and upper parts of the body (central obesity). The body may be described as "apple-shaped."
• Insulin resistance. The body uses insulin less effectively than normal. Insulin is needed to help control the amount of sugar in the body. As a result, blood sugar and fat levels rise.

Other risk factors include:

• Aging
• Genes that make you more likely to develop this condition
• Hormone changes
• Lack of exercise

People who have metabolic syndrome often have the following two problems that can either cause the condition or make it worse:

• Excess blood clotting
• Increased levels of blood substances that are a sign of inflammation throughout the body

The ITG 3 Step Plan targets prevention and solutions to “metabolic syndrome.”  To qualify as part of this epidemic that is steamrolling North America, adults or children need only suffer from 2 of these 4 components of metabolic syndrome:

1. Obesity
2. Blood sugar issues (diabetes)
3. Cholesterol problems
4. High blood pressure

 To address this, the ITG Diet is focused on insulin production, and stabilizing and maintaining weight loss long term.

The word “protein” is derived from a Greek word meaning “of first importance.”  A daily supply of protein is necessary to support the body and promote or maintain many metabolic functions.  In addition to helping with weight loss, protein helps:

• Build and repair body tissues including muscle, major organs, and collagen.
• Keep hair, skin bones, and nails healthy.
• Regulate body processes including digestion and metabolism.
• Form hormones, enzymes and immune system antibodies to help your body function properly.

Providing your body with adequate protein throughout the day as part of a balanced diet allows you to maintain good health while you lose weight!

During digestion, protein is metabolized into amino acids, the building blocks of protein. The body uses amino acids for energy as well as to produce enzymes and other essential proteins.  The body synthesizes some amino acids but it cannot synthesize the “essential” amino acids.  These essential amino acids must be consumed in the daily diet.  That’s where the ITG Diet comes in.  ITG protein products contain some of the highest-quality proteins and are low in carbohydrates and fat.

You need a minimum of ½ of your target weight in grams each day.  For example, if your target weight is 160 pounds, you will need a minimum of 80 grams of protein per day.  This is just a guideline.  You will need more protein depending on your lifestyle and physical activity.

These diets have been around since the 1800s and not just necessarily for weight loss.  By definition a VLCD is a food or meal replacement diet providing enough essential nutrients to maintain health functioning during a 2 - 6 month period to produce a more rapid weight loss.

The design of these programs is a marked reduction in calories and a shift in micronutrients to reflect a higher protein and lower carbohydrate intake to elicit a metabolic pathway change from burning glucose to lipid as the primary fuel source or dietary ketosis.  By tapping into fat stores readily available in adipose tissue, weight loss results are rapid and effective in favorably changing body composition.   Women generally lose 3 to 3 ½ pounds per week and men lose 4 to 5 pounds per week on a VLCD diet. These average losses are 2 - 3 times greater than those resulting from conventional calorie-reducing diets used for the same time period. ^1,2.

In the early 1920s, VLCDs used food only, which made them very challenging to adhere to and thus interest in these diets became faint.  In 1975, Dr. George Blackburn out of Boston and Dr. Vertes and Dr. Genuth from the Cleveland Clinic promoted VLCD Diets.  Dr. Blackburn used an all food VLCD, while Vertes and Genuth introduced a VLCD utilizing new liquid meal replacements.  Some people still associate VLCDs with the “Liquid Protein Diet” from the early 1970s and question their safety.  The Liquid Protein Diets: of that time frame used collagen hydrolysate, which is an incomplete protein, and people would actually starve to death as lean muscle mass was not maintained and the body had to “consume” itself for survival and sometimes resulting in death.  The meal replacements utilized in today’s VLCDs are made with high quality complete protein, formulated to support the comprehensive nutritional needs of an adult during weight loss and are supervised by professional trained coaches. 

The ITG Diet is a modified VLCD diet.

VLCD diets usually induce dietary ketosis.  (See, what is Ketosis below).

1. Very low-calorie diets. National Task Force on the Prevention and Treatment of Obesity,
    National Institutes of Health. JAMA. Aug 25 1993;270(8):967-974.
2. Wadden TA. Treatment of obesity by moderate and severe caloric restriction. Results of
    clinical research trials. Ann Intern Med. Oct 1 1993;119(7 Pt 2):688-693

Ketosis merely means that our bodies are using fat for energy.  Ketones (also called ketone bodies) are molecules generated during fat metabolism, whether from the fat in the guacamole you just ate or fat you were carrying around your middle.  When our bodies are breaking down fat for energy most of it gets converted more or less directly into an energy carrier in the cells of all known organisms.  This is the energy molecule.  But ketones are also produced as part of the process.  When people eat fewer carbohydrates their bodies turn to fat for energy so it makes sense that more ketones are generated. 

As long as insulin is present, there is no ketosis that is associated with diabetic ketoacidosis. Because of this confusion, many patients will think that the natural state of dietary ketosis is toxic to the heart, kidney, causes muscle wasting, is debilitating and interferes with the sympathetic nervous system.  This is not true.  (Please note if you have any health issues such as type 1 diabetes, cardiovascular issues and other various issues that are listed on the Contraindications to the Plan document, you may not be a candidate for the plan.  However we do have an Optional Plan that may work for you.)  All dieters must fill out a Health Status Intake Form before they can start on the ITG Diet plan.  

Ketogenic is a term referring to a ketone based diet, hence the term "in ketosis." This is caused by the consumption of ultra-low carbohydrates - fewer than 100 grams per day for sure, but most often I think, under 30-40 grams - in order to force the body into ketosis. Ketosis is the point where there is not enough glucose to fuel the system, particularly the 100 grams or so it

takes to fuel the brain, which forces the liver to produce ketones for fuel. After a period of time, between 1-4 days normally, the brain adapts to using the ketones for fuel. After a longer period of time, between 2 and 4 weeks, the body begins to efficiently use body fat for fuel and decreases the use of ketones to fuel the muscles.

No, drugs are not necessary on the ITG weight loss plan.  Ketosis is a natural appetite suppressant so after the first couple of days you will be a little hungry.  Make sure that you are eating everything in Step 1, drinking your water and having  all your vegetables.  However, make sure that you take your recommended ITG supplements while you are on the Step 1 and Step 2, transition of the plan.  You can have an extra packet of the ITG protein lower carbohydrate products per day if you get hungry.

Since you are making a major change in your eating habits, your body may respond in several ways, here are some things to be prepared for.  The first 3 - 5 days you may feel slight light-headedness and fatigue, headache, slight hunger, nausea, diarrhea, constipation and bad breath.  (Your body will be eliminating ketonic bodies)  In the Dieters Folder there is a document that is called Potential Symptoms and Body Responses that will explain everything to you so you will know exactly what to expect.  Everyone is unique.   Many dieters breeze right through this first couple of days while others may experience some of the above.  Your coach will be able to guide you through this process.

Supplementation is crucial to your success since you will be missing out on some important nutrients during this plan.  Your coach reviews your Health Status Intake Form  to assist you in selecting the proper supple­mentation for your specific issues (e.g., food allergies, digestive issues).  Your coach will encourage you to consult with your health care provider regarding any medical issues.  Three supplements that are mandatory on the plan are the ITG Multivitamin, ITG Omega, and the ITG Cal/Mag.  If you are having leg cramps then you may want to add the ITG potassium.  The other supplements we offer are ITG Plant Enzymes to help in the digestion of proteins, fats, and carbohydrates – including lactase for the digestion of the milk sugar lactose.  ITG Colon-Lax may be helpful for improving bowel movements/constipation along with cleansing and detoxifying bowels.  ITG Antiox Caps combines an extensive array of nutrients that combat free radicals and helps support the detoxification of chemicals and heavy metals. We also offer the daily required supplements in an easy to carry bubble pack.  (2/day).  Or in individual bottles.  

There are thousands of different diets to choose from and you can lose weight on almost any of them.  There are thousands of different diets to choose from and you can lose weight on almost any of them. The difference it that on the ITG Diet Plan you lose fat and protect your lean muscle mass.  On many other weight loss programs you lose muscle and fat which is why so many people gain the weight right back.  It is not just about the calories, but what foods you eat.   You have to be ready to commit to a long term lifestyle change, not just a short term diet or weight  loss solution.  So you need to be mentally ready to begin the journey to a New You! 

The ITG Diet is a portion controlled, low calorie weight loss plan.  ITG Diet offers two unique plans.

OPTION ONE:  This is a Low Carbohydrate Low Calorie plan.  You will be eating approximately 40-60 grams of carbohydrates per day and consuming approximately 1,000 calories per day.  Your body will actually go into a light ketosis, which simply means your body is in a fat burning mode.

OPTION TWO:  This plan is for anyone who will not be able to participate on the Option One ketonic plan.  It could be for health reasons or the regular plan is too strict for you to follow.  You may also start this plan and move to Option One.  Please consult with your coach for the best plan for you.  On this plan you will be incorporating other food groups into your meal plan.  This is also a 3 Step plan that will get you to your goal.  However, your weight loss may be a little slower on this plan.  

Yes, it is a safe diet.  Before starting the diet you must fill out a Health Status Intake Form for your coach to review.   We also have a document, Contraindications to the Plan.  It lists any contraindications listed to make sure the plan is right for you.  However as with any major change in your diet we recommend that you consult with your physician before starting any diet or weight loss program.

Carbohydrates are found in a wide array of foods including but not limited to; bread, beans, milk, popcorn, potatoes, cookies, spaghetti, soft drinks, corn, and cherry pie. They also come in a variety of forms. The most common and abundant forms are sugars, fibers, and starches.  The basic building block of every carbohydrate is a sugar molecule, a simple union of carbon,

hydrogen, and oxygen.  Starches and fibers are essentially chains of sugar molecules.  Some contain hundreds of sugars.  Some chains are straight, others branch wildly.  Carbohydrates were once grouped into two main categories.  Simple carbohydrates included sugars such as fruit sugar (fructose), corn or grape sugar (dextrose or glucose), and table sugar (sucrose). 

Complex carbohydrates included everything made of three or more linked sugars.  Complex carbohydrates were thought to be the healthiest to eat, while sugars weren't so great.  It turns out that the picture is more complicated than that.  The digestive system handles all carbohydrates in much the same way—it breaks them down (or tries to break them down) into single sugar molecules, since only these are small enough to cross into the bloodstream.  It also converts most digestible carbohydrates into glucose (also known as blood sugar), because cells are designed to use this as a universal energy source.

Exercise is a necessary part of losing weight, improving metabolism, and maintaining weight loss.  Exercise also provides many health-enhancing benefits such as: improved blood sugar control, improved flexibility and balance, blood pressure control, strength and endurance, and help to decrease stress.  If you are not already exercising regularly when you start the ITG  Diet  we recommend you wait two to three weeks (and check with your physician) before you begin an exercise program.   Start an exercise program slowly, and gradually increase time spent on an activity (and intensity of the activity) as your body allows. Choose an activity that you can enjoy regularly.  ITG has The Body Basics program that you will have access to as you are on the plan.  The 12 Lessons are fun and easy to do.   If you have not exercised just simply walking and increasing your distance and time each week will be a great start.  

For an individual who has an exercise program in place prior to starting the ITG Diet, we recommend cutting the intensity and duration of your exercise program to ⅓ to ½ for the first couple of weeks to allow the body to adjust to its new calorie level.  As your body adjusts to this lower calorie level, you can increase time and intensity of your exercise plan.  For the entire time that you are on Step 1, we recommend 30 minutes of moderate exercise while limiting vigorous exercise to 45 minutes each day.  You also have to understand that once you are in ketosis (fat burning) your body is not accustomed to using these ketones as fuel and does not have the necessary enzymes to process them properly and you will burn muscle which is not what you want. 

Listen to your body and only do what it allows.  If you feel light-headed or faint, stop your exercise and take a rest before you resume.  Remember to drink fluids. Fluid intake is important when you exercise.  You may also require some additional packets of the ITG protein foods to make sure that you do not “burn your muscle” and work against your body.  You may find that you need additional water on the days you exercise, especially if it is hot outside.

Q.  Do you have Soy Free products?
A.  Yes, we have a list of our Soy Free products on the Nutritional Information Sheet in your folder.  Please note that if you have severe allergies you should check the ingredients of the product before ordering.  

Q.  Do you have Gluten Free products?
A.  Yes, we have a list of our Gluten Free products on the Nutritional Information Sheet in your folder.  Please note that if you have severe allergies you should check the ingredients of the product before ordering.  

Q. Do you have Kosher products? 
A.  Yes, we have several products that are Kosher certified.  See your Nutritional Information sheet in your dieter’s folder to see which products are Kosher.

Q.  What is a Limited ITG food?
A.   A Limited food is one of the ITG foods you can only have once a day.  This is based on carbs, calories and product.  On Step 1 you are limited to only one of these products per day.  Examples are the bars, snacks, spaghetti and Nacho Pasta.   See your Nutritional fact sheets in the Nutritional Information Sheet in your dieter’s folder for more detailed information.

Q. Can I use another protein powder while on Step 1?
A.  If you want to participate in the ITG Diet it is recommended to use the ITG Diet products.  The plan and the products are designed to give you the proper amount of carbohydrates, calories, and protein per day.  If you start using other products while on the plan our coaches will not be able to know exactly what you are consuming and what is in those products.

Q. How long will the plan take me? How long in the first Step? 
A.  It depends on how much you have to lose and how committed you are to reaching your goals.  When you reach 100% of your goal in Step 1, then Step 2 is your transition step.  Each week you will be getting a new food group back into your daily diet.  Step 2 is a four week plan.  Step 3 is Success For Life.   It is important that you go through all Steps of the plan.  Your length and success on the plan is determined by you staying compliant.  Actual weight loss will vary.  Based on your gender, body metabolism, age, and if you are on medications, etc.

Q. How will I feel the first couple of days when on the regular plan?
A.  When on the regular plan your body may respond differently.  We have a document in your dieter’s folder called Potential Symptoms and Body Responses.  You may feel a little light headed, fatigued, headache or hunger.  Make sure you review this document before you start.  It has hints to help you through these first couple of days.  Also ask your coach for any suggestions.  

Q. Are there rules about what ITG products to have and when on the plan? 
A. You can have any ITG meal at any time as per the plan; the only rule is that you are only allowed 1 Limited ITG food per day.  You can switch your lunch and dinner around depending on your work schedule and daily activities.  You can also add your snack into any part of the day.  If you eat a late dinner have it mid-morning or late afternoon.  You can also have one of the non-limited products as an extra packet at any time.  Have one of the fruity drinks.  They are under 100 calories with an average of 15 grams of protein.

Q. Can I skip some of the vegetables because I am full?
A.  You need to eat all of your vegetables throughout the day.  If you cannot eat them all in one meal spread them out.  Have some in your omelet for breakfast.  Have some fresh veggies in a zip lock bag to snack on during the day.  Something crunchy like broccoli or cauliflower, a cucumber is also a great snack and helps you get your daily vegetables in for the day. 

Q. Can I have an extra ITG food if I am hungry?
A.  Yes, if you are hungry, have an extra ITG Diet protein.  We recommend having one of the lower carbohydrate products like the drinks, puddings or light snacks.  See the Limited List in your dieter’s folder.

Q.  What can I do for constipation? 
A.This can result from your lower food intake amounts.   Make sure you are drinking your daily required water.  Eat all of your vegetables and the required amount of oil.  We have a product called Colon-Lax that is a gentle stool softener that is very effective.  You can also use sugar-free Benefiber to help relieve the constipation.

Q. Can I use salad dressings? 
A. Walden Farm products are the only dressings approved to use with the ITG Diet. But we encourage you to create your own with olive oil, vinegar, lemon, spices, etc. 

Q.  Can you explain what coaching entails?
A.  You will have weekly follow up visits with your clinic coach.  Make sure you bring in your Daily Food Diary each week.  They will measure and weigh you and offer guidance and support.  Your coach wants to see you be successful not only to lose the weight but keep it off the rest of your life.  

Q. Do you have a general range of the costs?
A.  Your average cost for meal is from $3 to $4 per meal.  The average cost per day for your ITG foods will be $10- $12 per day.   Many people would spend that alone on a salad for lunch with a beverage, tax and tip.