FirstLine Therapy® FAQ

Why do we recommend FirstLine Therapy® at The Center for Optimal Health?

Research indicates that many chronic diseases associated with aging are largely due to poor ‘lifestyle factors’ such as physical inactivity, stress and suboptimal nutrition. This makes lifestyle changes the first, and possibly the most important therapy doctors can prescribe for the treatment of many chronic disorders. It is this reason that the National Clinical Guidelines for most of these disorders advocate a multifactorial lifestyle approach; also known as “therapeutic lifestyle change or TLC.” FirstLine Therapy® is a therapeutic lifestyle program that teaches you how to make ‘everyday’ choices that will enhance your health, vitality and longevity. Download the FirstLine Therapy® brochure.

Who can benefit from FirstLine Therapy®?

FirstLine Therapy is for anyone who would like to optimize their health and prevent disease. It is recommended as a ‘first line therapy’ for diseases such as:

Heart Disease
High Cholesterol
High Blood Pressure
Metabolic syndrome/Insulin Resistance
Polycystic Ovary Syndrome (PCOS)
Type 2 Diabetes

FirstLine Therapy has also proved beneficial for patients experiencing health problems with:

Men with low testosterone
Inflammatory disorders

What is involved in the program?

The FirstLine Therapy® Program (FLT) is individualized to meet your own body and lifestyle needs. The core focus of FirstLine Therapy includes:

Low-glycemic index dietary choices, Nutritional supplements Medical foods Exercise (tailored towards your conditioning and physical capabilities) Stress management

FLT also integrates body composition testing into the assessment and monitoring plan. Body composition is a measure of the amount of fat tissue relative to lean body mass. Calculating your composition allows us to develop a comprehensive plan based on your individual composition and daily caloric requirement.

Why is Body Composition so important?

Research shows that body composition is directly related to health. Being overweight or having excess fat in relation to lean body mass is the most common type of altered body composition associated with a high incidence of cardiovascular disease, metabolic syndrome, hypertension and dyslipidemia. More importantly, “belly fat” may present the greatest risk for health problems. So improving your body composition is one of the most powerful changes you can make towards controlling the aging process and reducing your health risks.

Learn more about how body composition affects health (PDF).

How often is my body composition measured?

Body composition is measured each visit using a Bio-electrical Impedance Analysis machine (BIA). This is important so we can track and monitor your composition to ensure you are maintaining or increasing your lean body mass whilst reducing body fat. Many weight loss programs measure weight or body mass index (BMI) and do not monitor the type of mass lost. In fact, many programs result in a loss of muscle mass.

What are Medical Foods?

The UltraMeal® range and UltraGlycemX® Medical Foods used at The Center for Optimal Health are high quality, all natural, low-glycemic, nutrient-dense shakes consisting of specifically selected proteins, carbohydrates and fats. Clinical Studies have shown that when combined with a balanced diet and regular exercise program such as FirstLine Therapy® the UltraMeal® range helps to reduce fat and preserve muscle mass. UltraMeal® and UltraGlycemX® shake formulas are available in a variety of formulations to cater to individual health needs. UltraMeal® products are free from yeast, eggs, hydrogenated oils, sucrose, and gluten. The shakes are also fortified with a vitamin and mineral core and provide 35% or more of the RDI (recommended daily intake). The protein used in these shakes are derived from non-GMO (non-genetically modified) soy. For those allergic to soy, UltraMeal® is also available in rice or whey protein formulations.

Do I have to use Medical Foods?

No, medical foods are optional on the FirstLine Therapy program. However, most people find them convenient as a balanced meal replacement or healthy snack option. They are available in a several delicious flavors depending on the specific product selected for your body composition and health concerns.

What is the cost of the program?

The cost of FirstLine Therapy® initial visit is $195 for a 90-minute session and follow-up visits (45-minute session) is $105. Body composition analysis is included with each visit. A superbill with diagnostic and procedure codes will be provided for you to submit to your health insurance company for reimbursement. In general a portion of the fees are reimbursed if you have a PPO insurance and have out-of-network benefits. The cost of medical foods and nutritional supplements qualify as eligible medical expense with flexible spending accounts or health savings accounts. Each serving of medical food is comparable in cost to a specialty coffee drink at Starbucks. Considering the substantial benefits you can derive from the FirstLine Therapy® program in reducing diabetes and cardiovascular risks, it is well worth the time and financial investment now to avoid the medical expenses and loss of quality of life from chronic diseases in the future!

Are there studies to support the effectiveness of FirstLine Therapy and Medical Foods?

In a recently completed 12-week, open-labeled, randomized, 2-arm study of 44 subjects fulfilling 3 or more metabolic syndrome criteria, individuals who participated in the UltraMeal® Plus 360° Medical Food Program were shown to have:

Statistically greater reductions in lipid parameters

Fasting serum cholesterol
Cholesterol/HDL ratio
Triglyceride/HDL ratio

Statistically greater reduction in serum homocysteine
Significant increase in HDL (“good”) cholesterol
Persistent lowering effects on apoB and apoB/apoA1 ratio

ApoB may be a better indicator of CVD risk than total cholesterol or LDL
ApoB/apoA1 ratio is a newly recognized, increasingly significant indicator of CVD risk


Studies conducted at the Functional Medicine Research Center (FMRC)—the clinical research arm of Metagenics—show positive effects of the UltraGlycemX® Medical Food on:

Fasting glucose
Fasting insulin
Postprandial glucose
Postprandial insulin
Triglyceride/HDL ratio
Body mass index (BMI)
Blood pressure


Who runs the FirstLine Therapy® Program at The Center for Optimal Health?

Monette Paulsen and Kathleen "Linaya" Manger-Brown are certified lifestyle educators who administer the program under the supervision of Dr. Jannet Huang. Monette, Linaya and Dr. Huang have all been trained and certified in the FirstLine Therapy® Program.

**FirstLine Therapy® is a registered trademark of Metagenics, Inc, and is used with permission. This site is not owned or operated by Metagenics, Inc.


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