This Blog has been created for the sole purpose of sharing great ideas for Sneals and high quality meals.

The Rules:

Sneals must be within 60 to 250 calories.  They must be as close to equal carbs to protein ratio but remember that it has to be LEAN.

or

it can be just a Lean Protein.

A meal must be 250 to 400 calories and be in the same quality as a sneal.

Try and make the instructions as simple as possible.  These menus are to help everyone live a healthy lifestyle, lose weight, maintain weight, and feel GREAT!!

MIracle Noodle Recipe:

This ultra-quick dish is a delicious variation on the classic late-night
Roman staple, spaghettata  (Spaghetti with Garlic and Oil) that can be
thrown together from ingredients you may normally keep in your pantry and
fridge.

Preparation time: five minutes

Cooking time:  five minutes

1 bag Miracle Noodles angel hair,

1  6- or 7-ounce can or jar of tuna  in olive oil  (preferably Italian
tuna in extra virgin oil, but supermarket brands like Progresso or Genova
are fine. Solid or chunk light tuna is tastier than solid white, which
tends to be dry.)

Chopped or pressed garlic to taste 1 tsp to 2 tbsps (fresh is best, but
chopped garlic from a jar is fine)

½ to 1 cup chopped fresh parsley leaves (or if you must, 2-3 tbsps of
dried chopped parsley)

1 tbsp capers (optional)

Black pepper or hot red pepper flakes to taste

Extra virgin olive oil or lemon flavored olive oil (optional)

Salt to taste

1.       Prepare the Miracle Noodles according to package directions.

2.       Open the tuna can and drain the olive oil from the can into a
saute or frying pan.  Put the tuna in a bowl and flake it with a fork.

3.       Add chopped garlic  to the pan and stir over medium heat until
golden. Add parsley and capers; stir until parsley begins to wilt. Stir in
the black or red pepper.

4.       Add a splash (about ½ to 1 tbsp) of extra virgin olive oil or,
preferably, lemon-infused olive oil (sometimes called citron oil), then
add the flaked tuna, stirring for a minute or two until heated. If the pan
seems dry, add a bit more oil.

5.        Taste for salt and add a pinch if needed.  The tuna and the
capers are salty, so you won’t need much and if you have used capers
preserved in salt, you can probably omit it.

6.       Toss with Miracle Noodles in a bowl, or add the noodles to the
pan and toss over low heat. Serve immediately.

Variations:

For a one-pot, highly nutritious meal, increase the amount of garlic and
omit the parsley. Instead, add ½ to 1 bunch of chopped raw kale, Swiss
chard or spinach (with stems removed) in step 3; it will take a minute or
two longer to wilt than the parsley.  A shake or two of hot red pepper
flakes and lemon-flavored oil are particularly good with these greens. (My
preference is for the chard or kale, which have a milder taste that blends
well with the tuna.)

Or, add cut-up green beans, lightly steamed and drained, to the pan with
the parsley. (Lemon-flavored oil really adds to this version).

For a more piquant flavor, add 1 or 2 tbsps  chopped sun-dried tomatoes
along with the parsley, and omit the lemon olive oil.

YUMMY!!! You can get the Miracle Noodles at www.Carbessentials.net.  So lets break this one down into it’s nutrition.

It has protein from the Tuna.  It has a very good fat in the extra virgin olive oil.

The veggies are awesome in just great vitamins and minerals and are an excellent carbohydrate.  

The Miracle noodles are an amazing product because they are almost zero calories and they are a great source of fiber.

 

The Low Sodium Controversy

There has been a recent surge in the media/press about sodium intake in our American nutrition/diet. First what I am going to do is explain exactly what sodium is versus salt. Second I will give you what the medical and governmental guidelines are for what the human body requires and what we actually get from American foods. Then there are some confusing definitions by the Food and Drug Administration (FDA) on what is Low Sodium versus Very Low Sodium versus Reduced Sodium.

Sodium is an essential mineral and electrolyte (essential chemical) in human cellular function. It is used in every body organ and system and you could not function and yes you could possibly get very sick or die if your sodium levels rapidly change. But the body is very good at maintaining its sodium balance. There are human populations in Brazil that live on an extremely small amount of sodium. As well as in Japan some of the island populations consume over 10 grams of sodium and do just fine. If the body is healthy it will compensate and adjust. What I am trying to say here is that sodium is very important to human life. When consumed in moderation (Americans never do anything in moderation) sodium is an essential part of a healthy diet.

There has been a lot of controversy over sodium intakes in America since as far back as the 1960’s and 1970’s. Sodium and salt have been vilified as the scourge of society. There have been medical studies that say it’s a bad, bad, bad thing and you need to avoid it like the plague. Then there will be another study that says that it is fine and that all the bad press is bunk.

Recently (2010) more detailed studies show that in the amount of sodium that we consume in this country with all the other compounding medical stressors that we are developing (i.e., Heart Disease, Stroke, Diabetes, Hypertension, Metabolic Syndrome, Kidney Disease, and many more) we as a population are doing ourselves harm. Most recently the Institute of Medicine (IOM) and the National Institutes of Health (NIH) have strongly recommended that we limit our intake of sodium in our diets.

The Recommended Daily Allowance for sodium is 1,500 mg per day, believe it or not, that equates to 1 teaspoon of salt per day. “Did that just say 1 teaspoon a day!?” When you really analyze what we as Americans get in our daily intake of sodium it on average is 3 to 5 times that. Sodium is in almost everything we eat.

What all these current studies are finding is that if we limit our sodium intake it decreases the chances of developing many diseases. The restrictions of 1,500 mg of sodium per day is especially important in the elderly and people with chronic medical conditions like high blood pressure, diabetes, kidney disease, and many others.

If you look at food labels they will infer that we consume a diet with an average of 2,400 mg of sodium per day.

“So much confusion! Just simplify it for me and give me some basic guidelines Doctor!!”

So here you go:

If you are elderly (I’m not touching that one), an African American Man,

or if you have major medical issues as listed above

You should probably try to monitor your sodium intake and do your best to keep around 1,500 mg per day.

If you are otherwise a healthy adult (18 to 65ish) you really do not have to worry too much. But don’t think that you are invincible and that nothing is going to hurt you.

If I had to give you a recommendation I would still keep your sodium intake under 2,500 mg. Even that will be considered pretty low sodium compared to what most of us normally get on a daily basis.

Now to the definition of what is “Low Sodium”. The FDA has some rather complicated terms and definitions for how the quantify the amount of sodium in foods. Below what I have done is to simplify it into plain English:

SALT/SODIUM FREE: less than 5 mg per labeled serving

VERY LOW SODIUM: 35 mg or less per serving

LOW SODIUM: 140 mg or less per serving

REDUCED or LESS SODIUM: 25% or less sodium than a similar food

LIGHT SODIUM: if food is “Low Calorie” and “Low Fat” sodium is reduced by 50%

Or if sodium is reduced by at least 50% then comparable food.

You see it can get quite complicated. What we have decided to do with all of our Sneals at Carbessentials is to identify all that have 140 mg of sodium or less. You can already find these sneals on-line at www.Carbessentials.net. On the left hand side of the screen you will see a new button that says, “Low Sodium Sneal”, if you click on that button you will only see Sneals that are designated as low in sodium (140 mg or less).

I hope you can appreciate the hard work that goes into providing to our patients/customers the absolute best quality nutrition in Quick, Convenient, Portable Single Serving, High Quality Morsels of Food that we lovingly call Sneals. Then what we have done is to go above and beyond and take over 1,000 products isolate them out into specialized categories is truly a labor of love. We now have the following categories:

Low Sugar Sneals

Low Sodium Sneals

Fiber Sneals

Caffeinated Sneals

Gluten Free Sneals

Lactose Free Sneals

Soy Free Sneals

Vegetarian Sneals

Kosher Sneals

Whey Only Sneals

I hope all this makes sense to you. Remember that you can follow us @:

www.Physiciansplan.net see the featured articles by Dr. Powell

www.Carbesentials.net see the featured articles by Dr. Powell

www.twitter.com/Carbessentials

www.twitter.com/ppwmmc

Facebook become a fan of Carbessentials

Facebook become a fan of Physicians Plan Weight Management and Facial Aesthetics

I love to write and educate so please check in on a regular basis and you will see something new. Remember I am the “purchasing agent” and I am always looking for and finding new and unique products that fit the definition of a Sneal. We add many new products to the store every month.

Hippocrates (the founding father of medicine) said,  “Make your food your medicine”. That is an incredibly intuitive statement for anyone to say but to think that he was alive over 2,000 years ago even makes it more powerful.

Dr. Ray Powell, MD

Medical Director

“Eat Right, Live Right, Feel Right”

“The Easy Way to Eat Right”

This is what it is all about!!: The letter below is from one of our employees. She started as a patient and then was hired on as an employee at our Carbessentials store in Chico. She has been learning how to Sneal and by doing so she is naturally losing weight and feeling so much better. This is why I do Bariatric (weight loss) Medicine.

Hi Dr. Powell, Dominique and Julie:  I went to Petaluma Fair last week and it had been 1 year since most of the people saw me and since I had started your program.

My friends were beside themselves at the physical change in me since they last saw me.  There is no way for me to possibly thank you all for what you have done for me.  I know the work is being done by me, but without your “tools” I would not be successful. I must have walked all over that entire fairgrounds 10 to 20 times a day depending on the schedule, I parked my car in the lot and not right next to the office because I COULD walk to the office and show rings, I had not been to the main part of the grounds in years, because I couldn’t, I did this year.

I am so excited for my next 2 fairs and what I will be able to do and see that I have been missing for so long.  I was worried when I got down there that my water retention would return, not only did it not but I only had marginal swelling in my ankles from driving home.  When I got home my mom said “oh my god, your legs are so small”  My energy level was awesome, I can only imaging how great I will feel in the next 100 pounds.

Dr. Powell your program works and I am grateful for the knowledge you share with all of us.

Julie and Dominique - Thank you for seeing in me what I had lost and am now re-finding in myself, I am so grateful to be working in the store,with all the customers and patients, they are all so supportive and Lindsy and Kendra make it a fun place to come, I enjoy the relationship I have with them.

I am happy to CELEBRATE my 1 year of employment with you and my 1 year of successful weight loss on my way to becoming a much healthier person.  See you all soon, Tracy

A patient in my Chico office started her struggle with weight loss with our clinic 3 months ago with a starting weight of over 400 pounds. We have started to teach her to sneal throughout the day to feed her body.  She had met her first short term goal of 50 pounds of weight loss.  She shared with me something that most of us can never really appreciate.  She said to me, “After losing 50 pounds I don’t have to pick my places to stop in the parking lot to catch my breath anymore.”  Do most of us ever have to think about walking from our car in a parking lot to a building and where to stop and catch our breath?  We totally take that for granted don’t we?

She is changing her life for the better and I get to be there to help.

There is so much confusion about what is Low Carb or Net Carbs or Low Sugar. There is no set definition by the FDA for Low Carbohydrates. There is a specific definition for Low Sodium and Very Low Sodium but not for carbohydrates.

So here is our concept on carbohydrates at Carbessentials.net.

On a label you will have Carbohydrates listed. Underneath that, indented, are the items that make up the carbohydrates. There will be sugars, sugar alcohols, and fiber. Net Carbs is when you take the Total Carbohydrates and subtract the items that do not affect blood sugars. This will be the fiber and the sugar alcohols and what is left are the Net Carbs. Net Carbs affect blood sugars.

Example Carbohydrates: 20 grams
Sugars: 12 grams
Fiber: 3 grams
Sugar Alcohols: 5 grams
Net Carbs = 20 grams - (3F + 5SA) = 12 grams net carbs.

It can get rather complicated and the more math you have to do the more complicated it becomes.

But what if all the numbers underneath the Total Carbohydrates do not add up to the totals?  That is when it gets even more confusing. I talked to one of the nutritional manufacturers we use and he explained it like this.  There are other items within the carbohydrate family that are not required to be listed if they don’t add up to an appreciable amount (greater than 1 gram).  There can be several of these items and they can add up to several grams of carbohydrates but they are not required to be listed.  These are carbohydrates that do not affect your blood sugars.  Examples of these type of ingredients are sugar alcohols, glycerin, tapioca starch, potato starch, and I am sure many more.

So what we have done at Carbessentials is culled out all of our products that have 5 grams of sugar or less. So when you see the Low Sugar list you will know that it means: 5 grams of sugar or less.

These specialty lists that we have created truly put Carbessentials.net at a higher level than any other      on-line nutritional site. It is a labor of love for us.

These are being added to the Carbessentials.net website under the heading of Low Sugar Sneals.

CarbEssentials was opened in early 2003 by Raymond Powell, MD and his wife Dominique Powell. Dr. Powell, a board certified bariatrician, and has treated thousands of medical weight loss patients in his clinics and is always looking for high-quality, nutritional products to help his patients achieve their goals.  He calls these foods sneals.

This search for sneals takes Dr. Powell all over the United States. He personally selects each product sold in his stores to ensure that they meet his strict nutrition criteria. A majority of the products are medical grade, but a growing number of products are from the sports nutrition and unique niche industries. All products are taste tested by his family, employees and patients.

He has coined a term called a Sneal.  That is how he shops for these nutritional items.  He understands the reality of most of our lives.  He understands that most of us have very busy lives and need high quality nutrition that has to be; quick, convenient, portable, single-serving, and has to taste great.  That is where the word sneal came up.  It is a way to teach his patients a whole new way to think about nutrition

Dr. Powell also treats a growing number of patients who have had or about to have Gastric Bypass surgery and for those that are beginning to regain their weight back. He also consults with many other Gastric Bypass patients who are confused about what they should eat and take as supplements to get adequate nutrition while keeping their weight down. He has spent countless hours researching companies offering specialized products for weight loss patients. These low to moderate carbohydrates, low fat products are also available to the public and are excellent nutritional products for anyone, whether you have had Gastric Bypass surgery, trying to lose weight, or just looking for great nutrition.

These sneals are great for kids to take to school.  Again they are quick, convenient, portable, single-serving, high quality morsels of food that taste great.  Perfect to help treat and prevent childhood obesity or just to give kids great food to eat through the day.

Whether you are a medical weight loss patient just trying to lose a few pounds, or an athlete trying to optimize your diet, try our low to moderate carb, low-fat, high-protein, nutritional items. CarbEssentials and the Sneal a better low carb diet solution.  You can learn more about Dr. Powell, MD and Snealing at www.Physiciansplan.net and www.Snealtime.com.  You can shop for sneals on-line at www.Carbessentials.net.

CarbEssentials was opened in early 2003 by Raymond Powell, MD and his wife Dominique Powell. Dr. Powell, a board certified bariatrician, has treated thousands of medical weight loss patients in his clinics and is always looking for high-quality, nutritional products to help his patients achieve their goals.

This search takes Dr. Powell all over the United States. He personally selects each product sold in his stores to ensure that they meet his strict nutrition criteria. A majority of the products are medical grade, but a growing number of products are from the sports nutrition and unique niche industries. All products are taste tested by his family, employees and patients.

Dr. Ray Powell also treats a growing number of patients who have had or about to have Gastric Bypass surgery and for those that are beginning to regain their weight back. He also consults with many other Gastric Bypass patients who are confused about what they should eat and take as supplements to get adequate nutrition while keeping their weight down. He has spent countless hours researching companies offering specialized products for weight loss patients. These low to moderate carbohydrates, low fat products are also available to the public and are excellent nutritional products for anyone, whether you have had Gastric Bypass surgery, trying to lose weight, or just looking for great nutrition.

Whether you are a medical weight loss patient just trying to lose a few pounds, or an athlete trying to optimize your diet, try our low to moderate carb, low-fat, high-protein, nutritional items. CarbEssentials and the Sneal - a better healthy weight loss solution.

About every 5 to 10 years there seems to be a wave of hype through different areas of the country about the HCG Diet. The HCG diet has been known about for over 50 years.

So what the heck is HCG? It stands for Human Chorionic Gonadotropin. Yeah, say that three times fast. If you are not familiar with that term it is the pregnancy hormone Human Chorionic Gonadotropin (American English) that is made by the developing embryo soon after conception and later by a part of the placenta. Its role is to prevent the disintegration of the corpus luteum of the ovary and thereby maintain progesterone production that is critical for a pregnancy in humans. HCG may have additional functions; for instance, it is thought that HCG affects the immune tolerance of the pregnancy. Early pregnancy testing, in general, is based on the detection or measurement of HCG. Because HCG is produced also by some kinds of tumor, HCG is an important tumor marker, but it is not known whether this production is a contributing cause or an effect of tumor growth.

So what the heck does this have to do with a diet? Why on earth would someone actually take daily or weekly shots or daily or weekly sublingual (under the tongue) drops or even intranasal spray of HCG to lose weight? Do they actually think that it is a normal thing to utilize the pregnancy hormone in a non-pregnant person? Do they even know what that does to their normal hormone balance?

Typically it becomes a rave for a short time because the “Doctor” (I use that term very loosely) sells the HCG to the patient and then of course puts the person on an insane diet of 500 calories or less and tells them to do moderate exercise (45 minutes of cardio 5 to 6 days per week) and the patient loses weight at an extreme rate. The latest we heard in Mt. Shasta is that a friend of one of our patients lost 45 pounds in just 30 days!! Do you actually think that is even the least bit reasonable? Do you think that is safe? Do you actually think that all that weight loss was from fat? Of course not, not only is that crazy but completely unsafe. If a physician or any healthcare practitioner is allowing that to happen I personally consider that malpractice.

We had another patient come into the Redding office that went to a medical clinic in Redding and bought nasal HCG spray and was given a piece of paper that described a 500 calorie day diet and the recommendations for the same exercise regimen as above. The patient reports not seeing a practitioner in 7 weeks nor any other healthcare worker in that clinic. That sounds really safe doesn’t it?

So, where did all this hype come from? Who in their right mind would come up with something like this?

The next section below in blue is by Dr. Stephen Barrett, MD that has a website called the Diet Scam Watch.

Human chorionic gonadotrophin (HCG) is a hormone found in the urine of pregnant women. More than 50 years ago, Dr. Albert T. Simeons, a British-born physician, contended that HCG injections would enable dieters to subsist comfortably on a 500-calorie-a-day diet. He claimed that HCG would mobilize stored fat; suppress appetite; and redistribute fat from the waist, hips, and thighs [1]. There is no scientific evidence to support these claims [2-13]. Moreover, a 500-calorie (semi-starvation) diet is likely to result in loss of protein from vital organs, and HCG can cause other adverse effects.

Gabe Mirkin. M.D. has noted: At one time, HCG was the most widespread obesity medication administered in the United States. Some doctors liked it because it assured them of a steady clientele. Patients had to come in once a week for an injection [14]. Government Regulation in 1976, the FTC ordered the Simeon Management Corporation, Simeon Weight Clinics Foundation, Bariatrics Management Corporation, C.M. Norcal, Inc., and HCG Weight Clinics Foundation and their officers to stop claiming that their HCG-based programs were safe, effective, and/or approved by the FDA for weight-control.

Although the order did not stop the clinics from using HCG, it required

that patients who contract for the treatment be informed in writing that:

THESE WEIGHT REDUCTION TREATMENTS INCLUDE THE INJECTION OF HCG, A DRUG WHICH HAS NOT BEEN APPROVED BY THE FOOD AND DRUG ADMINISTRATION AS SAFE AND EFFECTIVE IN THE TREATMENT OF OBSITY OR WEIGHT CONTROL. THERE IS NO SUBSTANTIAL EVIDENCE THAT HCG INCEASES WEIGHT LOSS BEYOND THAT RESULTING FROM CALORIC RESTRICTION, THAT IT CAUSES A MORE ATTRACTIVE OR ”NORMAL” DISTRIBUTION OF FAT. OR THAT IT DECREASES THE HUNGER AND DISCOMFORT ASSOCTATED WITH CALORIE-RESTRICTIVE DIETS [1s].

Since l975, the FDA has required labeling and advertising of HCG to state:

HCG has not been demonstrated to be effective adjunctive therapy in the treatment of obesity. There is no substantial evidence that it increases weight loss beyond that resulting from caloric restriction, that it causes a more attractive or “normal” distribution of fat, or that it decreases the hunger and discomfort associated with calorie-restricted diets.

Promotion By Kevin Trudeau

Negative studies and government action reduced the use of HGC injections for weight control close to zero. However, their promotion by infomercial king Kevin Trudeau may cause their use to increase. His 2007 book, The Weight Loss Cure They Don’t Want You to Know About, claims that “an absolute cure for obesity was discovered almost fifty years ago” but was “suppressed” by the AMA, the FDA, and “other medical establishmentsthrough out the world.” Trudeau further claims that until now, “this miracle weight loss breakthrough has been hidden from the public so that drug companies can make billions of dollars selling their expensive drug treatments and surgical procedures for obesity.” The alleged cure consists of HCG injections plus 50 to 60 required and recommended do’s and don’ts [16]. In September 2007, the FTC charged Kevin Trudeau with violating a court order by misrepresenting the contents of the book. In infomercials, Trudeau falsely claimed that the book’s weight-loss plan is easy to do, can be done at home, and ultimately allows readers to eat whatever they want. Previous FTC action had led to a court order banning from using infomercials to sell any product, service, or program except for books and other publications The order specified that he not misrepresent the content of the books. The FTC is now charging that he violated that narrow exemption [7].

Ahhh!!!, the dreaded conspiracy theory. The “magic cure” that nobody wanted you to know about. The AMA and FDA suppressed to keep it a secret. Come on!!! There has been study after study after study (see the bibliography) that could never reproduce the supposed results that Dr. Simeon did that showed all of these benefits. It has been scientifically proven to NOT have any of these cure-all magic benefits that we all want. But man doesn’t it sound great? All these reported physiological benefits and look at the weight loss, WOW!! So what about the medical consequences and side effects? Take a close look at what their literature promotes. Do they mention anything about consequences or side effects?

The HCG diet (using daily hcg injections) will help you lose 1-3 pounds per day.  The HCG-diet combines the daily injections with a very low-calorie diet (500 calories per day).

500-calories per day is severely restrictive! It is not only restrictive, it is just plain CRAZY!!! Taking a patient even below 800 calories/day is just not done anymore. In fact, it is not enough calories to support normal brain function. Your body will compensate by using stores of glycogen, protein (muscle) and some fat, which lowers your resting metabolism. Before you can lose true weight, you will be so irritable, lightheaded, and cranky that you will reach for whatever food you can get your hands on and have a field day. Even if you do lose weight what did you lose? Answer: Muscle, then a bit of muscle, and even some ah? MORE MUSCLE! get my drift?

Negative side effects: The common side effects include headaches, mood swings, depression, blood clots, confusion, and dizziness. Some women also develop a condition called Ovarian Hyperstimulation Syndrome (OHSS); symptoms of this include pelvic pain, swelling of the hands and legs, stomach pain, weight gain, shortness of breath, diarrhea, vomiting/nausea, and/or urinating less than normal.

HCG ban: The hormone was recently added to the list of banned substances in Major League Baseball, as it was becoming increasingly popular among steroid users. Athletes turned to this, among other performance enhancing drugs because it mitigates the side effects of ending a cycle of steroids. This is what Manny Ramirez from the Dodgers got suspended this year for.

Remember, if it sounds too good to be true, it usually is. Weight loss is hard work you have to burn stored energy off of your body and it won’t come in a potion, pill, or injection. There is no magic pill or shot and there never will be. Remember it is not just weight loss it is what is the weight loss from. The most dangerous thing you should be doing to your body is trying a new exercise that intimidates you like rock climbing or completing a mini triathlon not putting a female pregnancy hormone into your body.

Below is another description from www.drugs.com see what you think:

What is HCG?

Human chorionic gonadotropin (HCG) is a hormone that supports the normal development of an egg in a woman’s ovary, and stimulates the release of the egg during ovulation.

HCG is used to cause ovulation and to treat infertility in women, and to increase sperm count in men. HCG is also used in young boys when their testicles have not dropped down into the scrotum normally. This can be caused by a pituitary gland disorder.

HCG may also be used for other purposes not listed.

Important information about HCG

HCG is given as an injection under the skin or into a muscle. If you use HCG at home, your doctor, nurse, or pharmacist will give you specific instructions on how and where to inject this medicine. Do not self-inject HCG if you do not fully understand how to give the injection and properly dispose of used needles and syringes.

Call your doctor at once if you have any of these signs of a blood clot: pain, warmth, redness, numbness, or tingling in your arm or leg; confusion, extreme dizziness, or severe headache.

Some women using this medicine have developed a condition called ovarian hyperstimulation syndrome (OHSS), especially after the first treatment cycle. OHSS can be a life-threatening condition. Call your doctor right away if you have any symptoms of OHSS: severe pelvic pain, swelling of the hands or legs, stomach pain and swelling, shortness of breath, weight gain, diarrhea, nausea or vomiting and urinating less than normal.

HCG can cause early puberty in young boys. Call your doctor if a boy using this medicine shows early signs of puberty, such as a deepened voice, pubic hair growth, and increased acne or sweating.

Using HCG can increase your chances of having a multiple pregnancy(twins, triplets, quadruplets, etc). A multiple pregnancy is a high-risk pregnancy for the mother and for the babies. Follow your doctor’s instructions about any special care you may need during your pregnancy.

Although HCG can help you become pregnant, this medication is in the FDA pregnancy category X. This means that using the medication once you are pregnant can cause birth defects in the baby. Do not use HCG if you are pregnant. Tell your doctor right away if you become pregnant during treatment.

Before using HCG

You should not use this medication if you have ever had an allergic reaction to HCG, or if you have:

• early puberty (also called precocious puberty); or
• a hormone-related cancer (such as prostate cancer).

Before receiving HCG tell your doctor if you are allergic to any drugs or if you have:

• a thyroid or adrenal gland disorder;
• an ovarian cyst;
• premature puberty;
• cancer or a tumor of the breast, ovary, uterus, prostate, hypothalamus, or pituitary gland;
• undiagnosed uterine bleeding;
• heart disease;
• kidney disease;
• epilepsy;
• migraines; or
• asthma.

If you have any of these conditions, you may need a dose adjustment or special tests to safely use HCG.

Although HCG can help you become pregnant, this medication is in the FDA pregnancy category X. This means that using the medication once you are pregnant can cause birth defects in the baby. Do not use HCG if you are pregnant. Tell your doctor right away if you become pregnant during treatment. It is not known whether HCG passes into breast milk. Do not use HCG without telling your doctor if you are breast-feeding a baby.

HCG side effects

Stop using HCG and get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any of these signs of a blood clot: pain, warmth, redness, numbness, or tingling in your arm or leg; confusion, extreme dizziness, or severe headache.

Some women using this medicine have developed a condition called ovarian hyperstimulation syndrome (OHSS), especially after the first treatment cycle. OHSS can be a life-threatening condition. Call your doctor right away if you have any of the following symptoms of OHSS:

• severe pelvic pain
• swelling of the hands or legs;
• stomach pain and swelling;
• shortness of breath
• weight gain;
• diarrhea;
• nausea or vomiting; or
• urinating less than normal.

HCG can cause early puberty in young boys. Call your doctor if a boy using this medicine shows early signs of puberty, such as a deepened voice, pubic hair growth, and increased acne or sweating.

Less serious side effects may include:

• headache;
• feeling restless or irritable;
• mild swelling or water weight gain;
• depression;
• breast tenderness or swelling; or
• pain, swelling, or irritation where the injection is given.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

Below is an article I found on the internet.

HCG diet was largely discredited long ago

Doctors comparing weight-loss results with HCG injections versus a placebo failed to produce evidence that the hormone was anything special.

By Elena Conis

November 2, 2009

A long-ago discredited fad diet has been getting increased attention lately, thanks to Web chatter and the claims of a bestselling author. The so-called HCG diet’s recent popularity is a bit surprising — and not just because research suggests it doesn’t work.

Other currently popular diets call for cutting back on fat and sugar, consuming whole grains and lean meats, and even indulging in red wine. The HCG diet, in contrast, calls for eating just 500 calories a day while taking daily injections of human chorionic gonadotropin (HCG), a hormone produced by the placenta during pregnancy and excreted in pregnant women’s urine.

According to the hype, HCG suppresses the appetite and prevents dieters from feeling weak or woozy on the low-calorie diet. But as with any fad diet, consumers should be wary of such claims, says Kelly Brownell, professor of psychology, epidemiology and public health at Yale University in New Haven, Conn.

The idea that daily hormone injections might help people lose weight first occurred to British physician A.T.W. Simeons in the 1930s. At the time, doctors had reported success treating children with Frohlich’s syndrome (a condition marked by obesity and slow development of the reproductive organs) by giving them injections of gonadotropin derived from pregnant women’s urine.

Simeons decided to experiment with giving the gonadotropin (it would later come to be called HCG) to people who were obese but did not have Frohlich’s syndrome. When he did so, his patients’ appetites diminished and the circumference of their hips and waists decreased — even though they did not lose weight.

Simeons interpreted those findings to mean that the hormone moved fat away from the places where it was traditionally deposited and rendered it available for metabolism. He further supposed that if he injected overweight people with the hormone while limiting them to no more than 500 calories a day, they would metabolize that newly available fat and lose weight in the process.

Over the next 20 years, Simeons placed 500 of his patients on a strict weight-loss regimen: a daily shot of HCG and two daily meals consisting of 100 grams of lean meat, some leafy vegetables, fruit and a piece of crispbread, for a total of no more than 500 calories a day.

In 1954, he reported in the medical journal the Lancet that patients who followed the regimen for 40 days lost 20 to 30 pounds, and that 70% of them maintained their weight loss after going off the diet. He credited the hormone with making fat available for metabolism and enabling his patients to remain on the low-calorie diet without feeling weak, dizzy or excessively hungry.

Over the next few years, doctors who put their own patients on Simeons’ regimen reported similar successes. But when doctors and researchers began to rigorously compare the diet’s key ingredient — HCG injections — to a placebo, or dummy injection, they failed to produce evidence that the hormone was anything special.

In 1959, researchers in Israel reported that they had placed 45 patients on Simeons’ diet, giving half the patients HCG injections and the other half saline injections. The two groups both lost weight at the same rate — and all 45 participants complained of being constipated, hungry or weak.

In the early 1960s, researchers at UC San Francisco and at a U.S. Army Hospital in Fort Carson, Colo., came up with the same results. All three studies were published in the American Journal of Clinical Nutrition.

In the decades that followed, researchers continued to study the diet and to show that the hormone added little to the low-calorie regimen. In 1995, Dutch researchers reviewed the results of the 24 studies that had been conducted on the HCG diet.

Just 12 of them were well-designed, the scientists found; of those, 11 reported that HCG was ineffective in treating obesity. The Dutch team published its results in the British Journal of Clinical Pharmacology.

Despite these decades of negative study findings, the HCG diet was given new life by bestselling author Kevin Trudeau’s 2007 book, “The Weight Loss Cure ‘They’ Don’t Want You to Know About.” Giving credit to Simeons, Trudeau recommended a multi-phase approach to weight loss, including a phase of daily HCG injections.

Trudeau has previously been targeted by the Federal Trade Commission for allegedly promoting unproven cancer cures, pain relievers and other products, and in 2004 was banned by the commission from appearing in infomercials selling products or services to the public. .

He said in a recent Chicago Tribune story that he wrote his latest book simply as a public service.

Regardless, the HCG diet continues to draw followers, with more and more online companies promising to supply the injections. The shots can come at a significant cost: Online prices range from $30 to more than $600 for a month’s supply. And they have side effects. Simeons noted that his female patients often became pregnant while on the shots, and today, in fact, HCG is approved by the Food and Drug Administration as a fertility treatment.

Brownell says that any trendy diet should give consumers pause.

“Research has not found fad diets to be safe, effective and permanent,” he says. “Consumers should be highly skeptical as the default.”
So do hear a bit of passion in my writing? This stuff gets my blood boiling. For the last 11 years I have had to defend what I do for a living on a daily basis. Finally in the last several years there is more and more medical and scientific studies that show how damaging obesity is to the body. It is truly a medical disease that has to be treated. But medical weight loss has gotten such a bad name/reputation over the years for many different reasons and has been considered by most of the medical society to be on the left fringe of medicine. I have to hold myself to a much higher standard on how I treat my patients. Finally Bariatrics is just beginning to be accepted and in the local area we have developed a great reputation within the medical community and we are getting more and more referrals from local primary care physicians. Then we start hearing of the current HCG craze with some local doctors (again I use that term loosely) doing this absolutely crazy, medically unsafe diet plan. Those practitioners are trying to take away the eleven years of hard work within the local medical community that we have been developing to make Bariatrics a mainstream part of medical treatment for their patients. I just want to scream from the top of Mt. Shasta that we are not the ones doing this absolutely crazy diet and we NEVER will.

References:

l. Simeons ATW. The action of chorionic gonadotrophin in the obese. Lancet 2:946-947, 1954.

2. Asher WL, Harper HW. Effect of human chorionic gonadotrophin on weight loss” hunger and feeling of well-being. American Journal of Clinical Nutrition 26:211218, 1973.

3. Bosch B and others. Human chorionic gonadotrophin and weight loss. A double-blind. placebo-controlled trial. South African Medical Journal 7 7 :1 85-189, 1990.

4. Carne S. The action of chorionic gonadotrophin in the obese. Lancet 2:1282-1284,1961.

5. Craig LS and others. Chorionic gonadotrophin in the treatment of obese women. American Journal of Clinical Nutrition 12:230234,1963.

6. Frank BW. The use of chorionic gonadotrophin

hormone in the treatment of obesity. A double-blind study. American Journal of Clinical Nutrition 14:133-136,1964.

7. Greenway FL, Bray GA. Human Chorionic Gonadotrophin

(HCG) in the treatment of obesity: a critical assessment of the Simeons

method. West Journal of Medicine 127:461463,1977.

8. Shetly KR, Kalkhoff RK. Human chorionic gonadotrophin

(HCG) treatment of obesity. Archives of Internal Medicine 137 :I 5 I -I 5

5, I97 7.

9. Lebon P. Treatment of overweight patients with chorionic gonadotrophin:

follow-up study. Journal of the American Geriatric Society 14 116125,1966.

10. Lijesen GK and others. The effect of human chorionic gonadotrophin

(HCG) in the treatmentof obesity by means of the Simeons therapy: a criteria-based meta-analvsis. British Journal of Clinical Pharmacology 49

:237-243, I995.

11. Miller R, Schneiderrnan LJ. A clinical study of the use of human chorionic gonadotrophin in weight reduction. Journal of Family Practice

4:445448, 1977. 12. Stein MR and others. Ineffectiveness of human chorionic gonadotrophin in weight reduction: a double-blind study.

12. American Journal of Clinical Nutrition 29:940-948, 1976.

Stein MR and others. Ineffectiveness of human chorionic gonadotrophin in weight reduction: a double-blind study. American Journal of Clinical Nutrition 29:940–948, 1976.

13. Young RL and others. Chorionic gonadotrophin in weight control. A double-blind crossover study. JAMA 236:2495–2497, 1976.

14. Mirkin G. Getting Thin. Boston: Little Brown & Co., 1983.

15. In the matter of Simeon Management Corporation et al. Order, opinion etc., in regard to alleged violation of Secs. 5 and 12 of the Federal Trade Commission Act. Docket 8996. Complaint, Oct 15, 1974. Final Order April 29, 1976.

16. Trudeau K. The Weight Loss Cure They Don’t Want You to Know About. Alliance Publishing, 2007.

17. FTC: Marketer Kevin Trudeau violated prior court order. FTC news release, Sept 14, 2007.

I was amazed when I looked at myself when I was 38 years old and I was 250 pounds. I was at least 75 pounds over weight. I hated myself. I looked at my wife and wondered,  ”how she could have been attracted to me when I was so fat.” My back was always killing me and I could not even keep up with my 5 kids.

I was in my second year of my Emergency Medicine Residency. Yes, a doctor who is morbidly obese. How can that happen? Aren’t doctors supposed to know how to stay healthy? Aren’t doctors taught everything there is about nutrition?

The reality of it is that I, like most of us, had been hit with multiple stressors over several years. To include becoming a disabled United States Air Force Veteran, a herniated L5-S1 vertebral disc, a reconstructed ankle, getting divorced and remarried, moving from Charleston, South Carolina to Lubbock, Texas, starting medical school, graduating after 4 years of grueling school and then moving to Columbia, South Carolina and at this point in time 2 years of grueling Emergency Medicine Residency and the birth of two of my 6 total children. There were a lot of great times and some very hard times. But life as we all live it is never stress free. When we are stressed two things immediately get pushed aside, how we eat or how feed us and how we “move our bodies” (exercise).

As I looked at myself in the mirror one day and said, “I can’t do this anymore.” I realized after 6 years of medical training I had no clue what to do about my nutrition. Should I do a “Low-Carb Diet”?. Should I do a “Low-Fat Diet”?. Should I do a “High-Protein Diet”?. Most doctor, according to a recent Congressional hearing, get less than 3 hours of nutritional education in their entire 4 years of medical training. Most people spend that amount of time watching TV each and every day!!! So I tried Atkins (Low Carb), Sugar-Busters, Slim Fast, The Zone and essentially lost a little bit of weight but then put it right back on.

I started to learn and research everything I could find about nutrition and the science of Obesity and how to treat it. Yes, OBESITY, that is what I have as a diagnosis. I will always have it. Obesity has been defined by just about every medical organization including the World Health Organization as a Chronic Relapsing Medical Disease and I have it.

As I start these Podcasts/Blogs I will explain to you the concepts I have learned about treating myself and thousands of patients for Obesity. The science of nutrition, what is the right combination of Protein, Carbohydrates and Fats. How much and when should your nutrition be eaten. It is not as easy and many people think. If it was we would not have a country and world that has become obese.

After I realized how little I knew about my own nutrition and treating patients for Obesity for several years. I realized that all these patients had one thing in common. They need to be shown what, when, and how to eat. For myself as well as my patients there were several common themes. Not eating often enough, Not eating enough, and a term called Food Amnesia. The beginning of my concept for “CarbEssentials” was born.

Read On!!.

The following is an internet interview that I did for a Mount Shasta Newspaper

Hi Dr. Powell,

Thanks so much for the interview! I’m planning to write a feature article about keeping New Year’s resolutions, and wanted your input in the losing weight section.

How many people have you helped to meet their weight loss goals?

Between my father, Dr. Richard J. Powell, MD and myself we have been practicing Bariatrics (medical treatment of Obesity as a disease) for over 35 years.  I have 4 offices and we see several hundred patients per week.

Why is it important/helpful to be under a physician’s care when losing weight?

Managing your weight is a complex task and depending on a persons initial weight and underlying medical conditions it can be medically dangerous to do it on your own.  There are thousands of diets out there and probably more than half of them are crazy and dangerous.  Whether a person has to lose 20 pounds or 200 pounds I would much rather have a person come in and have it medically managed than to do some crazy over the counter Fad diet that can be medically dangerous.

Is diet or excercise more important for those wanting to make a healthy change in their lives? Or are they equally important?

Exercise is very important for a persons cardiovascular health as well as their mental health.  For weight loss the exercise would have to be very aggressive and almost every day for it to effect your weight.  It should be continued if the person is doing it.  The change in nutritional behaviors and becoming “in-control” of one’s nutrition and being educated on what you are actually putting into your body and actually eating higher quality nutrition in smaller amounts more often is critical to keep the metabolism going.  One of the most critical item I see on a daily basis is that people don’t eat all day long and then they tend to overeat.

What is the one tip you would give to those wanting to lose weight in the new year?

Take the time to take care of yourself.  Start spending more time taking care of yourself then you do on your car.  Don’t start on some dangerous fad diet.  If you plan on changing your nutrition drastically seek medical advice.

What is your opinion on th e value of Nintendo’s Wii Fit? (I was considering adding a bit about it into the article).

We have one and it is AWESOME.  Our whole family uses it.  Of course the kids are a bit better at it then us adults.  It is the next generation in video gaming where you actually interact in a physical sense.  I recommend it to the parents of my teenage patients.  It was actually mentioned in lectures at the America Society of Bariatric Physicians in Tampa Florida in October of 2008.

What programs do you offer at the Mount Shasta office?

We offer medically directed programs that follow the guidelines of the National Institute of Health and the American Society of Bariatric Physicians.  We individually customize our programs around the patients medical conditions.  Our programs range from very aggressive Very Low Calorie Nutritional plans to Low Calorie programs.  One of my concepts is that of the “SNEAL”.  It is too long to describe here but please go to my blogs at www.Physiciansplan.net and I have a complete description of a SNEAL.

Plus… a few motivational statistics regarding weight loss… and anything else you think is of interest.

A 10% weight loss is a 57% reduction in risk for medical diseases directly related to weight (high blood pressure, diabetes, cancers, stroke, and many more)

A 10 pound weight loss take 100 pounds per square inch off of your knees.

A very famous statement that I think most of us have either forgotten or never heard is, “Make Your Food Your Medicine”  What an incredible statement.  What we have done is made our food our Poison.  The person who said, “Make Your Food Your Medicine”—–Hippocrates—over 2,000 years ago and we still haven’t figured it out.

Here one of mine, ” The Cure for Hunger is——FOOD!!!”

You need to learn to “SNEAL” (my word) See www.Snealtime.com.  You need to learn to find Quick, Conveinent, High Quality, Single-Serving, Tasty morsels of Food.  It is NOT a snack.  Refer to my previous blogs on my website:

www.Snealtime.com

www.Physiciansplan.net

www.Carbessentials.net

Initially quite often the patients we treat want to have their nutrition taken away from them Temporarily and that is why we have several different aggressive plans where we supplement them with “SNEALS” of our own. We sell tham at each office and we have three separate nutritional stores (Redding, Chico, and on-line @www.Carbessentials.net.

If you’d like to do the interview via phone, that would be great… my number at the office is ——–. I’ll be in most of tomorrow between 8:30 and 2 or so (I know it’s a holiday, so that might not work for you). I’ll also be in and out on Friday and Monday.

I am having an Epidural injection in my back (yeah me) on Friday morning and i will be home the rest of the day.  E-mail me a number that I can reach you on Friday and I will call you.

If hours during the evening are good for you, my cell number is ——–. Or email me a time, and I can call you then. Or, we could do it via email if you’re pressed for time.

Talk to you soon.  I hope this helps

What is Metabolic syndrome?

Screening and diagnosis

Although your doctor is not typically looking for “metabolic syndrome,” the label may apply if you have three or more of the traits associated with this condition. Several organizations have criteria for diagnosing metabolic syndrome. These guidelines were created by the National Cholesterol Education Program (NCEP) with modifications by the American Heart Association. According to these guidelines, you have metabolic syndrome if you have three or more of these traits:

§ Elevated waist circumference, greater than 35 inches for women and 40 inches for men. For people genetically at greater risk of diabetes, the circumference limit is slightly lower; 31 to 35 inches for women and 37 to 39 inches for men.

§ Elevated level of triglycerides of 150 milligrams per deciliter (mg/dL) or higher, or you’re receiving treatment for high triglycerides.

§ Reduced HDL (less than 40 mg/dL in men or less than 50 mg/dL in women) or you’re receiving treatment for low HDL.

§ Elevated blood pressure of 130 millimeters of mercury (mm Hg) systolic (the top number) or higher or 85 (mm Hg) diastolic (the bottom number) or higher, or you’re receiving treatment for high blood pressure.

§ Elevated fasting blood sugar (blood glucose) of 100 mg/dL or higher, or you’re receiving treatment for high blood sugar.

Treatment

Tackling one of the risk factors of metabolic syndrome is tough, taking on all of them might seem overwhelming. But aggressive lifestyle changes and, in some cases, medication can improve all of the metabolic syndrome components. Getting more physical activity, losing weight and quitting smoking help reduce blood pressure and improve cholesterol and blood sugar levels. These changes are key to reducing your risk.

Exercise. Doctors recommend getting 30 to 60 minutes of moderate intensity exercise, such as brisk walking, every day.

Lose weight. Losing as little as 5 percent to 10 percent of your body weight can reduce insulin levels and blood pressure and decrease your risk of diabetes.

Stop smoking. Smoking cigarettes increases insulin resistance and worsens the health consequences of metabolic syndrome. Talk to your doctor if you need help kicking the cigarette habit.

Work with your doctor to monitor your weight and your blood glucose, cholesterol and blood pressure levels to ensure that lifestyle modifications are working. If you’re not able to achieve your goals with lifestyle changes, your doctor may also prescribe medications to lower blood pressure, control cholesterol or help you lose weight. Insulin sensitizers may be prescribed to help your body use insulin more effectively. Aspirin therapy may help reduce your risk of heart attack and stroke.

Take our Metabolic Syndrome Test.

The Definition of a Sneal

The word Sneal is a new word that yours truly (Dr. Ray Powell) came up with to describe a new way of eating and a way of describing the quality of nutrition to my patients. I use the word as a test with my patients/staff/practitioners to see if they are learning something and WE as a total team effort are teaching them something as they go through our programs from weight loss to weight maintenance.

I want them to learn that from this time forward a “Snack” is a dirty word and should never be used again. It is a dangerous concept created by the American Food Industry. “Snacking” is what has made the American population as overweight and obese as it is.

So the first thing I need to do is define a SNACK,

The “American SNACK” is usually an American “white carbohydrate” (junk) and/or a fat. {Snack = Junky Carb and/or Fat}

The American food industry (grocery store) does not feed us SNEALS. They feed us snacks that have HUGE amount of calories, high in simple, white, sugary, bad carbohydrates. These jack your blood sugar through the ROOF and just to top it off they add in as much FAT as they can to make it REALLY taste good.

No more SNACKING!!!

The Physician’s Plan “SNEAL” A good carbohydrate (fruits and veggies) AND a LEAN Protein. {Sneal = Good Carb + Lean Protein}

OR

just a LEAN Protein.

{Sneal = Lean Protein}

{Range 60 to 250 calories/sneal}

SNEALING–How to do it?

When patients are first learning how to SNEAL and are in the process of losing weight they are started on very high quality SNEALS from the nutritional store that I have created for myself, my family and friends and for my patients and customers. The store is called Carbessentials, because Carbs are essential!!! But so is protein and a small amount of fat.

What I have done, essentially, is I have become the “purchasing agent” for products that fit all the requirements to become a SNEAL.

I initially started with the medical nutritional companies that provide prescription nutritional products to physicians for a medically safe weight loss. I continue to search for unique products from specialized companies that cater to a growing variety of nutritional niches. I have even tapped into the body building industry and have found some excellent products that fit my requirements perfectly.

So to review the concept again, a SNEAL is designed to be a small (60 to 250 calories), convenient, quick, easy, and high quality morsel of food that you eat every 2 to 3 hours.

It is designed in such a way nutritionally to keep the blood sugars leveled by providing the body with at least an equal amount of a complex carbohydrate and an equal amount of a very high quality lean protein or just a lean protein source if desired. What this also does is suppresses hunger and gives you more energy. People that just try to eat only high protein are not getting enough immediate energy because their bodies immediate carbohydrate stores have been depleted and if they don’t feed themselves any carbohydrates (i.e. trying to Atkins Diet) they will feel low energy and like they are running on empty.

So, SNEALING every 2 to 3 hours with nutritional products that have been hand-picked for you by someone with the scientific and medical background and intense desire to continue to learn and research nutrition is an added plus. When you look at nutritional products that are sold at the retail stores, BUYER BEWARE!!! Not all products are created equal and many of these so-called nutritional products are basically expensive looking candy bars.

So keep looking at my website, www.Carbessentials.net. I am always adding new products as I continue to find them in my journeys.

Dr. Ray Powell, MD