1.A Review of the Pharmanex Biophotonic Scanner, Supplements, the Cady White Paper, & Relevant Genomic Science in New AgeLOC Products Santa Ana, California November 9, 2013 Louis B. Cady, MD CEO & Founder Cady Wellness Institute Adjunct Professor University of Southern Indiana Adjunct Clinical Lecturer Indiana University School of Medicine Department of Psychiatry Child, Adolescent, Adult & Forensic Psychiatry Evansville, Indiana

2. Background for this presentation: There are no drug claims made for any products from NuSkin/Pharmanex No NuSkin/Pharmanex product nor any other OTC vitamin or supplement is designed to treat, prevent, mitigate, diagnose or do anything else to or for any disease. Pharmanex nutritional supplements & weight control products are designed to support the structure and function of the human body. (c) 2013 Louis B. Cady, M.D. - all rights reserved 3. CURRENT PRACTICE OF MEDICINE: What a patient had to say about her specialists:They just monitor my degeneration. 4. Cady Wellness Institute July 2005 The Reasons: Conventional medical practice had failed me twice. A lot of psychiatric cases WERENT psychiatric. Nobody was integrated. Nobody was looking at ALL of the peer-reviewed literature. 5. Today: A Tale of FOUR Guys 6. Learning objectives Importance of antioxidants (with refs) Origins and validity of the Biophotonic Scanner The critical three points of the Cady White Paper AgeLOC technology and YGCs (??) Vitality and TR90 7. Streaking, or..Better Buckle Up!!! Definition: Streaking is the act of taking offone's clothes and running naked through a public place. [ref:http://en.wikipedia.org/wiki/Streaking - accessed 09 02 2013] In 1973, what the press called a streaking epidemic hit Stephen F. Austin State University in Nacogdoches, TX, with streakers being seen in residence halls, at football games and at various other on-campus locations and events, including Spring graduation. (Harvard-Yale game, 2006) 8. www.slideshare.net/lcadymd 9. Here it is again :) www.slideshare.net/lcadymd 10. Evansville Courier & Press: May 29, 2006 11. As of 11/8/2013 12. As of 11/8/2013 13. As of 11/8/2013 14. Could it happen to you? 15. What causes oxidative stress? Environmental Toxins Heavy metals including Mercury (fillings!) Pesticides/herbicides Preservatives PCBs, Dioxins, Phthalates Toxins produced in the body Yeast and bacteria Products of cellular metabolism Emotional Stress Anxiety/Tension Fear Anger 16. Oxidative stress in the BRAIN why you should know your numbers 17. Why is the brain so susceptible to oxidative stress? Burns glucose generates free radicals. Uses 20% of total oxygen and energy consumed by the body. of this is for electrochemical nerve transmission. Contains IRON Contains essential fatty acids, which can be OXIDIZED (rancid fat) Limited supply of own antioxidants Limited ability to regenerate/repair damage 18. What are some consequences of oxidative stress? Behavioral deterioration Impaired cognitive function Decreased memory Psychiatric symptoms Increased inflammation Depressed immune system DNA damage cancer 19. Antioxidant assessmentReference: www.cadywellness.com/cadyw 20. Center for Biomedical Optics Dixon Laser Institute, University of Utah Werner Gellermann, Ph.D. Research Professor Colleague Igor Ermakov, Ph.D., et al. Technologies Novel Raman Spectroscopy and Raman Imaging. Funding: National Institutes of Health State of Utah Spectrotek, LLC 21. A method and apparatus are provided for the determination of levels of carotenoids and similar chemical compounds in biological tissue such as living skin. 22. Dissolved carotenoids in stratum corneum27 days 23. Scientific Validation: Peer-reviewed by the medical & research communities Society of Investigative Dermatology, May 25, 2000. Non-Invasive Raman Spectroscopic Detection of Carotenoids in Human Skin. Arch Biochem Biophys. 2010 Dec 1;504(1):40-9. Epub 2010 Aug 1. Validation model for Raman based skin carotenoid detection J Eur Acad Dermatol Ven. 2011 Aug;25(8):945-9. Skin carotenoid levels in adult patients with psoriasis. 24. RSS spectroscopy is a reliable method for non-invasive measurement of B-carotene levels in skin, and may be used as an important biomarker of antioxidant status in nutritional and health studies in humans. Ramirez-Velez, et al. Endocrinol Nutr. 2012 April 25. But is the scanner really valid and dependable? 26. The totality of the evidence supports the use of skin carotenoid status as an objective biomarker of fruits/vegetable intake ..skin carotenoids may effectively serve as an integrated biomarker of health Thus, this biomarker holds promise as both a health biomarker and an objective indicator of fruits & vegetables intake. 27. Scamo S et al. Br J Nutr. 2013 Sep 14;110(5):911-7. Good agreement between single and multiple measures (95% CI) + association with intake of total carotenoids A single RRS measure was reasonably accurate at classifying usual skin carotenoid state. 28. So where do I find this white paper? www.google.com www.cadywellness.com/ cadywhitepaper2008.pdf 29. Relationships of carotenoids to other more conventionally measured antioxidants (p 6 -7) Svilaas et al (2004): 2, 670 adults studied with serum carotenoids measured and correlated with vitamin consumption serum carotenoids were stronger predictors of other antioxidants than were alpha, beta, delta, and gamma tocopherols, as well as glutathione.* * Svilaas A, et al. Intakes of antioxidants in coffee, wine, and vegetables are correlated with plasma carotenoids in humans. J Nutr. 2004 Mar;134(3):562-7. 30. Convenience of carotenoids as antioxidant measurement (pp7-11) Hata, et al* (2000) correlated skincarotenoids (Raman) with carotenoid levels from skin from abdominoplasty patients (HPLC). Our technique can be usedfor assessing antioxidant status and the risk for diseases related to oxidative stress. [Palm of skin = highest carotenoid location] *Hata et al. Non-invasive Raman spectroscopic detection of carotenoids in human skin. J Invest Dermatol. 2000 Sep; 115(3):441-8. 31. The Svilaas/Hata Syllogism: Hata (2000) Raman measurements of carotenoid == HPLC skin measurements Svilaas (2004) skin carotenoids = better predictor of antioxidant status than mixed tocopherols and glutathione THEREFORE [Cady]: Raman spectroscopy is a better measure of antioxidant status than mixed tocopherols and glutathione. 32. BTW what does that SCS actually mean in REAL LAB MEASUREMENTS? Y = 12703 * X + 5891.7 Where Y is the SCS, and X is the carotenoid concentration in MICROgrams/ml, viz: 25,000 = 12703X + 5891.7 25,000 5891.7 = 12703 * X 19,108.3 = 12703 * X 19,108.3 /12703 = X X = 1.50 MICROgrams /ml Rule of thumb: 1,000 on SCS = .06 ug carotenoid/ml blood serum (e.g., SCS of 40,000 = 2.4 ug carotenoid/ml) Source: NuSkin/Pharmanex 33. You dont need vitamins: (a) you can getem in your food; (b)they just make expensive urine. I dont believe in antioxidants. from an MD!! 34. Inadequate intakes may result in chronic metabolic disruption, including mitochondrial decay. [They] cause DNA damage, such as chromosome breaks, in cultured human cells or in vivo.triage theory 35. 16,103 people 1994 1996. ZERO got 100% of all required vitamins and nutrients - Highest B12 =- 82.8% got enough - 66.8% - had adequate folate - Lowest Zinc only 26.6% got enough. 36. Seismic shift in the medical literature - 2002Pending strong evidence from randomized trials, it appears prudent for all adults to take vitamin supplements. Fletcher & Fairfield, JAMA 2002 37. Whats New since the cady report (2006 & 2008)? 38. Angela Mastaloudis Ph.D. Senior Scientist, Global Research & Development, Pharmanex 39. RS accurately measures total carotenoids in human skin with less intra-individual variability than measurement of serum carotenoids by HPLC analysis. RS technologyis a valid and reliable noninvasive method to rapidly assess carotenoid nutritional status in humans. (J Am. Coll Nutr 2009) 40. Epidemiology of Vascular Aging (EVA) 41. Epidemiology of Vascular Aging (EVA) Study population: N=1,389; age range {59-71 yoa} 9 year study Relative risks: all cause mortality at 2.94X in men in lowest quintile (95% CI, P=0.03) cancer 1.72X in men (95% CI, P=0.01 Total plasma carotenoids levels were independently associated with mortality risk in men. 42. Vitamin/mineral supplementation & cancer, cardiovascular, and all-cause mortality (EPIC-Heidelberg) Li K, Kaaks R., et al. Eur J Nutri July 2011 Purpose: evaluate vitamin/mineral supplementation with CA, CV dz, and mortality Methods: 23,943 healthy participants, followed 11 years Baseline and new-use supplementation notedResults: 513 CA deaths, 264 CV deaths No MVI supplement had any significant effect sick user phenomenon discussed. Baseline users of antioxidant supplements had significantly reduced risk of cancer [HR 0.52] and all cause mortality [0.58] 43. Antioxidants and brain tumors? free radicals are another etiological factor of brain tumor and are removed by cellular antioxidants in the human body. Inverse correlation between: antioxidant levels and oxidative DNA damage Grades of malignancy Decrease in antioxidants are associated with severity of malignancy 44. Conclusions It is concluded that administration of antioxidants could reduce the incidence of brain tumors and probably other types of cancer. - Shewelta SA , Sheikh, BY Curr Drug Metab. 2011 Jul;12(6):587-93. (Dept.of Biosciences & Technology, Alexandria University, Egypt.) 45. So why do you need a SYSTEM in your vitamin supplement/mineral complex?? And whats a nano? 46. A SYSTEMS approach to nutritional optimization 3 ega- s Om cid tty a fants trie ns mi onu vita hyt P nts s a ral xid ine ntio m lth) A hea one (b 47. What does Nano mean? Cylcodextrin ring benign, digestable Feeds the gut microflora 48. How do nano-nutrients work? Fat-soluble nutrients like Nano-encapsulated nutrients do carotenoids and coenzyme Q10 not clump; they DISPERSE. CLUMP in watery milieu. 49. The Nanotechnology Differencepmol/mg protein5-fold increase in absorption!Adapted from Craft et al, FASEB Journal. 2005; 19(4): Abstract #281.6, A449.-cyclodextrin complex 50. The train has left the station 51. Can you relax with an 81,000 scan score?? 52. Total organic fruits/vegetables intake, 9 12 servings per day. No supplements. 53. 74,000 54. what about other things besides carotenoids and Antioxidants?? Or why cant you just juice your way to complete and optimal health??? 55. Essential Fatty Acids relevant for: PsychMedical Seizures Rheumatoid arthritis (& anything with inflammation) Coronary heart disease (or health maintenance)Depression Bipolar depression Schizophrenia Autism AD(H)D Learning disabilities 56. Do YOU Need Fish Oil?5X reduction 57. Symptoms of B12 Deficiency Mental Irritability Apathy Personality changes Depression Memory loss Dementia Hallucinations Violent behavior AnxietyPhysical Diminished sense of touch and pain Clumsiness Weakness Pernicious anemia Chronic fatigue Tremors GI problems 58. LifePak Nano - % RDA in 2 packets B12 1,000% (as 60 MICROgrams cyanocobalamin) B6 500% Folic acid/folate - 150% Magnesium76% (as 300 Mg amino acid chelate) Zinc100% (15 mg as zinc chelate) Selenium200% (L-selenomethionine & NaSeO3) Iodine76% Chromium166% Vitamin C834% Vitamin A300% (83% as Beta carotene and plantextracts) 59. Why there is an epidemic of B12 deficiency?? Gastric intrinsic factor produced by parietal cells of stomach;. H1 blockers shut them down Cant absorb B-12 without it. Complex goes to last portion of small intestine, where complex is absorbed and B12 liberated. 60. Your brain and B12 If you are in the bottom 1/3rd for B-12 levels. SIX TIMES increase risk of brain volume loss (Odds ratio = 6.17, 95% CI) Vogiatzoglou A et al. Vitamin B12 status and rate of brain volume loss in community-dwellers. Neurology. 2008 Sep 9;71(11):826-32. (107 volunteers aged 61-87 years of age) 61. BRAIN SHRINKAGECONCLUSIONS: The accelerated rate of brain atrophy in elderly with MCI can be slowed by treatment with homocysteine-lowering Bvitamins. Smith AD, Smith SM, de Jager CA, Whitbread P, et al. (2010) Homocysteine-Lowering by B Vitamins Slows the Rate of Accelerated Brain Atrophy in Mild Cognitive Impairment: A Randomized Controlled Trial. PLoS ONE 5(9): e12244. doi:10.1371/journal.pone.0012244 http://www.plosone.org/article/info:doi/10.1371/journal.pone.0012244 62. LifePak Nano - % RDA in 2 packets B12 1,000% (as 60 MICROgrams cyanocobalamin) HOMOCYSTEINE B6 500% lowering Folic acid/folate - 150% Magnesium76% (as 300 Mg amino acid chelate) Zinc100% (15 mg as zinc chelate) Selenium200% (L-selenomethionine & NaSeO3) Iodine76% Chromium166% Vitamin C834% Vitamin A300% (83% as Beta carotene and plantextracts) 63. OK. It slows shrinkage. But are they sharper? [deJager CA et al. Int J Geriatr Psychiatry. 2012 June;27(6):592-600]B-vitamins appear to slow cognitive and clinical decline in people with MCI. 64. The Effects of high dose B vitamins on stress at work 3 month, double blind, placebo control, randomized study Measured: Personality, work demands, mood, anxiety, and strain The vitamin B complex treated group reported significantly lower personal strain and a reduction in confusion and depressed/dejected mood after 12 weeks. Strough C et al. The effect of 90 day administration of a high dose vitamin Bcomplex on work stress. Hum Psychopharmacol. 2011 Sept 8. doi 10.1002/hup.1229 (Swinburne University of Technology Hawthorn, Victoria, Australia.) 65. Micronutrient supplementation has a beneficial effect on perceived stress, mild psychiatric symptoms, and aspects of mood in apparently healthy individuals. Supplements containing high doses of B vitamins may be more effective in improving mood states. 66. What happens with biotin deficiency? Two LifePak Nano packets have 100% of recommended daily requirements of Biotin.Our results suggest that biotin deficiency promotes hyperglycemic mechanismsand decreased insulin secretion and sensitivity to compensate for reduced blood glucose concentrations. 67. One more time no supplement, under the DSHEA act, may be represented to treat, cure, mitigate or prevent any disease. No such health claims are being advanced for any Pharmanex/NuSkin supplement or product. The following slides represents a LITERATURE REVIEW It correlates antioxidants, carotenoids and various conditions described in the peer reviewed medical literature. - Louis B. Cady, MDOn November 8th, 2013More data: a mad dash through the literature 68. Chile has an increased cancer prevalence which is associated with poor quality diets, rising mean body mass index and a sedentary behavior. 69. 100 more citations in the last year! 70. OK. So Ill just drink carrot juice and pop some high potency Bs. What me worry? 71. 20 years ago - a hint of bad things to come North Americans, unfortunately, obtain about one-third of their total calories from nutrient-poor junk food. Even well-educated adults. fallshort in their consumption of important minerals, like magnesium, iron, zinc, and calcium.Hallfrishch, J., Muller, D. 1993. Experimental Gerontology, v28 : 473-83. 72. Magnesium mementos One of the first minerals to disappear with: Processed food Stress Decreased by EtOH, caffeine, sodas, meds Considered anti-stress mineral Decreases cortisol (rel to sleep disruption) Relaxes muscles, prevents cramps Decreases anxiety; improves sleep 73. Symptoms of Magnesium Deficiency PSYCHIATRIC ISSUES: Difficulty with memory and concentration Depression, apathy Emotional lability Irritability, nervousness, anxiety Insomnia Autism ADHDHealth Conditions Associated with Magnesium Deficiency Migraine headaches PMS Dysmenorrhea Fibromyalgia Fatigue CONSTIPATION 74. SELENIUM DEFICIENCY in FASEB: Adaptive dysfunction of selenoproteins from the perspective of the triage theory: whymodestselenium deficiency may increase risk of diseases of aging. Foundation of American Societies for Experimental BiologyMcCann, J, Ames BM. FASEB J. 2011 Jun;25(6):1793-814. 75. I+Se+the foot soldierLifePak Nano has 200% of RDA of selenium. And 76%of RDA of iodine. 76. Recentyears have seen a SUBSTANTIAL, and as yet UNRECOGNIZED ageindependent population-level decrease in T in American men. November 2009 Travison, Araujo, et al. Jrnl of Clin. Endocrinol & Metabol 92:1; 196-202.3 cohorts of men: 1987-1989; 1995-1997; 2002 -2004.Alpha Male issue 77. Fast food (lowZinc) is bad for you. Fast food = high energy density = low essential micronutrient density, ESPECIALLY ZINC Antioxidant processes are dependent on Zinc Fast food = severe decrease in antioxidant vitamins and zinc, correlating with inflammation in testicular tissue with underdevelopment of testicular tissue and decreased testosterone levels 78. Low Zinc associated with low testosterone Per USDA, 60% of US men between 20 49 years of age do not get enough. [N.B.: Do not supplement with > 50 mg daily (can interfere with Cu+ metabolism); rationale for SYSTEMS approach] Tsai, E.C., Boyko, E.J., Leonetti, D.L., & Fujimoto, W.Y. (2000). Low serum testosterone level as a predictor of increased visceral fat in JapaneseAmerican men. International Journal of Obesity and Related Metabolic Disorders, 24, 485-491LifePak Nano has 100% of daily RDA for Zinc. 79. Erectile dysfunction & antioxidants with MVIs?? 80. Ways to improve erectile quality (LP Nano concentrations in parentheses) Holistic: physical exercise, improved nutrition, weight control (R90 & TR90) Supplements: adequate intake Omega 3 fatty acids ( ~4 grams/ day in LP Nano) Antioxidants {+++} Calcium (600 mg = 60%) Folic acid (folate 600 ug = 150%) RX: Replacement of any T deficiency Meldrum DR et al. The link between erectile and cardiovascular health: the canary in the coal mine. Am J Cardiol. 2011 Aug 15;108(4):599-606 81. New Partners, New Products 82. LifeGen acquisition: Why? Owns all current and future genetic data on aging monopolizes the genetic knowledge on aging Applies LifeGen science to all products Unrestricted access Builds barrier to entry Enhances Nu Skin product innovation in antiaging (Apple of the industry)99 83. Is it safe to Influence Genes? ageLOC is NOT: gene therapy genetic engineering gene splicingageLOC is: NuSkin/Pharmanex - novel approach to developing products designed to support youthful gene expression. 84. An Entirely New Class of Anti-aging Products 85. BEFOREAFTER 6 MONTHS *Twice daily usage of ageLOC Transformation, and twice weekly usage of ageLOC Galvanic Spa and Facial Gels. 86. Mitochondrial Damage: Loss of EnergyMitochondria Free radical damage alters their energy production capability. Plus, they breathe their own exhaust. 87. MITOCHONDRIAL ACTIVITY DECLINES WITH AGE 86- 40%4218~3961~84Mitochondrial Dysfunction in the Elderly: Possible Role in Insulin Resistance Science 16 May 2003:Vol. 300. no. 5622, pp. 1140 1142 88. Transcriptional Biomarkers of Mitochondrial Aging and Modulation by Cordyceps sinensis CS-4.MuscleBrainR Weindruch, A Mastaloudis, SB Ferguson et al. Presented at Biology of Aging, Determinants of Health-Span. Switzerland August 22-27,2010 89. TARGET & RESET YOUTH GENE CLUSTERS Young Gene Expression TARGETOld Gene ExpressionOld Gene Expression RESETTranscriptional Biomarkers of Mitochondrial Aging and Modulation by Cordyceps Sinensis Cs-4. Gordon Research Conference, Biology of Aging, Determinants of Health-Span: From Cells to Humans, August 22-27, 2010. Les Diablerets Conference Center, Les Diablerets, Switzerland. 1 90. Youth Gene Clusters bogus or bonanza? Yeast species SPECIFIC genes Comparative genomics of fungal allergens and epitopes show widespread distribution of closely related allergen and epitope orthologues. Bower P, et al, BMCGenomics. 2006; 7:251. 91. Prostate Cancer more relevant? Pre-invention gene expressionPost-intervention gene expressionChanges in prostate gene expression in men undergoing an intensive nutrition and lifestyle intervention. Ornish, DeanProc Natl Acad Sci USA 2008 June 17; 105(24):8369-8374 et al. 92. Active mitochondrial research on energy 93. http://www.nature.com/scitable/topicpage/mtdna-andmitochondrial-diseases-903 94. Three active botanicals: Cordyceps Pomegranate extract Panax ginseng Promotes Three Dimensions of Vitality:* Physical Vigor Mental Acuity Sexual Health * These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. 95. Week 12 = +20% P=0.021 Vitality vs. Placebo Targeting Age-related gene expression improves mental and physical vitality Ferguson SB SM et al. Paper presented at 1st World Congress on Targeting Mitochondria, Strategies, Innovations & Clinical Applications. Berlin, German. November 18-19, 2010. 96. Excess body weight is correlated with excess morbidity and mortality. In particular, Grade 2 or higher obesity (BMI>35) significantly increases the risk of death. (c) 2013 Louis B. Cady, M.D. - all (www.cdc.gov/nchs/data/hus/hus11_InBrief.pdf) rights reserved 97. Obesity a national crisisA $586 Billion Market in 2014Fortune Magazine Feb 3, 2003 98. How do you lose it? 99. TBL: Its the INSULIN RESPONSE RX: EAT LESS CARBS AND SUGAR!!NEW APPROACH: -Turn on your genes in your fat cells to burn more fat and store less fat!! - Change hunger signaling to brain by changing gene expression 100. ageLOC TR90 Summary Healthy weight management and Body Shaping program. Based on gene expression science. Promotes Lean Muscle Maintenance - Appetite Control Studies on TR90 weight management program resulted in significant weight loss, fat loss and changes in gene expression. 101. Comparison of Genetic Profiles of Adipose Tissue in Identical Twins Pietilinen et al. PLoS Med. 2008 Mar 11;5(3):e51.Overweight TwinNormal Weight TwinSame DNADifferent Expression of GenesCompared to their normal weight twin, overweight twins exhibited down regulation of gene expression pathways related to: Fat Regulation (storage versus utilization) Muscle Protein Synthesis 102. Identified Gene Expression Pathways Linked to Fat Storage and Fat MetabolismLifeGen pre-clinical study of Adipose, Gastrocnemius muscle, Hypothalamus 103. Plants altering gene expression IngredientEffectFrom PubMedPrickly pear fruitbody silhouettePotent antioxidantGreen tea catechinsThermogenesis(Established)pomegranateFat reductionrelated to the presence of anthocyanins, tannins, and very high levels of antioxidants, including polyphenols and flavonoids.Tart cherryPrevents muscle damageincreasing total antioxidative capacity, reducing inflammation, lipid peroxidation 104. Green tea, black tea, epigallocatechin: Modifies body composition Improves glucose tolerance DIFFERENTIALLY ALTERS GENE EXPRESSION 105. Gene Expression relates to the Appetite Control Center of the Brain Appetite Control Eating Behavior Regulation of energy intakeGhrelin Leptin Insulin References: 1. 2. 3. 4. 5. 6. 7. 8. 9.Smeets et al. Proceeding of the Nutrition Society. 2012;71:511-520. Guthoff M, et al. J Clin Endocrinol Metab. 2010;95:748-755. De Silva, et al. Cell Metab. 2011;14:700-706. Malik S, et al. Cell Metab. 2008;7:400-409. Farooqi IS, et al. Science. 2007;317:1355 Suzuki K, et al. Experimental Diabetes Research. 2012:1-19. Viquerie N, et al. Diabetologia. 2005;48(1):123-131. Mager et al. European Journal of Endocrinology. 2008;158: Mutch DM, et al. Am J Clin Nutr. 2011;94(6):1399-1409. 106. Eating Plan Based on: Protein Science & Nutrition Science 3-2-1 eating plan designed to complement the supplements. Supports metabolically-active lean muscle and inhibits fat storage.Reference: Wycherley TP, et al. AJCN. 2012;96(6):1281-98. 107. Eating Most of Your Protein with Only One Meal of the Day Limits Duration of Metabolic BurnFAT STORINGZONESFAT BURNINGTime in Metabolic Burn Zone = Only 3 hours/dayBreakfastLunchAdapted from: 1.Paddon-Jones and Rassmussen. Curr Opin Clin Nutr Metab Care, 2009;12:86. 2.Layman DL. Nutrition and Metabolism, 2009; 6:12.Dinner 108. Eating Protein with Each Meal Accelerates Metabolic BurnFAT STORINGZONESFAT BURNINGTime in Metabolic Burn Zone = 9 hours/dayBreakfastLunchAdapted from: 1.Paddon-Jones and Rassmussen. Curr Opin Clin Nutr Metab Care, 2009;12:86. 2.Layman DL. Nutrition and Metabolism, 2009; 6:12.Dinner 109. So what the heck am I supposed to do with this stuff? 110. A personal close: How do YOU want to age?Me Jan 2013 111. The First Guy on TR90 Measurements from 10/25/13 (start date) 11/6/13 Lost: on waist (one belt loop) 1.25 total 4.4 lbs In 10 days 112. Wrapping Up: The Survival Curve Where Are You? 113. For me, the practice of medicine has opened the door to the greatest adventure in life. Medicine is like a hallway lined with doors, each door opening into a different room, and each room opening into another hallway, again lined with doors. Medicine is always wonderful and never will be finished. - Charles H. Mayo, M.D.